Women's Health Archive

If you’re planning an escape from the dreary winter weather, and you’re pregnant or trying to get pregnant, you may want to plan your destination carefully. There’s still a lot we don’t know about Zika virus — which is now widespread in several favorite tropical destinations, such as the Caribbean — and its potential pregnancy-related complications. Until we know more, it’s better to be safe and follow the precautions we’ve listed here.

They're convenient and affordable, but they don't replace a relationship with a primary care physician.

Walk into a drugstore, supermarket, or "big box" store these days, and you'll find more than prescriptions, food, and household goods. Many now feature health clinics. They're part of the big trend of making health care more convenient. "Twenty years ago you had to go to an emergency department if you got sick and needed immediate care. Now we have an explosion of options, such as retail health clinics," says Dr. Ateev Mehrotra, a researcher on the topic and an associate professor of health care policy at Harvard Medical School.

The clinics

Retail health clinics began showing up about 15 years ago. Today, there are about 2,000 clinics across the United States, mostly in large retail chain settings. A typical clinic is open from 7 a.m. to 7 p.m., seven days a week, and is staffed by a nurse practitioner or a physician assistant. Clinics offer all kinds of health services—everything from treating minor illness like a cold, pinkeye, or a urinary tract infection to providing physicals, health screenings, lab work, smoking cessation help, and vaccinations.

They're cute, cuddly, and loving, but dogs and cats aren't always appropriate for older adults.

There's a reason dogs are dubbed man's best friend. Dogs—and cats, too—make wonderful companions and provide many emotional and physical benefits. "I'm a believer in the beneficial effects of having a pet, and I'm impressed with the ability of dogs in particular to form bonds with human beings. I think the science is starting to support their special ability to do that," says psychiatrist Dr. Greg Fricchione, director of the Harvard-affiliated Benson-Henry Institute for Mind Body Medicine. However, there are a number of considerations to mull over before adding a pet to your household.

Benefits

The most obvious benefits of pet ownership are love and companionship. "We do best medically and emotionally when we feel securely attached to another, because we're mammals and that's the way we've evolved," says Dr. Fricchione. He points out that we feel especially secure with dogs and cats because of the unconditional love they provide. "No matter what you do or say, your dog or cat accepts you and is attached to you," says Dr. Fricchione. Taking care of a dog or a cat can provide a sense of purpose and a feeling of validation when you wake up or come home and there's someone who's happy to see you.

Fostering strong social connections does not come easy for many men, but it is one of the best means to a longer and healthier life.

Social connections are as important to your health as proper diet and exercise. Research has linked social bonding to longer lives, lower incidence of depression and anxiety, and reduced risk of disease.

"Our brains and bodies function best when we are part of a community and maintain close, personal connections," says Dr. William S. Pollack, assistant clinical professor in the Department of Psychiatry at Harvard Medical School.

The annual check-up is important for older men. Here is how to make the most out of your visit.

Men have a long reputation for avoiding check-ups, and that resistance tends not to soften when they are older.

"Many older men put off exams because they fear finding out something is wrong," says Dr. Suzanne Salamon, a geriatrician with Harvard-affiliated Beth Israel Deaconess Medical Center. "Also, many of today's baby boomers don't think they will have medical problems associated with age, so it can difficult for the 'younger older men,' like those in their 60s and early 70s, to see their doctor."

Ask the doctors

Q: I'm expecting and want to have a vaginal delivery, but many of my friends have had cesarean sections lately. Is this a preference, or are there medical reasons to have a cesarean?

A: The health of the mother and baby, the family's personal preferences, and the hospital in which a woman delivers her baby play a role in determining whether she has a cesarean. Common medical reasons for cesareans include fetal malpresentation (when the baby is turned so that its feet or buttocks will come out first), pelvic disproportion (a birth canal that is unusually shaped or too small in relation to the size of the baby), and a past cesarean. A study published in the Journal of the American Medical Association in December 2015 suggests that such commonly cited medical issues may account only partly for high cesarean rates.

These uterine tumors, though usually benign, can cause heavy bleeding, cramps, and pregnancy complications. But there are several good options for treatment.

Fibroids—smooth muscle tumors of the uterus—are common, affecting as many as 75% of women. They are rarely cancerous, and they cause symptoms in only about 20% of the women who have them. However, if you're one of those with symptoms like heavy menstrual bleeding, bad cramps, pelvic pressure, constipation, or frequent urination, you know how fibroids can disrupt your life. Even if they don't cause symptoms, they may grow into the uterine cavity, potentially complicating a pregnancy and raising the risk of miscarriage.

"Managing uterine fibroids depends on several factors, such as a woman's symptoms, whether or not she wants to have children, her age, and her personal preferences," says Dr. Hye-Chun Hur, director of the Division of Minimally Invasive Gynecologic Surgery at Harvard-affiliated Beth Israel Deaconess Medical Center and associate medical editor of Harvard Women's Health Watch.

There is no evidence that so-called "bioidentical" alternatives to prescription hormones are either safe or effective.

Over the past couple of years, science has validated what many women already know: hot flashes and other symptoms of menopause can persist long after menstrual periods stop. It's also well established that estrogen—alone or combined with a progestin—is the most reliable treatment for menopausal symptoms and that, for most postmenopausal women, it is safe to take these hormones for up to five years at doses that relieve hot flashes.

But in 2002 the Women's Health Initiative reported that Prempro—an FDA-approved preparation combining synthetic estrogens with a progestin—increased the risk of cardiovascular disease and breast cancer. Since then, women have shied away from pharmaceutical companies' hormones. A third of women who use hormones for relief of menopausal symptoms are now choosing custom-mixed preparations from compounding pharmacies, according to research sponsored by the North American Menopause Society (NAMS). Women surveyed by NAMS commonly said they believed "natural" or "bioidentical" hormones from compounding pharmacies to be safer than the available FDA-approved hormones.

The U.S. Preventive Services Task Force recently updated their guidelines on screening for depression. This time around, they recommended widespread screening through primary care practices, plus gave special attention to women who are pregnant or recently gave birth. These matter-of-fact, achievable guidelines and goals have the potential to reap enormous health benefits.

Ask the doctor

Q. In your discussions of breast cancer screening, you never mention ultrasound. Is it an alternative to mammography?

A. No. Although the FDA has approved an automated breast ultrasound system to be used in addition to mammography for asymptomatic women with dense breasts, there are not enough published data about its effectiveness in screening to support its use. Moreover, ultrasound alone is not an alternative to mammography for routine breast cancer screening because ultrasound cannot pick up the small deposits of calcium (microcalcifications) that can be a sign of breast cancer.