February 2012

Analgesic Response Varies Across Menstrual Cycle

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A study published last year in the journal Pain found that the effectiveness of narcotic pain killers varied across the menstrual cycle and according to whether a woman was taking oral contraceptives.  Researchers investigated pain levels post IV administration of morphine, pentazocine or placebo in two groups of women, normally cycling (n=30) and taking oral contraceptives (n=35) during the follicular and luteal phases of the menstrual cycle.  Researchers measured responses to three types of pain: heat, ischemic, and pressure pain sensitivity, both before and after analgesic administration. Change scores were evaluated.

The two groups demonstrated opposite pain responses and differing levels of analgesia.  Normally cycling women experienced more heat related pain during the follicular versus the luteal phase, but less ischemic pain. While women using oral contraceptives experienced the exact opposite response: more heat pain during the luteal phase and less ischemic pain during the follicular phase.  What was really interesting was that post analgesic administration, normally cycling women experienced less pain during the follicular phase-or a greater analgesic response than women using oral contraceptives. Normally cycling women also experienced more opioid-associated side effects.

This research, though preliminary, demonstrates the need to consider a woman’s hormonal state, (cycle phase and oral contraceptive usage) when addressing pain-related conditions.

Are Women Equal Ender the Law?

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The Raucous Birth Control Debate

When I was in my 20s, I was adamantly non-feminist. I considered myself equal to any man. I had control of my reproductive health. I could vote, hold office, play sports and saw no point in fighting those old battles. Boy was that naïve. I still consider myself equal to any man. I realize now, however, that much of the world does not agree. And rather than progressing towards more equality, as a country we seem to be moving towards less.

Here we are over a decade into the 21st century and we are once again arguing about a woman’s right to manage her own health. We’re arguing about birth control. Partly because of the political and economic dynamics of our time, the issue is more heated than ever. Wedge issues like this re-surface with every election cycle. From a dollars and cents perspective, who wants to pay for medications that 98% of the female population utilizes for years at a time?  Birth control is an expensive proposition for any institution.

Economics aside, I would contend that the birth control debate is not about birth control, or even one’s religious beliefs. No, this debate is about whether women are full citizens with all of the rights and privileges as men – including the right to make their own health care choices.

Are women equal to men under the law? Do we have the right to pursue health, happiness and liberty as we see fit?  Do we have the right to religious freedom?  Or per the current brouhaha, are we a special class of citizen with only some of the rights conferred to the male citizenry?

If the current discussions are any indication, there are many among us that believe that women’s rights are alienable and superseded by the rights of religious institutions or political expediency. How else does one explain the House Oversight and Government Reform Committee hearings  on women’s health that included no women, but highlighted the male hierarchy of congressional and religious power?  How else does one explain the conservative punditry’s fealty to the male view of women’s health (adroitly portrayed by John Stewart’s Vagina Ideologues ). How else does one explain the utter lack of women, even conservative women, present in these discussions about women’s health?

Maybe these events can be chalked up to the election year machinations of feckless politicians; maybe it is just a power play, positioning one party over the other; we can hope…

I worry, however, that as these conversations continue and the voices of women are denied, the prevailing discourse that women’s health and self-determination are matters of religious conscience and governmental intrusion, will become more and more entrenched. The line between election year politicking and reality is blurring quickly. These debates are defining not only who can speak about women’s health, but which topics are acceptable; only men and only reproduction.

As a woman and a fierce advocate for women’s health research, I find the current trends dangerously recursive.  No, these discussions are not about birth control or even religious freedoms. These issues aren’t even about liberal versus conservative or left versus right, though often framed as such. These discussions are about whether women are equal citizens with all the rights and privileges accorded. Do we have the right to make and manage our own health care decisions?  If the current discourse continues, the answer is trending towards no, women are not equal.

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Vitamin D3 and Pregnancy: Are Prenatal Vitamins Enough?

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When a pregnant woman is asked if she is hoping for a boy or girl, her inevitable response is similar to, “I only care that my baby is healthy.” Many expectant mothers do their best to have a healthy baby by leading a wholesome lifestyle and following doctors’ orders. Nonetheless, millions of babies are born with medical conditions, many of which affect children throughout their lives. 

Medical research suggests a number of health issues may be prevented if pregnant mothers enjoy sufficient vitamin D3 levels, ideally prior to conception.

Vitamin D3 is vital to pregnant women’s health. An expectant mom with adequate vitamin D3 levels may enjoy a decreased risk of pregnancy complications including: anemia; bacterial vaginosis; Caesarian section; gestational diabetes; and pre-eclampsia.  University of Pittsburgh researchers ascertained that women with low vitamin D3 blood serum levels (less than 15ng/mL) have five times the risk of developing pre-eclampsia, a common obstetrical condition that can lead to a fatal stroke.

Vitamin D3 is vital to fetal bone and cell development. A pregnant woman’s vitamin D3 levels may play a significant role in the health of a developing fetus, according to recent medical studies. Low maternal vitamin D3 levels may contribute to premature delivery and low birth weight.  Furthermore, babies born to mothers with a vitamin D3 deficiency are more likely to develop, inter alia; asthma; autism; soft bones (craniotabes, rickets); brain tumors; cardiovascular malformation; type 1 diabetes; epilepsy; pneumonia; and seizures.

Harvard researchers led a study (published in 2010) that examined the vitamin D3 status of over 900 New Zealand newborns. They found that babies born with adequate vitamin D3 from their mothers had a greater chance of a stronger, inherent immune system. The researchers concluded vitamin D3 was crucial not only to a newborn’s health but to his or her well-being throughout life.

Are Prenatal Vitamins Enough?

Unfortunately, the majority of pregnant women reportedly have vitamin D3 serum levels less than 50 ng/mL, a measurement on the lower side of adequate. (A number of vitamin D experts believe a healthy vitamin D3 range is at least 50-80 ng/mL.) You may be thinking, “My prenatal vitamin includes vitamin D, so I do not need to be concerned about my vitamin D levels.”  Most prenatal vitamins only contain 400 IU of vitamin D3—a woefully inadequate daily dose.  A 2010 National Academy of Sciences Institute of Medicine report stated that a safe upper limit for pregnant women for a daily vitamin D3 dose is 4,000 IU, an amount 10 times more than contained in prenatal supplements!

Why risk pregnancy and neonatal complications? Get your blood tested by your healthcare practitioner and talk to them about what you should do based on the results of your test. You will be on the road to becoming a vitamin D-healthy mother!

Copyright ©2012 by Susan Rex Ryan

All rights reserved.

Redefining Healthcare for Women

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As the dust settles on the Komen Foundation decisions of last week, I am reminded once again how compartmentalized and politicized the notion of women’s health has become.  Boobs and wombs seem to represent the sum total of interest in women’s health.  And if the Komen fiasco is any indication, one can’t care about both, because where one stands or one’s employer stands on reproductive issues is now becoming the litmus test that permits or denies access to care. If you are a woman, that is. No such criteria exist in men’s health.

Women’s health is inherently political. We carry the responsibility of continuing the species. With that responsibility inevitably comes intrusion (no pun intended). We seem to forget, however, that women have cancer (not just breast), heart disease, diabetes, immune diseases and the whole host of illnesses that are unrelated to whether or not we bear children. Certainly, whether we have born children impacts these diseases, more so than many are willing to admit, but what we think about birth has nothing to do with our health and should have nothing do with our access to healthcare.

As a private organization, Komen has every right to change its mission. It has every right to fund only those organizations that align with their political or religious views. If it believes strongly in those views, then it should change its mission and hold to it.  However, Komen should be prepared for mass defunding from those who don’t share the same ideology. Early signs of this were evident last week.

There is no delicate or politically adroit way around this issue for Komen and other organizations who believe that views on reproductive rights trump a woman’s access to healthcare or an agency’s access to research funding. If that is the litmus test, however, then say so. Take the stand and own the results. Tell the world that your organization provides preventative healthcare, supports breast cancer research and other activities only for some women and only for organizations that share your views.

Then let the rest of us get on with the business of providing healthcare and research for all women.

Deer antlers & osteoporosis

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What do deer antlers and osteoporosis have in common? Manganese.

New research out of Spain suggests that manganese deficiency may be the root cause of osteoporosis in humans. Manganese, a trace mineral responsible for activating a number of enzymatic reactions, is also required for the absorption of calcium into bone. When manganese levels are low, calcium is excreted in urine instead of absorbed into bone.

Researchers identified this connection from an unlikely source, broken deer antlers. An unusually cold winter in Spain 2005 depleted plant manganese stores and by association, deer nutritional status suffered. A subsequent increase in broken deer antlers lead researchers to speculate a possible connection. Analysis of those antlers revealed lower manganese levels associated with lower calcium and higher osteoporotic like antlers – more breakage. The research has yet to be confirmed in humans, but other studies have observed lower manganese in post-menopausal women with osteoporosis.

Dietary manganese can be found in dark leafy greens, berries and several grains like spelt and brown rice.