In a survey commissioned by Healthy Women, The National Stroke Association and the American College of Emergency Physicians, only 30% of adult women surveyed knew that women are at higher risk for stroke than men. Only 27% of women surveyed could name more than 2 of the six primary stroke symptoms. How would you do?

1.   Sudden numbness or weakness on one side of the face
2.     Sudden numbness or weakness in an arm or leg
3.     Sudden confusion, trouble speaking or understanding speech
4.     Sudden trouble seeing
5.     Sudden trouble walking, dizziness, loss of balance or coordination
6.     Sudden severe headache with no known cause

The common element here is the sudden onset of symptoms. If you experience any of the above symptoms, call 911 or have someone drive you to the emergency room. Women are used to taking care of family members, friends, and even casual acquaintances…remember to take care of yourself!

Depo-Provera injections are given every 3 months for contraception. This is the same synthetic progestin that is in PremPro. Depo-Provera has been a popular birth control option for women that have a hard time remembering to take a pill every morning. However, that convenience comes at a price. The Depo-Provera injections come with a black box warning that they cause bone loss in users. The longer women use the injections, the more bone density they lose…in some cases as much as 15% or more. There are 5 factors that seem to affect how much bone density a woman will lose while using Depo-Provera:

• Calcium intake-Having adequate calcium levels seems to slow the rate of bone loss. 
•  Vitamin D intake-Women with a low vitamin D level (which is very common in these days of sunblock and indoor living) are at much higher risk for bone loss.        
• Smoking-Smoking increases risk of bone loss dramatically.       
• Drinking alcohol- Women who drink tend to lose more bone density while using Depo-Provera
• Body Mass-Overweight women have been shown to lose the least amount of bone density.

After stopping the injections, a woman’s bones will start to rebuild. In the first 8 to 9 years after stopping injections, studies have shown a 15% increase in bone density on average. Some women won’t completely bounce back-usually the women with several of the risk factors listed above- but all of the women in the studies did show some improvement.

Researchers are now recommending monitoring serum vitamin D levels on all women using the Depo-Provera injections. Taking vitamin D supplements can help slow the expected bone loss.

Researchers at the Norwegian University of Science and Technology have found that women who exercised four or more times weekly were 29% less likely to develop fibromyalgia than sedentary women. Obese women (women with a BMI of at least 30) had a 64% higher risk than normal-weight women of developing the disorder.

Fibromyalgia causes long-term muscle and connective tissue pain, extreme fatigue, and disturbed sleep patterns. It also causes elevation of serum levels of proinflammatory cytokines and dysregulation of the hypothalamic-pituitary-adrenal axis (HPA). These symptoms are the same as those caused by obesity and depression. Therefore, treating the symptoms with exercise and anti-depressants can often help fibromyalgia sufferers.

The researchers in the Norwegian study stated, “Regular physical exercise, and thereby improved physical fitness, may serve as a buffer against the perpetuation of musculoskeletal symptoms that eventually lead to the development of fibromyalgia.” Another great reason to incorporate regular physical activity into your routine!

What puts you at risk for heart attack? Is it high blood pressure? Poor diet and lack of exercise? Or maybe high cholesterol? The answer can be any or all of these, but that’s not the whole story. Half of all heart attack victims have normal cholesterol levels…their heart attack was the first sign that something was wrong. Now there is a test that can tell you not only the standard total cholesterol, LDL, HDL and triglyceride levels…but the number of LDL and HDL particles and how big the particles are. Why is that information important? How can that knowledge affect the determination of risk?

First, let’s review some basic information about cholesterol. About 75% of the cholesterol in your blood is made in your liver and other assorted cells. The other 25% comes from the food you eat. Cholesterol is only found in animal products. Your body uses the cholesterol to produce hormones and several vitamins. Cholesterol doesn’t dissolve readily in water, so not much can be transported by the blood. For this, your body relies on lipoproteins to move cholesterol and triglyceride particles to where they need to go. Triglycerides travel on the inside of the particle, cholesterol sticks to the outside. Low density lipoproteins (LDL) have lots of cholesterol and very little protein in them. LDL lipoproteins are the major carriers of cholesterol in the blood. When there is a lot of cholesterol in the cells, the receptors are blocked which leaves the LDL circulating in the blood. The LDL is oxidized and taken up by macrophages which then swell and stick to the arterial walls, forming plaque. Plaque takes up valuable room in the artery, making it harder for blood to go through. This raises blood pressure and can eventually cause a heart attack by blocking an artery completely. High density lipoproteins have a lot of protein, so not much room for cholesterol; therefore they have less chance of depositing plaque on the arterial walls. HDL particles contain cholesterol that is not easily oxidized. It is thought that they “scour” the arterial walls and clean out excess cholesterol. The cholesterol that was removed from the walls is then transported back to the liver where it is processed and can do no harm. Triglycerides are chains of high-energy fatty acids that provide much of the energy your cells need to function.

In assessing cardiac risk, you need to know how much cholesterol a person has (we’ll call cholesterol particles “passengers”), how many lipoprotein particles a person has (“vehicles”), and how big the lipoprotein particles are (“busses vs. compact cars”). Now, if your arteries are the roads, the best scenario would be a small number of large vehicles to keep traffic flowing smoothly. Imagine 150 people (number of particles) being transported down a road (in the artery) - you could fit all the people into 3 busses (large particles) and traffic would be very manageable or you could have 150 little cars (small particles) vying for space slowing everyone down. It would also be prudent to take a closer look at the size and number of LDL particles vs. HDL particles.

The NMR LipoProfile test will report the traditional lipid panel with the addition of number and size of particles. Those readings are then used to determine insulin resistance and diabetes risk. One of the earliest signs of impending insulin resistance is alteration of lipoprotein metabolism. All these results combined with family history can help your physician create a much more effective treatment plan.