women's health mythsWhat are some myths about women’s health?

While many people view heart disease as a primarily male condition, heart disease is actually the leading killer of both men and women. Ovarian cancer – not breast cancer – is the most deadly female reproductive cancer. Despite historical thought, menopause is a natural stage of life, not a disease-state.

Several common health misconceptions dramatically affect women’s attitudes toward disease. For example, many people view heart disease primarily as a male disorder. But heart disease is the number one killer in the United States of both men and women. This means that more women die from heart disease than from any other disorder.

Because breast cancer receives a lot of publicity, women may assume that it is the most deadly of the female cancers. But ovarian cancer kills more women than other reproductive or female cancers, mainly because it is rarely diagnosed early enough. Once noticed, ovarian cancer has often already spread beyond easily treatable measures.

Finally, some medical doctors view menopause as a disease. And until recently, most people avoided discussing menopause as though it was somehow “wrong” or embarrassing. But now we know that menopause is a natural life process, marking the end of menstruation and the reproductive years.

What role do hormones play?

Hormonal changes guide all reproductive processes from adolescence to menopause, including menstruation, ovulation, pregnancy, childbirth, and breastfeeding. In addition to these reproductive actions, hormones also affect mood, libido, alertness, and bone density.

During adolescence, female reproductive hormones stimulate breast growth, feminine fat distribution, broadening of the hips, uterus enlargement, development of the external genitalia, hair distribution, and skin softness. After adolescence, hormones drive the reproductive processes of ovulation, menstruation, and pregnancy.

Girls typically begin to menstruate between ages 11 and 14. With its falling and rising hormone levels, this menstrual cycle dictates the days in which a woman may become pregnant. Menstrual bleeding occurs at the beginning of each cycle to remove the old endometrial layer from the uterus.

If the egg becomes fertilized during ovulation, hormones secreted by the placenta prevent menstruation, and pregnancy results. As the baby grows, estrogen and progesterone levels continue to rise, until they reach a peak at birth. Further interaction between hormones leads to contractions of the uterus, which results in childbirth. After the baby is born, other hormones make nursing possible.

Women continue the menstrual cycle until about 51 years of age, when they experience menopause, or ovarian failure. As reproductive hormone levels drop off, women experience drastic bodily changes, like vaginal dryness, decrease in libido, and loss of bone density.

But their effects are not only physical – hormones also influence mood, libido, appearance, self-image, and comfort. For example, during ovulation, many women experience heightened sexual desire. And almost all women are familiar with the mood swings and insecurity that accompany premenstrual syndrome.

Which hormones affect female reproduction?

The ovaries secrete estrogen and progesterone, which promote sexual development during adolescence, prepare the uterus for pregnancy, and maintain the uterus during pregnancy. The pituitary gland secretes follicle stimulating hormone and luteinizing hormone, which stimulate ovulation. It also secretes oxytocin, which causes contractions of the uterus and milk ducts during labor, and prolactin, which stimulates the production of breast milk. The hypothalamus secretes hormones that regulate the pituitary gland.

Three main structures control hormone production – the ovaries, the pituitary gland, and the hypothalamus. Functions of these structures are highly integrated. For example, the hypothalamus sends signals to the pituitary gland, which then releases a particular hormone. This hormone may induce ovarian activities such as preparation for ovulation or ovulation itself. The ovary then has both structural and chemical functions, as it prepares for egg release and also secretes hormones. In this manner the ovary acts as both an organ and a gland.

Located in the central part of the brain, the pituitary gland has an anterior lobe and a posterior lobe. Each lobe secretes different hormones.

The ovaries secrete two hormones involved in female development and reproduction. Estrogen, the best known of these hormones, initiates the development of female secondary sexual characteristics during adolescence. Estrogen also initiates uterus preparation for pregnancy, and leads to stimulation of egg release during the middle of the menstrual cycle.

Progesterone maintains female secondary sexual characteristics, and also helps to prepare the uterus for pregnancy.

The anterior lobe of the pituitary gland releases several hormones – follicle stimulating hormone, or FSH, luteinizing hormone, or LH, and prolactin. LH and FSH play important roles in the development and release of an egg from the ovaries. These anterior pituitary hormones also stimulate the release of estrogen and progesterone from the ovaries. Prolactin stimulates the production of milk in the mammary glands of the breasts after childbirth.

The posterior lobe of the pituitary gland releases oxytocin, which stimulates contraction of the uterus during labor and initiates the milk-ejection reflex that enables breast feeding.

The hypothalamus regulates the release of reproductive hormones from the pituitary gland. Gonadatrophin-releasing hormone stimulates the pituitary gland to release FSH and LH, while prolactin-inhibiting hormone prevents secretion of prolactin (thereby stopping milk production).

What are the most common contraceptive methods?

About 10.7 million women choose female sterilization for birth control, making it the most popular contraceptive method. Oral contraception is the second most common, followed by the male condom.

Modern contraceptive methods provide women with almost unlimited life options. Surveys show that 64% of reproductive-aged women use some form of contraception. About 10.7 million women choose female sterilization, in which the fallopian tubes are cut and tied, preventing the migration of an egg to the uterus.

Oral contraception is the second most common method of birth control, with about 10.4 million women using “the pill” each year. Studies have shown that oral contraception significantly contributes to low levels of vitamins and minerals. Women who use birth control pills may therefore need to supplement with a multivitamin.

Other common methods of contraception include the male condom, with 7.9 million users, and male sterilization, with 4.2 million users.

What should women do to stay healthy?

Healthy women take an active role in health, by having regular physical and gynecological exams, being aware of disease symptoms, exercising, and eating well.

Women with healthy breasts, ovaries, and uterus have women’s health exams at least every year, which include a pelvic exam, pap smear, and breast exam. These women also practice safe sex, using protection and common sense before engaging in sexual intercourse.

Most importantly, healthy women take an active role in health, by being aware of common symptoms, paying attention to pain, exercising, and eating well. Healthy women always strive to know more about their bodies and the risk for disease.

Does nutrition affect hormone health?

Improper nutrition may amplify symptoms of certain hormone-related disorders, like PMS and menopausal complaints. Some medications, like oral contraception, may lead to an increased need for certain nutrients. Women also need to consume large amounts of certain nutrients throughout life to avoid health risks associated with age and estrogen-loss, like osteoporosis.

Despite increasing rates of obesity, many Americans are malnourished, in that they eat foods rich in calories but poor in nutrition.

Because hormones influence women’s lives to such a high degree, improper nutrition could amplify hormone imbalance symptoms, as seen in PMS and some menopausal problems.

Oral contraception and hormone replacement therapies, among other medications, increase the risk for nutrient depletions and deficiencies. Women also require large amounts of certain vitamins and minerals throughout life. For example, women who fail to consume enough calcium throughout life may face an increased risk for osteoporosis. Low levels of folic acid before and immediately following conception have been shown to cause neural tube defects in developing babies.

Both men and women require various nutrients for a healthy life. But some nutrients may be especially beneficial for women, including calcium, iron, B-complex vitamins, zinc, vitamin A, vitamin E, soy, and acidophilus.

What should I know before supplementing?

Nutrients may lead to dangerous interactions if taken with certain medications. Women should therefore consult with a pharmacist before self-supplementing.

Numerous studies have shown that it’s better to obtain nutrients from food sources rather than from synthetic supplements. When possible, patients should therefore opt for the natural source of a nutrient. But when supplementation becomes necessary, attention to several guidelines may help to prevent dangerous interactions.

Supplementing with a nutrient is no different from taking a drug, in that both nutrients and drugs have the potential for harm if used incorrectly.

Before supplementing, women should consult with a pharmacist about existing health conditions, medications, and other supplements to determine if interactions or contraindications may be present. All parties involved in the health care process should be aware of nutrient properties, especially the mode of action, ideal dosage, contraindications, and interactions.

What should women know about herbal therapies?

Women should be aware of herbal cautions and interactions, and seek pharmaceutical advice before taking an herbal preparation.

Herbal therapies have become increasingly popular in the past few decades – some sources indicate that more than 80% of the world population use herbs for health care. Before the advent of modern pharmaceuticals, women frequently used herbs as medicine for themselves and their families.

While pharmaceutical medications currently dominate the market, many people are beginning to understand that herbs also provide valid therapeutic benefits. In fact, many of today’s synthetic medications were derived from plant components.

Just like any chemical, herbs have the potential to cause bodily harm if used incorrectly. Patients should therefore be aware of herbal cautions and interactions before using an herb for medicinal purposes.

Women have used certain herbs for centuries to alleviate menstrual and menopausal ailments. Some of these herbal remedies have never been proven, while others appear in numerous scientific studies, which validate their use. Some herbs useful for women’s health include black cohosh, chasteberry (Agnus Castus), cranberry, evening primrose oil, and St. John’s Wort

What are phytoestrogens?

Phytoestrogens are herbs that mimic estrogen, including black cohosh, ginseng, and saw palmetto. Such herbs should be used with caution, as clinical studies have not yet determined the long-term effects of estrogenic herbs on health.

Phytoestrogens are a class of herbs that mimic the structure and function of estrogen. We’ve already learned that black cohosh mimics estrogen to reduce symptoms of menopause. Other phytoestrogens may function in the same way, thereby reducing hot flashes and mood swings associated with low levels of estrogen.

Estrogenic herbs include alfalfa, aniseed, black cohosh, ginseng, licorice root, pleurisy root, red clover, and saw palmetto.

The term “phytoestrogen” has become an increasingly popular buzzword as the Baby Boom generation grows closer to menopause. Some sources claim that phytoestrogens prevent the symptoms of perimenopause without harmful side effects. Other sources declare that phytoestrogens might also prevent certain kinds of cancer.

But clinical studies have not been sufficient to form the basis for such claims. In fact, phytoestrogens may actually increase the risk for some cancers. Women should therefore use caution, and consult with a pharmacist before supplementing with a phytoestrogen.

Who should not use herbal medicine?

Pregnant women should never use herbs unless specifically advised and monitored by a physician.

Pregnant women should never supplement with an herbal preparation unless under close medical supervision. Some herbs may directly induce miscarriage by causing the uterus to contract, including fenugreek, pleurisy root, and vervain, among others. Other herbs may harm the baby, causing genetic mutations or abnormalities in development.

Science has not yet discovered the effects of most herbs on pregnancy or long-term infant health. Women should therefore avoid all forms of herbal supplementation during pregnancy unless directly recommended and supervised by a physician.

[Applied Health Publications are registered in the United States Library of Congress, ISSN: 1525-6359]