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Women Health

HEALTHY  WOMEN  _  KEY  TO  A  HEALTHY  WORLD

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 African-American Women with Breast Cancer Have Greater Mortality Risk

May 22, 2002 - African-American women with breast cancer (news - web sites) have a higher risk of dying than Caucasian women with breast cancer.

An analysis of 14 studies involving 10,001 African-American women and 42,473 Caucasian women found that African-American women with breast cancer were 1.22 times more likely to die from any cause, says a report in the June 1 issue of the journal Cancer.

The report says the African-Americans with breast cancer are younger, have more advanced disease and worse outcomes than the Caucasians with breast cancer.

Why this is so isn't yet clear. The researchers say that social and economic disadvantage don't completely explain the disparity. They say ethnicity is also an important factor, but they add that existing studies can't differentiate, identify and measure environmental, biological and genetic factors that might explain the difference between African-American and Caucasian women.

More research is needed into factors such as nutrition, genetics, lifestyle, healthcare and environment, the researchers say.

More information

The American Cancer Society has an excellent question and answer section from Lovell A. Jones, who is an authority on cancer rates among African Americans.

Source:(HealthScoutNews)

Menopause in African-American Women

By Jean F. Gibbs

HELLO, DIANE, I'M SO GLAD I CAUGHT YOU AT HOME.  I REALLY HAVE HAD SOME STRANGE THINGS HAPPENING LATELY TO ME... I have had hot and cold spells all day long. I'm sweating through my clothes, I wake up several times during the night and on come the covers - off go the covers.  I can't sleep and I' m so tired.  Lately, my husband says I' m so irritable.  I' m not interested in sex and I haven't been for some time.  It' s so dry down there and the last time we tried, I spotted.  I' m so tired and I have no energy at all.  Am I falling apart?  Is this the change of life I keep hearing about?   I' m too young for this, I' m only 43.  I thought all of this happened at age 50 or 55. I' m really scared...

The signs and symptoms reported above by a woman who apparently seems to be in a great despair are probably due to menopause. Her ovaries are probably producing less estrogen, causing these symptoms of estrogen deficiency.

Menopause (the stopping of menses) is the period of a woman's life cycle at which time she may   undergo either a few physical and mental changes that are barely noticeable, or she may have a full gamut of symptoms that cause her whole lifestyle to be seriously compromised. And many women do not know when it appears. Sometimes, the woman  still has her period and can become pregnant, so she may not realize what is happening to her.

More and more studies are finding significant differences in the way black women experience  menopause.

Even though African-American women often have more severe  symptoms than  white women, they  tend to view menopause differently.  Black women do not seem to place the same negative emphasis on aging as white women do.  The Study of Women's Health Across the Nation (SWAN) found that African-American women tended to view menopause more positively than white or Asian women.

The suggestion is that given the many other problems most black women have to deal with - such as racism, economic hardship, sexual discrimination - menopause is hardly a big deal.

As mentioned before, black women are likely to have more estrogen-related symptoms (hot flashes, incontinence, night sweats, and vaginal dryness) than women of other ethnic groups. They are also more likely to have more physical symptoms (such as headaches, difficulty sleeping, racing heart, stiffness and soreness in the joints) than other ethnic groups.

Does that greater severity of symptoms translate into increased use of hormone-replacement therapy (HRT) in African-American women?

The answer is No!   In fact, studies suggest that black women are 60 percent less likely to take HRT than their white counterparts.  A study from Johns Hopkins University found that only in five low-income  black women used hormone replacement.  And this disparity occurs despite the fact that HRT is known  to protect menopausal women against heart disease and stroke, two major killers of black women.

Several reasons could explain this lower use of HRT in black women.  There have been over the years inadequate representation of African-American women in biomedical and clinical research.  For example, African-American women made less than 1 percent of participants in 30 different studies on heart disease and HRT.  And it is the same for studies on HRT and osteoporosis, in which only 0.4 percent of black women were involved.

Others suggest that poverty could be another reason for this HRT under-use. Since many black women are poor, they are not given the option of HRT during their visits to the doctor.

Other studies have shown that African-American women may be less willing to take HRT, because of the cultural perception that menopause is a normal stage in a woman's life.  And those studies have also shown they prefer non-prescription remedies for relief of menopausal symptoms.

The  controversies now surrounding HRT as a cause of breast or uterine cancer will probably strengthen this perception and cause more women (black and white) to look for alternative medicine during this "change" of life.  Already, several physicians, including gynecologists, are leaning that way and telling their patients that HRT may not be the only answer to the disturbing or annoying symptoms of menopause.

Mastering menopause, this is how African-Americans are encouraged to take that journey. They are told the symptoms can be treated naturally with changes of habits and lifestyles. They are advised to get in shape, to "eat for vitality", to deal with stress, to de-fat their diet, to exercise, to increase their calcium intake, to practice sex therapy, to avoid illegal drugs, to use "nature's secrets"... In short, to do all the good things that we all are supposed to do in order to stay healthy.

In her book "Health, Wellness & Restoration", published at age 43,  under the sub-chapter 'Menopause',  Dr. Denise Davis,  an African-American gynecologist, wrote: "Ladies, you don't have to suffer.  Nor do you have to rely solely on prescription remedies.  You have many choices and options.  Read books, clip articles, take notes, talk to your physicians and be flexible.  You are only at the half way mark of your life's journey.  Perhaps the better half ! " 

Reviewed by the ALLABH  Medical Director on 01/02/2002                   

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