Category Archives: Women’s Health

An aspirin a day….

For this post I thought I would write about staying healthy, but in a slightly different manner than I’ve done in previous blogs. In older blogs I’ve written about screening, vaccinations, etc.  In this one I thought I’d talk about using a medication to stay healthy, and in this case talk about aspirin.

Aspirin has been around for more than 100 years, and perhaps is a bit under appreciated since it is an over the counter medication (meaning one can buy it without a prescription). It is also something that is derived from a natural product. Willow bark had been used to treat fevers  and it was eventually found that salicylic acid was the active ingredient. Salicylic acid was then derived from this. I won’t go into the chemistry of this (I figure if you’re a bit of science nerd like I am you probably already know, and if not I don’t want to bore you).

Most people probably think of it as a pain killer or a headache medication.  It is much more than that. Aspirin plays an important role in treatment of patients who’ve had heart attacks – it helps treatment and also helps decrease the death rate from heart attacks. It is used in primary prevention heart disease as well. In the past high dose aspirin was used in the treatment of Rheumatoid Arthritis. It’s use in this latter population (at least for treatment of Rheumatoid Arthritis) has been eclipsed by other medications. However it still should be used to treat/prevent heart disease in this group of patients.

Use of aspirin in ischemic stroke patients is advised as well.

Though less studied at this point, aspirin use to prevent recurrent deep venous thrombosis, is a consideration (this is after someone has been treated with coumadin for an acceptable length of time).   A link to a review on this subject can be found here: http://www.ncbi.nlm.nih.gov/pubmed/24745726

There is some evidence linking aspirin intake to a decreased chance of developing colon cancer. At the moment there is not enough evidence to routinely suggest people take aspirin solely to prevent colon cancer. There is also some evidence that it only helps prevent colon cancer in certain groups of people – those that have a particular form of a particular gene. The only recommendation is for aspirin to help reduce the risk of heart disease.

Aspirin, like any other medication, has its downside as well. It can cause stomach ulcers. If the ulcers are large enough they can cause a lot of bleeding. It should not be used in children, except in rare circumstances and even then only then under the guidance of a pediatrician or other health care provider who provides a lot of treatment to children (EG pediatric rheumatologists, family practice physicians, etc).

Random Thoughts on Women’s health

I’m dividing this post into two parts. The first is on the recommendations for screening in females. The other part is some general thoughts on women’s health in general (and are somewhat generalizable to anyone’s health, male or female). The recommendations are taken from USPSTF related sites.

If you’ve read any or all of my earlier posts, you know I’m into screening and catching diseases early, especially if there is treatment for the particular disease.

Women should get pap smears every 3-5 years with HPV testing. The frequency depends on a woman’s age, whether the pap smear is negative and the results of HPV testing. It is important that the HPV testing be done via one of the five tests that are FDA approved: the unapproved tests from what I understand are more prone to error. Ask your doctor if he or she knows whether the lab he or she uses is FDA approved.

Screening for STIs (sexually transmitted infections) is suggested. This includes syphilis and HIV in high risk individuals.

Breast cancer screening (mammography) is done every 1-2 years starting at 50 (the old recommendations were every two years starting at 40, then yearly after age 50). BRAC testing should only be done if there is a family history of breast, ovarian, peritoneal cancer.

Bone density should be done at least once after age 64. However one can consider doing bone densitometry at an earlier age.

As much time and energy that people put into screening for breast cancer, cervical cancer, etc I think there a tendency forget about screening for heart disease and colorectal cancer, things I think people tend to see as “a man’s disease”.   However in 2010, 23.5% of deaths in women were due to heart disease,  and 22.1% were due to cancer deaths (this includes all cancer deaths, not just breast cancer).  Lung cancer killed 70,000 women whereas breast cancer killed 40,000 women that same year. These are  for the most part “lifestyle diseases” in as much as most lung cancer is caused by smoking; diet, lack of exercise, obesity contribute to heart disease. These are all things that are modifiable to a  great extent.