TalkIng Women’s health for women’s history month
Hello, VegMichigan friends!
Anyone else besides me SO ready for Spring? It feels like it’s been a really long winter and it’s been nice to have a few sunny days recently. It reminds me that Spring is around the corner, and all the wonderful things that come along with the transition to Spring. I was telling a friend recently that with everything we have been through in the last year, my plan is to purposely enjoy and appreciate as much as I possibly can this coming Spring and Summer. My intention is to be more present and spend less time on my phone, be outside and absorb some natural Vitamin D, have fun and be active, grow and cook some beautiful vegetables, explore our beautiful state, and make the very most of our nice weather. I have never reflected on our transition to Spring this much and felt such anticipation as I have these last few weeks. I hope the change of seasons in the coming weeks gets you excited and thinking about how you want to make the most of your time as well.
I have something pretty cool to share! A few months ago, Plum Health DPC, the family medicine practice I am part of, had a very exciting opportunity to be featured nationwide on a PBS show called Start Up. The replay of the show is available online now! I am sharing the link to our show here if you would like to check it out and learn more about how we are making health care accessible and affordable throughout Metro Detroit!
With the start of March also brings Women’s History Month! In acknowledgement of the many exceptional women who have changed the course of history for the better through their intellect, innovation, bravery, and compassion, this is a good month to discuss some information about optimizing women’s health. In this month’s article, I will discuss several of the most common conditions affecting women today, the recommended guidelines for screening for these conditions, and my own recommendations about how we can help prevent these conditions.
Breast cancer is the second most common form of cancer among U.S. women, with about 250,000 new cases diagnosed each year. The U.S. Preventive Services Task Force currently recommends mammography screening every other year for women ages 50-74 who are not at increased risk for breast cancer. Women may start screening earlier than age 50 if they prefer to and many healthcare providers will recommend starting at age 40 as well. Deciding when to screen and how frequently should be based on shared decision making between the individual and their healthcare provider.
Genetics definitely plays a part in breast cancer risk, and if you have a family history of breast cancer I recommend discussing this with your healthcare provider. Outside of genetic influence, there are things we can do to decrease our own risk of developing breast cancer. Lifestyle factors such as a healthy diet rich in whole plant foods, along with regular physical activity, is protective against obesity, which in itself is a risk factor for many types of cancer including breast. Diet impacts our risk specifically, as we know that whole plant foods are rich in antioxidants that are protective against cancers. Other modifiable lifestyle factors include refraining from smoking and limiting alcohol consumption.
Cervical cancer used to be the number one cause of death from cancer among women in the U.S. This is no longer the case, thanks to advancements in cervical cancer screening and vaccination against the Human Papilloma Virus (HPV), which is the cause of nearly all cervical cancers. Screening guidelines for cervical cancer are based on age ranges and consist of the following:
Ages 21-29: Cytology testing (pap testing) every 3 years.
Ages 30-65: Cytology testing every 3 years, or every 5 years if only doing high risk HPV testing by itself, or every 5 years if doing both cervical cytology and high risk HPV co-testing.
Women over age 65: Screening is not recommended if she is low risk and if prior screening was both adequate and normal.
HPV is extremely common among younger women and men who are sexually active. Most individuals acquire the HPV virus at some point. In most cases the virus resolves spontaneously, but in some cases it does not and this is where medicine has made significant advances in screening and prevention over the last two decades. The HPV vaccine prevents the most common high risk strains of human papillomavirus that are known to cause cervical cancer. Along with screening at recommended intervals, I also recommend the vaccine to any person up to and including age 45, because we have data demonstrating as much as 90% decline in rates of cervical cancer since it became available.
colon cancer screenIng
In the United States, colorectal cancer is the third most common type of cancer and the third leading cause of cancer-related death among both men and women. The USPSTF recommends screening for colorectal cancer between ages 50 and 75. Anyone younger than 50 or older than 75 should consider screening based on personal risk factors. I recommend having a discussion with your healthcare provider about your own personal risk, and which type of colorectal cancer screening is the best fit for you.
The best way to prevent colorectal cancer is to keep up with regular screenings as recommended. Other ways to reduce your risk of colorectal cancer include a healthy diet high in fiber and with low to no animal products, not being sedentary, refraining from smoking, and limiting alcohol consumption.
Heart disease is the leading cause of death among women in the U.S. Interestingly, there are no formal recommendations from the USPSTF for screening for heart disease in asymptomatic women or men. Healthcare providers often use risk stratifying tools such as the ASCVD Risk Estimator to help determine an individual’s risk of having a future cardiac event. This tool incorporates factors such as age, biological sex, race, smoking history, high blood pressure, diabetes, and cholesterol levels to determine an individual’s personalized risk score.
If you are interested in learning more about your own risk for heart disease, I recommend asking your healthcare provider to obtain the necessary data and help you navigate through the risk estimator tool. It is well-known that a whole food, plant-based diet is protective against heart disease. Other ways to protect ourselves include regular physical activity, keeping blood pressure well controlled, avoiding a sedentary lifestyle, avoiding smoking, getting quality sleep, and managing stress.
sexually transmItted InfectIons
Screening for infections such as Gonorrhea and Chlamydia is recommended annually for all sexually active women less than age 25. In women over 25, screening is based on personal risk.
The only absolute way to prevent sexually transmitted infections is by abstinence. There are other ways to protect yourself and reduce your risk, including limiting partners and using adequate barrier protection every time. If you feel you may have been exposed, consider getting tested as soon as possible. In addition, I recommend considering the HPV vaccine if you have not done so, to prevent the human papillomavirus and reduce cervical cancer risk, as well as the Hepatitis B vaccine, as Hepatitis B can also be transmitted via sexual contact.
The USPSTF recommends screening for osteoporosis through bone density testing in all women over age 65. In postmenopausal women less than age 65, the recommendation to screen is based on personal risk through a clinical risk assessment tool.
There is a lot we can do through lifestyle medicine to prevent osteoporosis. A sedentary lifestyle is an extremely important factor. It is very important to continue regular physical activity and strength training well into our older years. For individuals already diagnosed with osteoporosis I recommend having a talk with your healthcare provider about safely optimizing your physical activity level. I also recommend optimization of calcium and vitamin D levels through both diet and supplementation. I do not recommend dairy consumption as a source of calcium and vitamin D. It is much healthier to obtain calcium through leafy greens and cruciferous vegetables and supplementation if needed, and vitamin D through supplementation and sunshine when we can. Here’s a very helpful article from the Physicians Committee for Responsible Medicine (PCRM) with some information about preventing osteoporosis.
Skin cancer is actually the leading cause of cancer among women and men in the U.S. with basal cell and squamous cell carcinomas being the most common. At this time there are no formal recommendations for skin cancer screening in the U.S., but dermatologists and many primary care doctors do regularly provide skin checks for patients to help identify suspicious lesions. Development of skin cancer is based on risk factors including increased number of sunburns early on in life, exposure to UV rays through indoor tanning, and limited protection against regular exposure to UV rays while outdoors. Without adequate protection, skin damage from the sun can begin in as little as 15 minutes.
I recommend regular use of protective clothing, as well as sunscreen with SPF 15 or higher when directly in the sun for extended periods of time. Additionally, I believe that diet plays a role in protection against skin cancer as well, since antioxidants in fruits and vegetables have been shown to offer increased protection against skin damage from the sun. I strongly recommend a diet consisting primarily of whole, plant-based foods in a variety of colors to ensure we are getting adequate amounts of antioxidants from our food.
Of course, there is so much more to discuss in regards to women’s health. These are just some of the things I discuss regularly with biologically female patients in my practice in an attempt to optimize their health. Overall, I hope this post demonstrates the importance of taking care of ourselves, both physically and mentally, as well as the importance of being screened for common health conditions whenever appropriate. In addition, a healthy diet rich in plant foods and staying physically active are extremely important factors in health optimization and prevention of cancers and other chronic conditions.
I hope you all have a great month of March! Let’s keep our fingers crossed that the warmer weather continues. Please take of your minds and your bodies, eat lots of plant foods, and remember to have fun! I’ll catch you all again next month!