In Women's Health Week, Time to Take Stock

By Christian, Sam | The Florida Times Union, May 15, 2013 | Go to article overview
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In Women's Health Week, Time to Take Stock

Christian, Sam, The Florida Times Union

Byline: Sam Christian

There's no better time for women to take stock of their health.

We're in the midst of National Women's Health Week, May 12-18, an effort by the U.S. Department of Health's Office on Women's Health to encourage women to make health a priority.

The good news is that over the last 40 years, the overall health of U.S. women has improved greatly, according to federal government statistics. Still, there's room for improvement.

Many changes in women's medicine and health services in the decades since the sexual revolution of the 1960s responded to the changing demands on women who are busier than ever as working mothers, single parents, engaged civic-minded volunteers and/or entrepreneurs who are postponing pregnancy.

Medical technology, pharmaceuticals and even the office hours offered today by many gynecologists and obstetricians are in response to modern women's fast-paced lives. A number of physicians now offer same-day appointments, lunchtime and extended office hours to accommodate hectic schedules.

Women today also have a lot more input in their health choices than in the old days when doctors were treated as gods. Our job is to give patients accurate information to help them make decisions on treatment options.

In my opinion, the most revolutionary development in women's medicine since the introduction of hormone replacement therapy in the 1940s and "The Pill" for contraception in 1960, was the introduction of laparoscopic surgical technology in the 1970s.

This minimally invasive surgical technology enables doctors to diagnose or treat in-office or in an outpatient setting a number of women's health problems that previously were done in a hospital and might have required hospitalization for several days or longer. Not only is laparascopy more cost-effective, but it also provides in most cases quicker recovery times. Other advantages include less pain - and less pain medication - less hemorrhaging and less likelihood of infection. Surgical procedures are less traumatic for patients as a result of such tehnological advances.

Laparoscopic surgery requires just one or two small incisions in the pelvic or abdominal cavity through which a telescopic rod with surgical tools, video imaging equipment and fiber optic lighting is inserted. The method is also used for diagnostics, such as determining whether issues with reproductive organs are the cause of infertility, whether pelvic pain is due to cysts, fibroids or endometriosis (cells that grow in the pelvic area outside the uterus and can cause pain and painful intercourse). This technology is used in treatment for endometriosis, ectopic pregnancy (an embryo growing outside the uterine cavity) and ovarian cysts.

Some of the disadvantages of this method for surgeons, such as depth perception and range of motion, are addressed by the newer robotic surgical technology. Physicians are able to do many more things using robotics because of incredible 3-D (high definition) optics and three working channels, plus the computerized stabilization feature that addresses vibrations and shaky hands.

Robotics has not been without controversy, as mentioned in recent news stories. It can cost more than laparoscopic surgery or more invasive procedures, according to a Columbia University study. Critics cite cases of inadvertent injuries to other organs and claim injuries are underreported. But defenders of robotics say the technology is only as good as the surgeon using it and inadvertent injuries can occur using any surgical procedure. Hospitals and their medical staff credential doctors who can use this equipment and ultimately determine which doctors are qualified for each procedure.

Medicine is an imperfect and ever-evolving science. Some of the serious stumbles over the last 40 years in new products, procedures and approaches to women's health care resulted in:

- Food and Drug Administration warnings in 1971 about using a synthetic form of estrogen to prevent miscarriage because of vaginal cancer risks for daughters of users.

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