The subject of women’s health is naturally tied to a bat mitzvah – for age 12 is when the average young woman will start to experience the time our hormones awaken. The average woman today may want to run away from all of the conflicting information and avoid doctors altogether! Beginning with menses – even at the tender age of 12 – a young woman can begin to experience the blessings and curses of being a woman. Hormones surge, the body develops into that of a woman, and she may celebrate her Jewish coming of age. She can also experience the same diseases as an adult: obesity, type II diabetes, arthritis, heart disease and more. Most of these diseases are “gender-neutral,” meaning they affect women as well as men.
Most women still do not realize that cardiovascular disease is the number one killer of women – not breast cancer. Virtually one-third of all American women will die from heart disease. Breast cancer certainly gets a lot of media attention, and the breast cancer genetic mutations – BRCA-1 and BRCA-2 – are commonly found in Ashkenazi Jews, so Jewish women often face the issue of genetic testing. But, the gene is tied to male cancers, too. So, oftentimes the whole family will be involved in genetic testing discussions.
Unfortunately, most studies involving new drugs, lifestyle changes and environmental impact are conducted solely on men. Often, this is because women of childbearing age are excluded from studies. As physicians, we try our best to extrapolate the data and resultant conclusions to our female patients and make informed decisions and recommendations regarding a woman’s medical care.
The debate regarding hormone replacement therapy (HRT) is almost exclusively a woman’s issue. Even as a physician, I find it difficult to hear study after study contradict the study that preceded it; one day we are supposed to take Vitamin E, the next day it is Vitamin D. One year we absolutely must take estrogen, the next year we have trouble finding a physician who will refill the very medication we were told it was imperative to take. And this phenomenon shows no sign of slowing down.
Additionally, the “typical” signs and symptoms of diseases in women – such as heart disease and acute myocardial infarction – differ from those of men. For example, a woman may not experience “crushing chest pain” when she has a heart attack. Instead, she may have nagging left arm pain, the feeling of a neck strain, or simply shortness of breath. This often leads to the woman’s delay in attributing her symptoms to those of a heart attack; delay in recognition of the problem in the emergency room; often a significant delay in treatment; and, overall, much greater morbidity and mortality from heart disease. All because we are women.
So what is a woman to do? First, it is imperative to build a rapport with a primary care or internal medicine physician. I am a fan of “concierge medicine” when it is an available and affordable option for a woman. Second, do the basics: mammograms, GYN exams, lab work, etc. Third, maintain a normal body weight; move your body even a little bit every day; and certainly do not smoke. Most importantly, take care of you. This final step is often overlooked by women, but it is so vital to the health of those who depend on us – our spouses, children, parents, schools, temples, communities and friends. For without our own good health – including our mental health and happiness – we are not able to nurture others.
In my aesthetic medical practice, I see women every day who feel isolated and unhappy, regardless of their overall health status, their age, their demographic or their appearance. The common theme seems to be a lack of connection or feeling of purpose. No matter how busy or involved they appear to be, they are lacking a deeper sense of meaning in their lives. Our society does little to celebrate, or even recognize, the contributions women provide in the world, and it is easy to feel marginalized and underappreciated. Also, as a parent of two teenage boys, I can say firsthand that you rarely get thanked and appreciated for being a responsible and present parent of teens. Usually, parents are the last thing they want to see – unless we have money or car keys in our hand!
So, back to the subject of women’s health: It is really everyone’s health. Women, though rarely studied, are virtually half of the population on this planet. Our health and health care is largely our own responsibility. We must be our own best advocate for our health care; we must take care of others; and most importantly, we must take care of ourselves in intangible ways that nurture our souls. If you find yourself tired, burned out, frustrated, isolated or in any other way suffering, take care of you. And, for those of you looking for a reason, there is even a study that shows Botox really can make you happier!
Elizabeth VanderVeer, M.D., is a board-certified internist and president/medical director at VanderVeer Center. A native Oregonian, she is a fourth-generation doctor who has dedicated her practice exclusively to aesthetics for many years and specializes in nonsurgical cosmetic medicine. Dr. VanderVeer is a published author and a sought-after international lecturer as well as a national trainer for numerous industry leaders.