Study: Many women can skip frequent bone scans

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ATLANTA (AP) — New research could mean millions of older women can skip frequent screening tests for osteoporosis: If an initial bone scan shows no big problems, many can safely wait 15 years to have another one, the study suggests.

Government advisers and leading doctor groups urge osteoporosis screening, but no one has known how often that should happen. The findings offer the best information to date on that question, experts said.

"This is landmark, in the sense that it could allow us to move on to more precise guidelines," said Dr. Heidi Nelson, a researcher at the Oregon Health & Science University who is an expert on the topic.

At issues are bone mineral density tests, which usually are done through X-rays and cost around $250. It takes about 10 minutes and involves less radiation than what's emitted during a chest X-ray. Medicare pays for testing every two years.

The new study feeds concerns that the tests are done too often, at least for some women.

"It's an expenditure of time, it's exposure to radiation, and it's cost. And there's no reason to expose yourself to any risks if there's going to be no benefit," explained Dr. Virginia Moyer, who heads the U.S. Preventive Services Task Force, a government panel that issues testing guidelines.

The test measures how thick bones are in certain spots, usually focusing on the hip and lower spine. Doctors use it to gain early warning of osteoporosis, a bone-thinning disease that can be staved off with better diet and exercise and treated with bone-building drugs. Nearly half of all women older than 50 will break a bone because of osteoporosis, according to the National Osteoporosis Foundation.

The government task force recommends that all women over 65 get a scan. The panel also recommends testing for younger postmenopausal women who seem at higher risk for fractures. But the task force has not said how often follow-up tests should be done, just that a couple years between tests are needed.

There are no immediate plans to update the task force's advice for osteoporosis screenings, but the new study will be an important consideration when the panel acts again, Moyer said.

The new, government-funded research involves nearly 5,000 women aged 67 years and older in a national health study that began in the 1980s. None had osteoporosis at the outset.

The researchers looked at how the women did on bone density tests, and watched for who got osteoporosis and when. They were followed for 15 years.

Based on that, the researchers concluded that women with a healthy initial test could wait as long as 15 years before getting a second screening. But women deemed at moderate risk should get tested about every five years. And women at high risk should get tested more often, perhaps even annually.

The research, published in Thursday's New England Journal of Medicine, was led by Dr. Margaret Gourlay of the University of North Carolina. She worries that her findings might be misinterpreted and cause some women to wait longer than they should for their next test. She cited earlier research suggesting not enough women get the recommended initial scan.

The 15-year interval applies only to postmenopausal women judged to be at low risk for osteoporosis from the first screening, she noted, and perhaps fewer than half of U.S. women over 65 fall into that category.

But she said even for those women, other risk factors have to be considered: smoking, slim build, prior broken bones and taking medication that has an eroding effect on bones.

She also noted that osteoporosis becomes a greater risk in the oldest patients, so a woman with a moderate risk who is 85 or older might be better off getting tested every three years instead of every five.

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Online:

New England Journal: http://www.nejm.org

Osteoporosis information: http://www.bones.nih.gov

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Survey: 1 in 4 women attacked by intimate partner

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ATLANTA (AP) — It's a startling number: 1 in 4 women surveyed by the government say they were violently attacked by their husbands or boyfriends.

Experts in domestic violence don't find it too surprising, although some aspects of the survey may have led to higher numbers than are sometimes reported.

Even so, a government official who oversaw the research called the results "astounding."

"It's the first time we've had this kind of estimate" on the prevalence of intimate partner violence, said Linda Degutis of the Centers for Disease Control and Prevention.

The survey, released by the CDC Wednesday, marks the beginning of a new annual project to look at how many women say they've been abused.

One expert called the new report's estimate on rape and attempted rape "extremely high" — with 1 in 5 women saying they were victims. About half of those cases involved intimate partners. No documentation was sought to verify the women's claims, which were made anonymously.

But advocates say the new rape numbers are plausible.

"It's a major problem that often is underestimated and overlooked," said Linda James, director of health for Futures Without Violence, a San Francisco-based organization that advocates against domestic abuse.

The CDC report is based on a randomized telephone survey of about 9,000 women and 7,400 men.

Among the findings:

— As many as 29 million women say they have suffered severe and frightening physical violence from a boyfriend, spouse or other intimate partner. That includes being choked, beaten, stabbed, shot, punched, slammed against something or hurt by hair-pulling.

— That number grows to 36 million if slapping, pushing and shoving are counted.

— Almost half of the women who reported rape or attempted rape said it happened when they were 17 or younger.

—As many as 1 in 3 women have experienced rape, physical violence or stalking by an intimate partner in their lifetimes, compared to about 1 in 10 men.

—Both men and women who had been menaced or attacked in these ways reported more health problems. Female victims, in particular, had significantly higher rates of irritable bowel syndrome, asthma, frequent headaches and difficulty sleeping.

—Certain states seemed to have higher reports of sexual violence than others. Alaska, Oregon and Nevada were among the highest in rapes and attempted rapes of women, and Virginia and Tennessee were among the lowest.

Several of the CDC numbers are higher than those of other sources. For example, the CDC study suggests that 1.3 million women have suffered rape, attempted rape or had sex forced on them in the previous year. That statistic is more than seven times greater than what was reported by a Department of Justice household survey conducted last year.

The CDC rape numbers seem "extremely high," but there may be several reasons for the differences, including how the surveys were done, who chose to participate and how "rape" and other types of assault were defined or interpreted, said Shannan Catalano, a statistician with the Bureau of Justice Statistics.

"It is an evolving field, and everyone is striving to get a handle on what's the best estimate," Catalano said.

The CDC's numbers don't seem surprising to people who work with abused women.

"I think that the awareness is growing," said Kim Frndak, community educator for the Women's Rescue Center to End Domestic Violence, which operates a shelter on the outskirts of Atlanta.

"More and more people are really saying, 'Oh, this is something that we need to pay attention to as well,' because it's your sister, it's your mother, it's your daughter, it's your son, it's your brother. Someone in your own circle is being affected by domestic violence, and the effects can be devastating," she said.

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Associated Press Writer Kate Brumback in Atlanta contributed to this report.

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CDC report: http://www.cdc.gov/violenceprevention/nisvs/

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More US women having twins; rate at 1 in 30 babies

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ATLANTA (AP) — The number of twins born in the U.S. soared over the last three decades, mostly the result of test-tube babies and women waiting to have children until their 30s, when the chances of twins increase.

In 2009, 1 in every 30 babies born in the U.S. was a twin, an astounding increase over the 1 in 53 rate in 1980, according to a government report issued Wednesday.

"When people say it seems like you see more twins nowadays, they're right," said Joyce Martin, an epidemiologist who co-authored the Centers for Disease Control and Prevention report.

Some increase was expected as more women are delaying starting a family until they are over 30. For some unknown reason, mothers in their 30s are more likely to have twins than younger or older women. As much as a third of the increase can be attributed to that, Martin said.

The rest of the rise is due to fertility drugs and treatments.

"You have a double whammy going on. There are more older moms and more widespread use of fertility-enhancing therapies," Martin said.

Starting in the early 1980s, couples who had trouble conceiving began to benefit from medical advances like fertility drugs and in vitro fertilization and other procedures. These treatments became fairly widespread in the 1990s but are expensive, and availability and insurance coverage varies.

The twin birth rate rose by more than 2 percent a year, on average, from 1980 through 2004. It leveled off to less than 1 percent annually although the rise from 2008 to 2009 was nearly 2 percent.

In 2009, twin rates increased in all 50 states, though the jumps were highest in lower New England, New Jersey and Hawaii. In Connecticut, twins now account for nearly 5 percent of births.

That's high. Nationally, 3.3 percent of all births were twins in 2009, up from 2 percent in 1980.

Over the last three decades, rates rose for white, black and Hispanic women, but the increases were not uniform. Rates doubled for whites, rose by half for blacks and by about a third for Hispanics. Historically, black moms have twins most often, but white moms have almost caught up.

"That's changed with infertility treatments," said Barbara Luke, a Michigan State University expert on twin births.

The greatest increase in twin rates was for women 40 and older. They are more likely to use fertility treatments and to have two embryos implanted during in vitro fertilization, whereas younger women are more likely to get just one.

About 7 percent of all births for women 40 and older were twins, compared to 5 percent of women in their late 30s and 2 percent of women age 24 or younger.

While a lot of attention is focused on the impact of fertility treatments, that's not the only factor. Before fertility treatments existed, about 2.5 percent of the babies born to women in their late 30s were twins, compared to under 2 percent for younger and older women. Some research has suggested women in that age group are more likely to produce multiple eggs in a cycle, increasing their chances of twins.

Clearly, there are more older moms. In recent years, more than a third of all births have been to women 30 and older, up from just one-fifth in 1980.

Take Victoria Jacobson. At 31, she gave birth to twin girls last April — her first children. With no history of twins in her family, and no fertility drugs, it was a big surprise when she found out at six months pregnant.

"I cried, because I'm more of a realist. My husband laughed," said Jacobson, of Glen Ellyn, Ill. "They were not tears of joy. Maybe shock, more than anything."

Still, Jacobson doesn't find the new report on twin births surprising. A good friend had twins four months after Jacobson's girls were born. "I'm stopped at every corner and in every store" by mothers who also have twins, or who know of other twins, she says.

"I never knew how many twins were around until I got twins."

Are more twins good news? Some experts say the trend is worrisome, noting that multiple births are more dangerous for the mother and their babies. The infants tend to be born earlier, smaller and weaker, and require much more care.

Jacobsons' twins arrived a month early and were tiny, about 3 pounds each. They had to be cared for in a hospital intensive care unit, and one needed a ventilator at first to help her breathe.

At 8 months, they are still small, but healthy and doing fine. Still, they don't sleep through the night, and breastfeeding two and getting them on the same schedule hasn't been easy, she said.

Despite the challenges, she has this advice to other moms of twins: Don't "think about it as double trouble. It's still a double blessing."

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AP Medical Writer Lindsey Tanner in Chicago contributed to this report.

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CDC report: http://www.cdc.gov/nchs/

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A link between HPV and heart attack in women

An intriguing new study finds a link between the human papillomavirus, or HPV, the common sexually transmitted infection is the cause of cervical cancer cervical most and an increased risk of heart attack and stroke in women.

Led by Dr. Kenichi Fujise the medical branch of the University of Texas at Galveston Texas, the study found that women who is controlled positive for any strain of HPV were 2.3 times more likely to have had a heart attack or a stroke than women which proved negative. The positive controlled women at high risk HPV strains, those known to cause cancer, had a higher risk of heart attack or stroke, 2.86 times higher than uninfected women.

The study includes 2 450 women, aged 20 to 59, who had attended the Centre for Disease Control and Prevention (CDC) National Health and Nutrition Examination Survey between 2003 and 2006. The participants were tested for the HPV — 44,6% tested positive for any strain of HPV and 23.2% tested positive for a strain to high risk - and reported their status as heart disease. In total, 1 141 women had HPV. Sixty years said they had had a heart attack or stroke, and 39 of these women against HPV.

More: HPV-related oral cancer more than tobacco

Researchers have focused on HPV in the hope of finding a clue of why some people develop heart disease, even if they are pas of cardiovascular risk factors traditional such as hypertension, obesity or a history of smoking - about 20% of patients with heart disease. HPV appeared to be a plausible candidate as the virus interferes with the function of a gene called p53. The inactivation of the tumor suppressor gene contributes to various cancers, but previous research has shown that p53 regulates also the atherosclerosis or hardening of the arteries; Disabling may also lead to inflammation and exacerbate the health of the artery.

Inactive HPV an another tumor suppressor gene called retinoblastoma protein, which regulates the growth of smooth muscle cells that line blood vessels, so interfering with its function could also affect blood flow and, therefore, risk of heart attack.

While the new findings are interesting, they show an association. They prove that HPV causes heart disease. It is possible, for example, that women with heart disease are prone to HPV infection, rather than vice versa, or that other underlying factors makes women vulnerable to both.

A study much more is required to make a link between HPV and cardiovascular risk can be definitively established. As the New York Times reported:

"We need to be careful," said Dr. [Lori] Mosca, Director of preventive cardiology at NewYork-Presbyterian Hospital/Columbia University Medical Center, who did not participate in the study]. "We have to go and make more stringent types of research that could answer the question more definitely".

She said that many researchers are investigating possible links between cancer, infections and diseases of the heart, but that so far no infections had been established to cause diseases of the arteries.

Work of Dr. Fujise, said, "has the possibility, if it pan, also inform the public about the potential benefits of vaccination for HPV. But she added that the results were too preliminary to be used as evidence for immunization.

More: Government recommends Vaccination against HPV for boys

HPV is sexually more common transmissible infection in the United States, affecting at least half of all sexually active men and women at some point. In 50 years, 80% of sexually active women had HPV. Most people clear the infection on their own, but in a small minority of cases, the infection may persist and lead to cancer. The HPV vaccine, which protects against genital warts and cancer of the cervix, vulva, vagina, penis, anus and throat, is recommended for both boys and girls aged 11 and 12.

If further study confirms the association between HPV and heart disease, it could help to shed valuable light on why people without the usual cardiac risk factors have heart attack anyway. Each year, 510,000 women have heart attacks in the United States, according to the American Heart Association. If the HPV is confirmed to play a role in heart risk, MSNBC reported, Fujise calculates that 4 321 women could have heart attacks each year due to HPV than other risk factors and that 1,618 women die each year from heart attack HPV.

The study was published in the Journal of the American College of Cardiology.

More: A surprising link between bacteria and cancer of the colon

Meredith Melnick is a journalist in time. Find him on Twitter at @ MeredithCM. You can also continue the discussion on the time Facebook page and Twitter time @.

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Little Women: When Puberty Starts Too Soon

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It's never easy to be 13 — especially when you're actually only eight. If there was one good thing about the unavoidable storms of puberty, it was that you could at least predict when they'd come. After 11 or 12 years of a relatively uncomplicated childhood, you would slowly begin the transition to your teen years and beyond. No more.

Increasingly, puberty in both the developed and developing world is beginning as young as age eight, seven or even earlier. In the U.S. two out of every 10 white girls, three out of every 10 Hispanic girls and four out of every 10 African American girls are showing breast development by age eight. Onset of puberty is falling for boys too — with doctors not even considering it a clinical problem unless the physical changes begin before age 9. It's girls, however, who are being hit the hardest.

MORE: New York City Mandates Sex Ed Classes for Public School Kids

The American obesity epidemic is surely to blame — at least in part — since fatty tissue can increase the body's output of certain hormones. So too may the agricultural hormones found in meat and dairy products. And so too may industrial chemicals, especially phthalates and BPAs in plastics, which are known as endocrine disruptors for their tendence to mimic, block or otherwise interfere with the function of hormones.

Kids whose puberty begins too soon face not just psychological risks, but physical ones too, with an increased likelihood of cancer, as well as skeletal changes that could prevent them from attaining their full adult height.

PHOTOS: Teens in America: Class Pictures

Drug therapies to shut off puberty are available, but is this really what we've come to — injecting preteens with hormone and growth regulators to control a process nature had already figured out perfectly well? TIME's investigative story, "Little Women," appearing in the current issue (and available to subscribers here), explores what's behind the plummeting age of puberty, and what we can do — must do — to fix the problem.

Jeffrey Kluger is a senior writer at TIME. Find him on Twitter @jeffreykluger. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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Do All Women Need Genetic Testing Before Pregnancy?

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For two years, a bunch of medical geneticists in Maryland and New Jersey sifted through 1,000 different genetic mutations. They looked for cellular changes that are fatal and ones that are treatable. They argued. Eventually, they decided to include close to 600 mutations found in more than 160 diseases in a single genetic screening test that will be available come January.

GenPath Women's Health, part of N.J.-based Bio-Reference Laboratories, announced the new development on Thursday at a meeting of the National Society of Genetic Counselors. GenPath says it is the most comprehensive screen currently offered: in a field of rare diseases, the test distinguishes itself by scanning for 95 disorders that are not screened for by any other company, including obscure tongue-twisters such as 3-hydroxy-3-methylglutaryl-CoA lyase deficiency and cerebrotendinous xanthomatosis.

Company officials put a lot of thought into a name for the test, ultimately deciding to call it the Pan-Ethnic Carrier Screen as a way to signal to all women, regardless of ethnicity, that genetic-testing is important for them.

But do all women really need to undergo genetic testing? More than half of pregnant women do some kind of prenatal screening or testing of their fetus, but there aren't readily available numbers on how many women choose to learn if they're carriers for various genetic diseases. The vast majority of women undergo carrier screening based on their ethnic background, although many, regardless of their heritage, are also screened for cystic fibrosis. Traditionally, certain ethnic groups — especially Ashkenazic Jews of Eastern European descent — have been advised to consider carrier screening for various fatal conditions including Tay-Sachs and Canavan diseases.

MORE: A Blood Test Determines a Baby's Sex Earlier than Ever. But at What Cost?

Indeed, GenPath is presenting the new test as a way to level the genetic playing field and expand testing to any woman, anywhere. "There are a good number of ethnicities that have been ignored by genetic testing," says Marc Grodman, CEO of Bio-Reference. "You don't have to be Jewish to have a genetic test. That's why we are calling this a 'pan-ethnic' screen."

In general, say genetic counselors, increased interest in genetic testing is welcome because it encourages women to better understand how their genetic makeup could impact their children. But pregnant women are getting bombarded with options: this is just the latest of a battery of new blood tests that can determine everything from fetal sex to Down syndrome to paternity.

When it comes to genetic testing, in particular, it's important to make sure that any screening is done in conjunction with a genetic counselor who can explain results, review options and offer guidance. "Sometimes that means not testing because the patient would not benefit or is not interested once they have a thorough understanding of the test, the benefits and possible limitations," wrote Karin Dent, president of the National Society of Genetic Counselors, in an email.

The GenPath test will be marketed to physicians, who will then offer it to their patients. It will cost $500 out-of-pocket should insurance companies decline to pay. Ideally, women would be tested before they get pregnant. Should they turn up positive for a mutation, their partner would need to be tested too. If they're both positive for the same mutation, they would have a 25% chance of having an affected baby.

MORE: How Do You Parent When There's No Tomorrow?

GenPath is not the only company working on new prenatal genetic tests. Good Start Genetics of Cambridge, Mass., is initially targeting fertility clinics with its DNA-sequencing test that will allow detection of a larger spectrum of mutations than the current genotyping method. Its cystic fibrosis screen, for example, is more sensitive than any test currently on the market, says Greg Porreca, the start-up's co-founder.

Its test, which should be available sometime next year, will look for about 20 conditions recommended by the American Congress of Obstetricians and Gynecologists (ACOG) and the American College of Medical Genetics. GenPath's test, on the other hand, has the potential to identify a host of additional diseases: 3-Hydroxy-3-Methylglutaryl CoA lyase deficiency, for example, is diagnosed when a person can't process an amino acid called leucine. Potentially fatal if untreated, the condition is so uncommon that it's been reported in fewer than 100 people worldwide.

ACOG officials declined to comment on GenPath's test, but its 2008 policy statement advises screening or testing "for a limited number of severe child-onset diseases." The American Pregnancy Association, meanwhile, expressed skepticism about the wide net that GenPath is casting. "Genetic testing historically is only recommended for those identified as at risk," says Brad Imler, the group's president. "We would advise testing because there is a reason to test, not just a hypothetical something-could-be-wrong."

But knowledge is power, argues Grodman, who is convinced that parents would want to know ahead of time about any increased risks in order to be prepared. "The biggest fear about rare disorders is that a baby is born and no one can make a diagnosis," says Grodman. "Just because it's a hard decision and a hard process doesn't mean we should shy away from asking the questions."

Bonnie Rochman is a reporter at TIME. Find her on Twitter at @brochman. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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IVF Linked to Ovarian Tumors. Should Women Worry?

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When TV host Giuliana Rancic was recently diagnosed with breast cancer after two rounds of in-vitro fertilization (IVF), cancer specialists were widely quoted as saying that there's no evidence that the large hormone doses involved in fertility treatment contribute to breast cancer. The link between IVF and ovarian cancer, however, was muddier.

Part of the problem when studying IVF and ovarian cancer risk is that infertile women already have a slightly higher risk of ovarian cancer than women who are able to conceive naturally, so it's difficult to figure out whether it's the infertility or the IVF that may raise ovarian cancer risk.

MORE: The Case of Giuliana Rancic: Is There a Link Between IVF and Cancer?

Now a study of 25,152 Dutch women with fertility problems — 19,146 of whom underwent IVF, while the rest did not — is the first to try to get around that problem. The researchers found that after about 15 years of follow-up, women who had undergone IVF, which requires hormones to stimulate the ovaries, were twice as likely to have developed an ovarian malignancy, compared with the non-IVF group.

Most of that increase in risk was driven by "borderline" ovarian tumors, however. These are tumors that may turn into cancer and require surgery to remove the ovary, but are rarely life threatening. The IVF group was nearly twice as likely to have a borderline tumor as the general population, and more than four times as likely as the subfertile comparison group.

"Our data clearly show that ovarian stimulation for IVF is associated with an increased risk of borderline ovarian tumors and this risk remains elevated up to more than 15 years after the first cycle of treatment," study author Flora van Leeuwen, head of the department of epidemiology at The Netherlands Cancer Institute, said in a statement.

So, how worried should women be? Not terribly. The absolute risk of ovarian tumors was very low. Researchers found just 61 ovarian malignancies in the IVF group, 31 of which were borderline tumors. In the Netherlands, the researchers note, the cumulative risk of ovarian malignancy, including borderline tumors, is 0.45% in women aged 55. "If our results are true, we would estimate a 0.71% risk for women who underwent IVF," they write — a less than 1% chance.

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The other 30 malignancies in the IVF group were invasive cancer. Although the women receiving fertility treatment had more invasive cancers than the comparison group, the difference was not statistically significant, the study found.

Further, the overall rate of ovarian malignancies did not rise with increasing numbers of IVF cycles, suggesting that ovarian stimulation is not causally linked to cancer.

"The main message is that women who have had IVF shouldn't be alarmed. The incidence of ovarian cancer was extremely low," Curt Burger, a co-author of the study published in the medical journal Human Reproduction, told the BBC.

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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Mammograms don't save as many lives as women think

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A doctor exams mammograms a clinic in Nice, south eastern France January 4, 2008.

Credit: Reuters/Eric Gaillard

By Julie Steenhuysen

CHICAGO | Tue Oct 25, 2011 3:02pm EDT

CHICAGO (Reuters) - Many women who have survived breast cancer often say it was a mammogram that "saved their life," a powerful testimonial that can encourage other women to get regular breast cancer screening tests.

But what are the chances that the test actually saved a woman's life? Not that great, according to a new analysis published in the Archives of Internal Medicine on Monday.

"The numbers suggest that at most, 13 percent of those diagnosed with breast cancer have been helped. That means the other 87 percent have not been helped," Dr. Gilbert Welch of Dartmouth College, who led the study, said in a telephone interview.

"That is important when we keep hearing these stories from breast cancer survivors," he said.

Welch said women who tell their stories about surviving breast cancer can be a powerful inducement for other women to get tested for breast cancer, and as mammogram technology has improved, the chances are even greater that doctors will find something suspicious.

But early detection for some women may not be much of a benefit, especially if a cancer is slow growing, Welch and colleagues say. And many women may be diagnosed and treated for a cancer growing so slowly it might never have caused any symptoms or threatened their lives.

The findings add new fodder to the simmering debate over the benefits of screening healthy people for cancer. Earlier this month, the government-backed U.S. Preventive Services Task Force recommended that healthy men not get a common blood test for prostate cancer, causing an uproar among cancer specialists who fear more men will die from prostate cancer.

In 2009, the same group recommended that women under 50 not get routine mammograms. For women 50 and older, it recommended the test only every other year, rather than yearly, causing an outcry from breast cancer advocacy groups.

But screening tests have both benefits and risks, says Welch, who views the current debate as positive for patients who are starting to think more about the risks of screening.

An earlier study by Welch found that routine screening for prostate cancer has resulted in as many as 1 million American men being diagnosed with tumors who might otherwise have suffered no ill effects from them.

In the latest study, Welch and colleagues looked to see how much mammography reduces deaths from breast cancer.

They found that for 50-year-old women whose breast cancers were diagnosed by a mammogram, there was a 13 percent chance that the screening test saved her life.

The question, then, becomes how to preserve the benefit of mammogram without exposing so many women to the harms of overdiagnosis -- which include being treated for cancers that might not cause harm, Welch said.

He said breast cancer screening technology has become better and better at spotting tiny cancers on the assumption that the earlier a cancer is detected, the better the chances of cancer survival.

But Welch said as treatments for breast cancer get better, the need for very early diagnosis is less great.

"For years we've been looking harder and harder for cancer. I think the time has come to ask the question, 'What if we looked a little less hard?'"

Dr. Timothy Wilt of the Minneapolis Veterans Administration, who wrote a commentary on the findings in the same journal, said the study gives doctors science-based information to share with patients, who are often influenced by anecdotes.

"Because survivor stories are often so powerful, but inaccurate, they can result in people making healthcare decisions that are not science based and may be wrong," he said.

(Editing by Cynthia Osterman)

(This story was corrected in paragraph 8 to show mammogram recommendations refer to women under the age of 50, not 40)

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BPA Exposure in Pregnant Women May Affect Daughters' Behavior

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A new study finds that exposure to bisphenol A before birth may lead to behavior problems in girls by age 3. The findings, published in Pediatrics, promise to heat up the debate over the safety of BPA, the ubiquitous chemical found in water bottles, linings of cans and even on the register receipts we get at the checkout stand.

Led by Joe Braun, a research fellow at the Harvard School of Public Health, the study suggests that exposure to BPA, especially in developing fetuses, may be long-lasting. Among a group of 244 mothers and their 3-year-olds whose BPA levels were measured in their urine, moms who had higher BPA levels during pregnancy were more likely to have children who were aggressive, anxious and hyperactive and showed poor emotional control, compared with moms with lower levels of BPA. The children's own BPA levels did not have an effect on their behavior patterns.

MORE: Pregnant Women Awash in Chemicals. Is That Bad for Baby?

The results highlight how important the pregnancy period is to early brain development, and suggest that there are critical windows during which exposure to chemicals like BPA can perhaps permanently influence a child's emotional and behavioral state. "It's possible that the brain is more vulnerable to the effects of BPA during certain parts of pregnancy, such as the early stages, and not as vulnerable later," says Braun. "Certain events take place in the brain, and once they take place, they are done."

Earlier studies in animals have linked BPA exposure in the womb to aggressive and anxious behavior among offspring, and studies in young children have linked the chemical to asthma.

The scientists tested pregnant women for BPA at 16 and 26 weeks gestation and at birth. Their children were tested annually until age 3. About 97% of the moms and children showed some BPA in their urine, confirming previous data from the Centers for Disease Control and Prevention, which show that nearly all Americans have a measurable amount of the chemical in their systems.

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The results held strong even after the researchers adjusted for other possible contributors to the children's behavior, such as breast-feeding, mother's education, depression and marital status, and possible study confounders such as differences in the strength of the urine samples. The results were the first to look at how BPA may affect executive functions of the brain, which regulate reasoning and planning as well as control of emotions. For every 10-fold increase in the mothers' gestational BPA concentrations, the children showed a 9-to-12-point increase in impulsivity and a lack of emotional control.

"The data suggest that at exposures that humans are typically exposed to, there seems to be an effect of BPA on behavior," says Braun.

The effect was more striking in girls than in boys, which hints at differences in the hormonal factors that may regulate development of executive and behavioral activities of the brain. Girls in the study were more than twice as likely as boys to show anxiety and depression if their mothers had been exposed to BPA. It's possible that BPA may be boosting levels of the hormone estradiol in female fetuses, disrupting the normal sexual differentiation of the brain, leading it to become more masculine. In animal studies, the female hormone estradiol has been shown to convert to testosterone in males, resulting in masculinization.

MORE: Even 'BPA-Free' Plastics Leach Endocrine-Disrupting Chemicals

Braun says it's not exactly clear yet why BPA may affect girl and boys differently, but he is hoping to investigate these results further to find out. More studies will also reveal whether there is a threshold level of BPA that triggers these changes in fetal brain development.

In the meantime, how should an expectant mom reduce her exposure to BPA? The Food and Drug Administration stands by its claim that current use of the chemical in food packaging is safe, but Braun says moms-to-be may reduce their exposure by avoiding canned and packaged foods. Whether or not pregnant women should also avoid handling thermal register receipts is less clear; there's a study currently underway that is investigating whether day-to-day handling of these receipts can significantly increase exposure. "To be precautionary," Braun says, especially for those who work at registers, "it's reasonable to wear gloves."

MORE: Dirty Money: Traces of BPA Found on Currency

Alice Park is a writer at TIME. Find her on Twitter at @aliceparkny. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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Study Asks Who's Funnier, Men or Women?

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(Updated) If men are funnier than women, then it's not by much — and mostly just to other men. Such is the conclusion of a new study by psychologists at the University of California, San Diego, who judged comic wit by asking students to write original captions for New Yorker cartoons.

Setting aside the fact that writing New Yorker cartoon captions is notoriously difficult, even for people who do funny for a living, and setting aside the question of whether caption-writing is really the best barometer of "funny" in the natural world, researchers asked 32 undergrads, split evenly between males and females, to come up with captions for 20 cartoons in 45 minutes and "to be as funny as possible."

The 640 resulting captions were then judged in a series of knockout contests. For each cartoon, the captions were randomly paired up and pitted against each other (the writers were kept anonymous), with readers — 34 male and 47 female students — choosing the funnier of each successive pair. Round 1 included 32 captions, whittled down to 16 survivors; Round 2 shrank that pool to eight, and so on. The further each caption advanced, the higher its score, earning 1 point for each round.

Overall, the study found, men's captions did better than women's, by a nose, scoring just 0.11 points higher — a margin that was "just at the edge of detectability," as co-author Nicholas Christenfeld, a UCSD professor of psychology, noted. That slight advantage was due largely to the fact that men found other men's humor funnier than women did. On average, male raters gave male writers' jokes 0.16 more points, while female raters gave only 0.06 points more to male-written captions.

Wrote Inga Kiderra, a director of communications at UCSD, in a particularly delightful press release for the university:

"Sad for the guys," Christenfeld said, "who think that by being funny they will impress the ladies, but really just impress other men who want to impress the ladies."

Interestingly, in a second, related experiment, the researchers found that when presented with the 100 funniest and least funny captions from the first experiment, readers not only tended to remember the funnier jokes better, but also, upon being asked to guess the gender of the writers, more often misattributed the funny captions to guys and the unfunny ones to women. That was true for both the male and female readers.

What's more, when the study's original caption writers were asked to predict their own performance, the men's self-confidence far exceeded the women's; men predicted their captions would score 2.3 on average, while women gave themselves a more modest 1.5. Based on those numbers, it appears that men's confidence also outstripped their actual competence, the authors concluded.

So, why does the men-are-funnier stereotype persist? It may just be a matter of cultural exposure, says lead author, Laura Mickes, a postdoctoral researcher in UCSD's psychology department: "We go around observing women laughing at men, men laughing at men, men as comedians, men asserting that they are funnier, and, most likely, men trying harder — none of which requires them to actually be more capable of producing humor."

Mickes summed up the findings this way to ABC News: "There is some shred of truth to the received wisdom about men being funnier, but it does not come close to explaining how much funnier they think they are."

That, I chuckled at.

The new paper, currently in press, is slated to be published online this week by the journal Psychonomic Bulletin & Review.

Update [2:25 p.m.]: This post has been updated with a comment from the study's lead author, Laura Mickes.

Sora Song is the editor of TIME Healthland. Find her on Twitter at @sora_song. You can also continue the discussion on Healthland's Facebook page and on Twitter at @TIMEHealthland.

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Study: Gulf Seafood Unsafe for Pregnant Women and Children?

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A worker shows off shrimp fresh from the Gulf of Mexico at a seafood retailer on May 18, 2010 in Port Sulfur, Louisiana.

Is Gulf seafood safe to eat? The Food and Drug Administration (FDA) gave the green light following the BP oil spill that dumped nearly 5 million barrels of crude off the coast of Louisiana last year, but now an environmental watchdog group says the agency's standards are "based on outdated science" and underestimate the risk of cancer-causing contaminants to pregnant women and children eating seafood from the Gulf.

At issue are what the FDA considers safe levels of polycyclic aromatic hydrocarbons (PAHs), compounds found in oil, coal and gasoline that have been linked to cancer in animals and humans. According to Miriam Rotkin-Ellman, a researcher with the Natural Resources Defense Council (NRDC), the FDA accepts 100 to 10,000 times more PAH contamination in seafood than the NRDC deems safe for vulnerable populations.

That conclusion was published online Wednesday in the journal Environmental Health Perspectives. On the same day, the NRDC filed a petition [PDF] asking the FDA to reevaluate its science and set new limits for PAHs in seafood to ensure public safety, especially for vulnerable populations like pregnant women and children.

VIDEO: Lingering Worries About Health and Seafood in Louisiana

On her blog, Rotkin-Ellman noted "six major flaws" in the FDA's assessment of PAHs in Gulf seafood: "assuming everyone weighs 80 kg (176 lbs), underestimating how much seafood Gulf residents eat, ignoring the cancer risk from naphthalene [a common PAH] contamination, failing to address the increased vulnerability of pregnant women and children, allowing for a high level of cancer risk, and assuming that the contamination will only last five years."

Safe standards for PAH contamination, based on new calculations by Rotkin-Ellman and her team, were markedly different from what the FDA found. Wrote Rotkin-Ellman:

For example, FDA said that 123,000 micrograms of naphthalene per kilogram of shrimp was safe for everyone to eat. According to our calculations, only 5.91 micrograms should have been allowed to protect pregnant women and children who eat a lot of seafood. For comparison, our calculations show that 46.99 micrograms of naphthalene per kilogram of shellfish would be safe for an adult consumer.

According to our calculations, the risk of cancer associated with eating Gulf shellfish contaminated at the levels FDA says is safe could be as high as 20,000 in a million. Put another way, this means that if 1,000 pregnant women (and their children) ate Gulf seafood contaminated at the levels FDA said are safe, 20 of the children born to them would be at significant risk of cancer from the contamination.

The NRDC study found that up to 53% of shrimp tested had PAH levels exceeding the safe limits that the group had determined for pregnant women who eat a lot of Gulf shellfish. Rotkin-Ellman said her study did not find reason for concern for other adults.

MORE: How Safe is Gulf Seafood?

For its part, the FDA stands by its calculations and says that seafood fished from areas of the Gulf that have been reopened since the BP spill or were never closed is safe. Reported the Tallahassee Democrat:

The FDA said most of the seafood it sampled after the spill had no detectable trace of oil. The Louisiana Department of Wildlife and Fisheries and the Louisiana Department of Health and Hospitals calculated that every day for five years the average person could eat 1,575 jumbo shrimp or 130 oysters without health concerns.

"We're very confident that the steps that we have put in place to assure the safety of seafood have worked," FDA spokesman Doug Karas told the Democrat. "We put in an extensive program of sampling, at that time and since then, and the results have consistently been 100 to 1,000 times below our levels of concern."

MORE: FDA, NOAA Deem Gulf Seafood Safe

Meredith Melnick is a reporter at TIME. Find her on Twitter at @MeredithCM. You can also continue the discussion on TIME's Facebook page and on Twitter at @TIME.

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Women freezing eggs for future

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"It's an insurance policy," Dr. Rachel Wellner says of freezing her eggs. An estimated 5,000 women nationwide are using egg-freezing technologyProcess costs thousands of dollars and it doesn't always workAmerican Society for Reproductive Medicine hasn't endorsed egg freezing

(CNN) -- When Dr. Rachel Wellner got a text from her brother Tuesday night that his wife was in labor, she was speaking at a fancy charity event for breast cancer research. As soon as her speech was over, she raced in her evening gown to Mount Sinai Hospital in Manhattan to watch her nephew, Lincoln Jacob Wellner, come into the world.

Holding the newborn baby in the delivery room, Wellner, 36, was overwhelmed with joy, but it was tinged with sadness as she wondered when -- or whether -- she would ever have a baby of her own. An accomplished breast surgeon, Wellner has no husband in sight.

Then she relaxed as she remembered what awaited her 50 blocks away: 13 eggs frozen in a bank at New York University Fertility Center.

If by the time Wellner gets married the eggs in her ovaries are too old to work, she can thaw out her frozen eggs, have them fertilized with her husband's sperm and implanted into her uterus, and hope that her younger eggs will succeed where her older eggs failed.

Freezing eggs for one's own future use has become a growing trend, with an estimated 5,000 women nationwide making use of the technology, according to Dr. Daniel Shapiro, medical director of the egg bank at Reproductive Biology Associates in Atlanta.

"I'm really hoping I find Mr. Right soon, but if I don't, having those eggs in the bank is a big weight off my shoulders," says Wellner, who banked her eggs in June.

"It empowers women," adds Dr. Jamie Grifo, program director of the New York University Fertility Center. "Patients get to be their own egg donors."

(Entertainment journalist Maria Menounos made news last week when she announced she's freezing her eggs, but it turns out she's actually doing something different -- read The Chart to find out what.)

"It's an insurance policy," says Wellner, director of breast services at the New York Eye and Ear Infirmary. "Maybe now I'll be one of those lucky girls who has babies later in life."

"I never thought I wouldn't have kids at this point."

Freezing your eggs may be an insurance policy, but it's an expensive one. It costs thousands of dollars (or in some cases, tens of thousands of dollars) and it doesn't always work.

Plenty of things can go wrong. Wellner's 13 eggs might not survive the freezing process. They might not create viable embryos when mixed with her future husband's sperm. And, even more likely, they might not attach to her uterus when doctors implant them.

That's why the American Society for Reproductive Medicine hasn't endorsed egg freezing, calling it experimental and unproven.

"Patients need to be advised there are some things we don't know," says Dr. Eric Widra, a spokesman for ASRM.

Pamela Madsen, founder of the American Fertility Association, says a woman has to decide whether it's worth it to take the financial risk.

"If not having a baby is not an option, then I'd go to Vegas and play my cards, knowing that it's Vegas," she says.

If you're considering preserving your eggs, here are five basic questions and answers:

1. How much will it cost?

Centers charge between $6,500 and $15,000 per cycle, according to Dr. Andrew Toledo, the CEO of Reproductive Biology Associates in Atlanta. RBA in Atlanta charges $7,600 per cycle, and NYU charges $12,000. Some women need more than one cycle to get enough viable eggs.

2. Will it work?

Shapiro at RBA estimates that a woman who freezes her eggs between the ages of 32 and 35 will have a 40 to 50% chance of achieving a successful pregnancy. If freezing between ages 35 and 38, the rate goes down to 35%. If freezing at 39 or 40, it's 20 to 25%, and if freezing eggs over age 40, the success rate will be less than 10%.

3. Can I find out in advance if it's worth the money to freeze my eggs?

A test for levels of anti-Mullerian hormone can help predict whether doctors will get enough eggs to make the procedure worthwhile.

"If the results are unfavorable, we say they're probably wasting their time and money," Shapiro says.

4. What's involved in freezing my eggs?

The procedure involves injecting yourself with medicines for 10 days, visiting the doctor¹s office five or six times. About two days later, doctors will harvest your eggs while you¹re under twilight sedation. Most women feel little pain aside from a bit of cramping and breast tenderness, and go back to work the next day.

5. How do I find the best place to freeze my eggs?

"Make them show you their data," Toledo advises. "How many patients have they treated? How many eggs did they get? What is the data on survivability when they're thawed?"

Wellner says even if her eggs don't work when she thaws them out, it was worth the financial risk.

"I spent all this money on my education. Twelve thousand dollars on my reproductive future is relatively inexpensive," she says.

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Middle-aged women happier with moderate exercise

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n">(Reuters) - Middle-aged women encouraged to exercise at moderate intensity were much happier and more likely to continue working out than peers who exercised more intensely, according to a study.

Researchers led by Steriani Elavsky of Penn State University in Pennsylvania recruited 255 women between 40 and 60 years old to do either moderate or vigorous exercise, then followed the volunteers to monitor their reactions.

Overall, women who did moderate exercise were about twice as likely to feel energized and confident they could do more exercise in the future, and more of them also showed decreased feelings of sadness and anxiety than the vigorous-exercise group.

"Exercise makes you feel better but it is going to be more pleasant when performed at moderate intensity as compared to vigorous, especially when you have been previously inactive or may be overweight," Elavsky told Reuters Health.

They were activities "that would allow you to talk in short sentences while you are doing them, but would not allow you to sing," she added.

Middle-aged women are among the least active and their level of physical activity declines with age. Understanding whether exercise of different intensities has different effects on mood and whether these predict overall physical activity in midlife women is an important question to address, Elavsky added.

Elavsky and colleagues at the Middle East Technical University in Ankara, Turkey studied the 255 women, who were not on hormone therapy and who kept a daily diary of activities and feelings for two weeks. She presented their findings at the North American Menopause Society meeting in Washington D.C.

At the beginning of the study, the women completed two bouts of moderate or vigorous exercise. The vigorous workout involved exercising on a treadmill to the point where they could no longer tolerate the intensity, and moderate exercise involved a 30-minute session, also on a treadmill, at a pace the women selected for themselves but could be considered moderate.

All women also wore an accelerometer, a small device the size of a match box, to track their energy expenditure and their time spent in activities of different intensities.

The study found that moderate intensity exercise caused more women to report later that they were in a better mood and to have greater feelings of energy, psychological wellbeing and "self-efficacy."

Moderate physical activity was also much better in these terms for obese and out of shape women, Elavsky said.

Vigorous exercisers showed smaller benefits to mood, and those who were overweight or had symptoms of illness reported "significant decreases in calmness" after the exercise bouts.

Examples of moderate intensity exercise include brisk walking, ballroom and line dancing, biking on level ground or with few hills, canoeing, general gardening including raking, trimming shrubs, sports such as baseball, softball, volleyball, tennis (doubles) and water aerobics.

Elavsky added she hopes her study will reaffirm to women that exercise can be a powerful way to enhance their wellbeing, and that they don't have to go all out with their level of exertion.

"The effects we observed were large and moderate intensity is sufficient, in fact it is optimal," she said.

"We also hope that clinicians will realize the importance of considering the proper exercise intensity when making recommendations about exercise."

(Reporting from New York by Fran Lowry at Reuters Health; editing by Elaine Lies)

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For women, risk of depression falls as coffee intake rises

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Some experts have speculated that the antioxidants in coffee may have health benefits.Some experts have speculated that the antioxidants in coffee may have health benefitsWomen who drink caffeinated coffee are less likely to become depressed, study saysThe study included more than 50,000 women between the ages of 30 and 55

(Health.com) -- A few cups of coffee a day may help keep the blues at bay. According to a large new study, women who drink caffeinated coffee are less likely to become depressed -- and the more they drink, the more their risk of depression goes down.

The study, which was published today in the Archives of Internal Medicine, included more than 50,000 women between the ages of 30 and 55 who periodically filled out surveys about their coffee consumption and health. None of the women had depression symptoms (or a history of depression) at the start of the study, but during the next 10 years roughly 5% received a depression diagnosis or began taking antidepressant medication.

Compared with women who drank little or no caffeinated coffee, those who averaged two to three cups per day were 15% less likely to develop depression, even after the researchers took into account a wide range of potentially mitigating factors including marital status, church or community participation, and various health measures. Drinking four cups a day was associated with a 20% lower risk of depression.

Health.com: The 10 most depressing states in the U.S.

The study doesn't prove cause and effect, so there's no reason to believe that drinking cup after cup will actually prevent depression, the researchers say.

"There's no need to start drinking coffee," says study co-author Alberto Ascherio, M.D., a professor of epidemiology and nutrition at the Harvard School of Public Health, in Boston. "The message is that coffee is safe to drink, with no adverse effects. That's really all that can be said."

Previous research, including a study published last year that was conducted among men in Finland, has linked caffeine consumption to a lower risk of depression and suicide.

"A couple of past studies found similar results," says Daniel Evatt, Ph.D., a psychiatry research fellow at the Johns Hopkins School of Medicine, in Baltimore, who was not involved in the new research. "This study validates the association, and it was done in the best possible way."

Health.com: Big perks: coffee's health benefits

It's not clear why coffee might protect against depression. Some experts have speculated that the antioxidants in coffee may have health benefits, but in the new study people who drank only decaf were no more or less likely to be depressed than women who drank no coffee at all.

The caffeine might be responsible, but the researchers weren't able to confirm or deny this theory because there wasn't enough data available to determine whether drinking caffeinated tea or sodas is linked to depression risk in the same way as coffee consumption. Eighty-two percent of the study participants drank coffee, while only 13% and 6% drank tea and soft drinks, respectively.

Evatt, who studies the psychological effects of caffeine, is "not terribly convinced" that caffeine can prevent depression. "There's a very strong indication that there is a real relationship there, but that doesn't mean that coffee will stop depression," he says. "We need to come up with a hypothesis for the mechanism at work, and then try to see what's really happening."

Health.com: 12 surprising sources of caffeine

Another possibility is that people who aren't depressed may simply be more drawn to coffee than their depression-prone peers. Non-depressed people tend to be more "behaviorally activated," and coffee drinking may therefore fit in better with their lifestyle, says Scott Bea, Psy.D., a psychologist at the Cleveland Clinic who was not involved in the study.

Similarly, Bea adds, some depressed people may steer clear of coffee because it can heighten anxiety, which often goes hand in hand with depression.

"We shouldn't rush to the conclusion that I should drink more coffee if I don't want to be depressed," Bea says.

Health.com: 12 nondrug remedies for depression

For his part, Evatt stresses that caffeine can have negative consequences for many people, whether they're experiencing depression symptoms or not.

"We shouldn't put caffeine in too positive a light," he says. "Some people have a relationship with caffeine that's similar to an addictive drug. I don't want to pin it as a public health problem, but people can become dependent on coffee and have troubling withdrawal symptoms."

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For older women, year following hip fracture can be especially deadly

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Fractures appeared to be most dangerous in the youngest segment of study participants.Many hip fractures happen in postmenopausal women with osteoporosisStudy is first to suggest cause-and-effect relationship between hip fracture and deathSeventeen percent of the women who experienced a fracture died during the year

(Health.com) -- Women age 65 and older who fracture a hip are much more likely to die from any cause during the following year than they would be if they had avoided injury, a new study suggests.

The increased risk of death associated with hip fractures was especially dramatic among younger women. In the 65- to 69-year-old age group, the odds of death were five times higher for women in a post-fracture year than they were for non-injured women of the same age, the study found.

Many of the 300,000 hip fractures that occur each year in the United States happen in postmenopausal women with the bone-thinning disease osteoporosis, typically after a fall or other accident. Researchers have already established that these fractures increase the risk of death, but they haven't been able to rule out the possibility that women who fracture a hip are already at greater risk before their injury.

Health.com: How to fight osteoporosis

The new study, which carefully compared age-matched women with and without fractures, is the first to suggest a possible cause-and-effect relationship between hip fracture and death, says lead author Erin LeBlanc, M.D., a researcher at Kaiser Permanente Northwest, the large nonprofit health plan in Portland, Oregon, that funded the study.

"Before we might have assumed that sicker women are just more likely to get hip fractures," she says. "But now we know that there is something about the hip fracture itself, and not an underlying condition, that is bringing on this increased risk of death."

LeBlanc and her colleagues, whose findings appear in the Archives of Internal Medicine, tracked women in four states across the country between 1986 and 2005, as part of a larger study funded by the National Institutes of Health. From this pool of study participants, the researchers matched each of the 1,116 women who'd had hip fractures with four women of the same age who had not.

Health.com: Surprising facts about healthy bones

Overall, women who suffered a hip fracture had twice the odds of dying within one year of their injury than did their counterparts in the control group during the same year. Seventeen percent of the women who experienced a fracture died during the year, versus 8% in the control group. (In addition to matching the women by age, the researchers took into account body mass index, medical history, and several other risk factors for hip fracture.)

The top three causes of death -- heart disease, stroke, and sepsis -- were the same for both the fracture and control groups. But more than half of the deaths in the fracture group occurred within three months of the injury, and nearly three-quarters occurred within six months; this suggests that something about the surgery, hospital time, immobility, or rehabilitation required after a hip fracture makes women more vulnerable, says LeBlanc.

In an effort to separate out the effect of hip fractures from the underlying death risk associated with preexisting health problems, the researchers performed a more detailed analysis in women age 80 and up, a group that is generally sicker and more likely to die.

Hip fracture did not measurably increase the one-year odds of death in this age group as a whole, but it nearly tripled the odds among the subset of women who considered themselves to be in good or excellent health. The fact that hip fracture was linked to an increased risk of death only when illness was removed from the picture provides more evidence that fracture can be a cause of death, the researchers say.

Health.com: 10 ways to prevent falls at home

Fractures appeared to be most dangerous in the youngest segment of study participants: For women 65 to 69, hip fracture quintupled the odds of death within one year. This was also the only age group in which the odds of death remained higher in the fracture group after the one-year mark.

The findings in these relatively young women should be a wake-up call to physicians and patients alike, says Silvina Levis, M.D., director of the osteoporosis center at the University of Miami Miller School of Medicine.

"Many people assume that this increased mortality mostly applies to the very old," says Levis, who was not involved in the study. "But having seen this result, I think younger women are the ones who should be very much aware and should talk to their doctors about ways of assessing risk."

Women should have a bone-density test at age 65 (or younger if they have other osteoporosis risk factors), and those with low bone mass or osteoporosis may want to consider taking medications to reduce their risk of fractures, Levis says.

Health.com: 11 foods for healthy bones

LeBlanc says it's important for all postmenopausal women to get enough bone-strengthening calcium and vitamin D in their diet, avoid smoking and excessive alcohol intake, and assess their homes for hazards that could cause slips and falls. "Thinning of the bones is silent," she says. "It doesn't hurt, and if you're not proactive you might not know you have it until you break something."

These steps are especially important for a woman who has already had a fracture, LeBlanc adds, since she is at high risk for a second one.

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HEALTH MANAGEMENT. The problem with the women and Science: it is hormone - or is it?

A new study of a rare genetic disease can illuminate the long and valiantly well-reasoned debate on whether women are underrepresented in scientific careers biology or discrimination and cultural influences.
Researchers at Penn State University has watched teens and young adults who have been exposed to levels abnormally high hormone androgen male while in the uterus. Compared to their brothers and sisters who were not so exposed, they were clearly more interested in a career related to things - including science, technology, engineering and mathematics - as opposed to careers related to people, the researchers found.
Fetal exposure to androgens is one of the results of a genetic defect known as congenital adrenal hyperplasia (CAH). The condition affects boys and girls, but it is generally less apparent in boys. Girls and women with CAH are genetically female and are treated as such, but they may have characteristics such as the hair of the face and ambiguous genitalia.
More: South Africa Runner Caster Semenya allowed to compete as a female
The new study by Sheri a. Berenbaum, Professor of psychology and Pediatrics at Penn State, included 125 young people in all, 73 with CAH and 52 of their brothers and sisters who have not suffered from the condition. Berenbaum and his team gauged levels of interest in stem careers participants say: science, technology, engineering and mathematics.
Not only are women with CAH more interested by these careers than their non-affected sisters, but the androgen more that they had been exposed to in utero, most they addressed to these vocations. Young men with CAH do not differ in their career as their typical brothers preferences; both were just as interested in the fields of the stem.
The results suggest a biological influence on career choices, the author said. "We will suggest that these interests are quite early in development," said Berenbaum.
Does this mean the traffic to attract women in science is a waste of time? Not necessarily, said Adriene Mr. Beltz, a student who has worked with Berenbaum. "Perhaps we could show female ways in which an interest in people is compatible with the stem careers.".
More: The Math formula + women complicated
By coincidence, the preliminary results of another study, released in August found that in community colleges, the disparity between the sexes in science is not as pronounced as in four years to elite colleges, a result that suggests the imbalance is largely the result of cultural forces, rather than biology. Faculties of the stem in community colleges have almost a 50-50 split type. The study of the National Science Foundation, which is still ongoing, seeks to analyse why community colleges do better on this front.
A teacher in Ohio, where the results are already in, said that it has to do with schools of the culture and the environment. "[Members of the Faculty] women are happy, they pay equity and there are more of them than in the four-year colleges," said Cynthia Anderson, Professor of sociology and anthropology at the University of Ohio.
Another tick in the nurture column is this fascinating study of the India dug up by Healthland contributor Maia Szalavitz, who believes that the expectations of a tribe of the mathematical skills of women overrides nearly completely any gender difference in ability.
If a bias towards the careers of people-centric (education, social work) and stem careers (surgery, he) a result inclination or biology? Probably both. But it might help to correct the imbalance if working with people and working with things were also paid.

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HEALTH MANAGEMENT. Increases death risk in African-American women with obesity and waist size

According to a new study led by researchers from the Slone Epidemiology Center at the Boston University higher overweight and obesity in African-American women, will increase the risk of death. Cause of death in women, moreover, was a larger waist size with a higher risk the not obese. The relationship between body size and risk of death was strongest for deaths from cardiovascular disease.
The study, published in the New England Journal of medicine, Deborah Boggs, ScD, a researcher at the Slone led.
Researchers assessed the relationship of body mass index (BMI) and waist circumference risk of death over a period of 13 years of follow up in the black women's health study, an ongoing study of 59,000 African-American women in the United States. The Auditors focused on 33.916 women who had never smoked and were free from cardiovascular disease and cancer at the beginning of the study.
The risk of death was 18 percent, for every 5 units increase in BMI and BMI most from cardiovascular disease death was connected. The risk of death from cardiovascular disease was two times higher for obese women (BMI 25-29) and three times higher for obese women (BMI of 30 or higher) compared with women with a healthy weight (BMI below 25). The researchers also found that a larger waist size increased risk of death among women is associated with, who were not obese been classified; A waist size was over 35 inches a 55 percent higher risk of death.
Whereas BMI is one good estimate of the total body fat, waist size is a measure of the distribution of body fat, particularly abdominal fat. Previous research suggests that belly fat is more metabolically active, plays a role in the development of insulin resistance and can be especially harmful for the long-term health. In those who are not obese may be waist size a better indicator of risk for many health consequences.
Earlier results found that risk of death with higher BMI in the white population increased, but the limited data available on African-Americans out, pointed, increasing risk of death only at a very high level of BMI.
"Today's results show that increases the risk of death in black women with increasing BMI of 25 or more similar to the pattern in the white people", said Boggs, main author of the study. "Our results emphasize the importance for women of a healthy weight, and keep additional inches from the waist in order to reduce the risk of death."

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