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A slew of recent medical advances just may save your life. "The past year has been one of the most amazing times in women's health," says Sherry Marts, PhD, vice president for scientific affairs at the Society for Women's Health Research in Washington, D.C. Doctors have discovered new medications to combat cancer, made revolutionary advances in infertility treatment, and developed better ways to predict a woman's risk of heart disease -- and that's just the beginning. We combed through all the medical research for the biggest breakthroughs and compiled them in this special report. Save it, discuss it with your doctor, share it with your friends. It's filled with vital information you need to know to protect your health.
Late last spring, the FDA approved a miraculous new vaccine that's nearly 100 percent effective in destroying the viruses responsible for approximately 70 percent of all cervical cancers, the second leading cause of cancer death in women worldwide. Called Gardasil, the vaccine prevents infection from four common types of the human papillomavirus (HPV), a sexually transmitted microbe for which there is no treatment. HPV is so widespread that about 20 million Americans are infected with it. Although the virus is usually harmless and clears up on its own, two strains of HPV cause genital warts, and two other very aggressive types are responsible for the majority of all cervical cancers, which kill 233,000 women worldwide each year. (According to a new study, consistent use of condoms may also protect against HPV.)
The vaccine has been approved for women and girls ages 9 to 26, though researchers say it works best in those who are not yet sexually active. (The vaccine can't kill HPV once the infection takes hold, which is why it's important to inoculate girls early.) Gardasil is given as three shots over a six-month period, for a total cost of $360. (As we went to press, it was not yet determined whether health insurance will cover it.)
Ongoing studies are testing whether the vaccine will help women in their 30s and 40s. "By age 30, many women have been exposed to HPV, usually in their teens and twenties, just after the onset of sexual activity," explains Debbie Saslow, PhD, a geneticist and director of breast and gynecologic cancers for the American Cancer Society in Atlanta. "That's why Gardasil has been approved for younger people. But a woman who has been infected with one or two types of HPV but not the cancer-causing strains may still benefit." One study shows that another vaccine in development may be effective for women up to age 55; more results are expected to be announced later in the year.
The two out of three women who suffer from insomnia can now rest easy. Rozerem, a new prescription sleeping aid, can help them drift off faster without nasty side effects, such as rebound insomnia, grogginess, or the sleepwalking, amnesia, and binge-eating episodes reported by people using other sleeping pills.
Rozerem, which can be taken daily, stimulates entirely different receptors in the brain than conventional prescription sleeping medications do. It mimics the action of melatonin, a hormone the body produces to ease us into a deep slumber. In a recent study, volunteers given Rozerem fell asleep 50 percent faster than those who took a placebo, and they experienced no residual effects the next day.
"This is welcome news for women, who often have difficulty falling asleep because of hormonal changes," says Thomas Roth, PhD, a sleep researcher at Henry Ford Hospital in Detroit.
Delivering a baby just got a little easier. A 2005 study found that giving women an epidural as soon as they asked for it -- rather than administering a narcotic shot for pain followed by an epidural later on -- helped both mother and child.
"Their labor was faster by about 80 minutes and they had better pain relief and less nausea. It also made no difference in the C-section rates, and the babies were more alert," says Cynthia A. Wong, MD, the study's lead author and an obstetric anesthesiologist at Northwestern Memorial Hospital in Chicago. While the researchers don't know why the effect was so dramatic, they believe that better pain control reduces a woman's anxiety, so her labor progresses more quickly.
Previously, women were often pressured to delay getting an epidural because doctors believed that taking the drug too soon (before the cervix had dilated to at least 4 or 5 centimeters) slowed contractions and led to caesarean sections. "Now there's no reason to deny the medicine early in labor," says Dr. Wong.
Insulin shots may soon be a thing of the past. Exubera, an inhaler that delivers aerosolized insulin to the bloodstream through the lungs, was approved by the FDA in January. Taking the medication just before meals can control blood sugar in people with type 1 and type 2 diabetes as effectively as a shot.
Doctors believe Exubera may help many of the 20 million Americans, roughly half of them women, who suffer from the disease. Those who are dependent on insulin often have trouble controlling their blood sugar, which involves numerous daily blood checks and shots. As a result, many patients develop serious complications such as heart attacks, says Larry C. Deeb, MD, an endocrinologist in Tallahassee, Florida, and president, medicine and science, of the American Diabetes Association. "Eliminating the need for injection may make it easier for people to use insulin," says Dr. Deeb.
There's good news for the 6.1 million American women who can't get pregnant. Doctors are now using ovarian transplants to help some of those suffering from infertility produce viable eggs.
Last year, a 25-year-old woman, who previously had been infertile after going through premature menopause, gave birth to a healthy baby after receiving an ovary from her twin sister at St. Luke's Hospital in St. Louis. Because her twin was a perfect match genetically, the woman didn't need to take transplant anti-rejection drugs, which can cause serious side effects.
Since then, ovarian transplants have been performed on five sets of identical twin sisters (three women are pregnant and two have resumed menstruating). Before the end of this year, Sherman J. Silber, MD, director of the Infertility Center of St. Louis and head of the surgical team there, hopes to increase the number of women who can benefit from this procedure by performing the transplant on sisters who are not identical twins.
Once that happens, he says, transplants could become routine within the next five years for women who could not otherwise get pregnant.
A new chart that determines a woman's fitness level can aid doctors in identifying those most at risk of dying from a heart attack. This simple advance has enormous implications: Heart disease is the number one killer of women in the U.S.; half a million die from it every year.
Doctors have long known that one of the best ways to determine whether a patient is at risk is to check her fitness level with a cardiac treadmill stress test. However, the guidelines they used were based on the amount of exercise men could do. As a result, "many women were incorrectly diagnosed as being below their fitness level -- and therefore at higher risk for a heart attack or death from cardiovascular diseases when they weren't," says Martha Gulati, MD, a cardiologist at Northwestern's Feinberg School of Medicine.
Last year, Dr. Gulati and her colleagues decided to do something about this problem. By analyzing the stress treadmill tests of more than 10,000 women, they determined the normal fitness level for women at different ages. They discovered that those whose exercise capacity was less than 85 percent of what it should be were two times more likely to die of heart disease.
The new guidelines are 15 percent more accurate than previous standards in identifying women at risk. "This information is vitally important to help prevent premature deaths," says Dr. Gulati.
If you suffer from symptoms such as chest pain, a pounding heart, or difficulty breathing, ask your doctor to perform a routine cardiac treadmill test using the new standards. Based on your fitness level, he or she will prescribe a potentially lifesaving exercise program.
A just-approved drug called Chantix can help even hard-core smokers kick the habit. In clinical studies, volunteers who took Chantix twice a day for three months were nearly four times as likely to stop smoking than people taking a placebo, and they had almost double the success rate as those taking Zyban, another medication prescribed to help people quit smoking. After one year, approximately 20 percent of the Chantix group was still smoke-free. "Those are much better results than what we usually see," says Thomas J. Glynn, PhD, a tobacco expert at the American Cancer Society in Washington, D.C.
Chantix may be a good option for the one in five American women who smoke, particularly those who are younger and use cigarettes as a way to help control their weight. The drug stimulates the same nervous-system receptors as nicotine and eases the serious craving and withdrawal symptoms that make quitting so difficult. While Chantix isn't an appetite suppressant like nicotine, "it is designed to fool the brain into believing it's received a nicotine fix," explains Glynn. "Chantix prompts the release of enough endorphins to give you some of the pleasure of smoking with fewer symptoms of withdrawal. The drug is a significant step forward."
Imagine a day when medications are custom-designed to be delivered at the right time and the right dose, based on your DNA and sophisticated diagnostic tests that will help doctors identify conditions like breast cancer and heart disease earlier -- and possibly even prevent them.
These developments will be possible within the next two decades, thanks to researchers who catalogued the female X-chromosome last year and uncovered unexpected variations in how those genes behave. "This is a huge advance," says Sherry Marts, PhD, of the Society for Women's Health Research. "We've learned that women, more than men, are a mosaic of different genetic influences."
These findings are expected to yield fresh insights into cancer, heart disease, autoimmune disorders, and other illnesses that strike women. This means that scientists may be able to understand and predict which diseases individual women will get, which symptoms to watch out for, and which treatments will be most effective, says Laura Carrel, PhD, a geneticist at the Pennsylvania State College of Medicine in Hershey. "These discoveries are very important first steps in that direction."
Originally published in FITNESS magazine, September 2006.