Women's Health in 2024 by Fran Joyce
A woman’s overall health may affect her risks of contracting several diseases.
It can be confusing. Every month there’s a new diet, a new fitness regime, and new advice about how much sleep to get, or which supplements, if any, we need.
Is it genetics or lifestyle? Is it a combination of the two or fate?
Following a healthy eating plan, yoyo dieting, fad diets, smoking/not smoking, not drinking/drinking in moderation/heavy drinking, exercise, heathy body weight, obesity, sedentary or active lifestyle, practicing safe sex, knowing her family medical history, adequate healthcare (wellness checks and health screenings), monitoring blood pressure and cholesterol levels, managing stress and depression (mental health affects physical health), maintaining positive healthy relationships, and avoiding abusive relationships all play key roles in her overall health.
Heart disease has become the leading cause of death for women. One out of thirty-one American women with breast cancer will die of breast cancer, but one out of three women with heart disease will die of heart disease. One in every five deaths of women are because of heart disease.
Over 60 million women (44% in the United States) are living with some form of heart disease. The CDC estimates that only 56% of women know that heart disease is the number one killer of women.
Doctors once regarded heart disease as a man’s disease, because more men die from heart disease than women. However, women are more likely to die from a heart attack than men. Because women typically experience different symptoms during a heart attack than men, they (and the people around them) may not recognize these symptoms as the warning signs of a heart attack and seek immediate medical help.
Doctors often missed the warning signs of heart disease in women. Thankfully, that’s changing, and more physicians are being educated about the importance of coronary care and screenings for their female patients.
One of our most effective tools for survival is knowing the risk factors associated with developing heart disease:
· Lack of awareness of women’s heart health issues
· Use of oral contraceptives and/or hormone replacement therapy may increase your risk of heart disease
· Early menarche – starting your period at a younger age - FYI girls are currently starting menstruation at an earlier age than their mothers and grandmothers.
· Early age of pregnancy
· Early menopause
· Atypical heart attack symptoms
· Undertreatment – studies show that women tend to focus more on the health of their family members and may skip wellness checks/medical screenings and ignore or downplay warning signs of their own illnesses
· Aging
· Smoking
· Stress
· Obesity
· Sedentary lifestyle
· Poor nutrition
· Hypertension
· Diabetes – diabetes increases a woman’s risk of heart disease by 44% more than it does for a man
· Lack of sleep
Gender Specific Screenings:
Certain electrocardiogram (ECG/EKG) readings impact women differently than men. If these tests are evaluated with male established norms, a potential impending cardiac event might be missed. Basing parameters according to age and gender can improve EKG interpretation.
Many of the risk factors of heart disease are also risk factors for developing certain cancers and other health conditions:
Obesity – Not maintaining a healthy weight opens a Pandora’s box of health issues such as heart disease, Type 2 diabetes, knee osteoarthritis, high blood pressure, high cholesterol, liver disease, obstructive sleep apnea, and certain cancers.
The good news is that we don’t all need to be a size 2 to be healthy. Not everyone who is overweight is obese. Modest weight loss can reduce your risk of developing these health issues. Difficulty losing weight may be caused by inherited physiological and environmental factors that may influence our choice of diets, physical activity, and our choice of exercise. Are/were your parents or other immediate family members obese? Are/were they physically active? Do/did they eat a healthy diet? Is/was food used to punish or award certain behaviors? Understanding your relationship with food can be a powerful tool for weight loss.
Diet – The word “diet” can mean different things to people. Your diet is simply what you eat. Stop thinking of a diet as something you do to lose weight. This definition conjures up images of deprivation and sacrifice. Instead, think of the food you eat as fuel for your body. Healthy foods are high octane fuel that will keep your body running at optimum levels. Making small changes and healthier choices will make you feel better. You will see improvements in your blood sugar, blood pressure, and cholesterol levels. The changes you see on the scale are a bonus.
Exercise – A sedentary lifestyle is dangerous. If you are planning to make changes in your activity level, check with your doctor first. You don’t have to run marathons to be healthy. Walking is one of the best ways to improve your health and jumpstart weight loss. You can listen to music or audiobooks while you walk. Walk with a buddy or start taking your dog for longer walks. Breathe in the fresh air. If you walk early in the morning soak up some vitamin D, but wear sunscreen during hours when UV rays are strongest. Consider using a standing desk at work. It may seem strange at first, but it’s better for your health. Play with your kids or get together with friends for Yoga, Zumba, Pilates, or Tai Chi. Park a little farther away from the entrance when you’re running errands and take the stairs.
Inflammation is part of the body’s defense mechanism. The immune system reacts to what it perceives to be harmful or foreign stimuli and begins the healing process. Acute inflammation may be severe, but typically only lasts for a short period of time. Chronic inflammation may last for months or years and can be harmful. It may an indication of an autoimmune disease which will cause the body to interpret some of its normal functions as foreign stimuli and attack them. See your doctor if you are experiencing signs of chronic inflammation and try modifying your diet to include foods rich in omega 3 fatty acids, polyphenols, or antioxidants such as kale, spinach, arugula, broccoli, cauliflower, cabbage, Brussels sprouts, fatty fish (salmon, tuna, or mackerel), nuts and seeds (chia seeds, ground flaxseeds, almonds), and fruits (apples, berries, oranges, and mangoes), olive oil, turmeric, green tea, and black tea. Avoid foods high in sugar, refined carbs, processed foods, fried foods, alcohol, trans fats, red meat, and processed meat. Smoking, lack of exercise or over exercise, and poor sleep habits can worsen inflammation.
Insulin resistance requires a medical diagnosis. It is when the cells in your muscles, fat, and liver do not respond well to insulin and have trouble taking glucose from your blood. Your pancreas will make additional insulin to help the glucose enter your cells. Eventually, you could end up with prediabetes or Type 2 diabetes. Certain medicines, poor sleep habits, or hormonal disorders can cause insulin resistance. There are usually no symptoms. Ways to combat insulin resistance include maintaining a healthy body weight, following a healthy eating plan, being physically active, and practicing healthy sleep habits.
Stress management - Stress is bad. We all know it, but sometimes we all get stressed. Managing that stress can save our lives. Meditation and exercise can help. Knowing our own limitations and learning how to say, ”NO,” can be liberating. Taking up a fun hobby or volunteering for a worthy cause can help relieve stress. Being well rested can help you cope better in stressful situations, so stop skimping on sleep.
Mental health – Take care of your mental health. Don’t be afraid to ask for help if you need it. Know the signs of depression and be honest with your medical health provider when answering questions. The last few years have been tough for everyone. Be gentle and forgiving to yourself.
I found three empowering quotes for last year’s issue on Women’s health that deserve repeating:
“The people around you are either your circle or your cage.” Christopher Ferry
“Their reaction to you holding them accountable is not your burden to carry.” Christopher Ferry
“Don’t let anyone who hasn’t been in your shoes tell you how to tie your laces.” Unknown author
Cancer is the second leading cause of death in the United States. One of every five deaths (men and women) in the United States is due to cancer. Let that figure set in. What are the cancers that most affect women?
Skin Cancer is the leading type of cancer affecting women in the United States. About 100,640 new melanomas will be diagnosed in the United States this year. Of them, 41, 470 cases of invasive melanoma will occur in women, an estimated 2,860 women will die. Melanoma is twenty times more common in White people than in Black people. Melanoma has become one of the most common cancers in young adults, especially young women. Risk factors for developing melanoma include ultraviolet light exposure, moles, fair skin, freckling, and light hair, family history of melanoma, personal history of melanoma or other skin cancers, having a weakened immune system, being older, being male, and Xeroderma pigmentosum – a rare inherited condition that affects skin cell’s ability to repair damage to their DNA. Early-stage melanoma is often treated with surgery. More advanced causes may require immunotherapy, targeted therapy drugs, chemotherapy, and radiation. Melanoma cannot be completely prevented, but there are certain steps you can take to minimize your risk - limit your exposure to UV rays, wear a shirt and hat, use a good sunscreen, and reapply often, wear sunglasses to protect your eyes and the skin around them, avoid tanning beds and sunlamps, and above all protect your children from the sun. Know the hours when UV rays will be the strongest and stay indoors during that time. Protect your immune system and watch for abnormal moles. Have a skin check during your wellness visits.
Breast Cancer
Your greatest risk of developing breast cancer is having breasts. Period. We are all at risk and even if we eat well, exercise, maintain a healthy weight, don’t smoke or drink, get adequate rest/sleep, we are still at risk. Do monthly self-exams, never skip your wellness checks, and get your mammograms starting at age 40 or younger if you have a family history of breast cancer.
I know this is our women’s health issue, but protecting our partners, fathers, brothers, and friends from a delayed breast cancer diagnosis is important. Men have 1% of the breast tissue women have, but that 1% can develop breast cancer. Men also need to perform monthly breast self-examinations. According to the American Cancer Society, 2,790 men will be diagnosed with breast cancer this year. That is 1% of the cases that will be diagnosed. Of those cases, 530 men will die of breast cancer this year. Why? Men and their doctors may initially dismiss a lump or breast soreness as a pulled muscle or a fat deposit because most of the time that’s exactly what it is. If it’s not, breast cancer can spread and worsen survival rates the longer it remains undetected.
Female breast cancer has now surpassed lung cancer as the most commonly diagnosed cancer in the world. It’s estimated that approximately 30% of all new female cases of cancer diagnosed in 2024 will be breast cancer. On average, a woman is diagnosed with breast cancer in the United States every two minutes.
More women in the United States are diagnosed with breast cancer than any other type of cancer, besides skin cancer. The disease accounts for 1 in 3 of new female cancers annually. More women under 50 are being diagnosed with breast cancer.
In 2024, approximately 310,720 women in the United States will be diagnosed with invasive breast cancer, and 56,500 women will be diagnosed with non-invasive (in situ) breast cancer. Since the mid-2000s, invasive breast cancer in women has increased by approximately half a percent each year. Likely causes for this include an increase in excess body weight in women overall, a drop in fertility rates, and rising age for first births. A woman’s chances of being diagnosed with breast cancer are 1 in 8. That encompasses approximately 13% of the female population of the United states. The chance that a woman will die from breast cancer is 1 in 39 or about 2.5%.
Currently, there are more than 4 million women who are living with or beyond breast cancer in the United States. That’s roughly the same number as last year. It should be higher. When caught early in its localized state, the five-year survival rate is 99%. Reoccurrence rates are highest during the first few years after treatment and decrease over time.
It is estimated that 42,250 women in the United States will die from breast cancer in 2024. Worldwide, female breast cancer is the fifth leading cause of death. Approximately 66% of breast cancer cases are diagnosed at a localized stage (before the cancer has spread outside the breast). The five-year survival rate for cancer diagnosed at the localized stage is 99%.
Lung Cancer is the third leading type of cancer affecting women in the United States behind skin cancer and breast cancer. About 118,270 (down from last year) new cases of lung cancer in women will be diagnosed in 2024 as compared to 116,310 in men. About 59,280 women and 65,790 men will die in 2024 from lung cancer. It’s the number one cause of cancer deaths in the United States. On a happier note, those levels are dropping because more people are quitting or not starting smoking.
Most people diagnosed with lung cancer are over 65 years old. One in 17 women will develop lung cancer in her lifetime. Lung cancer rates for women have risen 84% over the past 42 years while they have declined by 36% among men. Why? More women started smoking during that period. There are also environmental factors contributing to lung cancer rates. Risk factors include tobacco smoke, exposure to asbestos, family history, secondhand smoke, exposure to radon, exposure to cancer-causing agents in the workplace or home, diesel exhaust, arsenic in drinking water, previous radiation therapy to the lungs, air pollution all may play important roles in the development of lung cancer. Factors such as smoking marijuana, secondhand smoke from marijuana, talc and talcum powder, e-cigarettes are currently being evaluated as possible cancer-causing agents. Because marijuana is still illegal in many parts of the United States and the world, many patients with lung cancer do not admit to smoking it, so the data may be skewed. Treatment for lung cancer may include surgical removal of part or all of one lung, radiation, chemotherapy, targeted therapy, and immunotherapy.
Some people with earlier-stage lung cancers are reaching “cured status – no evidence of cancer for five full years after treatment.”
Women’s Reproductive Health
The conservative members of SCOTUS have taken decisions about women’s reproductive healthcare from women and their physicians and handed them to judges, politicians, government officials, and hospital administrators. How you feel about these decisions should affect how you vote, but this article is not about that. We will never tell you how to vote. Our purpose here is to inform you about medical conditions affecting women’s reproductive health, not the healthcare you or a loved one may or may not receive.
Uterine Fibroid Tumors are the most common noncancerous tumors in women of childbearing age. These tumors are made of muscle cells and other tissue that grow in or around the wall of the uterus. The cause of fibroids is unknown, but the risk of developing them are higher for African American women and women who are overweight. Symptoms include painful periods, bleeding in between periods, lower back pain, feeling full in the lower abdomen, painful intercourse, infertility, early labor, and multiple miscarriages.
Some women have no symptoms, so yearly exams are important for your reproductive health.
Endometriosis is a condition in which tissue similar to the tissue lining the inside of your uterus grows outside of the uterus on your ovaries, fallopian tubes, and/or the tissue lining your pelvis. In rare instances, endometrial-like tissue migrates beyond the area where pelvic organs are located. This tissue thickens, breaks down, and bleeds with each menstrual cycle, but unlike the tissue lining the uterus, it has no way to exit the body and becomes trapped creating a painful and unhealthy situation. Cysts on the ovaries may form. If the endometrial-like tissue becomes irritated, scar tissue may form and cause pelvic tissues to stick to each other. In addition to painful periods, women may experience pain during intercourse, and while urinating, or having bowel movements.
Endometriosis can worsen with time and may be confused with pelvic inflammatory disease (PID), Ovarian cysts, or Irritable Bowel Syndrome (IBS). It can affect a woman’s ability to get pregnant and carry a child to term. Approximately one-third to one-half of women with endometriosis have difficulty getting pregnant. Doctors often advise women with endometriosis not to delay having children because of the progression of their condition.
Ovarian cancer occurs at higher rates than expected for women with endometriosis, but researchers are unsure why. Another rare form of cancer, endometriosis-associated adenocarcinoma can develop later in life in women who have had endometriosis.
Early detection and treatment are important for women with endometriosis. If you have problems with painful periods, excessive bleeding, pain during intercourse, pain with bowel movements or urination, infertility, or symptoms such as fatigue, diarrhea, constipation, bloating nausea especially during menstrual periods, see your doctor.
Interstitial Cystitis is a chronic bladder condition which causes chronic pain in the bladder or surrounding pelvic area. The walls of the bladder may become inflamed or irritated causing scarring and stiffening of the bladder. Symptoms may include painful and/or frequent urination, mild to severe abdominal or pelvic discomfort or pressure, tenderness, or lower abdominal pain that increases as the bladder fills or empties.
Polycystic Ovary Syndrome (POCS) occurs when a woman’s ovaries or adrenal glands produce more male hormones such as testosterone than normal. Cysts may develop on the ovaries. Women who are obese are more likely to have PCOS. Women with PCOS are at higher risks of developing diabetes and heart disease. Symptoms include pelvic pain, infertility, excess hair growth on the face, chest, stomach, thumbs, or toes, hair thinning or hair loss, acne, oily skin, or dandruff, and thickened dark brown or black patches of skin.
Gynecological Cancers include cervical cancer, ovarian cancer, peritoneal cancer, Fallopian tube cancer, uterine cancer, vaginal cancer, and vulvar cancer.
Cervical Cancer begins in the cervix, the lower, narrow end of the cervix. The risks of developing cervical cancer can significantly be reduced by PAP smear screening and an HPV vaccine. Risk factors include smoking, increased number of sexual partners, early sexual activity, other sexually transmitted diseases, a weakened immune system, exposure to miscarriage preventing drugs. Reduce your risks by not smoking, having protected sex – using a condom and limiting your number of sexual partners, getting the HPV vaccine, and having regular PAP smears. Each year in the U.S. @ 11,500 new cases are diagnosed and about 4,000 women per year die of cervical cancer. There were @ 604,000 cases diagnosed in 2020 worldwide.
Ovarian Cancer is caused by abnormal cell growth in the tissue covering the ovaries. It is the deadliest reproductive cancer affecting women. In 2020, there were 18,518 new cases of ovarian cancer diagnosed in the U.S. In 2020 13,438 women died of ovarian cancer. Nine new cases of ovarian cancer were diagnosed for every 100,000 women and six out of every nine of those women will die. There are no early symptoms for this disease. Women with the genetic mutations BRCA 1 and 2 are at higher risk for developing ovarian cancer. Other risk factors include a family history of the disease, being over 50, infertility, and early menopause.
Peritoneal Cancer is a rare cancer the forms in the membrane lining of the abdominal cavity known as the peritoneum. Cancer that has spread to the peritoneal cavity from ovarian cancer, primary colorectal cancer appendiceal cancer, or mesothelioma and pseudomyxoma carcinomatosis are frequently referred to as peritoneal cancers. The risk factors are the same as for ovarian cancer. Symptoms are often vague and non-specific and may include abdominal swelling with pain, frequent urination and a sense of fullness while eating, weight loss, a change in bowel habits, or abnormal vaginal bleeding. Treatments may include surgery, chemotherapy or HIPEC, a heated chemotherapy bath of the affected area as well as targeted therapy, immune therapy, and radiation.
Fallopian Tube Cancer or tubal cancer is a rare cancer that develops in one or both of the fallopian tubes which leads from the ovaries to the uterus. It accounts for only 1-2% of all gynecological cancers and has the same risk factors as ovarian cancer. It is most common in Caucasian women who have never had children. Roughly 1,500 – 2,000 cases of fallopian tube cancer have been reported worldwide. Symptoms include abnormal vaginal bleeding, especially after menopause, pain, or pressure in the abdomen, abnormal pinkish or white vaginal discharge, or a pelvic mass. Treatments may include surgery and chemotherapy.
Uterine Cancer includes two types of cancer: endometrial cancer (most common) and uterine sarcoma (rare). Symptoms include bleeding between periods or after menopause. Endometrial cancer is the most common cancer affecting women’s reproductive systems and people AFAB in the U.S. It mainly develops after menopause and will affect roughly 3% of women and people AFAB during their lifetimes. About 65,00 cases are diagnosed each year. Symptoms include vaginal bleeding between periods before menopause, vaginal bleeding (even slight bleeding) after menopause, lower abdominal pain, thin clear or white vaginal discharge postmenopausal, extremely prolonged, heavy, or frequent vaginal bleeding if you are over 40 years old. Risk factors are age (higher as you get older), a diet high in animal fat, family history, obesity, diabetes, ovarian disease, menstruation, and reproductive history – early menstruation and late menopause, long menstruation span, not getting pregnant, earlier radiation therapy to your pelvis, estrogen replacement therapy, or the use of Tamoxifen – a drug used to treat hormone receptor positive breast cancer. Tests for uterine cancer include a CA-125 assay blood test, CT scans, MRI scans, trans vaginal ultrasound, endometrial biopsy. Hysteroscopy, and D&C (dilation and curettage) – a surgical procedure to remove uterine tissue. Treatments for cervical cancer may include removal of the uterus, chemotherapy, radiation therapy, hormone therapy, immunotherapy, and targeted therapy.
Vaginal cancer is not common. It is a disease characterized by malignant cancer cells forming in the vagina. Risk factors include older age and having had an HPV infection. Symptoms include pain or abnormal vaginal bleeding. Treatments may include surgery, chemotherapy, and radiation.
Vulvar Cancer is a rare type of cancer that occurs on the outside surface of the female genitalia. The vulva includes the clitoris and the labia. It usually appears as a lump or sore on the vulva that often causes itching. It can occur at any age, but most often occurs in older adults. Treatment usually involves surgery to remove the cancer and a small amount of healthy tissue. Sometime the entire vulva must be removed. Early diagnosis usually involves the least invasive surgical procedure. Risk factors include increasing age, exposure to HPV, smoking, a weakened immune system, previous history of precancerous conditions of the vulva, or having a skin condition involving the vulva. Prevention measures include practicing safe sex and getting the HPV vaccine.
Sexually Transmitted Diseases (STDs) are infections you can get from having sex with infected people. They are caused by bacteria, viruses, or parasites. STDs caused by bacteria or parasites can be treated and cured with antibiotics. Viral infections can be treated but not cured by antiviral medications. Correct usage of latex condoms helps prevent STDs.
HIV/AIDS – HIV is the human immunodeficiency virus. It affects CD4 cells in the body. Over time so many CD4 cells may be destroyed that it compromises your immune system preventing the body from fighting off infections. There is no cure for HIV, but there are now treatments. AIDS, acquired immune deficiency, can develop from HIV causing severe damage to the immune system. Women typically get HIV/AIDS from having unprotected sex with infected men or sharing intravenous needles with infected people. Pregnant women who are infected are at risk of spreading the disease to their children during pregnancy, childbirth, or after birth. Knowing your status can help protect your child from HIV/AIDS.
Sources for this article:
https://www.mayoclinic.org/diseases-conditions/obesity/symptoms-causes/syc-20375742
Cahttps://www.mayoclinic.org/diseases-conditions/endometriosis/symptoms-causes/syc-20354656
https://www.cdc.gov/reproductivehealth/womensrh/healthconcerns.html
https://my.clevelandclinic,org
https://www.cdc.gov/cancer/ovarian/index.htm