What you need to know about five common women’s health conditions
By Laurie Davies
Osteoarthritis is old news. Urinary incontinence is too embarrassing to discuss. And menopause’s hot flashes are just a fact of life. Well, right?
Not so fast. Women experience these and other real health issues as they age. So maybe it’s time to shed light on conditions such as these that fall to the bottom of the heap because they are uncomfortable, poorly understood or simply not one of the top 10 killers.
Menopause
What it is: Menopause can be a nasty, moody, ball of irritability and hormonal distress. In more clinical terms, menopause is the last menstrual period.
“Menopause is really the end of the process,” says UAB reproductive endocrinologist Richard D. Blackwell, M.D., Ph.D. “Where women have problems is in perimenopause, which can last up to 10 years.” Perimenopause is when a woman’s ovaries gradually stop producing eggs and the body produces less estrogen.
Prevention: There’s no preventing it, but you can reduce risk for early menopause by not smoking.
Symptoms: “We’ve trivialized menopause by thinking of it as one big hot flash,” Dr. Blackwell says. In reality, some women may have mild symptoms while others experience extreme hot flashes, night sweats, headaches, depression, mood swings, fatigue, vaginal dryness and painful intercourse.
Coping: In some cases, medications or herbal remedies can block hot flashes and other symptoms. Dr. Blackwell urges patients to discuss hormone therapy with their doctor rather than being fearful and succumbing to what he calls a “Chicken Little” effect about its potential risks. Finally, you might try toughing it out. “You may be in the lucky group whose symptoms end quickly,” he says.
Osteoporosis
What it is: Often called a “silent killer,” osteoporosis is a bone-thinning disease that affects an estimated 10 million Americans; 8 million are women. So, is it a normal part of aging? “That’s the most common misconception. People have gotten used to seeing women hunched over, having lost several inches of height due to osteoporosis,” says Jeffrey Curtis, M.D., MPH, a UAB clinician in the Osteoporosis Prevention & Treatment Clinic. “The fact is, this disease does not have to be a part of aging. Just because your mom had it doesn’t mean that it’s normal or that you have to.”
Prevention: The National Osteoporosis Foundation urges these prevention strategies: Get enough calcium and vitamin D, do weight-bearing exercise, avoid smoking and excessive alcohol use, talk to your doctor about bone health and get a bone-density test—using medication if needed, after talking to your doctor.
Also, women can work with specialists in osteoporosis, nutrition and physical therapy at UAB’s Osteoporosis Prevention and Treatment Clinic to increase bone density and prevent fractures.
Symptoms: Osteoporosis has no symptoms in its early stages. Usually, the first symptom is a broken bone.
Coping: Since you can’t feel weak bones, Dr. Curtis stresses the need for beginning bone-strengthening measures in young adulthood and bone-density testing at age 60 or 65, depending on your risk. Also be sure to fall-proof your home.
If you do have a fracture, exercise and prescription drugs may help strengthen your bones. “Many patients get great surgical care for their fracture, but don’t realize that they remain at high risk and need medical therapy to reduce their risk for another fracture,” Dr. Curtis says.
Urinary Incontinence
What it is: Urinary incontinence, also called loss of bladder control, is the inability to control the passage of urine. Women are more affected than men. In fact, UAB obstetrician/gynecologist Holly Richter, M.D., Ph.D., says half of all women are likely to have some kind of incontinence in their lifetime.
Prevention: Kegel exercises, a contracting and holding of pelvic muscles, can help strengthen those muscles and avert incontinence. Also, maintaining a healthy weight and quitting smoking can lessen your risk.
Symptoms: Involuntary leakage of urine is the chief symptom. However, sometimes fecal incontinence accompanies urinary incontinence.
Coping: Instead of going to the bathroom all the time or decreasing fluid intake, do Kegel exercises and talk to your doctor about bladder “retraining.” Surgery or vaginal devices that minimize leakage also may be options.
Fibromyalgia
What it is: Fibromyalgia is a chronic condition characterized by pain all over the body. About 5 percent to 7 percent of the U.S. population has it, and women are more commonly affected than men.
Prevention: Prevention strategies are tricky because the cause of fibromyalgia is unknown. Some evidence points to abnormal pain transmission responses in the spinal cord and/or brain.
Symptoms: Fibromyalgia is characterized by widespread aching and pain. It also is associated with fatigue, sleep problems, irritable bowel and headaches.
Coping: Water aerobics or physical activity may help. “Most patients feel a lot better if they get exercise, even though it’s hard to get going. It hurts,” Dr. Curtis says. Also, decrease stress, eat a well-balanced diet, avoid caffeine and try therapies such as light massage or acupuncture.
“Social support also is tremendously helpful,” Dr. Curtis says, “because sometimes patients may feel like nobody understands what they’re going through.”
Finding treatment for associated sleep problems, depression or anxiety disorders also can lessen the impact of fibromyalgia.
Osteoarthritis
What it is: Osteoarthritis is the most common type of joint disease and is most simply thought of as a degenerative disorder resulting from the breakdown of cartilage in the joints. However, there also are links to low-level inflammation that likely participate in the process and may be targets for intervention. Osteoarthritis occurs more often in women than men.
Prevention: The cause of osteoarthritis is unknown, although many factors contribute. Dr. Curtis recommends keeping your weight in check. “Every 1 pound you carry around your middle, puts 3 to 4 pounds on the knees,” he says.
Symptoms: Osteoarthritis begins with pain in the joints that worsens with use throughout the day. It typically affects the fingers, base of the thumbs, hips and knees, develops slowly and progresses over several years.
Coping: Range-of-motion exercises and water exercises can improve joint function. Applying heat or cold or using shoe inserts and knee braces also may help. Be sure to see your doctor rather than trying to cope on your own. “The disease changes over time, and there are a number of oral, topical and injectable medications that can provide benefit,” Dr. Curtis says.
Be Proactive
Kellie Flood, M.D., a UAB geriatrician, encourages women to take charge of their health. “Healthy aging can be a reality for everyone,” she says. “The longer we can stave off the onset of medical conditions, the healthier we’ll age.”
If the time comes when unpleasant or painful symptoms emerge, Dr. Flood urges patients not to go it alone. “Whether you have a chronic condition or uncomfortable symptoms, there’s always something your physician and healthcare team can do for you.”
To make an appointment with a UAB physician, call HealthFinder at (205) 934-9999 or 1-800-UAB-8816.