Speakers at Howell Foundation event review top women’s health stories of 2020

Clockwise from top left, Andrea LaCroix, Howell Foundation Executive Director Marla Black and Dr. Cynthia Stuenkel
Clockwise from top left, Andrea LaCroix, Howell Foundation Executive Director Marla Black and Dr. Cynthia Stuenkel discuss women’s health during the Howell Foundation’s annual lecture.

Ahead of her talk during the annual lecture of the La Jolla-based Doris A. Howell Foundation for Women’s Health Research, themed “Top Women’s Health Stories of 2020,” UC San Diego pediatrics professor Christina Chambers acknowledged that “the top 100 stories of 2020 are about SARS-CoV-2 and COVID-19.”

She and the two other speakers found stories pertaining to women’s health through the lens of COVID, and even one or two independent of it.

The Feb. 5 online event (normally a luncheon held in person) welcomed Chambers, who is co-director of the Center for Better Beginnings at UC San Diego; Dr. Cynthia Stuenkel, a UCSD clinical professor of medicine and a founding member and past president of the North American Menopause Society; and Andrea LaCroix, a UCSD professor and director of the Women’s Health Center of Excellence.

Focusing on the study of COVID-19 and pregnancy, Chambers said researchers spent much of 2020 looking at whether SARS-CoV-2, the coronavirus that causes the disease, could be passed from an infected mother to her fetus, whether antibodies could be passed on and more.

“There are many viruses that a mom can be infected with during pregnancy that are known to increase risk of harm to a developing baby,” Chambers said. “So when a new virus comes along, there is immediate interest in whether it might have an impact on pregnancy.”

Chambers said this was most recently explored when the West Nile virus came to the United States but has been studied as far back as the 1940s with German measles and rubella.

She said there are “mixed reports” on whether a mother can pass the coronavirus to her baby during pregnancy. But in a “positive spin,” a recent health paper looked for relevant antibodies in the umbilical cord blood in 83 infants born to infected mothers.

“They could measure COVID-19 antibodies in 73 of them, so more than three-quarters. And they found the earlier in gestation the mother was infected — so week 10 instead of week 37 — the higher the antibody level in the infant. I think that’s promising,” Chambers said.

Amid several other stories covering everything from hormone therapy for breast cancer to the link between adverse childhood experiences and dementia, LaCroix discussed how COVID-19 has affected cancer screenings and diagnoses and how it may change medicine going forward.

She said more and more people were putting off going to the doctor during the early months of the pandemic (approximately March to July) and getting screenings.

“We know the pandemic has really caused a natural experiment of lengthening cancer screening intervals that we are going to be learning from as we go forward,” she said.

LeCroix cited a study by Mass General Brigham, a Boston-based health care system, that looked at the number of patients who came in for cancer screenings from March to July and compared that with the previous three-month period, the subsequent three months and the same period in the previous year.

“During the pandemic, there was less cancer screening compared to the three months before, the three months after and the year prior,” she said. “We haven’t had a natural experiment in lengthening the intervals between cancer screenings like this in my lifetime. We will look at whether the rates of cancer death change as a result of the pandemic, and if they don’t change, in the context of current medical practice, it means we might be OK to go longer between cancer tests. We’ll have to wait for the future to show that.”

Steering away from COVID and recognizing that February is American Heart Month, Stuenkel focused on women and heart health.

“For us as women, I think it’s really important that we get that we are vulnerable to heart disease, and once we are in that mode, we can be more proactive going forward to manage our own risk,” she said.

Stuenkel said new risks have been brought to the scientific forefront. Doctors are now looking at a woman’s whole life, rather than just her later years, she said.

“If we were to step back and say what is the age that women are having heart attacks and strokes, in the past that has been in the 60s or even the early 70s,” she said. “But we have started to learn, in every phase of our reproductive life, there are some other factors that can come into play.”

Specifically, during what she called “the dual epidemics of obesity and diabetes,” heart disease is emerging in women much sooner, she said, and women should be screened for risk of heart disease starting as young as 20.

Stuenkel discussed stories from last year that showcased how heart disease can be linked to other women’s health issues, including pregnancy and the cardiovascular impacts from conditions like gestational diabetes; the overlap in health habits that can reduce the risk of breast cancer and heart disease; and whether common menopausal symptoms — such as hot flashes — may be predictors of heart disease.

“What can we do about all this?” she said. Early prevention is key.

“We know we have three key medical areas — we need to keep our blood pressure under control, we need to keep our blood sugar in control, we need to keep our blood cholesterol under control,” Stuenkel said. “Then there is such an importance to how we live our lives: through exercise, nutrition, keeping our weight stable and getting rid of the cigarettes … over as much of our life as we can.”

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