Women With Severe Hot Flashes At Higher Risk of Obstructive Sleep Apnea

MedicalResearch.com Interview with:
Stephanie S. Faubion, MD, FACP, NCMP, IF
Director, Executive and International Medicine
Director, Office of Women’s Health
Associate Professor of Medicine
Division of General Internal Medicine 

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

Response: The Data Registry on Experiences of Aging, Menopause and Sexuality (DREAMS) was used for this study investigating the association between vasomotor symptoms (hot flashes and night sweats) and risk for obstructive sleep apnea, a common and underdiagnosed sleep disorder in women which is associated with increased cardiovascular risk.

We found that Women who had severe or very severe hot flashes or night sweats were more likely to be at increased risk for obstructive sleep apnea.  This association held even after adjusting for age, body mass index, smoking and hypertension, such that the odds of women having intermediate /high risk for obstructive sleep apnea were 1.87 times higher for those with severe/very severe hot flashes/night sweats compared to those with less severe symptoms.  We decided to analyze the group of women with normal body mass index, and indeed, this finding was still significant in the lean group of women.

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Hormones Affect Carotid Plaque Stability and Stroke Vulnerability

MedicalResearch.com Interview with:

Marija Glisic Epidemiology, Erasmus MC

Marija Glisic

Marija Glisic
Epidemiology, Erasmus MC 

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

Response: Carotid atherosclerosis is one of most important risk factors for developing stroke. Carotid atherosclerotic plaques characterized by lipid core presence and intraplaque haemorrhage are considered to be unstable, and therefore more prone to rupture and lead to consequent stroke. Sex differences have been observed in carotid plaque composition as well as in stroke incidence. Sex hormones, particularly estrogen and testosterone actions are suggested to underlie the observed sex differences in atherosclerosis. Experimental evidence suggests a direct action of estradiol and testosterone on the vascular system, affecting various mechanisms that may impact plaque composition and subsequently stroke risk.

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Cataract Surgery Linked To Improved Health and Survival, As Well As Sight

MedicalResearch.com Interview with:

Anne L. Coleman, MD, PhD Center for Community Outreach and Policy, Stein Eye Institute David Geffen School of Medicine Director, UCLA Mobile Eye Clinic Department of Epidemiology, Fielding School of Public Health UCLA

Dr. Coleman

Anne L. Coleman, MD, PhD
Center for Community Outreach and Policy, Stein Eye Institute
David Geffen School of Medicine
Director, UCLA Mobile Eye Clinic
Department of Epidemiology, Fielding School of Public Health
UCLA

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

Response: Cataracts are a leading cause of vision loss worldwide, and cataract surgery is an intervention that is known to be extremely effective to address the vision loss related to cataract. However, it is unclear if there are benefits of cataract surgery beyond vision improvement in people with cataracts. Previous studies have suggested that in addition to improving vision, cataract surgery may decrease the risk of fractures and accidents, improve mental health, and improve overall quality of life. The purpose of the present study was to further investigate the potential benefits of cataract surgery and to determine if cataract surgery was associated with increased survival in people with cataracts.

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Half of Menopausal Women Report Getting Insufficient Quality Sleep

MedicalResearch.com Interview with:
Dr. Anjel Vahratian PhD MPH Maternal and Child Health Epidemiologist Branch Chief at the National Center For Health Statistics   Centers for Disease Control and PreventionDr. Anjel Vahratian PhD MPH

Maternal and Child Health Epidemiologist
Branch Chief at the National Center For Health Statistics
Centers for Disease Control and Prevention

MedicalResearch.com: Why did you conduct this study?

Response: Our research focuses on the health of women as they age and transition from the childbearing period. During this time, women may be at increased risk for chronic health conditions such as diabetes and cardiovascular disease.

As insufficient sleep is a modifiable behavior that is associated with these chronic health conditions, we wanted to examine how sleep duration and quality varies by menopausal status.

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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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Cardiovascular Fat in Women at Midlife Varies By Race and Body Shape

MedicalResearch.com Interview with:

Samar R. El Khoudary, PhD, MPH, BPharm, FAHA Associate Professor, Epidemiology PITT Public Health Epidemiology Data Center University of Pittsburgh Pittsburgh, PA 15260 

Dr. El Khoudary

Samar REl KhoudaryPhDMPH, BPharm, FAHA
Associate Professor, Epidemiology
PITT Public Health
Epidemiology Data Center
University of Pittsburgh
Pittsburgh, PA 15260  

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

Response: Heart fat is associated with greater coronary heart disease risk. Postmenopausal women have greater heart fat volumes than premenopausal women, and the association between specific heart fat depots and calcification in the coronary arteries is more pronounced after menopause. Race, central adiposity, and visceral adiposity are important factors that could impact heart fat volumes.

We evaluated whether racial differences in heart fat volumes and in their associations with central (abdominal visceral fat) and general adiposity (as measured by body mass index [BMI]) exist in midlife women. Our study included 524 women from the Study of Women’s Health Across the Nation (SWAN) (mean age: 51 years; 62% White and 38% Black) who had data on heart fat volumes, abdominal visceral fat and BMI.

After accounting for the potential health effects of lifestyle and socioeconomic factors we found that midlife Black women had less heart fat volumes than white women and not surprisingly, the more fat a women carries overall, the higher her risk for a fatty heart. However, white women with higher BMI had significantly more heart fat, as measured by a CT scan, than black women with the same BMI. For black women, the levels of heart fat were greater if they carried more fat in their midsection, as measured by a cross-sectional CT scan, compared with white women with the same volume of fat in their midsection. The results echo the findings we have reported previously in midlife men and published at the International Journal of Obesity (2015) 39, 488–494.
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Periodontal Disease is Associated with Higher Risk of Cancer in Postmenopausal Women

MedicalResearch.com Interview with:

Jean Wactawski-Wende, PhD Dean, SUNY Distinguished Professor Professor, Department of Epidemiology and Environmental Health School of Public Health and Health Professions University of Buffalo

Dr. Wactawski-Wende

Jean Wactawski-Wende, PhD
Dean, SUNY Distinguished Professor
Professor, Department of Epidemiology and Environmental Health
School of Public Health and Health Professions
University of Buffalo

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

Response: There has been a growing interest in the role of periodontal disease in system chronic diseases, including cancer. We explored the association of periodontal disease history and incident cancer in the women’s health initiative study of postmenopausal women. We found that women reporting periodontal disease history were at increased risk of developing cancer overall. In addition they were found to have significant increased risk of specific cancers including cancers of the lung, breast, esophagus, gallbladder and melanoma. The risk persisted after control for many other factors. In addition, the risk was seen in women regardless of their smoking history. Both ever smokers and never smokers were found to have increased risk of cancer associated with periodontal disease history.

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Women With Early Menopause At Higher Risk of Diabetes

MedicalResearch.com Interview with:

Eralda Asllanaj Department of Epidemiology Erasmus University Medical Center Rotterdamthe Netherlands

Eralda Asllanaj

Eralda Asllanaj
Department of Epidemiology
Erasmus University Medical Center
Rotterdamthe Netherlands

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

Response: It is known that women with early onset of menopause (age below 45 years) have an increased risk of cardiovascular disease and overall mortality. This increased risk is thought to be due to the adverse effects of menopause on cardiovascular risk factors.

Type 2 diabetes is a major risk factor for cardiovascular disease, but it remains unclear whether age at menopause affects the risk of developing type 2 diabetes. Our study shows that women who experience menopause before the age of 40 were almost 4 times more likely to develop type 2 diabetes than those experiencing menopause after 55 years old. Moreover, those who had menopause between 40 to 44 years were 2.4 times more likely to have diabetes later in life. The risk of having diabetes reduced by 4 % per year older the women experienced menopause. Adjustment for the various confounding factors and differences in genetic predisposition to early menopause did not affect the results.

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Late Menopause and Oral Hormone Therapy Linked To High Risk of Hearing Loss

MedicalResearch.com Interview with:

Sharon G. Curhan, MD, ScM Channing Division of Network Medicine Department of Medicine Brigham and Women's Hospital Harvard Medical School Boston, MA 02115

Dr. Curhan

Sharon G. Curhan, MD, ScM
Channing Division of Network Medicine
Department of Medicine
Brigham and Women’s Hospital
Harvard Medical School
Boston, MA 02115

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

Response: Hearing loss affects approximately 48 million Americans and the number is expected to increase as the population ages. Some previous studies suggested that menopause may increase the risk for hearing loss, presumably due to the reduction in circulating estrogen levels, and that postmenopausal hormone therapy might slow hearing decline by “replacing” estrogen. To evaluate the role of menopause and postmenopausal hormone therapy as risk factors for hearing loss, we examined the independent associations between menopausal status, oral hormone therapy, and risk of self-reported hearing loss in 80,972 women who are participants in the Nurses’ Health Study II, aged 27-44 years at baseline, and were followed from 1991 to 2013.

After more than 1.4 million person-years of follow-up, 18,558 cases of hearing loss were reported (~23% of the women developed hearing loss). We did not observe an overall independent association between menopausal status and risk of hearing loss.

However, the risk among women who underwent natural menopause at an older age was higher. Specifically, the risk among women who underwent natural menopause at age 50 or older was 10% higher than among those who underwent natural menopause before age 50 [multivariable-adjusted relative risk (MVRR): 1.10, 95% CI 1.03, 1.17]. When we conducted an analysis restricted to women who underwent natural menopause and did not use hormone therapy (HT), the multivariable-adjusted relative risk among women who underwent natural menopause at age 50-54 years was 21% higher (MVRR: 1.12, 95% CI: 1.10, 1.34), and among women who underwent natural menopause at age 55+ years was 29% higher (MVRR: 1.29, 95% CI: 1.11, 1.50), compared with women who underwent natural menopause before age 50.

Among postmenopausal women, we also found that use of oral HT was associated with higher risk of hearing loss, and the magnitude of the risk tended to increase with longer duration of use (p-trend < 0.001). Compared with women who never used any type of HT, the MVRR of hearing loss among women who used oral HT for 5-9.9 years was 15% higher (MVRR: 1.15, 95% CI: 1.06, 1.24), and for 10+ years was 21% higher (MVRR: 1.21, 95% CI: 1.07, 1.37). When specific types of oral HT were examined, longer duration of use of either oral estrogen-only or of combined estrogen plus progestogen HT were each associated with higher risk. Fewer women reported use of progestogen-only oral HT, yet among these women a higher risk was suggested, but not significant (MVRR: 1.15, 95% CI: 0.98, 1.35). Transdermal HT use was less common, but the associations observed were similar to those with oral hormone therapy. When examined separately by type of menopause, the results for HT use were similar.

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AbbVie Developing Elagolix For Heavy Menstrual Bleeding Associated With Fibroids

MedicalResearch.com Interview with:

Dr. James A. Simon, MD CCD, NCMP, FACOG</strong> Clinical professor of obstetrics and gynecology George Washington University, and Medical director, Women's Health & Research Consultants® Washington, D.C

Dr. Simon

Dr. James A. Simon, MD CCD, NCMP, FACOG
Clinical professor of obstetrics and gynecology
George Washington University, and
Medical director, Women’s Health & Research Consultants®
Washington, D.C

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

Response: The Phase 2b uterine fibroids study was a 24-week, multicenter, double-blind, randomized, placebo-controlled, parallel group clinical trial that evaluated the efficacy and safety of elagolix alone or in combination with add-back therapy (estradiol/norethindrone acetate) in women with heavy uterine bleeding associated with uterine fibroids. Elagolix is currently being investigated in diseases that are mediated by sex hormones, such as uterine fibroids and endometriosis.

The study was conducted in 567 premenopausal women, age 18 to 51, at 100 sites in the United States, Canada, Puerto Rico, Chile and the United Kingdom. The two cohort design study evaluated the safety and efficacy of two elagolix treatment regimens (300mg BID and 600mg QD) alone and in combination with two different strengths of add-back therapy (estradiol/norethindrone acetate). The data presented were results from the 300mg cohort. Results from the 600mg cohort were similar and will be reported in a future publication.

Current non-surgical treatments indicated for uterine fibroids are limited, and women suffering from heavy menstrual bleeding associated with uterine fibroids need more options.

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Pelvic Floor Symptoms May Lead To Exercise Avoidance in Menopausal Women

MedicalResearch.com Interview with:

Dr. Eija K. Laakkonen PhD Assistant professor Gerontology Research Center Faculty of Sport and Health Sciences University of Jyväskylä

Dr. Laakkonen

Dr. Eija K. Laakkonen PhD
Assistant professor
Gerontology Research Center
Faculty of Sport and Health Sciences
University of Jyväskylä

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

Response: Physical activity improves health and may delay the onset of chronic diseases. For women in particular, the rate of some chronic diseases accelerates at middle age around the time of menopause; therefore it is important to identify the determinants of health-enhancing physical activity during midlife in this population.

The main aim of this study was to characterize the level of physical activity and to examine the association between different female reproductive factors and objectively-measured physical activity in middle-aged women. The reproductive factors included cumulative reproductive history index, and perceived menopausal and pelvic floor dysfunction symptoms.

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Paracardial Fat Linked To Postmenopausal Coronary Artery Calcification

MedicalResearch.com Interview with:

Samar R. El Khoudary, Ph.D., M.P.H. Assistant professor Department of Epidemiology University of Pittsburgh Graduate School of Public Health

Dr. El Khoudary,

Samar R. El Khoudary, Ph.D., M.P.H.
Assistant professor
Department of Epidemiology
University of Pittsburgh Graduate School of Public Health

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

Response: Our study revealed a previously unknown, menopause-specific indicator of heart disease risk. For the first time, we’ve pinpointed the type of heart fat, linked it to a risk factor for heart disease and shown that menopausal status and estrogen levels are critical modifying factors of its associated risk in women.

My team evaluated clinical data, including blood samples and heart CT scans, on 478 women from Pittsburgh and Chicago enrolled in the Study of Women’s Health Across the Nation (SWAN). The women were in varying stages of menopause, averaged 51 years old and were not on hormone replacement therapy.

In a previous study, we showed that a greater volume of paracardial fat, but not epicardial fat, after menopause is associated with a decline in the sex hormone estradiol—the most potent estrogen—in women. The higher volume of epicardial fat was tied to other risk factors, such as obesity.

In the new study, we built on those findings to discover that not only is a greater paracardial fat volume specific to menopause, but—in postmenopausal women and women with lower levels of estradiol—it’s also associated with a greater risk of coronary artery calcification, an early sign of heart disease that is measured with a heart CT scan.

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Increased Risk of Heart Disease in Postmenopausal Women With History of Weight Cycling

MedicalResearch.com Interview with:

Somwail Rasla, MD Internal Medicine Resident Memorial Hospital of Rhode Island Brown University

Dr. Somwail Rasla

Somwail Rasla, MD
Internal Medicine Resident
Memorial Hospital of Rhode Island
Brown University

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

Response: Weight cycling has been studied as a possible risk factors for all-cause mortality and was found to be insignificant in some studies and significant in other studies when adjusted to age and timing of when the weight cycling occurred. It was proposed that weight cycling may increase risk of chronic inflammation by which weight cycling was considered to be a risk factor for increased morbidity and all cause mortalities. Other studies have reported that frequent weight cycling was associated with shorter telomere length, which is a risk factor for several comorbidities including CHD. Earlier studies showed that weight cycling has an association with increase in size of adipocytes as well as fluctuation of serum cholesterol, triglycerides, glucose, insulin, and glucagon which may contribute to the increased incidence of diabetes. Alternatively, in the nurses’ health study , weight cycling was not predictive of cardiovascular or total mortality.

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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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Menopause Has Variable Effect on Memory Decline in Women

MedicalResearch.com Interview with:
Jill M. Goldstein, Ph.D.

Director of Research for the Connors Center for Women’s Health and Gender Biology
Brigham and Women’s Hospital and
Professor of Psychiatry and Medicine at Harvard Medical School

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

Response: Maintaining intact memory function as we age is one of the primary public health challenges of our time. In fact, women are at almost twice the risk for Alzheimer’s disease and it is not only because women live longer. Thus, it is incumbent upon us to understand this sex difference and incorporate the knowledge into the development of sex-dependent therapeutics.

Our study focused on beginning this investigation by understanding how memory circuitry and memory function change over the menopausal transition, when we believe that sex differences in memory aging emerge. By understanding healthy aging, we will better understand how the brain goes awry with age differently in men and women and who might be at highest risk for Alzheimer’s disease later in life.

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Clinical Practice Guidelines For Diagnosis and Treatment of Postmenopausal Osteoporosis

MedicalResearch.com Interview with:

Pauline Camacho, MD, FACE Professor, Endocrinology Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Fellowship Program Director, Endocrinology, Medical Director, Osteoporosis Center

Dr. Pauline Camacho

Pauline Camacho, MD, FACE
Professor, Endocrinology
Director, Loyola University Osteoporosis and Metabolic Bone Disease Center, Fellowship Program Director, Endocrinology, Medical Director, Osteoporosis Center

MedicalResearch.com: What is the background for this report? What is the prevalence and significance of osteoporosis in US women?

Response: Osteoporosis is widely prevalent and is increasing in prevalence not only in the US but also around the world. 10.2 million Americans have osteoporosis and that an additional 43.4 million have low bone mass. More than 2 million osteoporosis-related fractures occur annually in the US, more than 70% of these occur in women ( from National Osteoporosis Foundation (NOF) estimates).

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Gene Variants Linked With Increased Risk of Hot Flashes in Menopause

MedicalResearch.com Interview with:

Carolyn J. Crandall, MD, MS, FACP Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, California

Dr. Carolyn Crandall

Carolyn J. Crandall, MD, MS, FACP
Professor of Medicine
David Geffen School of Medicine at University of California, Los Angeles
UCLA Medicine/GIM
Los Angeles, California

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

Response: Scientists have suspected that genes may contribute to the risk of getting hot flashes and night sweats, but studies so far have been few in number and only focused on small parts of the human gene code (for example, the gene coding for estrogen receptors). No study has ever comprehensively sampled gene variations that span the entire human genome to look for associations between genetic variation and risk of hot flashes and night sweats.

This was the first study of its kind, performed in more than 17.000 postmenopausal women participating in the Women’s Health Initiative Study. We examined 11,078,977 single-nucleotide polymorphisms, or SNPs, which are gene variants, in a genome-wide association study.

Our main results were that 14 gene variants (SNPs) that were significantly associated with increased risk of having hot flashes. All of these variants were located in chromosome 4, in the gene that codes for the tachykinin receptor 3.

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Nighttime Hot Flashes With Sleep Disruption Linked To Depressive Symptoms During Menopause

MedicalResearch.com Interview with:

Hadine Joffe, MD, MSc Associate Professor of Psychiatry, Harvard Medical School Vice Chair for Psychiatry Research Director of Division of Women's Mental Health / Dept of Psychiatry / Brigham and Women’s Hospital Director of Psycho-Oncology Research / Dept of Psychosocial Oncology and Palliative Care /Dana Farber Cancer Institute www.brighamwharp.org

Dr. Hadine Joffe

Hadine Joffe, MD, MSc
Associate Professor of Psychiatry, Harvard Medical School
Vice Chair for Psychiatry Research
Director of Division of Women’s Mental Health / Dept of Psychiatry / Brigham and Women’s Hospital
Director of Psycho-Oncology Research / Dept of Psychosocial Oncology and Palliative Care /Dana Farber Cancer Institute
www.brighamwharp.org

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

Response: We conducted this study to advance our understanding about causes of mood disturbance in the menopause transition that are specifically related to menopause. We used an experimental model to dissect out the contributions of hot flashes and sleep disturbance from contribution of changing levels of estrogen because hot flashes, sleep problems, and estrogen fluctuations co-occur and are difficult to distinguish from one another. Understanding whether hot flashes and/or sleep disturbance are causally related to mood disturbance will help us identify who is at risk for mood changes during the menopause transition. This is incredibly important now that we are finding effective non-hormonal treatments for hot flashes and sleep disruption.

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Early Menopause Linked To Increased Risk of Heart Disease and Carotid Atherosclerosis

MedicalResearch.com Interview with:
Taulant Muka, MD, MPH, PhD
Postdoctoral Researcher
Erasmus University, Rotterdam

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

Response: Menopause marks a major life transition for women, resulting in the loss of ovarian follicle development. Although menopause is a universal phenomenon among women, the timing of the final menstrual period differ greatly between women, and is considered a marker of aging. By quantifying data of nearly 310,329 non-overlapping women, we found that women who experienced an early menopause (i.e. younger than 45 years) have an excess risk of CHD, CVD-mortality and all-cause mortality. Furthermore, being 45-49 years at menopause compared to ≥50 years was associated with increased risk of carotid atherosclerosis.

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Early Hysterectomy With Preserved Ovaries Doubles Risk of Hot Flashes and Night Sweats

MedicalResearch.com Interview with:

Louise Wilson PhD Candidate The University of Queensland

Louise Wilson

Louise Wilson PhD Candidate
The University of Queensland

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

Response: Hysterectomy remains one of the most common gynecological procedures worldwide, with rates highest among women aged between 40 and 50. Between 30 and 40% of women aged in their 40s and 50s experience hot flushes and night sweats (vasomotor symptoms) that can greatly impact upon their overall quality of life. There is consistent evidence that women who have a hysterectomy and both ovaries removed are more likely to report more frequent or severe vasomotor symptoms, probably due to the abrupt decline in estrogen levels post-surgery.

For women who have a hysterectomy with ovaries retained, the evidence is less clear. We wanted to increase our understanding of the symptom experiences of these women. We examined 17 years of data from more than 6,000 women in the Australian Longitudinal Study on Women’s Health. Approximately one in five of the women had a hysterectomy with ovarian conservation before the age of 50.

We found that a third of these women experienced hot flushes that persisted in the long term, and around one in five were afflicted by constant night sweats. These rates were double those of women who did not have a hysterectomy over the 17-year study period, and could not be explained by differences in lifestyle or socio-economic factors.

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Menopause Speeds Up the Aging Process in Women

MedicalResearch.com Interview with:

Morgan Elyse Levine, PhD Postdoctoral Fellow Department of Human Genetics University of California, Los Angeles

Dr. Levine

Morgan Elyse Levine, PhD
Postdoctoral Fellow
Department of Human Genetics
University of California, Los Angeles

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

Response: From an evolutionary perspective, aging and reproduction are two processes that are linked. For instance, in order to maximize fitness, an individual has to survive and remain healthy enough to:

1) reproduce and

2) insure offspring survive to reproductive age.

Thus, the rate of aging is tied to a species’ timing of reproductive senescence and necessary length of parental involvement. There is also evidence that among humans, women with longer reproductive stages (later age at menopause, ability to conceive at older ages) are more likely to live to age 100, which we hypothesize is because they age slower.

Using an epigenetic biomarker believed to capture biological aging (previously developed by the Principle Investigator of this study, Steve Horvath), we tested whether age at menopause, surgical menopause, and use of menopausal hormone therapies were associated with a woman’s aging rate.

We found that the blood of women who experienced menopause at earlier ages (especially those who underwent surgical menopause) was “older” than expected, suggesting they were aging faster on a biological level than women who experienced menopause at later ages. We also found that buccal epithelium samples (cells that line the inside of the cheek) were epigenetically younger than expected (signifying slower aging) for post-menopausal women who had taken menopausal hormone therapy, compared to post-menopausal women who had never taken any form of menopausal hormone therapy.

Finally, we had a number of results that suggested that the previously mentioned findings were a result of the process of menopause directly speeding up the aging process—rather than the alternative explanation, which would have been that women who aged faster experience menopause earlier.

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Menopausal Hot Flashes Can Start Younger and Last For Years

MedicalResearch.com Interview with:

Rebecca Thurston, Ph.D. Professor in the University of Pittsburgh Department of Psychiatry and Epidemiologist at the University of Pittsburgh Graduate School of Public Health.

Dr. Rebecca Clark-Thurston

Rebecca Thurston, Ph.D.
Professor, University of Pittsburgh Department of Psychiatry and
Epidemiologist, University of Pittsburgh
Graduate School of Public Health

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

Response: Vasomotor symptoms – or hot flashes and night sweats – are the “classic” symptom of the menopause transition. Most women will get vasomotor symptoms, yet there have been striking gaps in our knowledge about them, including what their natural history is. The traditional thinking has been that vasomotor symptoms last a few years around the final menstrual period for most women. However, in this and several other papers we have debunked this myth.

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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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New Bone Balance Index Predicts Bone Loss Across Menopause Transition

MedicalResearch.com Interview with:
Albert Shieh, MD
Division of Endocrinology, Diabetes and Hypertension
David Geffen School of Medicine
University of California, Los Angeles

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

Response: Whether an individual loses or gains bone mass is dependent on how much bone is being broken down (by osteoclasts) and being formed (by osteoblasts). Both processes occur simultaneously in the human body. At present, we can measure markers of bone breakdown (resorption) and formation. However, we hypothesized that to better predict the amount of bone mass that will be lost in the future, these markers should be combined in an “index” to reflect both processes, rather than being interpreted in isolation. Indeed, we found that the ability of our new bone balance index predicted future bone loss across the menopause transition better than the bone resorption marker alone.

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No Herbal or Plant Remedies Found Effective for Menopausal Night Sweats

MedicalResearch.com Interview with:

Taulant Muka, MD, MPH, PhD Postdoctoral Researcher Department of Epidemiology Erasmus University Rotterdam, The Netherlands

Dr. Taulant Muka

Taulant Muka, MD, MPH, PhD
Postdoctoral Researcher
Department of Epidemiology
Erasmus University
Rotterdam, The Netherlands

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

Response: Hot flashes, night sweats and vaginal dryness are very common symptoms of menopause, affecting up to 80% of women. Despite the availability of a wide range of pharmacological treatments and the best effort of health care professionals, good control of menopausal symptoms and their adverse effects remains elusive for much of the women. Some women choose hormone replacement therapy to treat menopausal symptoms, but for many others estrogen is not an option as long as some research suggests that it may rise the risk for breast cancer and heart disease. Therefore, 40 to 50% of women in Western countries choose to use complementary therapies, including plant-based therapies. These are many plant based-therapies that have been suggested to improve menopausal symptoms, but there is little guidance about which plant-based therapy is effective.
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Telephone Delivered Cognitive Behavioral Therapy Improved Insomnia and Hot Flashes in Menopausal Women

MedicalResearch.com Interview with:

Dr. Susan McCurry Principal Investigator Clinical psychologist and research professor School of Nursing University of Washington

Dr. Susan McCurry

Dr. Susan McCurry
Principal Investigator
Clinical psychologist and research professor
School of Nursing
University of Washington

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

Dr. McCurry: Every woman goes through menopause.  Most women experience nighttime hot flashes/sweats and problems sleeping at some point during the menopause transition.  Poor sleep leads to daytime fatigue, negative mood, and reduced daytime productivity.  When sleep problems become chronic – as they often do – there are also a host of negative physical consequences including increased risk for weight gain, diabetes, and cardiovascular disease.  Many women do not want to use sleeping medications or hormonal therapies to treat their sleep problems because of concerns about side effect risks.  For these reasons, having effective non-pharmacological options to offer them is important. Continue reading

Oophorectomy Linked To Increased Risk of Colon Cancer

MedicalResearch.com Interview with:

Josefin Segelman MD, PhD Senior consultant colorectal surgeon Department of Molecular Medicine and Surgery Karolinska Institutet Ersta Hospital Stockholm Sweden

Dr. Josefin Segelman

Josefin Segelman MD, PhD
Senior consultant colorectal surgeon
Department of Molecular Medicine and Surgery
Karolinska Institutet
Ersta Hospital
Stockholm Sweden

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

Dr. Segelman: Hormonal factors influence the development of colorectal cancer. Observational studies and clinical trials have reported a protective effect of hormone replacement therapy and oral contraceptives. Oophorectomy alters endogenous levels of sex hormones, but the effect on colorectal cancer risk is unclear. Removal of the ovaries alters levels of sex hormones in both pre- and postmenopausal women. In premenopausal women, bilateral oophorectomy is followed by surgical menopause as the endogenous estrogen levels drop. Both before and after natural menopause, bilateral oophorectomy promptly decreases endogenous androgen levels by half as the ovaries and adrenals are equally important for androgen production.

MedicalResearch.com:  What are the main findings?

Dr. SegelmanThe present nationwide cohort study explored the association between removal of the ovaries for benign indications and subsequent risk of colorectal cancer. Among 195 973 women who underwent the procedure from 1965 – 2011, there was a 30% increased risk of colorectal cancer compared with the general population. After adjustment for various factors, women who underwent bilateral oophorectomy had a higher risk of rectal cancer than those who had unilateral oophorectomy (HR 2.28, 95% CI 1.33-3.91).

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Acupuncture May Improved Hot Flashes in Breast Cancer Patients

MedicalResearch.com Interview with:
Giorgia Razzini, PhD

Unit of Medical Oncology Civil Hospital
Carpi Italy;

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

Dr. Razzini: Hot flashes experienced by breast cancer patients is a significant clinical problem because there are few reliable treatment that are free of side effects and it sometime reduces compliance with endocrine therapy for prevention of cancer recurrence. Menopausal symtoms overall  heavily impact on quality of life..

Acclimat found that acupuncture combined with self-care for 3 months, is associated with significantly lower hot flash scores, compared to self-care alone ( advices on diet, physical exercise and psycoloigical support if needed).

Beneficial effects persisted up to 6 months follow-up. These effects were not associated with significant adverse events.

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

Dr. Razzini:  Research suggests that breast cancer women do not receive adequate care for menopausal symptoms in the clinical practice of most oncology department. Our study showed that oncologists can offer them specific integrative management strategy for menopausal symptoms including acupuncture and enhanced self-care to women with breast cancer, particularly in younger women when treatment with hormonal treatment is recommended, in order to help women to stay on their therapy and improve their quality of life.
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Adding Ovarian Suppression to Tamoxifen Worsens Menopausal Symptoms in Early Breast Cancer Patients

MedicalResearch.com Interview with:

Karin Ribi, PhD, MPH Head of Quality of Life Office IBCSG International Breast Cancer Study Group Bern Switzerland

Dr. Karin Ribi

Karin Ribi, PhD, MPH
Head of Quality of Life Office
IBCSG
International Breast Cancer Study Group
Bern Switzerland 

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

Dr. Ribi: This study investigated the quality of life (QoL) outcomes for women in the Suppression of Ovarian Function (SOFT) trial. SOFT investigated the value of adding ovarian suppression (OFS) to tamoxifen and to determine the role of the aromatase inhibitor exemestane+OFS as adjuvant (post-surgery) therapies for hormone-sensitive early breast cancer. SOFT was conducted by the International Breast Cancer Study Group (IBCSG) in over 3000 premenopausal women from more than 500 centers worldwide. The primary analysis of SOFT compared tamoxifen alone with tamoxifen+OFS in over 2000 women, and showed that adding OFS to tamoxifen did not provide a significant benefit in the overall population of premenopausal women. However, for women who were at sufficient risk for recurrence to warrant adjuvant chemotherapy and who remained premenopausal, the addition of OFS improved disease outcomes.[1]

With regard to the QoL main findings, patients on tamoxifen+OFS were more affected than patients on tamoxifen alone by hot flushes at 6 and 24 months, by loss of sexual interest and sleep disturbance at 6 months, and by vaginal dryness up to 60 months. Without prior chemotherapy, patients on tamoxifen alone reported more vaginal discharge over the 5 years than patients on tamoxifen+OFS. Symptom-specific treatment differences at 6 months were less pronounced in patients with prior chemotherapy. Changes in global QoL indicators from baseline were small and similar between treatments over the whole treatment period.
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Mediterranean Diet in Post Menopausal Women Linked to Better Bone Health

MedicalResearch.com Interview with:
Bernhard Haring, MD MPH
Department of Medicine I
Comprehensive Heart Failure Center
University of Würzburg
Germany

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

Dr. Haring: The primary aim of this study was to examine the association between adherence to a diet quality index constructed on the basis of dietary recommendations or existing healthy dietary patterns and bone outcomes in a large population of postmenopausal women.

We found that higher diet quality based on a Mediterranean diet may play a role in maintaining bone health in postmenopausal women.
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For Many Women, Migraines Worsen During Menopause

Dr. Vincent Martin, MD Professor of Internal Medicine University of Cincinnati College of Medicine Cincinnati OH

Dr. Martin

MedicalResearch.com Interview with:
Dr. Vincent Martin, MD
Professor of Internal Medicine
University of Cincinnati College of Medicine
Cincinnati OH

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

Dr. Martin: Past studies have found that the perimenopause is associated with an increased prevalence of migraine headache, but there have been no studies to determine if the frequency of migraine attacks is increased during this time period.  In our study we reported that high frequency headache (≥10 days per month with headache) was increased by 62% during perimenopause (irregular menstrual cycles) as compared to premenopause (regular menstrual cycles).  We later divided the perimenopause into early and late stages.  During the early perimenopause women experience irregular menstrual bleeding while during the late perimenopause women begin skipping menstrual periods for 2-11 months.  Of the two stages the late perimenopause in particular had the greatest likelihood for high frequency headache increasing its risk by 86%.  This could suggest that low estrogen and progesterone levels, which occur when menstrual periods are skipped, might account for the increased probability of headache attacks in women with migraine.

The common belief in the medical field is that migraine attacks improve in women during menopause.  To the contrary we found that high frequency migraine increased by 76% during menopause compared to premenopause.  This indicates that a subgroup of women with frequent headaches tend to worsen with menopause.  The increased probability of high frequency headache appeared to be secondary to an increased intake of pain medications occurring during this time period, which could result in “rebound headaches”.  Rebound headaches occur from overuse of pain medications.

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Acupuncture No Better Than Placebo For Hot Flashes

Acupuncture-Wikipedia-Image

Acupuncture Presure

MedicalResearch.com Interview with:
Carolyn Ee
MBBS
Department of General Practice
University of Melbourne
Carlton, Victoria, Australia

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

Response: Hot flushes affect up to 90% of women during the menopause and beyond, and women are turning to complementary therapies. Our randomised sham-controlled trial found no difference between real and sham acupuncture (given with a blunt needle) for hot flushes, with both groups improving by around 40% at the end of treatment.

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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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Menopausal Hormone Therapy May Raise Risk Of Basal Cell Carcinoma

MedicalResearch.com Interview with:
Elizabeth K. Cahoon, PhD
Radiation Epidemiology Branch
Division of Cancer Epidemiology and Genetics, National Cancer Institute
National Institutes of Health
Department of Health and Human Services
Bethesda, MD

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

Dr. Cahoon: Although basal cell carcinoma (BCC) is the most common cancer in the United States, there is relatively little research on risk factors since few population-based cancer registries do not capture information on this malignancy.

Sun exposure (in particular ultraviolet radiation) is the primary risk factor for basal cell carcinoma, but less is known about other factors that may affect this risk. A previous study found a relationship between menopausal hormone therapy (MHT) use and increased risk of BCC in a population of Danish women.

In our study we looked to see if factors related to estrogen exposure from multiple sources was associated with basal cell carcinoma risk in a large, nationwide, prospective study. These included use of oral contraceptives or menopausal hormone therapy, but also reproductive factors (like age at menarche and menopause).

We observed that women who experienced natural menopause later in life were more likely to develop basal cell carcinoma compared to women who had natural menopause at a younger age.

In addition, women who reported using menopausal hormone therapy for one year or longer were more likely to develop basal cell carcinoma compared to women who did not report MHT use.

Women who reported natural menopause and menopausal hormone therapy use for 10 or more years had the highest risk of basal cell carcinoma, compared to women with no menopausal hormone therapy use.
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Menopause Increases Asthma Risk

Kai Triebner, MSc Department of Clinical Science University of Bergen Bergen, Norway
MedicalResearch.com Interview with:

Kai Triebner, MSc
Department of Clinical Science
University of Bergen
Bergen, Norway


Medical Research: What is the background for this study?

Response: During the last decades female life expectancy has risen far beyond 50
years worldwide. This means that the quality of life after menopause is
highly relevant today. Menopause implies profound hormonal and metabolic
changes leading to higher risk of diabetes and cardiovascular diseases.
Although researchers are increasingly aware that hormonal status and
inflammation may also deteriorate respiratory health, our knowledge is
very scarce. So far, no prospective study had investigated whether
menopause increases the risk of asthma in the general population.

Medical Research:? What are the main findings?

Response: We studied the association between menopausal status and newly diagnosed  asthma, after the age of 44. We found that the odds of getting asthma
were more than twice as high for women going through the menopausal
transition or after menopause, compared to non-menopausal women. The
risk was particularly high for overweight and obese women. These results
were not due to general aging and were independent of smoking and
geographical location.

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Can Menopause Be Prevented In Young Women on Chemotherapy For Early Breast Cancer?

Rodrigo R. Munhoz, MD Hospital Sírio Libanês São Paulo, Brazil MedicalResearch.com Interview with:
Rodrigo R. Munhoz, MD
Hospital Sírio Libanês
São Paulo, Brazil 

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

Dr. Munhoz:  Chemotherapy-induced early menopause and its impact on quality of life is clinically relevant issue that often arises during the treatment with curative intent of premenopausal patients with early breast cancer. The use of neo-/adjuvant chemotherapy is associated with risks of ovarian dysfunction, permanent or transient amenorrhea, infertility and symptoms of menopause with a premature onset. In addition to osteoporosis, loss of libido, increased cardiovascular risk and atrophic vaginitis, early ovarian dysfunction may adversely impact quality of life and result in significant psychosocial burden.

Currently available guidelines addressing fertility preservation in young women undergoing treatment for early breast cancer recommend that patients at reproductive ages should be advised about the potential risks of fertility impairment and additional effects of adjuvant chemotherapy and that preservation techniques should be carefully considered. However, “evidence regarding the effectiveness of ovarian suppression” is quoted as “insufficient” and the use GnRH agonists as “experimental” .

The current meta-analysis includes a large number of patients and also the results of recently presented clinical trials, and suggest that the use of GnRH agonists is associated a higher rate of recovery of regular menses in patients with breast cancer undergoing chemotherapy.These results summarize the findings of different clinical trials and has immediate clinical implications – this was not clear in the literature, since negative results had been reported across different clinical trials.

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Is Lean Always Better? Body Fat and Mortality Not Linked In Older Women

Jennifer W. Bea, PhD Assistant Professor, Medicine Assistant Research Scientist, Nutritional Sciences University of Arizona Cancer Center Tucson, AZ 85724-0524MedicalResearch.com Interview with:
Jennifer W. Bea, PhD
Assistant Professor, Medicine
Assistant Research Scientist, Nutritional Sciences
University of Arizona Cancer Center
Tucson, AZ 85724-0524

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

Dr. Bea: The analysis was based on a subgroup of the largest study of post-menopausal women in the United States, Women’s Health Initiative (WHI), which has been answering important questions about health and wellness among post-menopausal women since the 1990s. In the analysis, body mass index, a proxy for body fat, and actual body composition (i.e. fat and muscle mass) determined by an imaging technique called dual energy X-ray absorptiometry (DXA) were used to predict risk of death. In the younger post-menopausal women,  aged 50–59 years, higher body fat increased risk of death by more than 2 times and the highest muscle mass decreased risk of death by almost 60%. Importantly, the relationships were reversed among the older women, aged 70–79 years (P < 0.05). These results were true in spite of BMIs in these groups spanning nearly the full range of possible BMIs (16.4–69.1kg/m2). These data indicate that BMI does not estimate mortality risk as well as we would hope among post- menopausal women.

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Growth Hormone Reduced Fractures in Osteoporosis Patients

MedicalResearch.com Interview with:
Emily Krantz (né Amundson) MD
Södra Älvsborgs Hospital
Borås, Sweden

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

Response: This study is a 10-year follow up of a double-blind placebo controlled trial in which women with post menopausal osteoporosis received Growth Hormone (GH) for 3 years (Landin-Wilhelmsen JBMR 2003;18:393-404). Positive effects of the treatment on the patients bone mineral density and bone mineral content were seen after another 7 years. Furthermore and most interestingly, fracture incidence decreased dramatically from 56% to 28% (p=.0003) in the osteoporosis patients while fractures increased significantly in the control group, from 8% to 32% (p=.0008). Health Related Quality of Life was also measured throughout the study’s duration and it did not change nor did it differ from the control group.

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Vitamin D Did Not Improve Bone or Muscle Health in Post-Menopausal Women

MedicalResearch.com Interview with:
Karen E. Hansen, M.D., M.S.
Associate Professor of Medicine
University of Wisconsin School of Medicine and Public Health
Madison, WI 53705-2281

Medical Research: What is the background for this study?

Dr. Hansen: The USPTF says to older community dwelling adults, “don’t bother taking vitamin D”, the Endocrine Society says “take 2,000-4,000 IU daily” and the Institute of Medicine gave an RDA of 600-800 IU daily. The Endocrine Society argues that optimal vitamin D levels are 30 ng/mL and higher, while the Institute of Medicine concludes that 20 ng/mL and higher indicates optimal vitamin D status. The disagreement between experts prompted my study.

Medical Research: What are the main findings?

Dr. Hansen: Among postmenopausal women whose vitamin D level was ~21 ng/mL at baseline, there was no benefit of high-dose or low-dose vitamin D, compared to placebo, on spine/hip/total body bone mineral density, muscle fitness by 5 sit to stand test or Timed Up and Go, or falls. We did see a small 1% increase in calcium absorption in the high-dose vitamin arm, but this small increase did not translate into clinically meaningful changes in bone density or muscle tests.

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No Association Between Kidney Stones and Osteoporosis or Fractures in Women

Monique Bethel, MD Subspecialty Service, Department of Veterans Affairs Medical Center, Department of Medicine, Section of Rheumatology Georgia Regents University Augusta, GAMedicalResearch.com Interview with:
Monique Bethel, MD
Subspecialty Service, Department of Veterans Affairs Medical Center,
Department of Medicine, Section of Rheumatology
Georgia Regents University
Augusta, GA

MedicalResearch: What is the background for this study?

Dr. Bethel: Osteoporosis and kidney stones share several risk factors, including elevated calcium in the urine (hypercalciuria), low potassium intake, and possibly, diets high in sodium. Accordingly, several studies have shown a significant relationship between kidney stones and osteoporosis in men. However, it is unclear if this relationship is also true for women. Previous studies examining this association have been small and inconclusive.   With the Women’s Health Initiative, we had data available from approximately 150,000 postmenopausal women in the US. Using this database, we were able to study the relationship between kidney stones and changes in bone mineral density and fractures.

MedicalResearch: What are the main findings?

Dr. Bethel: We found no association between the presence of kidney stones and changes in bone mineral density over time at the hip, lumbar spine, or the whole body. Also, there was no association between the presence of kidney stones and fractures. We also found that 14% of women who had a history of kidney stones upon entering the studies had another one occur during the course of the study (approximately 8 years).

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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 

Endocrine Therapies for Young Breast Cancer Patients Can Cause Abrupt Menopause Symptoms

MedicalResearch.com Interview with:
Dr. Jürg Bernhard Ph.D.

International Breast Cancer Study Group Coordinating Center and Bern University Hospital, Inselspital, Bern, Switzerland

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

Response: In the combined analysis of the SOFT and TEXT trials, the aromatase inhibitor exemestane was more effective than tamoxifen in preventing breast cancer recurrence in young women (premenopausal) who also receive ovarian function suppression (OFS) as adjuvant (post-surgery) treatment for hormone-sensitive early breast cancer, providing a new treatment option for these women. These trials were conducted by the International Breast Cancer Study Group (IBCSG) and involved more than 4700 patients of over 500 centers in 27 countries. Now we present patient-reported quality of life outcomes from these trials.

In the TEXT and SOFT trials, patients assigned exemestane+OFS reported more detrimental effects of bone or joint pain, vaginal dryness, greater loss of sexual interest and difficulties becoming aroused, while patients assigned tamoxifen+OFS were more affected by hot flushes and sweats. Global quality of life domains (mood, ability to cope and physical well-being) were similar between the randomized treatment groups. Continue reading

Menopausal SSRIs Increases Risk of Bone Fractures

MedicalResearch.com Interview with:
Dr Matthew Miller
Department of Health Science Northeastern University
Department of Health Policy and Management,
Harvard T.H. Chan School of Public Health Harvard University
Boston, Massachusetts

and Yi-Han Sheu
Department of Epidemiology
Harvard T.H. Chan School of Public Health
Harvard University Boston, Massachusetts

Medical Research: What is the background for this study?

Response: Selective serotonin reuptake inhibitors (SSRIs) were recently approved by the FDA to treat vasomotor symptoms associated with menopause. No prior study has directly examined whether fracture risk is increased among perimenopausal women who initiate SSRIs or among a population of women without mental disorders more generally..

Medical Research: What are the main findings?

Response: We found that SSRIs treatment for non-psychiatric conditions at doses customarily used to treat depression is, all else equal, associated with higher rates of fractures — an effect that first became evident several months after beginning treatment and, importantly, persisted over the five year study period.

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All-Cause Mortality Decreased In Post-Menopausal Women Who Reduce Sedentary Time

MedicalResearch.com Interview with:
Jasmine Lee, M.Sc. and Chris I. Ardern, Ph.D.
School of Kinesiology and Health Science
York University
Toronto, ON, Canada

Medical Research: What is the background for this study?

Response: Although the benefits of physical activity are well known, the health and mortality risks associated with sedentary time (activities <1.5 MET)—which can occur in long, continuous bouts, such as at the workplace, during motorized transportation and via screen time— have been less frequently explored, and may differ across subgroups of the population. Like physical activity, sedentary time may fluctuate with major life events and occupation (e.g. aging, retirement, etc.), which raises the question of the short-term relationship between changes in sitting time and mortality risk.

Medical Research: What are the main findings?

Response: Maintenance of minimal sedentary time, as well as short-term reduction in sedentary time, were found to reduce the risk of all-cause and cancer- mortality amongst a sample of middle-aged and older women (50-79 y) who are prone to high rates of physical inactivity and sedentary time.

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Early Onset, Frequent Hot Flashes Linked To Increased Cardiovascular Disease Risk

Dr. Rebecca Clark Thurston Ph.D Associate Professor of Psychiatry, Epidemiology, Psychology, and Clinical and Translational Science University of PittsburghMedicalResearch.com Interview with:
Dr. Rebecca Clark Thurston Ph.D
Associate Professor of Psychiatry, Epidemiology, Psychology, and Clinical and Translational Science
University of Pittsburgh

 

MedicalResearch: What is the background for these studies? What are the main findings?

Dr. Clark Thurston: The understanding of women’s cardiovascular disease and the role that reproductive factors play in women’s cardiovascular health is evolving. There are some studies showing links between menopausal hot flashes and cardiovascular disease risk in women. These studies help further refine this understanding. We showed in two separate studies that women who have hot flashes, particularly frequent hot flashes early in midlife, have poorer vascular health on certain indices.

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Phytochemical May Prevent Liver Damage In Post Menopause Women

Colette Nicole Miller FDN Department of Foods and Nutrition Edgar L. Rhodes Center for Animal and Dairy Science University of Georgia, Athens, GeorgiaMedicalResearch.com Interview with:
Colette Nicole Miller FDN
Department of Foods and Nutrition
Edgar L. Rhodes Center for Animal and Dairy Science
University of Georgia, Athens, Georgia

Medical Research: What is the background for this study?

Response: Our laboratory has been interested for quite some time in the relationship that natural, plant-derived compounds have on various tissues in the body. Both bone and adipocytes are derived from the same progenitor cell, mesenchymal stem cells. Thus, if a drug or compound affects one type of cell, it may affect both. When women transition through menopause, and see a reduction in their female sex hormones like estrogen, they can see adverse changes in both how much fat they store and their bone density. Thus our lab is interested in compounds that can be used to prevent the bone loss and visceral adipogenesis that menopausal women often experience. Previous work both in vivo and in vitro has shown that phytochemicals have synergistic effects and thus can ultimately work together to reduce the dosages needed to promote overall health. Through this work we have identified a combination of genistein, resveratrol, quercetin and Vitamin D that improve bone density in addition to promoting apoptosis of adipocytes. However, the health of the liver had never been addressed with our phytochemical blend. We know that supplements are sometimes toxic to the liver for many different reasons. Thus, it was very important for us to address the toxicity and potential risk of non-alcoholic fatty liver disease with our phytochemical blend in a menopausal rat model.

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Hot Flashes Linked With Increased Risk of Hip Fracture

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA 90024MedicalResearch.com Interview with:
Carolyn J. Crandall, MD, MS
Professor of Medicine
David Geffen School of Medicine
UCLA Medicine/GIM
Los Angeles, California 90024

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

Dr. Crandall: In a large group of postmenopausal women aged 50-79, we found that women who reporting having hot flashes at baseline had increased risk of hip fracture during the subsequent 8 years of observation, nearly double the risk compared with women who did not have hot flashes at baseline.
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Recommended Osteoporosis Screening May Not Effectively Screen Younger Patients

Carolyn J. Crandall, MD, MS Professor of Medicine David Geffen School of Medicine at University of California, Los Angeles UCLA Medicine/GIM Los Angeles, CA 90024MedicalResearch.com Interview with:
Carolyn J. Crandall, MD, MS
Professor of Medicine
David Geffen School of Medicine at University of California
UCLA Medicine/GIM Los Angeles, CA 90024

Medical Research: What are the main findings of the study?

Dr. Crandall: Clinical guidelines recommend that women aged ≥ 65 years should be screened for osteoporosis.  However, for younger postmenopausal women aged between 50 and 64 years, the United States Preventive Services Task Force (USPSTF) recommends osteoporosis screening for women who have a 10-year predicted risk of osteoporosis fracture that is ≥9.3%.  We tested the ability the USPSTF strategy, and two other strategies (called OST and SCORE), to distinguish between women who did and did not experience a fracture in the subsequent 10 years.  We found that the USPSTF strategy did not identify the majority of who experienced osteoporotic fracture in the subsequent 10 years.  Especially in women aged 50-54 years, the USPSTF strategy identified fewer than 5% of women who experienced fracture over 10-year follow-up.

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CHEST 2014: Obstructive Sleep Apnea Linked To Cognitive Difficulties in Postmenopausal Women

Chitra Lal, MD. Assistant Professor Medical University of South CarolinaMedicalResearch.com Interview with:
Chitra Lal, MD. Assistant Professor
Medical University of South Carolina

 

 

Medical Research: What are the main findings of the study?

Dr. Lal: We studied the prevalence of cognitive problems in early postmenopausal women (age 45-60 years) with obstructive sleep apnea syndrome (OSAS+) and without obstructive sleep apnea syndrome (OSAS-) using a questionnaire called the Mail-In Cognitive Function Screening Instrument (MCFSI).

We found that the mean MCFSI scores after adjusting for depression were significantly higher in obstructive sleep apnea syndrome+ then the OSAS- group, indicating more self-reported cognitive difficulty in OSAS+ women

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Postmenopausal Effect of Estrogen on Cardiovascualar Events and Hot Flashes

S. Mitchell Harman, M.D., Ph.D. CAPT US Public Health Service, retired Professor, Clinical Medicine, U of AZ College of Medicine Interim Chief, Dept. of Internal Medicine Chair, IRB Subcommitee Phoenix VA Health Care System Phoenix, AZ 85012-1892MedicalResearch.com Interview with:
S. Mitchell Harman, M.D., Ph.D.
CAPT US Public Health Service, retired
Professor, Clinical Medicine, U of AZ College of Medicine
Interim Chief, Dept. of Internal Medicine
Chair, IRB Subcommitee
Phoenix VA Health Care System
Phoenix, AZ 85012-1892

Medical Research: What are the main findings of the study?

Dr. Harman: The major findings are:

1.       Neither transdermal nor oral estrogen treatment significantly accelerates or decelerates rate of change of carotid artery intimal medial thickness (CIMT) in healthy recently menopausal women.

2.       Both estrogen treatments have some potentially beneficial effects on markers of CVD risk, but these differ depending on the route of estrogen delivery with improvements in LDL and HDL cholesterol seen with oral, and reduced insulin resistance with transdermal.

3.       No significant effects were observed on rate of accumulation of coronary artery calcium.

4.       Women reported significant relief of vasomotor (hot flush) symptoms with both estrogen treatments

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