Mediterranean Diet Linked to Lower Long-Term Cardiovascular Events in Women

MedicalResearch.com Interview with:

Samia Mora, MD, MHS Associate Professor of Medicine Harvard Medical School Director, Center for Lipid Metabolomics Brigham and Women’s Hospital Boston, MA

Dr. Mora

Samia Mora, MD, MHS
Associate Professor of Medicine
Harvard Medical School
Director, Center for Lipid Metabolomics
Brigham and Women’s Hospital
Boston, MA

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

Response: The Mediterranean diet is rich in plants (nuts, seeds, fruits, vegetables, whole grains, legumes) and olive oil, and includes moderate intake of fish, poultry, dairy, and eggs, and alcohol, and rare use of meats and sweets.The Mediterranean diet has been associated with lower risk of cardiovascular disease (CVD) events but the precise mechanisms through which Mediterranean diet intake may reduce long-term risk of CVD are not well understood. We aimed to investigate the biological mechanisms that may mediate this cardiovascular benefit.

Using a prospective study of 25,994 initially healthy women enrolled in the Women’s Health Study who were followed up to 12-years, we evaluated potential mediating effects of a panel of biomarkers (in total 40 biomarkers) that represent different CVD pathways and clinical factors.

Higher baseline intake of a Mediterranean-type diet was associated with approximately one quarter lower risk of CVD events during the 12 year follow up. For the MED-CVD risk reduction, biomarkers of inflammation, glucose-metabolism/insulin-resistance, and adiposity contributed most to explaining the association, with additional contributions from pathways related to blood pressure, lipids – in particular HDL or triglyceride-rich lipoprotein metabolism, and to a lesser extent LDL cholesterol, branched chain amino acids, and small molecule metabolites.  Continue reading

Hysterectomy Can Impair Short Term Memory (at least in rats)

MedicalResearch.com Interview with:

Heather A. Bimonte-Nelson, Ph.D. Professor, Barrett Honors Faculty Department of Psychology Arizona State University

Dr. Bimonte-Nelson

Heather A. Bimonte-Nelson, Ph.D.
Professor, Barrett Honors Faculty
Department of Psychology
Arizona State University

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

Response: The dogma in the field is that the nonpregnant uterus is dormant, and therefore it has not necessarily been of interest to study. Textbooks have described the nonpregnant uterus as “quiescent,” “dormant,” and “useless.” When I was in graduate school studying endocrinology, I read statements in books saying that the sole purpose of the uterus is for gestation.

However, all women aging into midlife will experience some type of menopause, and some of these women will undergo surgical menopause via removal of all, or a part of, their reproductive tracts. Research evaluating reproductive tract-brain connections has grown quite a bit in the last few decades. For example, the ovary-brain connection has been focused on quite a bit, and we now know that hormones coming from the ovaries (such as estrogens and progesterone) can affect more than reproduction, and can impact brain functioning. While the uterus-brain connection is not well understood, there is research indicating that the uterus and autonomic nervous system communicate directly.

We also know that hormones released from the ovaries impact the uterus. Therefore, there is a uterus-ovary-brain triad system. This uterus-ovary-brain triad has undergone little scientific investigation for functions outside of reproduction. Given that by age 60 one in three women experience hysterectomy, thereby interrupting this uterus-ovary-brain triad system, we believe it is important to understand the effects of variants of surgical menopause including hysterectomy.

This led to our current evaluation testing multiple variations in surgical menopause using a rat model, where we tested the effects of uterus removal alone (hysterectomy), ovarian removal alone, or uterus plus ovarian removal.

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Risk Factors for Melanoma in Women

MedicalResearch.com Interview with:

One example of malignant melanoma, courtesy of skin cancer foundation

One example of malignant melanoma, courtesy of Skin Cancer Foundation

Reza Ghiasvand, PhD
Oslo Centre for Biostatistics and Epidemiology
Faculty of Medicne
University of Oslo
Oslo, Norway 

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

Response: Melanoma is the most dangerous type of skin cancer. It is estimated that about 288,000 individuals will be diagnosed and about 61,000 will die from it in 2018, with the majority of patients in Australia, New Zealand, Europe and North America. Ultraviolet (UV) exposure (from both the sun and tanning beds) is the most important preventable risk factor for melanoma. However, the association between UV exposure and melanoma is complex and does not accord with a simple model in which risk increases directly with exposure. An individual risk of melanoma also depends on personal characteristics such as skin color and skin sensitivity to the UV exposure, hair color, number of moles, and age.

It has been hypothesized that the pattern of UV exposure may play a role in melanoma development in different body sites. For example, melanoma on the trunk (chest and back) has been linked to the recreational UV exposure such as sunbathing and frequent sunburns in people with high number of moles on their body. In contrast, melanomas on the head and neck have been linked to constant sun exposure such as occupational UV exposure, mainly in older people. Epidemiologic and molecular evidence in support of this hypothesis has been published based on analyses of small datasets. Also, melanoma on legs and arms is less studied under this hypothesis.

In our study, we examined UV exposure (sunbathing, sunburn and sunbed use) and pigmentary factors (skin, eye, and hair color, freckling, and number of moles), and risk of melanoma on different body sites. We used information from the Norwegian Women and Cancer Study, a population-based cohort study that started in 1991, and includes more than 161,000 Norwegian women followed for an average of 18 years.

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Surgical Menopause Linked To More Insomnia and Sleep Difficulties

MedicalResearch.com Interview with:

Sooyeon Suh, PhD Department of Psychology Sungshin University Seoul, Republic of Korea

Dr. Suh

Sooyeon Suh, PhD
Department of Psychology
Sungshin University
Seoul, Republic of Korea

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

Response: Women who are going through menopause frequently complain of sleep complaints and depressive symptoms in addition to other typical symptoms such as hot flashes and night sweats. Two of the most common ways of becoming menopausal are through natural menopause and surgical menopause. While natural menopause is usually experienced in the course of aging, surgical menopause is usually induced by OBGYN surgery such as bilateral oopherectomy, often as a result of illnesses such as ovarian cancer.

Many studies have found that women who experience surgical menopause often experience more psychological and physical difficulties compared to women who transition through menopause naturally due to a more acute drop in estrogen following surgery, it sometimes leads to the need for practices like Advanced Gynecology to help manage the symptoms. Unfortunately, in clinical settings, women who undergo surgical menopause are not provided with additional psychoeducation or customized treatment to address these issues.

The main findings of these studies support these issues. In 526 postmenopausal women, women who went through surgical menopause reported significantly worse sleep quality an shorter sleep duration. Additionally, they had a 2.13 times higher likelihood of having insomnia that warranted treatment.

Finally, even though women who went through surgical menopause engaged in the same sleep-interfering behaviors (e.g., drinking caffeine, drinking alcohol before bed, watching TV in bed, etc) as women who went through menopause naturally, their sleep was impacted more negatively. Continue reading

Female Genital Mutilation of Young Girls Declines in Africa, Not in Western Asia

MedicalResearch.com Interview with:
Professor Ngianga-Bakwin Kandala Professor of Biostatistics Department: Mathematics, Physics and Electrical Engineering Northumbria University, UKProfessor Ngianga-Bakwin Kandala

Professor of Biostatistics
Department: Mathematics, Physics and Electrical Engineering
Northumbria University, UK

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

Response: The background “UNICEF (2014) estimates that worldwide more than two hundred million women have undergone some form of FGM/C, and approximately 3.3 million girls are cut each year. Recent estimates show that if FGM/C practices continue at current, 68 million girls will be cut between 2015 and 2030 in 25 countries where FGM is routinely practiced and more recent data are available (UNJP, 2018).”

Main findings: The prevalence of FGM/C among children varied greatly between countries and regions and also within countries over the survey periods. We found evidence of significant decline in the prevalence of FGM/C in the last three decades among children aged 0–14 years in most of the countries and regions, particularly in East, North and West Africa. We show that the picture looks different in Western Asia, where the practice remains and affects the same age group.

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Is Pregnancy a “Stress Test” for Future Dementia Risk?

MedicalResearch.com Interview with:
"Pregnancy 1" by operalynn is licensed under CC BY 2.0Heather Boyd, Ph.D.
Senior researcher
Department of Epidemiology Research
Copenhagen Denmark

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

Response: We have known for a while that women who have had preeclampsia report different types of cognitive impairment (difficulties with short-term memory, attention deficits) in the years and decades after their pregnancies, and there are a few imaging studies suggesting that these women may have more white matter lesions in the brain and more signs of brain atrophy than women with uncomplicated pregnancies. We also know that women who have had preeclampsia are at increased risk of cardiovascular disease in the years and decades after delivery. Taken together, it was not a great leap to hypothesize that women with a history of preeclampsia might also be at increased risk of dementia later in life. However, the existing epidemiological data were unconvincing, possibly because it takes a great deal of power (a very large study population) to study links between two conditions that often occur decades apart.

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Nolasiban Phase 3 IMPLANT 2 Trial: IVF Live Birth Rate Increased Up to 35%

MedicalResearch.com Interview with:
Dr. Ernest Loumaye, MD, PhD
Co-Founder and CEO
ObsEva SA  

MedicalResearch.com: What is the background for this announcement? How does Nolasiban work to decrease contractions and improve uterine blood flow?

Response: The WHO has recognized infertility as a global health issue, and many couples undergo IVF treatment: there are more than 700,000 annual IVF treatment cycles in Europe and more than 200,000 in the U.S. However, more than 50% of IVF procedures do not result in pregnancy, and failure has tremendous emotional and financial costs to patients.  ObsEva is dedicated to improving fertility outcomes in IVF while also supporting the use of single embryo transfer to minimize multiple births that are associated with significant health risks to mother and baby, as well as significant health costs from premature delivery.

Nolasiban works by blocking the hormone oxytocin, which is known to induce uterine contractions.  Nolasiban reduces uterine contractions and could improve uterine blood flow, both effects being favourable for the embryo to properly implant. Continue reading

Mediterranean Diet Linked To Stroke Risk Reduction in Women

MedicalResearch.com Interview with:
“Vegetables” by Wagner T. Cassimiro "Aranha" is licensed under CC BY 2.0Professor Phyo Kyaw Myint MBBS MD FRCP(Edin) FRCP(Lond)
Clinical Chair in Medicine of Old Age
Academic Lead: Ageing Clinical & Experimental Research &
Director of Clinical Academic Training Development
The Lead Academic, Aberdeen Clinical Academic Training (ACAT) Programmes
School of Medicine, Medical Sciences & Nutrition
College of Life Sciences & Medicine, University of Aberdeen

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

Response: While Mediterranean Diet has been linked to reduced stroke risk it remains unclear
(1) its impact on populations within non-Mediterranean countries;
(2) its specific impact on different gender;
(3) the effect observed when using more robust dietary assessments; and (4) which specific components of the diet are most protective.

We therefore studied more than 23 thousand men and women (mainly British Caucasian) aged 40 years or older in Norfolk, UK as part of EPIC-Norfolk study and we found that the greater adherence to Mediterranean dietary pattern is linked to a significant reduction in stroke risk in women but not in men. This benefit was seen across the whole middle and older age population (particularly for women) regardless of their existing risk factors such as high blood pressure.

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HPV Testing or PAP Smear To Screen for Cervical Cancer?

MedicalResearch.com Interview with:

Joy Melnikow, MD, MPH Professor, Department of Family and Community Medicine Director, Center for Healthcare Policy and Research University of California, Davis Sacramento, CA 95817

Dr. Melnikow

Joy Melnikow, MD, MPH
Professor, Department of Family and Community Medicine
Director, Center for Healthcare Policy and Research
University of California, Davis
Sacramento, CA 95817

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

Response: This systematic review of the medical literature was conducted to support the update of the US Preventive Services Task Force Recommendation.  Because the effectiveness of cytology (Pap smear) screening is so well established, the review focused on the evidence on use of high risk Human Papillomavirus (hrHPV) screening, alone (primary screening) or combined with cytology (co-testing)

MedicalResearch.com: What should readers take away from your report?

Response: Current evidence supports the use of cytology, hrHPV testing alone, or co-testing as effective approaches to screening for cervical cancer.  hrHPV testing, alone or as co-testing, can be done at five year intervals, longer than the recommended 3 year interval for cytology. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work? 

Response: Additional research is needed to identify effective strategies for outreach and screening women who are not regularly screened.  Because most women in the US are not part of an organized screening program, effective outreach is especially important in the US. 

MedicalResearch.com: Is there anything else you would like to add?

Response: Since the prior review, more evidence has emerged to support the use of hrHPV testing as primary screening.

I have no financial conflicts of interest. 

Citation:

US Preventive Services Task Force. Screening for Cervical CancerUS Preventive Services Task Force Recommendation Statement. JAMA. 2018;320(7):674–686. doi:10.1001/jama.2018.10897

Aug 22, 2018 @ 12:01 pm 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Patients With Type II Diabetes Have Greatest Risk of Heart Failure

MedicalResearch.com Interview with:

Dr Araz Rawshani, PhD Department of Molecular and Clinical Medicine Institute of Medicine University of Gothenburg Gothenburg, Sweden

Dr. Rawshani

Dr Araz Rawshani, PhD
Department of Molecular and Clinical Medicine
Institute of Medicine
University of Gothenburg
Gothenburg, Sweden

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

 Response: Patients with type 2 diabetes have 2 to 4 times greater risk for death and cardiovascular events compared to the general population. There are several randomized trails that encourage a range of interventions that target traditional and modifiable risk factors, such as elevated levels for glycated hemoglobin, blood pressure and low-density lipoprotein cholesterol to reduce the risk for complications of type 2 diabetes. However, there are few randomized trails that have investigated the effects of multifactorial risk factor intervention in reducing the risk for death and cardiovascular events, as compared to patients that are treated with usual care.

We set out to investigate the extent to which the excess risk associated with type 2 diabetes may be mitigated or potentially eliminated by means of evidence-based treatment and multifactorial risk factor modification. In addition, we estimated the relative importance between various risk factors and the incremental risk of death and cardiovascular events associated with diabetes. Furthermore, we investigated the association between glycated hemoglobin, systolic blood pressure and low-density lipoprotein cholesterol (LDL-C) within evidence based target ranges and the abovementioned outcomes.

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HPV Testing Detects Cervical Pre-Cancer Earlier Than PAP Tests

MedicalResearch.com Interview with:

Gina Ogilvie | MD MSc FCFP DrPH Professor | Faculty of Medicine | University of British Columbia Canada Research Chair | Global control of HPV related disease and cancer Senior Public Health Scientist | BC Centre for Disease Control Senior Research Advisor | BC Women's Hospital and Health Centre BC Women's Hospital and Health Centre Vancouver, BC

Dr. Gina Ogilvie

Dr. Gina Ogilvie | MD MSc FCFP DrPH
Professor | Faculty of Medicine | University of British Columbia
Canada Research Chair | Global control of HPV related disease and cancer
Senior Public Health Scientist | BC Centre for Disease Control
Senior Research Advisor | BC Women’s Hospital and Health Centre
BC Women’s Hospital and Health Centre
Vancouver, BC

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

Response: HPV is known to be the cause of 99% of cervcial cancers.

In this study, we compared the routine screening test for cervical cancer, Pap test, to HPV testing.

We found that by using HPV testing, women were significantly more likely to have cervical pre-cancers detected earlier. In addition, women with negative HPV tests were significantly less likely to have pre-cancers 48 months later.

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Greater Risk of Diabetes in Women With Longer Work Week

MedicalResearch.com Interview with:

Mahée Gilbert-Ouimet, PhD Postdoctoral fellow/Chercheure postdoctorale Institute for Work & Health Hôpital du St-Sacrement,  Québec 

Dr. Gilbert-Ouimet

Mahée Gilbert-Ouimet, PhD
Postdoctoral fellow/Chercheure postdoctorale
Institute for Work & Health
Hôpital du St-Sacrement,  Québec 

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

Response: Diabetes is one of the primary causes of death worldwide, in addition to being a major risk factor for several other chronic diseases including cardiovascular diseases. Considering the rapid and substantial increase of diabetes prevalence, identifying modifiable risk factors is of major importance. In this regard, long work hours have recently been linked with diabetes, but more high-quality prospective studies are needed. Our study evaluated the relationship between long work hours and the incidence of diabetes among 7065 workers over a 12-year period in Ontario, Canada.

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USPSTF: Women 65 and Older Should Be Screened for Osteoporosis to Prevent Fractures

MedicalResearch.com Interview with:

Chien-Wen Tseng, M.D., M.P.H., M.S.E.E. Hawaii Medical Service Association Endowed Chair in health services and quality research Associate professor, and the Associate research director Department of Family Medicine and Community Health University of Hawaii John A. Burns School of Medicine

Dr. Chien-Wen Tseng

Chien-Wen Tseng, M.D., M.P.H., M.S.E.E.
Hawaii Medical Service Association Endowed Chair in health services and quality research
Associate professor, and the Associate research director
Department of Family Medicine and Community Health
University of Hawaii John A. Burns School of Medicine 

MedicalResearch.com: What is the background for this recommendation statement? What are the main findings and recommendations?

Response: Osteoporosis is a condition where bones become weak and can break or fracture more easily. These fractures can happen at the spine, hip, and other locations, and can have serious health consequences such as pain, limited mobility, or even death. By 2020, more than 12 million Americans over the age of 50 are expected to have osteoporosis and two million fractures occur yearly.

Since people often may not know they have osteoporosis until they have a fracture, the U.S. Preventive Services Task Force looked at the evidence to see if screening for osteoporosis can help to prevent fractures. We found that screening for and treating osteoporosis can prevent fractures in women ages 65 and older and in younger women who have been through menopause and have additional factors that put them at increased risk for osteoporosis.

In men, more research is needed to know if routine screening and treatment for osteoporosis can prevent fractures. Continue reading

Unique Vaginal Cells Facilitate HIV Infection and Persistence

MedicalResearch.com Interview with:

Manish Sagar, MD Assistant Professor of Medicine, Boston University School of Medicine Boston MA 

Dr. Sagar

Manish Sagar, MD
Infectious Disease Physician at Boston Medical Center
Boston MA 

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

Response: Women compromise the majority of new infections in the world and most of them acquire the virus after sexual exposure.  The goal of the study was to understand how HIV establishes initial infection in the female genital tract. We obtained discarded vaginal tissue and isolated cells present in the outermost layer that contact the virus during exposure.

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Obese Women Remain at Risk For Heart Disease, Even When Metabolically Healthy

MedicalResearch.com Interview with:
Nathalie Eckel, MSc

German Diabetes Center
Düsseldorf, Germany 

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

 Response: Obesity is associated with metabolic disorders such as diabetes, high blood pressure and hypercholesterolemia, and with a higher risk of cardiovacular disease compared to normal weight. However, there is also the phenomenon of the so-called “metabolically healthy obesity” and “metabolically unhealthy normal-weight”. So far it has been unclear how metabolic risk factors change over time in metabolically healthy people depending on body weight and what cardiovascular disease risk results from this.

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CPAP Improved Sexual Quality of Life for Women

MedicalResearch.com Interview with:

“The new CPAP machine” by Bryan Alexander is licensed under CC BY 2.0

One CPAP model
Image by Bryan Alexander

Sebastian M. Jara, MD
Resident Physician & Research Fellow
Department of Otolaryngology – Head & Neck Surgery
University of Washington Affiliated Hospitals 

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

Response: Sleep apnea is a common disorder associated with numerous health consequences and reduced quality of life. There is growing evidence that sleep apnea also affects sexual quality of life and that treatment for sleep apnea, with CPAP (continuous positive airway pressure), may improve sexual quality of life. The goal of this study was to evaluate the impact of long-term CPAP therapy on sexual quality of life in a group of men and women with sleep apnea.

Our study included 182 men and women with newly diagnosed obstructive sleep apnea, each of whom were prescribed a CPAP. Subjects completed a quality of life survey, which included questions on sexual quality of life, at their initial clinic visits and again one year later. Changes in sexual quality of scores over time were then compared between CPAP users and non-users.

Among the subjects, 72 used a CPAP nightly and 110 did not. When looking at all subjects, an overall improvement in sexual quality of life was observed in subjects that used their CPAP compared to subjects that did not, after accounting for several factors that can also affect sexual quality of life. When subgroup analysis was performed, a large improvement in sexual quality of life was noticed for women in the study. In contrast, men in the study experienced little-to-no improvement in sexual quality of life.

MedicalResearch.com: What should readers take away from your report?

Response: These findings add to a large body of evidence that CPAP improves overall health and quality of life, in both men and women with sleep apnea. Because sleep apnea is more common men, there are fewer studies, especially those assessing sexual dysfunction, in women. However, there’s growing recognition that women, too, are affected and can benefit from CPAP use. Our findings demonstrate that improved sexual quality of life is one of the many health benefits that comes with CPAP treatment for women.While this study showed no improvements in sexual quality of life for men, CPAP has been shown to have numerous other health benefits in men and use should still be encouraged. Our hope is that the findings of this study will help motivate patients of both sexes who sleep poorly to seek evaluation for sleep apnea as treatment can have a wide-range of health benefits, including improved sexual quality of life. 

MedicalResearch.com: What recommendations do you have for future research as a result of this work?

Response: In future studies, it will be important to study more comprehensive measures of sexual quality of life in sleep apnea patients. This will include both a more extensive assessment of sexual quality of life in patients themselves and effects on their bed partners. Additionally, it will be important to test the effects of other sleep apnea treatments, such as surgery. Although CPAP is the first-line treatment for sleep apnea, it can be cumbersome to wear and might adversely affect intimacy and sexual quality of life compared to other treatments. 

MedicalResearch.com: Is there anything else you would like to add? 

Response: This study was funded by the National Institutes of Health. The authors of this study otherwise have no other funding, financial relationships, or conflicts of interest to disclose. 

Citation:

Jara SM, Hopp ML, Weaver EM. Association of Continuous Positive Airway Pressure Treatment With Sexual Quality of Life in Patients With Sleep ApneaFollow-up Study of a Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg. Published online May 24, 2018. doi:10.1001/jamaoto.2018.0485

 

The information on MedicalResearch.com is provided for educational purposes only, and is in no way intended to diagnose, cure, or treat any medical or other condition. Always seek the advice of your physician or other qualified health and ask your doctor any questions you may have regarding a medical condition. In addition to all other limitations and disclaimers in this agreement, service provider and its third party providers disclaim any liability or loss in connection with the content provided on this website.

 

Women With PCOS Should Be Screened for Mental Health Issues

MedicalResearch.com Interview with:
Aled Rees, MD, PhD
Neuroscience and Mental Health Research Institute
Cardiff University School of Medicine, Health Park
Cardiff United Kingdom

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

Response: PCOS is a common condition, affecting 5-10% of women globally, in which elevated male hormone levels can cause a range of distressing and life-limiting symptoms, including reduced fertility, irregular periods, excessive facial and body hair, and acne. Previous studies have suggested a link between PCOS and poor mental health in women but the studies were small and did not adequately take other factors that can affect mental health into consideration. In addition, high levels of testosterone during pregnancy have been reported to increase the risk of neurodevelopmental disorders, such as ADHD and autism, in children.

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Perimenopause: Oral Micronized Progesterone May Reduce Hot Flashes, Night Sweats and Sleep Problems

MedicalResearch.com Interview with:

Jerilynn C. Prior, MD Professor in the Department of Medicine Division of Endocrinology and Metabolism University of British Columbia in Vancouver

Dr. Prior

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.  Continue reading

Women Who Walk Briskly At Least Twice Per Week Have Lower Risk of Heart Failure

MedicalResearch.com Interview with:
Dr. Somwail Rasla, MD

Primary Care Center
Brown University, Pawtucket, RI

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

Response: Heart failure (HF) is a major global epidemic. The risk of heart failure rises with age, It triples for women above age 60.
Studies have found an inverse relationship between the risk of heart failure hospitalization and midlife fitness.Walking is the most common form of physical activity reported in women
and older adults. T
his study aims at exploring the association of walking pace (speed), walking frequency and duration with the risk of incident acute hospitalized HF (HHF).

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Menopausal Hormone Therapy Linked To Favorable Cardiac Profile

MedicalResearch.com Interview with:

Mihir Sanghvi Academic Junior Doctor Barts Health NHS Trust

Dr. Sanghvi

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.

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Teenage Daughters More Likely To Have Abortion If Their Mother Had One

MedicalResearch.com Interview with:
“Don't forget the teens” by Jon Seidman is licensed under CC BY 2.0Ning Liu PhD Student

Senior Research Analyst at ICES
Institute of Health Policy, Management and Evaluation
Institute for Clinical Evaluative Sciences
University of Toronto

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

Response: Previous studies suggested intergenerational tendencies between a mother and her daughter in fertility patterns, such as when they give birth to a child for the first time, or the total number of children they have during their lifetime.

We explored whether there is also an intergenerational tendency for induced abortion practices between a mother and her teen daughter.

To do so, we used anonymized records of 431,623 daughters and their mothers, and found that a teenage daughter was twice as likely to have an induced abortion if her mother had had an induced abortion.  Continue reading

Even With Preserved Ovaries Hysterectomy Linked To Increased Cardiac and Metabolic Risks

MedicalResearch.com Interview with:

Dr. Shannon Laughlin-Tommaso MD Associate Professor of Obstetrics and Gynecology Consultant, Division of Gynecology, Department of Obstetrics & Gynecology Mayo Clinic, Rochester New York

Dr. Laughlin-Tommaso

Dr. Shannon Laughlin-Tommaso MD
Associate Professor of Obstetrics and Gynecology
Consultant, Division of Gynecology, Department of Obstetrics & Gynecology
Mayo Clinic, Rochester New York 

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

Response: There are increasing data from a number of studies about the long term risks of hysterectomy both with and without removing the ovaries. We studied women who underwent hysterectomy with conservation of both ovaries to determine the long-term risk of cardiovascular disease using the Rochester Epidemiology Project (REP). The advantage of using the REP is that we were able to follow women for an average of 22 years, where previous studies had only been able to follow for 7-10 years and we were able to determine which women already had cardiovascular disease risk factors at the time of hysterectomy.

We found that women who undergo hysterectomy have a 33% increased risk of new onset coronary artery disease, a 13% increased risk of hypertension, a 14% increased risk in lipid abnormalities, and an 18% increased risk of obesity. For women who had a hysterectomy before age 35 years, these risks were even higher: 2.5-fold risk of coronary artery disease and 4.6-fold risk of congestive heart failure.

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Maternal Ingestion of Placenta Has No Proven Therapeutic Benefit

MedicalResearch.com Interview with:

Placenta – Wikipedia Image

Daniel C Benyshek, PhD
Professor, Department of Anthropology
Adjunct Professor, UNLV School of Medicine
Co-Director, Metabolism, Anthropometry and Nutrition Lab
UNLV
Sharon M. Young, PhD (first author)

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

Response: Over the last several decades, human maternal placentophagy (postpartum ingestion of the placenta by the mother) has emerged as a rare but increasingly popular practice among women in industrialized countries seeking its many purported health benefits. Human placentophagy advocates, including many midwives, placenta encapsulation specialists, lactation consultants, and mothers who have experienced positive results previously from the practice, regularly claim improved lactation, energy levels, and postpartum mood, among other benefits, as a result of placentophagy. These advocates regularly speculate that these self-reported effects are likely due to (beneficial) changes to postpartum maternal hormone profiles as a result of the practice. While maternal placentophagy is ubiquitous among land mammals, including our closest primate relatives, recent research has shown that human maternal placentophagy is unknown as a traditional cultural practice. The conspicuous cross-cultural absence of maternal placentophagy among humans (as a long-standing traditional practice) thus remains a mystery. Our study is an important first step in the scientific (evolutionary and clinical) investigation of this rare but increasingly popular maternal practice.

Our study was a double-blind, and placebo controlled trial, meaning that there was a placenta group and a placebo group, and the participants and researchers didn’t know which supplement a participant had until the end of the study. We included 27 healthy women, recruited during pregnancy, who met with the researchers 4 times across pregnancy and early postpartum. At each meeting, they answered questionnaires on topics of interest (e.g., mood, energy, bonding, social support etc.), and we collected blood and saliva samples. At the first two meetings, they were not yet taking a placenta or placebo supplement, so we could collect baseline measures for their hormones and questionnaire data. After the second meeting, they were instructed to take either placenta or placebo supplements. Once the study had ended, we compared data between the two groups to identify any differences.

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Post-Menopausal Hormones Mitigates Effects of Stress on Cortisol and Working Memory

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

Dr. Herrera

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.

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Abortion Rate Among Adolescents Falls 46%

MedicalResearch.com Interview with:

Jenna Jerman Senior Research Associate Guttmacher Institute New York, NY   10038

Jenna Jerman

Jenna Jerman
Senior Research Associate
Guttmacher Institute
New York, NY   10038


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

Response:   Abortion is a critical component of public health. The objectives of this study were to assess the prevalence of abortion among population groups and changes in rates between 2008 and 2014, as well as to provide an updated estimate of the lifetime incidence of abortion.

To estimate abortion rates, we used data from the Abortion Patient Survey, the American Community Survey, and the National Survey of Family Growth; the estimate of the lifetime incidence of abortion used data from the Abortion Patient Survey. Between 2008 and 2014, the abortion rate declined 25%, from 19.4 to 14.6 per 1,000 women aged 15 to 44.  Abortion rates declined among all groups of women, though declines steeper for some populations than others. The abortion rate for adolescents aged 15 to 19 years declined 46%, the largest of any group. Abortion rates declined for all racial and ethnic groups but were larger for non-white women than for non-Hispanic white women. Although the abortion rate decreased 26% for women with incomes less than 100% of the federal poverty level, this population had the highest abortion rate of all the groups examined: 36.6. If the 2014 age-specific abortion rates prevail, 24% of women in that year will have an abortion by age 45.

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