Health for a Lifetime

Women's Health Issues

Three Angels Broadcasting Network

Program transcript

Participants: Allan Handysides, Don Mackintosh

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Series Code: HFAL

Program Code: HFAL000100


00:47 Hello, and Welcome to Health For A Lifetime.
00:49 I'm your host, Don Mackintosh.
00:51 We're glad you're with us, and doctor we're glad you're
00:53 with us as well.
00:55 Thank you.
00:56 Dr. Allen Handysides is the, well actually you're in charge
00:59 of the Health and Temperance Department for the
01:01 Seventh-day Adventist church worldwide, and your background
01:06 is that of dealing with children, Pediatrics and also
01:09 with women's health issues, that being Obstetrics
01:12 and Gynecology.
01:13 Is that right?
01:14 That's correct.
01:15 So today we're going to talk to men.
01:16 I can't imagine this, talking about women's health issues!
01:19 We want to talk about women's health issues,
01:21 and so what would you say some of the most important women's
01:26 health issues are?
01:27 Understanding that with two men talking here,
01:29 we could get in trouble.
01:30 Well, one of the issues might be why we're talking about it when
01:34 it ought to be two women talking about it,
01:35 but it is because we love them so much.
01:37 Yeah, at least I love my wife, and I'm sure you do yours.
01:40 Yes, I love my wife too.
01:42 And, really, women's issues are traditionally seen in terms of
01:47 things like breast cancer, cervical cancer, uterine cancer,
01:52 ovarian cancer, maybe childbirth problems.
01:58 And I would like to put another one in there: smoking.
02:03 And an extra one maybe: obesity.
02:07 I think these are current health issues for women.
02:11 Okay, I'm surprised that you would put smoking up there
02:14 on that list.
02:15 Why would you put it up that high?
02:17 Because there are more women that died this last year of lung
02:22 cancer than died of breast cancer.
02:24 Now that's a statistic that many women are unaware of,
02:28 but it's a fact, and here in North America the statistics are
02:35 more women are dying of lung cancer than breast cancer.
02:39 Has it always been that way?
02:40 Or is that a new phenomena?
02:41 No, this is a new phenomena.
02:43 We've seen the rate of lung cancer climbing steadily,
02:49 and reached this cross-over point just this last year.
02:54 And that's because of the increasing number of women
02:57 that are smoking.
02:58 Now is that a reflection of people that started smoking
03:01 10, 15, years ago, 20 years ago, or is that, ah...
03:04 Unfortunately.
03:06 Okay.
03:07 Unfortunately, it's a reflection of what they were smoking in the
03:09 past, but we know that more young women today are smoking
03:14 than have ever been smoking in the history of women in America.
03:19 And so we expect this number is going to increase.
03:23 We're going to reap a dreadful harvest 10, 15, 20 years
03:28 from now among the young women that have begun smoking.
03:32 So would it be fair to say that the single most important thing
03:34 you can do if you're a woman watching today, this program,
03:37 as we're talking, is if you're smoking, is to stop smoking.
03:39 I would say that for all the things we talk about,
03:43 and we're going to talk about quite a few things today,
03:45 but if you're smoking, if you're a woman that's smoking; stop.
03:48 And if you're a young lady that is contemplating starting
03:52 smoking; stop.
03:54 Stop and think.
03:56 What is it that you are going to do?
03:58 Because about 70% of young people who smoke 2 cigarettes
04:03 will continue to smoke.
04:05 70% that smoke only 2 cigarettes will continue.
04:08 ...Continue to smoke.
04:09 And that's a dreadful, dreadful statistic because 50% of those
04:14 will die of their cigarette smoking.
04:18 ...Lung cancer or something like that.
04:20 Lung cancer, emphysema, maybe bladder cancer, heart problems,
04:26 a whole host of things that are secondary to smoking.
04:29 What about osteoporosis in women?
04:31 Is that a big issue?
04:32 Yes, now osteoporosis is another of these issues
04:36 that we should mention.
04:37 Osteoporosis is more of a problem for women
04:40 than it is for men.
04:41 Men are protected by their testosterone in that regard.
04:44 I mean the testosterone makes us more bullish.
04:46 You know we get bullheaded, and we get into all kinds of
04:49 other problems because of the testosterone,
04:51 but it does protect our bones.
04:54 Women, when they come to the menopause, then their estrogen
05:00 levels are going to drop.
05:02 If I say estrogen, that's because I'm English, you know.
05:04 The Americans would say estrogen levels.
05:06 Okay.
05:07 The estrogen levels drop, and then they become
05:11 candidates for osteoporosis.
05:13 But osteoporosis, we shouldn't be talking about it in terms of
05:18 the menopause, we should be talking about osteoporosis
05:21 in terms of our 15 year olds.
05:23 What can they do to prevent it?
05:25 Because that's when they are in that positive anabolic tissue
05:29 building stage.
05:30 All their bones are building.
05:31 They're building their bones, you see.
05:32 They're putting money in the bank.
05:34 And if they will do weight bearing exercises,
05:38 if they will stay fit, participate in sports,
05:42 in activities, walking, running, and doing things that will
05:46 stress their bones just that little bit, build some muscle,
05:50 the muscles pulling them, they'll build a denser base.
05:53 Okay.
05:54 So they have more to loose.
05:56 Yeah, then they have more to loose.
05:58 My wife is a classic example.
06:00 She's rather thin boned, and I said to her,
06:03 "I think you'd better go and do a bone density.
06:04 I think you're going to have osteoporosis. "
06:06 So she, you know, went along and had her bone density.
06:09 Fine bones.
06:10 And then she said to me, "But you didn't really think
06:12 that I was going to be. "
06:13 I said, "Yeah, I thought you would be. "
06:14 She said, "But you forget, I'm a farmer's daughter.
06:16 I threw 35,000 bales of hay a summer. "
06:22 And I can throw you too!
06:24 "And I can throw you too!"
06:26 So, what about green leafy vegetables?
06:29 Would that help?
06:30 Well, they do, because, you know. green leafy vegetables
06:32 are a good source of calcium.
06:33 Um-huh.
06:34 And, when I say a good source of calcium, they're not the richest
06:39 source of calcium, but they are a good source, and their
06:43 proportion of absorption is actually greater than milk.
06:46 Now milk, if you are to take it as a source, most people would
06:50 promote milk as a source of calcium, and it is a good source
06:53 of calcium, and it is well absorbed.
06:56 Calcium is well absorbed in milk, but it is not as well
07:01 absorbed as it is from the green leafy vegetables.
07:03 Now, of course, you'd have to eat an enormous amount of green
07:06 leafy vegetables to match what you'd get in the milk.
07:10 But one has to say, if you're talking about milk,
07:13 there definitely should be no fat, or skim milk, because the
07:17 the fat in the milk...
07:18 Oh, excuse me.
07:21 So calcium, plus weight bearing.
07:24 If you just had calcium, it wouldn't help you?
07:26 You had to have to have the weight bearing exercise?
07:28 The weight bearing exercise is so...
07:29 But you know, everything fits together just so beautifully.
07:33 You know, we tend to take everything apart,
07:36 and we look at this like a kid with a flower.
07:39 We pull all of the petals off and we want to...
07:41 but we look at the whole picture-everything meshes
07:44 together so beautifully.
07:45 It's the exercise, the muscular strength, working with the
07:49 bones, the nutrients, everything works together so beautifully.
07:52 Someone told me once that coffee drinking can also lead
07:56 to osteoporosis.
07:57 Caffeine is a definite factor in osteoporosis.
08:03 So is smoking.
08:04 The nicotine is another definite factor in... and it may be
08:09 because they are diuretics.
08:10 It may be that you excrete more calcium because of diuretics.
08:14 So it depletes you of calcium that way.
08:16 Now one of the things we hear a lot about, you mentioned
08:19 already, and that's breast cancer.
08:20 How worried should women be about that, and what can they
08:24 do to avoid it?
08:25 The first thing that I'd like to say to women is that you should
08:28 realize 9 out of 10 breast lumps are innocent, benign.
08:32 They are not cancer.
08:34 If we could get that message across to women.
08:36 That's a very important message because
08:39 so many women are scared of breast cancer
08:41 that they don't follow through.
08:44 I was in-I was down in-
08:46 They ignore it.
08:47 Ignore it.
08:48 I was in Indonesia about eight weeks ago, and a woman came up,
08:52 and we were talking about breast cancer.
08:54 She came up and she showed me her arm.
08:57 And in her armpit she had a lump the size of a chicken's egg.
09:00 And she was saying, "Do you think I should do something
09:03 about this?
09:04 And she had another lump in her breast.
09:07 She was just absolutely petrified.
09:10 And her fear had just made her not do anything about it.
09:13 So fear is a very, very major thing.
09:17 The other thing is self examination.
09:19 I think women need to examine themselves.
09:22 Now the Cancer Society says examine yourself every month.
09:26 What do you do once a month that you remember to do?
09:30 I don't remember to do anything on a monthly basis.
09:32 Change the calendar- besides that.
09:35 But I don't even remember to do that until 3 or 4 days into...
09:38 I think that I would recommend a weekly self examination.
09:43 And for the first month when you're learning how to do it,
09:45 if you haven't been doing it, do it on a daily basis.
09:48 And if you do it daily, you'll go through the full cycle.
09:51 If you're a premenstrual woman, you'll get the full change.
09:54 You'll understand.
09:55 At the end of the month you know your breast.
09:57 And then every Sunday morning, or every Friday evening,
10:01 sometime when you're relaxed, sometime when you can spend
10:04 a little time with yourself without the hassles of the day,
10:06 just quietly, meticulously, and methodically examine the breast.
10:11 There's not much to examining the breast that
10:14 really is mystical.
10:16 You just have to remember to examine from the midline of
10:19 the sternum, down to the rib cage below, right across the
10:23 axilla and up to the clavicle here.
10:25 You can do it in a circular, contour thing,
10:29 or you can do it up and down.
10:31 Use both hands and examine every square centimeter of the breast.
10:36 Anything that you find that you don't understand,
10:39 and you're worried about, you go and get it checked.
10:41 But don't go in a panic, just get it checked.
10:44 Do some things make people, or women, more prone to
10:47 breast cancer than other things?
10:49 There are; for instance the family history.
10:51 Breast cancer is going to involve 1 in 9, 1 in 10 women
10:57 in North America.
10:58 So it's pretty prevalent.
11:00 So the chances are that you'll have somebody in your family,
11:02 especially if it's a big family, that has breast cancer,
11:05 just on that basis alone.
11:07 But if you have a very strong family history of your
11:11 grandmother, or your mother and her sisters, or aunts and two of
11:18 your sisters have it, then you need to say,
11:20 "Hum, maybe there's a family history here.
11:24 Now they can identify two abnormal genes.
11:27 There are two genes called BRCA 1 and BRCA 2.
11:33 That stands for breast cancer 1, breast cancer 2.
11:37 If these genes are defective, then it seems that there is an
11:41 an inhibition of the protective mechanisms.
11:44 And can you find out if you have those genes?
11:46 Yes, you can.
11:47 Now what are you going to do?
11:49 It's like a dog chasing a car, you know?
11:51 What's he going to do with it when he finds that he's
11:53 got the car, you know?
11:54 It's a big question, you see, because what are you going to do
11:58 if you find you're carrying a gene for breast cancer?
12:01 You're going to get worried if you're one type of person.
12:02 Ah, there's all kinds of problems that come up,
12:05 but you need to think that through, and decide in
12:08 conjunction with a good advisor, with your personal doctor,
12:11 or personal physician, to discuss this issue
12:14 as to what you should do.
12:15 If he and she, or she and he, feel that this is what
12:20 you should do, then you maybe would go through
12:23 and have that testing.
12:24 Okay.
12:25 So, in other words, you don't necessarily have to run and get
12:27 that test, but check with your health care provider,
12:30 and they can let you know.
12:32 What if a doctor does find a breast lump, or if you find one,
12:36 and let your doctor know about that?
12:37 How do they find out whether or not it's malignant or benign?
12:41 I'll give you a classic example in our family.
12:43 My sister-in-law came.
12:45 Her daughter had been married on the Saturday night.
12:49 So the daughter was married.
12:51 Sunday morning, 7 o'clock, knock on the door.
12:54 I was staying out at the farm.
12:56 And she said, "Al, will you come and examine my breast?"
12:59 I said, "Examine your breast?"
13:01 I mean it's 7 o'clock in the morning.
13:03 My sister-in-law's coming wanting me to examine
13:05 her breast!
13:06 But she had found, in the shower that morning, a small nodule,
13:09 just on the median side of her breast.
13:12 I didn't know...
13:13 It was the size of maybe a split pea.
13:15 I couldn't tell whether it was malignant,
13:18 or if it wasn't malignant.
13:19 So I said to her, "You need to have it checked out. "
13:20 What do we do?
13:21 Well, go for a mammogram.
13:23 A mammogram may show small needle point calcifications,
13:28 or it may show slight distortions of the tissue.
13:32 That suggests that there's something growing there.
13:34 It may be a big lump that somebody feels.
13:36 It may be an ultrasound of that breast will show fluid in it
13:40 that it's cystic.
13:41 So you need to have it methodically examined,
13:44 but the gold standard is a biopsy.
13:47 Biopsy: take a tissue sample.
13:49 A tissue sample.
13:50 There are probably 6 or 7 different ways of obtaining a
13:53 biopsy, but depending on what and where this lump is,
13:59 it needs to be categorized as to whether it's malignant or not.
14:03 And time is of the essence.
14:04 This is one of those things that when the woman feels a lump
14:08 she thinks it's an emergency.
14:09 Bang, bang, right now!
14:10 Got to get it out!
14:11 You know, it's panic buttons.
14:13 Okay.
14:14 In reality, it's probably been present for many weeks or months
14:18 before, maybe even a couple of years it's been there.
14:21 So a week or two is not going to make or break it.
14:26 So they need to be reassured, although emotionally they don't
14:29 want to see a lot of time wasted in investigating that.
14:32 And a good physician will see to it that they don't
14:34 wait too long.
14:35 We're talking with Dr. Allen Handysides.
14:37 He's a specialist in women's health issues.
14:39 We hope that you join us when we come back.
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15:51 Welcome back.
15:52 We've been talking with Dr. Allen Handysides,
15:54 two men today, talking about women's health issues.
15:57 We're glad you're with us doctor.
15:59 When we left we were talking about breast cancer, breast self
16:03 examination, and how to tell whether it's
16:05 a malignancy or not.
16:06 Many people, or many women, have questions about hormone
16:10 replacement and its role in breast cancer.
16:12 Can you help us with that?
16:13 Well, you know, this is a very interesting question.
16:17 Hormone replacement therapy came in primarily for the symptoms of
16:21 menopause: hot flashes, and feelings of agitation,
16:26 nervousness, sleeplessness, and so forth.
16:28 When they were introduced they started treating people with
16:32 just estrogens alone.
16:35 It wasn't too long after that that they began to find that
16:39 there was an increased instance of endometrial cancer, cancer of
16:44 the lining of the uterus, so then they added to the
16:49 replacement therapy, the progestin's, so that they would
16:52 more closely mimic the natural cycle of hormones.
16:56 Then there was a fall in the rate of endometrial cancer.
17:01 But there has always been a question of what is happening
17:03 to the breast with the prolongation of these hormones.
17:07 It's not as though the hormones are very high doses.
17:10 In fact, probably, the usual replacement is about a sixth of
17:14 the dose that you would find in a birth control pill.
17:16 But it is known that prolonged usage of birth control pills,
17:20 over fifteen years, is associated with a slight
17:22 increase in breast cancer.
17:23 So this question was raised, and for many years it wasn't
17:27 able to be answered.
17:28 And that's a good sign, that it wasn't able to be answered.
17:30 It means it's not a horrific association.
17:32 But on the other hand, in the last few years, it has become
17:38 clear that there is definitely a slight increase in risk.
17:43 A relative risk increase.
17:44 A relative risk increase which actually goes from about
17:47 a 1 to 1.1, which is a 10% increase in risk.
17:51 So should they, or should they not take hormone replacement?
17:55 Well, you know, it's very easy to say they shouldn't take it,
17:59 but I couldn't say that, and especially as a man, I couldn't
18:05 ay that, because we don't go through the menopause.
18:08 There are a lot of people who would say, don't take the
18:13 hormones at all, but I've suspected they belong to the
18:17 50%, if they're women, who don't have any symptoms of menopause.
18:22 Now there are substances available which are synthetic,
18:25 "hormone like" compounds, and they have good effects on the
18:30 blood lipids, and the heart, and have good effects on the
18:33 bone for osteoporosis, but they don't control the symptoms.
18:37 So, really, you could make a good case for being on hormone
18:42 replacement therapy, but I'm a little suspicious that all the
18:48 information is not in yet, particularly as I'm watching
18:51 the literature, I see that some of the reports on the benefits
18:56 to the heart are not panning out as much as they had
19:00 said they would.
19:01 See, we used to argue that...
19:04 It would be good for the heart to take those additives.
19:06 Yes, we used to argue that you would get a 40% reduction in
19:10 cardiovascular problems.
19:11 Well, seeing as about 600 women per 100,000 women in the
19:15 65 to 75 age group, or 10 years there anyhow, would die of heart
19:21 problems, a 40% reduction was a considerable improvement,
19:26 and offset a 10% increase when the numbers of women who were
19:31 dying of breast cancer were only about 111.
19:33 In other words, you had six times more heart disease,
19:36 so you should have a 40% reduction of something that's
19:38 6 times more, is much more important than a 10% increase
19:43 in something that's 6 times less.
19:45 But, on the other hand, it looks as though those benefits
19:48 to the heart may not be coming out in some of the
19:51 long term studies.
19:52 Not as pronounced.
19:53 Now, you know, some people may be listening that are younger
19:57 women, or are men, like you and I, and they don't know what
20:00 menopause means, or what it's about, or what the symptoms are.
20:04 And I'm not asking you from personal experience to share
20:07 about what that is, but you've seen a lot of ladies, and
20:09 what kind of symptoms are we talking about?
20:11 Do you see these grey hairs?
20:13 That means that I've lived long enough to know what it's like to
20:16 experience the menopause, because my wife's gone through
20:19 the menopause.
20:20 Okay, alright!
20:21 I've experienced it secondhand.
20:23 Okay.
20:24 The menopause comes because the ovaries cease
20:27 to produce eggs.
20:29 And then when there are no eggs coming out, there are none of
20:32 of those cells around that produce the estrogen
20:35 and the progesterone, so there's a hormonal falloff.
20:38 As I said, only half of the women have this falloff
20:42 actually are symptomatic, but the other half
20:45 may be very symptomatic.
20:46 So it varies from a few mild flushes, and a few headaches,
20:52 to incapacitating, and I really mean incapacitating, anxiety,
20:59 restlessness, sweats, and so forth.
21:02 So I never like to say to a woman, you would, or you will
21:06 not, you should, or you should not.
21:07 I like to explain the background, and to look at
21:11 that individuals setting.
21:12 Of course, a lot of women say, well I'll take natural stuff.
21:15 I'll take mine as isoflavones or in soy products or something.
21:20 That, in a way, is a little bit begging the question because
21:23 what you're doing is you're just taking a different
21:25 form of estrogen.
21:26 And you really don't know how much you took.
21:27 And you don't know how much you're taking.
21:28 So to be a purist, and honest, one has to say, well,
21:32 then we're not arguing whether you will or won't, it's how much
21:39 or what kind.
21:40 You don't really even know, right?
21:41 Does this menopause, and the hormonal change, does it effect
21:46 the woman's sexuality, or anything in that regard?
21:48 It appears that a very considerable number of women
21:53 have a decreased sex drive or libido.
21:57 Um... okay.
21:58 Not all though.
22:00 Some in the menopause actually see an increased libido.
22:04 The sex drive comes from testosterone.
22:07 Some testosterone is produced by the ovaries, but there is
22:12 another amount of testosterone that is produced
22:14 by the adrenal glands.
22:16 So the menopause may be associated with a slightly
22:20 relative increase, or it may be a decrease, depending on where
22:26 the prime production of it is coming from.
22:29 You probably see a lot of, speaking of sexuality,
22:36 you probably see a lot of sexually transmitted diseases
22:39 in your practice.
22:43 Can you comment a little bit about that?
22:45 Is that a big problem today in America?
22:47 What's happening in that realm?
22:49 Yes, we're now jumping to a younger group of women.
22:53 Right, yeh.
22:54 Sexually transmitted diseases are a plague to America's
22:58 young women, and young men.
23:00 But to the youth, we've seen large numbers of young people
23:06 with sexually transmitted diseases, sometimes not the ones
23:10 that we have traditionally talked about.
23:12 For instance, syphilis.
23:13 It seems to be somewhat less prevalent than it used to be.
23:17 And gonorrhea is not as prevalent as it used to be.
23:21 Chlamydia is up.
23:23 And why is that?
23:25 I don't know, maybe sensitivity to antibiotics and so forth
23:29 might be partly to blame there.
23:31 Also young women who have Chlamydia infections
23:35 are often asymptomatic.
23:36 The majority of them are asymptomatic.
23:38 So they don't even know that they've got it until maybe
23:41 a late stage, or infertility, when they try to have children
23:44 they can't have children.
23:45 I think a measure of sexual transmission is the human
23:48 papilloma virus.
23:50 Human papilloma virus probably effects more than 35% of women
23:55 in the states.
23:56 Human papilloma virus?
23:57 That's the warts virus.
23:58 Oh, okay.
23:59 Now the warts virus is what kids have on their fingers.
24:02 Right.
24:03 But when we start to see genital human papilloma virus,
24:07 particularly on the cervix, that is one of the ecological agents
24:12 in carcinoma of the cervix.
24:15 Cancer of the cervix.
24:17 That's what you do your pap smears for.
24:19 I see.
24:20 To check and find the carcinoma of the cervix.
24:22 Herpes is another thing that's very, very common.
24:25 And, of course, these are viral infections for which there are
24:30 no eradicative treatment- no known cure.
24:35 So, once you get it, it sits there for a lifetime.
24:39 So these are things that you really want to be careful with
24:42 if you're a younger woman.
24:43 It's not something that is just to be dismissed.
24:46 You need to be very careful about these things.
24:48 Well, what are the things you would tell someone?
24:53 Well, with the advent of penicillin, the young marine
24:54 used to think what it was a shot in the butt, and he was
24:57 on his way again.
24:58 And that was fine in the early days for gonorrhea,
25:01 even for syphilis.
25:02 It was very easily treated with penicillin.
25:07 But we're finding more resistance.
25:10 We're finding more and more of these previously less common
25:15 diseases coming to the fore, and they become much more
25:20 important in society.
25:21 So God's plan is really the best to prevent, because you can't
25:26 really reverse these things once they start.
25:29 There's no doubt about it.
25:30 He had love in His heart, to protect us from things that
25:38 that could come our way.
25:39 In your practice as a physician, you see a lot positive things,
25:43 a lot of babies being delivered, a lot of happy times.
25:46 But when you're dealing with someone...
25:48 You know, I think of the woman in the Bible in Luke 8 that had
25:52 gone to many physicians, and spent all she had,
25:54 and had a flow of blood.
25:56 Or I think about the compassion that Jesus had with women's
26:00 health issues, if you will.
26:02 What story especially grips you, and impacts you?
26:06 What kind of spiritual hope can you give to ladies today?
26:09 That's the story!
26:11 That's a wonderful story-the one that you talked about.
26:13 The implications are sometimes lost on us.
26:16 An issue of blood.
26:17 What could that be?
26:18 Well, if you ask a Gynecologist he knows it's not a cancer
26:20 because she would have died before twelve years were up
26:24 from a bleeding cancer.
26:25 So he goes through:
26:26 Could it be fibroids?
26:27 Could it be a polyp?
26:28 What was the diagnosis?
26:31 It doesn't really matter what the diagnosis was.
26:33 This woman was a social outcast.
26:35 Because of blood impurity.
26:36 Her husband couldn't touch her.
26:38 She was unclean.
26:40 Right.
26:41 So here, if she was young, and she would be young,
26:43 she looses the emotional support of the family.
26:47 In desperation she pushes through the crowd and touches
26:51 the hem of His garment.
26:53 The hem that brushes in the dirt, in the dust, the hem that
26:58 represents the touching point between divinity and humanity,
27:02 heaven and earth.
27:03 And when she touches Him that power goes through her.
27:06 I love the old King James version where it says,
27:09 and He felt virtue had gone out from Him; goodness.
27:13 Boy, it must be amazing to be in a position where sometimes
27:18 you get a little glimpse of what the Master Healer
27:22 must have seen.
27:23 Well, it's nice to be associated with our Lord in healing,
27:26 but we should never, never think that we can be like Him.
27:30 That's right.
27:31 He is so wonderful.
27:32 We've been talking with Dr. Allen Handysides.
27:35 His specialty is women's health issues.
27:37 I hope that today's program has been especially useful to you,
27:41 no matter what age you might be.
27:43 We hope that you've listened to the practical things that have
27:47 been shared today.
27:48 And we hope that as a result of today's program each woman
27:51 that's listening can have health that lasts not just for now,
27:55 but for a lifetime.


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Revised 2014-12-17