Study Finds 5-7 Years Post-Menopausal Hormone Therapy Not Associated with Increased Risk of Mortality

MedicalResearch.com Interview with:

JoAnn E. Manson, MD, DrPH Chief, Division of Preventive Medicine Brigham and Women's Hospital Professor of Medicine and the Michael and Lee Bell Professor of Women's Health Harvard Medical School Boston, Massachusetts  02215

Dr. Manson

JoAnn E. Manson, MD, DrPH
Chief, Division of Preventive Medicine
Brigham and Women’s Hospital
Professor of Medicine and the
Michael and Lee Bell Professor of Women’s Health
Harvard Medical School
Boston, Massachusetts  02215 

MedicalResearch.com: What is the background for this study?

Response: The current report provides new information on total mortality and the rates of death from specific causes (cardiovascular disease, cancer, other major illnesses) over 18 years of follow-up in the Women’s Health Initiative (WHI) randomized trials of hormone therapy (estrogen + progestin and estrogen alone). This is the first WHI report to focus on all-cause and cause-specific mortality. It includes all of the 27,347 women in the 2 hormone therapy trials with >98% follow-up over 18 years, during which time 7,489 deaths occurred. This is more than twice as many deaths as were included in earlier reports. The report also provides detailed information on differences in results by age group (ages 50-59, 60-69, 70-79) at time of study enrollment.

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Cross-Sex Hormone Therapy Associated With Medical Risks and Psychosocial Benefits in Transgender Patients

MedicalResearch.com Interview with:

Carl G Streed Jr. M.D. Pronouns: he, him, his, himself Fellow, Division General Internal Medicine & Primary Care Brigham & Women’s Hospital

Dr. Streed

Carl G Streed Jr. M.D.
Pronouns: he, him, his, himself
Fellow, Division General Internal Medicine & Primary Care
Brigham & Women’s Hospital 

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: Recent reports estimate that 0.6% of adults in the United States, or approximately 1.4 million persons, identify as transgender. Despite gains in rights and media attention, the reality is that transgender persons experience health disparities, and a dearth of research and evidence-based guidelines remains regarding their specific health needs. The lack of research to characterize cardiovascular disease (CVD) and CVD risk factors in transgender populations receiving cross-sex hormone therapy (CSHT) limits appropriate primary and specialty care. As with hormone therapy in cisgender persons (that is, those whose sex assigned at birth aligns with their gender identity), existing research in transgender populations suggests that CVD risk factors are altered by CSHT.

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Menopausal Hormone Therapy Benefits Bone Health For Several Years After Discontinuation

MedicalResearch.com Interview with:

Dr Georgios Papadakis FMH, Médecin InternenMédecin assistant Service d'endocrinologie, diabétologie et métabolisme Lausanne

Dr Georgios Papadakis

Dr Georgios Papadakis
FMH, Médecin InternenMédecin assistant
Service d’endocrinologie, diabétologie et métabolisme
Lausanne

MedicalResearch.com: What is the background for this study?

Response: This study was mainly motivated by the absence of available data on the effect of menopausal hormone therapy (MHT) on bone microarchitecture, as well as contradictory results of previous trials regarding the persistence of a residual effect after MHT withdrawal.

We performed a cross-sectional analysis of 1279 postmenopausal women aged 50-80 years participating in OsteoLaus cohort of Lausanne University Hospital. Participants had bone mineral density (BMD) measurement by dual X-ray absorptiometry (DXA) at lumbar spine, femoral neck and total hip, as well as assessment of trabecular bone score (TBS), a textural index that evaluates pixel grey-level variations in the lumbar spine DXA image, providing an indirect index of trabecular microarchitecture.

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Hormone Combination Effective For Male Contraception But With Many Side Effects

MedicalResearch.com Interview with:
Mario Philip Reyes Festin, MD

World Health Organization
Geneva, Switzerland. 

MedicalResearch.com: What is the background for this study?

Response: Researchers are trying to identify a hormonal male contraceptive that is effective, reversible, safe, acceptable, affordable, and available. Most of the research has been done either by groups of university researchers. However, in the 1990s, WHO undertook two multi-center, multinational studies.

The studies were unable to provide evidence to support the development of a commercially viable, and user-acceptable product.

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Androgen Deprivation For Prostate Cancer Linked to Dementia

MedicalResearch.com Interview with:
Kevin T. Nead, MD, MPhil

Resident, Radiation Oncology
Perelman School of Medicine
Hospital of the University of Pennsylvania.

MedicalResearch.com: What is the background for this study?

Response: Androgen deprivation therapy is a primary treatment for prostate cancer and works by lowering testosterone levels. There is a strong body of research suggesting that low testosterone can negatively impact neurovascular health and function. We were therefore interested in whether androgen deprivation therapy is associated with dementia through an adverse impact on underlying neurovascular function.

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Abuse of Anabolic Steroids May Impair Insulin Resistance For Years After Discontinuation

MedicalResearch.com Interview with:
Jon Rasmussen, MD, PhD fellow
Department of Internal Medicine
Herlev Hospital, Denmark

MedicalResearch.com: What is the background for this study?

Response: Abuse of anabolic androgenic steroids has become highly prevalent among young men involved in recreational strength training. A recent meta-analysis estimated that approximately 18% of young men involved recreational strength training abuse anabolic steroids.

Well-known adverse effects following abuse of anabolic steroids include hypogonadism (For those who have interest, we have recently published a paper concerning this issue, it can be read and downloaded at: http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0161208).

Yet, we have a poor understanding on the adverse effects these compounds might have on the metabolism and insulin sensitivity.

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Estrogen Patch in Newly Postmenopausal Women May Reduce Alzheimer’s Risk

MedicalResearch.com Interview with:

Kejal Kantarci, M.D. M.S. Professor of Radiology Division of Neuroradiology

Dr. Kejal Kantarci

Kejal Kantarci, M.D. M.S.
Professor of Radiology
Division of Neuroradiology

MedicalResearch.com: What is the background for this study? What are the main findings?

Response: A rapid decline in estrogen with menopause may be associated with an increased risk of Alzheimer’s disease risk in women. This study was conducted in newly postmenopausal women who received 17β-Estradiol via a skin patch or conjugated equine estrogen orally or placebo.

Those who received 17β-Estradiol patch had reduced β-amyloid deposits, the plaques found in the brains of people with Alzheimer’s disease, three years after the end of the hormone therapies.

In the study, women with APOE e4 — one form of the most common gene associated with late-onset Alzheimer’s disease — who received the 17β-Estradiol patch had lower levels of β-amyloid deposits than those who received placebo.

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Early Menopause Raises Risk of Postmenopausal Depression

MedicalResearch.com Interview with:
Eleni Petridou, MD, MPH, PhD
Marios K. Georgakis, MD
Department of Hygiene, Epidemiology and Medical Statistics
School of Medicine
National and Kapodistrian University of Athens
Athens, Greece

Medical Research: What is the background for this study?

Response: Previous epidemiologic studies have shown that women during their reproductive life are more vulnerable (by a factor of two) to depression than men; this has been particularly evident during peaks of intense fluctuations of ovarian hormones, like the premenstrual, perimenopausal and postpartum periods. Endogenous (natural) female sex hormones, however, have been shown in various experimental studies to possess neuroprotective and anti-depressive properties. Production of these hormones is diminished after menopause; therefore, age at menopause can be used as a proxy of the lifetime exposure to endogenous hormones. Our research hypothesis was whether longer exposure to endogenous sex hormones has a cumulative anti-depressive action, i.e., whether later age at menopause decreases the risk for postmenopausal depression.

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Study Finds Women Who Take Anticoagulants Can Use Hormonal Therapy

Ida Martinelli MD, PhD A Bianchi Bonomi Hemophilia and Thrombosis Center Fondazione IRCCS Ca' Granda Ospedale Maggiore Policlinico Milan, Italy

Dr. Martinelli

MedicalResearch.com Interview with:
Ida Martinelli MD, PhD
A Bianchi Bonomi Hemophilia and Thrombosis Center
Fondazione IRCCS Ca’ Granda Ospedale Maggiore Policlinico
Milan, Italy 

Medical Research: What is the background for this study? What are the main findings?

Dr. Martinelli: Hormonal therapies are associated with an increased risk of venous thromboembolism. Patients with acute deep-vein thrombosis or pulmonary embolism require anticoagulation, but women of childbearing potential require also an adequate contraception, as oral anticoagulants cross the placenta potentially leading to embryopathy or fetal bleeding. This study was aimed to evaluate the safety of hormonal therapies together with anticoagulant therapies in terms of recurrent venous thrombosis and uterine bleeding. We demonstrated for the first time that women who take oral anticoagulants can safely use hormonal therapies, as their risk of recurrent venous thromboembolism or uterine bleeding is not increased.

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Postmenopausal Hormones Linked To Decreased Colon Cancer Risk

Dr. Hannah Arem Ph.D. M.H.S. Postdoctoral Fellow Nutritional Epidemiology Branch Division Cancer Epidemiology and Genetics National Cancer InstituteMedicalResearch.com Interview with:
Dr. Hannah Arem Ph.D. M.H.S.
Postdoctoral Fellow
Nutritional Epidemiology Branch
Division Cancer Epidemiology and Genetics
National Cancer Institute

MedicalResearch: What is the background for this study?

Dr. Arem: In the United States, men are more likely to develop colorectal cancer (CRC) than women. In large prospective studies, researchers observed that women who reported taking menopausal hormone therapy (MHT) containing estrogen had a 30-40% lower risk of colorectal cancer, compared to women who did not report menopausal hormone therapy use, suggesting an anti-carcinogenic role for estrogen.

We investigated the relationship between estrogen exposure (hormonal and reproductive factors) in relation to survival (risk of death) among women diagnosed with colorectal cancer.

MedicalResearch: What are the main findings?

Dr. Arem: We found a 20% lower risk of death overall among women who reported current menopausal hormone therapy use at study entry (HR=0.79, 95% CI 0.66-0.94) and a 24% lower risk of death from colorectal cancer (0.76, 0.59-0.99), compared to women who reported never using menopausal hormone therapy.

Among women in our study, we observed no statistically significant associations for colorectal cancer mortality with oral contraceptive use, menarche age, age at first birth, parity, or menopausal age.

MedicalResearch: What should clinicians and patients take away from your report?

Dr. Arem: Our study was designed to investigate a mechanistic role for estrogen on carcinogenesis for research purposes. We do not expect these findings to influence clinical practice or behavior.

MedicalResearch: What recommendations do you have for future research as a result of this study?

Dr. Arem: Future studies should focus on the mechanisms by which exogenous estrogen exposure might affect tumor progression and colorectal cancer survival.

Citation:

Reproductive and hormonal factors and mortality among women with colorectal cancer in the NIH-AARP Diet and Health Study

H Arem, Y Park, A S Felix, A Zervoudakis, L A Brinton, C E Matthews and M J Gunter

British Journal of Cancer , (23 June 2015) | doi:10.1038/bjc.2015.224

 

 

Dr. Hannah Arem Ph.D. M.H.S. Postdoctoral Fellow (2015). Postmenopausal Hormones Linked To Decreased Colon Cancer Risk