Menopause / 25.04.2024

Menopause isn't merely a biological process—it's a journey that marks a new chapter in a woman's life. It comes with its share of whispers and shadows, often stirring a mix of emotions from relief to apprehension. As the familiar rhythm of your body shifts, it can feel like you’re navigating a path bristling with unknowns, each step echoing with the beats of change. Imagine embracing this transition not just with endurance, but with empowerment. Menopause, with all its intricacies, isn't the end of youth but a rebirth of freedom and strength. Let's redefine what it means to walk through this phase, equipped with knowledge and wrapped in understanding.

Understanding Menopause

From menstrual cycle regularity to temperature regulation, understanding these hormonal changes is essential as they underlie myriad experiences during menopause.

Hormonal Changes

As you approach menopause, your body begins a natural shift in hormone production, primarily estrogen and progesterone. These changes are the conductors behind the scenes, orchestrating everything from your menstrual cycle regularity to the temperature of your skin. Understanding these hormonal ebbs and flows is crucial, as they are pivotal in what you experience during menopause. (more…)
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…)
Author Interviews, JAMA, OBGYNE / 07.07.2023

MedicalResearch.com Interview with: Dorothy A. Fink, MD Deputy Assistant Secretary for Women's Health Director, Office on Women's Health US Department of Health & Human Services Rockville, MD MedicalResearch.com: What is the background for this study? Response: Delivery-related mortality in U.S. hospitals has decreased for all racial and ethnic groups, age groups, and modes of delivery while the prevalence of severe maternal mortality (SMM) increased for all patients, with higher rates for racial and ethnic minority patients of any age. This study specifically looked at inpatient delivery-related outcomes and found a 57% decrease from 2008-2021. The decreasing mortality rates within the inpatient delivery setting demonstrated as statistically significant and a welcome finding for all women. This study also looked with greater granularity at the impact of race, ethnicity, and age. Mortality for American Indian women decreased 92%, Asian women decreased 73%, Black women decreased 76%, Hispanic women decreased 60%, Pacific Islander women decreased 79%, and White women decreased 40% during the study period. (more…)
Alzheimer's - Dementia, Author Interviews, Brigham & Women's - Harvard, Gender Differences, JAMA, Menopause / 03.04.2023

MedicalResearch.com Interview with: Rachel Buckley, PhD ​Assistant Professor Department of Neurology Massachusetts General Hospital/Harvard Medical School MedicalResearch.com: What is the background for this study? Response: While a fair amount of studies have focused on the effects of menopause and hormone therapy on risk of dementia, far fewer studies have tested their association with the biology of Alzheimer’s disease, namely amyloid and tau. This is critical to know given that it still remains unclear what might be the driving mechanism of the menopause transition on risk for dementia. This is what our study set out to investigate. This study is one of the first to report a link between women’s age at menopause and tau in the brain, which we measured with positron emission tomography neuroimaging. We found that in multiple areas of the brain that tend to be most likely to show higher tau in women than men, women with earlier age at menopause and elevated levels of amyloid showed higher levels of tau than those who reported an average age at menopause (~50 years in the United States). Women who reported premature menopause (<40 years at menopause onset) exhibited a much higher risk of tau in the brain. This supports the notion that longer exposure to estrogen throughout life might be protective against Alzheimer’s disease. (more…)
Author Interviews, Hip Fractures, Vegetarians / 21.08.2022

MedicalResearch.com Interview with: James Webster PhD Lead author Nutritional Epidemiology Group, University of Leeds MedicalResearch.com: What is the background for this study? Response: Hip fractures are the most severe consequence of osteoporosis and are a major public health problem. There are growing concerns of poor bone health and higher risk of fractures in vegetarians, but prospective studies comparing risk of hip fracture in vegetarians and meat-eaters over time are scarce and limited. A study of British men and women in the EPIC-Oxford cohort showed a greater risk of hip fracture in pescatarians, vegetarians, and vegans compared to meat-eaters. The only other study on the topic, the Adventist Health Study of US adults, found no clear evidence of a difference in hip fracture risk between vegetarians and meat-eaters, but identified hip fractures through questionnaires, which are susceptible to selective loss to follow-up. To build on previous research, we investigated the risk of hip fracture in occasional meat-eaters, pescatarians, and vegetarians compared to regular meat-eaters in middle-aged UK women, who are at a greater risk of hip fracture than men, with hip fractures accurately confirmed using objective and complete hospital records. (more…)
Author Interviews, Brigham & Women's - Harvard, Fertility, Heart Disease, JACC / 19.04.2022

MedicalResearch.com Interview with: Emily Lau, MD, MPH Cardiologist Instructor in Medicine, Harvard Medical School Director, Menopause, Hormones & Cardiovascular Disease Clinic Massachusetts General Hospital MedicalResearch.com:  What is the background for this study?  What are the main findings? Response: Emerging data suggest that a woman’s reproductive history influences her future risk of heart disease. Infertility is a reproductive risk factor that affects ~14% of women but has not been rigorously studied with respect to its relationship with cardiovascular disease risk. We studied over 38,000 women enrolled in the Women’s Health Initiative and found that infertility was associated with greater risk of heart failure. In particular, we found that the association was driven by greater risk of heart failure with preserved ejection fraction, a form of heart failure that is far more common among women. (more…)
Author Interviews, Gender Differences, Heart Disease, JACC, Surgical Research / 06.04.2022

MedicalResearch.com Interview with: Mario F.L. Gaudino, M.D. PhD Attending Cardiac SurgeonDepartment of Cardiothoracic Surgery Antonino Di Franco, MD Adjunct Clinical Assistant Professor of Cardiothoracic Surgery Weill Cornell Medicine   MedicalResearch.com:  What is the background for this study?  What is the aim of this review?  Response: Biological and socio-cultural differences between men and women are complex and likely account for most of the variations in the epidemiology and treatment outcomes of coronary artery disease (CAD) between the two sexes. Despite the growing recognition of sex-specific determinants of outcomes, representation of women in clinical studies remains low, and sex-specific management strategies are generally not provided in guidelines. We summarized the current evidence on sex-related differences in patients with CAD, focusing on the differential outcomes following medical therapy, percutaneous coronary interventions, and coronary artery bypass surgery. (more…)
AHA Journals, Author Interviews, Heart Disease, Social Issues, UCSD / 03.02.2022

MedicalResearch.com Interview with: Natalie Golaszewski, PhD Herbert Wertheim School of Public Health and Human Longevity Science University of California, San Diego La Jolla, CA 92093 MedicalResearch.com:  What is the background for this study?  Response: Social isolation and loneliness are growing public health concerns as they are associated with health conditions that increase the risk of cardiovascular disease including obesity, smoking, physical inactivity, poor diet, high blood pressure and high cholesterol. (more…)
Author Interviews, NEJM, OBGYNE / 05.01.2022

MedicalResearch.com Interview with: Laura Schummers, ScD (she/her/hers) Postdoctoral Fellow, Contraception and Abortion Research Team CIHR Patient-Oriented Research Leadership Fellow Post-doctoral Trainee, ICES McMaster UBC - Department of Family Practice | Women's Health Research Institute MedicalResearch.com: What is the background for this study? Response: Canada was the first country in the world to remove all supplemental restrictions on the dispensing and administration of mifepristone, making the drug available as a normal prescription. This meant that the abortion pill could be prescribed by any doctor or nurse practitioner, dispensed by any pharmacist, and taken by patients when, where and if they choose. (more…)
Author Interviews, Gender Differences, JAMA / 09.12.2021

MedicalResearch.com Interview with: Christopher J. D. Wallis, MD, PhD Assistant Professor, Division of Urology University of Toronto Urologic Oncologist, Division of Urology Mount Sinai Hospital and University Health Network MedicalResearch.com: What is the background for this study? Response: Previous research has shown that female and male physicians communicate differently with patients. Further, there is evidence that female physicians, including surgeons, spend more time with patients. This, coupled with evidence that female patients may experience disparities in the management of their pain, led us to consider that communication differences may underpin differences in surgical outcomes previously noted (eg. Wallis et al, BMJ 2017) between male and female physicians. We postulated that there may be a differential association between surgeon sex and patient sex in behaviours that would translate into clinically important outcomes. (more…)
Author Interviews, Heart Disease, Menopause, Osteoporosis / 12.05.2021

MedicalResearch.com Interview with: Yeonyee E. Yoon, MD, PhD Associate Professor Division of Cardiology, Cardiovascular Center Seoul National University Bundang Hospital South Korea  MedicalResearch.com: What is the background for this study? Response: Although atherosclerotic cardiovascular disease (ASCVD) has been traditionally considered to affect men predominantly, it is nearly common in women. ASCVD is the leading cause of death in both men and women globally, and the population-adjusted risk of ASCVD mortality in women is significantly greater than that in men. Nevertheless, the current focus on the 10-year ASCVD risk estimated by a risk-scoring algorithm such as the Pooled Cohort Equation has shown unsatisfactory accuracy in women. Therefore, new strategies beyond the conventional risk stratification algorithm are needed to improve identification for women at high risk for ASCVD. ASCVD and osteoporosis are major age-related diseases contributing to significant morbidity and mortality in women, and previous epidemiologic studies have suggested a potential association between these diseases. Given that millions of women are screened for osteoporosis using dual-energy X-ray absorptiometry (DXA), potential associations between low bone mineral density (BMD) and ASCVD in women would provide an opportunity to improve the risk stratification of women without any additional costs. Therefore, we aimed to investigate whether the evaluation of BMD provides independent and incremental prognostic values for ASCVD prediction in women.  (more…)
Author Interviews, Gender Differences, Heart Disease, NYU, Women's Heart Health / 11.05.2021

MedicalResearch.com Interview with: Darcy Banco, MD, MPH Internal Medicine Resident NYU Langone Health MedicalResearch.com: What is the background for this study? Response: We became interested in this question because of recent epidemiological data showing that despite improvements in the number of heart attacks in overall population, that number is rising among young adults (<= 55 years old) and in particular, young women. Compared to young men, young women with heart attack experience more delays in care and have higher mortality and poorer quality of life after heart attack. Despite these findings, there was also a study that asked young adults who had experienced heart attack: “When you first went for help, did the health care providers think that you were having a problem with your heart?” Women were more likely to answer no to this question. Therefore, our study asked: Are young women evaluated and treated differently than men when presenting to the emergency room with symptoms of chest pain? (more…)
Author Interviews, Fertility, JAMA, Menopause / 10.04.2021

MedicalResearch.com Interview with: Duke Appiah, Ph.D., MPH Assistant Professor,Public Health Texas Tech University  MedicalResearch.com: What is the background for this study? Response: Reports from several countries point towards increasing trends in age at natural menopause. However, epidemiological report from the United States on the long-term trends in age at natural menopause or reproductive life span among a nationally representative sample of women is lacking. Understanding changes in the timing of age at natural menopause and length of the reproductive life span and their associated factors are important. For instance, earlier age at natural menopause is reported to be associated with cardiovascular diseases, neurological diseases and osteoporosis while later onset of menopause has been associated with the occurrence of breast, endometrial, and ovarian cancers. Similarly, longer durations of reproductive life span are associated with reduced morbidity and mortality. (more…)