Do Women Need Different Health Care Than Men?

By Monica Moore, M.D., Scripps Memorial Hospital La Jolla

Imagine you’re a physician, and one of your male patients comes in complaining of a crushing sensation in his chest and pain shooting down his left arm. Your diagnosis? You’d probably suspect he might be having a heart attack. Now, imagine one of your female patients describes the stubborn indigestion and unusual fatigue she’s been feeling for the past week or so. Most likely, you wouldn’t think about heart attack. But that just may be the case.

The fact that women’s heart attack symptoms can vary so drastically from men’s is just one example of what we’re learning about the health care needs of the “fairer sex.” From cardiovascular disease to reproductive health to and exercise, it’s important for women to understand the risks they face and the steps they can take to stay healthy.

Heart Disease
While heart disease is the leading cause of death among men and women alike, their cardiovascular care needs can be quite different.

As the earlier example illustrates, early warning signs of heart attack in women can include persistent indigestion and significant fatigue, as well as nausea, belching jaw pain and discomfort in the right arm rather than the left. What’s more, women may begin experiencing such symptoms as long as a month or more before a heart attack—but may never have chest pain.

That’s why proper screening for cardiovascular disease is so important for women. Along with the usual blood pressure check and cholesterol test, physicians may recommend a fairly new lab test known as C-reactive protein (CRP). The CRP test measures the amount of protein in the blood and indicates the presence of inflammation. Inflamed blood vessels are much more prone to injury and, in turn, to developing scar tissue, which can attract plaque and lead to narrowed or blocked arteries. A high CRP level, then, may signal a higher risk for heart disease.

What else can women do to help protect their cardiovascular health? We recommend that women age 50 and over talk with their physicians about taking a daily baby aspirin (81 mg) to help ward off blood clots. (Some medications, such as NSAIDs, should not be taken with aspirin.)

Cancer
Breast cancer gets a lot of attention, and deservedly so it may affect 1 in 10 women during their lifetime. However, two other types of cancers that affect only women, cervical and ovarian, should not be overlooked.

Cervical cancer, or cancer of the cervix, has been linked to the sexually transmitted HPV virus. When detected early, cervical cancer has a very high cure rate. Moreover, a recently approved vaccine can prevent four of the most common strains of HPV. The vaccine, a series of three injections given over six-month period, is most effective when given to women before they become sexually active.

Ovarian cancer is less common than breast or cervical cancer, but it is more likely to be fatal. Moreover, because ovarian cancer has few symptoms, it may not be discovered until it has reached an advanced stage. Annual Pap smears can help diagnose ovarian cancer early, when the likelihood of a cure is greatest.

Osteoporosis
Studies have found that osteopena, or bone loss, can begin as early as age 30. To help protect bones and prevent osteoporosis, we recommend women in their 30s take a daily calcium and vitamin D supplement.

Strength-training exercises can also help build bones. Women tend to spend more time doing aerobic workouts such as jogging, walking, cycling or cardio machines and less time on strength-training exercises. Aerobic exercise is a great way to burn calories and build a strong heart, but not strong bones. Free weights, machines and body-resistance exercises can all help keep osteoporosis at bay.

Finally, beginning at age 50, women should have an annual bone-density screening to check their bone health.

Monica Moore, M.D., is a family medicine physician with Scripps Memorial Hospital La Jolla.