Women's Health and Wellness

Eating Disorders

Eating disorders are very common, especially in young women. Signs that are suspicious for eating disorders include:

• secretive eating, bingeing (eating much more than someone normally would at one sitting, and feeling unable to stop oneself)

• disappearing to the bathroom after eating (to vomit), use of laxatives or water pills (diuretics)

• very limited amount or avoidance of certain types of food (e.g. totally avoiding fat in foods)

• fighting with friends or family about what or how much to eat

• thinking about food all the time, food rituals (e.g. cutting food into tiny pieces and eating them very slowly)

• hating any body fat, perfectionist tendency, sudden significant weight loss

• compulsive exercise

• using diet supplements

Usually several of these symptoms are present if someone truly has a problem.  So…what should you do if she does have some of these symptoms?

• DON’T criticize or nag

• DON’T focus on food, weight or body image

• DO point out strengths and talents

• DO focus on health and happiness; let her know you’re concerned if she is
  feeling blue

• Do encourage her to seek help from a physician, counselor, dietitian or support group; all of these are available here on campus (free to undergrads):

 - Health Center x93131
 - Counseling Center x93141; support group available
 - Wylan Ganote, RD x94225

If your friend denies that there is a problem (which is very common), consider talking to a physician or counselor yourself.

While you can’t force others to change, sometimes you can benefit from some support yourself and can discuss your concerns.
BTW, guys can get eating disorders too, though symptoms tend more toward compulsive exercise than food rituals and restrictions.

If you are concerned about a friend’s or your own eating habits, you might be interested in attending The Thin Line, presented on campus March 8.

Dr. B

Hormone Replacement Therapy

  I have heard that women who take synthetic hormones may have many side effects including increased risk for heart disease, depression, and more. Do you have any information on Human Identical Hormones? Do women who need hormone replacement due to hysterectomy or removal of the ovaries need testosterone replacement as well? What can you tell me about hormone treatments?

    Rosalyn

    Hormonal treatments are in a real transition now. It is only in recent years that there has been really good research that is double-blinded, prospective and on-going. The Women’s Health Initiative is the study that had the medical profession questioning some of its long-held assumptions about hormone replacement therapy (HRT). Now we are finding that HRT with both estrogen and progesterone is not protective against heart disease, and may actually increase risk for some. 

    That may not be true for those who take only estrogen (only recommended in women who have had a hysterectomy, as estrogen alone can cause precancerous endometrial changes). This part of the study is still in progress.
   

    Human Identical (also called “Natural”)  Hormones haven’t been prescribed much, not because doctors have anything particular against them; we just don’t have much in the research literature that has used them. If there are no standard protocols for using them, how do I know how much, what route (pill, cream, etc.), for what type of results (hot flashes, bone protection, heart protection)? The problem is that those questions haven’t been answered.
  

    HRT still is useful for hot flashes, and a woman and her doctor must decide how long to continue the treatment. HRT was our only option to prevent osteoporosis 15 years ago, and that was a disease that caused many problems and loss of independence for senior women. Today we have non-hormonal alternatives.
Women who have had surgical menopause with removal of their ovaries do need some kind of hormone replacement, and, yes, many women do actually need a little testosterone replacement too.
   

    I hope that covers the basics. The medical profession is looking at hormone alternatives, but definitive answers are not yet available.
   

    I think that as far as bone and heart health are concerned, the most important things are long-term lifestyle changes: exercise (cardiovascular for the heart, and weight-bearing for the bones) and a moderate-fat diet with adequate calcium. Older women, particularly petite, thin, white women who smoke or drink at least one alcoholic drink daily (those are the biggest risk factors for osteoporosis), should have their bone density checked to see if they need any further treatment.
 

    Take care.

Dr. B

Well Woman Exams

    What kinds of health services does the Health Center provide? (specifically STD testing, gynecological examinations, mammograms, available contraceptives, pregnancy testing)

    Sarah

    The UD Health Center provides a wide range of women's services to undergraduates. Actually, women's health interests are the primary reason the University wanted a woman physician. The following are available to students at the Health Center:

• Well-woman exams, including breast exams, Pap smears/pelvic exams, teaching in self-exam techniques.

• STD screening for Chlamydia, gonorrhea, herpes, HIV, syphilis, chanroid, trichomonas, molluscrum contagiosum, genital warts, cervical cancer (yes, this is considered to be a sexually transmitted disease caused by HPV, human papilloma virus), hepatitis B&C.

• Patient education and answers to questions about STDs and STD risks (including questions particular to gay/lesbian/bisexual students).

• Treatment of minor gynecological problems including irregular menses, prolonged lack of periods, problems related to birth control pills, and regulation of periods, breast pain or lumps, nipple discharge, etc.

• Follow-up testing after a diagnosis of an abnormal Pap or after treatment of an STD to check for sure - results can be Faxed to your primary gynecologist if requested.
  Free pregnancy testing

• Referrals to local OB/GYN physicians for more complicated gynecological problems.

    While I can order mammograms, usually they are less helpful in young women with breast problems because women under 30 generally have more glandular and fibrous tissue and less fatty breast tissue (fat makes the mammogram easier to read and to see worrisome changes).

    Because UD is a Catholic institution, we do not routinely prescribe contraceptives, consistent with Church teachings. However, there are some diagnoses that do require hormonal treatments. These are considered an acceptable treatment by the Catholic Church (because the primary intent is treatment of a medical problem, not contraception), and are available at the Health Center.
 

    I hope this answers your question, Sarah. If you have other questions that I haven't addressed, feel free to come in and talk to me. If you're not familiar with my hours, call x93131 and they will let you know.
 

Dr. B