Mayo Clinic Doctor on Women's Health

We speak to Mayo Clinic's Dr. Jacqueline Thielen about developments in women's health including some of the best treatment options for menopause. Thielen is in town for the Mayo Clinic’s conference Controversies in Women’s Health which includes presentations from key women’s health specialty and subspecialty disciplines including obstetrics and gynecology, reproductive medicine, sexual health, and menopausal medicine. 

Breast Cancer
While it’s unclear what causes breast cancer, it is one of the most common forms of cancer diagnosed in women in the U.S. Breast cancer occurs when some breast cells begin growing abnormally—these cells divide more rapidly than healthy cells do, and the accumulation of them causes a lump or mass to form. Only 5 to 10 percent of breast cancers are linked to inherited genetic mutations according to doctors' estimates.

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Risk factors for breast cancer include:

  • Being female
  • Increasing Age
  • A personal and/or family history of breast cancer
  • Inherited genes that increase cancer risk
  • Radiation exposure
  • Obesity
  • Beginning menstruation at a younger age
  • Beginning menopause at an older age
  • Having your first child at an older age (after age 35)
  • Having never been pregnant
  • Postmenopausal hormone therapy
  • Drinking alcohol

Treatments for breast cancer are dependent on the type of cancer, its stage, grade, size and whether the cancer cells are sensitive to hormones. Doctors will determine breast cancer treatment options, which include surgery, radiation therapy, chemotherapy, hormone therapy, and targeted drugs. While no alternative medicines have been found to cure breast cancer, many alternative therapies may help breast cancer patients cope.

According to the Mayo Clinic, there are more than 100 types of the human papillomavirus (HPV). An HPV infection causes warts (different types of HPV cause warts on different parts of a person’s body), and more than 40 strains of HPV affect the genital area. While most types of HPV infections don’t lead to cancer, some types of genital HPV can cause cervical cancer.

Gardasil is a vaccine to protect against the types of HPV that cause cervical cancer and cause genital warts. Cervarix is another HPV vaccine that protects against cervical cancer, but not genital warts.

The CDC recommends routine HPV vaccination for girls and boys ages 11 and 12 (For HPV vaccines to be effective, the CDC argues they should be given prior to exposure to HPV). The vaccines are administered in three doses over six months. If men and women do not receive the vaccine at a young age, women can receive the vaccine through age 26 and men can receive it through age 21 (the CDC also states that young men who are gay or bisexual, or have compromised immune systems can receive the vaccine through age 26).

Pap Smear (Pap Test)
The procedure is used to test for cervical cancer in women. According to the Mayo Clinic, women should start getting tested at age 21. Guidelines recommend repeating testing every three years between ages 21-65. Women ages 30 and older can be tested every five years if the procedure is combined with HPV testing.

Doctors may recommend patients with the following risk factors be tested more frequently:

  • A diagnosis of cervical cancer or a Pap smear that showed precancerous cells
  • Exposure to  diethylstilbestrol (DES) before birth
  • HIV infection
  • Weakened immune system due to organ transplant, chemotherapy or chronic corticosteroid use  

Menopause affects women in their 40s and 50s and is marked by the first 12 months after your last menstrual period. Menopause affects all women differently. Some women experience hot flashes and emotional symptoms. Some women have feelings of sadness and loss. 

There are treatment options for women including hormone therapy, non-hormonal options including antidepressants, and lifestyle modifications like acupuncture or an avoidance of triggers like alcohol, stress, or caffeine. 

Symptoms for menopause include: 

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

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