Health and Pills

Posts Tagged ‘Women’s Health’

A new study concludes that the osteoarthritis drug Vioxx(R) (rofecoxib) is both safe and effective in relieving the pain associated with menstrual cramps.

• researchers at the Merck Research Laboratories compared the effects of rofecoxib to those of both the non-steroidal anti-inflammatory drug (NSAID) naproxen sodium and placebo in 127 women, aged 18 and older, who had histories of moderate to severe menstrual pain.
• found that menstrual pain at eight and 12 hours after medication was relieved similarly in both rofecoxib and naproxen sodium recipients.
• side-effects were similar among all three groups in the study.
• authors note that menstrual pain is thought to be caused, at least in part, by substances called prostaglandins, and that rofecoxib works to reduce the production of prostaglandins by inhibiting the COX-2 enzyme.

Complete Guide To Women's Health

Author: American Medical Association
Random House of Canada, Ltd, 1265 Aerowood Dr, Mississauga, ON L4W1B9
1996/759 pp

Good starter guide to women’s health

Strengths

Well formatted, easy to read, practical approaches to common problems, focus on wellness and preventive health

Audience

General public

This comprehensive reference volume for women contains common-sense approaches to a number of important health issues. Its target audience is middle-class American women with a moderately high level of literacy. The book aims to provide women with up-to-date medical information to guide decision making and to facilitate communication with their physicians.

Its four main sections cover health maintenance, sexual and reproductive health, pregnancy, and the common health concerns of women. It is well laid out with useful summaries, flow charts, sidebars containing helpful hints, questions women often ask, and narrative vignettes that lend a dynamic and personal tone to the main text.

I found the chapters on nutrition, fitness, avoiding risky behaviour, and stress management refreshingly frank and practical. The sections on pregnancy and childbirth are well illustrated and cover many of the issues women enquire about in my own practice. Although there are excellent chapters on family violence, sexual assault, and bereavement, the social context of women’s health is not explored in sufficient depth. The short section on sexual abuse, for example, makes only passing mention of the health consequences that an adult survivor of abuse might experience. In contrast, the 19 pages on elective cosmetic surgery seemed excessive.

The book is written with a specialty focus, emphasizing early referral. Very little is said about family physicians and their potential for providing comprehensive care and building health partnerships with women over time. There are no references or suggestions for further reading for women who wish to pursue controversial or rapidly changing issues, such as prevention guidelines. It is also unclear how consultants evaluated the evidence behind their recommendations. I found it surprising, for example, to see episiotomy presented as a procedure to prevent excessive tears during childbirth when there is evidence in the literature to the contrary.

The overall strength of this publication is its range, its detail, and its attention to the prevention of illness, making it a good starting place for many women to access health information and to consider dialogue with their physicians. In this regard, it fulfils the authors’ objectives. Because of its expense and likelihood of dating quickly, I would recommend it as a resource volume for a public library or community health clinic.

Research geared to meet women’s special needs.

A total of almost 400 drugs are now in various stages of development to meet the special needs of women. The drugs, many of which offer innovative therapeutic approaches, are intended to treat diseases that either disproportionately affect women or are among the leading causes of death. The top causes of death in women are heart disease, cancer, cerebrovascular disease, chronic obstructive pulmonary disease, pneumonia, diabetes, adverse drug reactions, Alzheimer’s disease, nephritis and septicemia.

Drug Research

Cancer drugs are far in the research lead. Between the early 1970s and the early 1990s, the incidence rate for lung cancer more than doubled and the death rate rose 182% in women. Of the 94 drugs being developed for cancer in women, 44% are targeted for breast cancer, 30% are for lung cancer and 20% for ovarian cancer. Uterine cancer, including endometrial cancer, is the most common malignancy of the female genital system, followed by ovarian cancer. The second largest number of investigational drugs are for obstetric/gynecologic disorders.

Cardiovascular Issues

Much attention has been paid to cancers in women, but cardiovascular disease is the leading cause of death. Heart attacks alone claim 250,000 lives annually and of those women who suffer a heart attack, 44% die within a year, compared to 27% of men. Cur-rently, 48 drugs are in development for cardiovascular disease.

Musculoskeletal disorders

Women suffer high incidences of musculoskeletal disorders. Osteoporosis, for example, affects one in every four women past age 50. And about 23 million women, including half of women over 65 years of age, suffer from arthritis. A total of 55 drugs are being developed to treat musculoskeletal disorders.

Antipsychotic drugs

Women are 60% more likely than men to experience major depression. Most of the antipsychotic drugs in research are for treatment of depression.

It makes sense when you think about it: Like many patients with asthma who experience problems with exercise, two-thirds of patients with asthma find that symptoms interfere with their sex lives. Yet, many patients suffer in silence.

Ilan H. Meyer, PhD, of the Harlem Lung Center at Columbia University’s Joseph L. Mailman School of Public Health and Harlem Hospital Center in New York City, was the lead researcher of this study. He noted: “There’s a surprising lack of attention to this problem. With asthma on the rise, quality of life issues such as sexual activity deserve more attention.”

Dr. Meyer and his colleagues surveyed 353 adult patients about whether their asthma had interfered with their sexual functioning during the two-week period prior to a visit to the Emergency Department at Harlem Hospital for their asthma. Only one-third of patients said their sex life had not been affected.

Almost half (47 percent) of patients found that their asthma symptoms interfered with sexual activity with the severity of problems ranging from minimal to total limitation. Nineteen percent said their sexual activity was very or totally limited, 16 percent experienced moderate or some limitation, and 12 percent had little limitation. Nineteen percent of patients reported that they did not engage in sex at all.

Jean G. Ford, MD, director of the Harlem Lung Center and principal investigator of this study, which was funded by the National Heart Lung and Blood Institute, observed: “Our results indicate that sexual dysfunction is common among asthmatic patients. Physicians should ask asthmatic patients about their sexual functioning as a potential indicator of asthma that is not well controlled. Additional research is needed to determine whether such sexual dysfunction simply represents exercise-induced asthma, or whether other mechanisms contribute to it.”

Known as the REACH Study (Reducing Emergency Care in Harlem), this study looked at the quality of life among patients with asthma. Patients were given a questionnaire that included one question about limitation in sexual functioning. Lower-income patients and patients who were older tended to have greater limitations while gender appeared to have no impact.

Not surprisingly, patients with more severe disease were more likely to have limitations as were patients with depression. What researchers don’t know, however, is whether patients are depressed because of the limitations in their sexual activity, or vice versa. According to Dr. Meyer, “Maybe patients are depressed because of the limits asthma places on their lives, or maybe the depression itself contributes to the limited activity.”

Dr. Meyer believes research should address whether similar measures that are used to manage exercise-induced asthma, such as taking medications prior to exercise and changing activities, might also be useful for these patients. Learning more about the reasons these patients have difficulty is key to finding solutions, and there are a number of factors that could be involved. In addition to physical exertion, exposure to allergens such as those found in bedding, and emotional factors may also play a role. Other diseases that the patient might have, for example, hypertension or diabetes could be involved as well.

Dr. Meyer added, “Patients shouldn’t be shy about bringing up this problem with their doctor. It’s important that patients understand that asthma can have implications on sexual activity. Working with their doctor, they can find solutions.” Dr. Ford agreed, stating, “The patient should talk to their doctor who can then review their clinical history” to help them identify the cause of their problem and ways to deal with it.