Introduction & Background

What Is Weight Gain?

Weight gain refers to the increase in body mass, typically due to an increase in fat, muscle, or water retention. For women, weight gain can occur due to various factors like hormonal changes, lifestyle choices, medical conditions, or even genetics. Understanding these factors and how they impact women’s health is crucial for addressing the causes, symptoms, prevention, and treatment of weight gain.

Why Weight Gain Matters for Women

For women, maintaining a healthy weight is essential not only for aesthetic reasons but also for overall health. Weight gain, especially when it involves an increase in body fat, can lead to several serious health conditions, including:

• Heart Disease: Excess fat can strain the cardiovascular system and increase the risk of heart disease.
• Diabetes: Excessive weight, particularly abdominal fat, is a risk factor for Type 2 diabetes.
• Joint Pain: Increased body weight can place additional stress on the joints, leading to pain and mobility issues.
• Sleep Apnea: Excess weight, especially around the neck, can block the airways and interfere with breathing during sleep.

Women face unique challenges and experiences with weight gain due to their hormonal fluctuations, reproductive health stages (like pregnancy and menopause), and societal pressures.

Causes of Weight Gain for Women

Several factors can contribute to weight gain in women, including biological, environmental, and lifestyle-related causes.

1. Hormonal Imbalances

Hormones play a crucial role in regulating metabolism, appetite, and fat storage. Fluctuations in hormones like estrogen, thyroid hormones, and insulin can contribute to weight gain.

• Estrogen: Decreased estrogen during menopause can lead to weight gain, particularly around the abdominal region.
• Thyroid Hormones: Hypothyroidism, a condition where the thyroid doesn’t produce enough hormones, can cause a slowing metabolism and weight gain.
• Insulin Resistance: Insulin resistance often leads to weight gain, especially around the abdomen. This is common in conditions like PCOS (polycystic ovary syndrome).

2. Pregnancy

Pregnancy naturally leads to weight gain due to increased blood volume, breast tissue, and fat storage for breastfeeding. However, excessive weight gain during pregnancy can increase the risk of gestational diabetes and other complications.

3. Menopause

During menopause, estrogen levels decline, which can result in weight gain, particularly in the abdominal area. The metabolism tends to slow down, and fat storage increases, making it harder to maintain a healthy weight.

4. Sedentary Lifestyle

Lack of physical activity is one of the primary contributors to weight gain. When women do not exercise regularly, their metabolism slows, and the body stores excess calories as fat. The modern sedentary lifestyle, characterized by long hours of sitting and less physical labor, is a major factor.

5. Poor Diet

A diet high in processed foods, sugary drinks, and refined carbohydrates can lead to weight gain. Women are particularly prone to emotional eating and cravings, which often contribute to unhealthy food choices.

6. Stress and Mental Health

Stress can trigger the release of cortisol, a hormone that increases appetite and promotes fat storage, especially in the abdominal area. Depression and anxiety can also lead to overeating or lack of motivation for exercise.

7. Medical Conditions

Certain medical conditions, including hypothyroidism, polycystic ovary syndrome (PCOS), and insulin resistance, can lead to weight gain or make it more difficult to lose weight.

8. Medications

Some medications can cause weight gain as a side effect. These include:

• Antidepressants
• Corticosteroids
• Antipsychotics
• Birth control pills

Indications of Weight Gain Issues for Women

Weight gain may not always be immediately noticeable, but there are specific indicators that suggest weight gain could be problematic:

• Increased Size of Clothing: A noticeable increase in body size often results in a need for larger clothing.
• Fat Distribution: Weight gain often accumulates around the abdomen, thighs, or hips. This redistribution of fat can be a sign of hormonal imbalances.
• Fatigue or Low Energy: Sudden weight gain can be linked with low energy levels and general sluggishness.
• Breathing Issues: Extra weight can lead to respiratory problems, including sleep apnea.
• Elevated Blood Pressure: Weight gain, especially in the form of abdominal fat, can increase the risk of hypertension (high blood pressure).
• Joint Pain: Added weight can lead to pain in the knees, hips, and lower back due to increased pressure on the joints.

Symptoms of Weight Gain

The symptoms of weight gain may vary depending on the cause, but common signs include:

• Increased Weight: The most obvious symptom of weight gain is a significant increase in body weight.
• Changes in Body Composition: Weight gain may result in changes in body composition, such as increased fat and decreased muscle mass.
• Appetite Changes: Weight gain may be associated with an increase in appetite or cravings, particularly for sugary or fatty foods.
• Stretch Marks: Rapid weight gain can cause the skin to stretch, leading to stretch marks, particularly on the abdomen, hips, and thighs.
• Difficulty Sleeping: Excess weight can make it difficult to sleep, leading to fatigue during the day.
• Breathing Difficulties: Excess fat around the neck and chest can obstruct the airways, leading to conditions like sleep apnea.

Prevention Strategies for Weight Gain

Preventing weight gain involves lifestyle modifications and paying attention to both physical and emotional health.

1. Balanced Diet

Eating a balanced diet with the right proportion of macronutrients (proteins, fats, and carbohydrates) and micronutrients (vitamins and minerals) is essential. Focus on whole, minimally processed foods, including:

• Lean proteins (chicken, tofu, fish)
• Whole grains (quinoa, brown rice)
• Healthy fats (avocados, nuts, olive oil)
• Vegetables and fruits

2. Regular Exercise

Exercise helps maintain a healthy weight by burning calories and promoting muscle mass. A combination of cardiovascular exercise (like running, cycling, or swimming) and strength training (such as weight lifting) is recommended.

3. Adequate Sleep

Getting 7-9 hours of sleep each night is crucial for metabolic health. Poor sleep can disrupt hormonal balance and increase cravings for unhealthy foods.

4. Stress Management

Learning to manage stress through relaxation techniques such as yoga, meditation, and deep breathing exercises can reduce emotional eating and hormonal fluctuations.

5. Hydration

Drinking plenty of water throughout the day helps control appetite and supports metabolic function. Sometimes, thirst is confused with hunger, leading to overeating.

6. Regular Monitoring

Keeping track of food intake and exercise routines through apps or journals helps create awareness and accountability. This can help prevent unhealthy habits from developing.

7. Consultation with Healthcare Providers

It is vital to see a doctor for regular check-ups, particularly if there are symptoms of weight gain due to underlying health conditions such as thyroid problems or PCOS.

Myths and Facts About Weight Gain for Women

1. Myth: Weight Gain is Only Due to Overeating

• Fact: While overeating plays a role, hormonal imbalances, stress, and certain medical conditions can also contribute to weight gain.

2. Myth: Women Should Lose Weight Quickly for Health

• Fact: Rapid weight loss can lead to muscle loss, nutrient deficiencies, and other health issues. Gradual weight loss is healthier and more sustainable.

3. Myth: Intermittent Fasting Works for Everyone

• Fact: Intermittent fasting may work for some but is not suitable for everyone. Its effectiveness depends on the individual’s body type, lifestyle, and metabolism.

4. Myth: Weight Gain Only Happens with Age

• Fact: While age-related hormonal changes can contribute to weight gain, unhealthy eating habits and lack of exercise are significant factors at any age.

Treatments and Therapy for Weight Gain

Medication-Based Treatments

Some women may benefit from medications designed to manage weight gain. These include:

• Appetite Suppressants: Drugs like phentermine may reduce hunger and promote weight loss.
• Hormonal Therapy: Hormonal treatments may be used for conditions like PCOS or hypothyroidism.
• Fat Absorption Inhibitors: Medications like orlistat block fat absorption in the digestive system.

Surgical Treatments

For individuals with extreme weight gain, bariatric surgery may be an option:

• Gastric Bypass: A surgical procedure that reduces the size of the stomach and reroutes the intestines, leading to reduced food intake and absorption.
• Sleeve Gastrectomy: A portion of the stomach is removed, leaving a smaller stomach pouch.
• Liposuction: A cosmetic procedure that removes fat from targeted areas.

Physical Therapy and Rehabilitation

For women dealing with weight gain-related joint pain or mobility issues, physical therapy can help. Rehabilitation programs tailored to individual needs can restore strength and mobility.

Lifestyle and Behavioral Interventions

Programs like Cognitive Behavioral Therapy (CBT) can help individuals address emotional eating and develop healthier food and exercise habits. Support groups and individualized therapy can also play a crucial role.

Alternative and Complementary Medicine

Certain alternative treatments like acupuncture, herbal remedies, and mindfulness practices may assist in reducing stress and promoting healthier weight management strategies.

1. What are the main causes of weight gain in women?

• Weight gain in women can be caused by a variety of factors, including hormonal imbalances (like those during menopause), sedentary lifestyle, poor diet, stress, medical conditions (e.g., hypothyroidism or PCOS), and certain medications.

2. How do hormonal changes affect weight gain in women?

• Hormonal changes during puberty, pregnancy, and menopause can significantly impact a woman’s metabolism, fat distribution, and appetite. Estrogen and progesterone fluctuations, for example, can cause weight gain, particularly in the abdominal region.

3. Can stress cause weight gain in women?

• Yes, stress can lead to weight gain, especially if it results in emotional eating. The body releases cortisol during stress, which increases appetite and can lead to the storage of abdominal fat.

4. How does menopause contribute to weight gain?

• During menopause, the body experiences a decline in estrogen, which can lead to fat being redistributed to the abdomen. Additionally, a slower metabolism makes it easier to gain weight and harder to lose it.

5. Can medications lead to weight gain in women?

• Certain medications, including antidepressants, corticosteroids, and birth control pills, can cause weight gain as a side effect. It’s important to discuss this with a healthcare provider if you suspect medication is affecting your weight.

6. Is weight gain common during pregnancy?

• Yes, weight gain is a normal part of pregnancy as the body supports fetal growth, increased blood volume, and fat reserves for breastfeeding. However, excessive weight gain during pregnancy can increase risks for both mother and baby.

7. How can I manage weight gain during pregnancy?

• A healthy, balanced diet with controlled portions, regular light physical activity (as advised by your doctor), and staying hydrated are essential for managing weight gain during pregnancy. Always follow your healthcare provider’s recommendations.

8. What are the most effective exercises for weight loss in women?

• Cardiovascular exercises (running, swimming, cycling) and strength training (weight lifting, bodyweight exercises) are effective for weight loss. Combining both helps burn fat while building muscle mass, which boosts metabolism.

9. Is it possible to lose weight without exercise?

• While exercise is beneficial for overall health and weight management, diet plays a major role in weight loss. A calorie-controlled, nutrient-dense diet can contribute to weight loss, but incorporating exercise will accelerate the process.

10. Can a poor diet contribute to long-term weight gain?

• Yes, a diet high in processed foods, sugary beverages, refined carbs, and unhealthy fats can lead to long-term weight gain. Consuming too many calories without balancing them with physical activity will result in weight gain over time.

11. Can I lose weight quickly?

• While rapid weight loss may be possible, it is not sustainable or healthy. Quick weight loss often results in muscle loss, nutritional deficiencies, and a slower metabolism. A gradual, steady approach is the most effective and healthiest way to lose weight.

12. Does breastfeeding help with postpartum weight loss?

• Breastfeeding can help some women lose weight after childbirth by burning extra calories. However, weight loss varies by individual, and it is important to focus on a balanced diet and regular exercise.

13. What role does sleep play in weight management?

• Lack of sleep disrupts hormones that control appetite (such as ghrelin and leptin), leading to increased hunger and cravings. Poor sleep is also linked to slower metabolism, making it harder to manage weight.

14. How does age affect weight gain in women?

• As women age, their metabolism tends to slow down due to hormonal changes (especially during perimenopause and menopause). Additionally, muscle mass decreases, leading to a higher percentage of body fat and weight gain.

15. Can I still lose weight after menopause?

• Yes, it is possible to lose weight after menopause. Although hormonal changes make it more challenging, adopting a balanced diet, regular exercise, and stress management can help manage weight effectively.

16. How do I know if I have an underlying medical condition that is causing weight gain?

• Symptoms like unexplained weight gain, fatigue, changes in skin or hair, or mood swings could indicate an underlying condition such as hypothyroidism or PCOS. It’s important to consult a healthcare provider for proper diagnosis and treatment.

17. What is the role of genetics in weight gain?

• Genetics can influence how your body stores fat, how your metabolism works, and how easily you gain or lose weight. Some people are genetically predisposed to store more fat or have a slower metabolism, but lifestyle factors still play a significant role.

18. Can weight gain be prevented with a healthy lifestyle?

• Yes, maintaining a healthy lifestyle with a balanced diet, regular physical activity, stress management, and proper sleep can significantly reduce the risk of weight gain and help you manage your weight effectively.

19. Is intermittent fasting effective for weight loss in women?

• Intermittent fasting can be effective for some women by reducing calorie intake and improving metabolism. However, it may not work for everyone, and it’s important to consult with a healthcare provider before starting any fasting regimen.

20. What are the best foods to prevent weight gain?

• Eating whole, nutrient-dense foods can help prevent weight gain. This includes fruits, vegetables, lean proteins (such as chicken, fish, and tofu), whole grains (like quinoa and brown rice), and healthy fats (such as olive oil, nuts, and avocados). Avoiding processed foods and sugary snacks is key to maintaining a healthy weight.

Conclusion

Managing weight gain is a multifaceted issue that involves understanding the causes, symptoms, and treatments. For women, weight gain is influenced by a complex combination of hormonal, genetic, and lifestyle factors. By making conscious dietary and lifestyle choices, addressing underlying health conditions, and seeking professional support, women can achieve a balanced weight and improve overall health.

The post Weight Gain for Women: A Comprehensive Guide appeared first on MyMedicPlus.

It’s true!  One in ten women struggle with this condition.  

Yet with so little still known about the disease, it’s so easy to get confused by different claims and myths around it.  Here’s my take on the main nuggets of (mis)“information” that you may hear when you’re on your endo journey.

IT’S JUST BAD PERIOD PAIN.

Probably one of the first myths you’ll hear, and sadly not just from friends and family but this is also something I’ve known to come from the mouths of some in the medical profession.  Which beggars believe in this day and age;  when the very people you turn to, probably after years of symptoms, gaslight you and your symptoms.   Endometriosis is not “just a bad period”.  I mean yes, it’s a bad, bad period but it is so much more than that.   Did you know that period aren’t meant to be painful?   A small amount of cramping for one or two days, maybe, but anything over and above that isn’t right.   It doesn’t mean you’ve got endometriosis but it does mean that you may need to do a bit of investigation as to why you’re experiencing this pain.   

I know the pain I’ve experienced from my endo is almost indescribable.  (Apologies if you’re eating…)  I always describe the pain as if someone has a coat hanger wrapped around my uterus and is simultaneously twisting it and pulling it down.  And that isn’t just pain in my abdomen; there’s also pain right down my right leg and into my lower back.    And that’s just the pain at menstruation – there’s also a lesser pain mid-cycle, too. 

And that’s just the pain – there’s also the bleeding.  (Again, apologies if you’re eating)  Did you know that ‘healthy’ menstruation is bring red blood, without any clots? Not too heavy?  Maybe lasting a few days?   Well with endometriosis, not only is the blood dark and full of clots but it can go on for days. 

So yes, it’s kind of a really, really, REALLY bad period.  But calling it such diminishes the symptoms of endo beyond recognition – inferring that it’s something that will pass, something that other women wouldn’t worry about or something that is fundamentally normal (and beautiful).  It is none of these.   That’s like saying that a brain tumour is just a bad headache.   

There’s no cause.  Everything has a cause.  It’s just that Western medicine can’t pinpoint an exact cause just yet.  The trouble with this myth is that is adds a sense of hopelessness to the list of crappy mindset stuff you’re already feeling.   It DOES have a cause – there is a reason you’ve got endometriosis.  Eastern medicine may explain it (I totally believe it does).  Even if you don’t know or believe what your cause is, there is a cause and you can get to the bottom of it.

If you have minimal disease, you’ll only have minimal symptoms.  I have never really been able to figure out why endometrioses has been classified like it has.  Its classifications suggest a progressive illness, or at the very least an illness that gets more severe in different classifications.  But it really isn’t.  

I was diagnosed with stage 2 endo in my mid-20s.  There are four stages, with stage 1 being classed as the most ‘minimal’ endo and stage 4 the most ‘impactful’.   I couldn’t fathom how I could be experiencing the levels of pain and fatigue I was experiencing (amongst other stuff) when I “only” had stage 2.  I was almost embarrassed to admit it was stage 2 because, to my layperson’s mind, it sounded to me like it wasn’t much at all.  It was almost like it was adding fuel to the “just a bad period” fire.  

Endo doesn’t work like that, though.  Stage 1 is almost a different illness to stage 4; it simply denotes the amount of endo and the existence of other issues like cysts and adhesions.   But stage 1 endo can be more painful than stage 4 endo.  Fertility tends to be more impacted by stages 3 and 4, yet my laparoscopy showed endo on my ovary and I was told that this did impact on my fertility.  So no, the ‘stage’ of your endo has NO link at all to the symptoms you experience.  

PREGNANCY IS A CURE FOR ENDO.  

There is kind of a shred of truth to this in that, for some women, pregnancy can see the end of their endo;  sometimes it never returns sometimes it does.  But let’s be clear – it isn’t a cure and it should not be seen as a cure if for no other reason that the issue of pregnancy in itself can be a huge trigger for women with endo.  One of the first things we worry about when we get the diagnosis is the impact on our ability to conceive and to pile even more pressure on an event that is so impacted by stress and anxiety (and endo) anyway is not helpful.

In fact, the ability of women with endo to get pregnant is another myth; all too often we’re told that we can’t get pregnant with endometriosis, or that it will be really difficult.  But that isn’t necessarily true – it all depends on a range of factors:  such as what stage of endometriosis you’re diagnosed with, your age, you other symptoms and your general health.  Also, just because you’re diagnosed with a certain stage in certain places, that doesn’t mean that you can’t do something about it.   Many women have successfully reduced their “fertility-limiting” endo and gone on to have children.   Everyone is different and if you’d like to explore this avenue then it is better doing so sooner rather than later, as it can take time.  

Just because you’ve got endometriosis does not necessarily mean that you can’t have children.    And just because you may get pregnant with endometriosis does not mean that your endo will disappear. 

YOU CAN’T HAVE ENDO IF YOU’VE HAD A HYSTERECTOMY   

This is the myth that breaks my heart the most, because this is the myth that can potentially cause the most damage.  Let’s be VERY clear about this…  you don’t need to have a uterus to have endometriosis, so the removal of the uterus is not a cure for endometriosis.  For some women it can ease the symptoms but in most cases, they come back and sometimes pretty quickly.  

You can also have your ovaries removed as part of your hysterectomy, which technically lessens the risk of the endo symptoms returning HOWEVER, this puts the body into an early (and forced) menopause.  This obviously impacts on your hormone levels (that’s the point), but the knock-on impact of this is an increased risk of osteoarthritis and brittle bones, hair loss etc etc.   So most doctors will recommend a course of HRT to counteract these symptoms but guess what… that will then pump your body full of oestrogen, which will then encourage the return of the endo.  

So many women report feeling as though this is their last resort, or only option purely because their doctors simply don’t know what else to do.   This is one of the biggest travesties about our illness. 

MYTH-BUSTING THE MYTH-BUSTING

All that said, there are a couple of common “myth-busts” that I disagree with.   This is my current favourite;

YOU DON’T NEED TO GET A DIAGNOSIS TO GET TREATMENT.   

So one myth-busting website I saw (and no disrespect, because I actually really like this site), used the analogy of a car;  if you were driving down the road and your car lost power, you wouldn’t accept the mechanic just poking around trying random things without knowing what was wrong (sic) so why would you do that with your body.   Agreed in so far as Western medicine goes HOWEVER, with “massively improved” waiting times for endo diagnosis still averaging over 7 years, why on Earth wouldn’t you try to get better during this time?  

I realise it’s easy for me to say this because I got diagnosed 20 years ago.  I had no first-hand experience of alternative or Eastern medicine at this point and all of my skills and knowledge has been gathered since my diagnosis.  I can’t say how I would have felt at the time if someone would have said I could get rid of all the pain, the bloating, the bleeding and everything else before I got the diagnosis.  Now?  Well, I wouldn’t hesitate but I’ve had 20 years of successes, learning, appreciation and witnessing the impact Eastern medicine can have.

So in regard to this myth – it’s TRUE you do not have to wait for your diagnosis to seek help.  It’s not the same as a car because Eastern medicine doesn’t need work on a diagnosis basis – it uses your symptoms (ALL of them) to identify the root causes itself.  As a Therapist, I would follow exactly the same processes and protocols whether you had your diagnosis or not.  So it makes little difference to me if you’ve been diagnosed with endometriosis. 

The risk is that your symptoms clear before you get your diagnosis, so you may never formally have had endomitosis.  Are you happy with that?  That has to be your own, personal choice.  But at least you know you have a choice…

The post My take on the myths that surround endometriosis appeared first on MyMedicPlus.

Bikila Balis

Department of Midwifery, School of Nursing and Midwifery, College of Health and Medical Sciences, Haramaya University, Harar, Western Oromia, Ethiopia

Correspondence: Bikila Balis
School of Nursing, College of Health and Medical Sciences, Haramaya University, Harar, Ethiopia
Tel +251 921788619
Email bik.balis2008@gmail.com

Background: Human immunodeficiency virus infection has been one of the top health-related challenges for the past four decades. Ethiopia is extremely infected by HIV pandemic every year, whereby 22,300 people were newly infected and 690,000 were living with HIV at the end of 2018. Sexual behavior of HIV positive individuals visiting treatment clinics is a neglected issue. Nonetheless, it has been a significant way of HIV transmission to serodiscordant partners.
Methods: A facility-based cross-sectional study design was used on a sample of 432 women attending treatment clinics in west Oromia from February 26 to March 26, 2019. Systematic sampling was used to select the study participants. A pretested and structured interviewer-administered questionnaires were used to collect the data. The data were coded, entered, cleaned and exported to SPSS version 20.0 for analysis. Descriptive statistics were used to present frequency distributions. Variables with P-value < 0.25 during bivariate analysis were entered into multiple logistic regression models to control for all possible confounders. Odds ratio along with 95% CI were estimated to measure the strength of the association. Level of statistical significance was declared at a p-value less than 0.05.
Results: Out of total respondents, 240 (56.9%), 95% CI: (52.1– 61.6%) were involved in risky sexual practices in the prior 12 months. Urban residence [AOR: 3.24, (95% CI: (1.52, 6.89)], those with no formal education [AOR: 2.77, (95% CI: (1.18, 6.54)], being on ART for > 2years [AOR: 2.74, (95% CI: (1.13, 6.65)] and CD4 count ≥ 200 cells/mm³ [AOR: 3.20, (95% CI: (1.50, 6.82)] were factors significantly associated with risky sexual practice.
Conclusion: A considerable number of respondents were involved in risky sexual practices 240 (56.9%) due to being rural residence, not attending formal education, being on ART for > 2 years and CD4 count ≥ 200 cells/mm³.

Keywords: women, HIV/AIDS, risky sexual practices, Oromia, Ethiopia

The post Risky Sexual Practice and Associated Factors Among Women Living with HIV/AIDS Receiving Antiretroviral Therapy at a PMTCT Clinic in Western Oromia, Ethiopia appeared first on MyMedicPlus.

Hypertension is assumed to be more prevalent in the male population. However, experts suggest that it affects both the genders equally.

A recent study published in the Journal of Hypertension indicates that there is a direct association between social ties and risk of hypertension in women. The longitudinal study including more than 28,000 people between the ages of 45 and 85 years found that women with a small social circle and limited social participation (less than two social activities in a month) are more likely to get hypertension than women who had better or more social interactions. Hypertension risk was also found to be higher in widowed women than married women.

Hypertension (high blood pressure) is assumed to be more prevalent in the male population. However, experts suggest that it affects both the genders equally. In fact, after a certain age, women are more prone to the condition than men and the former have several very unique risk factors for high blood pressure both in the pre and post-menopausal age.

Unique risk factors

According to the American Heart Association, high blood pressure is not directly related to gender. However, pregnancy, menopause and use of birth control pills are some unique factors that put women at a higher risk of hypertension.

Research suggests that women who smoke, have a genetic predisposition to hypertension or are overweight are highly likely to have high blood pressure on regular use of birth control pills.

Similarly, pregnant women often experience high blood pressure. If you have had a history of hypertension, you may have to consult your doctor before trying to conceive since high blood pressure can harm both the baby and the mother.

Gestational hypertension develops after 20 weeks of pregnancy; you may develop this type of hypertension even if you never had the condition before. And then there is pre-eclampsia, a pregnancy complication wherein the woman has high blood pressure and limb swelling and protein in urine. Pre-eclampsia can be life-threatening for the mother and preterm delivery is the only way to resolve it.

Finally, after menopause, when the estrogen levels drop, a woman’s chances of developing hypertension increases significantly. Studies suggest that a combination of various factors including individual genetics, body mass index (BMI) and increased sympathetic nervous system activity are responsible for this spike in risk. The sympathetic nervous system is responsible for the flight and fight response. It increases blood pressure, decreases intestinal motility and accelerates heart rate.

Difference in symptoms

As per the European Society of Cardiology, hypertensive women experience more arterial stiffness, atrial fibrillation and heart failure in older age than hypertensive men. Since they have a smaller diameter of arteries, aneurysms in women rupture at a much smaller size than in men.

Hypertension is said to be a silent killer. Usually, it does not show any symptoms unless there is organ damage. However, in some young and middle-aged women, the condition can also be symptomatic. Such women report some of the following symptoms:

• Headache
• Blurred vision
• A feeling that the bra is too tight
• Chest pain due to stress or continuous pain in chest that often travels up the shoulder and left arm or jaw
• Hot flushes
• Excessive sweating day and night
• Sleep disturbance
• Tiredness

A lot of these symptoms are associated with stress or menopause. Experts suggest that if you notice these symptoms, it is best to consult a doctor, especially if you have a family history of hypertension.

For more information, read our article on High blood pressure.

Health articles on News18 are written by myUpchar.com, India’s first and biggest resource for verified medical information. At myUpchar, researchers and journalists work with doctors to bring you information on all things health.

The post Hypertension in Women: How the Symptoms and Risk Factors Vary appeared first on MyMedicPlus.

Two-time survivor, current patient talk about cancer experiences

While most people will relate 2020 with COVID-19, Kelly Harrell will remember it for an entirely different disease.

Harrell, 31, was diagnosed in March with breast cancer.

“During spring break a change in my right breast was really bothering me,” she said.

She didn’t think it was anything serious enough to see the doctor for, but her husband and mother insisted. So, she called her OB/GYN.

“She saw me the next day and that same day she wanted me to get a mammogram,” Harrell said.

She said she could tell by the small talk the technician made that something was wrong.

“I knew something was there when the ultrasound tech asked me if cancer runs in my family,” she said.

Three days later she had a biopsy and that confirmed two spots in her breast and a third in the lymph nodes under her arm. It was an invasive ductal carcinoma, a kind that can spread rapidly.

“It was scary at first,” she said.

On April 6 she had her first oncology appointment at The University of Texas MD Anderson Cancer Treatment Center. By April 13 was beginning her first round of chemotherapy treatments – a 20-week process. She was given Adriamycin, also known as Red Devil medicine. It made her sick and her hair fell out.

Although the treatment was rough, it worked.

“They were very pleased that it was shrinking,” she said.

For her second round of chemo, Harrell was given Taxol. They had to stop it a short time later when she developed neuropathy in her feet.

“They moved my surgery up to Sept. 4. I had a double mastectomy,” she said.

On Oct. 12 Harrell underwent the knife again.

“They took some stomach fat and reconstructed my breasts … and I got a tummy tuck,” she said by phone while recovering in her room at MD Anderson.

There are several types of breast cancer and they affect women (and some men) differently.

Noah Hankins of San Felipe has battled it twice. She was first diagnosed in 2005 while she was working as a teacher’s aide at O’Bryant Intermediate School in Bellville. She had surgery and six months of chemo, all while continuing to work. She had the dreaded Red Devil medication and went bald.

“I never wore a wig. I didn’t feel comfortable wearing a wig,” she said.

Hankins was cancer free for 13 years.

“On Good Friday in 2018 I found a lump. I had cancer again, this time in the opposite breast,” she said.

This time she underwent six weeks of radiation treatment.

“Radiation was very tough on me,” she said.

She had surgery again. This time they removed the other breast, five lymph nodes, and the implant she had from her first bout with cancer.

“They took the implant out because it had an infection in it,” she said.

This time she opted not to have new implants or reconstructive surgery.

“I’m cancer free and I’m feeling good,” she said.

She isn’t the only one in her family to be a double cancer survivor. Her husband Terry had hairy cell leukemia in 1999 and in 2010 had prostate cancer. He said it was harder helping his wife go through her cancers than his own.

“It was a rough road, very trying at times,” he said.

Hankins had her treatment at Houston Methodist West Hospital in Katy. She praised her doctors and everyone who helped her through it.

“You just put your faith in the Lord and he helped us through it, made us stronger,” Terry Hankins said.

Noah Hankins said the toughest part for her was telling their four children about her cancer.

“It was hard to see my kids,” she said. “I’m supposed to be the strong one.”

Their children are adults now. The youngest was in college when Noah had her first bout with cancer.

One of the unfortunate side effects of her treatment was damage in her eye due to the chemo. Unknown to her at the time, she had an eye infection. As a result, she can only see half an image out of one eye.

The couple, who attend Trinity Lutheran Church, relied on their faith and the prayers and support of family and friends to get them through. Even her doctors prayed with her before surgery.

“God doesn’t give it to you, he’s just seeing how you’ll handle it and grow,” Noah Hankins said.

Faith also played a major role in Kelly Harrell’s recovery.

“My children were praying that mommy’s treatments would go well,” Harrell said.

She said a lot of people were praying for her and offering support to her family. She had help from the school where she works as well as her church, Hope City in Houston.

“There was an amazing outpouring of love that has blown me away,” she said.

Her husband Chase and children Hunter and Hailey have been her biggest supporters. He mother retired a couple months earlier than planned so she could help out at home.

Harrell is a third grade teacher at Sealy Elementary School and plans to return to the classroom in January. She said she was “super quarantined” at home during the summer but feels safe returning to the school despite the COVID-19 pandemic.

“We will have masks and face shields … I’m not worried about it,” she said.

Both Harrell and Hankins are doing what they can to help others. Hankins does breast cancer walks and often talks with women going through treatment. Harrell said she is trying to “pay it forward for other people as well.”

“Our emphasis is on the positive,” she said.

The post Women share their breast cancer journeys appeared first on MyMedicPlus.

In the past 10 years, she has meticulously screened 28 states, two union territories and Delhi. Her largest survey cover 1,24,000 participants – possibly the largest such survey in the world. 

What would you expect from the granddaughter of the ‘Father of Diabetology’ M Viswanathan and the daughter of Dr V Mohan and Dr Rema Mohan, who are icons of diabetes treatment, who established the largest and the most trusted chain of Diabetes Speciality Centres in the world? 

Implementation of a plan to screen the whole of India for diabetes, a deep dive into the real cause of its rise among Indians and a global plan to stem the development of the disease, starting from the young. 
Dr RM Anjana, MD, PhD, the managing director of Dr Mohan’s Diabetes Specialities Centre, which has a base of 8.3 lakh patients in 32 cities and 50 centres, started this nationwide survey with support from the Indian Council for Medical Research. 

In the past 10 years, she has meticulously screened 28 states, two union territories and Delhi. Her largest survey cover 1,24,000 participants – possibly the largest such survey in the world. With an astounding number of people developing diabetes in India, Dr Anjana has also been measuring their diet and exercise levels. She has found that over 60 per cent of women are inactive, (7 per cent more when compared to men). Nearly 90 per cent of women perform no leisure time physical activity at all – pushing them towards lifestyle diseases such as diabetes.

Women in India are discouraged from playing active physical sports and have limited access to any fitness activities due to social taboos. A woman cannot go outside the house after dark, cannot play field sports, cannot join health clubs and does not have time to spend on her wellbeing. Even her clothes are an inhibitory factor. This is a nationwide problem stemming from our cultural inhibitions. With the number of individuals affected by diabetes rising, it is necessary to devise a socially acceptable method to make women adopt a healthier lifestyle. Dr Anjana and choreographer Santhosh have combined high intensity interval training, dance moves and desi beats of popular Bollywood tunes to create THANDAV – an exercise in dance form. This can be done even for a short duration to burn maximum calories and also at home. No special clothes or equipment are needed. It can be a group activity and so it is easily accepted by youth too.

Dr Anjana’s and Dr V Mohan’s dream of checking the increase of the number of patients with diabetes in India through mass sensitization is now slowly turning to reality. Dr Mohan’s Diabetes Specialities team plans to reach masses, school by school, colony by colony, through educational institutions to prevent childhood obesity and early onset of diabetes. This endeavour will also help decrease polycystic ovary disease and other complications that obesity brings to women. Dr Anjana strongly believes and has ample evidence that reversal of diabetes is possible in people with pre-diabetes and early diabetes if such fitness measures, dietary regimen and precision diabetes management are adopted. Dr Anjana has also spearheaded, along with her team of scientists, the development of special dietary products for people with diabetes through food and nutrition research. 360 degree care for patients with diabetes with a strong drive towards prevention of complications has been the core value of Dr Mohan’s Diabetes Specialities Centre and it will continue to remain so.

Precision diabetes
An advocate of precision diabetes – right management for the right person at the right time through accurate diagnosis, Dr Anjana has been working closely in multinational collaborative research, championing the ways and means to keep the disease from affecting body organs

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New York/IBNS: “The struggle to beat AIDS is inseparable from the struggle for women’s rights and from the struggle against all forms of discrimination”. This is the message from Winnie Byanyima, Executive Director of UNAIDS, on Zero Discrimination Day, which falls on Sunday March 1. The theme of this year’s Day is the fight against discrimination faced by women and girls, and the organization aims to raise awareness, mobilize action, and promote equality.

Time for change

Discrimination against women and girls occurs in many different forms, across the world. These include laws that limit women’s sexual and reproductive rights, criminalize people for their gender identity or sexual orientation, or for transmitting HIV.

UNAIDS has outlined several societal changes that need to take place, to end discrimination and help in the fight against AIDS.

These include ensuring equal participation of women in political life, uphold human rights for women, and guaranteeing them economic justice, which includes ending the ongoing gender pay gap.

Violence against women must end, and laws that protect women form violence must be put in place and respected, with policies to support and protect survivors of violence.

Health care must be available, without any stigma, discrimination or barriers, and care for women must respect their autonomy, with guaranteed sexual and reproductive health and rights.

Any age of consent for health services should be lifted, and married women should not need the permission of their spouse to access care.

UNAIDS also calls for free education for all, and an end to the large gender gap which still exists in access to education, and a response to climate change that takes into account the fact that women are disproportionately affected, and are particularly vulnerable to sexual and gender-based violence during climate-related emergencies.

This is personal

Byanyima, who has lost family members to AIDS, said that it can only be beaten if the international community takes on social and economic injustices faced by women and girls, and spurs scientific innovation to help those living with the disease.

“Both my own family experience, and our collective experience at the United Nations, have highlighted the same key lesson: the struggle to beat AIDS is inseparable from the struggle for women’s rights and from the struggle against all forms of discrimination”.

AIDS is the biggest killer of women aged 15-49. For UNAIDS, gender-based violence, inequality and insecurity must end, and women and girls must have equal access to education, health and employment, if AIDS is to be beaten by 2030.

In addition, society must be transformed so that there are no second-class citizens, and everyone’s human rights are respected, said the UNAIDS chief.

“AIDS cannot be beaten while marginalized communities (such as the LGBTQI community, people who inject drugs and sex workers) live in fear of the state or of socially sanctioned violence and abuse”, said Byanyima.

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USA: A recent study on the journal Diabetes Care has found a direct link between and lower risk of type 2 diabetes. According to the study, women with a history of gestational diabetes who lactate for a longer duration are at a lower risk of developing type 2 diabetes in later life.

Gestational diabetes or diabetes during pregnancy is characterized by high blood sugar and occurs approximately in 1 in 20 pregnant women.

Sylvia H. Ley, Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, and colleagues examined the association of lactation duration with incident type 2 diabetes among women with a history of gestational diabetes mellitus.

For the purpose, the researchers monitored 4,372 women with a history of gestational diabetes who participated in the Nurses’ Health Study II for incident type 2 diabetes over 25 years up to 2017. Lactation history was obtained through follow-up questionnaires to calculate lactation duration. Follow-up blood samples were collected from a subset of these women at median age of 58 years through the Diabetes & Women’s Health Study.

873 incident cases of type 2 diabetes were documented during 87,411 person-years of follow-up.

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Antiretroviral therapy (ART) prescribing practices in the United States do not align with current national guidelines for approximately half of pregnant women with HIV, according to a study published in JAMA Network Open.

Treatment guidelines published by the Department of Health and Human Services (HHS) for pregnant women living with HIV have been available since 1994. The study aimed to examine ART prescribing practices over time among pregnant women living with HIV and identify factors associated with receiving recommended regimens.

For the analysis, the researchers used a cohort of 1582 pregnant women with HIV to examine the proportion of regimens prescribed that qualified as preferred or alternative regimens, according to HHS guidelines, stratified by timing of initiation.

According to the results, antiretroviral medications were initiated prior to conception for 42.3% of women, resumed during pregnant for 33.5%, and initiated during pregnancy for 24.2% of women. Overall, only 49.5% of pregnancies were associated with prescribed ART designated as preferred or alternative, whereas 26.4% involved ARTs with insufficient evidence for use during pregnancy and 7.3% involved ARTs that were not recommended during pregnancy.

Other findings showed:

• A higher proportion of treatment-naïve pregnant women initiating ART were prescribed preferred or alternative ARTs compared with those resuming treatment or those treated with ART before conception.
• A total of 20.1% of women initiating ART during pregnancy were prescribed ART with insufficient evidence for use during pregnancy or not recommended during pregnancy.
• Among women resuming ART, those with a viral load greater than 1000 copies/mL early in pregnancy had higher odds of being prescribed guideline-recommended ART (adjusted odds ratio, 2.03 [95% CI, 1.33-3.10]) compared with those with a viral load of 400 copies/mL or less.

The researchers wrote that the study findings suggest that US ART prescribing practices for pregnant women do not align well with the recommended national guidelines.

“This finding is particularly concerning when treatment is initiated during pregnancy,” they wrote. “Further research is needed to understand disparities between prescribing practices and evidence-based guideline recommendations.”

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Women who go on to develop type 2 diabetes after having gestational, or pregnancy-related, diabetes are more likely to have particular genetic profiles, suggests an analysis by researchers at the National Institutes of Health and other institutions. The findings provide insight into the genetic factors underlying the risk of type 2 diabetes and may inform strategies for reducing this risk among women who had gestational diabetes.

The study was conducted by Mengying Li, Ph.D., of the Division of Intramural Population Health Research at NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), and colleagues. It appears in BMJ Open Diabetes Research & Care.

“Our study suggests that a healthful diet may reduce risk among women who have had gestational diabetes and are genetically susceptible to type 2 diabetes,” said the study’s senior author Cuilin Zhang, M.D., Ph.D., of NICHD’s Division of Intramural Population Health Research. “However, larger studies are needed to validate these findings.”

Gestational diabetes (high blood sugar that first occurs during pregnancy) increases the risk of complications for mothers and their infants. In most cases, the condition resolves soon after the baby is born, but nearly half of women with gestational diabetes go on to develop type 2 diabetes later in life. Type 2 diabetes increases the risk of heart disease, kidney disease and other health problems. However, little research has been done on the genetic factors influencing a woman’s risk for progressing to type 2 diabetes after gestational diabetes.

In the current study, researchers analyzed data from 2,434 women with gestational diabetes who participated in the Diabetes & Women’s Health Study. The study followed women before, during and after pregnancy and captured data on their health later in life. Of the original group, 601 women with gestational diabetes went on to develop type 2 diabetes.

Previous research has linked variations in certain genes (called single nucleotide polymorphisms) to a higher risk of type 2 diabetes. In the current study, researchers checked genetic scans of the 2,434 women for the presence of 59 gene variants thought to be more common in people who have type 2 diabetes. The researchers found that women who had the largest proportion of these gene variants were 19% more likely to develop type 2 diabetes, compared to those who had the lowest proportion of these variants.

The researchers also ranked the women’s diets according to the proportion of healthy foods. Among women who adhered to a healthier diet, the risk associated with the gene variants was lower than that of the other women, but the differences between the two groups were not statistically significant.

The authors believe their study is among the largest to date that looks at genetic factors underlying development of type 2 diabetes among women with prior gestational diabetes. However, the number of women participating in the study may not be large enough to find a significant interaction between healthy diet and genetic susceptibility in relation to this risk, explained Dr. Zhang.

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(Reuters Health) – The AbbVie drug elagolix, already used to treat the pain of endometriosis, can significantly reduce the chances of heavy menstrual bleeding caused by uterine fibroids, according to the results of two studies reported in The New England Journal of Medicine.

Uterine fibroids are non-cancerous growths in the uterus that can cause problems such as pain, pressure, heavy periods and infertility in as many as half the women who have them. They are very common, particularly among African American women.

The elagolix treatment, if approved by the U.S. Food and Drug Administration, could give women a new option for dealing with the bleeding. Current treatment sometimes involves injections given monthly or every three months. Elagolix is a pill whose effects appear and fade much more rapidly and predictably. The new studies did not directly compare the two treatments.

“This does provide a different approach and many women may prefer that,” lead study author Dr. William Schlaff of Thomas Jefferson University in Philadelphia told Reuters Health in a telephone interview. “We know it’s effective for at least six months. If that can be prolonged, it could act as a bridge to get to menopause, where hormone levels drop naturally.”

“But if you’re 32 years old (with a fibroid bleeding problem) this may not be a bridge you want to use for 20 years,” he said. Such women may want to consider a hysterectomy or some other option.

The two new studies – which were identical – followed a total of 790 women with a menstrual blood loss of more than 80 milliliters (about 2.7 ounces) per month.

At the six-month mark, among women getting placebo treatment, 8.7% in one study and 10% in the other saw their monthly blood loss reduced by at least 50%.

When the women were given elagolix alone, the success rates were 84.1% in one study and 77% in the other.

The treatment suppresses ovarian sex hormones, increasing the odds of osteoporosis. So in some women, doctors also gave hormone therapy to compensate.

With that hormonal “add-back therapy,” monthly flow was still reduced by at least 50% in 68.5% of women in one study and in 76.5% in the other.

Add-back therapy alleviated decreases in bone mineral density caused by elagolix but it also increased the number of hot flushes in both trials, and in one trial, it increased the likelihood of spotting between periods, the researchers found.

Most side effects of the drug “were considered by the investigators to be mild or moderate in severity,” they reported.

The studies, known as Elaris UF-1 and Elaris UF-2, were financed by AbbVie, which sells the drug under the brand name Orilissa.

The 300-milligram twice-daily elagolix treatment would cost more than $47,000 per year, according to prices on goodrx.com. In contrast, monthly leuprolide injections, which are an established treatment, costs roughly $7,000 per year.

Compared with placebo recipients, elagolix recipients with add-back therapy also had higher levels of the oxygen-carrying protein hemoglobin in their blood and were more likely to have their periods cease altogether.

They also tended to score higher on quality of life questionnaires.

Schlaff, who chairs the department of obstetrics and gynecology at Thomas Jefferson, predicted that if the drug is approved for fibroid bleeding, it will change the way women are treated.

“A lot of women want to use oral medication” instead of periodic injections, he said. “Women are going to say, ‘I don’t want to commit to a 1- or 3-month dose.’ Or they may want to start with one and move to another.”

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Endometriosis is a chronic pain disorder that affects an estimated 1 in 10 women around the world between the ages of 15 and 49. Yet, despite the disorder’s prevalence and often debilitating pain, women suffering from it tend to be either dismissed or offered a limited number of treatment options. 

But a new study from researchers in Spain may change that. The research team has demonstrated, using a mouse model, that a moderate dose of THC could not only reduce pain associated with endometriosis, but could even be effective at reducing internal cysts associated with the disorder.

Not a Modern Medical Mystery 

While discussions of endometriosis may have become more common in recent years, with women voicing their first-person accounts of the disorder, the disease itself is far from new. Descriptions of the disorder appeared in medical texts as far back as the late 1800s, and despite a better modern understanding of what causes endometriosis pain — the inflammation of endometrial tissue that has grown outside of the uterus on a woman’s ovaries, bowels, or pelvis — the cause of endometriosis itself is still unknown.

As for treating the disorder, women often face challenges from the start, not only because endometriosis symptoms present similarly to other disorders, like pelvic inflammatory disease, but also because endometriosis pain is often dismissed as merely menstrual pain. After diagnosis, treatment options for endometriosis range from over-the-counter pain relief, like ibuprofen, to hormone treatments to, in severe cases, hysterectomy.

Mice and Medical Marijuana 

In search of better options, a team of Spanish researchers turned to mice and the psychoactive component of marijuana — THC. 

“With a lack of effective treatments, women with endometriosis usually rely on self-management strategies,” the study’s senior author Rafael Maldonado, Professor at the University Pompeu Fabra of Barcelona, Spain, said in a statement. “Although cannabis comes with a large number of potential side effects, its medicinal properties could provide pain relief in endometriosis and other conditions.”

The researchers implanted endometrial tissue around the pelvis of an experimental group of female mice, in order to mimic endometriosis symptoms, and left a control group of mice untouched. As with endometriosis in women, the afflicted female mice began to demonstrate pain and anxiety symptoms, as well as cognitive impairment and the development of endometrial cysts. Once these symptoms were established, both groups of mice were given daily 2mg doses of THC over a 28-day period. 

More Than Pain

The team found that the mice with endometriosis experienced decreased pain in their abdomens as a result of their THC doses, as well as lessened cognitive impairment. While this study certainly isn’t unique in connecting cannabinoids with pain relief, the team did find another surprising effect of the THC dosage: cyst inhibition. The researchers found that endometriosis mice had smaller endometrial growths after completing the THC regimen. 

Swing and a Miss 

Despite the promising results of the study, the researchers were still unable to determine THC’s effectiveness in several key areas of endometriosis, including anxiety, fertility, painful intercourse and extreme menstrual cramps. However, following this study the researchers have partnered with the Gynecology Service of the Hospital Clinic of Barcelona, Spain, to begin conducting clinical trials of this approach in women with endometriosis. 

With any luck, positive results from this impending clinical trial could finally spell relief for the tens of thousands of women suffering from endometriosis.

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The conventional wisdom has been that when heart disease shows up in women, it simply arrives more slowly, generally lagging about 10 to 20 years behind men. But a review of blood pressure measures for nearly 32,800 people collected over four decades casts doubt on that view—and suggests, once again, the health system must do more to recognize men and women are different, and thus, diseases act differently.

A study published recently in JAMA Cardiology found certain vascular diseases not only develop earlier but progress quickly, which the authors said can set women up for late-life heart problems “that tend to present differently, not simply later” than those in men.

The authors—who came from Harvard, Cedars-Sinai Los Angeles, and Turku University in Finland—reached their conclusions by shedding old assumptions of the past. Instead of assuming that men and women are basically the same physically, this team assumed they are different, and by looking for gender-specific differences in the blood pressure data, they uncovered new insights.

The researchers used data from 144,599 separate blood pressure readings taken between 1971 and 2014 from patients aged 5 to 98, which were recorded in four different studies.

Compared with men, women “clearly exhibit a steeper increase in [blood pressure] that begins as early as the third decade and continues throughout the life course” they wrote.

What causes gender-related differences in blood pressure? The authors say there could be a host of reasons, including hormonal factors, chromosomal factors, and differences in gene expression. Women are smaller, and their organs—including the heart—are smaller, too. The most differences are those associated with when women begin menstruating and having children; beyond the hormonal changes, blood volume increases, and so does the heart rate.

The differences beyond biology can matter, too. “Importantly, complex social, economic, and structural environmental factors lead to differences in the lived experience between men and women that can affect physiology as well as vascular biology,” the authors write.

Such differences are important because of studies of drugs developed for type 2 diabetes are now being shown to be effective in some forms of heart failure. More studies are expected that may show whether these drugs, called SGLT2 inhibitors, are effective in the form of heart failure associated with stiffness in the heart’s left ventricle. As the authors note, this dangerous condition is more likely to affect women, especially if they have high blood pressure. Right now, no drugs have been shown to prevent early death from this condition.

More work is needed, the authors said, to understand how the differences between men and women affect cardiovascular risk, so that prevention and management efforts can be tailored for each.

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A review published in Nature Medicine reveals an alarming failure to successfully treat cardiometabolic disorders, such as diabetes, heart disease, and stroke, in women.

The authors urge health services to consider the biological differences between men and women when treating heart disease.

The review, by Prof. Eva Gerdts, of the University of Bergen, in Norway, and Prof. Vera Regitz-Zagrosek, of the Charité Universitätsmedizin Berlin, in Germany, compares the common risk factors for both sexes.

The authors summarize the results of over 18 major studies that have explored the causal factors of heart disease in each sex.

The overwhelming finding was that women are more at risk of receiving the wrong treatment because health service professionals fail to spot symptoms or risk factors that are unique to women.

Obesity at the heart of it

Recent research has substantiated fears that the global rise in cardiometabolic disorders is linked to obesity. Meanwhile, fresh evidence suggests that obesity and associated damage to the heart occur differently in men and women.

Global figures show that obesity in women is on the rise, and as Prof. Gerdts’ review explains, women store fat differently from men. The mechanisms behind this process combine to create an increased risk of type 2 diabetes and heart disease.

“If we see this from a life span perspective, we can see that obesity increases with age and that this trend is greater for women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease,” explains Prof. Gerdts.

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The estrogen advantage

The hormone estrogen works to impede metabolic syndrome by preventing connective tissue from forming in the heart. This also helps keep blood pressure stable.

But the decrease in estrogen that occurs during menopause can increase the risk of arterial stiffening and subsequent disease.

This helps explain an increase in hypertension among women over 60. In men, meanwhile, hypertension is more common before the age of 60.

Lifestyle risks increase with age

Socioeconomic status and lifestyle factors also play a role in cardiovascular risk discrepancies.

The researchers highlight the fact that, around the world, women are more likely to experience low levels of education, low income, and joblessness, and that studies have associated each of these factors with diabetes and depression — two major contributing factors for heart disease.

Meanwhile, the adverse effects of unhealthful habits, such as smoking — which is on the rise in women — multiply as we age. This can lead to high blood pressure, which can cause heart failure if a person does not receive treatment.

“For women, the effects of risk factors such as smoking, obesity, and high blood pressure increase after menopause,” says Prof. Gerdts.

What can we do?

Prof. Gerdts hopes to incite action among the medical community; she calls for healthcare providers to place more emphasis on sex differences when treating cardiometabolic disorders.

The present study highlights an imbalance in available research, in an effort to pave the way for further work.

The outlook is promising if we consider that cardiac arrest — which is more common in men — is now treatable and preventable. If the same resources and research were applied to the factors that put women at risk of heart failure, perhaps similarly effective interventions could be developed in the near future.

In the meantime, it is important for healthcare providers to help women in high-risk groups lower their blood pressure, reduce the risk or effects of obesity, and put quitting smoking at the top of their list of 2020 goals, if necessary.

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Two transgender women are suing Florida government agencies for being denied gender-affirming health care under the state employee health plan’s exclusion for “gender reassignment or modification services or supplies.”

It’s the latest legal challenge to state health plans that deny coverage for gender-affirming procedures.

The Florida lawsuit, filed Monday, argues that the state’s exclusion of gender-affirming care violates Title VII of the Civil Rights Act and the U.S. Constitution’s equal protection clause. The plaintiffs, Jami Claire and Kathryn Lane, are state workers who were denied treatment for gender dysphoria. Claire is a scientist who has worked at the University of Florida for over three decades, and Lane is an attorney in the public defender’s office in Tallahassee.

“This was an intentional decision made by the [Florida] Department of Management Services to exclude this type of care, and we know that because there is already an exclusion for non-medically necessary care,” Simone Chriss, attorney at Southern Legal Counsel, told Rewire.News. “If what our plaintiffs were seeking was not medically necessary, it would just be denied for that reason, but it wasn’t. It was denied under the exclusion for gender-affirming care, which means that they recognize it is medically necessary but they choose not to cover it.”

The ACLU of Florida, Southern Legal Counsel, and pro bono attorney Eric Lindstrom filed the lawsuit against the Florida Department of Management Services, the Public Defender of the Second Judicial Circuit of Florida, and the University of Florida.

Claire said Florida’s exclusion of gender-affirming care has affected her financially and emotionally. She has had to pay out of pocket for many of the procedures she needs.

“When I had tried to access the medical care, the exclusion was there and I couldn’t access it and I had three suicide attempts,” she said. “Life wasn’t worth living at that point.”

Claire added, “I’ve spent thousands of dollars already and if this exclusion is not overturned and I get to the point where I retire, I will have to use approximately a third of my retirement money to pay for bottom surgery.”

Hormone replacement therapy, electrolysis, augmentation mammoplasty, orchiectomy, and facial feminization surgery were some of the procedures denied by the plaintiffs’ state plans due to the exclusion of gender-affirming care.

Transgender people face numerous barriers to health care access, including discrimination by health-care providers and economic barriers to accessing affordable care. According to the 2015 U.S. Trans Survey from the National Center for Transgender Equality, one-third of respondents who had seen a health-care provider in the past year had at least one negative experience related to being transgender. One in four respondents said they had a problem with their insurance in the past year related to being transgender, such as being denied gender-affirming care. Black, Native American, Latinx, and multiracial trans people were more likely to be uninsured than white trans people, according to the survey.

Twenty-two states and the District of Columbia have policies that prohibit health-care discrimination based on gender identity, according to the Pew Charitable Trusts’ Stateline. Twenty-one states have no policy for health-care coverage for trans people.

Billy Huff, a transgender man who worked at the University of Florida as the director of LGBTQ Affairs, said he was surprised when he found out about the state’s exclusion. He had only researched Aetna to find out if he had coverage.

“I was heartbroken,” he said. “I was at that point literally marking days off on my calendar until my surgery date and already had my consultation and paid for my down payment on the surgery out-of-pocket.”

There have been other lawsuits against exceptions for gender-affirming care in state plans. In 2018, Lambda Legal filed a lawsuit against the state of Alaska on behalf of Jennifer Fletcher, a state legislative librarian, because the state prohibited coverage for her transition-related care. The LGBTQ rights-focused organization, which does litigation and public policy work, said the denial of care violated Title VII of the Civil Rights Act. The case is still open.

Lambda Legal and the Transgender Legal Defense & Education Fund (TLDEF) filed a lawsuit in 2019 on behalf of current and former employees of the state of North Carolina who were denied transition-related care under the state employee health plan. In the complaint, Lambda Legal and TLDEF argue this violates the equal protection clause, the nondiscrimination clause of Affordable Care Act, and Title IX, since the defendants include state colleges and universities.

Lambda Legal attorney Taylor Brown told Rewire.News that defense of state plan exclusions vary from arguing that the procedures aren’t medically necessary and qualify as “cosmetic” to claiming that refusing to cover gender dysphoria is not discriminatory.

“We’re doing the research about these exclusions and looking into state plans and looking into public record requests on when these decisions were made and debated, and they often rely on outdated science or just pure speculation and misinformation,” Brown said.

“Every major medical association in the United States recognizes the medical necessity of transition-related care for improving the physical and mental health of transgender people and has called for health insurance coverage for treatment of gender dysphoria,” according to the American Medical Association. The American Medical Association also cites studies showing that health coverage that includes gender-affirming care is cost-effective compared to the costs associated with untreated gender dysphoria.

Brown said the claim that refusing treatment for gender dysphoria isn’t sex discrimination doesn’t hold legal water.

“We argue that it’s sex discrimination because these procedures we call transition-related health care—they’re often procedures available to cisgender people. So they’ll say that this is not sex discrimination. It’s condition discrimination. We’re not treating gender dysphoria. But we understand that the only people who have gender dysphoria are transgender people,” she said.

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