Question Mark: Why Am I Making So Many Pit Stops?

There are those who have suggested that this feature appears to take an unseemly delight in the decline of the human body: ears that don't hear as well, spines that compress and curve, nose sensors that fade. And did we mention those hairs that start growing out of places other than the head? So we are happy to report on one thing baby boomers may find they do as well as well as ever: urinating. In fact, not only are they still doing it, they may well be doing it more often than ever. A lot more often.

Herman Wouters

Older men may feel more affinity for this  famous fountain in Brussels than they'd like.

Um, wait a minute. It turns out this may be another one of those decline-of-the-human body pieces. Because for many people, their bedtime routine may now consist of reading, a strategic dash to the bathroom right before lights out, and a plea to Neptune to hold back the waters so they will make it through the night without having to get up.

Even if they do manage to do that, they may feel chagrined if they are parents and see their children roll out of bed, eat breakfast and head off to school without making a single pit stop. Your children may not be better people. But they may have better kidneys, said Dr. Sharon A. Brangman, a professor of medicine at SUNY Upstate Medical University.

People may urinate more as they get older for a number of reasons, including medical problems like hypertension or diabetes. It may also be a symptom of infection. “That’s often the first thing we look at when people complain of frequent urination,” said Dr. Tomas Griebling, vice chairman of urology at the University of Kansas and a spokesman for the American Urological Association. Some medicines can also be the cause.

Getting older, Dr. Griebling said, does not necessarily mean more trips to the bathroom. But many people do notice that they have to go more often, and often the explanation lies with normal changes in the body.

As people age, their kidneys may become less adept at concentrating urine and may draw in more water from elsewhere in the body, said Dr. Brangman, a past president of the American Geriatrics Society. This means more urine is produced and sent on to the bladder which, as it happens, is not getting any younger, either, and may be losing some storage capacity. The urethra, through which the urine exits the body, may also be shortening and its lining thinning.

Adding to the problem is that as people age, their bodies produce less of a hormone, aldosterone, that lets them retain fluid. In women, estrogen levels also drop, a change associated with increased urination. And in men, as the prostate gets bigger, it may become harder to urinate, or to do so completely. (Men and women may also develop some incontinence, especially common in women who have borne children.)

Increased urination knows no time of day, but people seem to notice it more at night. The National Sleep Foundation says that when it surveyed people ages 55 to 84, two-thirds reported losing sleep at least a few times a week because of the problem.

Questions about aging? E-mail boomerwhy@nytimes.com

Booming: Living Through the Middle Ages offers news and commentary about baby boomers, anchored by Michael Winerip. You can follow Booming via RSS here or visit nytimes.com/booming. You can reach us by e-mail at booming@nytimes.com.

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Apple shares tumble after relatively unimpressive earnings report

Apple Inc. may still make products customers love, but its latest earnings report appears to have broken investors' hearts.

For the third quarter in a row, Apple reported revenue and profit that were impressive by normal standards, but short of what analysts had expected. Investors reacted harshly, driving Apple's stock price down more than 10% in after-hours trading Wednesday.

If that trend holds when trading opens Thursday, Apple will have lost almost $50 billion in market value in the blink of an eye, and its stock will have given up almost all the extraordinary gains it had made in the last year. Investors' and fund managers' belief in one of the world's most widely held stocks will be severely tested in the coming days.

More fundamentally, despite upbeat talk by Apple Chief Executive Tim Cook, the performance is unlikely to quell growing worries that Apple's remarkable run of dominance might be over.

"Overall, compared to other companies, it's impressive. But for Apple's standards, it's not great," said Patrick Moorhead of Moor Insights & Strategy. "I do think this somewhat fuels the perception that Apple is slowing down a bit.... And it's driven by the fact that some of its competitors are catching up, and in some markets have already caught up."

Apple executives did their best during an hourlong conference call with analysts to project optimism and excitement about both the last quarter and the months ahead. They noted that the company had trouble meeting demand for both iPads and Macs, and could have sold many more had they been able to build enough.

They also pointed to a growing business in China and the expansion of iTunes, which is now available in 119 countries.

"Apple is in one of the most prolific periods of innovation in its history," Cook said. "We continue to believe our fundamentals, our remarkable people, our clear and focused strategy will serve us well in the coming months and years ahead."

Cook praised the record numbers posted by Apple. For the three months that ended in December, Apple said revenue increased 18% to a record $54.5 billion. Profit also set an all-time high but was up only slightly from the year-earlier quarter, rising to $13.08 billion, or $13.81 a share, from $13.06 billion, or $13.87.

Apple said it sold a record 47.8 million iPhones last quarter, up from 37 million iPhones in the same quarter of 2011. Despite that massive figure, some analysts had hoped to see stronger demand with sales exceeding 50 million.

"Meeting expectations is not enough for Apple," said Colin Gillis of BGC Financial. "So that's a little bit of a disappointment…. International sales were a little weaker than people expected. So we'll see how that shakes out."

Last quarter saw the introduction of the iPad mini, a 7.9-inch version of Apple's popular tablet computer. The Cupertino, Calif., company said it sold a total of 22.9 million iPads in the quarter, also a record, up from 15.4 million a year earlier. The company didn't break out iPad mini numbers from its total tablet sales, but Chief Financial Officer Peter Oppenheimer told analysts that the smaller version has been a hit and that the company experienced significant backlog getting the product to store shelves. The 22% lower average selling price for Apple's tablets suggests the mini has performed well but probably cannibalized some sales of its 9.7-inch version.

Historic comparisons were challenging this year because the most recent quarter had only 13 weeks, compared with 14 weeks for the same quarter of 2011.

Like many retailers and consumer electronics companies, the quarter from October to December is typically Apple's largest because of the holiday shopping season. Last year, Apple managed to stun investors by beating its own revenue estimates by more than 25% and earnings forecast by nearly 50%. That sent the stock soaring.

But even as Apple extended its lead as the world's most valuable company, and set a record in August for most valuable company ever when not adjusted for inflation, doubts began to creep into the minds of analysts and investors.

Shares have plummeted 27% in the last four months. On Wednesday, shares rose $9.24, or 1.8%, to $514.01 during regular trading.

Apple reported strong earnings in both the third and fourth quarters last year, but the numbers missed analysts' consensus estimates. Gradually, analysts began lowering their forecasts for Apple's earnings for the current fiscal year. At the same time,

Apple experienced some uncharacteristic gaffes. The new Apple Maps app that replaced Google Maps on iOS 6 devices had reliability problems, prompting a rare apology by Apple. And the iPhone 5 that went on sale in September faced long shipping delays as Apple suppliers struggled to adapt to the new, longer screen size.

The dismissal of iOS chief Scott Forstall, a favorite of the late Apple co-founder Steve Jobs, raised eyebrows. But so did a new strategy for launching products: Whereas Apple updates to products used to be few and far between, the company has lately begun increasing the number of products as well as the introduction of new versions.

The first quarter saw one of the busiest product launch cycles in the company's history. The quarter was the first full quarter of sales for the iPhone 5, a new iPod Touch and nano, the fourth iPad, a new 13-inch Retina MacBook Pro, and, of course, the first iPad mini.

Observers have pointed to this accelerated pace as an indication that Apple is facing more competitive pressure from rivals such as Samsung Electronics Co., which is now the world's biggest seller of smartphones, with its Galaxy series of phones. The concern is that the faster upgrade cycle plus the smaller iPad mini will cut into Apple's historically high profit margins.

Such fears over lower profits have also been stoked by the debate over whether Apple plans to release a cheaper iPhone aimed at capturing market share in emerging economies and the concern that Apple has not been able to strike a deal with China's largest carrier.

Now that the first-quarter numbers have been released, analysts will be busy recalibrating their projections over the next couple of days. But the focus is also likely to shift to renewed speculation about new products that investors are hoping will drive another big run for the stock.

chris.obrien@latimes.com

andrea.chang@latimes.com

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Pentagon ends ban on women in combat

WASHINGTON – Defense Secretary Leon E. Panetta is ending the ban on women serving in combat in the U.S. military, potentially opening up more than 200,000 positions on the front lines and possibly also jobs with elite commando units.

Pentagon officials said Wednesday that Panetta gave the armed services until 2016 to ask for special waivers if they believe any positions should remain closed to women.

The decision specifically overturns a 1994 rule that barred women from serving with smaller ground combat units.

Panetta’s decision was seen as a recognition of women’s contributions to the wars in Iraq and Afghanistan. Because of the demand for troops, women often found themselves on the front lines serving as drivers, medics, mechanics and in other roles when commanders attached their units to combat battalions. They didn’t receive combat decorations or other special recognition, however.

Complete coverage of the 2013 inauguration

The move will also help women climb the military ranks. Female service members have struggled to gain promotions in part because of their lack of combat experience; the Pentagon’s first four-star female general, Ann Dunwoody, wasn’t promoted until 2008.

The Pentagon took an initial step in February when it opened 14,000 combat-related jobs, mostly in the Army, to female service members. The new policy would open up to women more than 200,000 combat jobs, including in Army and Marine infantry units.

Rep. Loretta Sanchez (D-Garden Grove), a member of the House Armed Services Committee and founder of the Women in the Military Caucus, praised Panetta’s decision. He is expected to step down next month, and a Senate confirmation hearing is scheduled next week for Chuck Hagel, whom President Obama has nominated as the next Pentagon chief.

“I have been a firm believer in removing the archaic combat exclusion policy for many years,” Sanchez said in a statement.  “I am happy to hear the secretary will be making significant changes as part of an effort to expand opportunities for women in the military.”

PHOTOS: A look ahead at 2013’s political battles

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Racy Victorian divorces online at genealogy website

LONDON (Reuters) – The original Mrs Robinson’s diary and scandalous suggestions about a former heir to the British throne are all part of the latest ancestral revelations to go online.

British genealogical website Ancestry.co.uk said on Tuesday it has put the transcripts of thousands of Victorian divorce proceedings online, which reveal the racy details of an era that most modern Britons consider to have been dominated by imperial duty, a stiff upper lip and formal familial relations.

The UK Civil Divorce Records, 1858-1911 date from the year when the Matrimonial Causes Act removed the jurisdiction of divorce from the church and made it a civil matter.

Before this, a full divorce required intervention by Parliament, which had only granted around 300 since 1668. The records also include civil court records on separation, custody battles, legitimacy claims and nullification of marriages, according to the website.

Primarily due to their high cost, divorces were relatively rare in the 19th century, with around 1,200 applications made a year, compared to approximately 120,000 each year today, and not all requests were successful due to the strength of evidence required.

The rarity of such cases, combined with the fact that it was wealthy, often well-known nobility involved, made the divorce proceedings huge public scandals, played out in the press as real life soap operas.

Famously high-profile divorces included that of Henry and Isabella Robinson, the inspiration for the novel “Mrs Robinson’s Disgrace”, by Kate Summerscale.

Henry Robinson sued for divorce after reading his wife Isabella’s diary, which included in-depth details of her affair with a younger married man.

The diary was used as court evidence and when reported by the media became a huge scandal, partly because of the language used within the journal. Isabella, however, claimed the diary was a work of fiction, which led to her victory in court.

Conservative MP and baronet, Charles Mordaunt, filed for divorce in 1869 from his wife Harriet who stood accused of adultery with multiple men.

The case became national news when the Prince of Wales was rumored to be among the men who had had an affair with her. This rumor was never proven and Lady Mordaunt was eventually declared mad and spent the rest of her life in an asylum.

“At the time, such tales often developed into national news stories, but now they’re more likely to tell us something about the double standards of the Victorian divorce system or help us learn more about the lives of our sometimes naughty ancestors,” Ancestry.co.uk UK Content Manager Miriam Silverman said in a statement on Tuesday.

When the divorce laws first came into effect, men could divorce for adultery alone, while women had to supplement evidence of cheating with solid proof of mistreatment, such as battery or desertion.

Despite this double standard, roughly half of the records are accounts of proceedings initiated by the wife. Many of the nullifications of marriages fall into this category, with failure to consummate the nuptials a common reason.

One such example in the records shows a Frances Smith filing for divorce in 1893 under such grounds.

In the court ledgers it is noted that the marriage was never consummated, with the husband incapable “by reason of the frigidity and impotency or other defect of the parts of generation” and “such incapacity is incurable by art or skill” following inspection.

(Reporting by Paul Casciato; editing by Patricia Reaney)

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Sundance stars sound off on gun violence in film

PARK CITY, Utah (AP) — The Sundance Film Festival isn't home to many shoot-em-up movies, but action-oriented actors at the festival are facing questions about Hollywood's role in American gun violence.

Guy Pearce and Alexander Skarsgard are among those who say Hollywood shares in the blame.

Pearce is in Park City, Utah, to support the family drama "Breathe In," but he's pulled plenty of imaginary triggers in violent films such as "Lockdown" and "Lawless." He says Hollywood may make guns seem "cool" to the broader culture, but there are vast variations in films' approach to guns.

"Hollywood probably does play a role," Pearce said. "It's a broad spectrum though. There are films that use guns flippantly, then there are films that use guns in a way that would make you never want to look at a gun ever again — because of the effect that it's had on the other people in the story at the time. So to sort of just say Hollywood and guns, it's a broad palette that you're dealing with, I think. But I'm sure it does have an effect. As does video games, as do stories on the news. All sorts of things probably seep into the consciousness."

Skarsgard, who blasted away aliens in "Battleship," says he agrees that Hollywood has some responsibility for how it depicts violence on-screen.

"When (NRA executive director) Wayne LaPierre blames it on Hollywood and says guns have nothing to do with it, there is a reason," he said. "I mean, I'm from Sweden. . We do have violent video games in Sweden. My teenage brother plays them. He watches Hollywood movies. We do have insane people in Sweden and in Canada. But we don't have 30,000 gun deaths a year.

"Yes, there's only 10 million people in Sweden as opposed to over 300 (million) in the United States. But the numbers just don't add up. There are over 300 million weapons in this country. And they help. They do kill people."

Ellen Page, who co-stars with Skarsgard in "The East," noted that gun restrictions are much more pervasive in her home country, Canada.

"You can't buy some crazy assault rifle that is made for the military to kill people. And like that to me is just like a no-brainer," she said. "Why should that just be out and be able to be purchased? That does not make me feel safe as a person."

Skarsgard says it may be time to revisit the Second Amendment.

"The whole Second Amendment discussion is ridiculous to me. Because that was written over 200 years ago, and it was a militia to have muskets to fight off Brits," he said. "The Brits aren't coming. It's 2013. Things have changed. And for someone to mail-order an assault rifle is crazy to me. They don't belong anywhere but the military to me. You don't need that to protect your home or shoot deer, you know."

___

AP Entertainment Writer Ryan Pearson is on Twitter: www.twitter.com/ryanwrd .

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Research on Deadly Bird Flu to Resume After Safety Debate

Experiments with a deadly flu virus, suspended last year after a fierce global debate over safety, will start up again in some laboratories, probably within the next few weeks, scientists say.

The research touched off a firestorm in 2011 when it became known that two groups, one in the Netherlands and another in the United States, had genetically altered a dangerous bird flu virus to make it more contagious in mammals. Some scientists warned that a deadly pandemic could break out if the mutant virus leaked out of the lab accidentally or if terrorists stole it or made it themselves, using articles in scientific journals for the recipe.

The outcry led scientists conducting the experiments to declare a voluntary moratorium a year ago, in part to let research organizations and governments decide what safety rules to require.

Now, flu researchers say, the moratorium should end because most countries have rules in place. A letter from 40 scientists — the same ones who called the moratorium last year — was published on Wednesday in the journals Science and Nature, saying it is time for the work to begin again in countries ready to allow it.

But the United States, which pays for much of the flu research both at home and abroad, has not yet released new guidelines. So scientists in America will not be able to resume experiments yet, nor will those in other countries who depend on grant money from the United States.

During a telephone news conference on Wednesday, Ron Fouchier, a virologist who conducted some of the flu experiments at Erasmus Medical Center in the Netherlands, said the scientists were lifting the moratorium without waiting for guidelines from the United States.

“How long do you want us to wait?” Dr. Fouchier asked. “If this was the Netherlands, would the U.S. wait? Should all countries really wait for the U.S., and why?”

He said his laboratory would resume research within a few weeks. Although he receives research money from the National Institutes of Health in the United States, funding from other sources will allow him to go ahead, he said. Other researchers in the European Union would be free to pick up the research if they had funding that did not come from the United States government, he said. Laboratories in China and Canada may be ready to start up, but Japan, like the United States, is still working on new guidelines, researchers said during the teleconference.

Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said the Department of Health and Human Services was reviewing new guidelines, and that he expected them to be approved in weeks. The guidelines will specify the laboratory conditions under which this type of research is permitted and require that experiments have a potential benefit for public health.

The experiments involve a type of bird flu virus called H5N1. It does not often infect people, but appears unusually deadly when it does. Of 610 known cases in people since 1997, slightly more than half have been fatal. But the real death rate is not known and could be lower than half because some mild cases may go uncounted.

So far, H5N1 has rarely spread from person to person. People who fall ill have nearly always caught it from poultry. But flu viruses mutate a lot, and the fear has been that H5N1 will somehow become more contagious in humans.

The debated experiments, by Dr. Fouchier and Dr. Yoshihiro Kawaoka, at the University of Wisconsin-Madison, involved ferrets, which are considered a good model for flu research because they react to the virus in much the way people do. Researchers can infect ferrets with H5N1 by squirting the virus into their noses or lungs, but then the animals normally do not infect one another. However, by genetically manipulating the virus, researchers created a form that became airborne and spread from ferret to ferret. Its transmissibility set off alarms.

Advocates of the research insist it can be done safely. And they say it is necessary so scientists can recognize changes in naturally occurring viruses that are dangerous and signal the need to eradicate infected animal populations. Understanding the viruses better should also help researchers develop more effective vaccines and antiviral drugs, Dr. Fouchier said.

He said other scientists could be given samples of the mutant virus for research only with the permission of Erasmus Medical Center, the National Institutes of Health and virus experts at the Mount Sinai Medical Center in Manhattan.

But some scientists still have reservations. Michael T. Osterholm, director of the Minnesota Center of Excellence for Influenza Research and Surveillance at the University of Minnesota and a member of a United States biosecurity board, said that he thought the research should go on, but that details should not be published for fear others would try to replicate it without safety precautions.

“The work they’re doing is really important,” he said, “but I don’t see it as work I want in the hands of every potential gene jockey out there.”

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Home building outlook is cautiously optimistic

Although recent months have seen improvement in the number of housing starts and permits pulled, it will be multi-family builders that feel the uptick initially, according to a panel of economists speaking at the International Builders' Show in Las Vegas Tuesday.

Apartment builders will be the first to benefit by an increasing number of new households as young adults move out on their own and fewer households double up, the experts said.

Continued low interest rates and an increase in homes prices in most markets are likely to bring back home buyers who have been sitting on the sidelines, they said.

"Finally, people feel if they buy a house, it will appreciate," said David Crowe, chief economist for the National Assn. of Home Builders.

Home loan rates are expected to remain below 4% in 2013, said Frank Nothaft, chief economist at Freddie Mac. However, he cautioned of some "headwinds" to housing growth, including strict mortgage qualification requirements, uncertainties about employment and consumer cautiousness.

Other questions clouding the picture include the spending and budget issues yet unresolved in Washington.

Describing his panel as "relatively conservative in our forecasts," David Berson, senior vice president and chief economist at Nationwide Insurance, cited low interest rates, job growth, new household formations and house price gains as other factors supporting a housing recovery.

ALSO:

Supply of 'shadow' homes declines again

Home sales jump to highest pace in three years

Builder confidence in housing is highest in six years

lauren.beale@latimes.com

twitter.com/@LATHotProperty

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Election of new DNC leaders points up tensions with White House

WASHINGTON -- After a messy fight that highlighted strains with the White House, the Democratic National Committee completed what should have been the routine election of a new slate of officers Tuesday.

As expected, Rep. Debbie Wasserman Schultz of Florida was given another term as national party chairwoman. But below that level, chaos reigned for a time as DNC members balked at rubber-stamping a White House-approved list of replacements for several veterans of the pre-Obama era.

Among the incoming DNC leaders are vice chairwomen Maria Elena Durazo, a Los Angeles labor official, and Tulsi Gabbard, the newly elected congresswoman from Hawaii. Henry R. Munoz III of San Antonio was named finance chairman, the first Latino in that post.

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But many on the DNC strongly resisted the forced removal of longtime activist Alice Travis Germond as DNC secretary. Highly popular with the membership, Germond, who calls the roll of the states at presidential nominating conventions, is only the third person to hold that job since 1944. In order to tighten its control of the DNC, the White House wanted to replace her with Stephanie Rawlings-Blake, the mayor of Baltimore, who has no experience in national politics.

Angered by the handling of the leadership change by Patrick Gaspard, a former Obama organizer who serves as the party’s executive director, DNC members tried to postpone election of the secretary until the fall. A clearly flustered Schultz, after halting the proceedings and huddling offstage with Germond, returned to announce that Germond had agreed to become secretary emeritus of the party and an at-large DNC member. With that, the slate of officers, including Rawlings-Blake, was approved.

The unexpected drama came only days after President Obama announced creation of his new national advocacy operation, Organizing for Action, widely seen as undermining the DNC’s already weakened status as a political organization.

Schultz, who was Obama’s pick as party chairwoman during his first term, defended the president’s decision, telling the DNC that the new Obama group didn’t pose a threat to the national party.

PHOTOS: President Obama’s second inauguration

Schultz said that she was “thrilled” that Obama’s campaign hadn’t ended with the 2012 election and that his new organization would be “complementing the work we are doing.” She said the Obama group would be training and engaging grass-roots volunteers “so that our work at the Democratic Party can continue to be about electing Democrats up and down the ballot.”

The dispute during the meeting at a Washington hotel, one day after Obama’s inaugural celebration, dragged on for so long that Vice President Joe Biden was forced to cool his heels in a nearby ballroom until the DNC members finished their business.

Although the party organization’s influence may be fading, the hundreds of national committee members still retain at least one measure of clout: They are automatic “superdelegates” to the Democrats’ presidential nominating conventions (though Obama aides briefly considered, and then rejected, getting rid of their delegate power several years ago).

Biden, who would covet those DNC delegate votes if he ran for president in 2016, eventually was able to schmooze with the members at a private reception after the meeting.

PHOTOS: Past presidential inaugurations

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BlackBerry Z10 Looks Like iPhone 5, Takes on Siri

RIM is set to announce the first devices running its new BlackBerry 10 operating system at an event on January 30. A lucky few, however, have already gotten their hands on what looks to be the new hardware, including German site TelekomPresse.

[More from Mashable: Watch These iPhone Knockoffs Get Bulldozed]

The site has the BlackBerry Z10, a touchscreen device with a similar look to some of the other popular smartphones out there — especially the iPhone 5.

Curious to see how the two compared, they put them side-by-side in the video above, running through both the physical design of both devices as well as some of their features.

[More from Mashable: RIM May License BlackBerry 10 to Other Manufacturers]

Notably, the video shows a Siri-like voice control functionality in BlackBerry 10, that we haven’t seen previously. As you can see in the test above, it beats Siri for speed.

SEE ALSO: RIM Adds 15,000 BlackBerry 10 Apps in a Weekend

While similar at first glance, design-wise the two phones do have some differences. The Z10 has a 4.2-inch screen, slightly larger than the iPhone 5’s 4-inch display. Both phones have a power button on top, however, the button on the BlackBerry is in the center of the top of the phone, while the iPhone’s is on the right on the device.

The volume controls are on the right side of the Z10, and left side of the iPhone 5. When it comes to power, the connection for the iPhone 5 is on the bottom of the device with the headphone jack, while the HDMI and USB connections on the Z10 are located on the left.

Check out the video above for a look at the full comparison of the two devices. Are you looking forward to BlackBerry 10? Can the new OS save RIM? Let us know your thoughts in the comments.

BlackBerry 10 Lock Screen

You unlock a BlackBerry 10 device by swiping up from the bottom of the screen.

Click here to view this gallery.

This story originally published on Mashable here.

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The Well Column: Facing Cancer, a Stark Choice

In the 1970s, women’s health advocates were highly suspicious of mastectomies. They argued that surgeons — in those days, pretty much an all-male club — were far too quick to remove a breast after a diagnosis of cancer, with disfiguring results.

But today, the pendulum has swung the other way. A new generation of women want doctors to take a more aggressive approach, and more and more are asking that even healthy breasts be removed to ward off cancer before it can strike.

Researchers estimate that as many as 15 percent of women with breast cancer — 30,000 a year — opt to have both breasts removed, up from less than 3 percent in the late 1990s. Notably, it appears that the vast majority of these women have never received genetic testing or counseling and are basing the decision on exaggerated fears about their risk of recurrence.

In addition, doctors say an increasing number of women who have never had a cancer diagnosis are demanding mastectomies based on genetic risk. (Cancer databases don’t track these women, so their numbers are unknown.)

“We are confronting almost an epidemic of prophylactic mastectomy,” said Dr. Isabelle Bedrosian, a surgical oncologist at M. D. Anderson Cancer Center in Houston. “I think the medical community has taken notice. We don’t have data that say oncologically this is a necessity, so why are women making this choice?”

One reason may be the never-ending awareness campaigns that have left many women in perpetual fear of the disease. Improvements in breast reconstruction may also be driving the trend, along with celebrities who go public with their decision to undergo preventive mastectomy.

This month Allyn Rose, a 24-year-old Miss America contestant from Washington, D.C., made headlines when she announced plans to have both her healthy breasts removed after the pageant; both her mother and her grandmother died from breast cancer. The television personality Giuliana Rancic, 37, and the actress Christina Applegate, 41, also talked publicly about having double mastectomies after diagnoses of early-stage breast cancer.

“You’re not going to find other organs that people cut out of their bodies because they’re worried about disease,” said the medical historian Dr. Barron H. Lerner, author of “The Breast Cancer Wars” (2001). “Because breast cancer is a disease that is so emotionally charged and gets so much attention, I think at times women feel almost obligated to be as proactive as possible — that’s the culture of breast cancer.”

Most of the data on prophylactic mastectomy come from the University of Minnesota, where researchers tracked contralateral mastectomy trends (removing a healthy breast alongside one with cancer) from 1998 to 2006. Dr. Todd M. Tuttle, chief of surgical oncology, said double mastectomy rates more than doubled during that period and the rise showed no signs of slowing.

From those trends as well as anecdotal reports, Dr. Tuttle estimates that at least 15 percent of women who receive a breast cancer diagnosis will have the second, healthy breast removed. “It’s younger women who are doing it,” he said.

The risk that a woman with breast cancer will develop cancer in the other breast is about 5 percent over 10 years, Dr. Tuttle said. Yet a University of Minnesota study found that women estimated their risk to be more than 30 percent.

“I think there are women who markedly overestimate their risk of getting cancer,” he said.

Most experts agree that double mastectomy is a reasonable option for women who have a strong genetic risk and have tested positive for a breast cancer gene. That was the case with Allison Gilbert, 42, a writer in Westchester County who discovered her genetic risk after her grandmother died of breast cancer and her mother died of ovarian cancer.

Even so, she delayed the decision to get prophylactic mastectomy until her aunt died from an aggressive breast cancer. In August, she had a double mastectomy. (She had her ovaries removed earlier.)

“I feel the women in my family didn’t have a way to avoid their fate,” said Ms. Gilbert, author of the 2011 book “Parentless Parents,” about how losing a parent influences one’s own style of parenting. “Here I was given an incredible opportunity to know what I have and to do something about it and, God willing, be around for my kids longer.”

Even so, she said her decisions were not made lightly. The double mastectomy and reconstruction required an initial 11 1/2-hour surgery and an “intense” recovery. She got genetic counseling, joined support groups and researched her options.

But doctors say many women are not making such informed decisions. Last month, University of Michigan researchers reported on a study of more than 1,446 women who had breast cancer. Four years after their diagnosis, 35 percent were considering removing their healthy breast and 7 percent had already done so.

Notably, most of the women who had a double mastectomy were not at high risk for a cancer recurrence. In fact, studies suggest that most women who have double mastectomies never seek genetic testing or counseling.

“Breast cancer becomes very emotional for people, and they view a breast differently than an arm or a required body part that you use every day,” said Sarah T. Hawley, an associate professor of internal medicine at the University of Michigan. “Women feel like it’s a body part over which they totally have a choice, and they say, ‘I want to put this behind me — I don’t want to worry about it anymore.’ ”

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