Women's Health Archive

If you're "leaning in" by putting in extra hours on the job, you may be gaining gender equality that you don't want—the same stroke risk as your male colleagues. A recent analysis indicates that women who work 55 hours or more per week have a 30% higher risk of having a stroke than those working standard hours, making them just as likely to have a stroke as their male counterparts.

The analysis, published online Aug. 20, 2015, by The Lancet, was conducted by European public health re-searchers. It involved data from over 600,000 women and men enrolled in long-term observational studies in Europe and the United States. It was the first such analysis of the relationship between working long hours and stroke. The researchers noted several factors that might have contributed to the elevated stroke risk, including the additional stress of balancing the extra work hours, inactivity, long periods of sitting, and ignoring stroke warning signs.

The purpose of treating ductal carcinoma in situ (DCIS)—the earliest, noninvasive form of breast cancer (often called "precancer")—is to prevent those lesions from becoming invasive and thereby greatly reduce the risk of dying from breast cancer. As mammography has become more precise, it has detected more DCIS, and more women get treatment with surgery and often radiation as well. An analysis published online by JAMA Oncology on Aug. 20, 2015, adds to increasing questions about the best way to manage DCIS in most women diagnosed with it.

Canadian researchers analyzed 20 years of data from 108,000 women with DCIS in a database maintained by the National Cancer Institute. Most women were treated with lumpectomy, often followed by radiation, or mastectomy. The researchers found that treatment with radiation or mastectomy did not lower the overall breast cancer death rate in women with DCIS. It remained at 3.3%—the average death rate from all breast cancers. However there were some groups—including African American women and women under 40—in whom the death rate was higher (7% to 8%).

Although vitamin D is essential to bone health, a controlled clinical trial published online by JAMA Internal Medicine on Aug. 3, 2015, found that vitamin D supplements didn't build bone in postmenopausal women with blood levels of vitamin D below the 30-ng/mL threshold generally considered necessary for good health. Researchers at the University of Wisconsin randomly assigned 230 women to three groups: one got 800 IU of vitamin D daily and a placebo twice a month; one got a placebo daily and 50,000 IU of vitamin D twice a month; the third got placebos both daily and twice a month. The study lasted a year. The researchers found that neither dose of vitamin D had a significant effect on bone mass, falls, or fractures.

The Wisconsin study may not have used the right doses of vitamin D or lasted long enough to show an effect. One ongoing study, The Vitamin D and Omega-3 Trial (VITAL), is large enough to demonstrate even small-to-moderate benefits of vitamin D supplementation. VITAL is evaluating a 2,000-IU daily dose for five years in 26,000 women and men. The results are expected in 2017. Until then, it's still important to get the recommended daily dose of vitamin D: 600 IU for adults through age 70 and 800 IU for people ages 71 or older

Ask the doctor

Q. I'm 62 years old, and my last menstrual period was at age 51. My doctor told me that my hot flashes would end after "about three to five years," but I still have them. Am I unusual, and what can I do?

Among 400 postmenopausal women who were previously inactive, those who did 300 minutes per week of moderate or high intensity exercise had more success at reducing total fat after one year than those who exercised for 150 minutes per week.

Urinary tract infections (UTIs) occur in women of all ages. Physical and hormonal changes can leave women at midlife particularly vulnerable. No woman should have to put up with the inconvenience and discomfort of recurrent UTIs. Self-help measures can be effective, but if they don’t do the trick, see your doctor. He or she can identify and treat any underlying problems and recommend other strategies to keep UTIs at bay.

An analysis from the Women's Health Initiative (WHI) suggests not only that postmenopausal women who are overweight or obese have a higher risk of invasive breast cancer than women of normal weight but also that the excess risk increases as a woman's weight rises beyond obesity. The results were published online June 11, 2015, by JAMA Oncology.

A team of investigators from several medical centers studied data on 67,000 postmenopausal women who enrolled in the WHI between 1993 and 1998. They were followed for a median of 13 years. During that time, 3,388 invasive breast cancers were detected. The researchers analyzed the distribution of breast cancer among weight classes and calculated the risks for women who were overweight (body mass index, or BMI, of 25 to 30), obese (BMI 30 to 35), or very obese (BMI over 35) compared with women of normal weight (BMI 25 or less). They found that the increased risk of developing breast cancer ranged from 17% in women who were overweight to 59% in those with a BMI over 35. Among women who began the study at a normal weight, those who gained at least 5% of their original weight had a 12% higher risk of developing breast cancer than those who maintained their original weight. Neither losing weight nor using hormone therapy had a significant effect on risk for women of any weight.

A randomized controlled trial of Finnish women over 70 has demonstrated that regular exercise can significantly reduce the risk of serious injury from a fall. Researchers from Tampere University studied 370 women who had fallen during the previous year. They were randomly divided into two groups. One group of 187 participated in classes in which they learned exercises to increase strength, balance, and agility. They attended exercise class twice a week for a year and once a week the next year. They exercised at home on the days they weren't in class. The women in the control group continued their normal routines. All the women kept daily diaries in which they noted whether they had fallen, and if so, the type of injury they sustained and whether they required medical attention. They mailed their diaries to the researchers every month.

At the end of the period, the number of falls was about the same in both groups: 140 in the exercise group and 141 in the control group. The consequences of those falls, though, differed noticeably between the groups: women in the exercise group had 20 falls requiring medical attention, including eight fractures and six head injuries. That compared with 39 such falls in the control group, involving 14 fractures and 12 head injuries.