Dr. Prior[/caption]
Jerilynn C. Prior, MD
Professor in the Department of Medicine
Division of Endocrinology and Metabolism
University of British Columbia in Vancouver
Dr. Prior has written the second edition of the award-winning book, Estrogen’s Storm Season—Stories of Perimenopause this year as an ebook on Google Play.
MedicalResearch.com: What is the background for this study?
Response: There is an urgent need for an effective therapy for perimenopausal hot flushes/flashes and night sweats (vasomotor symptoms, VMS). Although often considered “estrogen deficiency symptoms” VMS are common and very problematic for women in the menopause transition and who have not yet been one year without flow. About 23% of North American women are now in the perimenopausal age range. Surprisingly VMS are more common in perimenopause than in menopause; 9% of perimenopausal women have severe VMS as classified by the FDA, meaning more than 50 VMS per week of moderate to intense severity.
The commonly used therapies for VMS in midlife women have not been proven more effective than placebo! That includes combined hormonal contraceptives (CHC) and menopausal-type hormone therapy (MHT) as well as the SSRI/SNRI anti-depressants and gabapentin.
Dr. Carolyn Crandall[/caption]
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.
Dr. Hadine Joffe[/caption]
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.
MedicalResearch.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.
MedicalResearch.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.
MedicalResearch.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
MedicalResearch.com Interview with:
Stephanie Faubion, M.D
Director of the Women’s Health Clinic
Mayo Clinic in Rochester
Medical Research: What are the main findings of the study?
Dr. Faubion: In this study that included over 1800 women, we found that caffeine intake was associated with more bothersome hot flashes and night sweats in postmenopausal women.