Author Interviews, Heart Disease, Lancet, Menopause, Women's Heart Health / 10.03.2018

MedicalResearch.com Interview with: Mihir Sanghvi Academic Junior Doctor Barts Health NHS Trust MedicalResearch.com: What is the background for this study? What are the main findings? Response: The effect of menopausal hormone therapy (MHT), previously known as hormone replacement therapy, on cardiovascular health in post-menopausal women remains controversial and unclear. Extensive observational data had suggested MHT to be cardioprotective, leading to MHT being routinely prescribed for both primary and secondary prevention of coronary heart disease (CHD). However, subsequent data from the Women’s Health Initiative (WHI) and Heart and Estrogen/Progestin Replacement Study (HERS) studies cast doubt on the beneficial cardiovascular effects of MHT; this was reflected in learned societies’ clinical guidance concerning MHT’s role in CHD prevention. The most recent randomised trial data on the subject arose from the Danish Osteoporosis Prevention Study, which indicated that women taking menopausal hormone therapy had a reduced risk of the composite endpoint of mortality, heart failure and myocardial infarction but the study has been subject to criticism [10]. In more recent work, again from the WHI, there was no difference in cardiovascular mortality in MHT users compared to placebo, although the authors themselves state that cause-specific mortality data should be interpreted “cautiously”. The UK Biobank is an ongoing, large-scale, population-based study designed to examine determinants of health in middle and old age. Besides extensive collection of health questionnaire data, biological samples and physical measurements, it has incorporated cardiovascular magnetic resonance (CMR) imaging – the gold standard for analysis of cardiac structure and function – to provide detailed imaging phenotypes. At present, there is a paucity of data on the effects of  menopausal hormone therapy on left ventricular (LV) and left atrial (LA) volumes and function, alterations in which are markers of subclinical cardiovascular disease and have prognostic implications. We found that in a large, population-based cohort of post-menopausal women free of cardiovascular disease, use of menopausal hormone therapy is not associated with adverse, subclinical changes in cardiac structure and function. Indeed, we demonstrate significantly smaller LV and LA chamber volumes which have been linked to favorable cardiovascular outcomes in other settings. (more…)
Author Interviews, Endocrinology, JAMA, Menopause, OBGYNE / 13.12.2017

MedicalResearch.com Interview with: Dr. Suzanne Fenske, MD Assistant Professor of Obstetrics, Gynecology and Reproductive Science Icahn School of Medicine at Mount Sinai  MedicalResearch.com: What is the background for this study? What are the main findings? Response: USPSTF recommendations are based off several studies, but is mainly based off of the Women's Health Initiative. The Women's Health Initiative was a 15 year prevention study with a focus on death, disability and impaired quality of life in postmenopausal women. This study was originally performed in 1991. The USPSTF reevaluated the data along with several other studies to assess the role of hormone replacement therapy in prevention of chronic diseases such as heart disease, stroke, blood clot, gallbladder disease, dementia.  The USPSTF has found that hormone replacement therapy has some benefit in reducing the risk of fractures, and, potentially, diabetes.  The USPSTF has found that hormone replacement therapy can increase the risk of coronary artery disease, stroke, blood clot, gall bladder disease, urinary incontinence and dementia. With these risks, the USPSTF states that hormone replacement therapy should not be used as a preventative medicine, but, rather, used for treatment of symptomatic menopause and not prevention of osteoporosis or heart disease. (more…)
Author Interviews, Menopause, Obstructive Sleep Apnea / 09.11.2017

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. (more…)
AHA Journals, Author Interviews, Gender Differences, Lipids, Menopause / 06.11.2017

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, JAMA, Menopause, Ophthalmology, UCLA / 31.10.2017

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 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. (more…)
Author Interviews, CDC, Menopause, Sleep Disorders / 02.10.2017

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. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Hormone Therapy, JAMA, Menopause / 13.09.2017

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  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. (more…)
Author Interviews, Heart Disease, Menopause, Race/Ethnic Diversity, University of Pittsburgh / 03.08.2017

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   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. (more…)
AACR, Author Interviews, Cancer Research, Dental Research, Menopause / 02.08.2017

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 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. (more…)
Author Interviews, Diabetes, Endocrinology, Menopause / 20.07.2017

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brigham & Women's - Harvard, Endocrinology, Hearing Loss, Menopause / 11.05.2017

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 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. (more…)
Author Interviews, Menopause, OBGYNE / 01.05.2017

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Exercise - Fitness, Gender Differences, Menopause, OBGYNE, PLoS / 28.02.2017

MedicalResearch.com Interview with: 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. (more…)
AHA Journals, Author Interviews, Heart Disease, Menopause, University of Pittsburgh, Women's Heart Health / 23.02.2017

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 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. (more…)
Author Interviews, Heart Disease, Menopause, Weight Research, Women's Heart Health / 20.11.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Endocrinology, Hormone Therapy, JCEM, Menopause, Osteoporosis / 20.11.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Brigham & Women's - Harvard, Gender Differences, Memory, Menopause / 12.11.2016

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. (more…)
Author Interviews, Endocrinology, Menopause, Osteoporosis / 27.10.2016

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 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). (more…)
Author Interviews, Genetic Research, Menopause / 21.10.2016

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 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. (more…)
Author Interviews, Brigham & Women's - Harvard, Depression, JCEM, Menopause, Sleep Disorders / 28.09.2016

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 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. (more…)
Author Interviews, Gender Differences, Heart Disease, JAMA, Menopause / 15.09.2016

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. (more…)
Author Interviews, Menopause, OBGYNE / 05.08.2016

MedicalResearch.com Interview with: 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. (more…)
Aging, Author Interviews, Gender Differences, Genetic Research, Menopause, UCLA / 28.07.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Menopause, University of Pittsburgh / 20.07.2016

MedicalResearch.com Interview with: 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. (more…)
Alzheimer's - Dementia, Author Interviews, Endocrinology, Hormone Therapy, Mayo Clinic, Menopause / 13.07.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Bone Density, Endocrinology, Menopause, Mineral Metabolism, UCLA / 25.06.2016

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. (more…)
Author Interviews, JAMA, Menopause / 21.06.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, JAMA, Menopause, Telemedicine / 19.05.2016

MedicalResearch.com Interview with: 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. (more…)
Author Interviews, Colon Cancer, Menopause, Surgical Research / 05.05.2016

MedicalResearch.com Interview with: 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. Segelman: The 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). (more…)
Author Interviews, Breast Cancer, Journal Clinical Oncology, Menopause / 14.04.2016

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. (more…)