Ways to Help Improve Women's Health

Below are several ways you can help improve women’s health through your clinic, practice, community, or organization. Whether you want to take on one project as an individual or several as a group, there’s something for anyone interested in encouraging women to practice prevention to be healthy and safe.

Breast and Cervical Cancer Screening
CDC provides high-quality screening and diagnostic services to detect breast and cervical cancer at the earliest stages through the National Breast and Cervical Cancer Early Detection Program (NBCCEDP). The program helps low-income, uninsured, and underinsured women (ages 40-64 years), gain access to breast and cervical cancer screening and diagnostic services.

DES Exposure
Research shows that women exposed to diethylstilbestrol (DES) in utero (DES Daughters) were at increased risk of the development of clear cell adenocarcinoma of the vagina and cervix. CDC's DES Update has been specifically designed to help health care providers learn more about DES exposure and its known health effects to facilitate identifying, managing, and counseling DES-exposed patients.

Gynecologic Cancer Awareness
Help raise awareness of the five main types of gynecologic cancer: cervical, ovarian, uterine, vaginal, and vulvar. When gynecologic cancers are found early, treatment is most effective. Know the central messages of the campaign, and use the fact sheets to increase awareness.

Sun Protection
Exposure to the sun's ultraviolet (UV) rays appears to be the most important environmental factor involved in the development of skin cancer. When used consistently, sun-protective practices can prevent skin cancer. People with certain risk factors are more likely than others to develop skin cancer.
Take Continuing Education Courses

Women's Health Continuing Education for Health Professionals
View a listing of selected CDC continuing education programs related to women’s health and other topics.
Start a Needed Program in Your Community

A Family Lifestyle Approach to Diabetes Prevention (Power to Prevent)
This program is designed to encourage African Americans at increased risk for type 2 diabetes to become more physically active and to eat healthier foods to prevent or delay the disease.

Assuring Healthy Caregivers- A Public Health Approach to Translating Research into Practice: The RE-AIM Framework
Those concerned with caregivers and their family and friends can use this framework in their work on caregiving. It suggests additional resources for those interested in pursuing the use of RE-AIM for caregiver support programs and policies.

Preventing Falls: How to Develop Community-Based Fall Prevention Programs for Older Adults
This “how-to” guide is designed for community-based organizations who are interested in developing their own effective fall prevention programs. This guide is designed to be a practical and useful tool, and it provides guidelines on program planning, development, implementation, and evaluation. See also Preventing Falls: What Works- A CDC Compendium of Effective Community-Based Interventions from around the World.

WISEWOMAN
Well–Integrated Screening and Evaluation for Women Across the Nation (WISEWOMAN) provides low-income, under- or uninsured 40- to 64-year-old women with the knowledge, skills, and opportunities to improve diet, physical activity, and other lifestyle behaviors to prevent, delay, and control cardiovascular and other chronic diseases. The interventions may vary from program to program, but all are designed to promote lasting, healthy lifestyle changes. See also Wise Interventions.
Use Resources

Women's Health Podcasts
Take one to six minutes to listen to a podcast to learn more about issues impacting women's health and safety, including cancer, reproductive health, sexually transmitted infections, and violence. See also CDC Podcasts.

Women's Health Professional Resources
View a variety of resources for health professionals, including campaigns, continuing education, slidesets, videos, and more.

Assisted Reproductive Technology (ART) Success Rates Report
The goal of this report is to help potential ART users make informed decisions about ART by providing some of the information needed to answer the following questions: What are my chances of having a child by using ART? Where can I go to get this treatment?

Bleeding Disorders in Women
The most common bleeding disorder is von Willebrand disease (VWD). VWD results from a deficiency or defect in the body's ability to make von Willebrand factor, a protein that helps blood clot. Although VWD occurs in men and women equally, women are more likely to notice the symptoms because of heavy or abnormal bleeding during their menstrual periods and after childbirth. Certain women should be tested.

Breastfeeding
Newborn infant Crib Cards can be used by hospitals for recording a newborn’s vital information. It can also help parents be better informed about breastfeeding and help make this important infant feeding decision at the pertinent time.

Intimate Partner Violence and Sexual Violence Victimization Assessment Instruments for Use in Healthcare Settings
This publication includes a comprehensive inventory of assessment tools that will help practitioners identify victims of intimate partner violence and sexual violence victimization in clinical/healthcare settings and make appropriate referrals for additional services.

Prenatal Testing for HIV Infection
The One Test. Two Lives. campaign focuses on ensuring that all women are tested for HIV early in their pregnancy. One Test. Two Lives. provides quick access to a variety of resources for providers and patients to help encourage universal voluntary prenatal testing for HIV.

Sexually Transmitted Disease Treatment Guidelines
Keep up with the latest guidelines on the treatment of sexually transmitted diseases. These guidelines were developed by CDC after consultation with a group of professionals knowledgeable in the field of STDs. The guidelines are updated periodically.

Be a Role Model

Be Physically Active
Participating in moderate-intensity or vigorous-intensity physical activity on a regular basis can lower an individual's risk of developing coronary heart disease, stroke, non-insulin-dependent (type 2) diabetes mellitus, high blood pressure, and colon cancer by 30–50%. Also, active people have lower premature death rates than people who are the least active. CDC recommends a minimum of 30 minutes of moderately intense physical activity most days of the week.

Eat Healthy
Health professionals recognize the benefits associated with a healthful eating plan based on the Dietary Guidelines for Americans, including decreased risk of overweight and obesity; decreased risk of micronutrient deficiencies; and decreased risk of chronic diseases, such as type 2 diabetes, hypertension, and certain cancers.

Be Smoke-Free
People who stop smoking greatly reduce their risk for many chronic diseases and for dying prematurely. Make this the year you quit smoking for good.

Asthma risk from too many nuts in pregnancy

Pregnant women who eat nuts or nut products like peanut butter daily raise the risk their children will develop asthma by 50 percent, Dutch researchers said on Tuesday.

The study also showed that moderate amounts did not seem to have an effect, meaning it is too soon to say whether pregnant women should give up nuts because they contain many important nutrients and healthy fats a developing fetus needs, they said.

"We were the first to find these strong effects on asthma symptoms," said Saskia Willers, an epidemiologist at Utrecht University, who led the study linking nuts with asthma.

But until we are certain we don't want to restrict them from the diet. So it is important that other studies replicate the findings," she said.

Asthma is an inflammatory disease causing wheezing, coughing and labored breathing that can be life threatening. In some countries as many as 30 percent of children develop the condition, according to the World Health Organization.

Scientists do not exactly know why some children develop asthma, although some believe that allergies can trigger the disease that causes a narrowing of the bronchial tubes.

Nuts and seafood are known to contain allergens that cause food allergies but the Dutch team only found a link between peanuts and asthma, Willers said.

In their study, more than 4,000 pregnant women completed a dietary questionnaire that asked whether they consumed vegetables, fresh fruit, fish, eggs, milk, milk products, nuts and nut products rarely, regularly or daily.

The researchers, who published their findings in the American Journal of Respiratory and Critical Care Medicine, then assessed the children's diets and looked to see who had developed asthma over an eight-year period.

Children whose mothers ate as little as one peanut butter sandwich a day had a far higher risk of asthma, Willers said in a telephone interview.

"If you eat moderately, it is probably not a problem," she said. "It is only if you eat nuts or nut products on a daily basis."

The study did not find a mechanism but Willers said peanut allergens may be crossing the placenta and sensitizing a fetus, making a child more prone to the disease.

The researchers also found a small benefit from eating fruit daily, and reported that the link between asthma and nuts remained after factoring for the child's diet, Willers added.

Ladies, give your breasts a rest, research says

Like many women, I’ve felt guilty about my slipshod breast exams for years. Sure, I’ll give the girls a good once-over in the shower now and then, but I’ve never diligently gone through all the motions (circular and otherwise), month in and month out.

So it was with a certain amount of relief that I read a new analysis confirming that the breast self-exam (or BSE) truly doesn’t make much of a difference after all.

According to a review by the Cochrane Collaboration, an international organization that evaluates medical research, there’s no evidence that self-exams actually reduce breast cancer deaths. In fact, the often-recommended monthly chore may even do more harm than good, according to the group’s analysis of a pair of studies of nearly 400,000 Chinese and Russian women.

Data from two large trials do not suggest a beneficial effect of screening by (BSE) but do suggest harm in terms of increased numbers of benign lesions identified and an increased number of biopsies performed,” concluded the authors in Tuesday’s issue of The Cochrane Library. “At present, screening by breast self-examination … cannot be recommended.”

One fewer thing to do?
Chris Herget, a 44-year-old notary public from Bellevue, Wash., says while she’s surprised to hear this news, she, too, feels relieved.

“I’ve never really felt competent doing it myself anyway and I have very fibrous breasts so everything feels like a ‘pea,’” she says. “In fact, the first time I told a doctor that I thought I’d found a lump, he was like, ‘That’s nothing, that’s a fat cell.’”

But the news that the BSE is officially on the way out perplexes others.

“I guess it’s one less thing that I need to be doing, but it is a little confusing,” says Liz Lane, a 29-year-old public relations manager from New York City. “Now I’m not sure what I am supposed to do to check myself.”

The issue is complicated, acknowledges Dr. David B. Thomas, breast cancer epidemiologist at Seattle’s Fred Hutchinson Cancer Research Center and professor of epidemiology at the University of Washington.

“It’s important to separate out the public health implications from the implications for an individual woman,” says Thomas, who is also the author of the 2002 landmark study involving more than 250,000 Chinese women that was analyzed and affirmed by this latest review.

“If a woman is highly motivated — let’s say her mother or sister has been diagnosed with breast cancer — then of course she should practice breast self-exam. But that’s a different situation than trying to reach women on a mass scale. Our study shows that that’s probably a waste of time. You’re not going to get women sufficiently motivated to practice it well enough and frequently enough to make that big of a difference.”

Lumps and bumps can be normal
What’s more, Thomas says BSEs can be problematic because the lumps and bumps women do report often turn out to be benign.

“The price you pay for doing more thorough breast exams is you’re going to find more benign lesions and that will result in unnecessary surgical procedures,” he says.

Rhebe Greenwald, a 65-year-old retired art director and systems analyst from Port Townsend, Wash., has experienced this firsthand.

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“I’ve never felt breast self-exams were that useful for me,” she says. “I’m extremely lumpy and I’ve had three benign tumors removed that were all found through self-exams. The last time, they removed about a quarter of the tissue in my breast and found nothing.”

But others, like Dianne Pomon, a 59-year-old registered nurse and breast cancer survivor from Pottstown, Pa., swear by the BSE.

“I’ve been diagnosed with breast cancer three times and found the lumps myself every time,” she says. “I would strongly encourage women to check themselves every month.”

What's a woman to do?
What’s a woman to do? It all depends on your age and family history, says Thomas.

“Women in their 20s and 30s rarely get breast cancer,” he says. “But they do have a lot more benign lumps and bumps. It’s not worth emphasizing breast self-exams for women at this age.”

As we get older, though, the benign lumps tend to go away and the breast cancer risk goes up.

When women are in their 40s, it’s a good time for them to become more aware of their breasts and more aware of changes that might be due to breast cancer,” he says. “It’s kind of controversial as to whether it’s worth the screening — either BSEs or mammograms — but they can do both if they want.”

After age 50, though, an annual mammogram is a proven lifesaver, he says, reducing the risk of breast cancer death by about 30 percent to 40 percent. And women who know they’re at high risk for breast cancer may be able to enhance the benefit of mammograms with diligent BSEs between screenings.

As for me, while I'm relieved to scratch breast self-exams from my to-do list for good, I’ve got no problem putting my girls into the hands of true professionals. I’m heading for the local breast health care center for my annual mammogram. It’s time.

Menopause raises risk of metabolic syndrome

As women begin to enter menopause, their risk of developing a collection of heart disease risk factors appears to climb, a study has found.

Researchers found that among 949 U.S. women followed for nearly a decade, the risk of developing metabolic syndrome increased during perimenopause — the years during which a woman’s body begins to transition into menopause, usually starting somewhere in her 40s.

Metabolic syndrome refers to this cluster of risk factors for heart disease, stroke and diabetes — including high blood pressure, abdominal obesity, high blood sugar, low levels of ”good” HDL cholesterol and high triglycerides (another type of blood fat). The syndrome is usually diagnosed when a person has three or more of these traits.

The new findings, published in the Archives of Internal Medicine, appear to be the first showing that the incidence of metabolic syndrome begins to rise during perimenopause.

More specifically, the study found, the risk is related to increases in testosterone activity.

The “main message” here for women is that maintaining a healthy lifestyle may be especially critical during perimenopause, lead researcher Dr. Imke Janssen, of Rush University Medical Center in Chicago, told Reuters Health.

Healthy habits can help
Not smoking, eating a healthy diet and getting regular exercise can all help reduce a woman’s risk of the various components of metabolic syndrome, Janssen said.

She and her colleagues based their findings on an ethnically diverse sample of U.S. women who were between the ages of 42 and 52 and free of metabolic syndrome at the outset. The women were followed for nine years.

Overall, Janssen’s team found, nearly 14 percent developed metabolic syndrome by the time they had their final menstrual period. The risk of developing the syndrome increased progressively starting six years before the final menstrual period.

But while the odds of developing metabolic syndrome were elevated after menopause, the risk was greater during perimenopause, Janssen noted.

It has long been known that women generally have a lower risk of cardiovascular disease than men do before the age of 45. But after age 55, the trend reverses, with women actually being at greater risk than men their age.

“Obviously, something happens there, between 45 and 55,” Janssen said, noting that it was once assumed that diminishing levels of estrogen told the whole story.

Testoserone may play greater role
But in this study, women’s estrogen levels were unrelated to the odds of developing the metabolic syndrome. Instead, the syndrome correlated with an increase in testosterone activity — suggesting that the direct negative effects of testosterone are more important than the loss of estrogen’s positive effects in women’s cardiovascular risks.

This idea, Janssen and her colleagues note, is consistent with clinical trials that have found no cardiovascular benefits from estrogen replacement therapy.

The bottom line for women, according to Janssen, is that during these years of hormonal change, healthy habits become more important than ever.

Urban teens misunderstand ‘morning-after pill

Urban-living minority girls appear to lack general knowledge about emergency contraceptive pills — more commonly known as the "morning-after" pill, new research hints.

Morning-after pills, which are taken after intercourse, consist of hormones that prevent a pregnancy from occurring. Since they can be taken immediately after intercourse (instead of waiting until the "morning after"), some doctors prefer the term "emergency contraception."

The emergency contraceptive pill is a safe and effective means of preventing pregnancy for up to 5 days after unprotected intercourse or when other forms of contraception, such as birth control pills or condoms, have not been effective, Dr. Cynthia J. Mollen of Children's Hospital of Philadelphia in Pennsylvania told Reuters Health.

Yet, "multiple misconceptions" about emergency contraceptive pills exist, Mollen said.

Mollen and colleagues assessed the knowledge of, and attitudes toward, emergency contraceptive pills among 30 English-speaking black girls between 15 and 19 years old who sought emergency department care.

Sixteen of the girls said they were sexually active — 5 with a history of pregnancy — and 14 said they were not sexually active, the investigators report in the medical journal Pediatrics.

In hour-long interviews with each girl, the researchers learned that 94 percent of the sexually active girls had at least heard of the morning-after pill, Mollen said. However, 40 percent of these young women were unable to answer follow-up questions on how the pills work.

Among girls who were not sexually active, 50 percent had never heard of the morning-after pill, and just 4 girls who had heard of this form of contraception knew when to use it or how to obtain it.

Mollen's group found only 7 girls (5 sexually active and 2 not sexually active) who knew of the Food and Drug Administration approval of non-prescription Plan B — a brand name emergency contraception pill for women age 18 and older.

Many of the adolescents said emergency contraceptive pill users should feel embarrassed and thought healthcare providers would likely call users' parents or caregivers. The girls' also expressed concerns about side effects, including those not known to occur with the morning-after pill, Mollen said.By identifying specific barriers to the use of emergency contraception in this population, Mollen notes, "we provide a framework for future interventions aimed at increasing emergency contraception pill use.

More women are having fewer children, if at all

More women in their early 40s are childless, and those who are having children are having fewer than ever before, according to the U.S. Census Bureau.

In the last 30 years, the number of women age 40 to 44 with no children has doubled, from 10 percent to 20 percent. And those who are mothers have an average of 1.9 children each, more than one child fewer than women of the same age in 1976.
The report, Fertility of American Women: 2006, is the first from the Census Bureau to use data from an annual survey of 76 million women, ages 15 to 50, allowing a state-by-state comparison of fertility patterns. About 4.2 million women participating in the survey, which was conducted from January through December 2006, had had a child in the previous year. The statistics could be used by state agencies to provide maternal care services, the report said
The survey found that in 2006 women with graduate or professional degrees recorded the most births of all educational levels. About 36 percent of women who gave birth in the previous 12 months were separated, divorced, widowed or unmarried.

Unemployed women had about twice as many babies as working women, although women in the labor force accounted for the majority — 57 percent — of recent births. Only a quarter of all women who had a child over the past year were living below the poverty level.

Coupled with fertility data collected biannually, the report also revealed longer term trends, including how second-generation Hispanic women are having fewer babies than their foreign-born grandmothers and first-generation American mothers.

Differences among states also emerged. California, Nevada, Texas, Arizona, Florida, Illinois, New York and New Jersey had a greater percentage of foreign-born women who became mothers in 2006. A bigger share of women in the Southeast and Southwest who gave birth in the year prior to the survey did so in poverty.

Surrogate mom, 61, gives birth to own grandkid

A 61-year-old Japanese woman gave birth to her own grandchild, using an egg donated by her daughter, a clinic said Thursday.

Surrogate births are extremely rare in Japan and banned by industry groups, but they are not illegal. The Suwa Maternity Clinic in Nagano, northwest of Tokyo, refused to provide information such as the date of the birth or gender of the baby. News reports said the baby was born last year.

The clinic said it performed the procedure because the woman's daughter has no uterus, but didn't give details on why she had that condition. The surrogate mother used a fertilized egg donated by her daughter.

Both surrogate mother and baby were fine," said Chihiro Netsu, a spokeswoman for the clinic.

Dr. Yahiro Netsu, who runs the clinic, has long defied national opposition to such procedures, arguing that they should be an option for women who are infertile.

Japan's oldest new mother?
In 2001, he performed what is thought to be the country's first successful surrogate birth. In 1998, Netsu was expelled from Japan's gynecology association for performing in-vitro fertilizations with eggs and sperm of donors who were not married to each other, though he was later reinstated.

Mainichi newspaper reported that the previous oldest mothers in Japan were two 60-year-old women implanted with their own fertilized eggs in the United States.

Japan Society of Obstetrics and Gynecology, a powerful body with over 15,000 members, has banned such procedures, but they are not illegal and individual clinics are free to perform them — though few actually do.

At Suwa Maternity Clinic, eight surrogate mothers have given birth. Of them, four women have delivered babies using fertilized eggs from their daughters.

The clinic will report the latest case at a conference of the Japan Society of Fertilization and Implantation later this month. It was the first time the fertilization conference had taken up the subject of surrogate births, Netsu said.

Yoga soothes worst symptoms of menopause

Yoga can reduce hot flashes and night sweats among women going through menopause, and also appears to sharpen their mental function, researchers from India report.

To investigate whether yoga would help women with physical and cognitive symptoms of menopause, they randomly assigned 120 menopausal women, 40 to 55 years old, to yoga practice or simple stretching and strengthening exercises five days a week for eight weeks.

The postures, breathing and meditation included in the yoga intervention were "aimed at one common effect, i.e. 'to develop mastery over modifications of the mind' ... through 'slowing down the rate of flow of thoughts in the mind,"' the researchers explain.

Women in the yoga group also listened to lectures on using yoga to manage stress and other yoga-related topics, while those in the control group heard lectures on diet, exercise, the physiology of menopause, and stress.

Fewer hot flashes, better concentration
After eight weeks, women in the yoga group showed a significant reduction in hot flashes, night sweats, and sleep disturbances, while the women in the control group did not, Dr. R. Chattha, of the Swami Vivekananda Yoga Anusandhana Samsthana in Bangalore, India, and colleagues found.

Both groups showed improvements in a test of attention and concentration, although improvement in the yoga group was significantly greater. In a test of memory and intelligence with 10 components, the yoga group improved on eight, while the control group improved on six. Improvements were significantly greater in the yoga group than in the control group on seven of the subtests.

"The present study shows the superiority of yoga over physical activity in improving the cognitive functions that could be attributed to emphasis on correctness in breathing, synchronizing breathing with body movements, relaxation and mindful rest," the researchers suggest.

Tips for a Healthy Life for Women

Eat Healthy
"An apple a day keeps the doctor away." There's more truth to this saying than we once thought. What you eat and drink and what you don’t eat and drink can definitely make a difference to your health. Eating five or more servings of fruits and vegetables a day and less saturated fat can help improve your health and may reduce the risk of cancer and other chronic diseases. Have a balanced diet, and watch how much you eat.

Keep a Healthy Weight
Obesity is at an all time high in the United States, and the epidemic may be getting worse. Those who are overweight or obese have increased risks for diseases and conditions such as diabetes, high blood pressure, heart disease, and stroke. Eat better, get regular exercise, and see your health care provider about any health concerns to make sure you are on the right track to staying healthy.

Be Active
More than 50 percent of American men and women do not get enough physical activity to provide health benefits. For adults, thirty minutes of moderate physical activity on most, preferably all, days of the week is recommended. It doesn’t take a lot of time or money, but it does take commitment. Start slowly, work up to a satisfactory level, and don’t overdo it. You can develop one routine, or you can do something different every day. Find fun ways to stay in shape and feel good, such as dancing, gardening, cutting the grass, swimming, walking, or jogging.

Be Smoke-Free
Health concerns associated with smoking include cancer, lung disease, early menopause, infertility, and pregnancy complications. Smoking triples the risk of dying from heart disease among those who are middle-aged. Second-hand smoke - smoke that you inhale when others smoke - also affects your health. If you smoke, quit today! Helplines, counseling, medications, and other forms of support are available to help you quit.

Get Check-Ups
Sometimes they’re once a year. Other times they’re more or less often. Based on your age, health history, lifestyle, and other important issues, you and your health care provider can determine how often you need to be examined and screened for certain diseases and conditions. These include high blood pressure, high cholesterol, diabetes, sexually transmitted diseases, and cancers of the skin, cervix, breast, and colon. When problems are found early, your chances for treatment and cure are better. Routine exams and screenings can help save lives.

Get Vaccinated
They’re not just for kids. Adults need them too. Some vaccinations are for everyone. Others are recommended if you work in certain jobs, have certain lifestyles, travel to certain places, or have certain health conditions. Protect yourself from illness and disease by keeping up with your vaccinations.

Manage Stress
Perhaps now more than ever before, job stress poses a threat to the health of workers and, in turn, to the health of organizations. Balancing obligations to your employer and your family can be challenging. What’s your stress level today? Protect your mental and physical health by engaging in activities that help you manage your stress at work and at home.

Know Yourself and Your Risks
Your parents and ancestors help determine some of who you are. Your habits, work and home environments, and lifestyle also help to define your health and your risks. You may be at an increased risk for certain diseases or conditions because of what you do, where you work, and how you play. Being healthy means doing some homework, knowing yourself, and knowing what’s best for you... because you are one of a kind.

Be Safe - Protect Yourself
What comes to mind when you think about safety and protecting yourself? Is it fastening seat belts, applying sunscreen, wearing helmets, or having smoke detectors? It’s all of these and more. It’s everything from washing your hands to watching your relationships. Did you know that women at work die most frequently from homicides, motor vehicle incidents, falls, and machine-related injuries? Take steps to protect yourself and others wherever you are.

Be Good to Yourself
Health is not merely the absence of disease; it’s a lifestyle. Whether it’s getting enough sleep, relaxing after a stressful day, or enjoying a hobby, it’s important to take time to be good to yourself. Take steps to balance work, home, and play. Pay attention to your health, and make healthy living a part of your life.