Women’s Health and Wellness

1. Women’s Health and Wellness Lisa Zaynab Killinger, DC

2. Overview of Women’s Issues • Leading health concerns • Heart Disease-#1 Killer of women • Cancer- 2nd leading cause of death • Stroke- 3rd leading cause of death • Osteoporosis- Common to almost all older women • Dementia- Leading cause of nursing home placement • Menopause-A quality of life issue for 1/3 of women • Concerns of younger women: Menstrual issues, nutrition, fertility, overweight, exercise

3. Heart Health in Women • Heart disease: Leading cause of death • What’s special about women? • Women are twice as likely to die if they have a heart attack, than a man • Women’s heart attacks are often missed/mis-diagnosed • Disproportionate % of heart attacks happen at 9 am Monday morning • Many women don’t recognize or believe they are having a heart attack • Heart attacks present differently in women- • Neck, jaw or arm pain (or no pain) • Panicky or uneasy feeling • Shortness of breath • General discomfort or tightness in chest • Sweating • Any of the above, exacerbated by exertion or stress

4. Why are heart attacks more deadly in women? • Women have smaller blood vessels with thinner walls (fragile) • Emergency room staff and medical professionals often miss the diagnosis due to unusual/mild symptoms • Women, often too busy to go to the doctor, may endure pain/discomfort in silence.

5. Heart Disease Prevention: ♀ • Advise patients to quit smoking • Keep patient adjusted • Recommend regular physical activity • Monitor/control blood pressure & cholesterol • Manage stress effectively-yoga, relaxation techniques, biofeedback, exercise

6. Heart Disease and Nutrition • Mediterranean Diet-Shown to lower risk of heart attack (More fruit, veggies, grains, less animal fat/red meat, more fish, etc.) • Whole bran foods-Oats, Wheat bran etc. (increase fiber intake) • Lower sodium intake • Vitamin E, other antioxidants, selenium

7. Heart Health & Nervous System • The Heart is innervated by: • Related Spinal Levels are: • Thoracic spine: T4-6

8. Cancers and Women

9. Lung Cancer • Leading cause of cancer death in women • Very preventable! • Most cases are related to smoking or radon • Have home checked for radon gases • Advise pts to quit smoking • Provide good smoking cessation materials • http://www.surgeongeneral.gov/tobacco/quits.htm

10. Lung Dis-ease and the Spine • Lungs are Innervated by: • Spinal Levels Related to Lung:

11. Breast Cancer • Breast Cancer- • 200,000 cases/year & 40,000 deaths/year • Risks: • Obesity, sedentary lifestyle • Alcohol use • High fat diet • Family history (only 10% of cases) • Genetics (BrCA1 and BrCA2 genes)

12. Breast Health and the Spine • Breast tissue is innervated by: • Related spinal levels are:

13. Colo-Rectal Cancer • Third leading cause of cancer death • Prevention recommendations: • Diet high in fiber • Diet low in animal fat • High calcium intake • Resources: www.cancer.org

14. The Colon & the Nervous System • The Colon is innervated by: • The related spinal levels are:

15. Stroke: The 3rd Leading Cause of death in women • Risks: • Smoking • Overweight • Sedentary lifestyle • Use of oral contraceptives/hormone replacemt. • High blood pressure or cholesterol

16. Stroke: Patient Presentation • Headache or neck pain-Severe • Dizziness • Speech disturbance (may be mild or none) • Vision disturbance (may be mild or none) • Unusual weakness, numbness, etc (not injury related)

17. Strategies for Stroke Prevention in Chiropractic Practice • Adjusting Strategies: • In patients with risk factors: • Avoid extension and rotational vectors • Employ a least invasive to most invasive strategy • Do not adjust if stroke symptoms are present • Recommend Stroke Prevention For Your Patients • Exercise!! • Quit Smoking • Increase fruits, vegetables, and whole grains • Decrease animal fat and red meat • Consume more fish

18. Osteoporosis: The “silent thief” • Osteoporosis is silent: • Often patient knows nothing about their bone loss until a fracture occurs • 1/3 of women over 70 have osteoporosis • 84% of women over 70 have low bone mass (osteopenia) • Osteoporosis is PREVENTABLE

19. Low calcium intake Sedentary lifestyle Hi caffeine intake Alcohol use Smoking Soda pop drinks European or Asian descent Fair skinned Sm. framed/lo weight Family history of OP Early hysterectomy Identify who is at risk…Controllable risks Uncontrollable risks

20. Recommendations for Bone Health • Exercise: Walking or other axial loading exercises, weight lifting • Calcium Supplementation: 1,200-1,500 mg/day • Avoid smoking, caffeine, alcohol, soda pop, etc

21. Menopause • 1/3 of women in the US are menopausal • Process starts in mid forties w/ pre-menopause • Night sweats, mood swings, depression, sexual changes. • Patients seek help!

22. Menopause and Health • Post menopausal increase in risks • Breast, uterine, cervical, ovarian cancer • Osteoporosis • Heart Disease/Stroke • Dementia/memory problems

23. Help: Natural remedies • Isoflavones • Black Cohosh • Red Clover • DongQuai • Alfalfa • Passion Flower • Wild Yam

24. Especially…. • Black Cohosh: <Remifemin> Used for relief of general menopausal symptoms, nervousness, anxiety, hot flashes, vaginal dryness • Resources: Whiting, Clouston, Kerlin. M J Australia 2002;177(8):440-443. • Leiberman: J Women’s Health 1998;7(5):525-529.

25. What herbs for what? • Herbs For Bone Loss: • Wild Yam: natural progesterone source • Chaste Berry-LH/Progesterone stimulant • Red Clover: All 4 isoflavones • Daidzen, Genistein, Formononetin, Biochanin • Source: Nestel et al. J Clin Endocrinol Metab. 1999; 84(3):895-8.