Women’s Health: Motivations and Methods for Achieving Wellness

Women’s Health: Motivations and Methods for Achieving Wellness - While healthy living is an important topic for all Americans, a number of aspects of achieving good health and adopting a healthy lifestyle are gender based. Women have health issues that are unique to them, but some of the health issues that affect both men and women affect women differently. But women also approach their health in different ways than men.

Women’s Health: Motivations and Methods for Achieving Wellness

Women hold strong attitudes about achieving health and adopting preventive strategies. Women are more involved in the care of their own health (as well as in the care of others) for numerous, differing reasons. The longer life expectancy of women may be a result of some of these behaviors, but the bottom line is women have a strong desire to take a proactive approach to their health and wellness. Understanding how and why women have such interest and approaching them with the information, products and services they want and need can resonate with this receptive audience.

Strong Motivations for Good Health
Research conducted by the Natural Marketing Institute (NMI) in two key quantitative consumer studies shed some light on women’s health priorities. In December 2013, NMI conducted the 15th wave of its annual health and wellness study titled "The State of Health and Wellness in America™" among more than 3,000 U.S. adults. Additional insight is provided by NMI’s Trends in Healthy Aging™ research based on more than 3,600 U.S. adults adding to a nine-year compilation of trended data in this study. These studies reveal unmet needs, explore underlying female health-related behaviors and attitudes, and identify many marketplace opportunities.
Nearly three-quarters of all women believe it is important to live a healthy lifestyle. And they are active and involved in this endeavor. Seven in 10 stated they “will take whatever means necessary to control my own health" and most believe that taking personal responsibility for one’s health is the best way to stay healthy. Comparatively speaking, women hold significantly stronger opinions than men when it comes to their health.
Many stated they are achieving their goal of good health. More than eight in 10 rate their current health as excellent or very good. And most state they are about as healthy as they would have expected at this age; about one in four even consider themselves healthier than they would have imagined at their current age.
Women aim to maintain a healthy lifestyle for myriad reasons. Chief among these are lifestyle factors: wanting to have energy to remain active and enjoy life. Losing weight is another strong motivator, as most understand that maintaining a healthy weight has a significant impact on overall health and related disease avoidance. Family concerns are also strong; half want to be sure they are “around" for their spouse/family, and they do not want to be a burden on their loved ones should their health fail.

Disease and Health Conditions Currently Managed
Despite strong stated health status and intentions as mentioned earlier, women are currently managing a myriad of health issues. And regardless of whether they are actively treating these conditions, many women express concern about preventing them. Perhaps as a result of these health issues and concerns, most women report they “are very concerned about their health and are actively managing it."

Methods to Achieve a Healthy Lifestyle
 In the management of their health, many feel prevention is key, and more women lean toward “preventative wellness" than “managing illness." There are wide and varied methods by which women go about achieving this goal.
Most believe it is important to make healthy lifestyle decisions, including managing sleep, mental attitude and stress levels. Food also plays a key role; beyond consuming nutritious and healthy foods, many specifically cite the importance of natural, fortified/functional and organic choices. Women also want more healthy ingredients in their foods, including calcium, fiber, vitamins/minerals, antioxidants and probiotics. And many are more likely to purchase foods and beverages that claim to offer benefits for specific health conditions, including losing/maintaining weight, reducing cholesterol, providing heart health, strengthening bones and reducing risk of high blood pressure/stroke, among others. 
                                
New Approaches
Many products and services are available to help women address their health concerns and live full and healthy lives. Nonetheless, two-thirds perceive a healthy lifestyle will become more difficult as they age. To that end, a majority are interested in new approaches to manage their health, and are always looking for new self-care methods to prolong their health and vitality. They are discerning consumers, however, and most want health -related products that have proven scientific or clinical proof. The health-related choices and changes women make have a significant impact on their life and longevity. Offering women options to assist them in achieving better and healthier lifestyle habits is a win-win for all involved.

Women’s Health: Motivations and Methods for Achieving Wellness

Women’s Health: Motivations and Methods for Achieving Wellness

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Focus on Women's Health

When it comes to health care, men really could be from Mars and women from Venus. Women are more likely to seek medical care and use health care regularly than men are. They have unique and very different needs regarding their anatomical and hormonal makeup. Women also have unique psychological issues; they experience twice the rate of depression as men, regardless of race or ethnic background. 
Over the past year, the pharmacotherapy landscape has undergone much change in the field of women’s health. Here are overviews of those changes and insights into the contributions pharmacists can make to the health of their women patients.

Bone health

Bone health is an area of much recent drug-related activity. Conjugated estrogens and bazedoxifene (Duavee—Pfizer) was approved by FDA last year for both moderate to severe vasomotor symptoms associated with menopause and prevention of postmenopausal osteoporosis.  Odanacatib, developed by Merck & Co.,  is awaiting approval after its Phase III clinical trial was published in 2013.1 Romosozumab, which inhibits osteoblast activity, is currently in a Phase III clinical trial comparing its efficacy and safety with that of alendronate. 
The National Osteoporosis Foundation published a new Clinician’s Guide to Prevention and Treatment of Osteoporosis, which included a recommendation on adequate intake of calcium (1000–1200 mg/d) and vitamin D (800–1000 IU/d) to reduce the risk of fracture.2 “Pharmacists can educate patients to not try to get vitamin D from the sun, which will increase the risk of skin cancer, but rather to get it from food sources or supplementation,” said Sally Rafie, PharmD, BCPS, Medication Safety Specialist, University of California at San Diego (UCSD) Health System, and Assistant Clinical Professor of Health Sciences, UCSD Skaggs School of Pharmacy and Pharmaceutical Sciences. 
Bisphosphonates are also included in the recommendation, but with a limited duration of therapy of 3 to 5 years in low-risk patients due to emerging safety concerns, chiefly osteonecrosis of the jaw during prolonged therapy.

Cardiovascular outcomes

“A lot of older women are worried about getting breast cancer, but they are seven to eight times more likely to die of heart disease than breast cancer,” Rafie said. “Obesity is now a big problem, as one-third of women in the United States are obese, and it is only going to get worse.”
A recent study demonstrated that inactivity among a large cohort of Australian women was the highest attributable risk factor for heart disease compared with high body mass index, smoking, and high blood pressure.3 “Girls are getting obese now due to inactivity, which is a big concern,” added Rafie. “We have to approach this problem not just as a weight issue but as overall well-being. [Our clinic] has a team-model approach to taking care of our patients, which includes dietitian, pharmacist, and other providers [who] can send a message to the patient from multiple angles.” 
“We are doing a good job at monitoring the use of hormonal replacement therapy for postmenopausal symptoms,” said Christina M. Madison, PharmD, BCACP, AAHIVP, Associate Professor of Pharmacy Practice at Roseman University of Health Sciences, and Clinical Pharmacy Faculty member at the Southern Nevada Health District in Las Vegas. “For some women, it does make a difference in their quality of life, so it might be warranted for short-term use at a low dose,” Rafie said. New data have emerged for using paroxetine for menopausal vasomotor symptoms. Paroxetine 7.5 mg safely reduces the frequency and severity of menopausal vasomotor symptoms persistently through 24 weeks of treatment, a study showed.4

Access to reproductive health care

Fifty percent of all pregnancies in the United States are unintended, according to Rafie. Sometimes it’s a question of access to service, according to Madison. In 2012, 15% of women lacked health insurance, “which should hopefully be addressed by the Affordable Care Act,” Rafie said. California has progressive medical care in helping women better manage their reproductive health; the state administers a program called Family Planning, Access, Care, and Treatment (Family PACT), which provides a comprehensive family planning service to 1.8 million low-income families, without any shared costs.5 “For every dollar we invest in [Family PACT], we save $9,” Rafie added. 
Pharmacists’ roles in women’s health are also increasing in the nation’s most populous state. California’s 2013 law expanding pharmacists’ scope of practice includes furnishing self-administered hormonal contraceptives (HCs), independently ordering and administering routine vaccinations, and furnishing prescription medications for international travelers. 

Adherence to HCs

“Adherence is an issue with oral contraception. … Women are missing two to three pills per cycle, but we don’t have a good system set up for women to ensure [their] continuous use,” said Rafie. This nonadherence may contribute to the unnecessary use of emergency contraceptives (ECs). “We also know that copper intrauterine devices (IUDs) are the most effective ECs and can potentially get the patient to see a physician for other health-related concerns since they have to be inserted by a health care provider,” Rafie said. 
The removal of EC age restrictions and behind-the-counter checkpoints has given women the opportunity to prevent potentially unintended pregnancy; however, it also results in bypassing an important opportunity for pharmacists to educate patients about sexually transmitted infections (STIs) and future contraceptive methods, as well as to screen for any signs of mental health issues, sexual assaults, or domestic violence.

STIs and HPV immunization

“The incidence of STIs has plateaued, but we are still seeing an increase in HIV infections, disproportionately  affecting women of color,” said Madison. “Part of the issue is a lack of early comprehensive sex education in schools about the transmission and prevention of STIs. A number of states are opting for ‘abstinence-only’ education in lieu of sex education.”
According to CDC’s Sexually Transmitted Disease Surveillance 2012, released in January 2014, the most prevalent STIs are chlamydia and gonorrhea, with peak incidence among 15- to 24-year-olds.6 Syphilis increased by 11% over a single year primarily because of increased rates in gay and bisexual men; women in relationships with bisexual men are at risk secondarily. Nearly 20 million new STIs occur each year, with 50% in young people aged 15 to 24 years. Of more than 110 million STIs currently in the United States, nearly 80 million cases are caused by human papillomavirus (HPV), making it the most common STI in the country.
Women’s Health: Motivations and Methods for Achieving Wellness

 “We offer HPV vaccination in our public health department’s Sexual Health Clinic to improve vaccination rates in at-risk men and women,” said Madison. “Since Tdap [diphtheria and tetanus toxoids, and acellular pertussis vaccine] is mandated in the state of Nevada to the sixth grade, HPV is also offered at the same visit to boys and girls, thereby increasing the vaccination rate.” 
“We are finding that people do not complete the vaccination course,” Rafie added. “For unknown reasons, they do not get the second or third dose of HPV.” Because immunization records are not currently shared with community pharmacies in most cases, patients’ regular pharmacists cannot intervene and help increase the adherence rate for completion of HPV immunization. “If we can expand immunization scope of practice within the community pharmacy, this would definitely be helpful,” Rafie added.
Women older than 26 years sometimes inquire about receiving HPV vaccine. “A clinic can make a decision based on the FDA labeling, but if the patient is able to pay for the vaccination, she should get it,” Rafie said. “In theory, if she has not had any sexual encounters, she could also be able to get the vaccine, [because the age cutoff] is so arbitrary,” Madison added. “If women are able to complete the vaccine regimen within 6 months of turning 27 years old, we still vaccinate them even though they have already been sexually active because we don’t know to which strain they have been exposed. The vaccination can cover 70% of all cervical cancer. In development is a vaccine to cover the other 30% caused by strains beyond 6, 11, 16, and 18.” CDC publishes information for patients about HPV and how to discuss the vaccination with children.7

Pregnancy and lactation

Medication-related problems during pregnancy and fetal exposure to medications are of significant concern for all parties involved. According to CDC, about 90% of women take at least one medication during pregnancy, and 70% take at least one prescription medication. Over the past 30 years, use of prescription medications during the first trimester of pregnancy has increased by more than 60%. Information about teratogenic and lactation risks to the fetus is not always clear-cut with medication use. Many women do not realize they are pregnant until they are 6 to 8 weeks along, when the major fetal organs have begun or completed forming. 
“One of the problems with the current pregnancy categories is that they do not take into account the dose and duration of the drug therapy received during the pregnancy,” Madison said. Clinicians have been waiting for a final rule on pregnancy and lactation labeling that FDA proposed  in 2008, which would change the current system of letter designation to provide a more evidence-based summary of the risks and clinical considerations for clinicians. The proposed rule also addresses lactation risks in a similar manner.8 Pharmacists can use a free database called LactMed, provided by the National Institutes of Health both online and as a mobile application, to access peer-reviewed and referenced information on the effects of maternal medication use on infants.


Whether you're trying to lose weight, get in shape or just live a healthier life, eating healthy provides a variety of benefits. No matter what motivates you, here are the top 10 reasons why you should sneak a few more nutrient-packed foods into your diet.

1. You'll be more productive:
Just like your car, your brain needs quality fuel to run efficiently. One study found that eating unhealthy foods puts you at a 66 percent increased risk of productivity loss. Eating a healthy, balanced diet to make sure your brain has the fuel it needs means more energy and increased productivity at work.

2. You'll be happier:
What we eat has an impact on our brains. Did you know bananas contain 10 milligrams of dopamine, a chief mood booster in the brain? Dark chocolate, packed with polyphenol, is also known to boost serotonin, a neurotransmitter that many antidepressants also target. You should see a doctor if you're seriously concerned about your moods, but for the rare gloomy day, try a dark-chocolate covered banana.

3. You won't be as stressed:
Certain foods have the ability to moderate our body's level of cortisol, the stress hormone. Some studies have found that foods packed with vitamin C, omega-3 fatty acids and magnesium help reduce cortisol levels. When the body is in a chronic state of stress, it breaks down protein to prepare for battle. Eating a protein-rich diet, including fish and dairy, can help replenish protein stores and keep cortisol levels at bay.

4. You'll control your weight:
Simple healthy choices such as replacing soda with water, choosing carrots instead of chips, and ordering a side salad in place of fries not only will help you lose weight, it also can help you save money. The average household spends about $850 a year on soft drinks, which could easily be replaced with healthier -- and free -- water.

5. You'll eat less:
When it comes to eating healthier, quality trumps quantity. Fresh foods contain fewer low-nutrient fillers that the body burns through quickly. If you are buying and eating less food, then you will have more money in your pocket.

6. You'll think it tastes better:
Who would trade their Big Mac for a beet burger? Although taste is subjective, healthy food can taste delicious if it's prepared well. One study showed that people perceive healthy food as tasting better even if it doesn't. In a blind taste test, participants said organic coffee tasted better than regular coffee, even though the two cups were the same. So perhaps the beet burger is better after all -- even if it's only in your head.

7. You'll age better:
Why pay for expensive and painful Botox procedures when you can improve your skin through your diet? Fruits and vegetables high in antioxidants can help protect your skin. The antioxidants in fresh berries and salmon's omega-3 fatty acids both help improve the health of your skin's cells and slow premature aging.

8. You'll be healthier:
Unhealthy eating -- especially over the long term -- can be a risk factor for chronic diseases such as cancer, diabetes, obesity and heart disease. If you miss out on too much of the protein, vitamins and minerals that your body needs, your muscle mass will decrease as your fat stores increase. Some estimates say at least 30% of cancers are linked to poor diet. One study of over 6,000 women found that those who ate the most cabbage, turnips, broccoli, cauliflower and kale had a lower risk of developing breast cancer after menopause.

9. You'll live longer:
Healthy eating can help you avoid diseases that may lower your life expectancy. One study showed that a diet of fruit and vegetables, in combination with exercise, extended life expectancy for women in their 70s. Elsewhere, researchers reviewed a group of studies that suggest vegetarian or low-meat diets could help you live a longer life. And another study points to nuts as a way to reduce your risk of early death. No matter how you cut it, a healthy diet can play an important role in how long you'll live.

10. You'll save money:
Many of the benefits of healthy eating contribute to potential savings. If you stay healthy, you'll have fewer medical bills to pay and by cutting back on food, you'll eat less and have fewer groceries to purchase. Save your body and your wallet and eat your greens today.

Women’s Health: Motivations and Methods for Achieving Wellness

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