Women’s problems keep them up at night

Many so-called women’s problems can cause sleepless nights, according to an article in the October issue of McCall’s. For example, nearly one-third of all women are trying to lose weight. Fasting for a day or losing more than a couple of pounds a week can cause sleep loss.

Hormone swings also can affect sleep time. At least 5% of all women have problems sleeping before their period because of a sudden dip in progesterone, a hormone that causes sleepiness. Pregnant women experience higher levels of the hormone, making them sleepy during the day. The hormone also weakens bladder control, which can cause many nighttime bathroom trips. Hot flashes and night sweats among menopausal women also can disturb sleep.

The author recommends the following remedies to help women sleep better:

• Make yourself drowsy by taking a warm bath or drinking milk or chamomile tea, which contain sleep inducers.

• Don’t drink alcohol before going to sleep because it makes sleep more fitful.

• Exercise more because it appears to increase deep sleep time.

• Don’t lose more than a pound or two a week.

• Eliminate distractions such as noise and stress.

Another article in the October McCall’s recommends, in a series of case studies, that women consider every option when deciding how to deal with breast cancer. The choices women face include whether to have a lumpectomy or a mastectomy, whether to opt for radiation or chemo-therapy, and what type of reconstructive surgery to have. Rather than have an implant, some women can have skin, fat, and a small amount of muscle removed from the abdomen to form a breast-like structure. This type of surgery, known as a flap procedure, involves a longer recovery time than an implant but produces a more aesthetically pleasing result. McCall’s recommends these steps for women diagnosed with breast cancer:

• Find out exactly what stage your cancer is in and if there is anything unusual about it.

• Start a file of your medical records, including pathology reports, mammograms, and slides.

• Consider joining a breast cancer support group.

• Ask whether the therapy your doctor advises is widely accepted. If it’s not, ask why he or she is suggesting it.

• Research both types of reconstruction and the pros and cons of having it at the same time as your mastectomy.

Perimenopause is the subject of an October Good Housekeeping article. Perimenopause occurs about four years before menopause, when menstruation slows down. No test exists to confirm perimenopause, but some doctors say high levels of follicle-stimulating hormone (FSH), which cause the release of an egg, provide proof. Others say FSH levels increase throughout a woman’s life and don’t necessarily indicate perimenopause. Apparently the only true indicator is irregular periods. Loss of a loved one or other trauma can cause many of the other symptoms.

The author recommends a healthy lifestyle to counteract many of the symptoms. Caffeine, alcohol, spicy foods, and excessive salt or sugar can trigger hot flashes, and smoking can intensify them by constricting blood vessels. Exercise can improve circulation and increase tolerance of temperature extremes. Soy foods, which contain phytoestrogens, can replace small amounts of estrogen. Over-the-counter lubricants can treat vaginal dryness. Dressing lightly keeps women cool, and keeping water close by replaces fluids lost by sweating. Also, perimenopausal women need 1,500 mg of calcium daily.

Birth control pills also can help control erratic periods, hot flashes, vaginal dryness, and insomnia. They often aren’t prescribed because of a possible link to stroke in older women; however, at least one doctor says it is safe in women who don’t smoke and are otherwise healthy. Most doctors don’t recommend hormone replacement therapy until a woman is in actual menopause because it can make periods even more erratic.

An October Glamour article, "How OB/GYNs are failing women," says doctors aren’t paying enough attention to their patients’ STD risk. In a survey of women 18 to 44 who had been to a new provider for gynecological or prenatal care in the past year, only 12% discussed STDs other than AIDS. More than 400 of the 482 women did not discuss STDs with their doctors at all. Of those who didn’t, more than half weren’t asked if they were in a monogamous relationship, if they used condoms regularly, how many sexual partners they’d had, or if they’d had oral or anal sex. Thirty-five percent were not asked if they were sexually active. The doctor’s gender made no difference.

Women also aren’t likely to volunteer this information. Only 3% of the women surveyed gave information about their sex lives or asked about STDs. This may be because they assume they aren’t at risk, since 97% of those surveyed said they were "not at all" or "not very much" at risk. The article says women are at higher risk for STDs if they have experienced: sex without a condom; many sexual partners; anal sex; douching; or sexual abuse. It recommends at least one screen for each common bacterial STD and not assuming STD tests are done with Pap smears. ß