WEDNESDAY, June 11 (HealthDay News) -- A drug already approved to reduce the risk of breast cancer in high-risk women also seems to cut the risk for other women.

A new analysis finds that those who took raloxifene (Evista) regularly over a number of years were less likely to develop invasive estrogen-receptor (ER) positive breast cancer, compared with women who did not take the drug.

Raloxifene did not, however, cut the risk for noninvasive breast cancer or invasive ER-negative cancers.

"This is a reaffirmation that the drug raloxifene is a very powerful SERM [selective estrogen receptor modulator] for reducing the risk of invasive breast cancer," said Dr. Jay Brooks, chief of hematology/oncology at Ochsner Health System in Baton Rouge, La.

The study, published in the June 10 online issue of the Journal of the National Cancer Institute, was funded by Eli Lilly and Co., which makes Evista.

SERMs block the female hormone estrogen by binding to estrogen receptors; estrogen helps fuel the growth of some breast cancers. Raloxifene and other hormonal therapies have an "estrogenic tickle" effect, explained V. Craig Jordan, author of an accompanying editorial in the journal and vice president and research director for medical science at Fox Chase Cancer Center in Philadelphia. Jordan did some of the early laboratory research on raloxifene.

Raloxifene was originally developed to prevent and treat osteoporosis, and only later was found to help reduce the risk of invasive breast cancer in high-risk women.

The new study expands on the original results of the RUTH (Raloxifene Use for the Heart) trial, originally designed to see if raloxifene, which has cholesterol-lowering properties, could reduce the risk of dying from coronary heart disease.

The trial involved more than 10,000 postmenopausal women with coronary heart disease or at risk for the condition. Participants were randomly chosen to receive either daily raloxifene or a placebo and followed for a median of 5.6 years.

Raloxifene turned out not to have any effect on heart disease mortality risk, but it did reduce the risk of invasive breast cancer by 44 percent, which translates into 1.2 women per 1,000 treated for one year who were spared the agony of a breast cancer diagnosis.

The new analysis looked more specifically at raloxifene's effect on breast cancer and found a 55 percent lower incidence of invasive ER-positive tumors, but no effect on noninvasive breast cancer or invasive ER-negative breast cancer.

According to the study authors, these findings are consistent with results from other trials involving women without heart disease. This trial and others found an increased risk of blood clots and fatal strokes among women taking raloxifene, indicating that women need to weigh the risks and benefits of the drug.

Another question is how long to take raloxifene for breast cancer prevention, although the authors speculated that up to eight years might be safe and effective.

"We're learning more about this class of drugs, what works and what doesn't work," Jordan said. "[Raloxifene] is good for osteoporosis, no good for coronary heart disease, but breast cancer is inhibited."

More information

The U.S. National Cancer Institute has more on SERMs and how they work.

MONDAY, June 9 (HealthDay News) -- Trouble in your marriage can cause trouble in bed, but not necessarily the kind of trouble that first comes to mind.

New research has found that women in happy marriages tend to sleep more soundly than women in unhappy marriages. In fact, women with good marriages have about 10 percent greater odds of getting a decent night of shut-eye compared to women who aren't happy with their spouse.

"Marriage can be good for your sleep if it's a happy one. But, being in an unhappy marriage can be a risk factor for sleep disturbance," said the study's lead author, Wendy M. Troxel, a psychologist at the University of Pittsburgh.

The million-dollar question, Troxel said, is which comes first -- does the unhappy marriage lead to poor sleep, or does poor sleep contribute to a bad marriage?

"We have future studies planned, and we need to tease that out," she said. "If you're not sleeping, you're more irritable, have lower frustration and tolerance levels, so it's possible that could affect the marriage. But we suspect it's in the other direction," that the bad marriage is affecting the quality of sleep because you're trying to sleep next to someone you may be fighting with, and that's stressful.

"If you're stressed or anxious, it can have an effect on your sleep," agreed Dr. Ana Krieger, director of the New York University Sleep Disorders Center in New York City.

Troxel and her colleagues reviewed data on about 2,000 married women who participated in the Study of Women's Health Across the Nation (SWAN). The women were an average age of 46 years. Just over half were white, 20 percent were black, 9 percent were Hispanic, 9 percent were Chinese, and 11 percent were Japanese.

All of the women reported their sleep quality, the state of their marriage, how often they had difficulty falling asleep, if they stayed asleep, and how early they woke up.

Happily married women had less trouble getting to sleep, had fewer sleep complaints, had more restful sleep and were less likely to wake up early or awaken in the middle of the night than women whose marriages were less than ideal.

Even after the researchers adjusted the data to account for other factors known to disturb sleep, the researchers found that happily married women still slept more soundly. And, these findings appeared to hold up across racial lines. The only groups that the findings weren't statistically significant for were Chinese and Japanese women, but Troxel suspects this may be because there weren't as many Chinese or Japanese women in the study as white and black women.

Troxel was expected to present her findings June 9 at Associated Professional Sleep Societies annual meeting, in Baltimore.

"All marriages aren't created equal, and having a high quality marriage may be good for sleep, whereas an unhealthy marriage is a potent source of stress. You could be sleeping with the object of your hostility," Troxel said.

If you have a lot of stress from your marriage or another source, such as your job, Krieger said you need to try to fix the situation that is causing the anxiety. If you can't change the stressful situation, she recommended trying to change how you perceive the stress. Good ways to help you relax are meditation and yoga, she said.

Troxel said that if you're in an unhappy marriage, marriage therapy -- or individual therapy if your spouse won't go to therapy -- can be helpful.

She also recommended practicing good sleep habits, such as going to bed at the same time and waking up at the same time every day.

More information

Get more advice on getting a good night's sleep from the National Sleep Foundation  .

MONDAY, June 9 (HealthDay News) -- The procedures used to open narrowed heart arteries work just as well in women as in men, and the results for both genders have improved steadily in recent years, new research finds.

The study in the June 17 issue of the Journal of the American College of Cardiology is a marker in a fading debate about the value for women of what cardiologists call percutaneous coronary intervention (PCI), in which a balloon-tipped catheter is inserted to open a blocked blood vessel. Older studies have reported a lower use of PCI for women and a higher death rate for those getting the intervention.

But looking at 25 years of PCI done on almost 19,000 people, Mayo Clinic cardiologists report increasing effectiveness for the most recent years and equal effectiveness for men and women when risk factors such age are taken into account.

"Women should feel reassured," study author Dr. Mandeep Singh, an associate professor of medicine, said in a statement. "Not only has there been significant improvement in PCI outcomes over time, women's outcomes are similar to those of men."

The Mayo researchers compared 7,904 people, 28 percent of them women, who had PCI between 1979 and 1995, with 10,981 people, 31 percent of them women, treated between 1996 and 2004. They found a reduction in the death rate in the 30 days after the procedure for men, from 2.8 percent in the early group to 2.2 percent in the more recent group; for women, it went from 4.4 percent in the early group to 2.9 percent in the later group.

Overall, the success rate in opening arteries was almost identical for both sexes, 89 percent for women, 90 percent for men.

The higher mortality rate for women could be explained by risk factors such as age, the report said. Women having PCI were an average of five years older than men. They were also significantly more likely to have severe chest pain, diabetes and high cholesterol.

"Improvements in procedure account for most of the gain in women," said Dr. Robert F. Wilson, a professor of interventional cardiology at the University of Minnesota, and co-author of an accompanying editorial. "One is the use of stents, because the results with stenting are better."

Stents are flexible tubes inserted after angioplasty to help keep arteries open.

"Also, anticoagulation has improved tremendously," Wilson said. "Women in general are more prone to bleeding complications, and our understanding of anticoagulation has improved over 10 years. We don't give as much of the drugs, and we have better drugs to give."

While the American Heart Association had to issue a 2005 statement saying that PCI was as helpful for women as men, "there is a growing consensus that it is as effective in women as in men," Wilson said.

Age accounts for much of the higher toll, and "heart disease tends to develop later in women, which is partly related to their hormonal condition," he said. "After menopause, the disease takes off."

The new report backs the findings of a study done in Pennsylvania several years ago, said Christopher Hollenbeak, an associate professor of surgery and public health sciences at Penn State University. That study, which he led, looked at data on more than 31,000 state residents who had PCI in 2000.

"The same conclusions they reached, we reached as well," Hollenbeak said. "When you control for the risk factors, much of the difference in outcomes goes away. Of course, we used one-year data, from 2000, and over time, physicians are changing the way they practice."

More information

Background on PCI for women is offered by the Cleveland Clinic  .

FRIDAY, May 2 (HealthDay News) -- Pregnancy is hard work, and it's even harder when you're working while pregnant.

"By anticipating and planning for some of these challenges, working mothers-to-be can enjoy these nine months both on the job and off," Dr. Tamara Kuittinen, an emergency medicine physician at New York-Presbyterian Hospital/Columbia University Medical Center and an expecting mother, said in a prepared statement.

Colleague Dr. Laurie Zephyrin, an obstetrician/gynecologist, advises that pregnant working women bring any questions or concerns to their doctor, especially if they are older than 35 since those women run a higher risk for complications like preterm labor and preeclampsia.

"There are no signs or symptoms that you shouldn't discuss during your pregnancy. This will help us catch any potential problems that can be prevented or treated in order to keep you and your baby safe and healthy," Zephyrin said in a prepared statement.

Here are answers to what the two doctors said are the 10 most common questions about working while pregnant:

• How do I fit in doctor visits? Visits start as monthly, then increase until they are weekly in your final month of pregnancy. Schedule appointments during your lunch break or find a doctor offering early and late hours. Don't skip visits. Regular, proper prenatal care lowers your risk of having a baby born with low birth weight or other problems.
• Is it safe to see the dentist? Contrary to popular belief, dental hygiene during pregnancy is very important. Some studies link poor dental hygiene with preterm labor. However, tell your dentist that you're pregnant and avoid X-rays, if possible.
• What can be done about morning sickness and fatigue? Morning sickness usually occurs only in the first trimester. Cope with it by drinking and eating in small amounts throughout the day. If you can't keep down fluids, you should see your doctor. Eating balanced meals, taking prenatal vitamins and taking short naps may help with first trimester fatigue.
• What can I do about insomnia? Insomnia is especially common in the second and third trimesters, when the increased size of your belly can cause back pain. Sleeping on your side may help. Try hugging a full-body pillow and staying on a regular sleep schedule. If you wake up, do something productive and focused like paying bills or reading a book.
• Can I still drink coffee? You should reduce your caffeine intake as recent research shows that excessive caffeine may increase your miscarriage risk. You don't have to go cold turkey, but try to reduce when you can. Remember caffeine is present in some sodas and teas as well.
• What should I eat? Fruits, veggies, grains, protein and dairy are all essential. Keep a list of the food groups that you should get daily on the refrigerator with a list of specific foods in each group that you enjoy. Avoid fish high in mercury, including shark, swordfish, king mackerel, tilefish and albacore tuna.
• Can I still hit the gym? Talk with your doctor about your exercise programs at your first prenatal visit. If you have a normal, low-risk pregnancy, it's safe to keep up your routine. In fact, it helps beat stress and keeps baby healthy by improving blood flow. However, you may need to lessen the intensity or change methods as your pregnancy progresses. Your joints and ligaments are looser during pregnancy, so exercise that emphasizes stretching like yoga and Pilates may open you to more injury. Remember -- walking is a fantastic exercise and stress reliever.
• Can I travel? The best time to travel is between 14 and 28 weeks of your pregnancy unless you have a high-risk condition. Consult with your doctor first, especially if going to foreign countries. Keep a detailed copy of your pregnancy record with you at all times. If sitting for a long time during travel, try to get up for a walk at least once an hour to decrease your risk of forming blood clots in your legs. Also, consider wearing support or pressure stockings.
• What if I get sick? Check with your doctor before taking any medication, even over-the-counter drugs. Stay away from natural remedies and supplements like echinacea that have not been studied on pregnant women. Urinary tract infections are common in pregnancy, so contact your doctor if you experience burning and irritation during urination. If your temperature is above 100.4, see your doctor.
• How do I plan for delivery while still working? Get your due date from your doctor and know the signs of labor. Have a game plan: suitcase ready with key items you will need in the hospital, someone at the ready to drive you to the hospital and take care of any of your other children while you're away. Research your job's maternity leave policies early on. Plan to return to work only when you're physically and emotionally ready.

More information

The U.S. Department of Health and Human Services has more about prenatal care.