THURSDAY, June 13 (HealthDay News) -- Can women blame men for menopause?

They may have a case, according to new research that suggests it was men's interest in mating with younger females that gave evolutionary rise to menopause by sidelining older women from reproduction.

Menopause -- when a woman stops getting menstrual periods and can't become pregnant -- is unique to humans and its cause is still unknown, explained study author and evolutionary biologist Rama Singh. "We accept as a given the idea that older women tend to be unable to reproduce," but Singh said this is actually an "evolutionary puzzle."

It has long been thought that menopause is what causes women, primarily in their early 50s, to stop being able to get pregnant, but the researchers found evidence that things could actually have occurred the other way around. In other words, infertility may have been the cause, not the effect, of menopause in early humans.

There are at least 10 theories of why menopause occurs, according to the researchers, including ideas based on the fact that women are living longer and depleting the number of eggs in their ovaries, to what is called the "grandmother hypothesis." That idea holds that menopause allows older women to provide childcare that contributes to the survival of their grandchildren, making them more fit or valuable to the human tribe.

But Singh's research, published online June 13 in the journal PLOS Computational Biology, suggests something altogether new.

"This paper is saying that men have played the major or dominant part in choosing mates," said Singh, who is a professor of population genetics and evolution at McMaster University, in Canada. "Somewhere along the line in our evolutionary history, males did not mate randomly but preferred young women because they are more attractive."

Going way back in human history, people reproduced all their lives, explained Singh. While it's possible that some women may have experienced menopause 30,000 years ago, now 100 percent of women experience it. "Menopause is an evolutionary phenomenon," he said.

The scientists found that the development of menopause seems to have done nothing to improve the chances of human survival over time, but rather occurred because women of a certain age weren't finding mates, and thus reproductive ability was unnecessary for them.

Yet Singh pointed out that if women long ago had been the ones choosing younger mates, older men would have been the ones losing their fertility, not women.

The process of natural selection favors the most fit, so women who are most likely to reproduce are protected, explained Singh. Natural selection is the gradual, non-random process through which biological traits become either more or less common, due to the way reproduction occurs, Singh explained.

The researchers used computational models and computer simulations to show how male mating preference for younger females could increase the number of mutations that stopped women's reproductive ability, creating menopause.

Singh said his research suggests that it might be possible for women who delay childbearing to also postpone menopause, allowing them to have a longer window in which to conceive. "We might be able to extend the time period in which you can have children, rather than rush it," he said.

Lynnette Leidy Sievert, a biological anthropologist and a professor at the University of Massachusetts, Amherst, raised questions about the study.

"The study showed that by the age of 50 or 60, 50 percent of the population was still living, but that just doesn't match what we know about human evolution," she said. "By the age of 50, the skeletal evidence shows that only 10 percent of Neanderthals lived beyond 50. Our own homo sapiens [humans] had about 17 percent living past the age of 40."

Sievert, a member of the board of trustees of the North American Menopause Society, also questioned whether the concept of men mating with younger women fully explains menopause.

"Because it's a human and mammalian pattern for men to die younger [than women], you have a younger female with an older male who is going to die," she explained. "I get mixed up about how that pulls a woman's lifespan across menopause."

Singh said he's planning to do more simulations based on a Canadian long-term study of aging that is following 50,000 men and women. He is interested in learning more about the relationship between menopause, reproduction and genetic markers. "I really want to see if you can do something to delay menopause," he explained.

More information

Learn more about menopause from the U.S. National Library of Medicine.

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THURSDAY, June 13 (HealthDay News) -- Newly identified genetic variations may help predict which women will respond to breast cancer prevention therapy, a new study suggests.

By determining who would and would not receive possible benefit from two preventive drugs, women who aren't likely to respond could be spared the treatment and its side effects, the study authors noted.

Researchers examined data on women enrolled in two large breast cancer prevention trials, including 592 women who had developed cancer along with 1,171 similar women who did not.

The investigators found that women with a favorable genetic variation (called a "single nucleotide polymorphism" or SNP) in the gene ZNF423 and another near the gene CTSO were more likely to respond to prevention therapy with tamoxifen and raloxifene.

Women with unfavorable variations of these SNPs may not benefit from prevention therapy and have a five-fold increased risk of developing breast cancer, according to the study published June 13 in the journal Cancer Discovery.

"The recent guidelines by the U.S. Preventive Services Task Force emphasize that ... therapy with tamoxifen and raloxifene can lower a woman's risk for developing breast cancer. But about 50 women have to be exposed to the treatment and side effects to prevent a single case of breast cancer," study author Dr. James Ingle, a professor of oncology at the Mayo Clinic in Rochester, Minn., said in a journal news release.

"Our findings are important, because for the first time, we discovered genetic factors that could be used to select women who should be offered the drugs for prevention. Also of substantial importance is that we have discovered new information on how tamoxifen and raloxifene work to prevent breast cancer," he added.

"Findings from our study provide clear direction as to which women are likely and which are unlikely to benefit from tamoxifen or raloxifene," Ingle explained. "The best chance we have of decreasing the burden of breast cancer is to prevent it in the first place. Our findings provide the basis for a reinvigoration of research efforts in breast cancer prevention."

More information

The U.S. National Cancer Institute has more about breast cancer prevention.

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THURSDAY, June 13 (HealthDay News) -- For dads aiming at marital bliss, a new study suggests just two factors are especially important: being engaged with the kids, for sure -- but also doing a fair share of the household chores.

In other words, just taking the children outside for a game of catch won't cut it.

"In our study, the wives thought father involvement with the kids and participation in household work are all inter-related and worked together to improve marital quality," said Adam Galovan, lead author of the study and a researcher at the University of Missouri, in Columbia. "They think being a good father involves more than just doing things involved in the care of children."

Galovan found that wives feel more cared for when husbands are involved with their children, yet helping out with the day-to-day responsibilities of running the household also matters.

But Galovan was surprised to find that how husbands and wives specifically divide the work doesn't seem to matter much. Husbands and wives are happier when they share parenting and household responsibilities, but the chores don't have to be divided equally, according to the study. What matters is that both parents are actively participating in both chores and child-rearing.

Doing household chores and being engaged with the children seem to be important ways for husbands to connect with their wives, and that connection is related to better relationships, Galovan explained.

The research was recently published in the Journal of Family Issues.

For the study, the researchers tapped data from a 2005 study that pulled marriage licenses of couples married for less than one year from the Utah Department of Health. Researchers looked at every third or fourth marriage license over a six-month period.

From that data, Galovan surveyed 160 couples between 21 and 55 years old who were in a first marriage. The majority of participants -- 73 percent -- were between 25 and 30 years old. Almost 97 percent were white. Of participants, 98 percent of the husbands and 16 percent of the wives reported they were employed full time, while 24 percent worked part time. The average couple had been married for about five years, and the average income of the participants was between $50,000 and $60,000 a year.

Couples indicated which spouse was generally responsible for completing 20 common household tasks -- or if both or neither of them were responsible. Fathers rated their involvement in their children's lives and mothers noted how involved they felt their husbands were with the kids. Both spouses rated how happy they were with how they divided household tasks and with their marriage.

Men and women differed in how they reported marital quality. For wives, the father-child relationship and father involvement was most important, followed by satisfaction with how the household work was accomplished.

For husbands, satisfaction with the division of family work came first, followed by their wife's feelings about the father-child relationship, and then the degree of involvement the dad had with his children.

For her part, Laurie Gerber, president of Handel Group Life Coaching in New York City, said the study rings true. Women really appreciate getting hands-on help at home, but men don't realize this intuitively because they see things very differently, she said. "If a man wants to get into his wife's good graces he should do a chore," she said. "If a woman wants to get into a man's good graces, she should jump him."

A study published earlier this year in American Sociological Review showed that married men who spend more time doing traditional household tasks reported having less frequent sex than do husbands who stick to more traditional masculine jobs, such as gardening or home repair. While women like getting help, doing too many of the chores may inadvertently turn the husband into more of a helpmate than a lover, the research found.

Rather than basing the choice of chores on traditional roles, Gerber recommends that tasks be divided based on both who cares most about getting the particular job done and who is best at it. "My husband doesn't care if my kids have matching outfits on and I don't care about getting the oil changed," she said. Couples need to sit down and discuss who will be primarily responsible for what. "That stops fights and clears so much air."

For Gerber, it's critical to try not to be influenced by how you were raised, what your culture says you should do or what the gender stereotyping says, but rather, by what you think is right. "Marriage is all about being there for the other person and you work as a team to get the job of the family done," she said.

More information

Learn more about parenting from the U.S. National Library of Medicine.

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WEDNESDAY, June 12 (HealthDay News) -- Taking high doses of iodine and kelp supplements can be hazardous to your health, warns the American Thyroid Association.

Adequate iodine intake is required for normal function of the thyroid, a gland in the neck that produces hormones that control the rate of many bodily activities. But too much iodine can lead to thyroid dysfunction.

Daily supplements containing more than 500 micrograms of iodine should be avoided, the association recommended. Many iodine, potassium iodide and kelp supplements contain iodine amounts that are up to several thousand times higher than the daily tolerable upper limit of 1,100 micrograms per day, they noted.

The recommended daily limit for iodine intake is 150 micrograms for men and non-pregnant women. The recommended daily intake is 220 to 250 micrograms for pregnant women and 250 to 290 micrograms for women who are breast-feeding.

Women should take multivitamins containing 150 micrograms of iodine daily before conceiving, during pregnancy and while breast-feeding, the experts said in an association news release.

"For other individuals, the U.S. diet generally contains enough iodine to meet nutritional needs, with common sources being iodized salt, dairy products, breads and seafood," Dr. Angela Leung, chair of the association's public health committee and an assistant professor of medicine at Boston University School of Medicine, said in the release.

There are only a few medical conditions in which the short-term use of high amounts of iodine is indicated, the association added.

More information

The U.S. Office of Dietary Supplements has more about iodine.

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WEDNESDAY, June 12 (HealthDay News) -- A pregnant woman's exposure to environmental contaminants affects her unborn baby's heart rate and movement, a new study says.

"Both fetal motor activity and heart rate reveal how the fetus is maturing and give us a way to evaluate how exposures may be affecting the developing nervous system," study lead author Janet DiPietro, associate dean for research at the Johns Hopkins Bloomberg School of Public Health, said in a school news release.

The researchers analyzed blood samples from 50 high- and low-income pregnant women in and around Baltimore and found that they all had detectable levels of organochlorines, including DDT, PCBs and other pesticides that have been banned in the United States for more than 30 years.

High-income women had a greater concentration of chemicals than low-income women.

The blood samples were collected at 36 weeks of pregnancy, and measurements of fetal heart rate and movement also were taken at that time, according to the study, which was published online in the Journal of Exposure Science and Environmental Epidemiology.

The researchers found that higher levels of some common environmental pollutants were associated with more frequent and vigorous fetal movement. Some of the chemicals also were associated with fewer changes in fetal heart rate, which normally parallel fetal movements.

"Most studies of environmental contaminants and child development wait until children are much older to evaluate effects of things the mother may have been exposed to during pregnancy," DiPietro said. "Here we have observed effects in utero."

How the prenatal period sets the stage for later child development is a subject of tremendous interest, DiPietro said.

"These results show that the developing fetus is susceptible to environmental exposures and that we can detect this by measuring fetal neurobehavior," she said. "This is yet more evidence for the need to protect the vulnerable developing brain from effects of environmental contaminants both before and after birth."

More information

The MedlinePlus Medical Encyclopedia has more about fetal development.

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TUESDAY, June 11 (HealthDay News) -- Newer, costlier treatment for rheumatoid arthritis appears no better than an older, less-expensive regimen for people who don't respond to the first-line drug methotrexate, a new study suggests.

"Newer isn't always better," said researcher Dr. Ted Mikuls, an associate professor in the rheumatology division at the University of Nebraska Medical Center, in Omaha. "Some of the older medications can be effective."

Rheumatoid arthritis causes inflammation in the joints, resulting in swelling, stiffness, pain and reduced joint function. It can also affect other parts of the body.

"We compared two different ways of treating rheumatoid arthritis -- one that included a new biologic [medication] with an older, more conventional oral medication," Mikuls explained. "We basically showed that at the end of the day patients, regardless of what they got, looked very similar in terms of pretty much every outcome we looked at in the study."

Patients whose arthritis didn't respond to methotrexate alone who were then given a combination of methotrexate, sulfasalazine (Azulfidine) and hydroxychloroquine (Plaquenil) did as well as patients given methotrexate and the new biologic drug etanercept (Enbrel) -- which is given by injection -- the researchers said.

"The treatments are very different in terms of costs," Mikuls said. If a patient had to pay out of pocket for etanercept it could cost around $20,000 a year, while the out-of-pocket costs for the other drugs is a few hundred to a few thousand dollars, he said.

The out-of-pocket cost of etanercept varies by insurance provider, including those covering the Medicare drug benefit program, Mikuls added.

The report was published online June 11 in the New England Journal of Medicine to coincide with presentation of the study at the Annual European Congress of Rheumatology meeting in Madrid, Spain.

"This study addresses a real-life scenario for rheumatologists where patients are often on methotrexate and are not doing well and the question is what to do next," said Dr. Soumya Reddy, an assistant professor in the rheumatology division of the dermatology department at NYU Langone Medical Center, in New York City.

About 20 percent to 40 percent of patients don't respond methotrexate or can't take the drug either because of side effects or it is not indicated for them, said Reddy, who was not involved in the study.

The findings are "reassuring," in that when a biologic is not an option, due to cost or other reasons, the older regimen is effective, she said.

Which regimen is best really needs to be tailored to each patient, Reddy said.

For the study, researchers randomly assigned 353 patients to methotrexate, sulfasalazine and hydroxychloroquine or to methotrexate and etanercept for 48 weeks. Some patients switched from one regimen to another midway through the study.

The researchers found that both groups improved significantly, with no difference between the two treatments.

In addition, improvements in both groups were similar with regard to pain, quality of life, progression of their arthritis as seen on X-rays or side effects of the drugs.

For her part, Dr. Diane Horowitz, a rheumatologist at North Shore University Hospital, in Manhasset, N.Y., said the trial wasn't long enough to really tell if treatment with etanercept is equal to the three-drug regimen.

"In other studies, people on biologics did better over the long term," said Horowitz, who is also with the LIJ Medical Center, in New Hyde Park, N.Y. "I want to see more long-term data."

For patients who don't do well on methotrexate alone "there is some significant evidence that doing methotrexate plus sulfasalazine plus hydroxychloroquine [gives] a good response, and you don't always have to jump to a biologic right away," she said.

More information

To learn more about rheumatoid arthritis, visit the U.S. National Library of Medicine.

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TUESDAY, June 11 (HealthDay News) -- While the number of women dying from breast cancer is decreasing, mammography screening can't take the credit, according to a new study from England that looked at 40 years of data.

"We find no effect of mammographic screening on population-based breast cancer mortality rates," said study author Toqir Mukhtar, a researcher at the University of Oxford.

"While this does not rule out an effect at the individual level of women," she said, "the key point is that these effects are not large enough to be detected at the population level."

In their study, published June 11 in the Journal of the Royal Society of Medicine, the researchers found the greatest reduction in breast cancer deaths over the nearly 40 years studied was in women under 40, an age group not routinely offered screening.

Improvements in treatments and other factors may explain the decline, she said. Or, the benefits of screening may take a longer period of time to show up, she added.

However, Robert Smith, senior director of cancer screening at the American Cancer Society, disagreed that mammography doesn't deserve the credit, and cited flaws in the new study.

Mukhtar's team analyzed death rate trends from breast cancer before and after the introduction of the United Kingdom's National Health Service Breast Screening Programme in 1988.

The researchers evaluated death statistics in the Oxford region. In that area, unlike the rest of the country, all causes of death are listed on the death certificate, not just the underlying cause. The investigators also compared that with death statistics for the whole of England.

The analysis in Oxford spanned the years 1979 to 2009. The analysis of national breast cancer death rates looked at the years 1971 to 2009.

Death rates began to decline before the 1988 introduction of screening, the findings indicated.

The researchers found no evidence that decreases in death rates were greater in women screened once, several times or not at all.

The new findings run counter to the results of other studies. For instance, the Marmot Report, commissioned by the English Department of Health and published in 2012, found a 20 percent relative reduction in breast cancer deaths in women offered screening.

Meanwhile, Smith and his colleagues reported in 2010 in the Journal of Medical Screening that screening was linked with a substantial reduction in breast cancer deaths in studies of Swedish and English women. That benefit in terms of lives saved is greater than the harm of overdiagnosis, with two or more lives saved for every overdiagnosis.

"We have more studies showing a benefit than those who don't," Smith said.

He also took issue with a statistical method used in the new study, in which researchers looked at breaks in patterns. "The researchers analyzed intervals that includes years before screening was offered and after," he said. Ideally, they should have compared death rates before screening launched and after, he said.

Another point: "Some of the women who died from breast cancer after the screening program started had been diagnosed before mammography was even available," Smith said, further complicating the analysis.

"We know mammography screening contributes to significant mortality reduction [from breast cancer] in the U.S.," he said.

While individual U.S. organizations differ in specific mammography guidelines, including whether to start at age 40 or later and which intervals are best, they do agree on one point, Smith said: "Regular screening is a good thing to reduce your risk of dying from breast cancer and your need for a mastectomy."

More information

To learn more about early detection of breast cancer, visit the American Cancer Society.

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TUESDAY, June 11 (HealthDay News) -- Overweight or obese women who are pregnant are more likely to give birth prematurely, and the risk of preterm delivery increases with their amount of excess weight, according to a study of more than 1.5 million deliveries in Sweden.

Researchers speculate that the health problems associated with overweight and obesity -- high blood pressure, insulin resistance, high cholesterol, increased chance of infection -- have a direct impact on a woman's ability to carry their child to term, according to the study, which was published in the June 12 issue of the Journal of the American Medical Association.

Birth of an infant prior to 37 weeks of gestation is the leading cause of infant mortality, neonatal illness and long-term disability in children, said researchers led by Dr. Sven Cnattingius of the Karolinska Institute in Stockholm.

A U.S. expert not involved with the study said he wasn't surprised by the findings.

"This just reinforces the fact that the complications of obesity and additional weight gain are deleterious to both mother and fetus," said Dr. Raul Artal, a professor and chairman of the department of obstetrics, gynecology and women's health at the Saint Louis University School of Medicine.

Artal said this study, along with previous research, makes the case that overweight and obese women who are pregnant can protect the health of their unborn child by maintaining their current weight or even shedding some pounds.

"The concept that we propagated for years that pregnancy is not a good time for weight loss and physical activity is wrong," he said.

For the study, researchers analyzed the records of 1.59 million births between 1992 and 2010, reviewing the body-mass index (BMI) of the women at their first prenatal doctor's visit as well as information recorded following birth about health risks, maternal diseases and pregnancy complications.

BMI is a measure of body fat based on height and weight.

The statistics came from the Swedish Medical Birth Register, which maintains detailed data on all births in that nation and serves as a valuable resource for researchers, a U.S. expert said.

"There's a lot of good obstetric data that comes out of Sweden because of that register," said Dr. Russ Fothergill, vice chairman of the department of obstetrics and gynecology at Scott and White Healthcare in Temple, Texas.

The researchers found that the risk of extremely premature (22 to 27 weeks), very premature (28 to 31 weeks) and moderately premature (32 to 36 weeks) deliveries increased with a woman's BMI.

The authors said that even though the study is Swedish, the results can be generalized to other populations with similar or higher rates of maternal obesity or preterm delivery.

For example, the United States has preterm delivery rates twice as high as Sweden's. In the United States, slightly more than half of women are either overweight or obese in early pregnancy, and severe obesity is much more common than in Sweden. Extremely preterm births accounted for 25 percent of all U.S. infant deaths among single births, and extremely preterm birth is also the leading cause of long-term disability, according to study background information.

The study's results seem to suggest an interplay between health risks linked to overweight and obesity, said Dr. Jill Rabin, chief of ambulatory care, obstetrics and gynecology, and head of urogynecology at Long Island Jewish Medical Center in New Hyde Park, N.Y.

Earlier studies have found that women who suffer a spontaneous preterm delivery have increased levels of inflammatory proteins called cytokines, which are associated with neonatal health problems such as weakening of the membranes and preterm contractions.

Both obesity itself and the health problems that come with obesity increase the amount of inflammation in a woman's body, Rabin said. Obesity and the inflammation that accompanies it also make it more likely that a woman could suffer an intrauterine bacterial infection.

"Obese women have increased risk of urinary tract infections and vaginal infections," Rabin said. "These increase the risk of preterm delivery."

The study noted that a bacterial infection is considered the most important risk factor for spontaneous extremely preterm delivery.

The American Congress of Obstetricians and Gynecologists has issued a recommendation that it is OK for women who are overweight or obese to not gain weight during pregnancy, or even to lose weight, said Artal, of Saint Louis University.

"I consider pregnancy to be an ideal time for behavioral modification," Artal said. He noted that pregnant women have an improved chance to adopt healthy habits because they have better access to medical care than at any other time in their life, are more prone to comply with recommendations because they have the added responsibility of their unborn child, and are under close medical supervision.

Although the study found an association between maternal obesity and premature birth, it did not establish a cause-and-effect relationship.

For his part, Fothergill said the study cries out for follow-up research that will better elaborate upon the link between obesity and premature birth.

"There needs to some additional research that explains why these women are delivering early," he said. "What is it about obesity that's making these women go into labor early?"

More information

The March of Dimes has more about overweight and obesity during pregnancy.

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TUESDAY, June 11 (HealthDay News) -- Breast-feeding is good for a baby's brain, a new study says.

Researchers used MRI scans to examine brain growth in 133 children ranging in age from 10 months to 4 years. By age 2, babies who were breast-fed exclusively for at least three months had greater levels of development in key parts of the brain than those who were fed formula only or a combination of formula and breast milk.

The extra growth was most evident in parts of the brain associated with things such as language, emotional function and thinking skills, according to the study published online May 28 in the journal NeuroImage.

"We're finding the difference [in white matter growth] is on the order of 20 to 30 percent, comparing the breast-fed and the non-breast-fed kids," study author Sean Deoni, an assistant professor of engineering at Brown University, said in a university news release. "I think it's astounding that you could have that much difference so early."

In addition to brain imaging, the researchers gave older children tests of thinking ability and found increased language and motor control performance, and increased visual perception in those who were breast-fed.

The researchers also found that babies who were breast-fed for more than a year had significantly more brain growth -- especially in areas of the brain that control motor skills -- than those who were breast-fed for less than a year.

This is not the first study to suggest that breast-feeding helps babies' brain development, but it is the first imaging study to examine breast-feeding-related differences in the brains of very young and healthy children, according to Deoni.

"We wanted to see how early these changes in brain development actually occur. We show that they're there almost right off the bat," he said.

The findings add to a substantial body of evidence that breast-feeding is good for children's brains.

"I think I would argue that combined with all the other evidence, it seems like breast-feeding is absolutely beneficial," Deoni said.

More information

The U.S. Office on Women's Health has more about breast-feeding.

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TUESDAY, June 11 (HealthDay News) -- The U.S. government has dropped its effort to block a court order that would make the morning-after contraceptive pill available over-the-counter to all women and girls.

After fighting for an age threshold on the nonprescription use of the Plan B One-Step pill for months, the U.S. Food and Drug Administration said in a statement late Monday that it would heed the ruling of Judge Edward Korman, of the United States District Court for the Eastern District of New York. The drug prevents conception if taken within 72 hours of having sexual intercourse.

The Obama administration appears to have concluded that it could lose its case, and would have to weigh whether to request that the Supreme Court hear any appeal, the New York Times reported.

Women's reproductive rights groups, which had sued the government to clear the way for broader distribution of the drug were happy with the decision, the Times reported, but they still wanted to see the details of how the change would be implemented.

"We will not rest in this fight until the morning-after pill is made available without delay and obstruction," said Mara Verheyden-Hilliard, executive director of the Partnership for Civil Justice Fund, which represented the plaintiffs in the case, the newspaper reported.

"This is a huge breakthrough for access to birth control and a historic moment for women's health and equity," Planned Parenthood President Cecile Richards said in a news release. "The FDA's decision will make emergency contraception available on store shelves, just like condoms, and women of all ages will be able to get it quickly in order to prevent unintended pregnancy."

However, the decision is certain to anger abortion rights opponents, who oppose allowing young girls access to the drug without the consent or involvement of a parent or a doctor.

Korman first issued his order April 5, igniting a battle over whether young girls could gain access to emergency contraception without a prescription. Soon after, on April 30, the U.S. Food and Drug Administration lowered to 15 the age at which people could purchase the Plan B One-Step pill over-the-counter -- two years younger than the prior age limit of 17.

A day later, on May 1, the Obama Administration stepped in to appeal the Korman decision.

At the time of the FDA's move to lower the age limit, agency commissioner Dr. Margaret Hamburg said in a news release that, "research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States."

"The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly and that it does not prevent the transmission of a sexually transmitted disease," Hamburg said.

Plan B prevents implantation of a fertilized egg in a woman's uterus through the use of levonorgestrel, a synthetic form of the hormone progesterone used for decades in birth control pills. Plan B contains 1.5 milligrams of levonorgestrel, more than the pill contains. It is considered a form of birth control, not abortion.

Other brands of emergency contraception include Next Choice and Ella.

Planned Parenthood has long pushed for wider access to emergency contraception, with Richards calling it "an important step forward."

But conservative groups have objected to the move. In April, Janice Shaw Crouse, director of the Beverly LaHaye Institute, the think tank for the conservative women's group Concerned Women for America, called Korman's ruling "a political decision, made by those who stand to profit financially from an action that puts ideology ahead of the nation's girls and young women."

More information

There's more on emergency contraception at the World Health Organization.

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MONDAY, June 10 (HealthDay News) -- Hurricane season is here, and pregnant women need to take extra precautions to ensure their health and safety during a storm, an expert says.

Pregnant women who are close to their delivery date and those with high-risk pregnancies need to let their health care provider know where they will be during a hurricane. They should also ask their health care provider if it's safe for them to leave before a storm strikes, said Dr. Alfred Robichaux, chairman of obstetrics and gynecology at the Ochsner Medical Center in New Orleans.

Here are some other tips:

• Plan an alternate birth location in case of evacuation or problems with road travel.
• Have phone numbers and locations for local obstetricians and midwives in case you cannot reach your regular health care provider during evacuation.
• Women in late pregnancy who are evacuating should bring a copy of their prenatal care record and immunizations, as well as their birth bag. They should also bring a two weeks' supply of any medications, including prenatal vitamins and prescriptions.
• Pregnant women who go to an evacuation center should immediately notify officials and get information about the location of hospitals in the area.
• Do everything you can to reduce stress, which is a major factor in preterm labor. By planning and preparing early, you can help reduce stress levels.
• Create a family communication plan so everyone knows what needs to be done before and during evacuation.

Floodwaters after a storm may be polluted with infectious agents and toxic chemicals, which can harm both mother and baby. "If you are in a flood-prone area, it's probably a good idea to again fall back on your plan and evacuate so you avoid being put in that situation," Robichaux said in a medical center news release.

Robichaux also offered advice for new mothers, including creating a hurricane food kit for the entire family that can be used either at home or during a car ride to a safer location.

"Make sure mom has enough high-protein snacks and clean water to drink to prevent dehydration," Robichaux said.

He said breast milk is the sole source of recommended nutrition for babies less than 6 months old, and new mothers should pack a hand- or battery-operated pump and clean storage bottles or bags, and have a method of freezing or cold storage for pumped breast milk.

More information

The U.S. Centers for Disease Control and Prevention has more about hurricane readiness.

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MONDAY, June 10 (HealthDay News) -- Reducing the number of unnecessary and high-dose CT scans given to children could cut their lifetime risk of associated cancers by as much as 62 percent, according to a new study.

CT (computed tomography), which uses X-rays to provide doctors with cross-sectional images of patients' bodies, is frequently used in young children who have suffered injuries.

Researchers concluded that the 4 million CT scans of the most commonly imaged organs conducted in children in the United States each year could lead to nearly 4,900 cancers in the future.

They also calculated that reducing the highest 25 percent of radiation doses could prevent nearly 2,100 (43 percent) of these future cancers, and that eliminating unnecessary CT scans could prevent about 3,000 (62 percent) of these future cancers.

The study was published online June 10 in the journal JAMA Pediatrics.

"There are potential harms from CT, meaning that there is a cancer risk -- albeit very small in individual children -- so it's important to reduce this risk in two ways," study lead author Diana Miglioretti, a professor of biostatistics in the department of public health sciences at the UC Davis Health System, in California, said in a health system news release.

"The first is to only do a CT when it's medically necessary, and use alternative imaging when possible," she said. "The second is to dose CT appropriately for children."

The researchers examined data on the use of CT in children at a number of health care systems in the United States between 1996 and 2010. Among children under 5 years old, CT use nearly doubled from 11 per 1,000 in 1996 to 20 per 1,000 between 2005 and 2007, and then decreased to about 16 per 1,000 in 2010.

Among children aged 5 to 14, CT use nearly tripled, from 10.5 per 1,000 in 1996 to a peak of 27 per 1,000 in 2005, before falling to about 24 per 1,000 in 2010.

Researchers examined 744 random CTs of the head, abdomen/pelvis, chest and spine conducted on children between 2001 and 2011 at five of the health systems to calculate radiation exposure levels and estimated cancer risk. These areas of the body account for more than 95 percent of all CT scans, the researchers said.

Head CT -- the most commonly performed CT in children -- poses the highest risk of radiation-induced leukemia and brain cancers, according to the study. Meanwhile, CTs of the abdomen and pelvis -- which had the most dramatic increase in use, especially among older children -- pose the highest risk of radiation-induced solid cancer. Leukemia and breast, thyroid and lung cancers account for 68 percent of estimated future cancers in girls who have had CTs, while leukemia and brain, lung and colon cancers account for 51 percent of future cancers in boys who have had CTs.

More information

The American College of Radiology/Radiological Society of North America has more about CT scans and children.

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SUNDAY, June 9 (HealthDay News) -- For many Americans, summer just wouldn't be the same without a backyard barbecue. However, the blackened meats and smoky flavor that come with grilling could put your health at risk, experts caution.

The good news, though, is that by planning ahead and making some smart choices, you can enjoy summer barbecues and reduce your exposure to cancer-causing chemicals.

High-heat grilling can convert proteins found in red meat, pork, poultry and fish into heterocyclic amines (HCAs). These chemicals have been linked to breast, stomach, prostate and colon cancer.

"What happens is that the high temperature can change the shape of the protein structure in the meat so it becomes irritating in the body and is considered a carcinogenic chemical," Stacy Kennedy, a nutritionist at the Dana-Farber Cancer Institute, said in an institute news release.

Another cancer-causing agent, called polycyclic aromatic hydrocarbons (PAHs), is found in the smoke from the barbeque. PAHs form when fat and juices from meat cooking on the grill drip down onto the heat source.

"That's where the main cancer-causing compound occurs in grilling," Kennedy said. "So you want to reduce the exposure to that smoke."

For those who plan to fire up the grill this summer, Kennedy offered the following tips to reduce exposure to cancer-causing agents:

• Choose meats wisely. Avoid grilling high-fat meats, like ribs and sausages. Instead, choose lean meats, which create less dripping and less smoke. Always trim excess fat and remove skin. It's also a good idea to choose smaller cuts of meat, such as kabobs, which require less cooking time.
• Try thin marinades. Thicker marinades tend to char, which could increase exposure to cancer-causing agents. Choose marinades made with vinegar or lemon, which will form a protective layer on the meat.
• Reduce grilling time. Always thaw meat before cooking. Meat and fish also should be partially cooked in the microwave before grilling. This will reduce cooking time and the risk for smoke flare-ups.
• Flip often. Flipping burgers once every minute will help prevent burning or charring.
• Consider food placement. Be sure to place food at least six inches away from a heat source.
• Create a barrier. Do not allow juices to spill and produce harmful smoke. Line the grill with aluminum foil or cook on cedar planks.
• Consider veggies. Try grilling your favorite vegetables since they do not contain the protein that forms harmful HCAs. "People are surprised, but you can safely eat charred vegetables," Kennedy said. "They have different proteins that are not affected the same way as the meat protein.

Despite the risks, Kennedy said, barbecue enthusiasts should keep things in perspective. "If you're grilling and following the proper safety tips, the risk of getting cancer from grilling food is very low," she said. "Being overweight or obese, which are at epidemic levels in the U.S., are far greater risk factors for developing cancer than the consumption of grilled foods."

More information

The U.S. National Cancer Institute has more about HCAs and cancer risk.

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FRIDAY, June 7 (HealthDay News) -- Many middle-aged women develop aches and pains and other physical symptoms as a result of chronic stress, according to a decades-long study.

Researchers in Sweden examined long-term data collected from about 1,500 women and found that about 20 percent of middle-aged women experienced constant or frequent stress during the previous five years. The highest rates of stress occurred among women aged 40 to 60 and those who were single or smokers (or both).

Among those who reported long-term stress, 40 percent said they suffered aches and pains in their muscles and joints, 28 percent experienced headaches or migraines and 28 percent reported gastrointestinal problems, according to the researchers at the Sahlgrenska Academy of the University of Gothenburg.

The study appeared recently in the International Journal of Internal Medicine.

Even after adjusting for smoking, body weight and physical activity levels, there was a clear link between stress and an increased risk of physical symptoms, the researchers said.

The women in the study were followed since the late 1960s. Among those who experienced long-term stress but did not report any stress-related physical symptoms at the start of the study, 27 percent had new muscular and joint pain symptoms 12 years later, and about 15 percent reported new complaints in the form of headaches or gastrointestinal problems.

"Since 1968, women's lifestyles have changed in many ways," researcher Dominique Hange said in a university news release. "For example, many more women now work outside the home. Naturally, these changes can affect the experience of stress."

"Although we've used exactly the same question since 1968, we can't take it for granted that the term 'stress' has exactly the same meaning today," Hange added. "It might also be more socially accepted today to acknowledge one's experience of stress."

Hange said the "most important conclusion [from this study] is that single women, women who do not work outside the home and women who smoke are particularly vulnerable to stress. Here, we see a greater need for preventive measures from society."

The next step is to identify methods that doctors can use to help patients deal with stress-related physical complaints and illnesses, and to pinpoint ways to reduce stress at work, the researchers said.

More information

The U.S. National Institute of Mental Health has more about stress.

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FRIDAY, June 7 (HealthDay News) -- Poor sleep appears to contribute to the progression of heart disease in women by raising their inflammation levels, but this effect was not seen in men, researchers say.

"Inflammation is a well-known predictor of cardiovascular health," lead author Aric Prather, a clinical health psychologist and assistant professor of psychiatry at the University of California, San Francisco, said in a university news release.

"Now we have evidence that poor sleep appears to play a bigger role than we had previously thought in driving long-term increases in inflammation levels and may contribute to the negative consequences often associated with poor sleep," Prather added.

Previous research has shown that sleeping fewer than six hours per night may raise the risk of chronic health problems, including heart disease, and is associated with higher levels of inflammation.

This new study included nearly 700 men (average age 66) and women (average age 64) with coronary heart disease. Among the women, poor sleep quality was significantly associated with increases in markers of inflammation over five years. However, this was not the case among men.

Most of the women in the study were postmenopausal and their lower levels of estrogen could help explain the link between poor sleep and higher levels of inflammation, the study authors suggested.

"It is possible that testosterone, which is at higher levels in men, served to buffer the effects of poor subjective sleep quality," Prather's team wrote in the study published online June 5 in the Journal of Psychiatric Research.

The researchers said their findings reveal potentially important gender differences and provide evidence that increased inflammation may be a major way that poor sleep contributes to the progression of heart disease in women.

Although the study found an association between self-reported poor sleep quality and increased signs of inflammation among older women with heart disease, it did not prove a cause-and-effect relationship.

More information

The U.S. Centers for Disease Control and Prevention has more about heart disease.

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THURSDAY, June 6 (HealthDay News) -- Low breast-feeding rates in the United States are a serious threat to women's health and a drain on the nation's health dollars, according to a new study.

Researchers concluded that low breast-feeding rates may be linked to as many as 5,000 cases of breast cancer, nearly 54,000 cases of high blood pressure and almost 14,000 heart attacks among American women each year.

But some experts question the study's methodology and maintain that more research is needed before drawing conclusions about lags in breast-feeding and women's health.

The researchers, who used a simulated model to arrive at their conclusions, said the costs of premature death caused by illnesses related to low breast-feeding rates are $17.4 billion a year. The study, published online June 6 in the journal Obstetrics & Gynecology, defines premature death as death before age 70, or more than 10 years before the average U.S. woman is expected to die.

Only about 25 percent of U.S. women follow medical recommendations to breast-feed each child for at least one year, the researchers said. This low rate also is associated with $734 million more in direct medical costs for women and $126 million more in indirect costs each year, they said.

"Thousands of women are suffering needless disease and premature death because they are not able to breast-feed their infants as long as they may want to," said study lead author Dr. Melissa Bartick, an assistant professor of internal medicine at Harvard Medical School and an internist at Cambridge Health Alliance, in Massachusetts. "Support from all sectors of society is important to help women breast-feed much longer than they do now."

Other experts said the findings should be viewed with caution.

"Although there is general agreement that breast-feeding provides benefits to both the mother and child, assuming that it will decrease cost by using a simulated model is risky," said Dr. Stephanie Bernik, chief of surgical oncology at Lenox Hill Hospital in New York City.

"For example, although breast-feeding may reduce the risk of heart disease, perhaps it is not the actual breast-feeding, but rather the mother's demeanor that reduces her risks," Bernik said. If a woman has the time and patience to breast-feed for one year, this may reflect a less stressful life, which could be the actual reason she is less likely to suffer a heart attack later in life, she said.

"The findings of this study are provocative, but more research needs to be done to clearly delineate why breast-feeding may be good for overall health," Bernik said.

Dr. Frank Monteleone, director of the breast health program at Winthrop-University Hospital in Mineola, N.Y., also pointed out shortcomings in the study. The link between breast cancer and breast-feeding is still fuzzy, he said.

"More clinical and scientific studies need to be performed before we can establish a clear link between breast cancer and breast-feeding," Monteleone said. "This study is based on estimated and expected results rather than actual results of a study looking at the effects of breast-feeding on breast cancer rates."

According to the U.S. Centers for Disease Control and Prevention, 60 percent of American women do not breast-feed as long as they intend to.

Policies are needed to enable women to meet their own breast-feeding goals and also meet medical breast-feeding recommendations, Bartick said in a Cambridge Health Alliance news release. For example, she said, mothers who deliver in "baby-friendly hospitals" are more likely to get the early breast-feeding support they need.

"They want to breast-feed longer," she said. "We need to support their goals."

More information

The U.S. Office on Women's Health has more about breast-feeding.

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The American Academy of Family Physicians offers these suggestions for moms-to-be:

• Visit your doctor regularly for prenatal care.
• Gain an appropriate amount of weight. Don't try to shed pounds during pregnancy.
• Eat a healthy, balanced, nutritious diet. Avoid ingredients that could harm your baby, such as caffeine.
• Take vitamins or prenatal supplements (including folic acid) as recommended by your doctor. Consult your doctor before taking any medications or supplements.
• Ask your doctor about whether it's safe to continue working, have sex and exercise throughout pregnancy.

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WEDNESDAY, June 5 (HealthDay News) -- In the latest chapter of the legal wrangle over the non-prescription sale of "morning-after" pills, a New York appeals court on Wednesday ruled that some forms of the emergency contraception could be sold over-the-counter while the issue winds its way through the courts.

According to The Associated Press, the 2nd U.S. Circuit Court of Appeals in Manhattan ruled that two-pill versions of emergency contraception can be sold without a prescription or a restriction as to the buyer's age while the court mulls the validity of a U.S. government appeal.

However, a prior ruling by Brooklyn Judge Edward Korman that one-pill products -- including Plan B -- also could be sold without restrictions has now been suspended by the Manhattan court, the AP reported.

That suspension will stay in effect until the appeals court rules on the merits of the case later this year.

Korman issued his order April 5, igniting a battle over whether young girls could gain access to emergency contraception without a prescription. Soon after, on April 30, the U.S. Food and Drug Administration lowered to 15 the age at which people could purchase the Plan B One-Step pill over-the-counter -- two years younger than the prior age limit of 17.

A day later, on May 1, the Obama Administration stepped in to appeal the Korman decision. It is that appeal that is now working its way through the courts.

At the time of the FDA's move to lower the age limit, agency commissioner Dr. Margaret Hamburg said in a news release that, "research has shown that access to emergency contraceptive products has the potential to further decrease the rate of unintended pregnancies in the United States."

"The data reviewed by the agency demonstrated that women 15 years of age and older were able to understand how Plan B One-Step works, how to use it properly and that it does not prevent the transmission of a sexually transmitted disease," Hamburg said.

Plan B prevents implantation of a fertilized egg in a woman's uterus through the use of levonorgestrel, a synthetic form of the hormone progesterone used for decades in birth control pills. Plan B contains 1.5 milligrams of levonorgestrel, more than the pill contains. It is considered a form of birth control, not abortion.

Other brands of emergency contraception include Next Choice and Ella.

Planned Parenthood has long pushed for wider access to emergency contraception, with the group's president, Cecile Richards, calling it "an important step forward."

But conservative groups have objected to the move. In April, Janice Shaw Crouse, director of the Beverly LaHaye Institute, the think tank for the conservative women's group Concerned Women for America, called Korman's ruling "a political decision, made by those who stand to profit financially from an action that puts ideology ahead of the nation's girls and young women."

More information

There's more on emergency contraception at the World Health Organization.

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WEDNESDAY, June 5 (HealthDay News) -- Group counseling is more effective than individual therapy in reducing symptoms of post-traumatic stress disorder, depression and anxiety among victims of sexual violence in war zones, a new study shows.

"Survivors of sexual violence have high rates of depression, anxiety and post-traumatic stress symptoms. We know what works for treating these victims in developed countries, but very little has been done to determine what treatments can help women in war-torn, resource-poor settings," lead author Judith Bass, an assistant professor in the department of mental health at the Johns Hopkins Bloomberg School of Public Health in Baltimore, said in a school news release.

She and her team conducted their study in the eastern region of the Democratic Republic of the Congo, where conflict has raged for more than 20 years. A recent study showed that two of every five women in this area had been victims of rape.

The sexual violence survivors in the study were screened for symptoms of post-traumatic stress disorder, depression and anxiety, and offered either individual support or cognitive processing therapy, which included one individual session and 11 group sessions.

Symptoms of post-traumatic stress disorder, depression and anxiety were reduced among all the women in the study, but the reduction was much greater among those who received cognitive processing therapy. Six months after treatment, only 9 percent of women who received that therapy met criteria for probable post-traumatic stress disorder, depression or anxiety, compared with 42 percent of those who received individual support.

"We saw women, who had once felt too stigmatized to be a part of their community, re-engage after receiving [cognitive processing therapy] and they expressed that they felt they could again be productive members of their families and communities," Bass said.

The study was published in the June 6 issue of the New England Journal of Medicine.

More information

The U.S. Centers for Disease Control and Prevention has more about sexual violence.

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MONDAY, June 3 (HealthDay News) -- The belt tightening triggered by the recent recession appears to have forced families to make tough choices about care for children with chronic physical or emotion problems, a new study suggests.

The study, which was published in the June issue of the journal Health Affairs, used a large government database to track out-of-pocket costs for families with private health insurance carriers from 2001 to 2009.

Researchers were particularly interested in spending for children with special health care needs.

"Those are children who require health or related services beyond those required by children generally," said lead researcher Pinar Karaca-Mandic, an assistant professor of public health at the University of Minnesota. "A child with asthma would fit in this category, for example. A child with depression, ADHD or a physical limitation would also fit this definition."

Nearly one in five children in the United States meets the criteria for having a special health care need. Parents pay about twice as much to care for children with special needs as they do caring for children without ongoing problems. Their own health care costs usually go up, too, as they deal with the added stress of caregiving.

In the years leading up to the recession, out-of-pocket expenses climbed steadily for all family members -- children and adults alike. But in 2007, the trend lines changed.

For children who were generally healthy, medical expenses jumped as insurance plans became less generous and families bore a greater share of the total tab for medical care. Average annual out-of-pocket costs rose from about $280 in 2007 to $310 in 2009.

But for children with special needs and adults, out-of-pocket costs actually dropped. Adults cut spending on their own care by an average of $40 if they had children without chronic conditions. In families with special-needs kids, adults pared their own medical bills by an average of about $65 during each year of the recession.

Spending on children with special health care needs fell even further, by about $73 each year of the recession. Families spent an average of $774 a year to care for children with special needs in 2007. By 2009, that figure was down to $626.

Taken together, researchers said it looks like parents cut back on their own care to continue to afford services for their kids.

But when those children had chronic conditions, even those sacrifices were not enough to keep up with the rising costs, and families started to make difficult decisions about the kinds of care they could do without.

"We looked at what kinds of services were most affected in terms of the utilization," Karaca-Mandic said. "We saw that services such as dental care and prescription drugs were the most hit."

The survey used to conduct the study, which is called the Medical Expenditure Panel Survey, or MEPS, doesn't track health outcomes, so researchers couldn't tell if the drop in spending translated to poorer health.

An expert who was not involved in the research praised the study for offering the first direct, national comparison of out-of-pocket spending on children with and without special health care needs.

"What we are seeing is a slight increase in the prevalence of kids that have special health care needs and an increasing trend toward those involving emotional, behavioral and mental health problems, including things like autism, [attention-deficit/hyperactivity disorder], depression and anxiety," said Christina Bethell, professor of pediatrics at Oregon Health and Science University, in Portland. "We know that the health care system is the weakest in those areas."

"We're not putting a system of care together for kids that appears to be optimal, and families are struggling," said Bethell who also directs the Child and Adolescent Health Measurement Initiative at the university.

But Bethell said she has not seen a drop in out-of-pocket spending for children with special health care needs, even through the years of the recession. But she said that could be because her study is tracking slightly different measures.

She said one thing both studies seem to point to is the plight of low-income families with private insurance.

Many of the families in the study were low or middle income. More than a third had incomes that were less than 125 percent of the federal poverty threshold, which was about $22,000 for a family of four in 2009.

"They do the worst," Bethell said. "They need to be on public insurance. Public coverage is better for lower-income people."

In 2014, those families could be covered by Medicaid if they live in states that take advantage of federal funding through the Affordable Care Act to expand their programs. Bethell said the switch could ease the strain on low-income families that have children with special health care needs.

"It's going to vary a lot [state-by-state] because of how much freedom the states have," she said. "We're going to have to track it closely to see."

More information

To learn more about children with special health care needs, visit the Data Resource Center for Child & Adolescent Health.

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