New report card on state rankings in women’s health

The Alliance for a Just Society recently released the 2014 Women’s Health Report Card that rates the 50 U.S. states on issues related to health coverage, access to care, and health outcomes.   The Alliance is a group of 14 racial and economic justice organizations around the U.S.    This report uses different methodology than early reports entitled “Making the Grade on Women’s Health” published in 2000, 2004 and 2007 and 2010 by the National Women’s Law Center and the Oregon Health and Science University.

Just two states, Massachusetts and Connecticut, received A’s in all three categories.   Twelve states received D or F in all three categories.   Our WHRI home state of Illinois received an overall B rating.  The entire report is available from the Alliance website.   To just view the table chart for all fifty states, click Here.

Pioneer research often lacked informed consent

The Conversation, an online newsletter originally based in the United Kingdom and Australia, recently launched its US edition.  On Oct. 30 they published an interesting “conversation” about the history behind the “father of modern gynecology” that discusses his early work on surgical repair of obstetrical fistulas.   Like much early experimental medical procedures, it was often the poorest, most vulnerable women who were used as subjects (in this case slaves) so the lack of consent is concerning.  Yet these “experiments” often ended up helping people in the greatest need.   It is an interesting ethical discussion that has value for young researchers and doctors.  Informed consent today is much more regulated and monitored with legal oversight.  The article in its entirety can be accessed HERE.

Birth of the “pill” has profound effect on women’s health

A new book, The Birth of the Pill, by Jonathan Eig tracks the involvement of four individuals who were key crusaders in the advent of readily available contraception that women controlled!   For readers who were not around for the sexual revolution of the late 1960s, here are some factoids that you might find interesting:

  • Four key players are featured in the book:  Margaret Sanger, feminist, and co-founder Planned parenthood;  Gregory Pincus, biologist who was fired by Harvard for his controversial research on in vitro fertilization and is considered the “inventor” of the Pill ;  John Rock, a Catholic,  ran clinical trials on the pill, and served as an intermediary with his Church; and Katherine McCormick, an heiress who funded the research on the pill.
  • Early on, due to Rock’s intervention, the Vatican almost supported the pill as a natural form of “rhythm”…but in the end did not!
  • One of the pre-FDA approval users of the pill was Sue Dixon whose father was Jack Searle the CEO of G.D. Searle and Company–the company that eventually marketed the pill.
  • Early clinical trials for the pill were conducted in Puerto Rico where, at the time, regulations for consent and other ethical issues was far less stringent than they are now.
  • Early versions of the pill were stronger than necessary because scientists wanted to be sure it was 100% effective.  Today, the dosages has been scaled down considerably reducing risks and adverse effects.
  • David Wagner, a product engineer at Illinois Tool Works, Inc.  designed a circular pill dispenser after his wife complained of forgetting to take the pill everyday.  His design was rejected by Searle but picked up by Ortho who was preparing to release their own version on the pill called “dialpak”.  This dispenser design helps distinguish the “pill” in a unique way that still exists today!
  • The pill was initially FDA approved as a treatment for menstrual disorders, giving its manufacturer a  “gentle” release into the market.

 

Missing work when children are sick takes a financial toll on family income

A new data note from the Kaiser Family Foundation reports on the number of working mothers who must take unpaid time off when their children are sick and discusses state and national policies addressing the issue.

Balancing on Shaky Ground: Women, Work and Family Health recounts findings from a recent national Kaiser survey, including:

  • Four in ten working mothers (39 percent) report that they must take time off and stay home when their children are sick, over ten times the share of men (3 percent).
  • Among mothers with no alternative to missing work when a child is sick, 60 percent say they aren’t paid for the time off, up from 45 percent in 2004.
  • Working mothers with lower incomes are particularly affected. More than half report they must miss work to care for sick kids at home, while 36 percent say their jobs offer paid sick leave and 43 percent say they get paid vacation days.

For more information about women’s health policy, visit kff.org.

Prosthesis approved to help women with bladder muscle contraction

The U.S. Food and Drug Administration today allowed marketing of the inFlow Intraurethral Valve-Pump, a replaceable urinary prosthesis for use in female adults who cannot contract the muscles necessary to push urine out of the bladder (impaired detrusor contractility or IDC).

IDC is a condition where patients are unable to spontaneously urinate due to insufficient bladder muscle contraction, which can result from significant neurologic disease or injury such as stroke, multiple sclerosis, spinal cord injury, spina bifida or diabetic neuropathy. IDC is typically managed with various types of catheters, including clean intermittent catheterization (CIC).

“The inFlow device allows women with IDC to urinate, without the need to catheterize daily or be attached to a urine drainage bag,” said William Maisel, M.D., M.P.H., deputy director for science and chief scientist in the FDA’s Center for Devices and Radiological Health. “This may allow for increased mobility and the ability to be more self-sufficient.”

To read more click HERE.

Still time to comment on Sex Inclusion in Research

Today, NIH released a Guide Notice (NOT-OD-15-012) announcing that the response date for the Request for Information “Consideration of Sex As a Biological Variable in Biomedical Research,” has been extended to October 24th. If you have not had a chance to submit your thoughts, please do so by October 24th.

The issue of including more females in all level of research (cells, animals and human) has been a major national story…and an important one!   This request is part of the usual process for federal implementation and the more people who comment, the more likely the government will move quickly toward changing policies.

Apple and Facebook Announce Egg Freezing Health Coverage

In a bold announcement today, Apple and Facebook now will offer health coverage for their women employees to freeze their eggs. Egg freezing may enable women to protect and preserve their fertility—and with the steep price of $10,000+, this coverage may be seen as a significant investment in family planning, while others may see this as concerning. Climbing the corporate ladder while raising a family can be a significant barrier for many women and the health coverage to freeze one’s eggs can provide women with the choice and freedom to devote time to work and to one’s family. However, some argue this potentially pushing women to focus on their careers as primary and family as secondary.

Egg-freezing has reportedly doubled over the past year as women continue to seek this as a solution to longer fertility years. Indeed, the option to freeze one’s eggs has spurred feelings of empowerment in women, Emma Rosenblum even writing, “Not since the birth control pill has a medical technology had such potential to change family and career planning.” Women often report barriers surrounding a seeming choice between work or family. The action of Apple and Facebook is intended to alleviate some stress surrounding career and family planning, while empowering women with the more choices and control in life. While positive in their intentions, some may read Apple’s and Facebook’s new announcement as potentially implying that women should focus on their careers first and family planning second. Whatever the implications, this is certainly an game-changing announcement.

Source: NBC News

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Pregnancy Possible during Perimenopause

Perimenopause  is the time when a women naturally starts having menopausal symptoms.  This natural change usually lasts about a year and is often referred to as the ‘menopause transition’.  At  this time, fertility declines but a woman may still get pregnant, and effective birth control should be used if she does not want to have a mid-life baby.  Generally, after a year of no menses, a woman can be considered infertile and menopausal.

There are several appropriate birth control methods recommended for perimenopausal women:

  • Hormonal oral contraceptives
  • Non-oral hormonal contraceptives (ring, patch, injection)
  • Intrauterine devices (IUD)
  • Sterilization
  • Barrier Methods (diaphragm, spermicide, sponge, condoms) though these require some discipline to be effective.

Natural family planning method (rhythm) is not recommended during perimenopause because women have irregular periods during this phase and it is hard to predict ovulation.  Emergency contraception is a back up option but it should not be considered as a regular birth control method.

Hormonal oral contraceptives have some benefits during this time including more regular cycles, less cramps and bleeding during periods, decreased risk of certain cancers and maintenance of bone strength.  It may also help with hot flashes and acne outbreaks that are common when hormones are fluctuating.   There are also some risks of oral contraceptives during perimenopause.  They include increased risk of blood clots (especially if a smoker or diabetic), some withdrawal bleeding, and delayed confirmation when menopause is reached.

To learn more about menopause, visit menopauseNU.org

Source:  North American Menopause Society

 

Northwestern Medicine to focus on fibroids

Uterine fibroids are the most common noncancerous tumors in women of childbearing age and the second most common reason these women undergo surgery. Uterine fibroids can lead to significant pain, bleeding, and fertility problems. Treatment options include watchful waiting; treatment with drugs or hormones, embolization, or ultrasound; and invasive procedures such as partial or total hysterectomy. However, there is little evidence about the effectiveness of these therapies or their outcomes, including fibroid reoccurrence and women’s ability to have children.

Northwestern Medicine will be one of ten investigational sites for a landmark study that seeks to improve the way uterine fibroids, one of the most prevalent health issues impacting women, are treated.

Erica E. Marsh, MD, a reproductive endocrinologist with Northwestern Fertility and Reproductive Medicine, serves as the principal investigator for Northwestern’s portion of the $20 million research project, which evaluates the effectiveness of different treatment strategies for women with uterine fibroids by building a national database tracking patients, treatments and outcomes.

“Right now there’s very, very little clinical trial data on fibroid outcomes,” said Marsh, who is also an assistant professor of Obstetrics and Gynecology-Reproductive Endocrinology & Infertility at Northwestern University Feinberg School of Medicine. “This type of study with a huge sample size in the thousands across the nation will allow us to start to tease apart some of those questions we’ve always asked ourselves as physicians who take care of women with fibroids. What can I tell my patients about the risk of occurrence after one treatment versus another? The impact on fertility? The likelihood that her symptoms will return? Having this type of outcomes data will allow us to answer some of those questions.”

OTC Medication Can Affect your Driving

Last Spring, CBS 60 Minutes, highlighted the fact that a popular prescription sleeping pill, Ambien, was causing next morning impaired driving in women.    This finding eventually resulted in the FDA halving the recommented dosage for women on the label.  Had the drug been well studied in both sexes, this difference would have been noted earlier in the discovery process with less adverse effects reported.  Now, there are steps being taken at the NIH and FDA to ensure both sexes are adequately included in drug and devices studies.

What about other drugs, especially those that are available over the counter?  Can they affect your driving?  It is important that you read the DRUG FACTS that come with the OTC medication especially the “active ingredient”  and the “warning” sections.   The “when using this product” section will include warnings about drowsiness or impaired driving.

Some of the most common OTC drugs that can cause drowsiness and impair driving include:

  • Antihistamines (used to treat cold symptoms, congestion, allergic symptoms)
  • Antidiarrheals (e.g. Imodium)
  • Anti-emetics (used to treat nausea, motion sickness, etc).

Source:  Food & Drug Administration