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"The first complete and major revision in 14 years includes new photographs and the latest health and medical information...speaks to women from a variety of ethnic, economic, and age groups."
From Chapter 24: Selected Medical Practices, Problems, and Procedures
GENETIC TESTING AND INHERITED RISK
All breast cancer appears to be associated with alterations in specific genes in one or more breast cells, but research indicates that only 5 to 10% of breast cancer is inherited in the sense that it runs in families. In other words, 90 to 95% of all breast cancer is not inherited. So far, researchers have identified several genes, most notably BRCA1 and BRCA2, which they think are associated with breast cancer. Everyone is born with these genes, receiving a copy of each from her father and mother. If a woman receives an abnormal or mutated copy from either parent, her risk of developing breast cancer may be increased. If she has a BRCA1 or BRCA2 mutation and is from a family with a strong history of breast and/or ovarian cancer (several family members on one side of the family with breast and/or ovarian cancer in several generations, particularly in women under 40; cases of bilateral breast cancer; and/or cases of male breast cancer), her risk of developing breast cancer in her lifetime may be about 70%. At present, there is no accurate estimate of the risk for a woman with one of these mutations who does not have a strong family history of breast or ovarian cancer.
Researchers have developed blood tests that can identify BRCA1 and BRCA2 mutations. Initially, these tests were administered primarily within research protocols; now they are commercially available and are aggressively marketed by the biotech companies that developed them. This is problematic for several reasons. Genetic testing should be considered only in certain limited situations. A positive test result does not mean that the individual will develop breast cancer; it means only that if she has a strong family history and a family member with cancer who has had a positive test result for the same mutation, she has a greatly increased risk of developing breast cancer. Without this family history, her risk is unknown. A negative test does not mean a woman will never develop breast cancer; it means that she has the same lifetime risk as most other women in the U.S.
The measures you can take if your test result is positive are quite limited at this time. Some physicians recommend frequent mammography beginning at age 25, or 10 years earlier than the youngest age at which a family member has developed the disease. One problem with this strategy is that mammography is much less effective in younger women because of the density of their breast tissue, and there is no evidence that it will detect breast cancer at an early stage. There are also unanswered questions about the safety of exposing young women who are at high risk of developing breast cancer to repeated X rays.
Another possible strategy is prophylactic -- that is, preventive -- surgery. This is a drastic step that is reassuring to some women from high-risk families, but its effectiveness is still unproved (see box on p. 613).
Genetic testing can cause great psychological distress and create a variety of problems for individuals and their families. Anyone considering genetic testing needs to get in-depth counseling from a trained genetic counselor. Research centers that conduct tests under a research protocol are more likely to have doctors and other professionals who are experienced in guiding individuals and their families through this complicated process. However, genetic testing is now available through private physicians. Some doctors may suggest it too casually and inappropriately, for example, to assist in a decision about whether or not to prescribe birth control pills or hormone therapy. Far too little is known about the meaning of these genetic tests for physicians to use them as a basis for this type of medical decision. (See also the boxed text on genetic testing in chapter 25, The Politics of Women's Health and Medical Care.)
Undergoing genetic testing may put an individual and her family at risk for discrimination. As of late 1997, only half the states in the U.S. had enacted laws that provided protection against different forms of genetic discrimination. At that time, federal law had only just been introduced in the Congress to protect people from discrimination in insurance, employment, and other areas on the basis of genetic information or the results of genetic tests. Not only the individuals who have been tested but their family members may be denied health or other types of insurance. The results of a genetic test could be used against an individual in a custody dispute, to deny an adoption, to disqualify someone for organ transplant surgery, or in other ways. Current state and federal laws do not adequately protect the confidentiality of individuals who undergo genetic testing; there are numerous ways in which such information could be inadvertently or deliberately disclosed. All genetic testing should be accompanied by complete information, professional counseling, and comprehensive written informed consent.
It is likely that more genes associated with breast cancer and other diseases will be identified. If and when truly effective treatment and prevention methods are developed for women with inherited gene mutations, genetic testing may have more to offer these women. What it has to offer right now is limited and problematic, and the disadvantages far surpass the advantages for most women.
Copyright © 1984, 1992, 1998 by the Boston Women's Health Book Collective
|Preface to the 25th Anniversary Edition||15|
|An Introduction to Online Women's Health Resources||25|
|1||Taking Care of Ourselves|
|3||Alcohol, Tobacco, and Other Mood-Altering Drugs||75|
|4||Women in Motion||89|
|5||Holistic Health and Healing: Navigating Your Way to Better Health||101|
|6||Our Emotional Well-Being: Psychotherapy in Context||122|
|7||Environmental and Occupational Health||131|
|8||Violence Against Women||158|
|2||Relationships and Sexuality|
|Introduction: Sexual Orientation and Gender Identity||179|
|9||Working Toward Mutuality: Our Relationships with Men||185|
|10||Relationships with Women||200|
|3||Sexual Health and Controlling Our Fertility|
|Introduction: Deciding Whether to Have Children||263|
|12||Understanding Our Bodies: Sexual Anatomy, Reproduction, and the Menstrual Cycle||269|
|14||Sexually Transmitted Diseases||341|
|15||HIV, AIDS, and Women||359|
|16||Unplanned Pregnancies: Finding Out You're Pregnant and Deciding What to Do||378|
|18||Assisted Low-Tech and High-Tech Reproductive Technologies||420|
|22||Child-bearing Loss, Infertility, and Adoption||527|
|5||Knowledge is Power|
|23||Women Growing Older||547|
|24||Selected Medical Practices, Problems, and Procedures||590|
|25||The Politics of Women's Health and Medical Care||680|
|26||The Global Politics of Women and Health||723|
|27||Organizing for Change: U.S.A.||741|
From Chapter 4: Women in Motion
By Suzanne Bremer, based on earlier work by Janet Jones
A lot more women are out in the world moving around -- and it feels good. We are swimming, walking, dancing, jogging, power lifting, rollerblading, fencing, and hiking. We play basketball, softball, soccer, rugby, badminton, racquetball, volleyball, lacrosse. We are bowling, skiing, gardening, canoeing, wrestling, skating, rock climbing, wheelchair dancing, and sitskiing. We play tennis, football, ice hockey, golf. We are boxing, surfing, scuba diving, motorcycle racing. We practice archery, karate, yoga, tai chi, and gymnastics. We bike, skate, sail, ride horses, race cars, take aerobics, and skydive.
Women have not always exercised and done sports. Throughout history, women working on farms, in factories, and in the home doing domestic labor have led such physically demanding lives that "exercise" for its own sake has been meaningless and not really an option. During the 19th and early 20th centuries, exercise for middle-class women, for the most part, was deemed unladylike. Well-to-do women may have played golf or tennis, but they played corseted and gloved. Today, many women's lives may not be as physically demanding as the lives of our foremothers, but sedentary work is draining in its own way, and most women's lives are full of many stresses. Most of us have to work at getting the kinds of movement that a healthy body, mind, and spirit need.
Over the last 20 years, women have become more active, both because of our increased awareness of the health benefits of exercise and because the women's movement has raised our consciousness and created increased opportunities to participate in sports and exercise. Not all of us may be out there exercising all of the time -- because there are still obstacles, both internal and external -- but more of us are out there more often.
Living is moving. Even when we lie still, all is in motion inside: the blood flows, the chest expands and contracts as we breathe, we digest food and eliminate wastes. The mind is full of thoughts, ideas, feelings, dreams. It is natural to want to move externally, too. We go outside and move around. Exercise is good for many systems in our bodies. Most women with chronic health problems and disabilities such as asthma or diabetes can benefit from some kinds of exercise.
When we move vigorously on a regular basis for 20 or more minutes at a time, the heart (a muscle) gets stronger and more efficient, pumping more blood with fewer strokes. Over time, this kind of aerobic exercise -- that is, exercise that keeps us breathing hard (and thereby taking in more oxygen) while our blood is circulating rapidly increases the actual number and size of blood vessels in our tissues and so increases their blood supply. When we exercise hard, blood circulates faster through these expanded vessels, bringing oxygen and nutrients to every part of us and taking wastes away more quickly. That's why we usually feel refreshed and invigorated afterward.
WALKING FOR WELLNESS: THE NATIONAL BLACK WOMEN'S HEALTH PROJECT
Walking for Wellness, a health promotion and disease prevention program of the National Black Women's Health Project (NBWHP), was launched by NBWHP's founder, Byllye Avery, in 1992. The Walking for Wellness campaign encourages black women, their families, and their communities to take the initiative to improve and safeguard their health through their participation in an organized walking program. Goals of the Program
- To increase the number of black women and their families in walking programs.
- To support and expand walking groups
- To increase awareness of the relationship between exercise and the reduction of risk factors associated with disease and disability.
- To support women in their efforts to make lifestyle changes,
- To provide ongoing education about health promotion and disease prevention.
Walking for Wellness encourages employers to allow employees to develop walking groups and walk during working hours. Walking for Wellness provides worksite walking groups, community walking groups, and individuals with
- Education, orientation programs, group support sessions and health information sessions.
- Preselected walking sites designed for 20- to 30-minute walks, three times per week;
- Walking records so individual walkers can chart their own progress; and the opportunity to participate in the annual Walking for Wellness walkathon.
- Periodic health screening and confidential health risk appraisal, as well as ongoing program assessment.
Through a partnership with the American Heart Association and the National Conference of Black Mayors, the NBWHP held Walking for Wellness Days in Baltimore and Detroit in the summer of 1997 and will expand the program to ten cities in 1998. Walking for Wellness Days are day-long community-based, family events designed to encourage physical activity, preventive care, and health education in the community. To contact NBWHP, call (202) 835-0117 or E-mail NBWHPDC@aol.com.
Exercise has been shown to reduce hypertension (high blood pressure) and increase "good cholesterol" (see "Heart Disease, Heart Attack, Hypertension, Stroke, and Other Vascular Disorders," chapter 24, Selected Medical Practices, Problems, and Procedures, p. 644). African-American women in particular have high levels of hypertension. As a self-help strategy, the National Black Women's Health Project has created a "Walking for Wellness" program. With regular aerobic exercise, many women are able to keep their blood pressure at normal levels.
The Respiratory System
Exercising makes us breathe more deeply and regularly as more air moves rhythmically in and out of the lungs. The lungs develop a larger capacity, opening the air sacs up to the top and way down to the bottom of each lung for better gas exchange. We end up taking in more oxygen, which is essential for each cell in the body. If we practice rhythmic patterns of inhaling deeply, holding our breath, and exhaling all the air slowly, we strengthen the respiratory system while quieting the mind.
The Musculoskeletal System
Muscles increase in size when they are used regularly. Strong back and abdominal muscles are good insurance against the lower back pain that plagues so many of us these days. The abdominals also help hold the stomach and intestines in place and are critical to good digestion and elimination. Solid leg muscles get us where we are going and help the heart: when they contract, they squeeze the veins and so push the blood toward the heart, usually against the pull of gravity. Well-developed biceps and triceps muscles in the arms allow us to carry more and to perform everyday tasks with less effort and more independence. For self-defense purposes, more muscle power can sometimes help protect us. When our muscles are firm and flexible, they protect us in many ways from the stresses and strains of living. And besides, being physically strong feels good.
When we exercise, our bones get stronger, too. As muscles contract they pull on the bones, which increases bone strength over time. Also, the body lays down extra minerals in the bones along the lines of stress, decreasing our risk for osteoporosis (weakened bones due to gradual loss of calcium) later in life. If you walk or run, for example, the long bones in your legs will be gradually reinforced to meet the added pressure from your feet hitting the ground over and over again. This is true for women of all ages, even those who are postmenopausal (see also "Exercise and Growing Older," p. 93).
The Reproductive System
Far from "damaging our internal organs," as women were once taught, exercise helps them. Exercise will not hurt our breasts or cause a prolapsed uterus. in fact, the more active we are, the less premenstrual tension and painful menstruation are likely to interfere with our lives. Exercise can ease cramps, so unless we have excessive bleeding, nausea, or vomiting, we can go at it as hard as we like during this time of the month. Exercise during and after most pregnancies is highly recommended.
Those of us who run over 30 miles a week or exercise heavily in other ways may find that we menstruate less or not at all. One or more factors may be responsible: intensity of effort, length of workout, fat loss, and/or emotional stress. Amenorrhea is not healthy, particularly for young women. The hormones we produce during our menstrual cycles help to strengthen our bones and prevent osteoporosis. If you aren't menstruating, try cutting back on your workouts to see if you resume your cycles. And remember that you can become pregnant during long periods of amenorrhea.
How Exercise Makes Us Feel
Whether we hate our jobs, are involved in a difficult relationship, or simply have too much to do while we try to juggle work, family, and friends, many women in late 20th-century North America feel anxious and stressed much of the time. Stress may seem natural -- just a part of life -- but it is dangerous to our health. Tense muscles in the neck can cause splitting headaches; in the leg, charley horses; in the gut, stomachaches. Overcontracted muscles restrict breathing, slow down or even cut off the blood supply in their vicinity by squeezing the vessels shut, and actually limit our strength and sap our energy.
Exercise is not the only answer to stress in our lives (you may want to tell off your boss or practice daily meditation), but it is a great way to release tension and take some time for ourselves. You may not be "flying" after working out, but you will almost invariably feel better than you did before: calmer, less tired, more refreshed.
Due to multiple sclerosis I haven't been able to run off stress in the conventional manner for years. But I have discovered a substitute that works for me. I have a motorized scooter and when the old urge to go for a run hits me, I get on my scooter and ride at high speed around the block a few times. The fresh air on me has the "feeling" of running and is a great stress buster.
I love the way exercise makes me feel -- strong, confident, and relaxed. It is a fun activity for me, allowing me to let out tension and just go "nuts." It raises my spirit on a day when I'm feeling down and gives me a physical boost when I'm tired.
I have always bad a poor body image. I have been on some weight loss scheme or another since age ten. Exercise has given me the power to actually enjoy listening to my muscles and inner rhythms and actually enjoy watching new muscles or contours. Although I will always have weight issues, I am not obsessed with them as before.
I feel energetic, in control and fit....After exercising a huge sense of optimism overcomes me.
After a good workout, you feel that you have met your challenge for the day. And when you feel sore it is kind of good because you know it is working. The only problem is getting the energy and the motivation to get started.
Copyright © 1984, 1992, 1998 by the Boston Women's Health Book Collective
By Jane Pincus
Welcome to Our Bodies, Ourselves for the New Century! We offer first-time readers and old friends a greatly updated and expanded book that remains true to its beginnings. First published in 1970, the book grew out of a course by and for women about health, sexuality, and child-bearing. The original contributors began meeting weekly in Boston at the end of the dynamic 1960s, when women throughout the U.S. and the world were getting together to share experiences and expose the injustices in women's lives. In recounting our life stories and health care experiences, we discovered with surprise and elation that the "personal is political" -- that we were not alone in what happened to us. By pooling all we knew about ourselves, we could create a useful body of knowledge. We soon realized that forces much larger than ourselves determined the availability and quality of health and medical care, and that by working in unison and sharing our knowledge and clout, we could become a force to alter the system to meet our needs. The resulting book became a road map for women and helped to launch and sustain the national and international women's health movement, selling more than four million copies in many languages throughout the world.
Unlike most health books on the market, Our Bodies, Ourselves for the New Century is unique in many respects: It is based on, and has grown out of, hundreds of women's experiences. It questions the medicalization of women's bodies and lives, and highlights holistic knowledge along with conventional biomedical information. It places women's experiences within the social, political, and economic forces that determine all of our lives, thus going beyond individualistic, narrow, "self-care" and self-help approaches, and views health in the context of the sexist, racist, and financial pressures that affect far too many girls, women, and families adversely. It condemns medical corporate misbehavior driven by "bottom-line" management philosophy and the profit motive. Most of all, Our Bodies, Ourselves encourages you to value and share your own insights and experiences, and to use its information to question the assumptions underlying the care we all receive so that we can deal effectively with the medical system and organize for better care.
This newest Our Bodies, Ourselves has been thoroughly revised, and every chapter contains new and updated information. We have listed and critiqued online health resources for women. The chapters "Body Image" and "Sexuality" deal for the first time with issues of racism. We emphasize overwork, violence, and girls' increasing use of tobacco as major threats to women's health, and we highlight more than ever the importance of good food and exercise. We explore the new issues that arise as more lesbians choose to have children. We include transgender and transsexual issues, and discuss women living with HIV as well as the most recent safer sex advice. We explore more extensively the connections between race, class, and gender-based oppressions as they affect the health of women. We offer tools for negotiating the complex and often unregulated "managed care" system, which affects women's lives much more profoundly than men's, and discuss its advantages and disadvantages. Most important, we advocate for an equitable, single-payer national health care system.
Over these past three decades, Our Bodies, Ourselves has grown in scope and depth. From the start, the original authors have involved more and more women in its creation, adding new perspectives to each edition, expanding the "we" that appears so frequently throughout the book. This expansion has been a vital process, as the many contributing communities -- lesbians, women of color, women with disabilities, older and younger women, to mention several -- have changed in self-definition and focus.
While it is exciting that this book stays alive, growing and changing, the process of becoming more inclusive has been difficult and painful at times. For example, like many groups initially formed by white women, we have struggled against society's, and our own, internalized presumption that middle-class white women are representative of all women and thus have the right to define women's health issues and set priorities. This assumption does a great injustice by ignoring and silencing the voices of women of color, depriving us all of hard-won wisdom and crucial, life-saving information. This time around, many more women of color have been involved in creating this book, writing some of the chapters, and editing and critically reading every chapter. During this process, tensions sometimes arose about what to include or leave out and how to frame certain issues. The resulting vigorous discussions have greatly enriched the book's content. But as in any organic process, some conflicts still remain to be resolved.
Those of us who worked on the original edition are now in our 50s or older. Some of us have made the politics of women's health our lives' work. To continue the book's long history and to ensure that it remains up-to-date, hundreds of women -- including "ordinary" women, community organizers, social scientists, student interns, friends, health activists, and medical professionals -- have contributed to this edition. Many women who were not yet born when the first edition of Our Bodies, Ourselves was published -- including some daughters of Health Book Collective members -- have shaped the book significantly with their voices and experiences. More than ever before, the staff of the Women's Health Information Center has anchored our research efforts, responding to readers, gathering and documenting health information, participating in national and international women's health endeavors, and strengthening the women's and documentation center movements.
Despite the achievements of the larger women's health movement, it is clear that the same forces that created the need for Our Bodies, Ourselves twenty-nine years ago exist today. Disparities in health continue to grow. Determinants of poor health, such as poverty, homelessness, and hunger have worsened, disproportionately affecting communities of color, non-English-speaking women, and women with low incomes in this country and throughout the world. The medical system remains a vast business more tightly connected than ever to drug and medical supply corporations, and increasingly controlled by larger national and international profit-making industries. As "consumers" we must still fight for control and accountability in health plans. Industries continue to pollute water, land, and air. Our increasingly conservative national government embraces the wishes and demands of business interests while seriously reducing or eliminating crucial federal funds for programs dedicated to maintaining and improving our health and lives. Welfare "reform" is causing even more anguish for immigrants and mothers with low incomes.
Thus, as the millennium approaches, our original goals for this book remain as important to us as ever: to fit as much information about women's health between the covers of this book as we can, providing women with tools to enable all of us to take charge of our health and lives; to support women and men who work for progressive change; and to work to create a just society in which good health is not a luxury or a privilege but a human right.
One of the most valuable things we did in our early years together was to talk in small groups about our lives. In doing so, we were reclaiming an important part of our common heritage as women who have always, in traditional communities, achieved wisdom by exchanging experiences with one another. We encourage you to meet together, to speak out and listen to one another, and to learn from one another. We recognize that in these times, more women must work harder than ever before and have very little time left over, even for our families. See what you can do close to home, in your living rooms, in your communities. Seek each other out at church, synagogue, or mosque; at the YWCA; at a nearby women's center; and at informal gatherings. Find ways to support the work of nonprofit groups whose efforts you value. Talk together and organize around crucial issues. Fighting back can be good for you and can feel good, too!
We gain political strength by identifying what we have in common, respecting the special needs of each group, and standing in unity. Despite everyone's efforts, this unity remains fragile. We are still evolving ways to form communities that will stand in solidarity with one another. Too often, differences in race, class, ethnicity, financial circumstance, sexual orientation, values, strategies, and degrees of power make it difficult to listen to one another, and these differences divide us. By telling the truth about our lives, women with dissimilar backgrounds and experiences make it more possible for every woman's voice to be heard and for every woman's life to be nurtured. To transform the world into a healthy place we need the energy of all women.
While the information contained in Our Bodies, Ourselves will hopefully empower you and give you useful tools and ideas, this book is not intended to replace professional health and medical care.
The Boston Women's Health Book Collective is a nonprofit organization devoted to education about women and health. Our many projects and services include a Women's Health Information Center; extensive distribution of free materials to women and organizations in the United States and other countries; several midwifery and reproductive health projects; assistance for women in other countries to develop their own translation/adaptions of Our Bodies, Ourselves; and a speakers bureau. Royalties income from the sale of Our Bodies, Ourselves is not sufficient to support our work. Therefore, the Collective continually needs additional funding from contributions and grants. Tax-deductible donations (made payable to BWHBC) are welcome. Send to Box 192, West Somerville, MA 02144. Thank you.
Copyright © 1984, 1992, 1998 by the Boston Women's Health Book Collective
Posted March 24, 2005
Very excited to hear that the new edition is on its way. This is a book I read cover-to-cover as a young adult, again in my mid-thirties and now, am referring to again as I wrestle with peri-menopause. Invaluable.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted November 16, 2004
This book was truly revolutionary. I read it as a girl and learned so much. Very informative and much much more. I insist on having my daughter read the same book. So ill be running to purchase the new book today for her.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted September 13, 2002
This is the book my mother purchased for me at age 12. It was better than sitting down and having an awkward discussion. Not only does this cover the facts of sexual development but also help with the emotional aspects that go along with it that all of us had trouble with. Plus I was better educated than all my friends ( I knew better than to believe some of the garbage facts that people/kids make up or pass around)Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted December 7, 2001
I have the original edition of this book and continually give it to my young women friends. This book helped me understand who I was in the sixty's and continues to be a great referance. Wonderful book for any woman!!Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted March 16, 2001
Comprehensive book about everything you need to know about what's going on in your body. Great book for young women discovering their bodies and all the health issues that go with it.Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.
Posted August 14, 2000
I owned this book as as a teen, it changed my life! Well almost, I grew up in a household where sexuality, menstruation, etc. was NOT discussed--EVER! It really helped my to understand alot about the physicall and emotional aspects of being a women!Was this review helpful? Yes NoThank you for your feedback. Report this reviewThank you, this review has been flagged.