By Maria Serraino and Patricia Nicholson

2011 was a good year for women’s health. As Women’s College Hospital celebrated its 100^th anniversary, the hospital and the Women’s College Research Institute (WCRI) continued to add to their legacy of women’s health breakthroughs, and to shine a spotlight on issues that need attention.

The spirit lives on

The Spirit of Discovery in Women’s Health Research showcased some of the groundbreaking research underway at Women’s College Hospital and Women’s College Research Institute.

• Osteoarthritis (OA) affects one in ten Canadians, and is a major cause of disability. Women’s College Hospital physician-in-chief Dr. Gillian Hawker is researching issues such as access to joint replacement surgery (one of the most effective treatments for serious OA), as well as OA pain and how it is linked with disability, sleep and fatigue. Her discoveries have led to new approaches to OA management. Read more.
• The Familial Breast Cancer Research Unit at Women’s College Research Institute continues its pioneering work, including the Jewish Women Undergoing Genetic Testing for BRCA 1 and 2 study. About one in 250 women carry a BRCA mutation, but the prevalence is higher in certain groups such as women of Ashkenazi Jewish descent. After testing more than 2,000 women in this group, Dr. Kelly Metcalfe and her WCRI colleagues found that the prevalence of BRCA mutations was one in 100 – much higher than the general population, even though the women had no family history of breast cancer. The study has been expanded to include 5,000 women. Read more.
• In the Negative Study, WCRI researcher Dr. Joanne Kotsoupoulos is analyzing risks in women with a strong family history of breast cancer, but no BRCA mutations. These women have a significantly increased risk of breast cancer, but not as high as women with BRCA mutations. Only about 25 per cent of women with a strong family history of breast cancer have a BRCA mutation, so Dr. Kotsoupoulos is investigating risks in the 75 per cent of this group who don’t have a mutation. She is looking looking at factors such as hormonal and reproductive issues, diet and risk reduction. The study includes 1,400 women from 365 families. Read more.

Journal entries

Influential medical journals carried the results of Women’s College research throughout 2011. Highlights include finding clues to breast cancer risk in women with BRCA mutations; testing safe, affordable treatments for osteoporosis; and alerting women undergoing cancer treatment to diabetes risks.

• The International Journal of Cancer published study results by Dr. Steven Narod and the WCRI Familial Breast Cancer Research Unit finding that Polish women with BRCA1 mutations have a 46 per cent lower annual risk of getting breast cancer, compared to North American women with the same mutation. The research team suspects that environment or nutrition may play a role, so Dr. Joanne Kotsoupoulos is analyzing the women’s blood nutrient levels to try to identify dietary factors. Read more.
• In the Journal of the American Medical Association, WCRI scientist Dr. Sophie Jamal, who is director of the Multidisciplinary Osteoporosis Research Program at Women’s College Hospital, reported promising results for treating osteoporosis with a safe and inexpensive drug that’s already widely available: nitric oxide. Osteoporos is affects about one-quarter of older women. Read more.
• Dr. Lorraine Lipscombe, WCRI scientist and endocrinologist at Women’s College Hospital, reported in the journal Cancer that older women who take the breast cancer drug tamoxifen may be at increased risk for diabetes. The increased risk returns to normal after they complete tamoxifen treatment, but there is no suggestion that they should discontinue treatment early. Instead, they should talk to their doctors about getting tested for diabetes.
• The Canadian Medical Association Journal published a study on cultural preferences in birth control by Dr. Sheila Dunn, clinician and research director, department of family and community medicine at Women’s College Hospital. The study found that women from different cultures often have different considerations and preferences when choosing a birth control method, and accommodating these preferences is important to ensure that women from all backgrounds have easy access to their method of choice.

Empowered by POWER

The POWER (Project or an Ontario Women’s health Evidence-based Report) study is a comprehensive report on women’s health funded by Echo: Improving Women’s Health in Ontario. Each chapter probes a different area of interest, generating an in-depth look at women’s health. POWER chapters published in 2011 looked at gynecological and reproductive health, and the health of older women.

• Ontario is a very safe place to give birth for both mothers and babies. The authors of the gynecological and reproductive health chapter – including Dr. Sheila Dunn, physician and research director at the Family Practice Health Centre at Women’s College Hospital – reported that women across the province have access to high-quality reproductive and gynecological care, but the findings varied across the province. Read more.
• Women tend to outlive men, but older women are more likely than men to be affected by chronic conditions – especially low-income women and those with lower education levels. Dr. Paula Rochon, vice-president, research at Women’s College Hospital, and her colleagues recommended in the Older Women’s Health Report that new, integrated models of care are needed to address the complex needs of older women. The study also found that lifestyle changes may improve the odds of a healthy life for many older women: 60 per cent were physically inactive, and many had inadequate fruit and vegetable intake. Read more.

There’s work to be done

Some Women’s College researchers highlighted areas that need attention, including issues of stigma and the oppression of women.

• A study in PLoS Medicine highlighted the stigma and discrimination that marginalized women with HIV still face, in many forms and on many levels.  The study, led by WCRI scientist Dr. Mona Loutfy in collaboration with Women’s Health in Women’s Hands, found that HIV-related stigma often overlapped with other types of stigma and discrimination, including racism, sexism, homophobia and transphobia. Stigma was common on many levels, from the interpersonal to larger-scale discrimination and exclusion from the community and services. The coping strategies that women used to deal with stigma and discrimination also operated on several levels. Read more.
• An editorial in the medical journal BMJ, co-authored by WCRI scientist Dr. Janice Du Mont, highlighted the need for action on the worldwide oppression of girls and women. Citing grim statistics about issues ranging from gender-based violence, rape and human trafficking, to female infanticide and honour killings, the editorial urged action from governments, state organizations, and individuals to end gendered oppression. Read more.

Throughout 2012, Women's Health Matters will be bringing you more important health news and features from Women’s College and beyond. Bookmark our homepage to stay up to date, like us on Facebook or follow us on Twitter.

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100 years of women's health