Transcript Slide 1

The Wisdom
of
Women’s Health
Presented by:
Earlexia Norwood, MD
Date: May 19, 2011
Program Objectives:
• Understand the key health issues facing women today
• Understand why prevention is key to maintaining good
health and minimizing the risk of disease.
• Become knowledgeable of recommended screenings and
tests
• Learn how to communicate effectively with your doctor
• To understand the mind, body and soul connection as it
relates to health
Key Health Issues Facing Women
• Heart Disease
• Breast Cancer
• Osteoporosis
• Depression
Heart Disease
• Fact
Heart disease is the leading cause of death in
American women. The latest data show that
1 in every 3 women die of cardiovascular
disease. It is estimated that nearly 35% of the
women in the United States presently have
cardiovascular disease
• Fact
Men and women both may experience chest
pain as the most common warning sign for
heart attacks. Women, however, may also
report other symptoms, such as indigestion,
heavy arms, or fatigue on exertion.
Heart Disease
• Fact:
Some tests such as the standard treadmill
exercise test are less reliable for diagnosing
heart disease in women
Diagnosing Coronary Heart Disease
(CHD) in Women
• Electrocardiogram
• Exercise treadmill test
• Stress echocardiogram
• Stress thallium
Atherosclerosis
Normal vessel
Atherosclerotic vessel
Breast Cancer
• Breast cancer is the most common cancer in women
• The earlier breast cancer is found, the better the
chance of survival
• Survival rates for localized
breast cancer exceed 95%
Primary Breast Cancer Risks
•
•
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•
•
•
Early menarche (before age 12)
Late menopause (after age 55)
Family or personal history
Bearing children after 30, or not at all
Age (women over 50)
Consumption of high fat foods and excessive
alcohol
• Overweight
• Use of postmenopausal hormone therapy
Breast Cancer: Reducing Risk and
Early Detection
• Women age 35-40: need a baseline
• Women age 40-69: Have a mammogram
every 1-2 years, and a clinical breast exam
every year.
• Women at increased risk may need to be
examined earlier or more often. Be sure to
consult your doctor!
Osteoporosis
• It affects more than 1 out of 24 Americans
• Another 1 out of 13 Americans has enough
bone loss to be at risk
• Women are 4 times more likely to develop it
than men
• One out of 2 women versus 1 in 8 men over 50
will break a bone in their lifetime because of it
• Risk increases as we get older
Osteoporosis Risk Factors
• Menopause
• Absence of periods before menopause
• Certain medications (steroids, thyroid
hormone, antacids and others)
• Genetics
• Poor diet – low calcium intake
• History of multiple fractures
• Increased parathyroid hormone
• Excessive alcohol use
• Physical inactivity
• Smoking
Osteoporosis:
What Does It Look Like?
Normal Bone
Osteoporotic Bone
Consequences of Osteoporosis
• More than 1.5 million broken bones each year result, in
part, from osteoporosis.
– 300,000 hip fractures
– 700,000 spine fractures
– 250,000 wrist fractures
– 300,000 fractures in other
parts of the body
Common Fracture Sites
Screening for Osteoporosis
• DEXA – The T score compares your bone density
with that of the average healthy young adult woman
Osteoporosis Prevention
• Get enough calcium (1000 -1200mg) and vitamin D (800
– 1000IU)
• Limit protein and salt – may decrease calcium
absorption.
• Avoid smoking – smokers have less bone density
Limit alcohol – may reduce the intestinal absorption of
calcium and interfere with vitamin D conversion
• Exercise regularly
– Weight bearing – bone is living tissue and responds to
exercise by becoming stronger
– Resistance
Major Depression
• Depression is more
common than diabetes
and occurs more often in
women than men
• Biological, psychosocial,
and cultural factors
contribute to depression
risk
Symptoms of Major Depression
• Difficulty concentrating, remembering details, and making
decisions
• Fatigue and decreased energy
• Feelings of guilt, worthlessness, and/or helplessness,
hopelessness
• Irritability, restlessness
• Overeating or appetite loss
• Loss of interest in activities or hobbies , including sex
• Persistent sad, anxious, or “empty” feelings
• Insomnia, early-morning wakefulness or excessive sleeping
Major Depression
• Never be afraid to discuss
depressive symptoms
with your doctor
• Treatment consists of
medications and/or talk
therapy
• Allow time for therapies to
work
So How Do We Measure Health?
With Numbers!
What Should The Numbers Be?
• Blood Pressure –
Less than 120/80 mmHG
• Blood Sugar – Fasting
– Normal - lower than 100mg/dl
– Pre-diabetic - 100 -126mg/dl
– AIC - less than 7
• Waist Circumference
– Men – less than 40 inches,
– Women - less than 35 inches
• Body Mass Index –
- Based on height and weight
What Should The Numbers Be?
● Total Cholesterol – less than 200mg/dl
● Low-density lipoprotein (LDL) – less than
100mg/dl
● High-density lipoprotein (HDL)
● Women greater than 50mg/dl
● Men greater than 40mg/dl
● Triglycerides – less than 150mg/dl
How Do We Find the Numbers?
By partnering with
your health care
provider and
scheduling your
preventive
screenings
BMI Chart
Height in Inches
Weight in Pounds
120
140
160
180
200
5’1”
23
26
30
34
38
5’3”
21
25
28
32
35
5'5"
20
23
27
30
33
5'7"
18
22
25
28
31
5'9"
17
20
24
27
30
5'11"
17
20
22
25
28
Overweight
Obese
Screening Guidelines
18 - 40 yrs
Annual Health Risk Assessment
PAP/pelvic yearly until 3 normal results,
then every 3 years or as directed
Chlamydia screening for sexually active
25 yrs and younger and those over 26
yrs at high risk
Annual breast exam. Mammogram
beginning age 40 (every 1-2 yrs
Cholesterol and Lipid screening
every 5 years or as directed
40 – 50 yrs
50 – 65
yrs
65 and
over
Screening Guidelines
18 - 40 yrs
FOBT annually and/or sigmoidoscopy
every 5 yrs or colonoscopy every 10 yrs
or as directed
Blood pressure screening at least every
2 years or as directed
Diabetes screening. Fasting plasma
glucose (FPG) every 3 yrs at clinician’s
discretion
Human Papilloma Virus (HPV) all
females 26 yrs and younger
40 – 50
yrs
50 – 65
yrs
65 and
over
Screening Guidelines
18 - 40 yrs
Influenza vaccine annually if high risk
Pneumonia vaccine once at age 65; booster
may be needed after 5 years
Electrocardiogram (EKG) Baseline as
directed
Osteoporosis screening (Bone density test)
as directed
Vision exam – every 2 years
Height and weight annually
40 – 50 yrs
50 – 65
yrs
65 and
over
The Mind/Body Relationship
• Physical health and
mental health are
interdependent
• Stress and psychological
events that are potentially
negative worsen health
The Mind/Body Relationship
• Physical illness can
increase risk of
developing depression
and anxiety disorders
• Getting support has been
shown to improve health
The Benefits of Relationships
• Relationships are vital sources
of emotional support and good
health. It is important to have:
– Someone to talk to about things
at work or at home
– Someone who regularly helps
with responsibilities and tasks
– Someone who regularly helps
with the children
You and Your Doctor
• Good communication is the key to a successful
relationship!
• Go prepared to the office visit by making a list
of your concerns and be as specific as
possible.
You and Your Doctor
• Your doctor is your health care partner. It is
important to choose doctors who will give you
good care and who you can work well with.
How to Choose a Doctor
• Look for a doctor who accepts your insurance
and who is in your network (if you have an HMO
or PPO)
• Internists and family practice doctors are good
choices for a primary care doctor
• Ask relatives and friends for recommendations
In Summary: To Stay Healthy, Practice
Prevention
•
•
•
•
•
Eat healthy
Exercise regularly
Avoid tobacco use and limit alcohol
Manage stress
Get regular check-ups and recommended
health screenings
• Know your numbers and your family history
Thank-you!!!
Thank you for participating in today’s
workshop!
• HAP encourages you to take an active role in
managing your health.
• We offer iStriveSM for better health, a digital
health coaching program to HAP HMO and
Alliance members.
• The iStriveSM programs make it easy for you
to achieve better health.
HAP’s Vision: Enhancing the Health and
Well-Being of the Lives We Touch
Resources/References
•
Women and Cardiovascular Disease in Michigan Fact Sheet –
MDCH Feb.2009
•
What Your Cholesterol Levels Mean – www.americanheart.org
•
Heart Disease Health Center – Her Guide to a Heart Attack:
Recognizing Female Heart Attack Symptoms –
www.webmd.com
•
Depression Guide www.webmd.com/depression
•
National Institute of Mental Health www.nimh.nih.gov
•
Osteoporosis – National Osteoporosis Foundation www.nof.org