5 health questions you need to ask your mom

How your health is linked to your mom

Mothers and daughters are natural-born sharers of everything from family recipes to child-raising tips. But have you chatted about your mom’s past, and current, health?

While half of your genes come from your dad, your mom’s DNA and her health experiences, particularly with female-related issues, may affect your risk for the same conditions. So it’s important to start this conversation-even if some issues might be uncomfortable to discuss. Sharing this article with her can get the ball rolling. Her answers to your questions could help you become empowered about your own health.

“Did you have any difficulties getting pregnant?”

If you are thinking of starting a family, ask your mother if she was diagnosed with polycystic ovarian syndrome (PCOS), a hormonal disorder characterized by immature ovarian follicles, menstruation difficulties, excess hair growth on the body and weight gain. Also ask about endometriosis, a painful condition in which tissue that typically lines the inside of the uterus grows elsewhere in the body such as the abdomen or pelvis. These two conditions can cluster in families, and are known to disrupt fertility.

“PCOS affects five to seven percent of women; it is very common, especially in certain ethnic groups,” says Dr. Sony Sierra, a reproductive endocrinology and infertility specialist at the LifeQuest Centre for Reproductive Medicine in Toronto. Those groups include women from Southeast Asia, the Caribbean, China and southern Europe.

The most frequent trait of PCOS is an irregular menstrual cycle that is either very short, excessively long or completely absent. “When your cycles are irregular, chances are you’re not releasing an egg,” explains Sierra. A 2001 study found that if your mother has PCOS, you face a significantly higher risk (approximately 35 percent) of being diagnosed with it when compared to the general population.

Endometriosis is also widespread. According to the Society of Obstetricians and Gynaecologists of Canada, one in 10 women are affected, and studies have found that a daughter’s chances of having endometriosis are three to 10 times greater if her mother or sisters have the disease. “We don’t know what the genes or familial pattern of inheritance is, but endometriosis does tend to run in families. You might have a tiny bit of endometriosis and never know it, and then run into fertility issues,” says Sierra. (To learn more about this condition, see our story at besthealthmag.ca/endometriosis.)

How mom’s answer can help you: Being aware that you have a family predisposition to PCOS can give you the motivation “to try and ensure you have regular menstrual cycles, a healthy lifestyle and a normal body mass index,” says Sierra. All three of these are necessities for optimum fertility. “If your mom had irregular cycles, and you have irregular cycles and have been trying [to conceive] for six months, you should seek help sooner rather than later,” she says.

It may seem odd in this situation, but physicians will often prescribe oral contraceptives or the hormone progesterone to young women with PCOS, to regulate their cycles. If you are hoping to conceive in the near future, you should take the pill for a few months in order to have a dependable menstrual cycle-becoming pregnant is virtually impossible when your cycle is inconsistent. Once your cycle is regulated, you can stop taking the oral contraceptives or progesterone, and try to conceive naturally.

A healthy lifestyle that includes regular exercise and a nutritious diet may also help (a 2013 review found that a low-glycemic-index diet free of processed sugars and refined carbohydrates such as white bread improved menstrual regularity; see our story on fertility-boosting foods).

As well, Sierra says that being aware of your mother’s endometriosis can encourage you to be more pro­active. You will be more apt to undergo tests or fertility treatments sooner if you experience problems such as chronic pelvic, lower back or abdominal pain; severe menstrual cramps; or painful intercourse, urination or bowel movements.

“Have you ever had an abnormal mammogram or a breast biopsy?”

It is well-known that breast cancer can have a genetic component, but did you know that dense or fibrocystic breasts could also run in families? According to Dr. Sandhya Pruthi, an associate professor of medicine and a consultant at the Mayo Clinic’s Breast Diagnostic Clinic in Rochester, Minnesota, breast density is determined by comparing the ratio of dense tissue to breast fat ( “dense tissue” refers to lobes and ducts in the breast; the ducts carry milk from the lobes to the nipple). Years ago, your mother may not have been told that she had dense breasts, but today new research and a better understanding of breast tissue means that such findings are now regularly mentioned in mammogram reports. It’s important to know if you, or your mother, have very dense breasts, because this condition can result in a risk of breast cancer that is four times higher than that of a woman without very dense breasts. If your mom has dense breast tissue that is difficult to read in mammograms, you might encounter the same situation. Mammograms, ultrasounds, MRIs or biopsies may be ordered to disclose whether breast tissue is dense.

How mom’s answer can help you: If your mom’s doctor has not brought up the topic of dense breasts, she can prompt the discussion at her next mammogram. The infor­mation she gets will aid both you and her. Kiley Johnson, a certified genetic counsellor in the Mayo Clinic’s Center for Individualized Medicine in Rochester, Minnesota, says that knowing about your mother’s mammogram history can give you the heads-up if you need to be extra-vigilant about your own breast health, and possibly seek an early consultation with a physician.

“Some people are more predisposed to having benign types of tissue in the breast,” says Johnson, “but if your mom had a biopsy and laboratory findings come back as cancer, it can increase your breast cancer risk.”

“Do you have diabetes, or did you have gestational diabetes?”

Diabetes can have a familial link, and it can interfere with a healthy pregnancy. Gestational diabetes-a blood glucose imbalance that occurs during pregnancy-will strike between three and 20 percent of pregnant women, according to the Canadian Diabetes Association. Women are at high risk if they are of African, Asian, South Asian, Hispanic or Aboriginal descent; if they have a parent with type 2 dia­betes; or if their mother had gestational diabetes. Dr. William Mundle, chair of the obstetrics and gynecology section of the Ontario Medical Association, says that if you have any of these risk factors, you face a 30 to 40 percent chance of developing gestational diabetes when you become pregnant, too. This condition can lead to a larger baby that is difficult to deliver, and put your newborn at risk for weight issues or type 2 diabetes later on.

How mom’s answer can help you: Gestational diabetes is easily treated, and blood glucose levels in the mother usually return to normal following the birth; however, Mundle warns that these women will be at a higher risk for developing type 2 diabetes in the future. “If you had gestational diabetes, the risk of developing type 2 diabetes is about 40 percent,” he says. Regular exercise and a healthy weight gain during pregnancy (an additional 15 to 25 pounds for the average woman) can help prevent gestational diabetes.

“Did you experience postpartum depression?”

According to Dr. Jennifer Payne, an associate professor of psychiatry and the director of the Women’s Mood Disorder Center at Johns Hopkins Hospital in Baltimore, Maryland, if your mother had postpartum depression (PPD), then you are at an elevated risk. “For women with a history of a mood disorder who developed postpartum depression, there is a likelihood that they have a primary family member who also had this condition,” she says.

How mom’s answer can help you: If your mother had PPD and you feel sad or depressed, or are worried you might be after you give birth, seek help immediately; studies show that serious melancholia can be harmful not only to you but to the development of your baby. When moms are depressed, they do not interact normally with their babies. Says Payne, “These babies have lower IQs and language development, and are more likely to have behavioural problems.” Preventive treatments such as antidepressants, psychotherapy, regular exercise and a healthy diet adopted before PPD grabs hold can make a difference in how you feel, and how you connect with your child.

Payne says psychotherapy, cognitive behavioural therapy and medication are helpful interventions for preventing and aiding PPD. It is also recommended that new moms get help with the baby at night from their spouse, a relative or even a temporary nurse, so sleep isn’t interrupted as much.

“How old were you when you went through menopause?”

The age your mother was when she went through menopause could provide clues as to when you will, too. A 2012 Danish study examined ovarian egg reserves of women age 20 to 40, and compared the findings with their mother’s age at menopause. The study discovered the daughters with an earlier fertility decline often had mothers who experienced an earlier menopause. When fertility plummets at an earlier age, menopause is usually earlier as well.

According to Dr. Margery Gass, the Ohio-based executive director of the North American Menopause Society (NAMS), asking your mom when she had menopause can give you insight into your future. However, she says, “there’s no guarantee you’ll have it at that age.” The average age of menopause for Canadian women is 51 and, says Gass, the normal age range is from 41 to 55.

How mom’s answer can help you: Gass says your mother’s menopause information can help you decide when to have children. If she had early menopause, your fertility may decline early, too. In that case, if you do want children, it’s best to do it before age 35. Says LifeQuest’s Sierra, “If a woman in her early 30s tells me her mother had menopause at 40, we would be more aggressive in managing that patient’s concerns. I would check her [ovarian] reserves and if any compromise were found, we’d discuss options to optimize her fertility.”

So do ask questions and try to determine: In your family, do medical issues repeat over generations, or only affect one relative? Did they strike the loved one when she was young?

Find out about major illnesses, surgeries and environmental factors (such as exposure to air pollution and workplace pesticides)-all of these can impact health. Then talk to your doctor about what it could mean to you. And if you have kids, pay it forward by one day passing your own medical history on to them.

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