osteoporosis

What Every Woman Needs to Know about Osteoporosis

Osteoporosis is a silent disease that can lead to serious fractures, as well as back pain, loss of height and stooped posture. In fact, the disease is often not diagnosed until after a fracture has occurred.

While impacting both men and women, osteoporosis occurs more frequently in women because they tend to have smaller, thinner bones. As well, estrogen, that helps make and rebuild bone in women, drops significantly after menopause which can lead to bone loss. This is why osteoporosis and bone fractures are more common in older women.

Although osteoporosis can cause fractures in nearly any bone, they commonly happen in the wrist, spine and hip. In fact, 75 percent of all hip fractures occur in women (source: International Osteoporosis Foundation), largely due to osteoporosis. And, the consequences of osteoporosis-related fractures can be substantial, ranging from diminished quality of life and dependence on pain medication to increased depression and even permanent incapacitation.

Proactive Screening for Osteoporosis

Because osteoporosis typically has no symptoms until there is a fracture, it’s important for women to get proactively screened for the disease. Dual energy x-ray absorptiometry, commonly referred to as a DEXA scan, is the only test that can diagnose osteoporosis before a broken bone occurs. The National Osteoporosis Foundation recommends DEXA scans for women who are:

  • Age 65 or older
  • Over 50 and have broken a bone
  • Menopausal or postmenopausal with certain risk factors

The results of bone density testing can enable a woman’s doctor to make recommendations on how to reduce the chance of breaking a bone. Osteoporosis treatment often involves medication along with lifestyle changes. Bisphosphonates are the most common medications prescribed for osteoporosis.

The Osteoporosis Treatment Gap

Long-term bisphosphonate therapy has been linked to a very rare side effect, in which the upper thighbone cracks and may break. This problem was widely publicized and led many, who were prescribed these medications, to stop taking them. Out of patient fear, use of the most commonly prescribed osteoporosis drugs fell by 50 percent from 2008 to 2012 (source: Journal of Bone and Mineral Research), and the trend is continuing.

“Fears about these medications has resulted in patients not being able to take advantage of the many benefits they offer,” says Stuart Weinerman, MD, Assistant Professor at the Zucker School of Medicine at Hofstra/Northwell and Associate Chief, Division of Endocrinology, Department of Medicine at Northwell Health. “Diet, exercise and supplements are not enough to protect someone with low bone density.”

Medication, along with healthy lifestyle practices, remain the best bet in reducing the chance of a fracture in those identified as having low bone density. These practices include:

Exercise – Weight-bearing physical activity can strengthen bones and lower the chance of a fracture.

Balanced nutrition – A healthy diet with enough calcium and vitamin D can help maintain bone.

Quit smoking – Cigarettes can increase bone loss.

Limit alcohol – Drink in moderation. This means no more than one drink per day for women.

Find out more about osteoporosis prevention and treatment. At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

ovarian cancer

Facts about Ovarian Cancer Symptoms, Prevention and Treatment

Every 23 minutes, a woman is diagnosed with ovarian cancer, and one in 75 will develop the disease in their lifetime (source: National Cancer Institute). While most women are aware of their breast cancer risk, fewer are aware of their risk of ovarian cancer or the subtle early symptoms of the disease which often can be overlooked. The result is that women don’t seek help until the disease has begun to spread, making treatment more complex.

The most common ovarian cancer symptoms include:

  • Bloating
  • Pelvic or abdominal pain
  • Back pain
  • Fatigue
  • Urinary urgency
  • Nausea or indigestion
  • Shortness of breath
  • Weight gain

Testing and Screening for Ovarian Cancer

Unlike Pap tests for cervical cancer and mammograms for breast cancer, there is no routine screening test for ovarian cancer. Researchers have discovered new information about how BRCA1 and BRCA2 gene mutations can increase ovarian cancer risk. These are the same genes that are tested to determine the chance of developing breast cancer. Approximately 20 percent of women diagnosed with ovarian cancer have a hereditary tendency to develop the disease. Most of the time, these patients have a genetic mutation of the BRCA1 or BRCA2 gene.

All women with ovarian cancer are recommended to undergo genetic testing to identify these gene mutations. The information can help determine a woman’s risk of developing other cancers, as well as provide insight into whether other family members can benefit from testing, too. In some cases, siblings and others within the family that also have tested positive for the gene mutation can undergo preventive treatment or additional screenings and surveillance.

Innovations in Ovarian Cancer Treatment

For women who have been diagnosed with ovarian cancer, identified gene mutations may also play a part in determining the best treatment therapies. New research is providing guidance on how genes affect the biology of cancer growth, and targeted therapies are being developed to inhibit specific enzymes that contribute to cancers caused by mutations in BRCA1 and BRCA2.

“Use of these inhibitors can slow progression of the disease and result in tremendous improvements in survival,” says Dr. Jill Suzanne Whyte, MD, Gynecologic Oncology, Obstetrics and Gynecology at North Shore University Hospital.

Another new approach to ovarian cancer treatment that is showing promise is the development of tumor vaccines that help the immune system recognize cancer cells and attack them as they grow. The man-made antibodies used in the vaccines are similar to those that fight infection.

The Importance of Ongoing Ovarian Cancer Research

“Because ovarian cancer remains the leading cause of gynecological cancer deaths in the United States, the need for ongoing research to discover better ways to identify, treat and prevent the disease is essential,” notes Dr. Whyte. Due to decreased public funding of ovarian cancer research, there has been a substantial reduction in clinical trials over the last several years. Support for research funding is necessary for advancements to continue to be made. For women who are diagnosed, it’s also important to ask about specific clinical trials.

Find out more about ovarian cancer prevention and treatment. At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

cervical cancer screening

The Latest in Cervical Cancer Screening and Prevention

In previous generations of women, cervical cancer was one of the most common causes of cancer death, but advancements in cervical cancer screening have dramatically changed this statistic. Over the last 40 years, the cervical cancer death rate has decreased by more than 50 percent (source: American Cancer Society). The primary reason for the change? The increased use of the Pap test which can find cervical cancer in its most curable stages and even identify changes in the cervix prior to cancer developing.

Understanding Cervical Cancer Screening Guidelines

While cervical cancer screening was once routine as part of an annual well-woman exam, guidelines have changed through the years. Your age and health status now determine how often you need screening and which tests are recommended. Current guidelines are:

  • Age 21-29: Women have a Pap smear every three years
  • Age 30-65: Women have a Pap smear and HPV test (co-testing) every five years

For women with certain risk factors or symptoms, more frequent screening for cervical cancer may be suggested. It’s important to talk to your primary care doctor about the optimal cancer screening schedule for you, based on your health and family history.

“Healthcare is a partnership,” says Dr. Andrew Menzin, Chief, Division of Gynecologic Oncology, Central Region Department of OB/GYN, Northwell Health. “In today’s healthcare setting, women need to be proactive about their health through dialog with their doctor and maintaining important records, such as Pap test results.”
It’s also essential to contact your doctor right away if you are experiencing any unusual symptoms, such as:

  • Bleeding
  • Discharge
  • Pelvic pain

Gynecologist or General Practitioner?

Many young women rely on their gynecologist as their facilitator of primary care. Those who do should mention this during their well-woman exams to ensure they receive other necessary screenings, such as for blood pressure, bone density, weight, cholesterol and emotional health.

As women get older, their gynecological needs evolve. Cervical cancer screening may be discontinued in some women at 65 years, and the gynecologist can help navigate the medical issues that occur as part of the transition into the menopausal years. Regular visits remain an important part of women’s health maintenance.

Strides in Cervical Cancer Prevention

It is a unique moment in medical history when a vaccine can help prevent the development of cancer. This is currently the case with the available vaccines to prevent infection by certain types of the human papilloma virus (HPV). HPV causes most cases of cervical cancer, as well as many vaginal, vulvar, anal, penile and oropharyngeal cancers (cancers of the throat and mouth).

The American Cancer Society recommends routine HPV vaccination for girls and boys, starting at age 11 or 12. HPV vaccination is also recommended for females 13 to 26 and males 13 to 21 who have not already started the vaccines. Talk to your doctor for specific HPV vaccination recommendations for yourself or your child.

Find out more about cervical cancer prevention and treatment. At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

skin cancer

Reduce Your Risk of Developing Skin Cancer

Achieving that once enviable, sun-kissed glow of summer not only speeds up the development of skin discolorations and wrinkles, it also dramatically increases your chance of skin cancer. Today, we know that there is a clear link between sun exposure and skin cancer. Yet, many are surprised to learn their risk. More than 4 million cases of basal cell carcinoma and 1 million cases of squamous cell carcinoma are diagnosed in the United States each year. One in five Americans will develop skin cancer in their lifetime. (source: Skin Cancer Foundation)

Most of us are exposed to substantial amounts of the sun’s rays throughout our lifetime. They are present during daylight hours, even when it’s cloudy. UVA and UVB rays play a key role in skin aging, wrinkling and skin cancer. Exposure to them causes cumulative damage over time. Having had one or more blistering sunburns as a child or teenager can even increase your risk of developing skin cancer as an adult.

Make Sunscreen a Daily Habit

The good news is that you can greatly reduce your risk of developing skin cancer, as well as slow down skin aging, by using a few proven preventive strategies. This starts with applying a sunscreen daily with a sun protection factor (SPF) of at least 30 with a broad spectrum to protect against both UVA and UVB rays. Anything above SPF 30 has little incremental benefit, and below 30 is not effective enough. If applied correctly, this will block up to 97 percent of damaging rays. Reapplication is important, particularly if you are in the water or sweating.

There are two different sunscreen types on the market – chemical and physical blockers. Chemical blockers work by absorbing the sun’s rays, and physical blockers deflect the rays. Chemical sunscreens typically offer more coverage but take about 20 minutes after application to be effective. Some individuals can experience irritation from the active ingredients in sunscreens with chemical blockers. Physical sunscreens contain zinc oxide or titanium dioxide. They work immediately after application. Products containing zinc oxide are typically better for those with sensitive skin and offer protection against the entire spectrum of UVA and UVB rays. There are sunscreens on the market that contain both chemical and physical blockers.

Many women use makeup that contains sunscreen. While this can offer some level of protection, it typically is not sufficient. The safest bet is to apply a broad-spectrum sunscreen under makeup. Don’t forget to use a lip balm or lipstick that also has SPF.

Other Skin Protection Strategies

While making sunscreen application a regular part of your daily routine is an important part of reducing your chance of developing skin cancer, it’s not the only way to protect your skin.

“No sunscreen is going to block 100 percent of the sun’s rays,” says Dr. Victoria Sharon, Director of Dermatologic Surgery and Dermato-Oncology at Northwell Health. “You need a multi-faceted approach that also includes wearing protective clothing and sunglasses and avoiding sun exposure during peak sunlight hours between 10am and 3pm.”

There are also new options when it comes to UV-protective products. A growing number of retailers are selling shirts, hats, pants, swimsuits and other clothing items that are made from fabric infused with chemicals that absorb UV rays. You can also create your own protective clothes by using one of the laundry detergents or laundry additives now available that distribute UV protection chemicals onto fabrics during the wash cycle.

Watch for Skin Cancer Symptoms

Most skin cancers are highly treatable when caught at an early stage. This is why it’s also important to watch for common signs of skin cancer. This means remembering the ABCDEs:

  • “A” for asymmetrical. Is a mole or spot irregular with two parts that look different?
  • “B” for border. Is the border irregular or uneven?
  • “C” for color. Is the color inconsistent?
  • “D” for diameter. Is the mole or spot larger than the size of a small pencil eraser?
  • “E” for evolving. Has the mole or sot changed over a period of weeks or months?

If you have noticed a change, such as a new mole, a sore that doesn’t heal or any of the ABCDEs, get it checked out by your doctor. Learn more about the ABDEs of melanoma.

Want to learn more about preventing skin cancer? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

endometriosis

Endometriosis: Facts for Every Woman

Approximately 5 million women in North America have endometriosis. Symptoms can range from mild to severe and commonly include painful menstrual cramps (dysmenorrhea), pelvic pain, heavy menstrual bleeding, pain during intercourse or bowel movements and infertility.

Although endometriosis is common, it’s also widely misunderstood and often misdiagnosed. Education is important to increasing awareness. We recently joined Dr. Christine Metz, Investigator at the Feinstein Institute for Medical Research and Professor at the Hofstra Northwell School of Medicine, for a Q&A session on the topic of endometriosis. Dr. Metz shared some valuable information and insights.

What is endometriosis?

Endometriosis is characterized by the growth of endometrial tissue or lesions outside of the uterus. These lesions can grow on the lining of the pelvis, internal organs (e.g. the outside of the uterus, ovaries, Fallopian tubes and rectum). In some women, lesions can grow on more distant areas of the body, including the diaphragm, lungs, kidneys and brain.

What causes endometriosis?

The cause of endometriosis is not completely understood. However, many researchers believe that it arises after abnormal menstrual flow where menstrual blood is carried through the fallopian tubes into the pelvic cavity instead of exiting through the vagina. Like the endometrium, which sheds monthly, endometriosis lesions bleed in response to monthly hormone fluctuations. Other factors that may influence endometriosis are genetics and environmental and immune system factors.

How is endometriosis diagnosed?

One of the most frustrating problems for patients with endometriosis is delayed diagnosis, which can take up to 10 years. The diagnosis of endometriosis requires laparoscopic surgery with pathology confirmation of the biopsy specimens. Early diagnosis by a doctor who specializes in treating endometriosis patients is important because early treatment can dramatically improve patient outcomes.

Do pain and other symptoms correlate with the severity of endometriosis?

No. Pain and other symptoms do NOT always correlate with the severity of the disease.

What are the treatments for endometriosis?

While there is no cure for endometriosis, treatments include non-steroidal anti-inflammatory (NSAID) drugs and other pain relievers, hormonal contraceptives (e.g. birth control pills or vaginal rings), other hormonal agents (e.g. gonadotropin-releasing hormone (GnRH) agonists and antagonists, androgenic agents, progestins and Danazol) and surgery to remove the lesions or the uterus (in severe cases only).

What can women do?

Researchers at the Feinstein Institute for Medical Research at Northwell Health are looking for women with and without endometriosis to participate in the ROSE (Research OutSmarts Endometriosis) research study. Our goal is to investigate the causes of endometriosis and develop non-invasive diagnostic methods and new treatments for women suffering with endometriosis. For additional information, please contact us at ROSE@northwell.edu or call 516-562-ENDO (3636).

Katz Institute for Women’s Health is also here to answer your questions about endometriosis. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

Debunking Medical Myths

Debunking Medical Myths

Nearly every day, there are news stories about “breakthroughs,” “scientific findings” and “promising research.” There are also countless online medical resources, including many that publish unproven medical myths. With so much information out there of varying degrees of quality and accuracy, it can be very difficult to decipher the facts from fiction when it comes to women’s health and wellness. So, what’s the best way to determine the truth in medical headlines and online medical information? Here are a few tips to help guide you to the truth.

Don’t Jump to Conclusions

With increasing health-related headlines and news, it’s easy to become overwhelmed. What was once reported to be healthy can quickly be debunked and deemed downright risky. Before you make medical decisions based on a specific study or website, it’s important to consider that not all online medical information is significant or even valid.

Learn What Makes a Study Trustworthy

Not sure how to determine the validity or importance of a study? You will want to look at two key factors that can determine its reliability. First, it should be a randomized controlled trial. And, the study results should be published in an established journal such as the New England Journal of Medicine, the Journal of the American Medical Association or Lancet.

Rely on Reliable Health Information Websites

The Northwell Health site is a valuable source of accurate healthcare information. As well, the National Institutes of Health website is a trustworthy source for health information. Be leery of websites that are primarily testimonials or personal stories. Not everyone experiences health-related issues the same way. In other words, one person’s experience is not as compelling as clinical research.

Talk to Your Doctor

Most importantly, discuss any health or wellness issues with your healthcare provider. Don’t stop medication or treatment just because you saw a compelling report on a news channel. It’s important to talk to your doctor to determine if the study does apply to you and if it is reliable.

Do you have medical or healthcare questions? At Katz Institute for Women’s Health, we’re here with the latest information and facts. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

The Importance of Gender-Specific Research

The Importance of Gender-Specific Research

While there has been considerable publicity about the gender pay gap, it’s by no means the only inequality that women face on a widespread basis. We’ve learned that gender differences matter in all aspects of health and disease and we should not assume that study results for men are the same as for women. Historically, there has been a lack of gender-specific research which has had an impact on the ability of women to obtain accurate diagnosis and treatment. Because females have been generally excluded from research participation, they unfortunately have been overlooked in research findings.

Encouraging Researchers to Enroll More Women in Studies

There have been significant strides to encourage more gender-specific research which is enabling healthcare professionals to provide more specialized, effective care for women. More than 20 years ago, the National Institutes of Health (NIH) made a ruling that every study they funded had to state whether women and minorities were included and in what proportions. If women were not included, an explanation was required. In 2016, the Food and Drug Administration (FDA) Office of Women’s Health, in partnership with the NIH Office of Research on Women’s Health, launched the Diverse Women in Clinical Trials Campaign to further raise awareness about the importance of diverse women participating in clinical trials. The NIH, the FDA and the Centers for Disease Control and Prevention (CDC) continue to develop new policies, programs and procedures to mandate and implement the inclusion of more women, as well as racial and ethnic minorities, in research.

The Challenge of Gender Disparity in Medical Research

Despite efforts to enroll more women in studies, there continues to be an under representation of female participants. According to the NIH, only one-third of cardiovascular clinical trial participants are female. Yet, cardiovascular disease is the number one killer of both men and women, and their presenting symptoms and response to treatments are different.

“Large gender gaps in research participation limit our findings on the difference between men’s and women’s health,” says Dr. Christina Brennan, MD, MBA, Vice-President, Clinical Research, Northwell Health. “Even when women are enrolled, the data is not analyzed and reported separately which can limit our understanding of findings.”

More recently, in the cases of heart disease, as well as lung cancer, there has been increased inclusion of women in research and clinical trials. This has led to greater knowledge and better tools for clinicians to provide optimal care for women.

Participating in a Clinical Trial

Although many women participate in clinical trials, there is still the need for greater involvement. Women from all ages, racial and ethnic groups can participate in trials, including those with disabilities or chronic health conditions. Through participation, women can make a difference by helping doctors learn more about women’s health.

Want to learn more about gender-specific research? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.

Integrative Medicine: A Holistic Approach to Healthcare

Integrative Medicine: A Holistic Approach to Healthcare

What Are the Benefits of Integrative Medicine?

Integrative medicine is about teaching healthier habits and treating the whole person and not just specific symptoms. The benefits are often far-reaching and long-lasting for patients. Integrative medicine can be an excellent tool for sustaining good health, as well as for treating chronic issues and painful or debilitating diseases and injuries.

Key Principles of Integrative Medicine

Unlike alternative medicine which refers to an approach to healing that is used in place of conventional medical therapies, integrative medicine uses all appropriate therapeutic approaches to achieve optimal health and healing. The following are some of the key principles of integrative medicine:

  • A strong partnership between patient and physician
  • Use of both conventional and alternative medicines and modalities
  • A focus on non-invasive treatments when possible
  • A clear emphasis on promoting health and illness prevention through ongoing healthy living

Combining Therapies

Over the last several decades, the popularity of combining conventional treatments with complementary therapies has grown tremendously. Patients and healthcare providers who were once skeptical of alternative treatments have become believers in the benefits of an integrative approach.

Increasingly, healthcare professionals who specialize in modern medicine are incorporating integrative medicine to promote health and wellness. By combining these approaches with conventional therapies, integrative practitioners can partner with patients and their primary healthcare providers to help relieve pain, reduce stress and support overall well-being.

And, many healthcare providers themselves use integrative approaches for their own personal healthcare because of the distinct health and wellness benefits.

“All medicine is integrative,” says Lucy P. Gade, MD, MPH, Medical Director, Center for Wellness and Integrative Medicine, Northwell Health. “By shifting from being disease-oriented to health-oriented, we can identify risks and minimize them as part of a whole person approach to healthcare. This can enable individuals to live healthier and happier lives.”

Common Integrative Health Approaches Used in Integrative Medicine

  • Deep breathing
  • Yoga
  • Tai chi or qi gong
  • Meditation
  • Massage
  • Functional nutrition
  • Homeopathy
  • Guided imagery

Want to learn more about integrative medicine? At Katz Institute for Women’s Health, we’re here to answer your questions. Call the Katz Institute for Women’s Health Resource Center at 855-850-5494 to speak to a women’s health specialist.