Making Health Decisions — Mostly On Your Own — Requires Reliable Information

Wednesday, December 31, 2003

ROCHESTER, Minn. — How many significant health decisions did you make during 2003?

Because most health decisions are made outside your doctor's office, you need to have reliable health information to make the most informed choices. While your doctor remains your best source of information, self-care reference books, Web sites and newsletters can help you stay informed. For example, Mayo Clinic's Women's HealthSource provides medical and lifestyle information women can use to lead healthier lives.

Here's a recap of some women's health news in 2003 from Mayo Clinic Women's HealthSource:

Heart disease: No. 1 killer of women — Women are more concerned about their risk of breast cancer than heart disease. Big mistake. Although both deserve attention, heart disease is by far the No. 1 killer of women. Heart disease kills about 375,000 American women each year, compared with about 41,500 women who die from breast cancer.

Coronary heart disease develops slowly and silently. It's so sneaky that 63 percent of women who die suddenly of coronary heart disease had no previous symptoms.

The classic heart attack symptoms are sudden and intense chest pain, tightness in the chest, pain that radiates down your left arm and shortness of breath. But others may be more likely to occur in women. In one survey, 90 percent of women didn't know the less-common symptoms.

These include: Pain that radiates into your jaw. Pain in one or both arms. Discomfort that feels like indigestion. Pain high in your abdomen, upper back or neck. Breaking out in a cold sweat, nausea or lightheadedness.

Hormone therapy: Risky, but still an option to treat hot flashes — More than a year's worth of scary headlines make hormone therapy seem too risky to use for menopause symptoms. But the fact remains that estrogen therapy is still the most effective way to reduce or eliminate hot flashes.

In 2002, the Women's Health Initiative study found that a combination of estrogen and progestin resulted in more risks than benefits for menopausal women. Increased risks were noted for heart attacks, breast cancer, stroke and blood clots. Additional risks have been identified since then. The risk of dementia is double among Prempro users age 65 and older.

Women who do opt to continue hormone therapy can take preventive measures including yearly breast exams and mammograms. You can reduce your risk of heart disease with a low-saturated-fat diet, regular exercise and not smoking. Check with your doctor about other approaches that might be beneficial. Options include:

Take a lower-dose product. Many are available. If you need progestin, consider micronized progesterone (Prometrium). It has fewer adverse effects on cholesterol levels than do synthetic forms of the hormone. Also, consider taking it cyclically. One regimen is taking it 12 to 14 days every three months. This provides less exposure to the progestin hormone, which has been found to increase breast cancer risk more than estrogen alone.

Consider a hormone patch instead of pills. Estrogen patch therapy doesn't affect blood clotting the way estrogen pills do.

Alcohol: It's riskier for women's health — Drinking alcohol may pose more health risks for women than for men, according to new research that includes both sexes. Until recently, most alcohol-related research focused only on men.

Because women are generally smaller and have a higher percentage of body fat than do men, they metabolize alcohol less efficiently. But researchers have found that effects of alcohol on women go far beyond size and metabolism.

Liver damage: Researchers have found that compared with men, women develop alcohol-induced liver diseases over a shorter time and after consuming less alcohol. Findings suggest that women are more likely than men to develop alcoholic hepatitis and to die of cirrhosis of the liver.

Brain damage: Women may be more vulnerable than men to alcohol-induced brain damage. Researchers have found that a brain region involved in coordinating multiple brain functions is significantly smaller among alcoholic women than among both nonalcoholic women and alcoholic men.

Heart disease: Although there's some consensus that men who consume up to two alcoholic drinks a day have a lower death rate from coronary artery disease than do heavier drinkers and abstainers, in women a similar benefit is seen with just one drink a day. Larger amounts aren't clearly safe for women.

Problem drinking: Women have a shorter window of time than do men between the onset of drinking and the development of problem drinking with adverse health consequences. Studies show that women are more likely than men to drop out of a treatment program.

Breast cancer: More than two drinks a day increases the risk of breast cancer for women.

If you do drink and you're healthy, drink responsibly and in moderation. If you don't drink already, starting now isn't likely to result in any health benefits.

To subscribe to Mayo Clinic Women's HealthSource, call 800-876-8633.

Mayo Clinic in Rochester — Carol Lammers
507-284-5005 (days)
507-284-2511(evenings)
email: newsbureau@mayo.edu

Mayo Clinic in Jacksonville — Erik Kaldor br> 904-953-2299

Mayo Clinic in Scottsdale — Anne Tewksbury
480-301-4368 ###

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To obtain the latest news releases from Mayo Clinic, go to www.mayoclinic.org/news. MayoClinic.com is available as a resource for your health stories.