WOMEN'S HEALTH WATCH

Preconception Health Just as Important as Prenatal Health

For generations, women have been told to make sure thatthey see a doctor as soon as they find out they are pregnantto ensure the optimal health of their babies. Now potentialmothers are being encouraged to take better care of themselveseven before they conceive. Public health officials saythat, by the time a woman makes it to her first prenatal visit,she is usually 10 to 12 weeks pregnant—and "if a birth defectis going to happen, it's already happened" by then, accordingto Peter S. Bernstein, MD, MPH, FACOG, a maternal fetal medicinespecialist at Montefiore Medical Center in New York,who helped write new government guidelines on what isbeing called "preconception care."

The new guidelines, issued by the Centers for DiseaseControl and Prevention in the spring of 2006, include 10 specifichealth care recommendations and advise prepregnancycheckups that include screening for diabetes, HIV, and obesity;managing chronic medical conditions; reviewing medicationsthat may harm a developing baby; and making sure that themother's vaccinations are up to date. Daily doses of folic acidshould be taken 3 months prior to conception.

Stopping Menstruation Aids Cancer Survival

Women who undergo chemotherapy to treat breast cancersometimes experience amenorrhea, or cessation of theirmonthly periods. A new study from Austria shows that thishas added benefits for these women, as it has been shownto help them live longer and have fewer relapses. Theresearchers also found that women who still get their periodsdespite chemotherapy could benefit from treatmentthat lowers their natural levels of estrogen, which has beenshown to fuel cancer cells. The study results were presentedat the 29th Annual San Antonio Breast CancerSymposium in Texas in December 2006.

The study included 500 premenopausal women who weretaking chemotherapy drugs for breast cancer. About 50% ofthese women experienced amenorrhea due to taking themedicines, and all of them had hormone-receptor-positivetumors (which feed off of hormones), the most commontype of breast cancer. After 10 years since the start ofchemotherapy, women whose periods had stopped were40% less likely to suffer a recurrence than those whose periodsdid not stop. These women were also 10% more likely tosurvive the cancer, and almost all of them were under age40 when they started chemotherapy.

Iron Supplements May ReduceInfertility Risk

A new study suggests that taking iron supplements mightreduce the risk of infertility. Researchers from Harvard Schoolof Public Health and Medicine in Boston, Mass, examineddata on women enrolled in the Nurses' Health Study II. Thewomen were between ages 24 and 42. Over 8 years offollow-up from the study, researchers noted over 3500 casesof infertility among over 18,000 women who were attemptingto become pregnant. Of those women, 2165 were medicallyevaluated to try to determine the cause of their infertility,and 438 of those were found to suffer from an inability toproduce viable eggs.

After adjusting for such factors as age, smoking status, physicalactivity, and eating habits, it was shown that women in thestudy who used iron supplements regularly had an average40% less risk of ovulatory infertility than those who did nottake iron. It was also shown that the higher the dose of iron,the lower the risk of infertility; women who took the highestdoses of over 41 mg/day reduced their risk by 62%. The findingswere published in the November 2006 edition ofObstetrics & Gynecology.

Black Cohosh Doubtful for Menopause Treatment

Many women suffering from thesymptoms of menopause turn todietary supplements containing theherb black cohosh for relief. A recentstudy has found, however, that the herbhas no more effect on menopausesymptoms than placebo. Sales of thesupplement rose significantly after astudy sponsored by the National Institutesof Health (NIH) in 2002 reportedthat hormone therapy raised users' risk of heart attacks, breast cancer,blood clots, and stroke. Americanwomen turned to black cohosh indroves, spending 26% more on theherb in the year following the study'srelease.

Researchers from NIH studied blackcohosh, compared with placebo, in 351women, aged 45 to 55, who were dividedinto 5 treatment groups for 1 year:hormone therapy; black cohosh 160mg/day; a supplement consisting of 200mg of black cohosh and other botanicals;the multibotanical supplementplus counseling to consume more soyfoods; and placebo. The double-blindstudy required each woman to havealready experienced 2 hot flashes aday; the average was 6. After 3, 6, and12 months of treatment, the researchersfound no significant difference in theoccurrence of hot flashes between theblack cohosh groups and the placebogroup—only the hormone therapy wasmore effective.