So begins a certain country music song that unwittingly turned out to be an anthem of both the pro– and anti–feminism movements alike. Although the song itself dealt with broken hearts rather than unhealthy ones, the sentiment expressed in those seven words has a significant basis in medical fact.
There’s the obvious; that is, conditions and their sequelae that apply only to women:
•Gynecological health and disorders – menstruation and menstrual irregularities: menopause; urinary tract health, including urinary incontinence and pelvic floor disorders; and such disorders as bacterial vaginosis, vaginitis, uterine fibroids, and vulvodynia.
•Pregnancy issues – preconception care and prenatal care, pregnancy loss (miscarriage and stillbirth), preterm labor and premature birth, sudden infant death syndrome (SIDS), breastfeeding, and birth defects.
•Disorders related to infertility – uterine fibroids, polycystic ovary syndrome, endometriosis, and primary ovarian insufficiency.
•Violence against women – the statistics are stunning. According to the National Coalition Against Domestic Violence, one in every four women will experience domestic violence in her lifetime. An estimated 1.3 American women are victims of physical violence by an intimate partner each year.
And there’s the not-so-obvious, disorders that affect women in substantially higher numbers than men:
•Multiple sclerosis – two to three times more common in women.
•Lupus – women account for 90 percent of sufferers.
•Chronic fatigue syndrome – women are four times more likely to suffer.
•Depression – affects twice as many women as men.
•Celiac disease – 60 to 70 percent of sufferers are women.
•Rheumatoid arthritis – two-thirds of these patients are women.
There are even some that are esoteric:
•Turner syndrome – a chromosomal condition that describes girls and women with common features that are caused by complete or partial absence of the second sex chromosome. TS occurs in approximately 1 of every 2,000 live female births and approximately 10 percent of all miscarriages.
•Rett syndrome — a neurodevelopmental disorder that affects girls almost exclusively. It is characterized by normal early growth and development followed by a slowing of development, loss of purposeful use of the hands, distinctive hand movements, slowed brain and head growth, problems with walking, seizures, and intellectual disability.
There are conditions that occur in men and women in similar numbers, but which affect women very differently:
•Alcohol abuse – more and more women are abusing alcohol, which can lead to an increased risk of breast cancer, heart disease, liver inflammation, brain damage or fetal alcohol syndrome.
•STDs/STIs – The Centers for Disease Control and Prevention website states that sexually transmitted diseases remain a major public health challenge in the U.S., “especially among women, who disproportionately bear the long-term consequences of STDs. For example, each year untreated STDs cause infertility in at least 24,000 women in the U.S., and untreated syphilis in pregnant women results in infant death in up to 40 percent of cases.”
•Stress – a 2013 report by The Huffington Post states that stress in women can reduce their sex drive, cause irregular periods and reduce fertility. It can cause outbreaks of acne, digestive problems, insomnia, weight gain and depression. It can also lead to an increased risk of heart attack and stroke.
•Stroke – according to the National Stroke Foundation, women suffer more strokes each year than men, mainly because women live longer than men and stroke occurs more often at older ages. Additionally, women are two times more likely to die of a stroke than breast cancer annually.
And of course,
•Heart disease.
The National Institutes of Health reports that while more men suffer from heart disease, its toll on women is harsher: women are more likely to die of a heart attack than men. In the United States, one in four women dies from heart disease.
The most common cause of heart disease in both men and women is coronary artery disease, narrowing or blockage of the coronary arteries, the blood vessels that supply blood to the heart itself. It’s the major reason people have heart attacks.
Heart diseases that affect women more than men include coronary microvascular disease, a condition that affects the tiny arteries of the heart. Many researchers think the disease is caused by a drop in estrogen levels during menopause combined with traditional heart disease risk factors.
And, in keeping with the song, there actually is a medical condition known as “broken heart syndrome.” According to the American Heart Association, broken heart syndrome, also called stress-induced cardiomyopathy or takotsubo cardiomyopathy, can strike even a healthy individual.
Women are more likely than men to experience the sudden, intense chest pain — the reaction to a surge of stress hormones — that can be caused by an emotionally stressful event. It could be the death of a loved one or even a divorce, breakup or physical separation, betrayal or romantic rejection. It could even happen after a good shock (like winning the lottery.)
Broken heart syndrome can be misdiagnosed, because the symptoms and test results are similar to a heart attack. Tests show dramatic changes in rhythm and blood substances that are typical of a heart attack. But unlike a heart attack, there’s no evidence of blocked heart arteries in broken heart syndrome. In broken heart syndrome, a part of the heart temporarily enlarges and doesn’t pump well, while the rest of functions normally or with even more forceful contractions.
The threats to women’s health may be complex and varied; but with caring and dedicated physicians like the ones featured throughout the pages of this magazine, they can feel confident that they are in skilled, capable hands.
