Think beyond pink: Women's health risks

Breast cancer gets a lot of attention — and not just during October, which is Breast Cancer Awareness Month. There’s a good reason for that, as any of the quarter-million American women diagnosed with breast cancer each year will tell you.

But breast cancer isn’t the only serious health risk women should be aware of, according to county health professionals. Some are fatal; others are not. Some are well-known, others obscure. All affect the person’s quality of life, and all affect more women than men. We talked with some Howard County doctors in the know to find out what to look out for and where to learn more locally.


“It’s wonderful that breast cancer has a lot of support and funding and a huge public awareness campaign,” says Dr. Amanda Nickles Fader, director of the Kelly Gynecologic Oncology Service at The Johns Hopkins Hospital. “But there are other malignancies equally important for women to know about.”

Among those malignancies are what Fader calls “below-the-belt cancers,” led by uterine cancer, ovarian cancer and cervical cancer.

Every year, about 80,000 women in the U.S. are diagnosed with gynecologic cancer, and 35,000 women die from it, according to the Centers for Disease Control and Prevention.

Each of the cancers is unique, with different signs and symptoms, and only cervical cancer has an effective screening procedure that can detect it early — one reason fatality rates for the others are so high.

“These cancers are quite prevalent, and some of them are even [fatal more often] than breast cancer,” Fader says. “So it’s really important for women to know about them.”

Where to learn more:

In conjunction with the Foundation for Women’s Cancer, which coordinates awareness and educational programs about women’s cancer, Hopkins holds a day of gynecologic prevention and survivorship courses in Baltimore every year in September. (September is Gynecologic Cancer Awareness Month.)

In addition, the Sidney Kimmel Comprehensive Cancer Center at Hopkins and the Claudia Mayer Cancer Resource Center at Howard County General Hospital, among others, sponsor programs and offer resources for women diagnosed with gynecologic cancer.

But such efforts, Fader says, are not nearly enough.

“I think there is a great need for more regional and national gynecologic cancer awareness campaigns,” she says. “Every five minutes, a woman is diagnosed with a gynecologic cancer.”

For more information, visit


Of the 10 million or so Americans with osteoporosis, about 8 million are women, according to the National Osteoporosis Foundation. The higher rate is a result of women’s thinner, smaller bones and the fact that they lose bone mass quickly when they age.

While osteoporosis, a medical condition in which bones become brittle and fragile, is not deadly, it can have a deadly effect on a person’s quality of life — especially the older people most likely to have the condition.

“It leads to hip fractures, and studies have shown that hip fractures are one of the predictors of poor outcomes in elderly people,” explains Dr. Elizabeth Menachery, medical director of the Howard County Health Department. Hip fractures, she says, often lead to long hospital stays and prolonged rehab, which cost victims their independence and mobility, often taking them away from loved ones and leading to depression.

“And then there’s multiple care issues — they can’t walk anymore, so they become bedbound and have to go into assisted-living facilities or nursing homes,” Menachery says.

Where to learn more:

While osteoporosis has no month of its own, the county health department staff regularly attends health fairs and other events to get out the word about the importance of bone health. “We go where the people are and gear our messages to the people there,” she says. “Osteoporosis is a huge problem for women.”

For more information, visit, the website of the National Osteoporosis Foundation


Sleep, as the National Sleep Foundation notes on its website, is “as important for good health as diet.” Unfortunately for women, studies have found they are more likely than men to have trouble sleeping.

Sleep disorders more common among women include restless legs syndrome and insomnia, says Dr. Rachel Salas, assistant medical director of the Howard County Sleep Disorder Center at Howard County General Hospital. Sleep apnea, a disorder where breathing repeatedly stops and starts, is generally more common among men, she says, but postmenopausal women are also at high risk for that potentially dangerous condition.

Experts believe the greater incidence among women is related to hormonal changes and such stress-related factors as balancing multiple roles in their lives, depression and anxiety.

Whatever the reason, the ill effects can be serious. Those effects, according to Salas, include weight gain, greater risk for diabetes, high blood pressure, cardiovascular disease, heart attacks, strokes, car accidents and more.

Where to learn more:

Local clinics like the county Sleep Disorder Center diagnose and treat sleep disorders, and the National Sleep Foundation leads public awareness campaigns. The group’s website lists events publicizing sleep problems, including the annual Sleep Awareness Week, held annually in March. It also offers sleep tips and a directory of sleep professionals.

Salas says people often don’t bother consulting their doctor when they have trouble sleeping, writing it off as business as usual. But that’s a mistake.

“Sleep is a basic human need,” she says, “and when you’re not getting good-quality sleep or getting enough, there are consequences.”

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Also known as painful bladder syndrome, interstitial cystitis is a little-known chronic condition that affects some 3.3 million American women and about half that many men. IC is often mistaken for a urinary tract infection, as the symptoms are similar: discomfort and pain in the bladder and pelvic area, and increased frequency in urination.

Just why more women than men suffer from IC is unknown. In fact, the cause and the cure are also unknown, although the condition is often found in tandem with irritable bowel syndrome and pelvic trauma (sexual abuse), according to Dr. Jennifer Bepple, a urologist with the Central Maryland Urology Associates in Columbia.

“Basically there’s a problem with the bladder lining, so the urine, which is very caustic … becomes much more irritating,” says Bepple, who specializes in female urology. “It’s a chronic condition, so it’s not curable, but it is manageable.”

IC is managed, she says, by avoiding the conditions that make it act up, such as spicy and acidic foods (grapefruit, tomatoes, etc.) and drinks such as coffee and tea. As for prescription drugs, there is only one that is FDA approved, according to Bepple.

“It is important to raise awareness about this condition, given its significant effect on the quality of life of so many people,” she says.

Where to learn more:

Bepple says she is unaware of any local program aimed at increasing awareness of interstitial cystitis. She suggests that women who suspect they have it should see their primary care doctor and, ultimately, their urologist or gynecologist.  

For more information, visit

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