Women’s Health

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See What Happens After You Get A Mammogram

(Courtesy: JAMA)

(Courtesy: JAMA)

By Nancy Shute, NPR

Women and their doctors have a hard time figuring out the pluses and minuses of screening mammograms for breast cancer. It doesn’t help that there’s been fierce dissent over the benefits of screening mammography for women under 50 and for older women. Continue reading

Digital Mammograms: Pricey And Perhaps No Better for Older Women

In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)

In the U.S. 95 percent of mammography machine are now digital.(Mychele Daniau/AFP/Getty Images)

By Kara Manke, NPR

Medicare spending on breast cancer screening for women age 65 and older has jumped nearly 50 percent in recent years. But the rise in price was not associated with an improvement in the early detection of breast cancer.

“We did not see a change in the detection of early or late stage tumors.”

Researchers at the Yale School of Medicine found that Medicare spending on breast cancer screening rose from $666 million in the years 2001-2002 to $962 million in the years 2008-2009.

So why the big increases in costs?

“The way that we screen for breast cancer has changed dramatically,” explains Yale’s Dr. Cary Gross, an internist and a co-author of the study. The study was published this week in the Journal of The National Cancer Institute. Continue reading

Hobby Lobby Decision Has Limited Impact in California

 Anti-abortion advocates rally in front of the Supreme Court awaiting the decision in Burwell v. Hobby Lobby Stores was announced Monday. (Chip Somodevilla/Getty Images)

Anti-abortion advocates rally in front of the Supreme Court awaiting the decision in Burwell v. Hobby Lobby Stores was announced Monday. (Chip Somodevilla/Getty Images)

Most women in California won’t be affected by Monday’s U.S. Supreme Court landmark decision in Sebelius v. Hobby Lobby. The Christian owners of the craft store chain challenged the Affordable Care Act’s requirement that companies provide contraception coverage to their employees. The Court ruled that closely-held, for-profit companies can opt out if they object on religious grounds.

But it’s not so easy in California. That’s because the ruling doesn’t apply to state laws. California has had the Women’s Contraceptive Equity Act on the books since 1999. It requires health insurance companies that cover prescription drugs to also cover birth control.

“For most workers in California, nothing will change,” says Maggie Crosby, attorney with the ACLU of Northern California. “Women should feel secure that if they have birth control coverage today, they will have it tomorrow.”

She says the state law is still in full effect after Monday’s Supreme Court ruling. Continue reading

New Guidelines Say Many Women Can Skip Pelvic Exam

(Maigh/Flickr)

If this picture makes you shudder, you’ll want to understand the new guideline. (Maigh/Flickr)

No more dreaded pelvic exam? New guidelines say most healthy women can skip the yearly ritual.

Routine pelvic exams don’t benefit women who have no symptoms of disease and who aren’t pregnant, and they can cause harm, the American College of Physicians said Monday as it recommended that doctors quit using them as a screening tool.

It’s part of a growing movement to evaluate whether many longtime medical practices are done more out of habit than necessity, and the guideline is sure to be controversial.

Scientific evidence “just doesn’t support the benefit of having a pelvic exam every year,” said guideline coauthor Dr. Linda Humphrey of the Portland Veterans Affairs Medical Center and Oregon Health & Science University. Continue reading

Surprising Advantage for Older Moms: More Likely to Live Longer

(Getty Images)

(Getty Images)

As a woman who had not just her last child, but also her first child after age 33, I enthusiastically clicked on the NPR story in my Facebook feed this morning.

NPR reports that older moms — women who had their last child after age 33 — have twice the odds of “exceptional longevity” as women who had their last child before age 29. This “exceptional longevity” is defined as living to age 95. The research is according to a study published this week in the journal Menopause.

I got over the fact that “older moms” are women who had their last child after 33, which seems kind of young to me.

NPR explains why there may be a connection between bearing children later and longevity: Continue reading

Study: Heavy Bleeding Very Common As Women Approach Menopause

So common that it will help doctors determine when bleeding is normal, when interveetinon is necessary. (Getty Images)

The researchers hope their findings will help doctors and patients understand what “normal” bleeding is during perimenopause. (Getty Images)

 By Jennifer Huber

I could hear the fear and panic in my friend’s voice over the phone. She was having her period, but bleeding so heavily that she was debating whether to go to the emergency room. Yet she wasn’t sure. She wondered if she might be over-reacting, if her experience was simply what happened as a woman approached menopause.

More than three-fourths of women in the study reported periods lasting at least 10 days.

As women get older, their periods can begin to change. This perimenopausal time typically starts when a woman is in her 40s and lasts about four years. (The average age of menopause, when periods stop, is 51.) For some women, the transition means unpredictable, prolonged or heavy bleeding, and that can be frightening. Now new research shows that these changes may be quite normal.

In the study, researchers from across the country, including UC Davis and UCLA, reviewed data from 1,320 women ages 42-52 who kept detailed records of their menstrual cycles over time. The researchers found that instances of heavy or prolonged bleeding were very common. Continue reading

Money May Be Motivating Doctors To Do More C-Sections

(Getty Images)

(Getty Images)

By Shankar Vedantam, NPR

Obstetricians perform more cesarean sections when there are financial incentives to do so, according to a new study that explores links between economic incentives and medical decision-making during childbirth.

About 1 in 3 babies born today is delivered via C-section, compared to 1 in 5 babies delivered via the surgical procedure in 1996. During the same time period, the annual medical costs of childbirth in the U.S. have grown by $3 billion annually. There are significant variations in the rate of cesarean deliveries in different parts of the country — in Louisiana, for example, the C-section rate is nearly twice as high as in Alaska.

Obstetricians in many medical settings are paid more for C-sections. In a new working paper published by the National Bureau of Economic Research, health care economists Erin Johnson and M. Marit Rehavi calculated that doctors might make a few hundred dollars more for a C-section compared to a vaginal delivery, and a hospital might make a few thousand dollars more. Continue reading

Binge Drinking on Rise in American Women

(Getty Images)

The Centers for Disease Control defines binge drinking in women as 4 or more drinks during one occasion. (Getty Images)

Over on Facebook, the group Moms Who Need Wine has more than 660,000 likes. While most of the posts there seem pretty darn cheerful, they point to a darker reality. Alcohol abuse in women is on the rise. And a specific problem for them is binge drinking, as the Centers for Disease Control reported earlier this year.

In the report, the CDC found that 1 in 8 women over age 18 — that’s 14 million women — binge drink about three times a month. Binge drinking is defined as four or more alcoholic beverages in a two to three hour period. One in 5 high school girls binge drink.

Dr. Bob Brewer who leads the Alcohol Program at the CDC’s National Center for Chronic Disease Prevention framed the public health costs of alcohol consumption for a KQED Forum audience recently. It’s the third leading cause of preventable death in the U.S., with an estimated 80,000 deaths and 2.3 million years of life lost every year linked to excess drinking, he said.

But within that excess drinking, it’s the binge drinking that is really taking a toll. “We know that binge drinking is by far the most common pattern of excessive drinking in the United States,” he said, responsible for half of those 80,000 deaths. Continue reading

Pap Tests for Cervical Cancer Are Too Often Overused

Healthy cervix cells, gathered during a Pap test, as seen under a microscope. (Euthman/Flickr)

Healthy cervix cells, gathered during a Pap test, as seen under a microscope. (Euthman/Flickr)

January is Cervical Health Awareness month, and the Centers for Disease Control is celebrating by highlighting just how poorly the US is doing at following established guidelines.

In dual reports today, the CDC finds that many women are being screened for cervical cancer way too often — while other women are not screened enough.

Let’s start with the guidelines themselves. In 2012, three different groups, the US Preventive Services Task Force, the American Cancer Society and the American College of Obstetricians and Gynecologists all came to agreement: Women ages 21 to 65 should receive a Pap test — the definitive screen for cervical cancer — once every three years. If you’re either under 21 — or 65 or older, you don’t need one, barring certain limitations. (Some women opt for an additional HPV test and can be screened with a Pap test every five years.)

In addition, the overwhelming number of women who have had a total hysterectomy (in which the cervix is also removed) do not need any more Pap tests. As Dr. David Chelmow, a professor of obstetrics and gynecology at Virginia Commonwealth University Medical Center, told Reuters, “It’s tough to get cervical cancer without a cervix.”

The upshot from the CDC’s survey? Here are the numbers:

  • 41.5% of women ages 18 to 21 had a Pap test in the last year, despite the recommendations that they don’t need them Continue reading

No Evidence of Benefit from Routine Pelvic Exams

Women can add pelvic exams to list of medical tests they may not need as often — or at all

(Maigh/Flickr)

(Maigh/Flickr)

First, let’s review. We’ve been getting a lot of updates to cancer screening tests lately.

Pap Smears, a screening test for cervical cancer, were recommended to be done annually, until a group of experts in prevention concluded that every three years was equally effective. Most medical groups, including the American Cancer Society, agree on this one.

Then there’s mammography. I think everyone knows the debate around that. Every year or every other year? Starting at 40? or 50? The evidence points to every two years after age 50, although many doctors maintain younger and more often is better.

Women get them annually, even though we “lack data” that they do much for us.

But this latest one — about pelvic exams — caught me by surprise. It turns out there’s really not a whole lot of evidence that doing an annual pelvic exam makes any difference to a healthy woman’s continuing good health. (Again, we’re stressing healthy women. Women having symptoms are definitely candidates for a pelvic exam).

Here’s what the American College of Obstetricians and Gynecologists (ACOG) says about the pelvic exam, after recommending it be done annually: Continue reading