Posts made in March, 2009

Well, well, well…

Posted by Liz on Mar 30, 2009 in emotions, general | 3 comments

wellbeing, that is. Is it elusive during the menopause?

Earlier studies have suggested that the way that a woman experiences menopause is dominated by several factors, including changes in the structure of their lives (e.g. social roles, personal relationships). When these changes do not occur as expected, for example, menopause starts early or late, they can cause greater distress than when they occur on time sot to speak. The same holds for menopausal symptoms; those that are perceived as normal are not necessarily unpleasant, while unusually heavy bleeding, emotional outbursts or frequent hot flashes can be disruptive.

I was intrigued when I ran across a study published in 2007  in the journal Contemporary Nursing which explored these very themes. Researchers recruited 18 women who were post-menopausal and self-described as having experienced ‘wellness’ during menopause. Interviews were conducted with all study participants, during which they were asked to describe in greater depth their experiences.

The study findings showed that the menopause experience was dominated by three themes:

The continuity of the experience

How women experience menopause is inevitably individualized and not easily generalizable. Indeed, data demonstrated that the nature of menopause and how women go through ultimately determine sits impact and how disruptive it is. More specifically, abrupt changes in menstrual patterns can be more jarring than incremental slowing and gradual cessation of menstruation.

How embedded menopause becomes in the rest of one’s life

In the course of the interviews, the researchers found that a woman’s ability to incorporate menopause into her life and routines versus allowing it to change the routines was key to maintaining an equilibrium. Hence, bothersome symptoms became only “only one experience among many and not the most outstanding.” Even hot flashes, which can truly disrupt a moment, became no more valuable to an overall experience than other daily events, mainly because these women did not allow them to disrupt familiar patterns and daily activities.

Containment of menopause

Participants who experienced a sense of wellbeing during menopause were able to compartmentalize their symptoms and for the most part, did not allow them to encroach upon the emotional or psychological domains. These women rarely if ever, experienced irritability, nervousness, anxiety or moodiness.

So, what does it mean?

Overall, the researchers found that a key to a sense of wellbeing during the menopause is focus, i.e. women are not focused on physical symptoms but instead, consider them part of the the overall experience of being a woman and are able to place them in the background. In other words, “the body [is] experienced in a “taken for granted way” so that menopause is not disruptive to an overall continuity of living.

The women who were studied were fortunate in that fluctuating hormones did not appear to alter or disrupt their moods or emotions. Hence, they were quite well-equipped to challenge the natural changes that were occurring and keep them away from the foreground. That aside, continuity and continuing to live one’s life without allowing physical changes to get in the way appeared to define the experience of menopause in more positive terms.

This brings to mind the word “natural” and challenges the notion of menopause as a disease. If we can find ways to stay on an even keel and take actions that minimize daily eruptions as nuisances rather than allowing them to disrupt, then we are indeed, on the right track. Wellbeing during menopause isn’t elusive; it simply requires careful planning and a different mindset.

What do you think?

St John’s Wort, Quality of Life & Hot Flashes

Posted by Liz on Mar 27, 2009 in herbal medicine, hot flash | 0 comments

Can St. John’s Wort improve quality of life during perimenopause?

While the benefit  of St. John’s wort for treatment depression and other mood disorders remains inconclusive, there is new evidence that it might be useful for symptoms of perimenopause that affect quality of life, namely hot flashes.

In a small study published in the February 3 Advanced Edition of Menopause, researchers randomly assigned 47 perimenopausal women experiencing 3 to 5 hot flashes daily to 900 mg St. John’s Wort extract three times daily or placebo. All study participants were asked to keep daily diaries noting the frequency and intensity of their hot flashes. Quality of life and hot flashes scores were also calculated.

At three months, women who had been taking St. John’s Wort reported significant improvements in menopause-specific quality of life and significantly fewer sleep problems. They also experienced improvements in daily hot flash frequency and hot flash scores.

Although the researchers caution that this is small study and that larger trials are needed,they say that St. John’s Wort may improve quality of life in ways that are important to perimenopausal women.

About St. John’s Wort

In addition to controversy over its effectiveness in treating depression, experts recommend against taking St. John’s Wort at the same time as alcohol, narcotics, amphetamines, tyrosine supplements, flu medicines and foods containing tyramine (e.g. yeast, aged cheese, eggplant, soy sauce). St. John’s Wort can also interact with prescription antidepressants, oral contraceptives and certain medications that thin the blood. More information about St. John’s Wort, its side effects and risks can be found here.

As with any herbal preparation, it’s critical to speak to a healthcare practitioner before embarking on therapy. Acupuncturist and Chinese Medicine Specialist Elaine Stern has a few tips with regards to what you should look for.

In the interim, keep an eye out for more news about St. John’s Wort. These results are encouraging news for hot flashers!

Wednesday Bubble: Reproductive cancers and estrogen

Posted by Liz on Mar 25, 2009 in estrogen | 1 comment

I’ve written previously about HRT and its definitive link to increased breast cancer risk. But how much of a role does natural estrogen play? Moreover, is exposure time important?

I ran across an interesting study in the the journal Cancer Epidemiology, Biomarkers and Prevention that suggests that the amount of time a woman spends in the transition to menopause may influence risk for reproductive cancers. The reason: overall exposure to total levels of natural estrogen and unopposed estrogen (i.e. estrogen with little or no progesterone as the result of aging).

In this study, researchers collected daily urine samples from 108 women (ages 25 to 58 years)  for 6 months annually over a total of 5 years and tested them for total estrogen levels.  Using models that evaluated variations in the length of the participants’ menstrual cycles, they also estimated where study participants were in the menopausal transition.

The findings

The results showed that mean levels of total estrogen increased with age in the pre- and peri-transition stages and decreased in the late transition stages. What’s more, the number of days of exposure to unopposed estrogen was higher during the transition to menopause compared with the pre-transition period; it also did not decline until after the menopause.

What these results mean

In general, the study results indicate that women are spending more time exposed to both total levels of estrogen and unopposed estrogen than previously thought. However, because the time spent in perimenopause varies from women to women, exposure to natural estrogen also varies.

The bottom line? Because studies have linked reproductive cancers to lifetime exposure to estrogen, determining the length of time that a women spends in perimenopause may  help researchers determine cancer risk.

Stay tuned – these findings could ultimately  impact how we go through the menopause and what we can do to conquer our risk of developing certain cancers afterwards!

She’s got moxi

Posted by Liz on Mar 23, 2009 in hot flash | 0 comments

Have you heard of or experienced moxibustion? Moxibustion is a technique used during acupuncture in which mugwort (or artemsia vulgaris) is burned to warm certain regions or acupuncture points. It can be direct (in which the moxa is placed directly on the acupuncture point) and indirect (in which the moxa is palced approximately 1 to 2 cm above the acupuncture point). The purpose of moxibustion is to encourage better blood and energy flow through the area to promote healing.

A study in the March 13 advanced online edition of Menopause suggests that moxibustion plus acupuncture can reduce both the frequency and severity of hot flashes.

In this study, researchers randomly assigned 51 women, ages 45 to 60 years who experienced at least 5 moderate to severe hot flashes daily to:

• 14 sessions of indirect moxibustion plus acupuncture at points consistent with evidence from clinical practice experience
• 14 sessions of indirect moxibustion plus acupuncture at points consistent with evidence from published literature
• no treatment

To ensure that researchers were able to distinguish between general improvements and improvements resulting from treatment, all study participants had to go through a 1-week period during which time they used not treatments at all.

Study findings showed that compared with no treatment at all, women in both moxibustion groups experienced significantly reductions in hot flash frequency (roughly 60% in both groups), and continuous reductions in hot flash severity through the fourth week of the study (by as much as 50%). 10 participants experienced side effects due to the moxi smoke (e.g. fatigue, stomach upset, flare-up and headaches ) and 5 reported burns to their skin).

Notably, women receiving moxibustion along points directed by published literature also experienced more improvements in quality of life scores, particularly as they related to symptoms and psychosocial issues.

This study appears to indicatethat moxibustion may help to enhance acupuncture’s effect on hot flashes during the menopause. Clearly, more studies with larger samples are needed.

Bad to da bone, part 2

Posted by Liz on Mar 20, 2009 in bone health | 2 comments

Is there any way to prevent bone loss after menopause? It is possible that eating the proper balance of dietary fats (i.e. omega-3 fatty acids and omega-6 fatty acids) may help.

In a study published a few years ago in the Journal of Nutritional Biochemistry, researchers assessed bone mineral content and bone density in female rats. These measures are used to determine how much bone loss you have in a particular area and the risk for developing osteoporosis. The National Osteoporosis Foundation provides an excellent summary.

In the study, half the rats had their ovaries removed (leading to a rapid decline in estrogen and subsequent bone loss) and half remained intact. They were then fed diets with different ratios of omega-3s and omega-6s. After 12 weeks, data showed that rats with the lowest ratio of omega-6 to omega-3 fatty acids in their diets had significantly less bone loss and a higher bone mineral density, even in the absence of estrogen. This translated to significantly lower bone loss.

Omega-6 fatty acids are most commonly found in foods such as vegetables oils, nuts,  seeds and eggs while omega-3 fatty acids are more commonly found in fatty fish (salmon, mackerel),  nuts (walnuts) and certain vegetable oils. Notably,  eating both omega-3 and omega-6 fatty acids has been shown to lower the risk of heart and possibly other diseases. However, research continues to point to balance.

These particular findings may be due to the ability of omega-3 fatty acids to reduce the production of inflammatory compounds that associated with the breaking down or “resorption” of bones. Estrogen provides a similar protective effect but after its decline, the body becomes more vulnerable.

While researchers caution that the study results cannot be translated to humans, they certainly look promising.

It’s all about balance, right?!