From
the time she first got her period at 13, Andreas, now 30, had experienced
crippling cramps. By her early 20s, she was in pain nearly half the month,
accompanied by heavy bleeding. A series of doctors diagnosed harmless ovarian
cysts, which appeared and disappeared with each cycle. Beyond upping her
dose of pain relievers, they could offer little help.
In spite of the medication,
Andrea doubles over in agony at work three years ago. "It was horrible.
I had to cut short a session with a client and rush to a doctor, who examined
me and did a sonogram," she recalls," I had these before, but this one
finally indicated that I had advanced endometriosis" ( a disease where
fragments of the uterine lining grow in other parts of the pelvic cavity).
She immediately under went laparoscopic surgery to remove several large
endometrial cysts.
Andrea's mother had
part of one ovary removed because of a cyst and wondered if she, too, had
suffered from endometriosis. She obtained copies of her decades-old medical
records, and Andrea's surgeon confirmed that her mother's cyst had been
endometrial. No coincidence : endometriosis is often passed from mother
to daughter.
After surgery Andrea
began taking birth control pills to help keep the disease in check, and
she's been relatively free of pain since. But she can't help wondering
how much of her suffering could have prevented if her doctors had been
aware of her mother's health history, recognized her increased risk and
identified her disease earlier. "Endometriosis is not always an easy diagnosis,"
says Dr L.Russell Malinak, professor of obstetrics and gynaecology at Baylor
College of Medicine in Houston. "It can't be confirmed without laparoscopy
- passing a lighted tube in the abdomen. So it's very helpful when a woman
informs her doctor that her mother had endometriosis. Knowing the mother's
history alerts the doctor to an increased risk."
Scientists are learning that more and more of our health is inherited, from harmless traits to deadly diseases. And anecdotal evidence from doctors verifies the link between our mother's health and our own.
If your mother had breast cancer or ovarian cancer, chances are you know about it and realize that you should take preventive steps and remain vigilant about screening. But cancer is not the only illness with a strong mother-daughter health link. Here are the questions you need to ask about your mother's medical history, and what her answers mean to your future health.
1) DID your mother have a difficult
pregnancy?
While not all aspects
of pregnancy are inherited, asking your mother this question may give you
clues about what you can expect. For instance, the size of your pelvis,
including the shape of the birth canal, may come from your mother. These
structures can determine whether your delivery will be easy or arduous,
vaginal or Caesarean.
Obstetricians who
have practised for decades say they've observed the mother - daughter link,
"I've taken care of a good number of mothers and daughters, and there can
be distinct similarities in how the uterus contracts," says Dr Robert J.
Sokol, professor of obstetrics and gynaecology at the Wayne State University
School of Medicine in Detroit. "Pre maturity and going past term can run
in families, too." Such knowledge of family history can help doctors head
off potential complications.
What about the various
side effects of pregnancy?
"Varicose veins are
definitely hereditary," says Dr Gloria Bachmann, chief of obstetrics and
gynaecology service at Robert Wood Johnson University Hospital in New Jersey.
"If your mother had a real problem with them, then you should wear support
hose and keep your legs elevated." Regular exercise during pregnancy, such
as taking daily walks, may also keep varicose veins at bay.
Weight gain and morning
sickness are wild cards, however. "If you put on 20 kg during pregnancy,
there's no way to tell whether it's due to heredity, the pregnancy or just
how much you ate," says Br Bachmann. Nausea varies dramatically from pregnancy
to pregnancy.
2) DID your mother have endometriosis?
Scientists still can't
pinpoint the cause of endometriosis, but they have identified a hereditary
component. "If your mother - or a sister - had endometriosis, your risk
is increased to about seven percent, as opposed to two to three percent
fro the general problem," says Dr Malinak.
There is no proven
prevention for endometriosis, which can cause pelvic and back pain, discomfort
during intercourse, abnormal uterine bleeding and, in severe cases, bladder
and bowel problems, cysts and, possibly, infertility. But based on experience
more than on scientific studies, physicians believe that taking birth control
pills - which block ovulation and reduce menstrual flow - can help ease
symptoms and prevent the disease from progressing. Women who learn of their
mother's endometriosis ( which is usually negligible after menopause) should
consider the use of oral contraceptives.
3) DID your mother have uterine fibroids?
Fibroids - benign growths
in or on the uterus - are extremely common. "If you studied 10,000 women,
you'd probably find that 70 to 80 percent of them have fibroids," says
Dr Malinak. Many women never know they have this condition because their
fibroids cause no symptoms, but sometimes they grow large enough to cause
pelvic pain and heavy menstrual bleeding.
Dr Malinak explains
the genetic link: "Research has found that women whose mothers (or sisters)
were diagnosed with fibroids had a substantially increased risk of developing
them."
Tell your doctor if
your mother had severe fibroids. It may be wise to be screened for uterine
enlargement - part of a regular pelvic exam - every six months, instead
of yearly, during your 20s through your 50s, when fibroids are most common.
"The earlier you diagnose and treat fibroids the more likely you are to
prevent major damage to the uterus," says Dr Malinak, The various treatments
entail risks and side effects that you should discuss with your doctor,
but all options are less complicated when growths are smaller.
4) WHEN and how did your mother go through menopause?
"The age which a woman
begins menopause is very predictable from her mother," says Dr Lila E.Nachtigall,
author of What Every Woman Should Know - Staying Healthy After 40.
"The reason you go into menopause is that you run out of eggs, and the
number of eggs you have seems to be inherited from your mother." (If your
mother smokes, it may skew this connection, however, since smokers can
hit menopause as many as eight years earlier.)
Menopause symptoms
may also be inherited, gynaecologists note. "You're at greater risk for
difficulties like hot flashes, night sweats and insomnia if your mother
had them," says Br Bachmann, "because a lot of these symptoms have to do
with how your body handles oestrogen."
Alert your doctor
if your mother had a difficult menopause. Starting hormone-replacement
therapy early - when you first begin to skip periods - may help.
5) IS your mother's skin very wrinkled?
"One of the best ways
to forecast the wrinkling of your skin in the long run is to look at your
mother," says Dr Darrell S. Rigel, associate professor of dermatology at
New York University. "Your father's face isn't as predictive, because testosterone
makes male facial skin thicker and tougher."
Genetics is one factor,
but sun exposure will leave you with wrinkles as well. "If you're genetically
susceptible to wrinkles and get a lot of sun, you're going to age more
visibly than your mother did," says Dr Rigel. "If, on the other hand, you
might not become as wrinkled." Women who have reason to worry about wrinkling
can also minimize creases by not smoking.
6) Does your mother have a weight problem?
Scientists have yet
to isolate a weight gene, but genetics appears to play a role: Studies
comparing identical twins who have been raised separately found that these
siblings tend to maintain similar weights, no matter where or how they
were raised. A tendency to be overweight often runs in the families.
Many scientists believe
that genetics contributes to both how fat you are and your body shape.
"Patterns of growth, such as the age at which one becomes fatter or thinner,
can be inherited," explains Dr Michael Rosenbaum, assistant professor at
Rockefeller University in New York City. "For example, if your Mum suddenly
gained 5 kg when she turned 35, you might also gain weight at about the
same age."
Physicians still debate
how much a tendency towards fat is due to genetics and how much is due
to environmental factors like eating habits you learn from your family.
You may be able to counteract an inherited predisposition towards weight
gain with a healthy diet and regular exercise.
7) Does your mother suffer from heart disease?
Heart disease is the
leading cause of death in women, Coronary disease tends to run in families
and displays a definite mother-and-daughter-link. "The strongest hereditary
risk factor for a woman is having a mother or sister who developed coronary
disease prior to age 55, pre-menopausally," says Dr Mary Ann Malloy, spokeswoman
on women and heart disease for the American Heart Association. (Women whose
fathers had heart disease before age 45 are also at increased risk.)
"It's estimated that
you can manipulate your destiny anywhere from 50 to 80 percent by changing
your lifestyle and modifying your risk factors," says Dr Malloy. Preventive
measures include keeping overall cholesterol and LDL (bad cholesterol)
levels low through a low-fat diet; keeping HDL ( good cholesterol) levels
high; exercising regularly; avoiding smoking and maintaining a healthy
body weight.
If you have a family
history of heart disease, you should take symptoms such as chest pain very
seriously. Have a treadmill test around menopause if you carry additional
risk factors like high cholesterol, high blood pressure or smoking.
8) Could your mother have diabetes?
US diabetes expert
Dr Frank Vinivor, says "In one study, 33 percent of the people diagnosed
with type II diabetes (adult onset) had a mother with diabetes, and 17
percent had a father with it. So your chances of having it are doubled
if your mother had it."
Also, if your mother
had a large baby (over 4 kg), as this may indicate that she had gestational
diabetes, which predisposes her to developing Type II diabetes later.
If you're at risk,
there are steps you can take. Experts say, if you have a family history
of diabetes but control your weight and stay active, you may be able to
avoid the disease.
9) Does your mother (or grandmother) have osteoporosis?
"If a woman sits in
my office and tells me that her mother had osteoporosis and lost six inches
of height, I know that woman has to be treated for prevention," declares
Dr Nachtigall. If your mother is too young to show signs of osteoporosis,
you can get clues about your risk by looking at your grandmothers, especially
your maternal grandmother.
Many of the risk factors
for osteoporosis can be inherited, including early menopause , fair skin,
delicate bone structure and general thinness. A study at the University
of North Carolina, Chapel Hill, compared the bone mass of college-age women
with their mothers and found that heredity plays an overwhelming role in
how much bone the young women had accrued. But women at risk for osteoporosis
can take meaningful steps to protect themselves. Dr Wulf Utian , director
of obstetrics and gynaecology at University in Cleveland, recommends the
following: "Plenty of weight-bearing exercise - like jogging or aerobics
classes at least three time a week - and a diet high in calcium are critical."
10) Does your mother have problems with bladder control?
Women can inherit from
their mothers the strength of their pelvic musculature and the tightness
of their ligaments. Both characteristics can predispose them to stress
incontinence (loss of urine during physical stress like coughing, laughing
or exercise).
"If your mother had
incontinence, it's not inevitable that you will," says Dr Sokol, but you
should talk to your gynaecologist if you begin having problems. She will
probably recommend a routine of Kegel exercises (tightening and loosening
the muscles that control urine flow) and frequent bladder emptying.
11) HAS your mother suffered from depression?
"Major depression tends
to affect women more than men," says Dr Marlene E. Casiano, spokeswoman
for the American Psychiatric Association. "And having a first-degree relative,
such as your mother, with depression increases your risk of experiencing
it one-and-a-half to three times."
"I've treated mothers
and later their daughters, for depression," she continues."Often there
are similarities in their illnesses: for instance, the age at which they
first cecame depressed is the same."
For both sexes, depression
usually strikes in the 20s, so women whose mothers have battled this disease
may want to be vigilant from a young age, "Genetics makes a woman more
susceptible to depression, but often, the first episode won't occur until
she is under stress, say, when she goes to college or faces a divorce,"
says Dr Casiano. If you feel you are vulnerable to depression, take extra
care during high-pressure moments and major life changes, and don't hesitate
to contact a counsellor or psychiatrist for an assessment.
A mother's depression
may also provide valuablle clues about her daughter's treatment. "If you
know which medication she responded to, there's a good chance you'll respond
to it as well."
Another high-risk
period is during pregnancy and after childbirth. "If a woman's mother had
severe postpartum depression, she may need to look at preventive treatments,
such ascounselling, during pregnancy," says Dr Mary C. Blehar, cheif of
mood, anxiety and personality disorders research branch of the National
Institute of Mental Health. "And those who become depressed can safely
take certain medications soon after giving birth."
Scientists continue
to research family risks, but we know enough to take charge of our health.
Just as important, we can someday pass along this knowledge to our own
daughters, ensuring that the mother-daughter health link endures, not as
a chain of illness but as a strong line of positive habits passed down
the generations.
If Your mother had Breast Cancer or Ovarian Cancer ...
If she had breast cancer ...
Article Source - CLEO JANUARY 1999.