Entries for June 2008

I'll admit that when I first read news reports that actress Heather Locklear was suffering from anxiety and depression, my first thought was: What does she have to be depressed about, with that perfect body, great hair, and all that money? Not to mention boyfriend Jack Wagner? (Full disclosure: I had a major crush on him back when I was in middle school and he played Frisco on General Hospital.) I felt the same way when I found out that a childhood friend of mine was experiencing a bout of depression. This friend also seems to have everything going for her: two adorable sons, a devoted husband who's a surgeon, a house on the lake. Oh, and she runs marathons.

In the course of writing articles on depression, I've interviewed many women who've told me that their friends and families simply cannot understand why they're depressed when they don't appear to have any reason to be sad. Of course, I've also written about how legitimate sadness caused by, say, a nasty divorce, death of a parent, or house foreclosure may be too quickly diagnosed as clinical depression and too quickly treated with antidepressants.

There was some disheartening news on the HPV vaccine today for women ages 27 to 45 who were hoping to get vaccinated against cervical cancer and have the $360 cost covered by insurance. The Food and Drug Administration told manufacturer Merck that it needs more time to make a decision about expanded use for its Gardasil vaccine, already approved for females ages 12 to 26. The vaccine protects against four HPV types, two of which cause genital warts and two of which are responsible for 70 percent of cervical cancers; about 80 percent of women become infected with HPV at some time or other.

In a previous blog, I discussed the seemingly arbitrary age limit placed on this vaccine and how many doctors were already giving it to women ages 27 and over. At that time, gynecologist Diane Harper, a professor of women's and gender studies at Dartmouth College who conducted some of the HPV vaccine trials, told me she was concerned that the vaccine, which had been tested only in women up to age 26, wasn't approved for those ages 27 and above. "It's absolutely artificial to say that we shouldn't vaccinate older women," she said, or that the vaccine is effective for virgins only. Half of the women she inoculates are in or approaching middle age, and many are hitting the dating scene again after divorcing or becoming widows.

Did the 17 pregnant teenage girls from Gloucester, Mass., really have a pregnancy pact? Yesterday, Carolyn Kirk, the mayor of Gloucester, said she couldn't confirm that these girls really intended to get pregnant. Watch the video:

I was shocked and appalled to read the Time magazine piece published online Wednesday about a pregnancy pact at Gloucester High School in Massachusetts that led to 17 pregnancies over this past school year in girls age 16 and younger. This is four times the number of pregnancies that the 1,200-student school had last year, according to Time. Apparently, a number of girls made a pact to get pregnant in order to bring someone into the world who would love them unconditionally. The school also provides immense support for teenage parents, allowing them to bring their babies to a school daycare center. After administering more than 100 pregnancy tests to students this year, the story says, the school nurse in Gloucester was so desperate that she wanted to start handing out contraceptives without parental consent.

There's a battle brewing between physicians organizations and midwives who perform at-home births, and TV personality Ricki Lake has been dragged into the fray. She and filmmaker Abby Epstein came out with an interesting documentary in January called The Business of Being Born, which takes aim at doctors for treating every birth like a "potentially catastrophic medical emergency." The film included footage of Lake giving birth to her second son in the bathtub of her Manhattan apartment. Last weekend, the American Medical Association issued a resolution against home births at its delegates meeting and explicitly criticized Lake.

Making the case for home births, Lake and Epstein issued a joint response yesterday on the Huffington Post:

In fact, the largest and most rigorous study of home birth internationally to date found that among 5,000 healthy, "low-risk" women, babies were born just as safely at home under a midwife's care as in the hospital. And not only that, the study, like many before it, found that the women actually fared better at home, with far fewer interventions like labor induction, cesarean section, and episiotomy (taking scissors to the vagina, a practice that according to the research should be obsolete but is still performed on one-third of women who give birth vaginally).

Think you don't need to worry about breast cancer if no one if your family has it? Think again. Most women who get breast cancer have none of the known risk factors, detailed on the  American Cancer Societys website: family history, genetic mutations, early menstruation (before age 12), late menopause (after age 55), and previous breast biopsies or chest radiation. Instead, their breast cancer may be due to a combination of controllable factors, such as being overweight, not exercising, taking hormone replacement therapy, and drinking an excess of alcohol.

One risk the ACS website barely mentions is that posed by certain "environmental estrogens," chemicals that are thought to act in concert with your body's own supply of estrogen to fuel the growth of breast tumors. Yet a growing number of cancer experts believe there's now enough evidence of a link to recommend that women reduce their exposure to these chemicals. Suzanne Snedeker, associate director of Cornell University's program on breast cancer and environmental risk factors, feels so strongly that women should take action that she has put together a series of videos telling us exactly what to do. "It's ironic that breast cancer patients end up getting treatments that work against estrogen," she explains, "but we don't tell women about what's estrogenic in the environment and how to avoid excess estrogen in the first place."

I'm sure the folks at Starbucks are rejoicing at yesterday's headlines announcing that "coffee drinkers might live longer." Women who drank more than six cups of coffee a day were found to have a 17 percent lower risk of dying from heart disease, cancer, and other illnesses over 24 years of follow-up compared with those who drank less than one cup a month. My editor had a big smile on her face when she heard this news and happily told me that she downs eight cups of freshly brewed coffee every morning before she comes to work. Though I hate to burst her bubble, I have to point out that women who drank four to five cups per day actually had better protection: a 26 percent lower risk of dying.

Being a two-cup-a-day person myself, I think the findings of this study are more reassuring than life altering. The researchers carefully phrased their conclusion that "regular coffee consumption was not associated with an increased mortality rate" and that evidence of modest benefits needs to be studied further. Certainly, women shouldn't add coffee to their list of nutritious foods that they have to get more of. After all, male coffee drinkers in the study didn't enjoy a lower death rate, and too much caffeine can cause temporary increases in blood pressure—not good for those with hypertension or heart disease.

I was dismayed to read a front-page article in today's Washington Post that "pro-life pharmacies" are coming into fashion in this country, including one set to open this summer in Chantilly, Va. The Post reports that many, including the new one in Chantilly, won't stock Plan B emergency contraception (which prevents pregnancy within the first 48 hours of unprotected sex) or any kind of birth control; that means no access to condoms, spermicide, or the pill.

Pharmacists who work in these places have religious objections to contraception, but as the article points out, they have no trouble filling Viagra prescriptions. They also generally don't have signs in the pharmacy window labeling themselves as "pro life" establishments, so unknowing women who wander in may be forced into an embarrassing situation when they try to purchase Plan B or get their pill prescription filled. (I'm waiting to see whether women's rights advocates will be picketing these pharmacies much the way pro-life activists picket all those unmarked abortion clinics.)

Every so often, I open an E-mail that makes me cringe. This week a press release titled "How Botox can help you get a new job" brought out those frown lines. It detailed a study published in the June issue of the journal Dermatologic Surgery in which 300 volunteers rated "before" or "after" photos of 17 women who had had Botox injections in their brow, forehead, and eye wrinkles. The volunteers gave higher scores to the "after" photos for attractiveness, dating appeal, and athletic ability—all qualities that improve the first impressions people make when meeting a potential boss, argues the study's author.

But when I looked at a couple of the photos—which you can do below—I couldn't see much difference between the two images.

I previously wrote that mammograms are an imperfect imaging tool and do a lousy job finding breast cancers in women with dense breasts. They also may detect "false positive" abnormalities—in all women regardless of their breast density—that look suspiciously like cancer but are really benign, often necessitating an unnecessary biopsy. There are, though, ways to get a more accurate X-ray, since some mammography facilities are better than others, according to a study published this week in the Journal of the National Cancer Institute. The analysis of 44 facilities, which performed nearly half a million mammograms over five years, found that, on average, mammograms missed about 20 percent of breast cancers that were diagnosed soon after; about 10 percent of the time, they yielded a "false positive" result that later turned out not to be cancer.

But these were just averages. While the number of missed cancers didn't vary significantly among the facilities, the best of the group detected false abnormalities about 8 percent of the time compared with 12 percent of the time for the worst. What's important here is that the study researchers found particular things that differentiated the good from the not-so-good performers:

"What's the worst lie you've told lately?" I ask a few of my female coworkers recently. None of them could think of any really bad mistruths aside from the lies they told in high school to get out of trouble with their parents or teachers. One of my colleagues said she used a photocopied ticket for a school dance and didn't step forward when students were initially asked if they had fake tickets. After her dishonesty gnawed away at her, she later went to the principal to confess. All of them told me, though, that they feel comfortable telling those you-don't-look-fat-at-all white lies to please people and make them feel good. But downright dirty dishonesty? They feel too guilty to engage in it. (I'll take them at their word.)

Our society certainly frowns upon lying. Witness the brouhaha over former White House press secretary Scott McClellan's new book, What Happened: Inside the Bush White House and Washington's Culture of Deception, where he accuses his former boss of a "lack of candor." McClellan says he's most upset about the damage to his own reputation after he "unknowingly passed along false information" from administration officials.