Women’s Health and Wellness
MPH 342 HEALTH & WELLNESS
Dr Shai’
Department of Health PNU
Week of Oct 26, 2013 Lecture 4
objectives
Identify and understand primary health issues affecting women
Risks and prevention strategies
Recommendations and homework
Overview of Women’s Issues
Leading health concerns Heart Disease-#1 Killer of women Cancer- 2nd leading cause of death Stroke- 3rd leading cause of death
Osteoporosis- Common to almost all older women
Dementia- Leading cause of nursing home placement
Menopause-A quality of life issue for 1/3 of women
Concerns of younger women: Menstrual issues, nutrition, fertility, overweight, exercise
Heart Health in Women Heart disease: Leading cause of death
What’s special about women? Women are twice as likely to die if they have a heart attack,
than a man
Women’s heart attacks are often missed/mis-diagnosed
Disproportionate % of heart attacks happen at 9 am Monday morning
Many women don’t recognize or believe they are having a heart attack
Heart attacks present differently in women- Neck, jaw or arm pain (or no pain) Panicky or uneasy feeling Shortness of breath General discomfort or tightness in chest Sweating Any of the above, exacerbated by exertion or stress
Why are heart attacks more deadly in women?
Women have smaller blood vessels with thinner walls (fragile)
Emergency room staff and medical professionals often miss the diagnosis due to unusual/mild symptoms
Women, often too busy to go to the doctor, may endure pain/discomfort in silence.
Heart Disease Prevention: ♀ Advise patients to quit smoking
Keep patient adjusted
Recommend regular physical activity
Monitor/control blood pressure & cholesterol
Manage stress effectively-yoga, relaxation techniques, biofeedback, exercise
Heart Disease and Nutrition
Mediterranean Diet-Shown to lower risk of heart attack (More fruit, veggies, grains, less animal fat/red meat, more fish, etc.)
Whole bran foods-Oats, Wheat bran etc. (increase fiber intake)
Lower sodium intake
Vitamin E, other antioxidants, selenium
Lung Cancer Leading cause of cancer death in women
Very preventable!
Most cases are related to smoking or radon
Have home checked for radon gases
Advise pts to quit smoking Provide good smoking cessation materials
http://www.surgeongeneral.gov/tobacco/quits.htm
Breast Cancer
Breast Cancer- 200,000 cases/year & 40,000 deaths/year Risks:
Obesity, sedentary lifestyle Alcohol use High fat diet Family history (only 10% of cases) Genetics (BrCA1 and BrCA2 genes)
Colo-Rectal Cancer
Third leading cause of cancer death
Prevention recommendations: Diet high in fiber Diet low in animal fat High calcium intake
Resources: www.cancer.org
Stroke: The 3rd Leading Cause of death in women
Risks: Smoking Overweight Sedentary lifestyle Use of oral contraceptives/hormone replacement. High blood pressure or cholesterol
Stroke: Patient Presentation
Headache or neck pain-Severe
Dizziness
Speech disturbance (may be mild or none)
Vision disturbance (may be mild or none)
Unusual weakness, numbness, etc (not injury related)
Strategies for Stroke Prevention in Chiropractic Practice
Adjusting Strategies: In patients with risk factors:
Avoid extension and rotational vectors Employ a least invasive to most invasive strategy
Do not adjust if stroke symptoms are present
Recommend Stroke Prevention For Your Patients Exercise!! Quit Smoking Increase fruits, vegetables, and whole grains Decrease animal fat and red meat Consume more fish
Osteoporosis: The “silent thief”
Osteoporosis is silent:
Often patient knows nothing about their bone loss until a fracture occurs
1/3 of women over 70 have osteoporosis
84% of women over 70 have low bone mass (osteopenia)
Osteoporosis is PREVENTABLE
Identify who is at risk…Controllable risks Uncontrollable risks
Low calcium intake
Sedentary lifestyle
Hi caffeine intake
Alcohol use
Smoking
Soda pop drinks
European or Asian descent
Fair skinned
Small framed/low weight
Family history of OP
Early hysterectomy
Recommendations for Bone Health
Exercise: Walking or other axial loading exercises, weight lifting
Calcium Supplementation: 1,200-1,500 mg/day
Avoid smoking, caffeine, alcohol, soda pop, etc
Menopause
1/3 of women in the US are menopausal
Process starts in mid forties w/ pre-menopause
Night sweats, mood swings, depression, sexual changes.
Patients seek help!
Menopause and Health
Post menopausal increase in risks
Breast, uterine, cervical, ovarian cancer Osteoporosis Heart Disease/Stroke Dementia/memory problems
Especially….
Black Cohosh: <Remifemin> Used for relief of general menopausal symptoms, nervousness, anxiety, hot flashes, vaginal dryness
Resources: Whiting, Clouston, Kerlin. M J Australia 2002;177(8):440-443.
Leiberman: J Women’s Health 1998;7(5):525-529.
What herbs for what?
Herbs For Bone Loss:
Wild Yam: natural progesterone source
Chaste Berry-LH/Progesterone stimulant
Red Clover: All 4 isoflavones Daidzen, Genistein, Formononetin, Biochanin
Source: Nestel et al. J Clin Endocrinol Metab. 1999; 84(3):895-8.