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Sanjay Gupta MD

A Look at Women's Health Issues

Aired May 13, 2006 - 08:30   ET


ELIZABETH COHEN: Good morning and welcome to HOUSE CALL. I'm Elizabeth Cohen sitting in for Dr. Sanjay Gupta. We're celebrating Mother's Day by empowering women to take charge of their health. Experts say women often put their health last after their children's, after their husbands. But on Mother's Day weekend, we'd like to remind women that they need to take care of themselves, too.
Here's our Christy Feig with a list of tests women need to have.


CHRISTY FEIG, CNN CORRESPONDENT (voice-over): When Virginia Baza was diagnosed with breast cancer, she couldn't even feel the two centimeter lump in her breast. Neither could her doctor. It was found by an annual mammogram.

VIRGINIA BAZA, BREAST CANCER SURVIVOR: If there was no such thing as mammography, I don't know. The tumor probably would have grown.

FEIG: Because she caught it early, today, 18 years later, her doctors consider her cured.

BAZA: You have to be very, very careful. You have to, you know, make sure we catch this early.

FEIG: And that doesn't just apply to breast cancer.

ELMER HUERTA, DR., WASHINGTON HOSPITAL CENTER: We have to understand that heart disease, cancer and diabetes, they get give no symptoms when they start. It is until late when the disease has to really advance that a woman has a lump, bleeding, or is losing her weight.

FEIG: Dr. Huerta says before menopause, a woman should maintain a healthy weight and watch for high blood pressure or high cholesterol that could lead to heart disease.

HUERTA: Also, they should visit their doctors at least once a year to get a Pap smear, to learn how to do the breast self examination, and to also do a screening for depression.

After menopause, preventing heart disease and stroke and watching for any signs of breast, cervical, lung, or colon cancer become the priority in the annual check-up.

Lastly, Dr. Huerta says remember to pamper yourself. Many women have a lot to juggle, but it's important to take care of you.

I'm Christy Feig reporting from Washington.


COHEN: Thank, Christy.

So to be clear, don't wait until you're sick to get tested. Starting in your 30s, you should be getting regular heart health tests, thyroid, and skin exams. That's in addition to your yearly gynecological testing.

Here to answer all of your questions about women's health is Dr. Dorothy Mitchell. She's a women's health specialist, a gynecologist and reproductive endocrinologist here in Atlanta. Welcome to the show, doctor.


COHEN: What would you say is the biggest misconception that women have about their health?

MITCHELL-LEEF: I think that they'll just go on forever. And there's not really any problems except perhaps the breast cancer later in life.

But they don't take into account that all these things can occur over a long period of time and they need to really keep up on those things, that perhaps they're so young that it'll never happen to them. And that they need to definitely remember to be tested early and, for example, for cervical cancer. They just forget that they're supposed to be tested and that things can happen to them.

COHEN: Well, let's talk some more about tests that women need to have at different stages in life. For example, in their 40s, women need to start having mammograms. And at 45, they need to have regular diabetes testing. And at 50, colorectal cancer screening is recommended. A colonoscopy every 10 years.

And we have a lot of e-mails lined up actually on this topic. Let's get to one now. Karen from Colorado asks, "What is the magic about waiting until age 50 to have a colonoscopy?" Doctor, why 50? How did that number come about?

MITCHELL-LEEF: I think it just comes from the average age where colorectal cancer starts increasing. It's the third highest rate of cancer found in women. But over 50 seems that magic number where we start the rise of finding colon cancer.

So before that, it may not be beneficial. However, if you have it in your family history, it might be best to have tests done prior to that time.

COHEN: So it's worth talking to your doctor about? MITCHELL-LEEF: Correct. And also, checking with your family members and seeing who might have had colon cancer and did they have it early in life.

COHEN: Now there's another test that you hear a lot about and that's mammograms. Cheryl in New York wants to know if there's a better option. She asks, "Why are mammograms the method used for breast cancer detection when they detect so few tumors? Are ultrasounds and MRI's not a better option?" What do you think about ultrasounds and MRI's?

MITCHELL-LEEF: Well, we usually do the ultrasound if a mammogram is questionable, especially in patients who might have fiber cystic changes that are a dense breast, and they need to have those exams done a little more specifically. And that's when they do ultrasounds.

The problem with MRI's is that it takes almost an hour to do. You have to lie very still. And it's a long procedure.

So I think that if you could encourage people to actually have early breast exams, then get the mammogram that's requested. And then if there are any issues, they obviously will do the more specific test.

COHEN: But if you're particularly worried about breast cancer, let's say your mother had it, your grandmother or your aunt, might there be a reason for you to go ahead and get that MRI?

MITCHELL-LEEF: I think you could. I think you'd talk to your doctor and see what the specific issues are with you before you do it, but I have no reason except that it's just a longer procedure and a little more difficult to do as far as time wise.

COHEN: Well, let's get to another e-mail now. We have this one from Ray in Massachusetts. "Recent articles suggest calcium supplements may not be as effective as previously thought. For women in the post-50 set with a family history of osteoporosis, what do you recommend for better bone density?"

I think that study that came out a couple of months ago shocked a lot of people. Women were popping these calcium supplements...


COHEN: ...and so are they helpful or not?

MITCHELL-LEEF: Well, I think that you have to do a combination. We obviously know that as soon as women become menopausal and their estrogen levels come down, that the calcium is leaked from the bones.

So if you are candidate for taking estrogen, I think that's really important to do that.

The other thing is you can talk to your doctors about different preparations like Possimax (ph), Boniva (ph), things that actually - products that actually help women have their calcium stay in their bones and not lose it. And that way, they decrease their risk of osteoporosis.

So you may want to have some tests done, obviously, to see if they're in that range that they need to have those done.

COHEN: Well, we're going have, I know, a lot more questions from women about their health. More HOUSE CALL after the break.

UNIDENTIFIED FEMALE: It might save your life.


UNIDENTIFIED FEMALE: Probably as much as six weeks before she's actually had the heart attack, she's actually had a warning sign.


UNIDENTIFIED FEMALE: Learn what you need to know about women's unusual heart attack symptoms.

And later.


UNIDENTIFIED FEMALE: My skin definitely got clearer. I definitely got sick a lot less.


UNIDENTIFIED FEMALE: Find out why this girl is feeling so good.

But first, take today's quiz. What is the most deadly cancer for women? That answer, coming up.


UNIDENTIFIED FEMALE: Checking today's quiz, we asked, what is the most deadly cancer for women? The answer is lung cancer. And about 90 percent of those lung cancer deaths are caused by smoking.

COHEN: A lot of women don't realize it, but lung cancer will kill nearly 69,000 women in the U.S. this year. That's more than breast and ovarian cancer combined.

And consider this, in the past 20 years, lung cancer deaths among men have increased 20 percent, but increased 150 percent during this same time period for women.

And lung cancer doesn't just target smokers. Dana Reeves' death earlier this year from lung cancer is one example. She was young, just 44 when she died. And she'd never been a smoker.

Answering all of our questions this morning is women's health specialist Dr. Dorothy Mitchell-Leef. Doctor, let's get back to our inbox with a question from a worried viewer. Rhonda wants to know, "My mother was a non-smoker who died of lung cancer in her forties. Is there any preventive actions women like me can take who have a family history of non-smoking lung cancer?" Doctor, is there anything she can do? She's already not smoking.

MITCHELL-LEEF: Right. Make sure you aren't around anyone who does smoke. Secondhand smoke - just in Dana Reeves case is obviously an example of that.

I think that if you talk to your physician and say I've had this in my family, you might want to find out what kind of cancer that was, and to particularly get chest X-rays in an interval of time that might be appropriate so they could pick it up early.

COHEN: Now while cancer can be deadly, there's one disease that kills more women than every cancer combined and that's heart disease.

Our Judy Fortin reports many women ignore important symptoms.


JUDY FORTIN, CNN CORRESPONDENT (voice-over): Stomach or back pain may seem like ordinary ailments to some women, but they could be vital warning signs of a heart attack.

NIECA GOLDBERG, DR., CARDIOLOGIST: She doesn't necessarily have to be clutching her chest. She could have breathlessness without any chest discomfort. Sometimes the pressure is lower down in her chest. And women easily say oh, it's a stomach problem, it will go away, I have other things to worry about.

FORTIN: The American Heart Association says denial is typical for women who may not be aware they're having symptoms of a heart attack. Women don't always experience classic symptoms. They may complain about nausea and vomiting, unexplained fatigue, back and jaw pain. The symptoms could last for weeks.

GOLDBERG: In a woman who's having a heart attack, probably as much as six weeks before she's actually had the heart attack, she's actually had a warning sign.

FORTIN: Dr. Goldberg says ignoring those signs could be a fatal mistake if you don't get medical help immediately.

For HOUSE CALL, I'm Judy Fortin.


COHEN: Thanks, Judy. That's great information that we all need to remember.

Let's get to a question now about women and their hearts. Brenda in Virginia writes this, "If you had to choose one thing women can do to lower their risk of getting heart disease, what would it be?" Doctor, what would you pick as your one thing?

MITCHELL-LEEF: I would say this, it's very hard to do one thing. To be healthy, to eat right and to exercise is obviously the first thing. To think about -- and those go hand in hand. And I would say if you want to put a third, just to talk about it obviously, to check your family history because that might tell you if you're at risk and to make sure that you get checked out by your physician at an early age.

COHEN: That's a great idea. We've got time now for one more e- mail. Eleanor from Massachusetts wants to know, "Why do women on average get heart disease later in life than men do?" Why is that?

MITCHELL-LEEF: Well, it seems as though, again, estrogen has been in the past thought to be a protective hormone for women. And it just takes a lot longer for them, obviously, to get into the menopause and then to have some of the cardiovascular effects such as triglycerides that go up or different -- other lipoproteins that might be abnormal.

So I think it's just always been classically found that women just take a longer time. In essence has shown time after time, that that is the standard.

COHEN: So around at what age does heart disease seem to creep into women's lives?

MITCHELL-LEEF: It seems to go up more toward 55 to 60. It may now extend into the age of 65. But in the past, it showed a starting rise at about 55.

COHEN: Well, we'll be talking more about women's health and taking more of your questions on HOUSE CALL. Stay tuned.

UNIDENTIFIED FEMALE: Fighting some jelly in the belly after menopause. Discover how you can battle the bulge, coming up on HOUSE CALL.

First, more of this week's medical headlines in "The Pulse".


CHRISTY FEIG, CNN CORRESPONDENT (voice-over): Women can detect men who like kids just by looking at them, says a new study by the University of Chicago and the University of California at Santa Barbara. Researchers took pictures of several men who claimed to like children and some who didn't and showed the pictures to female students. Each woman correctly identified the men interested in kids and said they were more inclined to have a long-term relationship with those men.

And if you're taking certain prescription drugs, put down the grapefruit juice. A new study from the University of North Carolina School of Medicine found that compounds in grapefruit juice called Foranicumerins (ph) can cause certain drugs to absorb in the body too quickly, effectively giving some patients up to three times the dose. Statins, blood pressure medicines, and immunosuppressant drugs seemed to be the most affected by the juice. So if you're taking these drugs, talk to your doctor.

Christy Feig, CNN.



COHEN: Welcome back to HOUSE CALL. Dwindling numbers of eggs as we age, that's a reality check. Talking with us about fertility and menopause is Dr. Dorothy Mitchell-Leef. She's a woman's health specialist, a gynecologist and reproductive endocrinologist in Atlanta.

Doctor, women are waiting longer to conceive. We see all of these women, all of these celebrities having babies, some of them in their late 40s. Does that mean it's OK to wait until your late 40s?

MITCHELL-LEEF: No, no. In a word. Bottom line is you really start running out of eggs actually over the age of 35. And it definitely decreases over 40.

So we really tell people, if you have a chance, or you think about it, it's really better to wait -- not wait and try and get pregnant at a much earlier age.

COHEN: Now what is the oldest you've ever seen a woman get pregnant with her own eggs?

MITCHELL-LEEF: It's someone who just turned 46, but out of all of the years I've been doing those, I've only had six total patients between 45 to that one in 46 that ever got pregnant with their own eggs and never older than that.

COHEN: So you haven't had 47 year-olds, 48-year-olds pregnant with their own eggs?


COHEN: They're using someone else's eggs?


COHEN: OK. Got you.

Well, we're going to move on to another phase of life right now. Menopause. The average age it starts is around 51, but even before that, many women start feeling the signs, gaining extra weight, weight shifting from the hips and thighs to the stomach.

Amanda in the Dominican Republic is experiencing some of this and wants some help. "How I can lose my menopausal weight gain? Everywhere I read, it says to expect and accept it. Can we ever lose that weight?" Doctor, any help for Amanda? MITCHELL-LEEF: Well, I think it's very important, obviously, to stay on good diets, continue to exercise, which perhaps some people don't do as much, the older they get.

But I think it's important to make sure you don't have diabetes or insulin resistance, and you can get fasting insulin levels just to check to see if you've had some issues with diabetes of any sort. And I think that's important to ask your doctor to get tested about that.

COHEN: So if your insulin is out of whack, that might be contributing to your weight gain.

MITCHELL-LEEF: If you have a high rate of insulin rather than the low, which is true diabetic, you may actually not be able to metabolize your sugars. So you store the sugars as fat. And you might gain weight.

So we ask people to definitely get tested for that, and obviously, go on a high protein, low-carb diet, and to definitely avoid any sugars if they can at all help it. And I think that might help if they don't want to get tested. But I definitely recommend they do that.

COHEN: Well, we've got to take a quick break now. Stay tuned for more HOUSE CALL.

UNIDENTIFIED FEMALE: Thinking of going vegetarian? What kids and adults need to know about cutting out the meat, coming up on HOUSE CALL.


COHEN: Welcome back to HOUSE CALL. Attention all moms out there, has your child decided to become a vegetarian? It seems to be pretty in these days, but how safe is it for your children to give up meat? In this week's edition of "Fit Nation", Dr. Sanjay Gupta looks at the benefits and pitfalls for young vegetarians.


SANJAY GUPTA, HOST (voice-over): Grady High School in Atlanta is joining others around the country, offering vegetarian entrees in the cafeteria. Miriam Archibong went to Grady and pushed the idea.

MIRIAM ARCHIBONG, VEGETARIAN STUDENT: I saw the morning lunch menu and the breakfast options. And the caloric intake was like 900 calories. The sodium was like 56 grams. It was like incredibly high.

GUPTA: Archibong went to her principal, the school board, and the school's food service provider. They all agreed to adding a vegetarian offering.

Dr. Theresa Rohr-Kirchgraber is an internist works with adolescents. She says a vegetarian diet can be healthy for children, but a few things need to be addressed. THERESA ROHR-KIRCHGRABER, DR., INTERNIST: A vegetarian diet can be very healthy for adolescents. However, part of that has to be an understanding of what proper nutrition is because you can be a vegetarian and have a horrible diet.

GUPTA: According to the American Dietetic Association, approximately two percent of children aged 6 to 17 in the United States are vegetarian. Rohr-Kirchgraber's 15-year-old son Richard just gave up meat. And as a parent, she says the first thing to look at is why.

ROHR-KIRCHGRABER: Are they comfortable with how their own body looks? Or are they using that diet to influence their body shape? That's a different story than they don't want to eat meat because I love animals.

GUPTA: Rohr-Kirchgraber offers advice for parents of new vegetarians.

ROHR-KIRCHGRABER: We have to talk to them about what is a healthy diet. And that a vegetarian diet is not a bag of potato chips and a Coke for lunch.

The problem usually comes about when kids not really understanding nutrition, cut things out of their diet without substituting appropriate things back in. And protein is probably the biggest one.

GUPTA: Archibong is now a college student. She says she noticed a big change in her life since giving up meat.

ARCHIBONG: My skin definitely got clearer. I definitely got sick a lot less. I don't really get the cold as often that I used to or the flu.

GUPTA: Archibong says a family history of obesity inspired her to find ways to get and stay healthy.

Dr. Sanjay Gupta, CNN, Atlanta.


COHEN: Thanks, Sanjay. Well, grab a pen. When HOUSE CALL returns, we've got some great resources for women.


COHEN: For more information on women's health, go to Click on the link for the National Women's Health Week and you'll find free check-up sites in your area.

Another great option is It's women's health center provides information on issues from birth control to osteoporosis.

Well, we've been talking with Dr. Mitchell-Leef, who is an expert in women's health issues. And I have a question for you. What is the one piece of advice you like to give women who come in to your office, the thing you think women really need to hear?

MITCHELL-LEEF: Well, I think in general, you always want to make sure that women tell you things that have bothered them, and that any thing that they think has been out of the ordinary or something they feel is different in their care or not in their care, but in their health. And I think it's very important that if they think it's different or important, that they should stick to it, and make sure that their physicians listen, and follow up on tests that might be important to clear or clarify any concerns they might have.

COHEN: Can you think of any occasion where a women has told you something that's different in her life, that she might have just said oh, I'm not going to bother with this, but you were really glad that she bothered to tell you?

MITCHELL-LEEF: Well, a patient did tell me that she came off birth control pills. They were trying to let her have another child. And she said that her voice had changed. It had gotten deepened, and that she had a little more hair growth than usual. So I did some tests. And luckily, we proceeded quickly and she was diagnosed with adrenal cancer.

She's now alive, treated well today. Everything's fine. But if she hadn't told me that, or said that was important, she might not be here today. So I think those are the kind of things that we want patients to pay attention to, and to definitely speak up, and be your own advocate, especially in your healthcare.

COHEN: Well, thank you, Dr. Dorothy Mitchell-Leef. That is some great advice. And we really appreciate your being here with us today.

We've actually run out of time. So there's no more HOUSE CALL left for today.

However, please tune in next weekend when HOUSE CALL tries to help you get your zz's. We're talking about sleep and how to get more of it.

Thanks for watching. I'm Elizabeth Cohen. Stay tuned for more news on CNN.