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Women: What Is Your Biggest Health Concern?

Jill

Not to do the whole medical scare-tactic thing, but we should really be more focused on heart disease, which is the #1 killer of women over 25. It’s still largely seen as a male disease, and doctors notoriously misdiagnose and miss warning signs of heart disease in women. If you have a family history of heart disease, your risk of getting it will be even higher.

The findings are among those in a series of articles to be published today in two medical journals — the Journal of the American College of Cardiology, and Circulation — exploring the differences in heart disease between men and women. The subject has drawn increasing interest in recent decades, as scientists began to realize that the results of previous studies, done mostly in men, did not always apply to women.

Among the differences already known are that women with heart disease tend to be sicker than men by the time it is diagnosed, to benefit less from bypass surgery and to have more severe symptoms when they develop heart failure. Some of the difference is because women are older and frailer when they develop heart disease, but that does not account for all of it.

“…the results of previous studies, done mostly in men, did not always apply to women.” Doesn’t it seem like we hear this line a lot?

Heart disease, strokes and other cardiovascular diseases are the leading causes of death in the United States and other developed countries. They killed 910,600 people in the United States in 2003, the most recent year for which data are available; more than half the deaths, 484,000, were among women.

Although women’s risk is greatest after menopause and increases with age, heart disease is the No. 1 cause of death in all women older than 25. Overall death rates from coronary disease have declined in the past few decades, but most of the improvements have been in men’s rates.

For all the women out there, how many times have you been warned or made aware of your risk of heart disease compared to, say, breast cancer?

“To women as patients, the message is, look, if you have symptoms, don’t think because you are a woman you are immune to having a heart problem,” Dr. Sopko said.

And the message to doctors should be, “Look, if your patient has symptoms, don’t think because she’s a woman that she’s immune to having a heart problem.”

14 thoughts on Women: What Is Your Biggest Health Concern?

  1. When my mother had her heart attack, she didn’t even recognize that that was what it was, because the symptoms didn’t fit the “classic” model — shooting pains in the left arm and whatnot — which is derived from studies of men.

    As a result, she didn’t seek medical help for three days, because she thought she just had the flu. She’d probably be alive today if she knew what the common symptoms in women were.

  2. As a person with mitral valve prolapse syndrome, and a family history of high cholesterol and heart attacks, this is definitely something I think about.

    The two runners-up are infertility (I’m in my mid-thirties and not getting any younger, and I worry about accumulated environmental toxins) and breast cancer (because my mother had a scare with this).

    Speaking more broadly, my biggest health concern is the problem of paying for it all — I’m a person who’s preferred course of action is preventative care and lifestyle changes — but those are the sorts of things that tend to be out-of-pocket. I’m afraid of what might happen if all the deferred health-care costs spiral into something catastrophic one of these days. 🙁

  3. My biggest health care concern used to be ovarian cancer, but now it’s the lack of women’s reproductive care (other than being a baby-maching), lack of abortion services, and lack of access to contraception, including the Plan-B.

  4. How funny. I’m reading this over hotel Internet in southern Utah, and the womensenews.org link is blocked by “Clean Internet” because it falls under the category “Lifestyle.”

  5. “To women as patients, the message is, look, if you have symptoms, don’t think because you are a woman you are immune to having a heart problem,” Dr. Sopko said.

    Aaaargghhh. Why do these articles always have to end suggesting that the patient is causing the problem? I suspect that zuzu’s right to point out that a whole lot of women don’t even know what the symptoms are.

    I’ve been thinking a lot about how I would like the feminist movement (whatever that is) to take up issues of health care in a new way. It’s not that I’m at all opposed to the focus on reproductive freedom or on breast cancer, but it seems to me that there are a lot of issues we’re not talking about. For instance, we’re not talking about health issues in the context of the feminization of poverty. We don’t talk about the gutting of Medicaid and Medicare as feminist issues. We don’t talk enough about the neglect of research into diseases that disproportionately strike women of color. (I’m thinking about lupus here, although there may well be others.) I would really like to see more discussion of the extent to which private philanthropy sets research priorities in the U.S. and the ways in which that skews the research towards diseases that afflict affluent people. I think that the heart disease example brings up the question of ageism: do we neglect diseases that primarily strike old people?

    I feel like, on issues other than reproductive freedom, we’ve kind of lost some of our critical edge. We’re a bit too into the red dress, pink ribbon, awareness side of things, which is great, but at this point the mainstream media is willing to do that. So why aren’t we asking the hard questions about what gets funded and who gets treated and why?

    Sorry. That got slightly ranty.

  6. previous studies, done mostly in men, did not always apply to women.” Doesn’t it seem like we hear this line a lot?

    I really do wish that this line of thinking could gain more traction and bring about positive change. To put a dramtic point on this, consider:

    Taking all these genes into account, geneticists conclude that men and women differ by 1 to 2 percent of their genomes — which is the same as the difference between a man and a male chimpanzee (or a woman and a female chimpanzee).

    Sure, it’s a dramatic way of stating the problem, but maybe it’s needed to get the attention focused on these issues.

    On a related front, consider the 64 existing stem-cell lines:

    Based on discussions with most of the 10 laboratories with approved cell lines, we have concluded that as many as 49 of the lines are from white couples. As Alan Robins, chief science officer for one of the labs, BresaGen Inc. in Athens, Ga., told us, “Although we do not know for certain the racial background of our donors, it is reasonable to assume they are from white couples.” About 15 of the lines, harvested at clinics in Singapore and India, are of South and East Asian parentage, we believe, based on those discussions.

  7. Taking all these genes into account, geneticists conclude that men and women differ by 1 to 2 percent of their genomes

    Yes, because women have an X and men have a Y. There’s really no need to imply that men and women are separate species.

  9. No, not really. Don’t let me get in the way of your need to fetishize The Other, though–I’d lose my California driver’s license if I harshed your mellow.

  10. Not only are many women unaware of the differential in heart disease symptoms, it seems that many doctors don’t keep current, either. Over the summer I had repeated episodes of chest pains accompanied by nausea. One (male) doctor diagnosed it as acid reflux, gave me antacids, and sent me home. Another (female) doctor “explained” to me that these were symptoms of anxiety (though I told her repeatedly that I am a psychologist and that my symptoms were not consistent with an anxiety disorder) and wanted to put me on an anxiolytic. It was only after CAT scans (which neither of the first two doctors ordered) showed fluid in my lungs and heart, and blood tests showed severe inflammation, that an autoimmune disorder was diagnosed. Afterwards I was told that if I EVER experienced these symptoms again to report immediately to an ER, because while they could be a recurrence of the disorder, they were also common sympoms of cardiac arrest in females. Neither of the first two physicians I consulted–both board-certified and attached to major hospitals–thought to explore this possibility, and I wasn’t aware of it either.

  11. This is important stuff, and I do think that health is a big area where women, feminist or otherwise, should be focusing on advocating.

    They could watch the different diagnostic signs between genders; they could also stop telling people (esp. women) all the time that all their medical problems are stress-related or in their heads, and instead agree to medically treat them. I think women run into this more than men because we are thought to be more emotional, so a lot of male doctors assume that our emotions inform our problems.

    Example–I tend to miss my period because of stress and anxiety. Freshman year, I missed for an entire semester (I was a virgin, so I knew I wasn’t pregnant). Male family practitioner wouldn’t hear my concerns, saying “It’s normal to be stressed in college, why are you so worried” (even though I hadn’t had a period in 6 months). After the blackout I skipped it again, for 3 months, and he blamed the blackout and told me to quit panicking. Said his wife didn’t have a period for 2 years in college, and she’s had 4 children so it’s all fine.

    Female doctors, on the other hand, agreed that it was a problem, asked why I hadn’t called them sooner, and prescribed hormones to bring the cycles back. Said that a woman going without a period could indicate serious health concerns, fertility concerns, or simply chemical imbalances, but that it can be treated. They also offered to put me on the Pill to keep it regular, but I declined because they “regularized” on their own.

    Notice the difference–one assumes I’m just all over-emotional and need to chill; the other admits that yes it’s stress-related, but that it’s also a medical problem that can be solved.

    Related to that, I did go to the ER with chest pains once and was told “it’s stress, here’s some Xanax.” They didnt’ even do an EKG. So, I could have heart disease and not know it, because again, doctors keep telling me I need to chill.

  12. I’ve been told by several doctors that heart attacks are rare in pre-menopausal women. Our estrogen protects us until then. FWIW.

    My biggest health concern is skin cancer, since I fit the profile (fair skin, freckles, red hair) and have had dozens of severe sunburns, from the time I was a baby to my early 30s when I wised up.

    I drink loads of green tea to try to ward it off.

  13. After reading this, last night I went into Rite Aid to buy a candy bar and there were big signs by the door saying “Every minute a woman dies of heart disease,” so I suppose that’s a step in the right direction.

  14. I’ve been told by several doctors that heart attacks are rare in pre-menopausal women. Our estrogen protects us until then.

    That doesn’t necessarily mean that you can ignore the risk. It may be that you need to start taking preventative measures before you’re actually at risk for keeling over. I mean, osteoporosis is rare in premenopausal women, too, but the time to start preventing that is in your teens and twenties.

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