Author Interviews, Endocrinology, Hormone Therapy, Menopause / 17.07.2023

MedicalResearch.com Interview with: Jerilynn C Prior MD FRCPC (on behalf of all authors Professor of Endocrinology / Department of Medicine University of British Columbia Centre for Menstrual Cycle and Ovulation Research www.cemcor.ca BC Women’s Health Research Institute Vancouver BC Canada MedicalResearch.com: What is the background for this study? Response: Night sweats and hot flushes/flashes (together called vasomotor symptoms, VMS) disturb women who are still menstruating (in perimenopause) are at least as much or more than  menopausal women (without flow for a year or more)1. However, although studies have investigated various treatments for perimenopausal hot flushes/flashes, none have proven effective in these women who are also likely to be having heavy flow, breast tenderness, and premenstrual symptoms related to high and variable estrogen levels. These include randomized controlled trials (RCT) of the birth control pill2, and gel estrogen in women using a progestin-releasing IUD3. Neither showed that therapy was more effective than placebo; both studied too few participants to provide a clear answer. Meanwhile, major medical organization guidelines recommend menopausal hormone therapy (MHT, usually of estrogen with a progestin) for any women younger than 60 years old who are bothered by night sweats and hot flushes 4-6. However, there are no scientific RCT studies showing MHT is effective for perimenopausal night sweats and hot flushes. Giving more estrogen to someone whose own estrogen levels are often high, also did not make clinical sense. We previously performed an RCT showing that oral micronized progesterone (progesterone) was effective for menopausal hot flushes and also improved sleep7. Given that progesterone levels in perimenopausal women are declining, we considered that perimenopausal progesterone therapy for night sweats needed testing. (more…)
Aging, Author Interviews, Cognitive Issues, Gender Differences, Hormone Therapy, JAMA, Menopause, Weight Research / 05.07.2019

MedicalResearch.com Interview with: Rachel Zsido PhD student Department of Neurology International Max Planck MedicalResearch.com: What is the background for this study? Response: We integrated measures of brain network structure, visceral adipose tissue (VAT), serum estradiol levels, and cognitive performance from 974 participants in order to shed light on potential mechanisms underlying cognitive health. We believe it is imperative to assess sex-specific risk trajectories in brain aging and cognitive decline, especially given the known sex differences in both VAT accumulation patterns and estradiol fluctuations across the lifespan. Thus, we aimed to answer three questions in men and in women: 1) Does visceral adipose tissue exacerbate the association between age and brain network structure, 2) Does estradiol mitigate the negative association between VAT and brain network structure, and 3) What does this imply for healthy cognitive aging in men and women?  (more…)
Author Interviews, Endocrinology, OBGYNE / 08.05.2019

MedicalResearch.com Interview with: Prof. Arri Coomarasamy MBChB, MD, FRCOG Institute of Metabolism and Systems Research Professor of Gynaecology Director of Tommy's National Centre for Miscarriage Research University of Birmingham MedicalResearch.com: What is the background for this study? What are the main findings? Response: Progesterone hormone is known to be essential to maintain a pregnancy. Researchers and clinicians have debated for over 50 years whether progesterone supplementation in women with early pregnancy bleeding could rescue a pregnancy from miscarrying. There were some clinical studies suggesting progesterone could be useful, but the studies were of poor quality and small, so we could not be certain. So the current study, called the PRISM trial, was conducted using very sound methods and on a large population of women, in fact over 4000 women in the UK, to produce a definitive answer to this question. Overall, there were more babies in the group of women given progesterone compared with the group of women given the dummy placebo tablets, but there was statistical uncertainty in this finding. However, when we looked at the sub-population of women who were at high risk of miscarriage because of not only bleeding in early pregnancy but also having a history of previous miscarriage, we found progesterone was shown to have clear benefit. This is a hugely important finding as there is now a treatment option to women with early pregnancy bleeding and a history of previous miscarriages. (more…)
Author Interviews, Endocrinology, Gender Differences, Hormone Therapy / 26.03.2019

MedicalResearch.com Interview with: Joshua Safer, MD, Executive Director Center for Transgender Medicine and Surgery Mount Sinai Health System Senior Faculty, Medicine, Endocrinology, Diabetes and Bone Disease Icahn School of Medicine at Mount Sinai MedicalResearch.com: What is the background for this study? What are the main findings? Response: The standard trans feminizing hormone regimen includes estrogen both to suppress testosterone and so that the individual has sufficient circulating sex hormone in the body for good bone health. After orchiectomy, there is no need to suppress testosterone because the levels are very low and it is common to cut the estrogen dose in half.  Cis women with premature ovarian failure often take about 2 mg of estradiol daily so that dose has seemed reasonable for trans women without testes.  However, when my co-author Sira Korpaisarn and I checked estradiol levels and gonadotropins (pituitary hormones, LH and FSH) as a guide to dosing, we found that based on that testing, trans women may require higher doses of estrogens than the 2 mg that we expected. (more…)
Author Interviews, Biomarkers, Endocrinology, JCEM, OBGYNE, Yale / 25.10.2018

MedicalResearch.com Interview with: Valerie A. Flores, MD Clinical Instructor Division of Reproductive Endocrinology & Infertility Department of Obstetrics, Gynecology & Reproductive Sciences Yale School of Medicine - Yale New Haven Hospital MedicalResearch.com: What is the background for this study? What are the main findings? Response: Endometriosis is a debilitating gynecologic disease that affects 1 in 10 reproductive-aged women, causing pain and infertility.  It is a hormonally dependent disorder— estrogens promote growth of endometriosis, while progesterone inhibits estrogen-dependent proliferation. Although progestin-based therapies (including combined oral contraceptives) are first-line therapy in the management of endometriosis-associated pain, response to progestins is variable and currently unpredictable. (more…)
Author Interviews, Cancer Research, Testosterone / 19.07.2018

MedicalResearch.com Interview with: Traver Wright, Ph.D. Research Assistant Professor Department of Health and Kinesiology Texas A&M University College Station, TX MedicalResearch.com: What is the background for this study?   Response: Many cancer patients suffer from a loss of body mass known as cachexia which results in not only a loss of fat, but a debilitating loss of muscle mass and function. This cachexia negatively impacts patient mobility and quality of life, and can also reduce their eligibility to undergo treatments such as radiation and chemotherapy.  Despite the profound negative consequences of cachexia, there are no established therapies to directly address this debilitating loss of body mass during treatment. In this National Cancer Institute funded double-blind, placebo-controlled study we examined the effectiveness of 7 weeks of treatment with the muscle-building hormone testosterone to preserve the body condition of men and women with cervical or head and neck cancer.  Twenty-one patients received weekly injections of either placebo or testosterone.  Over the 7 weeks of treatment, patients were monitored for changes in body composition, activity level, physical ability, and questionnaires regarding quality of life and well-being. (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, Endocrinology, Hormone Therapy, JCEM / 04.11.2017

MedicalResearch.com Interview with: Alexandra Ycaza Herrera, Ph.D. Postdoctoral Scholar Leonard Davis School of Gerontology Department of Psychology University of Southern California Los Angeles, Ca 90089  MedicalResearch.com: What is the background for this study? What are the main findings? Response: ​Previous research has shown that estradiol treatment after menopause can reduce the stress response when exposed to a stressor, including the cortisol response to stress. Other work has shown that stress can impair certain types of memory​. We wanted to test whether post-menopause estradiol treatment would not only attenuate the cortisol response to stress, but if it could also reduce the negative effects of stress on memory. In particular, we tested the effects on a type of memory called working memory. Working memory allows us to maintain and update information we need to readily access in short-term memory. For example, imagine you stop at the grocery store after work and only have a mental list of the items you need to make dinner. Working memory is the memory type engaged in helping you maintain and update your mental list of items as you grab items off the shelves and check them off your list. We recruited women through the Early versus Late Intervention Trial with Estradiol, a randomized, double-blinded, placebo-controlled clinical trial. Women who participated in our study had received nearly 5 years of either estradiol or placebo. We found that women receiving estradiol showed significantly smaller cortisol responses to stress and less of an effect of stress on working memory than women that had been receiving placebo. (more…)
Author Interviews, Endocrinology, Epilepsy / 17.10.2017

MedicalResearch.com Interview with: Dr. Samba Reddy, Ph.D., R.Ph., FAAPS, FAAAS, FAES Professor Neuroscience and Experimental Therapeutics College of Medicine Texas A&M University Health Science Center MedicalResearch.com: What is the background for this study? What are the main findings? Response: For the past two decades, D. Samba Reddy, PhD, RPh, professor of neuroscience and experimental therapeutics at the Texas A&M College of Medicine, has been searching for answers to catamenial epilepsy, a subset of chronic epilepsy that causes a dramatic increase in seizures during women’s menstrual periods. Although this condition has been documented for millennia, there is currently no effective treatment for catamenial seizures, leaving many women and their families desperate for answers. In this report, the researchers discovers the neuro-code for treating women with menstrual period-linked epilepsy. A unique platform has been created for clinical trials for catamenial seizures with synthetic neurosteroid agents. (more…)
Author Interviews, Endocrinology, Fertility / 15.03.2017

MedicalResearch.com Interview with: Matthias Straub Senior Director, Clinical Development Abbott MedicalResearch.com: What is the background for this study? What are the main findings? Response: The Lotus I study provides clinical evidence that oral dydrogesterone is a treatment option for women who undergo in vitro fertilization (IVF) treatment. The current standard of care for IVF globally is micronized vaginal progesterone (MPV), which is administered vaginally. The Lotus I study concludes that oral dydrogesterone is similarly well-tolerated and efficacious compared to MVP, while being easier to administer than MVP. (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, Cancer Research, Endocrinology, Journal Clinical Oncology, Menopause, NIH / 07.11.2015

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. (more…)
Author Interviews, Breast Cancer / 25.07.2014

Rajkumar Lakshmanaswamy, PhD Research Director of the Center of Excellence in Cancer Research The Paul L. Foster School of Medicine Texas Tech University Health Sciences CenterMedicalResearch.com Interview with: Rajkumar Lakshmanaswamy, PhD Basic Science Research Director of the Center of Excellence in Cancer Research. The Paul L. Foster School of Medicine Texas Tech University Health Sciences Center Medical Research: What are the main findings of the study? Dr. Lakshmanaswamy: Our study supports a growing body of research suggesting a safe and effective role for natural steroid hormones in treating postmenopausal breast cancer, with fewer detrimental side effects and an improved health profile than with standard anti-hormone therapies. Using a mouse model mimicking human breast cancer after menopause, we found that treatment with estrogen, progesterone, and testosterone was associated with greater physical activity, improved cognition, and better cardiovascular and bone health, which demonstrates the potential significance of hormone treatment in postmenopausal women. (more…)