25 Jun New Bone Balance Index Predicts Bone Loss Across Menopause Transition
Posted at 19:56h
in Author Interviews, Bone Density, Endocrinology, Menopause, Mineral Metabolism, UCLA
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.
Dr. Taulant Muka[/caption]
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.
Dr. Susan McCurry[/caption]
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. 
Dr. Josefin Segelman[/caption]
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).
Dr. Martin[/caption]
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.
Acupuncture Presure[/caption]
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.
