From VBACs to Bone Health—Reporting Live from Women’s Health 2011

Arlington, Virginia. Crystal City Marriott. Imagine four Grand Ballrooms as one very large room filled with > 1000 women physicians (and a few men physicians, too. Yes, it is time to always characterize all physicians by their gender).

Smartly the American Medical Women’s Association (AMWA), the premier women physician’s organization in the world, has hitched its now 96th annual meeting to the much younger, but very exciting, 19th Annual Women’s Health Congress. Here I am sitting at the intersection of issues of women’s health and issues of women physician’s healthy careers.

Disclaimer—I am no expert in women’s health so I hope that if you are interested in any of these random bits of information which I found interesting, investigate further! Women’s health is a new area and it even has its own journal, The Journal of Women’s Health.

I am presently sitting in on lectures as I did in my medical student days, except then we didn’t talk about women’s health. Certainly not about VBACs (undergoing vaginal child birth after a previous Cesarian section), women’s cardiac disease, and bone health. A lecture about intra-uterine contraception? No way.

Morning the first. Random tidbits: It is getting more difficult to get a VBAC—liability issues (no surprise), so some women are resorting to home birth. Nurse mid-wives who are willing to help—I am actually sitting next to one from Virginia who offers such services. Bottom line, time to reduce rates of C-sections. Smart women don’t have planned C-sections for convenience, like Britney Spears and other celebrities, who already drive too much of what our young women think and do.

Dieting? Randomized studies about the most popular diets—Atkins, Zone, Ornish, and Weight Watchers—all showed the same effects. You can lose weight, no matter the menu, IF you lose weight (which unfortunately only about 30-50% did). Then your numbers (cholesterol, triglycerides, HDL, LDL, etc.) will improve. Best way to go: low carbs combined with a Mediterranean diet. AND no smoking, regular exercise, and not low-fat, but low sugar diet (my favorite is Sugar Busters!). Maybe just a little chocolate? Sigh. But when the talk turned to statins and fibrates, I was frankly lost.

Prevention of heart disease? Some popular stuff may not only be not useful but may be harmful! Hormone therapy and selective estrogen-receptor modulators (SERMs), antioxidant vitamin supplements (e.g., vitamins A, C, E), folic acid, with or without B6 and B12–all are NOT HELPFUL for the primary or secondary prevention of heart disease. As for aspirin, if you are >65 years, it shouldn’t not be used to prevent an MI. For the specifics related to your particular health profile, talk to your doctor. But make sure he/she is up on the latest in women’s health.

Next stop, intrauterine contraception. Did you know that OB-GYNs use intrauterine contraception at a rate 40 times that of the general population. What does that tell you? It tells me that they know something most of us don’t, but should. Time to talk to our daughters especially if they are thinking about systemic hormonal contraception—why should we take a chemical that affects the whole body in ways we only need the effect locally?

And for those 50% of unwanted pregnancies (yes, it sadly seems that the number is that high), there is post-coital intra-uterine contraception. Copper T IUD —melts away the sperm you don’t want meeting up with any of your eggs and just in case a clandestine meeting occurs, it also inhibits implantation. Another device thickens the cervical mucous so it is impenetrable to sperm. Great idea! Keep those little guys in their place and out of yours.

And for myth busting at its best, the most memorable line of the morning: “IUDs don’t cause PID (pelvic inflammatory disease), MEN do!” The audience cracked up.

So if you care about women (as do I), and you are interested in women’s health (as am I), then you also would be having a great time listening to all these fabulous speakers. And that was only the first two hours.