Month: August 2008

An interesting conversation is brewing among New York Times readers about a recent post in the paper’s “Well” blog about prescription drug sharing among women. Blogger Tara Parker-Pope wrote, “…drug-sharing rates were highest among younger women ages 18 to 44, raising special concerns about side effects and health risks of unchecked prescription drug use among women who might become pregnant,” prompting comments by many women “of child-bearing age” who expressed frustration over being considered “pre-pregnant,” and often nothing more, by the medical community. Particular sobering was comment #172, which drew a line between this type of attitude and the Bush administration’s proposal requiring health organizations receiving federal aid to hire health care providers regardless of whether they refuse to prescribe birthcontrol, emergency contraception, or perform abortions.

Although she responded defensively to women’s comments at first, Tara Parker-Pope has followed up with a podcast of an interview with Cindy Pearson from the National Women’s Health Network, in which they discuss in greater depth the implications of the medical community’s difficulty in seeing “women of childbearing age” as valuable patients in their own right. I recommend checking out the conversation if you have time.

Coincidentally, I read the “Well” column about five minutes after getting somewhat worked up about this article, titled “Vitamin D Deficiency May Lurk in Babies.” The article explores some recent findings that babies who are exclusively breastfed may be at higher risk for vitamin D deficiency and related conditions such as rickets. I’ll be honest and say that I was nervous while reading the article, afraid that it would draw the conclusion that formula is healthier than breastmilk and was relieved when they reported that vitamin D deficiency in babies can be prevented with a few vitamin drops.

“I completely support breast-feeding, and I think breast milk is the perfect food, and the healthiest way to nourish an infant,” said Dr. Catherine M. Gordon, director of the bone health program at Children’s Hospital Boston and an author of several studies on vitamin D deficiency, including Aleanie’s case.

“However,” Dr. Gordon continued, “we’re finding so many mothers are vitamin D deficient themselves that the milk is therefore deficient, so many babies can’t keep their levels up. They may start their lives vitamin D deficient, and then all they’re getting is vitamin D deficient breast milk.”

Wait a minute, mothers are vitamin D deficient themselves? That seems important, especially because, according to this very article, vitamin D deficiency can cause osteopenia (low bone mineral density), osteoporosis, diabetes, autoimmune diorders, and cancer. Surely the article addresses ways women themselves can end their vitamin D deficiencies, even if only as a means of being better breastmilk providers for their children!?!?

Sorry, no dice. As far as this article is concerned, the only thing newsworthy about women’s vitamin D deficiencies is that they are crummy vitamin D delivery systems for their children.

This article’s failure to address adult women’s health concerns reminded me of an experience I had last summer when my friend Rebecca called me in a panic one morning, asking for me to drive her to the hospital after she had unexpectedly broken her foot while walking across a parking lot. When the doctor heard that the brake hadn’t occurred during a fall or other serious impact, she recommended getting a test for vitamin D deficiency and made several suggestions about tips for building healthy bones as an adult woman.

Because osteoporosis is a potential side effect of vitamin D deficiency, here are some tips for women at different ages in their life interested in preventing the disease:

• Up through your twenties, you build bone density; after that, you maintain what bone density you have. Keep this in mind when considering your diet, at any age. If yours is low in calcium or vitamin D, consider changing it or taking supplements.
• Get some sun! Even though it is wise to be cautious about skin cancer, ten to thirty minutes of sunlight (depending on your skin tone and personal needs) helps decrease vitamin D deficiency.
• If you have risk factors such as a family history of osteoporosis, consider getting a bone density test at menopause. Otherwise, consider getting one at the age of 65. Transwomen should consult with their endocrinologist about how hormone levels have affected their bone density and when to have bone density tests.
• Do weight bearing exercise if you are able (such as dancing, jogging, or other movement where you hold your weight up), which builds bone matrix.

This is nowhere near a complete list, but is perhaps slightly more helpful than the generic “take more calcium” advice that seems to be the party line re: osteoporosis. I’m about the farthest thing from a doctor and this list is a compilation of tips I’ve heard from doctor friends of mine, internet resources, and conversations I’ve had with my own doctor. For a much more exhaustive collection of health resources for women, Our Bodies, Ourselves has gathered many women-oriented web-resources.

Regardless of the specific health issue, we all (regardless of gender) hope for access to quality medical care with providers we trust, who take our concerns seriously, and who put our needs and desires as patients first. Unfortunately, the idea that women’s health concerns are obscured when they are of “child bearing age” by the health of their children and (more insultingly) the children their doctor believes they might conceive, is another obstacle to quality medical care.

How do your experiences compare to those of the women responding to Parker-Pope’s column?