NAPLES —Pregnancy and childbirth. Breast examinations. Reproductive medical problems. Nutrition. Obesity.

Women’s health-care providers face these issues every day. So these were a few of the topics that had women riveted in a series of lectures and discussion groups this past weekend at Hodges University in North Naples.

At the Collier County Medical Society Women’s Health Forum an expert panel of physicians included women from virtually all disciplines in women’s medicine.

In addition to lectures and question-and-answer sessions for local doctors at the third annual forum, health-care providers and the businesses that work with them had booths featuring new medical enterprises and information about health-care professionals in the area.

The atmosphere at the forum was all about solutions and working together for better health for all women. Question-and-answer portions were extended far beyond the allotted times as women lined up throughout the building to ask the doctors their most pressing questions.

One of the hottest topics involved the field of breast health and a national trial for automated breast ultrasound.

“This trial is to determine if women with dense breasts will benefit from ultrasounds,” said Dr. Margaret Taha of Radiology Regional Center. “In 16 places around the country, we’re trying to enroll 2,000 women.”

The automated imaging of the whole breast is important, because current ultrasound that uses a wand to image the breast may not cover the whole breast. In densely breasted women, the density may be so great finding early cancer is harder than it is in women who have fatty breasts. Abnormalities in a dense breast may show up sooner than they might in a traditional mammogram.

Women who participate in the study will still have to receive a digital mammogram, and if the breast is found to be dense enough, they can be eligible for step two, which involves the automated whole breast imaging.

Radiologists will examine the mammograms and make recommendations.

Study participants for whom nothing abnormal is found will be expected to return in one year. the company conducting the trial for the U.S. Food and Drug Administration (FDA) will collect all the data for use in getting FDA approval of the whole breast imaging process.

“Even breast MRI may miss early low-grade cancer, and masses will recruit new blood vessels,” Taha said. “Very early cancer before it’s made a mass with calcifications is more likely to show up in a mammogram, which is needed to look for early cancer that only shows up with calcifications.”

Another topic that was on every woman’s mind at the forum was cardiovascular disease.

In the office of Dr. Diana Francu, 40 percent of patients are there for something to do with cardiovascular disease. the internal medicine physician focuses on preventive medicine.

“Preventing is always better than treating, but for women, cardiovascular disease is often overlooked and sometimes not diagnosed on time,” Francu said. “When a woman goes to the ER with chest pain, the condition is sometimes labeled as anxiety. Women die twice as fast as men of heart disease.”

Francu’s purpose in speaking at the Women’s Health Forum was to make women aware that they often have different symptoms from men, mainly fatigue. It’s a frequent symptom of heart disease in women that easily can be overlooked.

“If I could provide a prescription every day for diet and exercise I would start with that,” Francu said. “Both are so important but so ignored — patients often don’t understand how important it is to eat healthfully and exercise regularly.”

A subject that’s also frequently discussed in men’s health forums was presented by Dr. Carolyn F. Langford, a specialist in female urology. Ninety percent of the urology patients Langford sees are female.

Incontinence is a big quality-of-life issue for women, and today’s surgical and nonsurgical technologies have revolutionized the industry and made the condition manageable — if women come forward to discuss the issues with their doctors. but many women don’t discuss urological issues because of the stigma associated.

“Women often are embarrassed and think incontinence is part of aging, but it isn’t, and they’re also afraid they’ll have to do a major surgery to fix it and they often don’t,” Langford said. “Women don’t like to talk about private things like this, but they’ll sit with girlfriends and discuss it. Everybody’s female friends know what their problems are but their doctors often don’t.”

Most surgical treatments for incontinence and similar urological issues are less invasive than traditional surgery and for some procedures, incisions aren’t necessary.

“This is a generation of women who don’t want to settle for a poor quality of life,” Langford said. “All the doctors here are trying to improve the quality of life of all women, because they’re living longer and they want to live well.”

Part of living well includes getting bodies what they need, and nowhere is this truer than in the case of supplementing the intake of vitamins. In today’s preservative, fat-laden diet, it’s challenging to get enough vitamins and minerals.

Dr. Ruth DuPont spoke to those at the forum about vitamin supplements and prescription medications from an integrated medicine standpoint.

“Integrated medicine looks at the whole patient from physical, to the mental, to the spiritual and uses synergies to treat the patient,” said DuPont, a board-certified family physician who practices at Advanced Medical in Naples. “My most pressing concern with today’s women is nutritional status, because I’m finding upon testing that a lot of women think they are well and active but they are actually nutritionally depleted, which leads to disease processes and premature aging.”

DuPont said women can be tested for deficiencies through blood work and need to learn more about the role of nutritional supplements and how to build a better health plan. It all begins with a good multiple vitamin.

“Supplements can’t replace food but they are increasingly important in today’s stressful, polluted world,” said DuPont, who says many women are taking prescription and over-the-counter medications that can further deplete the body of nutrients.

All age groups can have nutritional problems that won’t be detected unless someone is looking for them.

The lecture on mental wellness by Dr. Marilyn Varcoe included tips on eliminating toxic stress, which is also the topic of the doctor’s book, “Toxic Stress — seven Steps to Recovery.” the lecture room was packed with women, many of whom identified with the stress of being involved in toxic relationships.

“We have lots of relationships in our lives and many of them are toxic, energy drainers,” Varcoe said. “Toxic relationships tear down self-confidence and self-esteem — but we can learn how to identify them and what to do about them.”

Varcoe said counseling can provide the motivation someone needs to make changes to create the kind of life they want. Part of what she does with her clients is to diagnose problems and then identify changes.

Even women who have been successful in business, who are creative and powerful in their jobs, can fall into depressive episodes as a result of spending their days doing what they don’t enjoy.

Varcoe, as a cognitive behavioral psychologist, works with helping clients change the way they think.

Not surprisingly, nutrition and issues that affect women’s endocrine systems were an important topic at the forum.

Dr. Teresa Sievers of the Restorative Health and Healing Center blames poor eating habits and running ragged for some of women’s most dire health issues.

“You have to be treating yourself nutritionally — not eating rice cakes and drinking diet soda,” Sievers said. “Women nurture everyone else except ourselves and we have a thousand reasons why we don’t, but women are captains of the ship. So if they go down, the whole family goes down.”

Sievers said by the time conventional labs find a problem, patients are 40 percent into an illness. So, watching for telltale signs can help reverse some issues, like Type 2 Diabetes if patients know about them ahead of time.

Dr. Catherine Kowal spoke about rheumatology, with a focus on arthritis.

Kowal has been in Naples for nearly two decades and organized the first forum. As chair for the women’s physician group, Kowal encourages women to get educated on women’s issues from women.

“Women need to be proactive, and attending things like the health forum is one way to get proactive,” Kowal said. “There is a lot of stress on early intervention and early diagnosis with radiology and with pharmaceutical input, and these are things that all help with diagnosing and preventing illness down the road.”

Kowal treats all sorts of arthritic conditions and autoimmune diseases, including systemic lupus.

And what of weight and the current state of female health in Collier County?

Like the rest of the country, weight is a major problem for women and one of the most challenging. One study found that without help or medical intervention, many women cannot lose the weight they need to become healthy.

And sometimes losing weight is not a matter of simple diet and exercise.

Medical issues are a huge factor in weight loss and a healthful lifestyle. It’s a challenge that Dr. Caroline Cederquist of Cederquist Medical Wellness Center faces with her patients every day.

Cederquist specializes in weight and nutritional deficiencies but works closely with primary care providers to determine treatment plans.

“I wanted the women to walk away from the health forum knowing that changes in hormones such as perimenopause and menopause cause weight gain but are treatable — women can lose weight once they know their chemistry,” Cederquist said.

Patients who come to see Cederquist give a detailed history, and there is fairly extensive lab work to determine nutritional deficiencies. there are three dietitians in her office.

Cederquist’s program is not a medically supervised weight program where lay people see clients. Cederquist sees patients herself.

As opposed to short-term diets, Cederquist’s weight programs address the complex and chronic nature of obesity. A multi-faceted medical, nutritional, physiological, behavioral and cognitive approach to weight loss and long-term weight management is necessary.

“When we know the chemistry, we can come up with a treatment plan for an individual person,” Cederquist said. “It’s not just about calories.”

For more information on the Women’s Health Forum or the Collier County Medical Society, go to CCMSOnline.org

Contact Kelly Merritt at Kelly@Kelly-Merritt.com

Ladies First: Collier Medical Society's Women's Health Forum showcases women's ...

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