Autoimmune diseases remain a mystery

Millions of women are suffering from painful, debilitating conditions that have been misdiagnosed and are having a hard time finding relief. Autoimmune diseases such as lupus, Sjogren’s syndrome, and rheumatoid arthritis are striking more and more women. According to an article in the February Ladies’ Home Journal, women are almost three times as likely as men to get autoimmune diseases. There are no cures. Symptoms can be chronic, and some treatments can cause severe side effects. Victims also are highly susceptible to infections, and bouts with the disease can strike at any time. Blood tests can identify autoimmune antibodies such as rheumatoid factor and antinuclear antibody, found in people with lupus, but the test is not always accurate.

Doctors and researchers cannot identify the exact causes of these diseases in women. Some speculate about a genetic defect or environmental agents that wreck their immune systems. Michael Lockshin, MD, has opened the first center focused on the study and treatment of women with autoimmune diseases. The Barbara Volcker Center for Women and Rheumatic Diseases at The Hospital for Special Surgery in New York City has a staff of rheumatologists, immunologists, obstetricians, and gynecologists who deal with the medical and psychological areas of the diseases. For more information about the center, write to: The Barbara Volcker Center for Women and Rheumatic Diseases, 535 E. 70th St., New York, NY 10021.

Genital warts, caused by genital human papillomavirus (HPV), is diagnosed more in young women because of recent advances in testing. Recent studies estimate that 30% to 40% of women under the age of 25 who are sexually active are infected with genital HPV. An article in the February Glamour says epidemiologists estimate that a woman who has four or more sex partners has an 80% chance of having HPV. The condition, transmitted through sexual contact, can cause no symptoms or can cause external warts, internal lesions, or precancerous cell growth in the genital area. Women can come into contact with the disease years or months before the symptoms begin to appear because of the long incubation period.

The growing number of cases in females is the result of more sophisticated tests that better diagnose genital HPV. An abnormal Pap smear could be an indication of the presence of HPV, and 95% of cervical cancer growths can contain genetic material from HPV. If abnormal Pap smear test results continue, doctors are now recommending a new Digene Hybrid Capture test to determine if cancer-causing strains of HPV are present. In a few years, researchers hope to have a blood test for genital HPV available.

To treat genital warts, there are prescription gels and creams such as podofilox (Condylox), made by Abbott Laboratories in Chicago, and imiquimod (Aldara). Aldara, manufactured by 3M Pharmaceu ticals in Northridge, CA, was approved by the U.S. Food and Drug Administration in 1997. In clinical trials performed by 3M, women had a 72% clearance rate of warts after 16 weeks. The Centers for Disease Control and Prevention in Atlanta says that consistent use of condoms will prevent most HPV infection. For more information about HPV, call the National STD Hotline at (800) 227-8922.

Women should be able to read the signs of their menstrual cycles and distinguish what is normal for their bodies, according to the February issue of Glamour. The article discusses how women can understand what a normal cycle is and what can trigger changes in their cycle patterns. There are 21 to 35 days between cycles, and they last from two to eight days. Normal flow is about 1 to 2 fluid ounces, and the color of the flow can vary from light-colored, dark brown, dark red, pink, to bright red. While having cramps is normal, some women have none. The pain can usually be curbed with over-the-counter medications such as Advil, Motrin, or Aleve. Lifestyle changes such as illness, stress, weight fluctuations, and contraception methods can also cause cycle changes.

Abnormal pain during periods is the kind that interrupts a woman’s normal lifestyle. Other warning signs of problems are extremely heavy bleeding, passing large clots, and bleeding in the middle of cycles. Severe bleeding occurs when a woman bleeds through more than one tampon or pad an hour for more than 24 hours. Any menstrual blood that has a clot bigger than a quarter is not normal, and a woman should tell her doctor. Bleeding between cycles could indicate a cervical inflammation caused by a sexually transmitted disease found by a urine test or Pap smear.

Keeping a menstrual journal helps women understand their cycles; and it helps when a problem arises and a doctor needs to know what the past few months of cycles have been like. Women can make notes using these guidelines:

• For each day of bleeding, make a note on a calendar or in a journal.

• Note the level of pain with 1 being low and 10 being high.

• Note the number of pads or tampons used and their absorbencies.