By Maxine Dovere
Women’s health directly impacts over half the world population, and, by natural extension the rest of world. American Friends of Soroka Medical Center recently sponsored a provocative forum – “Enhancing Women’s Health” – discussing issues ranging from the achievement of successful pregnancy, to the debilitating effects of osteoporosis, and wider issues around aging. Presenters were Dr. Ethel Siris and Dr. Asher Bashiri. Dr. Rebecca Amaru, a New York gynecologist and obstetrician, moderated.
Dr. Ethel Siris of New York-Presbyterian, a recognized expert on Osteoporosis who works in cooperation with Soroka Medical Center in Be’er Sheva, Israel, described osteoporosis as a silent condition that leads to easily broken bones. “Some fractures heal, some fractures make (you) shorter,” she cautioned. Noting that “bones change throughout life,” she cautioned that women suffer rapid loss of bone when the production of estrogen ceases post menopause. “Not only is there less bone, but the quality is altered, and falls can break a major bone.”
“Ethnicity and gender are important,” shared Dr. Siris. “Woman with darker pigments face a lower risk than do lighter skinned Ashkenazi women.” Other isk factors include diet, exercise – or, the lack of it – smoking, and alcohol consumption.
Dr. Siris discussed the use of calcium supplements and vitamin D: “Deficiency leads to the body taking calcium from the bones.” She stressed that a bone density test is “critical” to diagnosing osteoporosis. Both women (after 65) and men (after 70) should be tested.
Key factors to prevent fractures include carefully monitored medical treatment using antiresorptive and/or anabolics to “stimulate the formation of new bone.” Adequate calcium and vitamin D, better gotten from food than supplements where possible, are important.
Soroka Medical Center’s Dr. Asher Bashiri, Professor of Obstetrics and Gynecology, a specialist in Recurrent Pregnancy Loss, and part-time author at HMHB, held the rapt attention of his audience. RPL is an often hidden issue affecting women across all demographics.. Even the medical and clinical terms used to designate this loss have changed, he said. “The term ‘abortion’ is no long used to describe miscarriage.”
The point of delivery at which a baby has a chance of surviving is approximately 24 weeks. Fifty percent of miscarriages are explainable: genetic abnormalities – often related to maternal age, endocrine issues, thrombosis in the fetus, or maternal anatomy. The remainder have causes not yet known. “After two incidents, we consider this a disease.”
“Don’t wait to get treatment; it will be worse.” The doctor noted that “many first miscarriages are considered part of the cycle of normal pregnancy. If the all other factors are normal, the miscarriage could have occurred because of abnormality in the fetus.”
Dr. Bashiri is a renowned expert on the use of ultrasound as a subtle diagnostic tool. He noted that Vitamin D deficiency, a factor in later-life osteoporosis, can also affect the stability of a pregnancy. Maternal obesity also increases the chance for pregnancy loss. Recurrent Pregnancy Loss, while physical, can also give rise to understandable mental health issues , especially anxiety and depression.
Dr. Bashiri has been an influential proponent of the development of the World Congress on Recurrent Pregnancy Loss. Representatives of 60 countries attended the most recent forum, ranging from Italians to Iranians to Israelis – using just one letter in the alphabet of nations.
“Do research, don’t just talk.” he said. “Educate.”
Throughout his presentation, and in the intimate one on one conversations that followed, the doctor’s professionalism, knowledge and menchlekeit – depth of humanity – were clearly visible. Dr. Bashiri believes in the science of medicine, and the art of medical hope. In informal, yet extremely informative post lecture conversations, his depth of understanding, empathy, and medical expertise were displayed as he advised a victim of multiple miscarriages on medical possibilities, and humane considerations. “Don’t stop living,” he counseled.
He prescribed enjoyment, caring, relaxing, and keeping one’s confidence – not discussing the details of every aspect of the quest to create life with a wide range of family or friends. He stressed the need for medical excellence, awareness, and use of the most current advances in the treatment of RPL.
“Has your husband cried with you?” he gently asked, as a tear fell across a young woman’s cheek. “That is important.”