Even under Canada’s system of universal healthcare, low-income women are less likely than their wealthier counterparts to receive epidural pain relief during childbirth, a new study finds.

The findings mirror those of studies from the U.S. and other countries, and suggest that factors other than health insurance are at work, according to the researchers.

An epidural involves injecting pain medication through a catheter into the lower spine, and is considered the most effective way to relieve pain during childbirth. But studies have suggested that socioeconomics — including income, race or education — sway a woman’s likelihood of having an epidural.

For the new study, reported in the American Journal of Obstetrics & Gynecology, researchers looked at epidural use among more than 200,000 Ontario women who gave birth between 2004 and 2006.

They found that the one-fifth of women from the poorest neighborhoods in the study were 41 percent less likely to have epidural pain relief than the one-fifth of women from the wealthiest neighborhoods. There was a similar discrepancy between the least educated and most educated women.

The effects of income and education were seen even though the researchers accounted for factors like health problems in the mother and pregnancy complications — which can hinder the use of epidurals.

Moreover, given Canada’s universal health system, the findings suggest that factors other than insurance coverage are important, say the researchers, led by Ning Liu of the University of Ottawa.

“We argue that noneconomic maternal characteristics contribute much to the disparity,” Liu’s team writes.

A woman’s education level, for instance, could affect her willingness to have an epidural, the researchers note. Women with more education, they write, may know more about epidurals and be more open to having one.

Race, ethnicity and cultural views may also play a role, according to Liu’s team. There is evidence, for example, that women from Asia often feel that childbirth pain is natural and, therefore, they should “tolerate” it.

In addition, research in the U.S. has found that African Americans are less accepting of epidurals than whites.

Studies have also found that lower-income women are less likely to attend prenatal classes — a place where they would learn about the different types of pain relief available during childbirth.

The findings are based on the childbirth records of 220,814 Ontario women. Of women in the poorest neighborhoods in the province, 56 percent had an epidural, compared with almost 69 percent of women in the wealthiest neighborhoods.

Education appeared to make an even bigger difference. Among the one-fifth of women with the lowest education levels, half had an epidural. That compared with roughly 71 percent of the one-fifth of women with the highest education levels.

Those disparities were least apparent at large, academic medical centers, and most significant at small community hospitals, the researchers found.

Epidurals, in general, were used less often at small hospitals — which is not surprising, according to Liu’s team, since that trend has been documented in other studies. But it is not clear why income- and education-related disparities were greatest at small community hospitals.

They call for more research into the reasons for lower epidural rates among low-income women.

Attractive women may have the competitive edge by letting their temper flare more, research suggests.

Researchers found women who rated themselves as pretty displayed a war-like streak when fighting battles to get their own way.

The University of California interviewed 156 female students to gauge their temperament and how they handled conflict.

The findings appear in Proceedings of the National Academy of Sciences.

In the study, the women who believed they were good looking were more likely to respond angrily in disputes than those who rated themselves as less attractive.

Attractive women also had higher expectations of what they deserved.

Survival of the fittest

These were strategies that appeared to work because the same women were better at resolving situations in their favour.

When the researchers, led by Dr Aaron Sell, scrutinised the findings further, they found how attractive other people rated the women also tallied.

And so did hair colour – with blondes rated as more attractive than brunettes and redheads.

The researchers believe the findings have an evolutionary basis, ensuring that the “fittest” people mate and have offspring.

In men, they found a similar link but with physical strength rather than attractiveness per se.

Consultant psychologist Ingrid Collins, of The London Medical Centre, said the latest findings were interesting but should be interpreted with caution.

“This is a small study on a very limited sample group so it is not possible to generalise.”

Post-menopausal women who suffer from HIV have a higher risk of bone fractures, a new study suggests.

Although nutritional supplements such as vitamin D and calcium can help increase the strength of bones, a study published in the Journal of Clinical Endocrinology & Metabolism indicates that therapies used to make HIV patients live longer can be detrimental to bone mineral density.

Previous studies have indicated that HIV patients have a higher prevalence of low bone density due to metabolic complications brought on by treatment.

It has also been found that post-menopausal women are among the highest groups for those at risk for osteoporotic fractures.

The new study decided to combine the groups, noting that there was a significant risk factor for those who suffer from both issues, making HIV-positive post-menopausal women one of the most susceptible groups to the ailment.

“Estrogen protects against the effect of cytokines on bone resorption,” said the study’s lead author Dr. Michael Yin. “Therefore, as HIV-positive women become estrogen deficient during menopause, they may be at higher risk for accelerated bone loss and fracture.”

An April 2009 study by Jessica Dolle et al. of the Fred Hutchinson Cancer Research Center examining the relationship between oral contraceptives (OCs) and triple-negative breast cancer (TNBC) in women under age 45 contained an admission from U.S. National Cancer Institute (NCI) researcher Louise Brinton and her colleagues (including Janet Daling) that abortion raises breast cancer risk by 40%. [1]

Additionally, Dolle’s team showed that women who start OCs before age 18 multiply their risk of TNBC by 3.7 times and recent users of OCs within the last one to five years multiply their risk by 4.2 times. TNBC is an aggressive form of breast cancer associated with high mortality.

“Although the study was published nine months ago,” observed Karen Malec, president of the Coalition on Abortion/Breast Cancer, “the NCI, the American Cancer Society, Susan G. Komen for the Cure and other cancer fundraising businesses have made no efforts to reduce breast cancer rates by issuing nationwide warnings to women.”

Brinton was the chief organizer of the 2003 NCI workshop on the abortion-breast cancer link, which falsely assured women that the non-existence of the link was “well established.” [2]

Dolle’s team reported in Table 1 a statistically significant 40% risk increase for women who have had abortions. They listed abortion among “known and suspected risk factors.”

Brinton and Daling had previously studied this population from the Seattle-Puget Sound area in the 1990s and reported risk increases between 20% and 50% among women with abortions. [3,4] In the 2009 study, they and their co-authors wrote that their findings concerning induced abortion, OC use and certain other risk factors, “were consistent with the effects observed in previous studies on younger women.”

“Obviously, more women will die of breast cancer if the NCI fails in its duty to warn about the risks of OCs and abortion and if government funds are used to pay for both as a part of any healthcare bill,” said Mrs. Malec.

A brief analysis of the study (click here) , Dolle et al. 2009, was provided by Dr. Joel Brind, professor of biology and endocrinology and deputy chair for biology at Baruch College, City University of New York.

Last year, studies from Turkey and China also reported statistically significant risk increases for women who had abortions. [5,6]

The Coalition on Abortion/Breast Cancer is an international women’s organization founded to protect the health and save the lives of women by educating and providing information on abortion as a risk factor for breast cancer.

Women who ta

According to a new study in the International Journal of Food Safety, Nutrition and Public Health, researchers have found that when they gave flaxseed oil to female rats who had either had their ovaries removed or were diabetic, they reported a lower risk of developing osteoporosis.

However, the rats that had both post-menopausal symptoms and were diabetic were still considered at high risk for developing the disease.

It was also found that diabetes tends to have a stronger effect on the bones than menopausal symptoms, which is why those with the disease still may be at risk whether they take flaxseed oil or not.

Because of this, the researchers are looking for more studies to be done to understand why flaxseed oil cannot diminish the risk factors for diabetes.

“We recommend further investigations using animals and humans to confirm the effect of using dietary flaxseed oil to improve bone health and to prevent osteoporosis,” the researchers wrote.

A new study suggests that while nutritional supplements such as magnesium may help ease muscle pain in the neck and back, exercise may also help ease the discomfort.

The study published in the Journal of Applied Physiology, found that when women were exposed to strength training exercises with dumbbells, they experience a muscle build up that helps the tenderness and tightness of the upper trapezius muscle.

Research found that two-thirds of women in office jobs experience pain in their upper trapezius muscle, which may be a result of doing tedious computer work.

The study consisted of 42 working women who were split into groups utilizing a 10-week strength training exercise program, general fitness or counseling on diet and health regimens respectively.

It was found that the women who participated in the strength training experienced 50 percent less pain, and that those in the general fitness and control groups did not experience a significant decrease in discomfort.

The researchers noted that the strength training encouraged women to overcome their fears of using the muscles that hurt them, leading them to exercise more and decrease the tightness.

Flirtatious men are most likely to get lucky when a woman is at the peak of her fertility, suggests a new study.

To reach the conclusion, evolutionary psychologist, Dr Edward Morrison, of the University of Portsmouth, asked a group of women to examine various facial expressions.

He found when the women were ovulating they preferred flirtatious expressions, reports The BBC.

Dr Morrison said: ‘If we wanted to attract someone at the Christmas party, flirting effectively may help.’

He added: ‘An ability to ‘read’ and interpret the facial expressions and an awareness of what you are signalling with your own expressions could improve your chances of successful flirting.

‘It is difficult to define what constitutes flirtatiousness and much of it may be something we perceive without even realising it.

‘But it seems that in the absence of other cues, the ‘social properties’ of facial movement influences how we judge attractiveness.’

However, Dr Morrison added: ‘Science is still a long way from discovering the magic formula for what women find attractive in a man.’

The study has been published in Archives of Sexual Behaviour.

Having sex at an early age can double the risk of developing cervical cancer, a study of 20,000 women suggests.

The investigation into why poorer women have a higher risk of the disease found they tended to have sex about four years earlier than more affluent women.

Previously, it had been thought the disparity was the result of low screening uptake in poorer areas.

The International Agency for Research on Cancer findings are published in the British Journal of Cancer.

Although the difference in cervical cancer incidence between rich and poor – across the world – had been noted for many years, it was not clear why this is the case.

Especially as rates of infection with human papillomavirus (HPV) – the sexually transmitted infection linked with the vast majority of cervical cancers – seemed to be similar across all groups.

The study confirmed that the higher rates of cervical cancer were not linked to higher HPV levels.

But what it did reveal is that the two-fold increased risk was largely explained by women from poorer backgrounds starting to have sex at a younger age.

The age at which a woman had her first baby was also an important factor.

Screening was found to have some effect on the level of risk.

But the number of sexual partners a woman has and smoking did not account for any of the difference.

Lag time

Study leader, Dr Silvia Franceschi, said the findings were not restricted to adolescence and the risk of cervical cancer was also higher in women who had their first sexual intercourse at 20 rather than 25 years.

“In our study, poorer women had become sexually active on average four years earlier.

“So they may have also been infected with HPV earlier, giving the virus more time to produce the long sequence of events that are needed for cancer development.”

Dr Lesley Walker, director of cancer information at Cancer Research UK, said the study raised some interesting questions.

“Although women can be infected by HPV at any age, infections at a very young age may be especially dangerous as they have more time to cause damage that eventually leads to cancer.

“Importantly, the results back up the need for the HPV vaccination to be given in schools at an age before they start having sex, especially among girls in deprived areas.”

Post menopausal women who take anti-depressants face a small – but statistically significant – increased risk of a stroke, research suggests.

The US study was based on 136,293 women aged 50 to 79, who were followed for an average of six years.

Anti-depressant users were 45% more likely to have a stroke than women not taking the drugs.

The data, published in Archives of Internal Medicine, is taken from the Women’s Health Initiative Study.

When overall death rates were examined, those on anti-depressants were found to have a 32% higher risk of death from all causes during the study than non-users.

The researchers stressed that the overall risk of a stroke was relatively small. Even for women on anti-depressants, it was less than one in 200 chance in any given year.

However, they said that because so many women were taking anti-depressants the effect would be significant across the entire population.

It is not clear whether taking anti-depressants is solely responsible for the increased risk of a stroke.

Depression itself is known to be a risk factor for cardiovascular problems.

The researchers tried to take this into account in their analysis of the data – but could not rule out the possibility that it influenced the final results.

The study found no difference in stroke risk between the two major classes of anti-depressants, selective serotonin reuptake inhibitors (SSRIs) or tricyclic anti-depressants (TCAs).

However, the SSRIs did appear to convey a higher risk of hemorrhagic stroke caused by a bleed in the brain.

Lead researcher Dr Sylvia Wassertheil-Smoller, of Albert Einstein College of Medicine, stressed that treatment for depression was important, and that women should not stop taking prescribed medication without first consulting their doctor.

She said: “You have to weigh the benefits that you get from these antidepressants against the small increase in risk that we found in this study.”

Known links

The researchers said follow-up studies were needed before any firm conclusions could be drawn.

Dr Jordan Smoller, of Harvard Medical School, who also worked on the study, said: “We need to study this association more to determine exactly what it signifies.”

Joanne Murphy, for The Stroke Association stressed the study showed that overall risk for women taking anti-depressants was relatively small.

She said “We are already aware of links between depression and the risk of stroke and we are currently funding further studies to look into this.

“Everyone can help reduce their risk of stroke by making lifestyle changes, such as reducing their blood pressure, giving up smoking, reducing alcohol intake, improving their diet and getting plenty of exercise.”

Ellen Mason, of the British Heart Foundation, said: “Severe depression can be debilitating and even fatal, so it is important to weigh up any small increase in the risk of stroke with the benefits of treating depression.”

Bridget O’Connell, from the mental health charity Mind, said antidepressants produced a range of side effects that affected people in different ways.

She said: “Many people can experience huge benefits from taking antidepressants and it’s important they work with their GP to identify both the plus points and the drawbacks, and weigh up what treatment is best for them.”

“Soy foods are rich in isoflavones, a major group of phytoestrogens that have been hypothesized to reduce the risk of breast cancer. However, the estrogen-like effect of isoflavones and the potential interaction between isoflavones and tamoxifen have led to concern about soy food consumption among breast cancer patients,” the authors write.

Xiao Ou Shu, M.D., Ph.D., of Vanderbilt University Medical Center, Nashville, Tenn., and colleagues examined the association between soy isoflavone intake with breast cancer recurrence and survival. The researchers analyzed data from the Shanghai Breast Cancer Survival Study, a large, population-based study of 5,042 female breast cancer survivors in China. Women ages 20 to 75 years with diagnoses of breast cancer between March 2002 and April 2006 were recruited and followed up through June 2009.

Information on cancer diagnosis and treatment, lifestyle exposures after cancer diagnosis, and disease progression was collected at approximately 6 months after cancer diagnosis and was reassessed at three follow-up interviews conducted at 18, 36, and 60 months after diagnosis. A Shanghai Vital Statistics Registry database was used to obtain survival information for participants who were lost to follow-up.

After a median (midpoint) follow-up of 3.9 years, 444 total deaths and 534 recurrences or breast cancer-related deaths were documented among the group of 5,033 surgically-treated breast cancer patients. Soy food intake, as measured by either soy protein or soy isoflavone intake, was inversely associated with mortality and recurrence. P

atients in the group with the highest intake of soy protein had a 29 percent lower risk of death during the study period, and a 32 percent lower risk of breast cancer recurrence compared to patients with the lowest intake of soy protein. The adjusted 4-year mortality rates were 10.3 percent and 7.4 percent and the 4-year recurrence rates were 11.2 percent and 8.0 percent, respectively, for women with the lowest and highest groups of soy protein intake.

“The inverse association was evident among women with either estrogen receptor-positive or -negative breast cancer and was present in both users and nonusers of tamoxifen,” the researchers write.

“In summary, in this population-based prospective study, we found that soy food intake is safe and was associated with lower mortality and recurrence among breast cancer patients. The association of soy food intake with mortality and recurrence appears to follow a linear dose-response pattern until soy food intake reached 11 grams/day of soy protein; no additional benefits on mortality and recurrence were observed with higher intakes of soy food. This study suggests that moderate soy food intake is safe and potentially beneficial for women with breast cancer.”