Now more than ever, it's critical that all women tune into their inner guidance and the fact that their bodies were designed to stay healthy for life. It has long been my experience that what we call women's health in this country has very little to do with actual health. It's simply disease screening. Instead of viewing symptoms as indicative of underlying imbalances, we prescribe drugs to quell them. This is not the same as health either. Rather, it disconnects our intellect from the wisdom of our bodies (what I call the mind/body split).
When I look back at the top women's health stories of the last decade, I'm cautiously optimistic that they will bring change. Not only do they point to the limitations of the current model--drugs, excessive screening, and surgery are not better health care--they also support something every woman knows deep down inside of her. Whether she admits it or not, whether she is in touch with it or not, she can always improve her health by working with the wisdom of her body.
Technology has its place, but it doesn't replace a woman's wisdom. Here are some key stories from the last 10 years that highlight the innate wisdom and intelligence of a woman's body.
1. End of "One-Size Fits-All" Hormone Therapy. In 2002, The Women's Health Initiative (WHI) study on hormone therapy came to abrupt halt. Researchers studying the synthetic hormones Premarin and Provera determined that they were more dangerous than a placebo (when given to women age 60 and over to prevent heart disease). Neither Premarin (a synthetic estrogen derived from pregnant horse urine) nor Provera (a synthetic progestin) are found in the human female body. Hence, the adverse effects--heart disease and breast cancer, to name a couple--should have been expected. [1] Instead, the findings rocked the gynecological world and made many question customary hormone therapy protocol. When they heard the news, women everywhere abruptly stopped taking their hormone replacement, and doctors and patients were left looking for a better form of relief.
Until the study was released, Premarin and/or Provera were routinely given to nearly every woman with menopausal symptoms, beginning in the 1980's. Studies were skewed, and a customized, individualized solution was rarely offered. It was a one-size-fits all approach, and for many, it didn't fit!
Now, a full range of bioidentical hormones--taken individually or in combination--are available by prescription from conventional and formulary pharmacies. (There are three hormones that can drop to low levels or become out of balance relative to one another at midlife: estrogen, progesterone, and androgens such as testosterone.) These natural hormones can be individually adjusted and prescribed based on a woman's test results and symptoms, so that she takes only what is needed for her body.
2.Fetal Monitoring Doesn't Improve Pregnancy Outcomes. I was an intern in Boston when fetal monitoring was first introduced. It was intended to prevent cerebral palsy and all kinds of obstetrical injuries. Monitoring soon became standard. Birth attendants and laboring women alike began to pay more attention to the monitor strip than to their own experience. The monitor helped widen the mind/body split even further. The C-section rate soared as inexperienced healthcare providers interpreted fetal distress far more and rushed their patients into unnecessary surgeries.
Over the years, a few dissenting voices published papers suggesting that when a nurse listened to the baby's heartbeat during labor, it was just as good as a monitor, perhaps better. But by then fetal monitoring had taken on a life of its own, and people believed in it.
In 2009, 30 years later, the American College of Obstetrics and Gynecology came out with its latest statement on fetal monitoring. George Macones, M.D., who headed up the development of the latest fetal monitoring guidelines for the American College of Obstetricians and Gynecologists, summarized it quite nicely. He said, "Since 1980, the use of Electronic Fetal Monitoring (EFM) has grown dramatically, from being used on 45 percent of pregnant women in labor to 85 percent in 2002. Although EFM is the most common obstetric procedure today, unfortunately it hasn't reduced perinatal mortality or the risk of cerebral palsy. In fact, the rate of cerebral palsy has essentially remained the same since World War II despite fetal monitoring and all of our advancements in treatments and interventions." [2]
As we reach the end of this decade, one thing is clear. Today's obstetrical practices need overhauling. This may be our number one health care challenge for the next decade! After all, birth sets the stage for the health of our future generation. Most people are shocked to learn that the maternal mortality rate has doubled in the past 25 years despite all the new technology. The incidence of prematurity is now one in eight. And birth by C-section is 30-50 percent in many hospitals. (The World Health Organization says that a five to 10 percent C-section rate is optimal and that anything over 15 percent does more harm than good.) A C-section increases maternal mortality by a factor of four to six times that of vaginal birth. [3]
My hope for the next decade is that pregnant women will question the status quo instead of simply going along with inductions, epidurals, and so forth, and reclaim their right to birth naturally--something the beautiful female body has been doing for millennia.
For more information, read "A Woman's Nation: Reclaim Your Right To Birth Right" [http://www.huffingtonpost.com/christiane-northrup/c-section-or-natural-birt_b_323422.html].
3.Early Detection of Breast Cancer Is an Imperfect Solution. Early detection of breast cancer has been the gold standard of women's health for twenty years. Unfortunately, this approach is incomplete and has serious drawbacks. Consider the following:
Breast Self-Exam (BSE): That old disease-screening standby, the breast self-exam (as currently taught) doesn't change breast cancer mortality! But it does increase the likelihood of having a biopsy for benign disease. A 2002 study published in the Journal of the National Cancer Institute followed 260,000 women in Shanghai for five years. The researchers concluded that "women who choose to practice BSE should be informed that its efficacy is unproven and that it may increase their chances of having a benign breast biopsy." [4]
Because of studies like this, many healthcare organizations have stopped recommending routine BSE. For example, the American Cancer Society dropped BSE from their recommendations in 2003. In addition, the Canadian Cancer Society, the Canadian Task Force on Preventive Health Care, the World Health Organization, the U.S. Preventive Services Task Force, and the U.K. National Health Services also no longer recommend routine BSE. The American College of Obstetricians and Gynecologists, on the other hand, continues to include BSE in their breast cancer screening guidelines.
Mammography: In an unprecedented and much criticized move, the American Cancer Society released data that women in their 40's do not require routine annual mammograms. I applauded this move because, for years, I've seen the limitations of cancer screening, particularly for breast and prostate cancer. A 2005 study from the Fred Hutchinson Cancer Research Center published in the April 2005 issue of Cancer Epidemiology, Biomarkers, and Prevention found that the diagnosis of ductal carcinoma in situ (DCIS) has increased sixfold since 1980, while the incidence of true invasive breast cancer has remained flat.
I have always been concerned about the large number of slow growing and benign growths, such as DCIS, that are diagnosed as a consequence of a screening mammography. The proportion of cases treated by mastectomy is inappropriately high, particularly in some areas of the United States. Current treatment options include lumpectomy (although there is no lump per se), lumpectomy with radiation followed by tamoxifen, or preventive mastectomies. While having a mastectomy for such an early stage cancer seems extreme, more and more women are opting for this surgery because they're scared to death.
Almost all cancer screening modalities (except for thermography) identify the slow growing lesions that women would die "with" not "from." In other words, they would never become life threatening if left alone. In another nod to your body's wisdom, an intriguing and important study published in the November 2008 edition of Archives of Internal Medicine suggests that some breast cancers will indeed go into remission without any treatment at all [5]
4.Fish Oil Proven Protective Beyond a Shadow of a Doubt. One of the most helpful foods you can eat or take as a supplement is fish oil. [6] Fish oil confers benefits throughout the whole body, nourishing its tissues and organs. It helps balance hormones and promotes brain, cardiovascular, ocular, breast, and immune health. It's even helpful for skin! Research continues to pour in on the benefits of fish oil. Here are seven areas that fish oil is good for:
•Joint pain. Fish oil is a known anti-inflammatory, which is why studies have shown that it helps alleviate symptoms associated with arthritis.[6]
•The heart. Fish oil confers both protective and healing benefits for people with heart disease. Because research undeniably confirms that fish oil helps decrease the inflammation associated with cardiovascular disease, the American Heart Association began recommending it as a treatment option in 2003. [6]
•The arteries. Fish oil protects the arteries by lowering triglyceride (cholesterol and fat content) levels in the blood. In fact leading researchers have validated earlier findings that fish oil supplements, in as little as 2 gm per day, can be effective--and without any side effects. [6]
•Menstrual cramps. Fish oil, which contains DHA (docosahexaenoic acid) and EPA (eicosapentaenoic acid), has been shown to work well for menstrual cramps even in those who didn't change other aspects of their diets.[6]
•Health of young children. Studies show that fish oil aids in the development of a baby's immune system, nervous system, muscle tone, and brain. [6].
•Reducing hot flashes. A study done in Italy indicates that taking fish oil may lessen the frequency and severity of hot flashes by 25 percent over 24 weeks. [6]
•Lowering the affect of stress. Research suggests that fish oil's anti-inflammatory properties can help reduce the body's negative response to psychological stress. Doctors also believe that the fish oil helps modulate neurotransmitters in the brain, regulating its activity and increasing the feel good hormone serotonin. [6]
5.Vitamin D Critical for Robust Health. After decades of vilifying the sun because of the risk of skin cancer, vitamin D deficiency is a worldwide epidemic. Ironically, this comes at the same time we have irrefutable evidence that vitamin D protects virtually every cell in the body and promotes robust health in all of its systems. [7]
The body makes Vitamin D when sunlight hits the skin--unless the skin is covered with sunscreen! Those with optimal levels of the sunshine vitamin (52ng/ml or more) enjoy a 50 percent reduced risk of breast cancer, as well as a substantially reduced risk of colon cancer, multiple sclerosis, heart disease, and even risk of C-section (laboring women with optimal vitamin D levels are far more apt to birth normally). Optimal vitamin D levels are also associated with a far lower risk of osteoporosis.
Lying in the sun, feeling the warmth on our body feels too good to be all that bad! We know this deep in our bones, which, by the way, is a part of our body that depends on vitamin D for health. Natural light and sunshine is good for us, as long as we don't burn!
Learn more about how the sunshine vitamin promotes in "Protect Your Breasts With Vitamin D"
6.Stem Cells Discovered in Menstrual Blood. In 2007, researchers at Medistem, a biotech firm in Tempe, AZ reported the discovery of a new type of stem cell in menstrual blood dubbed endometrial regenerative cells. (Back in the 1980's, I wrote the forward for Lara Owen's groundbreaking book on menstruation called Her Blood is Gold. She was clearly ahead of her time!) The stem cells in menstrual blood are evidence of the body's wisdom and power. The very thing we are taught to hide or be ashamed of may have the ability to save our lives!
7.Iodine Reduces Breast Pain. Breast pain is one of women's most common complaints. Thankfully, the solution is simple: iodine. It turns out that breast tissue has an active iodine pump in the ductal cells. Research shows that those who take iodine in doses ranging from 6-90 mg/day feel healthier and have a greater sense of well-being. Taking iodine at these levels eliminates breast pain from fibrocystic changes about 70 percent of the time. [8] Iodine has also been shown to decrease estrogen's ability to adhere to estrogen receptors in the breast (which decreases the risk of breast cancer). [9]
In one recent study of women with breast pain, more than half of those who took six mg of iodine daily reported a significant reduction in overall breast pain. [10] Iodine taken in doses 100 times the RDA (which is only 100-150 micrograms per day) has important extra thyroidal benefits, too. These include its role as an antioxidant, in preventing and treating fibrocystic disease of the breast, and in preventing and treating cancer.
8.Natural Progesterone Holds Great Promise for Heart Health. Though there is much confusion in the medical literature, synthetic progestins are not the same thing as progesterone. Medroxyprogesterone (MPA), known more commonly as Provera, is not progesterone and its actions are entirely different.
Unfortunately, all the large clinical trials that have studied hormone therapy and heart disease have used MPA, a synthetic hormone, not natural progesterone. In fact, primate studies have shown that MPA increases the changes of constriction of coronary arteries, while progesterone helps enhance coronary blood flow. So it's little wonder that the WHI study and others have shown an increased risk of coronary artery disease using Prempro, which is made from Premarin and Provera! Progesterone also decreases the magnitude and duration of angina. A recent research paper reviewing the cardiovascular effects of MPA versus natural progesterone suggests that there is a minimal level of progesterone necessary for normal cardiovascular function in women. [11]
Sadly, most healthcare professionals still don't know the difference between synthetic and natural progesterone. The human female body, however, can feel the difference.
9.Breast Is Still Best. An analysis published in 2007 of more than 500 breastfeeding studies (selected from some 9,000 abstracts) concluded that breastfeeding reduced the risk of ear infections, gastroenteritis, severe respiratory tract infections, eczema, asthma, obesity, type 1 and type 2 diabetes, childhood leukemia, necrotizing enterocolitis (a gastrointestinal disease that mainly affects premature babies), and sudden infant death syndrome (SIDS). [12, 13] (Breastfeeding cuts the risk of SIDS in half, according to a 2009 study.) The 2007 analysis further found that breastfeeding is health enhancing for women, too, because it found that mothers who breastfed were less likely to get type 2 diabetes, breast cancer, and ovarian cancer.
A 2009 study that followed 704 women for 20 years found that breastfeeding reduced the mothers' chances of later developing metabolic syndrome (a cluster of risk factors such as high blood pressure and high triglycerides that are associated with obesity), especially for mothers who had gestational diabetes. Researchers found that those mothers who did not have gestational diabetes and who breastfed for more than nine months cut their risk of metabolic syndrome by anywhere from 39 percent to 56 percent. And a similar group of mothers who did have gestational diabetes cut their risk by anywhere from 44 percent to 86 percent! [14]
The study reported that the longer women breast-fed, the more their risk dropped. It's no wonder that the World Health Organization (WHO), the United Nations Children's Fund (UNICEF), the American Academy of Pediatrics, the American College of Obstetricians and Gynecologists, and the American Academy of Family Physicians all recommend that mothers breastfeed exclusively for six months. WHO and UNICEF recommend that mothers continue nursing (along with giving age-appropriate foods) until age two or longer.
10.Educating girls is the key to planetary health. Focusing on the needs and education of women and girls is the issue of this century. Pulitzer-Prize-winning journalist team Sheryl WuDunn and Nicholas D. Kristof, authors of Half the Sky: Turning Oppression into Opportunity for Women Worldwide (Alfred A. Knopf, 2009) write: "The world is awakening to a powerful truth: Women and girls aren't the problem; they're the solution." [15] Greg Mortenson, coauthor of Three Cups of Tea writes: "Young women are the developing world's greatest agents of progress. Just one year of schooling will dramatically raise a girl's later economic prospects and where girls get to fifth grade, birth rates and infant mortality plunge. Teaching girls to read and write reduces ignorance and poverty that fuel religious extremism and lays a groundwork for prosperity and peace. In military parlance, educating girls is a "force multiplier." [16]
No matter what the favored scientific evidence is saying. Yesterday's scientific truth is no longer true. As in the case of vitamin D, science keeps changing and updating. That said, each of us has access to the information needed to make decisions that are right for us. Our inner guidance--our gut--our intuition--is always there. It is timeless and will never fail us.
For more cutting edge articles on health and wellness, visit Drnorthrup.com and sign up for the Women's Wisdom Circle.
Copyright Christiane Northrup, Inc. All rights reserved. Reproduction in whole or in part without permission is prohibited.
This information is not intended to treat, diagnose, cure, or prevent any disease.
All material in this article is provided for educational purposes only. Always seek the advice of your physician or other qualified health care provider with any questions you have regarding a medical condition, and before undertaking any diet, exercise, or other health program.
References:
[1] Singer, N. and Wilson, D. New York Times, "Menopause, as Brought to You by Big Pharma," 12/13/2009. Available online. http://www.nytimes.com/2009/12/13/business/13drug.html?_r=1.
[2] American College of Gynecologists and Obstetricians, "Practice Bulletin No. 106: Intrapartum Fetal Heart Rate Monitoring: Nomenclature, Interpretation, and General Management Principles," Obstetrics & Gynecology, vol. 114, no. 1 (July 2009), pp. 192-202; American College of Gynecologists and Obstetricians, "ACOG Refines Fetal Heart Rate Monitoring Guidelines," press release dated June 22, 2009 and available online at www.acog.org/from_home/publications/press_releases/nr06-22-09-2.cfm.
[3] Althabe, F. and Belizan, J.F. "Caesarean Section: The Paradox:, The Lancet, vol 368 (2006) pp 1472-3.
[4] D. B. Thomas et al. "Randomized Trial of Breast Self-Examination in Shanghai: Final Results," Journal of the National Cancer Institute, vol. 94, no. 19 (Oct. 2, 2002), pp. 1445-57.
[5] Zahl, P., Maehlen, J., and Welch, H.G. "The Natural History of Invasive Breast Cancers Detected by Screening Mammography," Archives of Internal Medicine, vol. 168, no. 21 (November 2008), pp. 2311-6.
[6] Northrup, C. "Nothing Fishy about Fish Oil," Women's Health Wisdom e-newsletter, November 2009, www.drnorthrup.com/members/monthlywisdom/archive/nov2009.php.
[7] Khalsa, S. The Vitamin D Revolution. Hay House, 2008; Vitamin D Council's Web site, www.vitamindcouncil.org.
[8] Kessler, J. H. "The Effect of Supraphysiologic Levels of Iodine on Patients with Cyclic Mastalgia," The Breast Journal, vol. 10, no. 4 (2004), pp. 328-336; Ghent, W. R., et. al. "Iodine replacement in Fibrocystic Disease of the Breast," Canadian Journal of Surgery, vol. 35, no. 5 (October 1993), pp. 453-60.
[9] Eskin, B. A., et al. "Mammary Gland Dysplasia in Iodine Deficiency," Journal of the American Medical Association, vol. 200 (1967), pp. 115-19.
[10] Kessler, J.H. "The Effect of Supraphysiologic Levels of Iodine on Patients with Cyclic Mastalgia," The Breast Journal, vol. 10, no. 4 (2004), pp. 328-336.
[11] Hermsmeyer, R.K., et. al. 2008. Cardiovascular effects of medroxyprogesterone acetate and progesterone: a case of mistaken identity? Nat Clin Pract Cardiovasc Med, Jul;5(7):387-95 Epub 2008 Jun 3.
[12] Ip, S., et al. "Breastfeeding and Maternal and Infant Health Outcomes in Developed Countries," Agency for Healthcare Research and Quality (AHRQ), Evidence Report/Technology Assessment No. 153 (April 2007), pp. 1-186.
[13] Vennemann, M.M., et al. "Does Breastfeeding Reduce the Risk of Sudden Infant Death Syndrome?" Pediatrics, vol. 123, no. 3 (March 2009), pp. e406-10.
[14] Gunderson, E.P., et al. "Duration of Lactation and Incidence of the Metabolic Syndrome in Women of Reproductive Age According to Gestational Diabetes Mellitus Status: A 20-Year Prospective Study in CARDIA--The Coronary Artery Risk Development in Young Adults Study," Diabetes, published online December 3, 2009, and available at http://diabetes.diabetesjournals.org/content/early/2009/11/12/db09-1197.abstract.
[15] Kristof, N.D. and WuDunn, S. "The Women's Crusade," The New York Times Magazine August 17, 2009.
[16] Mortenson, G. "Fighting Terrorism in Schools," Parade Magazine, Nov. 22, 2009.