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No One Way to Hold Sway
Women Drive Online Health Traffic, but Use Varies

By Jennifer Huget
Special to The Washington Post
Tuesday, October 2, 2007

Six years ago, when my primary care physician suggested I have an MRI to help figure out why my left fingertips kept tingling, I went straight home, sat down at the computer and typed "tingling fingers MRI" into my Web browser's search box.

That's what we women do.

Independent studies conducted by the Pew Internet & American Life Project and market research done by the folks who run health-oriented Web sites show that women, more than men, turn to the Internet for help with their health. In 2006, a Pew survey found 82 percent of wired women used the Internet for health purposes; 77 percent of men did the same. And WebMD, the most-visited commercial health site on the Internet (according to research from HealthRatings.org), reports that a whopping 78 percent of its visitors are female.

But even though we gals are flocking to Internet health sites, we aren't all using them the same way.

Pew research shows that women are more likely than men to search online for information about a specific disease or medical problem (69 percent to 58 percent). But Nan Forte, executive vice president for consumer services at WebMD, says women's focus "is very much dependent on their age."

"Thirty percent of [the women visiting WebMD] have children under 18 in their household," Forte says. In other cases, the woman "is a caregiver for herself and for her family. That expands her interest to everything from poison ivy to PMS -- and the poison ivy probably isn't hers."

Forte points out that half of the younger women come to WebMD because they've experienced some kind of "health episode," while the other half are interested in their own "performance" issues: "looking better, working better, working on their body."

"The fastest-growing segment," Forte says, "is the woman over 50 managing her health and that of her family."

Forte adds that, across the board, women are watching for video more, which allows them quick access to experts they wouldn't get to consult in person. And the "community" section of the site, where viewers can communicate with one another, has grown increasingly popular. "Women very much value the insight of another woman," even if they don't know her personally, Forte says.

The Boston Women's Health Book Collective, the folks responsible for 1970s groundbreaking women's health bible "Our Bodies, Ourselves," runs the site http://www.ourbodiesourselves.org, which attracts 80,000 visitors a month, according to site manager Kiki Zeldes. People visiting the site ("We assume they're women, but we can't really back that up with science," Zeldes says) gravitate toward sections on sexuality, contraception and relationships, Zeldes observes; a blog launched a year ago and written by a non-physician is one of the site's most popular features.

Arthur Schoenstadt, a physician who is formally launching http://www.eMedTV.com (featuring what he calls the largest library of health-education videos on the Web) two weeks from today, says women's ways of using Web sites have informed the design of his site, which he says has attracted 3 million visits since its soft launch a year ago.

"A lot come to eMedTV for our pregnancy information," Schoenstadt says. Women with kids, he says, are "looking for quick answers: 'How long will a cold last?' or 'When's it okay to send my kid back to school?' "

Schoenstadt adds that women older than 50 "are looking for information for themselves and their significant other." Ninety percent of those viewing the site's section on menopause, he says, are women; for the section on prostate conditions, viewership is split 50-50 between males and females.

Two Users, Two Views

Gayle Weisman and Sarah Noonan have a lot in common. Both are ovarian cancer survivors. Each had the disease diagnosed at a young age: Weisman at 26, back in 1996, and Noonan at 31 in 2003. And both have used the Internet as a tool in managing, coping with and learning about the disease.

When Weisman was diagnosed, "the Internet was not used," she says. She did join an e-mail list for women with ovarian cancer, though. "It was great to be able to use the list, to talk to other women," she says. And not just for support: Weisman turned to these women for help figuring out whether to have her surgically installed chemotherapy port removed right away or to keep it intact, just in case. She says she recognized there would be some risk in taking their advice, but "I had to just take a leap of faith that under the circumstances these people would be honest and trustworthy."

Weisman says she does a lot of Internet research, particularly about medications, and takes the information she gleans to her doctor as a basis for asking questions. She also has taken advantage of the "rant and rave" section of one site. "It's a nice way of having other people to connect to" when she wants to, she says.

"I want to live my life, but I need help," Weisman says. "That's the beauty of the Internet. You're on your own terms. You don't have to show up the first Tuesday of every month."

Both Weisman, an event planner in New York, and Noonan, a physical therapist in Minnesota, say they appreciated being able to keep their friends and family informed about the progress of their treatment via mass e-mails. Those e-mails were great, Noonan says, because "it was so awesome to get responses back."

But Noonan says she's not one to use the Internet to ferret out information about her disease. "I'm a strong believer in patients' being advocates for themselves and educating themselves," she says, "but I've been blessed with amazing doctors, so I rely on them instead of spending a lot of time searching and searching and searching" on the Internet.

Noonan has, however, used the Web to participate in support groups for young survivors of ovarian cancer and is developing a site for her local chapter; it will offer education resources and support for young women coping with the disease and its aftermath. She also takes part in an online support community at http://www.caringbridge.org and participates in an online group of survivors who share practical and emotional concerns. "Sometimes I just vent, when I'm feeling sad about not being able to have children," she says. "It validates your feelings."

The Right Site

Back to me and my tingling fingers. My naive experience (I hadn't been a health reporter for long, back then) highlights several potential risks in relying on your computer for health information. My search led me to the shocking discovery that my doctor suspected I might have multiple sclerosis, which, it turned out, I do. Why, I wonder, hadn't I asked my doctor directly, when she recommended the MRI, what she thought that test might turn up? And why didn't she tell me herself? I'll never know, but getting the news from her in her office would have been lots nicer than being hit over the head with it, alone in my home office.

Beyond that, the peculiar wording of my search terms led me not to reputable and trustworthy sites such as that run by the National MS Society, where I would have received solid information, but to a tangled thicket of sites populated by people spouting scary stories about people landing in wheelchairs mere months after their diagnoses.

The wealth of inaccurate and misleading health information on the Web gives many doctors pause. "It's a two-edged sword," says Roger Smith, vice chairman of the department of obstetrics and gynecology at the University of Missouri at Kansas City. "It's good to have an informed and involved patient." But, he says, patients need to be mindful of sites' sources, sponsors and vetting practices.

Those concerns have prompted several agencies to develop guidelines to steer e-patients toward sites they can trust. The National Cancer Institute and Medline Plus (a service of the National Library of Medicine and the National Institutes of Health) offer such advice. Both urge health-info surfers to pay attention to who runs -- and who pays for -- the Web site, how health information is documented and whether it's attributed to bona fide expert sources (think doctors, not journalists); whether the information is peer-reviewed or otherwise vetted before it's posted; and how recently the information has been updated.

For further help, check HealthRatings.org for detailed ratings of the 20 most-trafficked health Web sites. WebMD, Aetna's InteliHealth, the National Institutes of Health, Drugs.com, the Mayo Clinic and KidsHealth are among those earning high honors. ¿

Jennifer Huget writes frequently for the Health section. Comments:health@washpost.com.

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