Women’s health care was the topic of an interview on CHI Mercy Health’s talk show on News Radio 1240 KQEN last week. Mitzi Thompson with Centennial Medical Group’s Harmony Health is a nurse practitioner with a subspecialty in menopause.
She spoke with Talking Health host Kathleen Nickel about women’s health issues and what women can do to improve their overall health.
The following is edited version of that conversation.
Kathleen: What do you see as the most important issues that women are facing today?
Mitzi: I’m very concerned about mixed messages that women in America are getting. They’re told you don’t need a pelvic exam, a mammogram, or a Pap smear annually. There’s actually some research that indicates that instances of some sexually transmitted diseases are going up dramatically because we are not routinely having these exams. I think that what we’re able to do proactively with screenings and exams is help our patient avoid future problems.
Kathleen: When you’re meeting with a woman to talk about screenings, what does that include, and do you talk about their family history?
Mitzi: Yes we do. Your health is your family history and your lifestyle today. We focus on what we can do to change the outcome of our own lives, and if someone doesn’t believe that is possible, my job is to help them become energized and realize that they need to be okay with putting ourselves as number one, especially when it comes to taking care of our health.
Stress is also a big issue. So I try to encourage a woman to see what’s going on in her life today, and how much of this can she let go. Sometimes it’s easier for someone to ask themselves to imagine what would take place if something happened . All the things that you have to do, who would do all the things you get done? I want all women, to see themselves as special enough to have that conversation, so that they will worry only about what they can control and give up the rest.
Kathleen: Let’s talk about supplements and multi-vitamins.
Mitzi: I think a supplement is just that. It’s made to supplement what you’re not obtaining in your diet, for instance through whole and fresh foods. We are lucky that our community can go from garden to table, but that being said, sometimes we just do not consume what we need and we can fortify with vitamins.
I do want all my patients to get their calcium in their diet as much as they can. Drink milk, eat yogurt and cheese. We also live in a place that is dark for several months of the year, so everyone, men and women should probably have vitamin D every day.
Kathleen: For your practice, you do see women of all ages, except pregnant women, so when do you recommend that a young woman should see a nurse practitioner focusing on health versus a pediatrician?
Mitzi: I think that every young woman should have a pelvic exam and pap smear, and be established with an adult provider, at least by the time she graduates from high school. But I see patients when they need us, and that may be earlier for some girls depending on what’s going on.
Kathleen: Speaking of those age groups, how do our health care needs change as we age?
Mitzi: The 20 year old is really taking over her health. Now that she’s independent, she’s going to make her own decisions, and I think that it’s important to support her decision in what she wants for her future. By the time someone is in their 30s and 40s they really are maximizing their health. So I encourage women to be seen regularly by a primary health provider so that we can stop a problem before it begins.
At our practice, we are more focused on gynecological issues, and we work closely with other providers. We want to be part of a care team, and that means making referrals to primary care and other specialists in this community, so we can network together.
In our 60s and 70s we need to hang on to what we’ve got and perfect that. I think women in this age group also need a lot of social connection, because women outlive men, generally speaking, and we can be alone for a long time. We can live 30 years beyond menopause, and we want those to be very active and happy years. Every day is important to me, and it is for my patients too.
Kathleen: You said you have a specialty in hormone therapy, let‘s talk about that.
Mitzi: Menopause is what we always think about with hormones, but there are other hormonal situations that affect women, like polycystic ovarian syndrome. Hormone replacement discussions during menopause unfortunately became an all or nothing attitude.
In 2002, there was a very important study on women’s health that was stopped prematurely for some of the participants because it was believed that women who took hormones had a higher risk for breast cancer.
What was very interesting about that study, though, is that it continued for 10 years with women who’d had a hysterectomy and therefore had estrogen only. Those women had a 30 percent less risk for developing breast cancer than women who took no hormones.
So what I’ve come to really believe is that estrogen is not the villain after all. What turns us from little girls into women are our hormones. When we lose these hormones during menopause it can create lifestyle issues for some women and really disrupt their life if they go untreated.
Not every woman needs hormone therapy, but that doesn’t mean that many would not be helped by them. It’s a conversation to have with your health provider. It’s hard to be a loving partner and active in the community when you are not sleeping well due to hot flashes and mood swings.
Our hormones rise and fall naturally, so menopause is not a disease at all, it’s another part of our life cycle.
Kathleen: What treatments are available and what options do women have today to deal with some of the changes that are going to occur during menopause?
Mitzi: Women come to me and say, I want a natural hormone. It’s interesting because I agree, if the body can get the molecule that it makes itself, then it just makes sense that it would be easier.
But we can also get an FDA approved preparation, so you can get natural progesterone in many forms. Since it’s FDA approved, it gives me better information about the good and the bad, which allows me to have a better conversation with my patient.
Kathleen: What are some of the newest advancements in women’s health?
Mitzi: I encourage moms and young teens, to get the HPV vaccination series. And I’m excited that we now have minimally invasive surgeries, so that patients do not have the hospital stays that they would have had even a few years ago. Also, urinary tract problems are something I see a lot in my practice, leaking when you cough or sneeze, or that sensation of having to pee all the time, and now we have an in-office treatment that can really help.