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The medicalization of healthy womanhood
POSTER PRESENTATIONS
Mayo Clinic, RochesteB MN, USA Objective: To compare the use of C o m p l e m e n t a r y and Alternative Medicine (CAM) by male (m) and female (f) patients seen in different specialty areas of an academic medical center. Method: A survey of CAM use during the previous 6 m o n t h s arranged into 3 domains: Treatments/ Techniques (21 qs), Vitamins/Minerals (12 qs, excluding multiple vitamins, vitamin D, folic acid, calcium, iron, potassium), and Herbs/Other Dietary Supplements (52 qs) was administered to 1514 adult patients in 5 specialties (General Internal Medicine, Oncology, Preoperative Clinic, Physical Medicine, Spine Center) between September and December 2002. Results: Response rate: 99.5% with 55% being women. Total CAM use: 76% of patients (m = 72%, f = 80%, P = 0.0003). Use was higher in w o m e n across all 5 specialties. Treatments/Techniques: the n u m b e r used differed by sex (m: 3.5; f: 4.6; P < 0.0001). More frequently used by w o m e n (P < 0.05): spiritual healing, weight loss programs, massage, aromatherapy, art therapy, reflexology, relaxation therapy, exercise, and energy healing. Vitamins/ Minerals: the n u m b e r used differed by sex (m: 1.7; f: 2.3; P < 0.0001). There was no specific Vitamin/Mineral more frequently used by either sex. Herbs/Other Dietary Supplements: the n u m b e r used differed by sex (m: 0.93; f: 0.99; P = 0.02). Besides the expected gender specific use of evening primrose oil and saw palmetto, green tea was more frequently used by w o m e n (P < 0.0001). Conclusion: CAM use was more c o m m o n in females (P = 0.0003), as was the n u m b e r of modalities used across all specialties. There was a gender specific difference in the use of several modalities in the Treatment/Technique and Herbs/Other Dietary Supp l e m e n t domain.
ly high concentrations of EGEE in their workplaces, the health effects b o t h in the degree of damage and target organs seemed different; subsequent health problems possibly due to EGEE exposure may be more severe in m e n t h a n i n WOlllen.
84
The Medicalization of Healthy Womanhood M i c h a e l A. W e i n g a r t e n
Sackler Faculty of Medicine, Tel Aviv University, Israel Western medicine has r e c o m m e n d e d healthy children to take routine s u p p l e m e n t s - - v i t a m i n s A + D, iron, and fluoride. Now healthy women, too, are categorized as requiring routine pharmacological support--sex h o r m o n e s for contraception and in menopause, folic acid and iron before and during pregnancy, and calcium and b i p h o s p h o n a t e s in old age. This is a remarkable exercise in the medicalization of healthy lives. By virtue of being female, the b o d y seems to require constant help even w h e n healthy. These recomm e n d e d preventive medicine protocols, if followed religiously, make pill-taking a routine part of life for a w o m a n from birth to death. Although each and every element in these preventive protocols can be justified individually, the total end result is counterintuitive. Normal biological life should n o t require constant pharmacological support. The fact that it is w o m e n in particular w h o are singled out as being deficient demands a reappraisal of the social, political, and commercial interests that m i g h t benefit from subjugating that half of the population to a life of monitored medical prescription. In this presentation I will suggest some candidate interests.
83
85
Gender-Specific Health Effects Following Exposure to Ethylene Glycol Monoethyl Ether Among Male and Female Workers
Johanna Wolfram
R u i s h e n g Wang; M e g u m i Suda; a n d Takeshi H o n m a
National Institute of Industrial Health, Kawasaki, Japan Ethylene glycol m o n o e t h y l ether (EGEE) is a solvent comm o n l y used in industry and consumer goods. This comp o u n d is k n o w n to have toxic effects o n reproductive and haematological organs in a n u m b e r of species. To investigate w h e t h e r there is any difference in the health effects following exposure to EGEE, we examined 19 male and 32 female workers exposed to high concentrations of this comp o u n d in two factories manufacturing p h o t o p o l y m e r sensitization plate. The m e a n age was 24.8 and 33.9 years for male and female, respectively. Average RBC count, h e m o globin levels, and hematocrit value were normal in b o t h groups. However, there were 5 out of 19 male subjects with an RBC count, hemoglobin concentration, or hematocrit lower t h a n the standards, whereas only 2 out of 32 female workers showed lower values of these indices. The blood level of prolactin was abnormally higher in 26.3% male workers, but only 15.6% in female subjects. As for the effects on reproductive system, there were 4 w o m e n reported abnormal menstruation, but almost all married w o m e n had children. On the other hand, there were 7 male workers showing lower sperm counts or progressive sperm percentage t h a n the standards. Overall, our study showed that although male and female workers were exposed to similar-
Sexual Dysfunction in Hypertensive Men Department of Cardiologie, Medical University of Vienna, Austria The incidence of sexual or erectile dysfunction (ED) in m e n already appears at 35-40 years and increases with age. Hypertensive m e n have a significantly increased risk to develop ED w h e n compared with normotensive subjects. Hypertension is a major risk factor for the d e v e l o p m e n t of cardio- and cerebrovascular disease, and the n u m b e r of diseased coronary arteries, for example, have been demonstrated to correlate positively with the severity of ED. The early diagnosis and sufficient treatment of hypertension appears therefore, to be crucial in order to avoid long-term complications. Equally important is the choice of the most appropriate drag. Angiotensin receptor blockers have been shown in several clinical trials to efficiently reduce blood pressure and to improve pre-existent ED or even prevent its development, while other anti-hypertensive drags (eg, beta-blockers) can actually aggravate ED. Lifestyle modifications and specific pharmacological antihypertensive therapy appear therefore to be the cornerstone to maintain sexual function in hypertensive men.
86
Trend Analysis of Sex Ratios of Births and Fetal Deaths in Japan, 1899-2003 Limin Yang; Naoko Sakamoto; and Eiji Marui $67
Mayo Clinic, RochesteB MN, USA Objective: To compare the use of C o m p l e m e n t a r y and Alternative Medicine (CAM) by male (m) and female (f) patients seen in different specialty areas of an academic medical center. Method: A survey of CAM use during the previous 6 m o n t h s arranged into 3 domains: Treatments/ Techniques (21 qs), Vitamins/Minerals (12 qs, excluding multiple vitamins, vitamin D, folic acid, calcium, iron, potassium), and Herbs/Other Dietary Supplements (52 qs) was administered to 1514 adult patients in 5 specialties (General Internal Medicine, Oncology, Preoperative Clinic, Physical Medicine, Spine Center) between September and December 2002. Results: Response rate: 99.5% with 55% being women. Total CAM use: 76% of patients (m = 72%, f = 80%, P = 0.0003). Use was higher in w o m e n across all 5 specialties. Treatments/Techniques: the n u m b e r used differed by sex (m: 3.5; f: 4.6; P < 0.0001). More frequently used by w o m e n (P < 0.05): spiritual healing, weight loss programs, massage, aromatherapy, art therapy, reflexology, relaxation therapy, exercise, and energy healing. Vitamins/ Minerals: the n u m b e r used differed by sex (m: 1.7; f: 2.3; P < 0.0001). There was no specific Vitamin/Mineral more frequently used by either sex. Herbs/Other Dietary Supplements: the n u m b e r used differed by sex (m: 0.93; f: 0.99; P = 0.02). Besides the expected gender specific use of evening primrose oil and saw palmetto, green tea was more frequently used by w o m e n (P < 0.0001). Conclusion: CAM use was more c o m m o n in females (P = 0.0003), as was the n u m b e r of modalities used across all specialties. There was a gender specific difference in the use of several modalities in the Treatment/Technique and Herbs/Other Dietary Supp l e m e n t domain.
ly high concentrations of EGEE in their workplaces, the health effects b o t h in the degree of damage and target organs seemed different; subsequent health problems possibly due to EGEE exposure may be more severe in m e n t h a n i n WOlllen.
84
The Medicalization of Healthy Womanhood M i c h a e l A. W e i n g a r t e n
Sackler Faculty of Medicine, Tel Aviv University, Israel Western medicine has r e c o m m e n d e d healthy children to take routine s u p p l e m e n t s - - v i t a m i n s A + D, iron, and fluoride. Now healthy women, too, are categorized as requiring routine pharmacological support--sex h o r m o n e s for contraception and in menopause, folic acid and iron before and during pregnancy, and calcium and b i p h o s p h o n a t e s in old age. This is a remarkable exercise in the medicalization of healthy lives. By virtue of being female, the b o d y seems to require constant help even w h e n healthy. These recomm e n d e d preventive medicine protocols, if followed religiously, make pill-taking a routine part of life for a w o m a n from birth to death. Although each and every element in these preventive protocols can be justified individually, the total end result is counterintuitive. Normal biological life should n o t require constant pharmacological support. The fact that it is w o m e n in particular w h o are singled out as being deficient demands a reappraisal of the social, political, and commercial interests that m i g h t benefit from subjugating that half of the population to a life of monitored medical prescription. In this presentation I will suggest some candidate interests.
83
85
Gender-Specific Health Effects Following Exposure to Ethylene Glycol Monoethyl Ether Among Male and Female Workers
Johanna Wolfram
R u i s h e n g Wang; M e g u m i Suda; a n d Takeshi H o n m a
National Institute of Industrial Health, Kawasaki, Japan Ethylene glycol m o n o e t h y l ether (EGEE) is a solvent comm o n l y used in industry and consumer goods. This comp o u n d is k n o w n to have toxic effects o n reproductive and haematological organs in a n u m b e r of species. To investigate w h e t h e r there is any difference in the health effects following exposure to EGEE, we examined 19 male and 32 female workers exposed to high concentrations of this comp o u n d in two factories manufacturing p h o t o p o l y m e r sensitization plate. The m e a n age was 24.8 and 33.9 years for male and female, respectively. Average RBC count, h e m o globin levels, and hematocrit value were normal in b o t h groups. However, there were 5 out of 19 male subjects with an RBC count, hemoglobin concentration, or hematocrit lower t h a n the standards, whereas only 2 out of 32 female workers showed lower values of these indices. The blood level of prolactin was abnormally higher in 26.3% male workers, but only 15.6% in female subjects. As for the effects on reproductive system, there were 4 w o m e n reported abnormal menstruation, but almost all married w o m e n had children. On the other hand, there were 7 male workers showing lower sperm counts or progressive sperm percentage t h a n the standards. Overall, our study showed that although male and female workers were exposed to similar-
Sexual Dysfunction in Hypertensive Men Department of Cardiologie, Medical University of Vienna, Austria The incidence of sexual or erectile dysfunction (ED) in m e n already appears at 35-40 years and increases with age. Hypertensive m e n have a significantly increased risk to develop ED w h e n compared with normotensive subjects. Hypertension is a major risk factor for the d e v e l o p m e n t of cardio- and cerebrovascular disease, and the n u m b e r of diseased coronary arteries, for example, have been demonstrated to correlate positively with the severity of ED. The early diagnosis and sufficient treatment of hypertension appears therefore, to be crucial in order to avoid long-term complications. Equally important is the choice of the most appropriate drag. Angiotensin receptor blockers have been shown in several clinical trials to efficiently reduce blood pressure and to improve pre-existent ED or even prevent its development, while other anti-hypertensive drags (eg, beta-blockers) can actually aggravate ED. Lifestyle modifications and specific pharmacological antihypertensive therapy appear therefore to be the cornerstone to maintain sexual function in hypertensive men.
86
Trend Analysis of Sex Ratios of Births and Fetal Deaths in Japan, 1899-2003 Limin Yang; Naoko Sakamoto; and Eiji Marui $67