Women's Health: Current Trends

Important women’s health issues were front and center at the recent annual meeting of the American College of Obstetricians and Gynecologists (ACOG), which convened in San Francisco, California, May 15-19, 2010. Researchers shared updates on topics that affect the lives of millions of women in the United States every day.

“The Pill” Turns 50

With the birth control pill celebrating 50 years in May 2010, the health care community is looking back at this much-studied medication, which gave women contraceptive options and also provided a host of benefits, including cancer prevention and relief from menstruation disorders.

“The pill has revolutionized women’s health care. Obviously, the contraceptive benefits are paramount, but I have become a huge advocate for all the noncontraceptive reproductive health benefits that the pill offers,” said Douglas H. Kirkpatrick, MD, immediate past president of ACOG. “Another advantage is that the pill has enjoyed incredible safety over its 50-year history.”

Millions of women have used the birth control pill over the decades, and it has remained the leading form of contraception in this country. The birth control pill reduces the risk of endometrial cancer—one of the most common forms of cancer in the United States—by up to 50%, and that protection may last up to 15 years after discontinuing it, according to ACOG. Women taking the pill also have a reduced risk of pelvic inflammatory disease, acne, benign breast disease, and ectopic pregnancy. It also prevents anemia, heavy uterine bleeding, and endometriosis pain.

Physicians believe that the birth control pill is here to stay. “In the near future, we’re likely to see variations in pill-taking regimens and different estrogens and progestins, but no radical changes are in sight,” said David A. Grimes, MD, of Family Health International in Durham, North Carolina. Another offspring of the birth control pill are the oral contraceptives for emergency contraception (EC) currently on the market, which pharmacists also see in their practices.

Focus on Female Depression

As the milestone of the birth control pill was celebrated, other important issues on the horizon for women’s health were the focus of papers at the ACOG’s 58th Annual Clinical Meeting. Clinical depression is common among reproductive-age women, and it is the leading cause of disability in women each year. Screening for depression during pregnancy and afterwards is seen as a priority by the college because it represents a serious health issue for the mother, but can also impact an infant’s cognitive, neurologic, and motor skill development, as well as negatively affect older children’s mental health and behavior.

Gerald F. Joseph, Jr, MD, president of ACOG, introduced postpartum depression as his 2009-2010 presidential initiative. “With over 4 million births in the US every year, we’re talking about a huge number of women with postpartum depression—between 200,000 to more than 1 million each year,” said Dr. Joseph. “And while we don’t have a firm recommendation for universal antepartum and postpartum depression screening, we realize the importance of screening our patients so that we can start gathering the data for future evidence-based guidelines.”

The Samuel A. Cosgrove Memorial Lecture entitled “Perinatal Depression: Screening, Diagnosis, and Treatment,” presented at ACOG’s meeting by Michael W. O’Hara, PhD, University of Iowa, focused on the tools and procedures that can be used to detect and diagnose perinatal depression. Pharmacists are involved in the medication management of this condition on an ongoing basis; this presentation stressed the importance of diagnosing and initiating treatment. Mary Jo Codey, the wife of the former governor of New Jersey and an advocate for more research for depression in women, spoke on “Recognizing Postpartum Depression—Speak Up When You Are Down” and underscored the pervasive nature of this uniquely female condition.

New Research in Women’s Health Issues

New research presented at ACOG’s 58th Annual Clinical Meeting highlighted a wide range of women’s health issues, delivering the latest unpublished research on such topics as experimental drugs, infertility, infectious diseases, gynecologic cancer, menopause, obstetrics procedures, urogynecology, caesarian delivery, and contraception. More than 250 research findings covered key areas for health care providers in women’s health, many of them groundbreaking new areas of study.

Women with cancer undergoing treatment who choose to become pregnant and seek to preserve their fertility, for example, now have a number of options available to them. A new medical discipline—called “oncofertility”—is looking at ways the reproductive outlook for women cancer patients can be improved.

The report by Teresa K. Woodruff, PhD, Northwestern University, outlined how a promising new technique for preserving ovarian tissue has the potential to safeguard the future fertility of younger cancer patients. Nearly 140,000 women younger than age 45 are diagnosed with cancer every year, and chemotherapy affects fertility by attacking follicles in the ovaries. Radiation treatment in the abdomen can also damage follicles, as well as the uterus. The new option involves outpatient surgery with ovarian tissue cryopreservation. Additional research is also underway that is working to perfect the use of preserved ovarian tissue in vitro follicle maturation. “Oncofertility: The Preservation of Fertility Options for Young People with Cancer” explored these new techniques that aim to preserve and extend the fertility of young patients.

The Edith Louise Potter Memorial Lecture entitled “Gestational Diabetes Mellitus: The Past, The Present, and The Future,” presented by Steven G. Gabbe, MD, chief executive officer, Ohio State University Medical Center, focused on another important health condition by discussing the current and proposed guidelines to detect gestational diabetes in pregnancy. Seven out of every 100 pregnant women develop gestational diabetes. Diabetes—which can develop later in life as well, especially in women who are obese, with a family history, or those who have hypertension—is a risk factor for coronary heart disease, the single leading cause of death for American women.

Pharmacists are in a unique position to counsel women patients during pregnancy and at other stages of their lives to help them control key risk factors, including diabetes, high cholesterol, and obesity. They can also suggest OTC products to reduce these risks, along with regular physician visits, prescription medications where indicated, and lifestyle changes that put women patients in the right direction for optimum health.

For more details and updates on current research in women’s health, visit www.acog.org.