emotional burden

Emotional burden of miscarriage

Early pregnancy loss represents a significant emotional burden for women, and to some extent for men, especially with regards to anxiety.

For many, the detrimental effects of miscarriage are enduring and display a complex course of resolution. Its been seen that many women and theirs partners continue to feel anxiety for more than a year after a miscarriage. As compared to depression, anxiety can prove to be more of a clinical burden in people who experience miscarriage.

To assess the long-term emotional impact of miscarriage on couples, researchers at Dr. Gray's Hospital, Elgin, United Kingdom studied symptoms of depression and anxiety in 273 women and 133 men within one month after the women experienced a miscarriage, and again 6 and 13 months later. These subjects were initially assessed by a semi-structured interview and a standardised self-report questionnaire. The latter was re-administered at the follow-up assessments.

The results showed that the main psychological burden in couples after a miscarriage was anxiety. Of the 273 women and 133 men who completed all assessments, just over 10 percent of the women and 4 percent of the men showed depression within the first month following miscarriage. After 13 months, depression could be identified in about 2 percent of the women and the men. Within the first month after miscarriage, over 24 percent of the women and over 5 percent of the men showed anxiety. At the final assessment, anxiety was still evident in nearly 16 percent of the women and over 4 percent of the men.

Thus, it is important for doctors to address the possibility of a negative psychological aftermath of a miscarriage and its potential negative effects on relationships, mental health, work and future pregnancy.

postmenopausal

Calcium intake benefits postmenopausal women

Women in early menopause who consume less calcium are at a greater risk of developing osteoporosis than their peers who take more calcium.

But the fact that these women are also more likely to be overweight, and thus have denser bones, may help protect them from brittle bones. However, it is unwise to offer a choice between drinking milk and gaining weight for protection against bone loss, as overweight people have a higher risk of developing metabolic syndrome.

Researchers from the University of Milan investigated how calcium intake and body weight might affect osteoporosis risk among women shortly after menopause. They evaluated bone density in 1,771 women who were not taking calcium supplements, estimating their calcium intake by determining how often they ate dairy foods. The more dairy the women consumed, the less likely they were to be overweight, and their average body mass index [BMI] - a measure of weight in relation to height - dropped as calcium intake rose. Calcium intake was not associated with osteoporosis when being overweight was not considered. However, when being overweight was considered in the analysis, women with the lowest calcium intake were more likely to have osteoporosis than were women with the highest calcium intake.

Thus, in early postmenopausal women, a low dietary calcium intake may increase the risk of osteoporosis, but its negative effect can be offset by the greater BMI found in women with a low calcium intake. However, further research is warranted to prevent, rather than treat, osteoporosis and to find safer alternatives to oestrogen in modifiable lifestyle factors such as nutrition.

blood pressure

Inadequate sleep raises BP risk in women

Women who regularly get less than seven hours of night sleep may have a higher risk of developing high blood pressure.

A number of previous studies have linked poor sleep quality to an increased risk of high blood pressure, diabetes and heart disease. Much of the research was focused on people with the breathing disorder - sleep apnoea, but some evidence suggests that sleep deprivation, in the absence of any overt sleep disorder, also takes a health toll.

Researchers from the Warwick Medical School in Coventry used data from a long-term health study of 10,300 white British civil servants aged between 35 and 55 years old. The researchers focused on participants who were free of high blood pressure in the 1997-1999 phase of the study and were reassessed in 2003-2005. During these two phases, 76 per cent and 68 per cent, respectively, of the original group were included in the evaluations. At both examinations, hypertension was defined as blood pressure more than 140/90 mm Hg or regular use of anti-hypertensive medications. At reassessment, 20 per cent of the study participants were newly diagnosed with high blood pressure, and the risk was greater among women who slept for shorter durations. Compared with women who said they typically got seven hours of sleep at night, those who slept for six hours were 42 per cent more likely to develop high blood pressure, while those who routinely slept no more than five hours had a 31 per cent higher risk. Risk factors for heart disease, such as smoking, being overweight or having a sedentary lifestyle, did partially contribute to the relationship. However, an independent link between sleep and blood pressure still remained. This could be because sleep deprivation might contribute to high blood pressure by keeping the nervous system in a state of hyperactivity, which in turn affects systems throughout the body, including the heart and blood vessels.

There was, however, no clear relationship between amount of sleep and blood pressure among men. The findings suggest there may be a "gender-specific" relationship between sleep deprivation and high blood pressure. However, the underlying reason is still not known. Further studies are needed to confirm that sleep duration, itself, affects blood pressure levels, and why these effects might be different in women and men.

heart attacks

Heart attacks preventable in women

Women can reduce the risk of heart attacks by eating right, staying physically active and keeping way from alcohol and smoking.

Heart disease is one of the most important causes of death and disability in women. As they approach menopause, women become more susceptible to heart disease. Simple changes in dietary habits and lifestyle, can reduce this risk, e.g, consuming a healthy diet and moderate amounts of alcohol, along with three lifestyle factors: nonsmoking, waist-hip ratio less than 0.85, and being physically active [at least 40 minutes of daily walking or bicycling and 1 hour of weekly exercise].

To assess the risk of heart attacks and its prevention in women, researchers at the Karolinska Institute, Stockholm studied the dietary and lifestyle patterns of 24,444 postmenopausal women. At the beginning of the study, none of the women had heart disease, diabetes or cancer. By analysing information contained in food frequency questionnaires, in which the women noted how often they ate 96 different foods, four major dietary patterns were identified. They were: healthy [vegetables, fruits and legumes]; Western/Swedish [red meat, processed meat, poultry, rice, pasta, eggs, fried potatoes and fish]; alcohol [wine, liquor, beer and some snacks]; and sweets [sweet baked goods, candy, chocolate, jam and ice cream]. Other information, including family history of heart disease, education level, physical activity, and body measurements, was also collected. These women were followed up for 6 years during which 308 heart attacks were identified.

The results showed that women who maintained a healthy diet - eating lots of vegetables, fruit, whole grains, fish and legumes - and drank a moderate amount of alcohol had a 57-percent lower risk of having heart attack, compared to women who maintained a less healthy diet and lifestyle pattern. The women combining the healthy diet and moderate drinking with the three healthy lifestyle factors [not smoking, being physically active and avoiding too much weight gain] had a 92-percent lower risk of heart attack.

Thus, by making simple changes in their diets and lifestyle, women can avoid the risk of heart disease.

chronic cough

Iron deficiency can lead to chronic cough

Some women suffering from chronic cough may need iron supplements instead of cough drops.

Women are more likely than men to suffer from otherwise unexplained chronic cough. Also, iron deficiency is very frequent in women due to pregnancy and menses. To correlate these two unrelated facts, Italian researchers from the University of Turin studied 16 women with chronic cough. These women had normal lung function, with no signs of asthma or other respiratory disease and no evidence of acid reflux from the stomach that could explain their coughing.

Tests on these women with chronic cough showed that all had iron deficiency anaemia and a simple iron supplement often cleared up the cough. All the women had signs of swelling in the back of the mouth and red, inflamed mucous membranes. Their vocal cords were also very sensitive, making them cough and choke easily, such as after vigorous laughing. These women were given iron supplements to improve their iron stores, and when these had normalised, after about two months, they were checked again.

The results showed that after iron supplementation, coughing and signs of inflammation in the mouth and vocal cords were improved or completely resolved. The hypersensitivity was nearly gone or vastly improved in all the women. This was attributed to the fact that iron helps regulate the production of proteins in the immune system that control inflammation, and iron deficiency might make the upper airway more prone to inflammation, leading to chronic cough.

Further research is required to study this association in detail. However, women patients with chronic coughs should be checked for iron deficiency.

pregnant women

Air pollution can harm pregnant women

Traffic related air pollution could have harmful effects on both the fetus and the mother to be.

Though air pollution is a major health problem affecting everyone, in the case of pregnant women, there is a greater risk both for the fetus and the mother to get affected by it. It is believed that women who live in areas with a high level of pollution are more likely to suffer pre-term birth as compared with women who live in less polluted areas.

To investigate the affect of pollution on pregnant women, researchers at the School of Public Health at the University of California, Los Angeles collected detailed information for more than 2,500 women who gave birth in Los Angeles County 4 years back. By conducting one-on-one interviews with the women, the air pollution risk was separated from other pre-term birth risk factors.

The results showed that the association between air pollution and increased risk of pre-term birth persists after accounting for other factors that might influence pre-term birth risk such as smoking, exposure to second-hand smoke and alcohol use. Women who live in areas with high carbon monoxide or fine particle levels - pollution caused mainly by motor vehicle traffic -- are more likely to give birth to pre-term babies [delivery before 37 weeks of pregnancy], when exposed to such pollution, compared with women who live in less polluted areas. This is especially true for women who breathe polluted air during the first 3 months of pregnancy or during the last months and weeks before delivery.

Thus, pregnant women need to take extra care in case they happen to live in highly polluted areas.

bacterial vagueness

Condoms lower the risk of bacterial vagueness

Women who use condoms consistently can lower their risk for bacterial vagueness and associated changes in vaginal microflora.

Bacterial vagueness is caused by an imbalance of the bacteria normally found in a woman's vagina, referred to as vaginal microflora, which is upset by an overgrowth of bacteria not usually present. It is the most common vaginal infection in women of childbearing age. Symptoms include discharge, odour, pain, itching and burning. Although any woman can get bacterial vaginosis, some activities or behaviours can upset the normal balance of bacteria in the vagina and put women at increased risk. These include having a new sex partner or multiple sex partners and using an intrauterine device [IUD] for contraception. It was unclear how effective condoms are at reducing bacterial sexually transmitted infections.

Researchers from the University of Pittsburgh, Pennsylvania investigated condom use, bacterial vaginosis and the growth of vaginal microorganisms associated with bacterial vaginosis in 871 women at high risk for sexually transmitted diseases. Overall, women who consistently used condoms [10/10 sex acts] had a 45 percent decreased risk of bacterial vaginosis compared with women who did not use condoms. For women at an intermediate stage of bacterial imbalance, consistent condom use had even more protective effects [63 percent risk reduction].

The findings support the theory that bacterial vaginosis is sexually transmitted, and provides a further rationale for recommending that women use condoms to reduce the risk of bacterial vaginosis.

menopausal symptoms

Helps treat menopausal symptoms

Pine-bark extract might offer a hormone-free alternative to reduce symptoms such as hot flashes in women entering menopause.

Pycnogenol, an extract of the bark of the French maritime pine tree [Pinus pinaster], contains a high concentration of antioxidant compounds that help prevent cell damage. It also seemed to ease symptoms of women starting menopause. Research suggests that the extract acts as an anti-inflammatory and may improve blood flow by enhancing blood vessel dilation.

Researchers from the Ham-Ming Hospital in Taiwan studied 155 women between the ages of 45 and 55 years entering menopause. At the study’s onset, fatigue, headache, vaginal dryness and menstrual problems were among the most common symptoms in the women. Roughly half of them were randomly assigned to take 100 mg of Pycnogenol, twice a day for six months; the rest took placebo capsules. All of them completed questionnaires on their symptoms at the outset, then again three and six months later. It was found that women in the Pycnogenol group reported improvements in symptoms ranging from hot flashes and sexual dysfunction to fatigue and depression. In addition, blood tests showed that the women's antioxidant levels climbed, while their cholesterol levels improved slightly. However, all symptoms tended to improve over six months of Pycnogenol treatment. In contrast, women who took placebo capsules generally showed no change, or sometimes worsening symptoms.

These findings are encouraging, since many women suffering from menopausal symptoms want an alternative to hormone replacement therapy, and pine bark extract may offer such an alternative.

migraine and depression

Childhood abuse may lead to migraine and depression

Women who have been victims of child abuse and suffer from migraine are more likely experience depression later in life.

Researchers from the University of Toledo-Health Science Campus surveyed 949 women with migraine about their history of abuse, depression and headache characteristics. Forty per cent of the women had chronic headache, more than 15 headaches a month, and 72 per cent reported very severe headache-related disability. Physical or sexual abuse was reported in 38 per cent of the women and 12 per cent reported both physical and sexual abuse in the past.

It was found that women with migraine who had major depression were twice as likely as those with migraine alone to report being sexually abused as a child. If the abuse continued past the age of 12 years, the women with migraine were five times more likely to report depression. The finding that a variety of somatic symptoms were also more common in people with migraine who had a history of abuse suggests that childhood maltreatment may lead to a spectrum of disorders, which have been linked to serotonin dysfunction. It was also found that women with depression and migraine were twice as likely to report multiple types of abuse as a child compared to those without depression, including physical abuse, fear for life, and being in a home with an adult who abused alcohol or drugs.

The findings indicate that abuse in childhood has a powerful effect on adult health disorders and the effect intensifies when abuse lasts a long time or continues into adulthood. The findings also support research suggesting that sexual abuse may have more impact on health than physical abuse and that childhood sexual abuse victims, in particular, are more likely to be adversely affected.

testosterone

Testosterone patches for women

Testosterone patches can restore sexual drive in some women going through surgical menopause.

Due to the reduced levels of testosterone after menopause, there take place a lot of physical changes in women. These changes are often seen as resulting in loss of libido, decreased sexual activity, diminished feelings of physical well-being and fatigue. Testosterone therapy is an option for the restoration of sexual drive. Testosterone patches can significantly boost the libido for some women with sub par sex drives after surgery to remove their ovaries, who report an average of one additional sexual encounter a week after starting to use the hormone.

To assess the effectiveness of testosterone patches, American researchers analysed the results of a six-month trial of testosterone patches in 132 women reporting a lack of sexual desire resulting in personal distress or relationship problems. All these women had got their ovaries removed. This resulted in low production of sex hormones, including testosterone.

The results showed that a mixed response of women to testosterone patches. While some women reported no benefit, others found them useful. Fifty-two percent of the 64 women who were on the patches said they experienced a meaningful benefit, compared to 31 percent of the 68 women on placebo. The women who reported a meaningful benefits said they were engaging in 4.4 more episodes of satisfying sexual activity every four weeks, compared with 0.5 episodes more per month for women who reported no benefit. However, women who reported no benefit from the patches also showed no significant change in desire or distress, still seldom feeling desire and often feeling distress.

Although, the US Food and Drug Administration has not approved any type of testosterone therapy for females, it's estimated that as many as one in U.S. testosterone prescriptions in US are written "off-label" for women.