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WOMEN’S HEALTH ISSUES AND DANGEROUS PRODUCTS

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Women have a unique set of health challenges that are influenced in large part
by the hormone changes that occur throughout their lives. The reproductive cycle
can take a toll on a woman’s body, even if she never has children. Women have
longer lifespans, stronger immune systems, and better trauma survival rates than
men. They are also more likely to visit their doctors and participate in
preventive health screenings. Yet they spend 15% of their lives in poor health,
compared with just 12% for men, and they are more likely to be diagnosed with
many chronic health conditions. While women’s proactive approach to healthcare
is wise, it does not always work in their favor. Pharmaceutical companies have a
history of pushing products for women that are not safe or effective and failing
to provide the proper warnings about potential risks. Additionally, clinical
drug trials are often performed with only male participants, resulting in
overmedicating and adverse reactions in women.


WOMEN AND CANCER

Cancer was the second-leading cause of death among adults in the United States
in 2020, leading to 284,619 female deaths. The American Cancer Society estimates
that 934,870 females will be diagnosed with cancer in 2022.


BREAST CANCER

Breast cancer is the most common form of cancer among American women, accounting
for 30% of new cancer diagnoses in women. Approximately 1 in 8 women develops
invasive breast cancer over the course of a lifetime. If the current trend
continues, 287,850 new cases of invasive breast cancer and 43,250 deaths are
expected in 2022.


Breast cancer risk factors:
 * Being a woman
 * Race/ethnicity
 * Age
 * Family history and genetics
 * Lack of pregnancy or first pregnancy after age 30
 * Lack of breastfeeding history
 * Onset of menstruation before age 12 or completion of menopause after age 55
 * History of hormone replacement therapy, especially combination (progesterone
   and estrogen) therapy

 * History of use of products containing dibutyl phthalate, an endocrine
   disruptor used in many medications and cosmetics
 * Radiation exposure
 * Dense breasts
 * Lack of exercise
 * Smoking
 * Alcohol consumption
 * Poor diet
 * Obesity

Breast cancer tends to spread to the lymph nodes and then to other parts of the
body. This makes early detection an important factor in the prognosis. During
the early stages of cancer, tumors are small, and cancer is confined to the
breast tissue and nearby lymph nodes.

During the later stages, tumors get larger and spread to an increasing number of
lymph nodes and ultimately to other organs.

The earlier the stage of cancer at the time of diagnosis, the higher the
survival rate. Stage 0 cancer (precancer) and stage 1 cancer have 100 percent
five-year survival rates. The survival rate for stage two cancer is 93 percent,
but it drops to 72 percent for stage 3 and just 22 percent for stage four.


TAMOXIFEN

Most breast cancer cells have hormone receptors for estrogen or progesterone.
These hormone-positive cancers begin in the milk ducts or lobules.
Tamoxifen is a drug used to prevent or treat estrogen-positive breast cancer by
blocking estrogen production. It can be prescribed to postmenopausal women and
premenopausal women over age 35.

Side effects include the following:
 * Hot flashes
 * Irregular periods
 * Spotting between periods
 * Leg cramps
 * Vaginal discharge, dryness, or itching

Tamoxifen is not without risks:
 * Blood clots (deep venous thrombosis) in the large veins
 * Blood clots in the lungs (pulmonary embolism)
 * Cancer of the uterus or lining of the uterus
 * Cataracts
 * Stroke

Other widely used breast cancer drugs include:
 * Raloxifene is an alternative to Tamoxifen that is less effective but has
   fewer side effects.
 * Taxotere is a popular chemotherapy drug that has had unexpected side effects,
   resulting in lawsuits:

 * Permanent hair loss
 * Vision loss


OVARIAN CANCER

Ovarian cancer is the deadliest reproductive cancer in women. It impacts one in
78 women. The National Cancer Society estimates that 19,880 women will be
diagnosed with ovarian cancer in 2022, and 12,810 will die.

When ovarian cancer is diagnosed at an early stage, the five-year survival rate
is 94%. Unfortunately, only 20% of ovarian cancer cases are diagnosed early.
Women rarely experience symptoms during the early stages, and there are no
reliable early screening tests.




TALCUM POWDER LINKED TO OVARIAN CANCER

Many cases of ovarian cancer can be attributed to asbestos exposure through
contaminated talcum powder. Talcum powder was the main ingredient in Johnson &
Johnson’s Baby Powder and Shower to Shower. Johnson & Johnson advertised these
products as feminine hygiene products.
Talcum powder is made from talc, a mineral often found in close proximity to
asbestos. This means the risk of contamination is common. When Johnson & Johnson
discovered their products were contaminated, they concealed the information and
continued promoting them.


Studies have found a direct link between these products and ovarian cancer, even
when they were not used for feminine hygiene. Johnson & Johnson has paid
billions of dollars in thousands of lawsuits and no longer offers talc-based
products in the United States.


CERVICAL CANCER

Cervical cancer was once the most common cancer death in women, but thanks to
the widespread availability of early screening, it is almost always caught
during the pre-cancer stage. The American Cancer Society anticipates 14,100 new
cases and 4,280 deaths from cervical cancer in the United States in 2022.


The most significant risk factors include:

 * Multiple sex partners
 * Unprotected sex
 * Smoking
 * Exposure to human papillomaviruses (HPV)




HPV

Human papillomaviruses are a group of viruses, most of which cause warts or
non-cancerous tumors (papillomas). These affect the mucous membranes, especially
around the vagina, anus, cervix, vulva, inner nose, mouth, throat, trachea, and
inner eyelids.

It spreads by physical contact with the affected area, especially sexual
contact. High-risk types of HPV can cause cervical cancer. Although less common,
cancers of the throat, vulva, vagina, mouth, and throat may be attributable to
HPV. The Gardasil 9 vaccine can prevent HPV when administered early in life,
either as a series of two injections in children ages nine to 12 or as a series
of three injections in young adults ages 13 to 25. The vaccine is most effective
when administered at a young age. It is not recommended for adults over the age
of 26.


EARLY DETECTION

Regular health screenings can detect cervical cancer and HPV. Women over the age
of 21 should schedule PAP smears and HPV tests periodically as recommended by
their physicians. These tests are usually necessary only once every three to
five years.


OTHER TYPES OF CANCERS

Cancers Caused by Zantac
Ranitidine, sold under the brand Zantac, was a widely used antacid that was
contaminated with N-nitrosodimethylamine (NDMA), a known carcinogen.
Consequently, it has been linked to gastrointestinal cancers, including cancers
of the following:
 * Stomach
 * Larynx
 * Pharynx
 * Anus

 * Intestines
 * Liver
 * Gall bladder
 * Pancreas


Lung Cancer
Previously thought of as a man’s disease, the incidence of lung cancer in women
is rising at an alarming rate, with an 84% increase among women over the last 42
years. Smoking is the most significant factor, but 20% of women diagnosed with
lung cancer have no smoking history. There are no behavioral explanations for
the increase in lung cancer in women. Exposure to the following substances has
been linked to a higher risk of lung cancer:
 * Tobacco smoke
 * Secondhand smoke
 * Radon (leading cause of lung cancer in non-smokers)
 * Asbestos exposure
 * Exposure to workplace hazards, such as industrial chemicals and diesel
   exhaust
 * Air pollution
 * Angiotensin-converting enzyme drugs (ACEIs), a class of drugs commonly used
   to manage high blood pressure

Family history is also a significant risk factor for lung cancer.


REPRODUCTIVE HEALTH

Women face many decisions regarding their reproductive health, from
contraception to hormone management. Too often, women are deprived of the
information they need to make informed choices. Thus, they ultimately sacrifice
their health to prevent unwanted pregnancies and treat reproductive issues.


BIRTH CONTROL


Although condoms offer a safe, effective method of contraception while also
protecting against sexually transmitted infections, many women prefer
alternative methods. Most of these require women to assume associated health
risks. Unfortunately, pharmaceutical companies have not always been transparent
about these risks.
Oral contraceptives
Yaz and Yasmin
What is it?
 * Oral contraceptives produced by Bayer Corporation
 * Contain drospirenone, a type of synthetic progesterone (progestin), which is
   different from the form used in other oral contraceptives
 * Contain Ethinyl estradiol, a synthetic estrogen

Ortho-Evra
What is it?
 * A contraceptive patch that delivers hormones transdermally

Intrauterine Device (IUD)
What is it?
 * T-shaped contraceptive device placed into the uterus through the cervix

NuvaRing
What is it?
 * A clear, flexible contraceptive “ring” that is inserted into the vagina
   monthly for three weeks and releases contraceptive hormones

Depo Provera
What is it?
 * An injectable contraceptive that is administered every three months




ENDOMETRIOSIS

Endometriosis occurs when tissue that is similar to the lining of the uterus,
the endometrium, grows outside the uterus.


This tissue may grow on the ovaries or fallopian tubes, and, less commonly, in
the vagina, bowel, bladder, or rectum. Rarely, growths may also appear in other
parts of the body, including the lungs, brain, and skin.


Although the growth is non-cancerous, it can cause severe symptoms, including
pain, inappropriate menstrual bleeding, digestive issues, and infertility.

No one knows what causes endometriosis, but links with the following events have
been established:
 * Retrograde menstrual flow
 * Genetic factors
 * Immune system disorders
 * Hormones imbalances, especially involving estrogen
 * Surgical errors

There is no cure for endometriosis, but it can be controlled in some cases with
hormonal contraceptives, including oral contraceptives and IUDs.


PREGNANCY

Women’s bodies change significantly during pregnancy to accommodate the needs of
both the mother and the growing fetus. Hormone levels fluctuate in the mother
while the fetus receives nourishment from the mother’s blood supply via the
placenta. During this time, common medications can cause miscarriages and birth
defects.

The following medications have been shown to cause miscarriages:
 * Ibuprofen
 * Isotretinoin (an acne medication)
 * Ergotamine and methysergide (migraine medications)
 * Natalizumab (an MS medication)
 * Antithyroid medication
 * Certain vitamins and herbal preparations
 * Methotrexate (a rheumatoid arthritis drug)

The following medications are known to cause birth defects:
 * Thalidomide
 * DES (Diethylstilbestrol)
 * Accutane (isotretinoin)
 * Aspirin
 * Ibuprofen
 * Naproxen
 * ACE inhibitors used to treat hypertension

 * Statins
 * Many antibiotics
 * Benzodiazepines
 * Warfarin
 * Certain antiseizure medications
 * Certain antidepressants
 * Psychiatric medications

Women who are pregnant or thinking about becoming pregnant should check with
their doctors prior to starting any new medication, vitamin, or herbal
therapies.


BREASTFEEDING

While breastfeeding is widely regarded as the healthiest feeding system for
infants, it is contraindicated in some circumstances:

 * The infant is diagnosed with galactosemia, a rare genetic disorder that
   causes a strong intolerance of lactose, including the lactose in breastmilk.
 * The mother is diagnosed with any of the following contagious viruses:

 * Permanent hair loss
 * T-cell lymphotropic virus Type I or Type II
 * Ebola virus disease

 * The mother is using illicit street drugs
 * The mother is infected with brucellosis, an infectious disease caused by
   bacteria, usually as a result of contact with infected animals or animal
   products
 * The mother has an active herpes virus infection with lesions on the breast
 * Any drugs or medications that shouldn’t be taken during breastfeeding
 * The mother is undergoing radiologic exams or treatments

Breastfeeding mothers can take most medications without adverse effects.
Medications can end up in breastmilk, some in larger concentrations than others.
In many cases, the impacts of medications are still unknown.
The following medications could reach the breastmilk in higher concentrations or
otherwise cause harm to the infant:
 * Many psychoactive drugs, including drugs that treat depression, anxiety, and
   psychosis
 * Drugs for smoking cessation
 * Illegal drugs
 * Codeine
 * Narcotic drugs, especially oxycodone
 * Certain herbal preparations, especially St. John’s wort and fenugreek


MENTAL HEALTH

Women are nearly twice as likely as men to be diagnosed with anxiety and
depressive disorders.


DEPRESSION

Symptoms:
 * Chronic sadness, guilt, or hopelessness
 * Weight changes
 * Sleep-pattern changes
 * Difficulty concentrating
 * Physical pain
 * Suicidal thoughts
 * Loss of interest in life activities
 * Fatigue
 * Overwhelm, lack of motivation

Common medications:
 * Selective serotonin reuptake inhibitors (SSRIs)
 * Serotonin-norepinephrine reuptake inhibitors (SNRIs)
 * Tricyclic Antidepressants (TCAs)
 * Monoamine oxidase inhibitors (MAOIs)

Contributing Factors

Puberty
Premenstrual syndrome (PMS)
Pregnancy
Postpartum depression
Menopause
Life circumstances and culture


ANXIETY

Types
 * Generalized anxiety disorder
 * Obsessive-compulsive disorder
 * Panic disorder
 * Post-traumatic stress disorder
 * Social anxiety

Medications for anxiety
 * Benzodiazepines
 * Buspar
 * Beta-blockers (high blood pressure medications)




PELVIC FLOOR DYSFUNCTION

The pelvic floor muscles support the internal organs. These muscles can weaken
due to childbirth, age, menopause, chronic coughing, nerve injuries to the lower
back, and obesity.


PELVIC ORGAN PROLAPSE (POP)

Pelvic organ prolapse occurs when the bladder or uterus drops into the vagina
due to the weakening of the pelvic floor muscles. Some cases of POP can also
involve the rectum. It affects 3% of women in the United States.


Treatment options include the following:
 * Pessary - a removable device inserted through the vagina to support the
   pelvic organs
 * Lifestyle changes, such as pelvic floor exercises and changing eating habits
 * Surgery to implant a supportive sling made of the woman’s own tissue, donor
   tissue or surgical mesh


STRESS URINARY INCONTINENCE (SUI)

Stress Urinary Incontinence occurs when urine leaks during activities that place
sudden stress on the bladder and urethra. This causes the muscles to open
slightly, allowing the leakage. In mild cases, activities like sneezing,
jumping, exercising, and coughing can trigger a leak. In severe cases, merely
standing up can trigger leaks.

SUI is caused by a weakening or stretching of the pelvic floor muscles.
Treatment options include:
 * Lifestyle changes

 * The use of absorbent pads
 * Kegel exercises (pelvic floor exercises)
 * Increasing fiber to improve bowel function, as constipation can worsen
   incontinence
 * Maintaining a healthy weight
 * Bladder training
 * Quitting smoking

 * Devices

 * Vaginal pessaries
 * Urethral plugs to be used during periods of high activity
 * Surgical slings placed under the urethra, most commonly the mid-urethral
   sling, made of body tissue, donor tissue or surgical mesh


COMPLICATIONS FROM TRANSVAGINAL MESH

Surgical mesh is a net-like material that has been used in the treatment of
abdominal hernias since the 1950s. It can also be used in heart stents. During
the 1970s, gynecologists began using it to treat pelvic floor disorders,
including POP and SUI, by implanting it through abdominal surgery.


In the 1990s, practitioners developed a less invasive approach of insertion
through a small incision in the vagina. Mesh implanted in this manner is known
as transvaginal mesh, a method that received FDA approval in 2002.


Implanting transvaginal mesh requires specialized surgical skill, but the
product was marketed heavily to gynecologists who may have lacked these skills.
While mesh inserted surgically through the abdomen has not resulted in
widespread complications, transvaginal mesh has caused the following:

 * Infections
 * Return of prolapse
 * Worsening incontinence
 * Vaginal scarring
 * Perforation of pelvic organs
 * Erosion and dropping away of the mesh from the site, resulting in protrusion
   from the vagina

Surgery is urgently needed for these complications. It requires even more
specialized skill because often the vaginal tissue has grown into the mesh, and
the separation process is delicate and complex.


The FDA recalled transvaginal mesh in 2019. The FDA estimates over 300,000 women
were implanted with vaginal mesh. Over 650 lawsuits are pending.


Surgical mesh implanted through the abdomen and mid-urethral slings are
considered safe and are not part of the recall or the litigation.


URINARY TRACT INFECTIONS (UTIS)

Urinary tract infections are infections of any of the urinary system organs,
which include the bladder, urethra, and kidneys. Most infections involve the
bladder and urethra. UTIs are more common in women than in men.

UTI Symptoms
 * Constant urge to urinate
 * Burning sensation during urination
 * Strong-smelling urine
 * Pain in the center of the pubic bone
 * Red, pink, or brown urine, indicating the presence of blood
 * Cloudy urine

Symptoms of kidney infections are more serious and include:
 * Back or side pain
 * High fever
 * Nausea and vomiting


CAUSES AND RISK FACTORS

UTIs are most commonly caused by bacteria entering the urinary tract. Women
experience a higher risk due to the close proximity of the bladder and urethra
to the anus and vagina. Bacteria from sexual contact, the gastrointestinal
tract, or sexually transmitted infections can enter the urethra and cause
infections.


Hormonal changes during menopause and birth control methods involving diaphragms
and spermicides also increase women’s risk of developing UTIs. Other risk
factors include catheter use, diabetes, and urinary tract abnormalities.


Urinary tract infections may not cause the same symptoms in elderly adults and
can be difficult to identify. For example, mental confusion that mimics dementia
is a common UTI symptom in elderly adults.


TREATMENT

Urinary tract infections are typically treated with antibiotics. Resistant
infections may require intravenous antibiotic therapy in the hospital.

Untreated UTIs can lead to more serious conditions:

 * Recurrent infections
 * Permanent kidney damage
 * Risk of low birth weight and preterm labor
 * Sepsis, a life-threatening infection


ELMIRON

Elmiron is a drug used to treat cystitis, a condition characterized by bladder
pain and inflammation. This product can cause the following conditions:

 * An allergic reaction
 * Nosebleeds
 * Bleeding gums
 * Blood in the urine or stools

 * Rectal bleeding
 * Coughing up blood
 * Lightheadedness
 * Pigmentary maculopathy




PIGMENTARY MACULOPATHY

The active ingredient in Elmiron, pentosan polysulfate sodium (PPS) is the only
known cause of pigmentary maculopathy, the symptoms of which include dark spots
in the vision field, difficulty reading or adjusting to dim lighting, loss of
color perception, eye strain, blurred vision and blindness.
The condition is often misdiagnosed as age-related macular degeneration or
pattern dystrophy.


More than 600 Elmiron lawsuits against Johnson & Johnson’s subsidiary Janssen
Pharmaceuticals are pending amid allegations that Johnson & Johnson knew soon
after releasing the product in 1996 that it could be linked to eye damage.


Johnson & Johnson ignored the evidence. In 2018, the link was established
through clinical studies, but Johnson & Johnson did not provide warnings until
2020.


MENOPAUSE

 * Changes in their period
 * Hot flashes
 * Night sweats
 * Urinary incontinence
 * Trouble sleeping
 * Mood changes
 * Vaginal dryness

 * Reduced libido
 * Loss of muscle tone
 * Weight gain
 * Stiff, aching joints
 * Headaches
 * Heart palpitations

When estrogen—which has a protective effect on women’s health declines, women
more vulnerable to age-related illnesses and events such as heart disease, heart
attacks, stroke, and osteoporosis.

Menopause is a normal part of aging that women experience during their
mid-forties into their fifties. It marks the end of the female reproductive
cycle. During this time, estrogen declines and periods cease.



The transitional period leading up to menopause is perimenopause. Women often
experience the following uncomfortable symptoms during perimenopause and
menopause:




OSTEOPOROSIS

Osteoporosis is characterized by bone loss. It is more common in women.
Approximately 10% of women over the age of 60 are afflicted. Osteoporosis
increases the risk of bone fractures, including hip fractures, reduced mobility,
quality of life, and lifespan. Additional symptoms include the following:

 * Back pain due to a fractured or collapsed vertebra
 * Loss of height
 * Stooped posture

Osteoporosis is often treated with calcium and Vitamin D supplementation. A
class of drugs known as bisphosphonates, such as Fosamax, is also an effective
treatment for this condition.

Other risk factors for osteoporosis include:
 * Smaller body frame
 * Family history
 * Overactive thyroid, parathyroid, or adrenal glands
 * Eating disorders
 * Low calcium intake throughout life
 * Gastrointestinal surgery

 * Long-term use of medications that treat seizures, gastric reflux, and cancer
 * Celiac disease
 * Cancer
 * Rheumatoid arthritis
 * Sedentary lifestyle
 * Alcohol or tobacco use


FOSAMAX SIDE EFFECTS

The body is constantly in a state of breaking down old bone and replacing it
with new bones. Fosamax is a bisphosphonate, which works by slowing down the
body’s natural process of breaking down bone.

The most common side effect is heartburn or similar gastrointestinal issues.
Replacing one bisphosphonate with another often remedies this issue.

Approximately one in 50,000 patients taking Fosamax develops osteonecrosis of
the jawbone, a condition characterized by a deteriorating jawbone.

Patients with a history of cancer have the highest risk of developing this side
effect. Femur fractures are another rare side effect.

Many physicians recommend a two-year break after taking Fosamax for the first
three years to reduce these risks.


ALZHEIMER’S

Alzheimer’s is a deadly degenerative disease that impacts memory and cognitive
function. It is most common in adults older than 65 and women. As many as
two-thirds of Alzheimer’s cases are in women.



While no one knows the reasons for this, researchers point to the following
characteristics of women as potential factors:

 * Longer lifespan
 * Structural and functional differences in women’s brains
 * Work and family patterns



The most common early symptom of Alzheimer’s is difficulty remembering newly
learned information. It is a progressive condition characterized by increasing
symptoms of dementia until patients can no longer carry conversations, recognize
loved ones or care for themselves. It is one of many types of dementias that
affect older adults.



There is no cure for Alzheimer’s. Treatment is normally focused on slowing its
progression. One promising new drug, Aducanumab, is showing promise.



The underlying issue behind Alzheimer’s disease is the buildup of amyloid
plaques in the brain. Removing these plaques can reduce the cognitive and
functional decline in Alzheimer’s patients.



This drug received accelerated approval by the FDA and is the first approved
drug that addresses amyloid plaques.


CARDIOVASCULAR DISEASE

The decline in estrogen puts postmenopausal women most at risk for
cardiovascular diseases. Women are also more likely to die from heart attacks
because they often experience atypical symptoms when a heart attack strikes.


HEART DISEASE

 * Neck, jaw, shoulder, back, or abdominal discomfort
 * Shortness of breath
 * Arm pain
 * Nausea or vomiting
 * Sweating
 * Lightheadedness/dizziness
 * Unusual fatigue
 * Heartburn/indigestion

One out of four women will die of heart disease, which is the leading cause of
death for both men and women in the United States. Because women’s symptoms are
not always obvious, they are not as often diagnosed early. Symptoms of heart
disease in women include:

Risk factors for women range from family history of heart disease to menopause.
Interestingly, the risk for developing heart disease is greater for women who
smoke than for men who smoke.
Other risk factors for women include:
 * High cholesterol
 * Obesity
 * Diabetes
 * Emotional stress/depression
 * Smoking
 * Inactivity/sedentary lifestyle
 * Menopause
 * High blood pressure or diabetes during pregnancy
 * Family history of heart disease
 * High blood pressure or diabetes during pregnancy

Women are more likely than men to have a heart attack without a severe blockage
(nonobstructive coronary artery disease)


STROKE

A stroke occurs when blood flow to an area of the brain is blocked, blood vessel
in the brain bursts.


3RD

leading cause of death among women
Kills twice as many women as breast cancer


TYPES OF STROKE


ISCHEMIC

clot obstructs blood flow


HEMORRHAGIC STROKE

blood vessel ruptures and prevents blood flow to the brain


TRANSIENT ISCHEMIC ATTACK (TIA) OR “MINI-STROKE”

caused by a temporary clot
Risk factors – High blood pressure


LONG-TERM EFFECTS

Paralysis on one side of the body
Vision issues
Memory loss
Speech and language difficulties
Treatment
 * Treatment varies based on the type and location of the stroke
 * Removal of obstruction/clot in ischemic strokes
 * Microcatheter-based surgery from the groin to the site of the stroke followed
   by medication directly to the area or other endovascular treatments
 * Surgical relief of the intracranial pressure
 * Removal of aneurysms followed by close monitoring and measures to reduce
   swelling or other complications
 * A long period of rehab may be required


Health Tips for Women
Women have more opportunities today than ever before to support and protect
their health and longevity. The following practices will promote a long,
healthy, and happy life.
Be your own health advocate.
Listen to your body.
Make sure your doctor listens to you.

Ask plenty of questions until you are satisfied.
Enlist support from friends, families, and groups.

Adopt a healthy lifestyle.
Moderate coffee and caffeine consumption.
 * Maximum of 16 ounces of coffee per day
 * Maximum of one alcoholic drink per day

Exercise regularly.
 * Include a combination of resistance training, aerobic exercise, and balance
   training.
 * Keep it fun so you will stay motivated.

Maintain social connections.
Quit smoking.
Take your vitamins, especially vitamin D and calcium.
Consume a healthy diet.
 * Eat plenty of fruits and vegetables.
 * Include a rainbow of colors.
 * Avoid sugar and processed foods.
 * Consume at least 64 ounces of water daily.

Maintain healthy sleep hygiene.
 * Go to bed and wake up at the same time each day.
 * Avoid the use of electronics close to bedtime.
 * Aim for eight hours of sleep daily.
 * Keep your sleep area dark and cool for the highest quality sleep.

Be proactive.
 * Perform recommended self-breast exams.
 * Take medications as directed.
 * Educate yourself about your health.
 * Attend annual wellness exams and preventive care screenings recommended by
   your doctor.




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