U.S. Health Secretary Kathleen Sebelius has declined to make the Plan B morning after pill readily available on store shelves.

As I wrote on the blog yesterday, Plan B One-Step is currently labeled over the counter for women aged 17 or older, but it is sold behind the counter. Girls aged 16 years and younger can only get the pill with a prescription.

The maker of the drug, Teva Women's Health, had applied to the Food and Drug Administration in February to make it available over the counter to all girls of reproductive age. The FDA had recommended approval.

Sebelius said that the science has confirmed the drug to be safe and effective with appropriate use. But she wasn't sure if there was enough evidence to show that young girls would understand the label to be able to use the pill appropriately.

Plan B contains a high dose of a hormone found in birth control pills and can lower the risk of pregnancy by up to 89 percent if taken within 72 hours of unprotected sex.

The average age for a girl to start her menstrual cycle in the United States is 12.4 years of age, while about ten percent of girls are physically capable of bearing children by 11.1 years of age.

"It is common knowledge that there are significant cognitive and behavioral differences between older adolescent girls and the youngest girls of reproductive age," Sebelius said in a statement." If the application were approved, the product would be available, without prescription, for all girls of reproductive age."

Read Sebelius' letter here. What do you think about her decision? Was it the right one?

Posted by Andrea Walker at 5:42 PM | Permalink | Comments (2)
Categories: Women's health
        

Join us noon EST Aug. 17 for a live chat at baltimoresun.com/healthchat with Dr. Paul Christo of Johns Hopkins on pregnancy and pain treatment. If you're suffering from a chronic pain condition, the pain doesn't stop while you're pregnant. Should you alter your treatment? If so, how else can you cope with the pain? Dr. Christo will answer your questions and concerns about these issues.

Christo is director of the Multidisciplinary Pain Fellowship Training Program at Johns Hopkins University School of Medicine. He also has a radio talk show Saturday nights on WBAL.

Can't make the chat? Send questions in advance to healthcalendar@baltsun.com and return here to read the transcript.

Posted by Kim Walker at 7:30 AM | Permalink | Comments (1)
Categories: Women's health
        

You won't get cancer from breast implants, but leave them in too long and they may wrinkle, rupture or even harden.

Those are the latest findings from safety studies required by manufacturers of silicone gel-filled breast implants. The U.S. Food and Drug Administration released a report today detailing data from the studies.

The report confirms that silicone gel-filled breast implants are safe and effective when used as intended. But the FDA also warns women that there is a price to looking cute.

For one, the regulatory agency said breast implants are not meant to last forever. The longer a woman has implants, the more likely the chance for complications.

One in 5 patients who received implants for breast augmentation will need them removed within 10 years of receiving them. For patients who received implants for breast reconstruction, as many as 1 in 2 need to have them removed within 10 years.

The most frequent complications are hardening of the area around the implant, additional surgeries and implant removal. Other common complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection.

Preliminary data shows no link to silicone gel-filled breast implants and breast cancer, reproductive problems or connective tissue disease, such as rheumatoid arthritis. But the FDA said futher studies need to be done to completely rule out these complications.

The report includes data from studies conducted by breast implant manufacturers Allergan and Mentor.

The FDA approved silicone gel-filled breast implants in November 2006 for breast augmentation in women over age 22 and for breast reconstruction in all women.

As a condition of approval, the FDA required each of the two companies to conduct six studies to look at the safety of the implants.

Posted by Andrea Walker at 11:09 AM | Permalink | Comments (4)
Categories: Women's health
        

Seems like everyone these days suddenly has the long, luscious locks of Rapunzel.

Weaves have allowed many of us to have the hair that nature didn't give us.

But these weaves are now causing health issues for many African American women.

A recent study found that braids, weaves and other types of hair extensions may be contributing to scarring of the scalp and hair loss in African American women.

Researchers at the Cleveland Clinic in Ohio issued questionaires to 326 African American women about hair loss. Hair loss in the center of the scamp and clinical signs of scarring were seen in 59 percent of the women who responded.

Type 2 diabeties was also higher in the women with hair loss, suggesting that metabolic irregularities may contribute. Bacterial scalp infections and braids and weaves also seemed to contribute.

So, ladies, although you may want hair down your back, think of the consequences that may come with getting it. Maybe lay off the weaves and be glad about what you have naturally.

Or you may end up bald-headed later.

(Caption, Lil Kim sports her long, yet fake, locks)

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (3)
Categories: Women's health
        

The rate of abortion, in decline for nearly three decades, stalled in 2008, according to the Guttmacher Institute, a research organization that tracks abortion trends.

The rate was 19.6 abortions per 1,000 women in 2008. That’s down from 29.3 abortions per 1,000 women in 1981.

“In this time of heightened politicization around abortion, our stalled progress should be an urgent message to policymakers that we need to do more to increase access to contraceptive services to prevent unintended pregnancy, while ensuring access to abortion services for the many women who still need them,” said Sharon Camp, president and chief executive of Guttmacher, in a statement.

More women were also choosing a two-drug combination for a “medication abortion,” verses a surgical one, the group found. The number of such procedures was 199,000 in 2008, up from 161,000 in 2005. And as a percentage of nonhospital abortions, the early medication procedures rose to 17 percent from 14 percent.

Nearly 60 percent of abortion providers offer the drugs.

The group also found that the number of abortion providers was about the same in 2008, rising to 1,793 from 1,787. About 87 percent of U.S. counties – where about 35 percent of women in their reproductive years live -- had no one providing abortions.

Those nonhospital abortion providers reported an increase in “harassment,” which is defined by the group as picketing and blocking patient access.

The data was collected in the group’s 15th “census” or abortion providers. It’s published online in the Perspectives on Sexual and Reproductive Health.

Continue reading "Number of abortions is flat, according to study" »

Posted by Meredith Cohn at 3:34 PM | Permalink | Comments (0)
Categories: Women's health
        

Giving iron and folic acid supplements to pregnant women in developing countries -- where iron deficiency is common -- increases their babies’ smarts, according to researchers from the Johns Hopkins Bloomberg School of Public Health.

The researchers looked at the intellectual and motor functioning of Nepalese children whose mothers got the micronutrients while they were pregnant. They found memory and fine motor functions were stronger.

The results were published in the December 22/29 issue of the Journal of the American Medical Association.

“Iron is essential for the development of the central nervous system,” said Parul Christian, lead author of the study and an associate professor with the Bloomberg School’s Department of International Health, in a statement. “Early iron deficiency can alter neuroanatomy, biochemistry, and metabolism, leading to changes in neurophysiologic processes that support cognitive and sensorimotor development.”

The researchers said that the scientific study showed that in very low-income settings, intervention during pregnancy can make a difference for their kids and international guidelines should be expanded to reflect this.

Perhaps this research isn’t startling given that American women are told to take their prenatal supplements. Why not hand them out to women in Nepal?

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Women's health
        

Greater Baltimore Medical Center has received $1 million from an anonymous donor to support a program that serves victims of sexual assault.

It is the largest gift ever for the GBMC Sexual Assault Forensic Examination program. There are 21 of the programs across the state.

Under the program, forensic nurse examiners complete a full assessment of victims of sexual assault age 13 and over. They collect forensic evidence and provide antibiotic therapy and emergency contraception. They also provide resources for crisis counseling.

Young women between the ages of 13 and 24 account for more than 60 percent of victims that use the program. 

The grant will be used to train nurses among other things.

Posted by Andrea Walker at 12:45 PM | Permalink | Comments (1)
Categories: Women's health
        

Who said women were the weaker sex? Johns Hopkins research out this week shows that when women are severely injured, they are more likely to survive than similarly injured men.

Specifically, women are 14 percent more likely to survive – maybe because of the negative impact of male sex hormones on a traumatized immune system.

The study, published in the September issue of the Journal of Trauma, looked at data on 48,000 women and men from the National Trauma Data Bank between 2001 and 2005.

Both men and women have estrogens and androgens, which are males sex hormones such as testosterone. But they have different amounts that change over time. The study could lead to new treatments for men, such as giving them drugs to block androgens when they are injured.

“Female sex hormones appear to give women better resiliency to extreme injury, while male sex hormones seem to worsen their survival after severe trauma” said Dr. Adil H. Haider, an assistant professor of surgery at the Johns Hopkins University School of Medicine and the study’s leader, in a statement. “And if we can come up with ways to manipulate those hormones in men, for example by temporarily blocking sex hormones, we may be able to improve their survival.”

During the study, the researchers discovered that there was little difference in survival among those 12 and younger and seniors – groups with undeveloped or diminished sex hormones. It was in the middle group with the highest levels of hormones where women showed higher survival rates.

The researchers said the link between hormones and an immune-enhancing effect has long been suspected. Those hormones, however, may also cause more auto-immune disorders such as lupus.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Women's health
        

Almost three quarters of people surveyed for Planned Parenthood Action Fund said that FDA-approved prescription contraception should be fully covered by insurance and not cost the user anything.

The pro-abortion rights group wants birth control pills and other contraception covered as a preventive health care service – those that are covered under the health care reform law such as mammograms.

The U.S. Department of Health and Human Services can decide what extra preventive care to cover under the Women’s Health Amendment to the health care law. A decision on benefits is expected next August.

The group’s survey – of 1,147 American voters completed in July -- also found that a third of women have struggled to pay for birth control at some point in their lives.
 
 “At Planned Parenthood, we see too many women choosing between birth control and basics like rent, tuition and childcare. Because our country leads the industrialized world in unintended and teen pregnancy, prescription birth control must be made available at no cost,” said Cecile Richards, president of the Planned Parenthood Federation of America, in a statement. “Making birth control available at no cost makes it possible for women to use the method that works best for them and will reduce the number of unintended pregnancies in America.”

Co-pays, the group says, for birth control pills range from $15 to $50 a month and co-pays and other expenses for other contraception cost more upfront.

The group says that the survey showed support from men (60 percent), Republican women (72 percent) and Catholic women (77 percent).

Do you support free contraception? 

Feature photo service

Posted by Meredith Cohn at 11:49 AM | Permalink | Comments (5)
Categories: Women's health
        

For all you ladies looking for the fountain of youth, it may lie in the amount of sleep you get.

Getting just the right amount of sleep will help you live longer, according to a recent study.

Less than five hours a night is probably not enough. Eight hours is probably too much, according to the study by the University of California San Diego School of Medicine.

The scientists from the medical school looked at data gathered by a previous study looking at data from 1995 and 1999.

They looked for the 459 women to see if they were still alive and kicking. Of the 444 who were located, 86 had died.

The researchers found that those women who slept 6.5 to 7.5 hours per night had the best survival rate. The findings were published online in the journal of Sleep Medicine.

(Baltimore Sun file photo)

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (1)
Categories: Women's health
        

Johns Hopkins scientists have found two genes whose mutations appear to be linked to one of the deadliest forms of ovarian cancer.

The research was published online in the Sept. 8, issue of Science Express.

The researchers, from the Johns Hopkins Kimmel Cancer Center, found an average of 20 mutated genes in each ovarian clear cell cancer studied. Clear cell cancer is generally resistant to standard therapy.

Two of the genes were more commonly mutated. ARID1A is a gene that suppresses tumors and was found in 57 percent of the tumors studied. PPP2R1A helps turn normal cells into tumor cells and was found in 7.1 percent of the tumors studied.

The scientists looked at 18,000 genes for the study in ovarian clear cell tumors from eight patients. The patients came from Johns Hopkins and institutions in Taiwan and Japan.  Researchers found 268 mutations in 253 genes from the eight tumors. There were an average of 20 mutations per tumor.

Ovarian clear cell cancer accounts for about 10 percent of cancers that start in the cells on the surface of the ovaries. It mainly affects women ages 40 to 80 and is resistant to chemotherapy.

Posted by Andrea Walker at 5:35 PM | Permalink | Comments (0)
Categories: Women's health
        

Johns Hopkins researchers have uncovered what they think contributes to a high risk of infertility in obese women.

The researchers found that the pituitary gland actively responds to chronically high insulin levels, triggering hormonal changes that disrupt ovarian function and hurt fertility.

The research was conducted on mice and published online in the journal Cell Metabolism.

The findings challenge the widely held belief that infertility is a result of insulin resistance, or a body's insensitivity to very high insulin levels. Instead, the Hopkins researchers said the problem is heightened sensitivity to insulin's effects on the pituitary gland.

Scientists have traditionally focused on treating infertility by lowering insulin levels. The new models provide evidence that the better treatment is decreasing the pituitary's sensitivity to insulin.

Posted by Andrea Walker at 12:00 PM | Permalink | Comments (0)
Categories: Women's health
        

Women who are stressed have more pronounced PMS symptoms, according to NIH research.

Women who felt stressed two weeks before the beginning of menstruation were two to four times more likely to report moderate to severe PMS symptoms than women who did not feel stressed, according to the study by NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development. Researchers from the University of Massachusetts-Amherst and the State University of New York Buffalo also participated in the study, which was published online in the Journal of Women's Health.

PMS is a group of physical and psychological symptoms that occur around the time of ovulation. They include anger, anxiety, mood swings, depression, fatigue, decreased concentration, breast swelling and tenderness, general aches and abdominal bloating.

The researchers issued questionaires to 259 women ages 18 to 44. The women didn't have any long-term health conditions and were not using birth control pills or taking other hormones.

Each women was provided with an at-home fertility monitor to follow different phases of their menstrual cycle. They were then asked questions about their stress levels during their four-week cycle.

Women whose responses indicated they were stressed were more likely to report more severe levels of psychological symptoms, such as depression, anxiety or crying spells. Physical symptoms such as body aches, abdominal bloating, lower back pain and cravings for salty or sweets foods were also greater.

Women reporting high stress levels were two to four times more likely to have moderate or severe PMS symptoms, the study found.

The study followed women over several menstrual cycles and found PMS was worse during those cycles when they were stressed.

There are medications that can be used to treat PMS, but the researchers said further studies should look at how stress reduction techniques might help PMS.

So try some yoga or meditation next time you're feeling stressed before your cycle.

Posted by Andrea Walker at 7:00 AM | Permalink | Comments (2)
Categories: Women's health
        

For people self-conscious about varicose veins, summer can be torture. They affect one out of two people above age 50, according to the National Institutes of Health.

Later this week, I'll be talking to Robert Weiss, a dermatologic surgeon at the Maryland Laser, Skin and Vein Institute, about varicose veins and the latest treatments for our Ask the Expert feature. If you have any questions, leave them in the comments here, and I'll work them into the interview.

Posted by Kim Walker at 7:00 AM | Permalink | Comments (1)
Categories: Women's health
        

Do love ballands put you in the mood?

Some French researchers believe they do. They say picking the right soundtrack could improve the odds women will hand out their phone number to an "average" looking guy.

The study appears in the journal Psychology of Music, published by SAGE.

The researchers point to studies showing that violent video games or music with aggressive lyrics may increase the agressive behaviour. So they set out to see about the impact of love songs. (They had already studied the effect on males in a flower shop. The romantic music made them spend more.)

Researchers Nicolas Guéguen and Céline Jacob from the Université de Bretagne-Sud along with Lubomir Lamy from Université de Paris-Sud tested out romantic lyrics on 18-20 year old single females.

They first found agreed upon romantic French songs.  They had a group of women rate a group of men, and picked out the most average one. Then they had 87 females spend time in a waiting room with the music playing. They went to a second room and were told to discuss food products.

Then they were told to wait. At that point, the average male chatted them up. Then he asked for their phone number.

The love song in the waiting room almost doubled Average Guy's chances: 52 percent of the women said yes. Only 28 percent said yes if they heard a non-romantic song instead.  

The researcher say more studies are needed, but they concluded that prosocial media prosocial media may foster prosocial outcomes. And if you're a hopeful single, a little lovely music wouldn't hurt.

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (1)
Categories: Women's health
        

The Food and Drug Administration said this week that a pill that is to be the female equivalent of the male sex enhancement drug Viagra isn't working so great for women.

The drug, flibanserin, only improved sex drive slightly in premenopausal women, the FDA said. It called results of the drug "not compelling."

An FDA committee will vote on the effectiveness and safety of the drug Friday. The drug is being produced by German drug company Boehringer Ingelheim.

So, all you women out there, would you buy a female drug to help your sex drive?

Posted by Andrea Walker at 11:04 AM | Permalink | Comments (4)
Categories: Women's health
        

Mothers these days are older and better educated than they were a decade ago, according to a new report from the Pew Research Center.

The study analyzes the shifting demographics of motherhood between 1990 and 2008 with the help of some Census figures. Consider that in 1990, 13 percent of all births were to teen mothers, while 9 percent were to women 35 and older. In 2008, it was the reverse: 10 percent of births were to teens, while the share of births to women  35 and older was 14 percent.

In 2006, a little more than half of all moms of newborns (54 percent) had at least some college education, up from 41 percent in 1990. Of older moms of newborns, 71 percent had at least some college education.

Couples are waiting to have children after they've achieved certain goals such as completing an advanced degree, starting a career and marrying later -- and in many cases not at all -- the authors said. Meanwhile, breakthroughs in fertility treatments mean women can have children later in life.

Continue reading "Today's moms older and better educated" »

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Women's health
        

Tanning is getting it from all sides these days.

Howard County has banned minors from tanning beds. Baltimore County considered it and the state recently began requiring parental consent for those under 18. As part of federal heatlh care reform, the government plans to begin taxing tanning beds in July.  

But tanning devotees told me they are not put off. Read my full story in The Sun.

"There are worse things you can do, like smoke or drink or do drugs," said 20-year-old Melissa Halecki, who has been coming to the Sunset Tanning Salon in Pasadena five days a week for a couple of months. "This is therapeutic for me. On that 80-degree day a couple of weeks ago, everyone was out with their shorts and their white legs, but mine were tan, and it felt good."

Women of all ages said it felt good to be in the tanning beds and it felt good after. They tan in place of shopping, getting massages or vacationing. And they said they knew the risks.

Experts say not everyone who tans will get skin cancer, you're just increasing your odds -- by a lot if you're young and tan over a life-time. And by even more if you burn.

Michele Lanasa, owner of Sunset, said the business has already suffered from the economy and the weather. People dont come in when it's way too cold or way to sunny.

But she and her regular customers said adults should be able to make their own choices. And she's careful about carding kids and warning the adults, too. In fact, she's even a fan of the sunless tanning lotions.

For now, adults face no restrictions, only warnings and those taxes. The war of words seems to stem from a World Health Organization agency that recently upped tanning beds to the highest category for carcinogens. And another study published in the Archives of Dermatology recently has also gotten a lot of attention. It likened the repeated use of tanning beds to an addiction.

Salon industry people say there are benefits such as new machines that don't burn. They also say that the base tan protects people from burning. But experts say all the beds damage skin and there's really no such thing as a base tan that protects you from skin cancer.

What do you think? Dangerous? Not more than smoking or drinking?

Baltimore Sun photo of Michele Lanasa at Sunset Tanning Salon in Pasadena/Amy Davis

Posted by Meredith Cohn at 7:00 AM | Permalink | Comments (0)
Categories: Women's health
        

Nearly a third of all births in the United States are by C-section -- an all time high. The rates have increased steadily over the years, sparking debate and concern for some time with critics saying that too many mothers and their babies are exposed to major surgery.

Now, a group that advocates for preventing unnecessary cesareans aims to shed light on what they call the emotional and physical consequences of the procedure with a new art exhibit in Baltimore.

While C-sections can be life-saving, some are unnecessary and the effects can linger for a woman, the group says.

“Women are essentially hushed by their friends, families and physicians when they try to convey that their cesarean left them in pain, with complications, or with emotional consequences  ranging from lingering disappointment to full blown post-traumatic stress,” said Barbara Stratton, co-leader for the ICAN of Baltimore chapter in Maryland.  “We wanted to give women an outlet to share and validate their experiences."

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Women's health
        

Tennis legend Martina Navratilova has been diagnosed with a non-invasive breast cancer called ductal carcinoma in situ. Known as DCIS, the condition affects the milk ducts and has about a 98 percent survival rate.

The malignancy can be detected by mammograms and accounts for 20 to 25 percent of all breast cancers diagnoses. But how and if to treat it remains controversial, particularly in light of renewed debate over the merits of breast cancer screening for women in their 40s.

Researchers with the U.S. Preventive Services Task Force say it's unknown if DCIS progresses to an invasive cancer and argue that treatment of it may represent overdiagnosis and overtreatment.

A recent study in the Journal of the National Cancer Institute recently called for more research on how to deal with DCIS, the LA Times explains.

AP photo

Posted by Kelly Brewington at 2:54 PM | Permalink | Comments (2)
Categories: Cancer, Women's health
        

A new national health initiative aims to keep expectant moms on track for a healthy pregnancy through nuggets of advice via text message.

As Meredith Cohn reported in The Sun yesterday, text4baby aims to cut down on the high number of premature births both across the country and in Maryland, with free messages about all things pregnancy, from tips on good nutrition to how to find a health care provider. The program, sponsored by the National Healthy Mothers, Healthy Babies Coalition, has already rolled out in Maryland with more than 18,000 women signed up so far.

Lack of prenatal care is one of the leading causes for bad birth outcomes. Both Baltimore and Maryland have rates of premature births above the national average. Much of this can be prevented, advocates say, by better informing moms-to-be.

Texting is getting huge in medical circles, with doctors offices using messages as reminders for appointments and taking medication. Not adhering to medical advice is one of the biggest causes of poor outcomes in many chronic health problems, this NY Times article explains.

Up until recently, I thought texting was just for "the kids" -- teenagers with lightening-fast thumb reflexes who seem far better at electronic multitasking than I. But these days, my coordination is improving and I text a lot more than I used to. With some 90 percent of people in the U.S. with cell phones, sending 1.5 trillion texts a year, it makes sense that the medical community would tap into this quick, easy tool to keep patients informed.

Does your doctor text? Would you use text messaging for health purposes?

Baltimore Sun photo

Posted by Kelly Brewington at 7:00 AM | Permalink | Comments (0)
Categories: Women's health
        

Once a C-section, always a C-section. That was the standard medical routine for years. But vaginal birth after Cesarean is not only safe, it should be encouraged for more women, an NIH-convened panel of experts said yesterday.

We reported on the issue today in The Sun, including the voice of a Towson mother who just gave birth to her eight child, the seventh vaginal birth after a C-section with her firstborn 13 years ago.

The decision to try a vaginal birth after Cesarean, or VBAC, is individual and should be made only after discussion between doctor and patient, the panel said. Among the most dangerous risk is uterine rupture, which can be deadly.

That risk, however, is small -- less than 1 percent -- and 74 percent of VBACs are successful, according to the panel's report, the culmination of a three-day conference on the contentious issue. 

Nevertheless, VBAC has dwindled in recent years, the C-section rate has surged to an all-time high, and an emotional, medical and legal debate over VBAC has raged on.

About one in three babies in the U.S. are born by C-section while VBACs dropped from a high of 28 percent in 1996 to just 10 percent today. 

The panel expressed concern about women being denied an opportunity at a vaginal birth because doctors won't allow it and hospitals outright ban the practice. 

I caught up with Barbara Stratton, head of the Baltimore chapter of International Cesarean Awareness Network, and chairwoman of the group's nationwide effort to reverse hospital bans. She also attended the NIH conference. In Maryland, most hospitals allow VBAC. But women on the Eastern Shore and western part of the state encounter a handful of hospital bans and providers who will not allow the practice, she said. The group worked to reverse a ban in Frederick a few years ago, Stratton said.

Continue reading "Panel urges better access to vaginal births after C-section" »

Posted by Kelly Brewington at 11:00 AM | Permalink | Comments (0)
Categories: Women's health
        

Join us today for a chat with Dr. Jean Warner, director of the Tyanna O'Brien Center for Women's Imaging at Mercy Medical Center, about mammograms. You can submit your questions now using the widget below; Dr. Warner will start answering questions live at noon.

Please note when posting your questions that our guest expert's responses represent general information ONLY and do NOT represent a diagnosis; those seeking personal/individual medical advice are recommended to consult with their physician or medical specialist.

Posted by Carla Correa at 9:02 AM | Permalink | Comments (2)
Categories: Women's health