By Lyndaliu
You know that a crushing chest pain is a reason to dial 911. But
what you probably don't know is that if you're a woman, a bout of
nausea could also be a warning sign of heart attack.
There are a number of serious diseases that, for many women,
don't announce themselves with the classic red flags. Heart
disease, for example, has symptoms that can be far different for
women than for men. Others, such as ovarian cancer, have subtle
warning signs that could be mistaken for minor conditions.
Read on to learn when those little pains spell big trouble.
Ovarian cancer is tough to diagnose in its early, more curable
stages, because its symptoms could just as easily signal anything
from an ulcer to a hernia, says Dr. Carolyn D. Runowicz, professor
and director of the division of gynecologic oncology at Albert
Einstein College of Medicine and Montefiore Medical Center, both in
Bronx, N.Y. Because the disease usually strikes women over 40, you
may be told that your indigestion and bloating are signs of
menopause.
Unfortunately, only 24 percent of ovarian cancers are found when
survival rates are high. Overall, less than half of all women who
have what's known as the ``cancer that whispers'' are alive five
years after they're diagnosed. Though it accounts for only 4
percent of cancer in women, ovarian cancer is the fourth leading
cause of cancer death in women ages 35 to 74.
Symptoms of ovarian cancer include bloating or swelling in the
abdomen, gas, loss of appetite, nausea, or indigestion, pelvic
pressure that makes you feel as though you have to urinate or have
a bowel movement all the time, pain during intercourse and unusual
vaginal bleeding. If your primary care physician makes a noncancer
diagnosis, and you don't feel better after a few weeks of
treatment, see a gynecologist for a pelvic examination, Runowicz
says.
There are no effective mass screening tests for ovarian cancer,
although a new blood test that measures the amount of a substance
that causes ovarian cancer cell growth has shown promise in early
studies. Unfortunately, it's not yet available.
If you're over 18, you should be getting an annual pelvic exam
in which your doctor feels for anything abnormal. If you're over
35, that should include a rectovaginal exam.
If you're at high risk (you have a family history of ovarian,
breast or colon cancer), you should regularly have a transvaginal
sonography _ an ultrasound performed with a small instrument placed
in the vagina. You should also have a blood test to determine if
the level of a tumor marker called CA-125 has increased in the
blood.
Be aware, however, that some noncancerous diseases of the
ovaries elevate this blood marker. So do other cancers, and even
menstruation.
Recent studies have provided some good news for women with a
family history: Taking birth control pills for a total of five
years (does not have to be continual) may decrease your risk by up
to 60 percent. Talk to your gynecologist.
HEART DISEASE
Heart attacks are the No. 1 killer of American women -- but that
seems to be medicine's best-kept secret. A nationwide survey of
1,000 women conducted by the American Heart Association in Dallas
found that only 18 percent had received information about heart
disease from a health care professional. Most were unaware that
along with the classic symptoms of heart attack (crushing chest
pain that can also be felt in the neck, shoulder, or arm,
breathlessness and sweating), they could experience more subtle
symptoms that may not raise the same kind of alarm.
Heart attack symptoms include mild pain in the arm, back, upper
abdomen, jaw and throat, shortness of breath, nausea, dizziness
lightheadedness and cold sweat.
Your doctor may miss the warning signs as well. ``We're still in
a battle to convince doctors that women get heart disease and get
different symptoms,'' says cardiologist Dr. Elizabeth Ross, of the
Washington Hospital Center in DC.
If you experience any of these symptoms, call your local
ambulance or 911. Chew a 325-milligram aspirin: Studies show that
it can increase your survival if taken in the early stages of a
heart attack.
Even if you haven't had any of these symptoms, discuss them with
your doctor to make sure that you're both aware of the
gender-specific red flags of heart attack. Most important, think
prevention. First, have a complete physical. Your doctor should
take a health history and perform several tests, including checking
your blood pressure, cholesterol, and other blood fat levels. You
may be at risk if you smoke; are postmenopausal (particularly if
you're not on hormone replacement therapy, which may protect your
heart); have diabetes, high blood pressure, or high cholesterol
levels; are physically inactive or obese; or have a family history
of heart disease.
For More Information, visit the AHA's Web site at www.
amhrt.org. To find out more about their free Take Wellness to Heart
campaign, which is designed to help women live heart-healthy lives,
visit women.americanheart.org.
BLEEDING DISORDERS
If you get heavy periods, your doctor has probably told you that
it's nothing to worry about. But menorrhagia _ prolonged and/or
heavy menstrual cycles _ could be a sign of von Willebrand disease,
the most common inherited bleeding disorder.
People with von Willebrand disease take longer to stop bleeding
due to defects or deficiencies in a substance that helps blood clot
(known as the von Willebrand factor). Typical symptoms include
nosebleeds, easy bruising and bleeding from the mouth or gums. The
most common symptom for women, however, is excessively heavy
periods.
Although it affects up to 2 percent of the population (equal
numbers of both sexes) and is 100 times more common than
hemophilia, von Willebrand disease is widely misunderstood.
``Because hemophilia is a male disease, there's a common
misconception even among the medical profession that only men have
bleeding disorders,'' says Anne Dilley, an epidemiologist in the
Hematologic Diseases Branch of the Centers for Disease Control and
Prevention in Atlanta. (Actually, an estimated 1 to 3 percent of
women have bleeding disorders, most of them von Willebrand
disease.)
Von Willebrand disease can lead to anemia, unnecessary
hysterectomies and complications (even fatalities) from surgery and
other trauma. Misdiagnosis can lead to potentially fatal postpartum
bleeding. Because it seems like ``woman trouble,'' you're more
likely to see your gynecologist than a hematologist (blood
specialist).
``We believe that, if gynecologists can't find a gynecological
cause, then they often say, 'I don't see anything wrong here. Your
heavy periods are probably normal,''' Dilley says. ``In many cases,
they don't think to explore hematological causes.''
If you suffer from these symptoms, talk to your doctor about
being tested for von Willebrand disease, suggests Dr. Stephanie
Seremetis, associate professor of medicine at the Mount Sinai
School of Medicine in New York City.
The disease is diagnosed through a series of tests that look at
the blood's ability to clot normally. It's usually treated with
desmopressin acetate, a nasal spray, injection or tablet that helps
increase the amount of von Willebrand factor in the blood. Using it
at the beginning of the menstrual cycle will, for most women, bring
blood loss to normal levels. People may also be given desmopressin
acetate before surgery or to prevent other types of bleeding.
For more information, call the National Hemophilia Foundation at
(800) 42HANDI (424-2634) or visit their Web site at
www.hemophilia.org.
LUPUS
Because of its smorgasbord of symptoms -- many of them mild --
lupus has been called ``the disease with 1,000 faces.'' Women make
up 90 percent of the 1.4 million Americans diagnosed with this
autoimmune condition -- one that causes the body's immune system to
attack its own healthy tissue and organs.
Symptoms to be aware of are fatigue, achiness, swollen joints,
persistent fevers over 100 F, skin rashes, including a
butterfly-shaped rash across the nose and cheeks, chest pain,
anemia and hair loss.
A recent study found that younger women with lupus -- those ages
18 to 44 -- were more than two times more likely to have a heart
attack than women in that age group without the disease.
Because the symptoms of lupus, such as fatigue and achiness,
don't appear to be life threatening and can easily be explained
away, families, friends, and even doctors may dismiss them, says
Duane Peters, director of communications and advocacy for the Lupus
Foundation of America in Rockville, Md. And sometimes the symptoms
just go away on their own, making them easy to write off as simple
tiredness or stress.
There's no way to prevent lupus, nor is there one single test to
diagnose it. If your doctor suspects you have it, you'll have a
blood test known as an immunofluorescent antinuclear antibody test.
A positive result alone doesn't mean you have lupus since other
diseases and some drugs can cause false positives. Your doctor may
also order a blood count test (people with lupus can have lower
white cell counts) or check for abnormalities in the urine, a sign
that the kidneys may be affected.
You can help your doctor diagnose correctly by keeping a record
of your symptoms and when they occur, says Dr. Evelyn V. Hess,
professor of medicine at the University of Cincinnati Medical
Center. Check your family history too.
``It's helpful to tell your doctor if someone has had lupus or
an autoimmune disease because these things tend to cluster in
families,'' Hess says.
