Posts made in March, 2009

Wednesday Bubble: professional drivers only

Posted by Liz on Mar 18, 2009 in humour | 0 comments

[wpvideo vM0t96dI]

A friend of mine sent me a video the other day entitled “Menopausal Women in a Parking Lot.”

I got such a kick out of it that I decided to take a slight detour from our regular scheduled Wednesday program and share the joy.

Ladies, please! Do not try this at home. These are professional drivers actors.

Timing is everything

Posted by Liz on Mar 16, 2009 in estrogen, hot flash, menopause, nightsweats | 0 comments

Headache, irritability and mood swings….they’re going to disappear someday. Promise.

Research findings show that certain symptoms commonly linked with menopause decline linearly, meaning that as you move through the transition, those bothersome symptoms will move with you and then gradually diminish. Phew!

A study that appeared in Obstetrics & Gynecology early last year showed a direct association between menopausal symptoms and reproductive hormones at any given time during the menopause. Researchers evaluated menstrual bleeding patterns, symptoms and levels of estradiol, follicle-stimulating hormone (FSH) and testosterone in women over a nine-year period. Stages of menopause were analyzed based on bleeding patterns. All women underwent structured interviews, completed symptoms questionnaires and were followed for bleeding dates and hormone measures.

The results showed that headache was significantly associated with stage of menopause, declining in the pre- to postmenopause transition. Mood swings and irritability were both associated with declining FSH levels. Additional analyses also revealed a link between PMS, perceived stress and all three of these symptoms (i.e. headache, irritability and mood swings).

So what about other symptoms like hot flashes and night sweats and depression? A small percentage of women may have to deal with them a bit longer. In fact, data suggest that they may persist well into the postmenopausal period although the reasons are not entirely clear.

What’s your sleep number?

Posted by Liz on Mar 13, 2009 in hot flash, Meditation/mindfulness therapy, menopause, mind-body therapy, sleep disturbance | 2 comments

[Rembrandt van Rijn, Sleeping Woman, 1658]

On a scale of 1 to 5 would you say that your sleep number (the quality of your sleep) is:

1. nonexistent, I never sleep
2. occasional, I sleep one or two nights a week
3. obstructed, I sleep but I wake up regularly throughout the night
4. pretty good, I rarely wake up
5. great, I typically sleep through the night

If you are like most peri- post menopausal women, it’s likely that you rate the quality of your sleep about a “3. ” In fact, a review in the journal Current Neurology and Neuroscience Reports suggests that 28% to 64% of peri- or postmenopausal women have some form of sleep disturbances that may aggravated by sleep apnea, periodic limb movements syndrome (restless leg syndrome) and psychological distress (anxiety, major depression).

One of the primary causes of sleep disruption during menopause is declining estrogen levels, which increase peripheral and central temperature, dilate blood vessels and lead to hot flashes. Unfortunately data also suggest that  hot flashes double the time spent awake although ironically, they often follow rather than proceed awake times.

More good news: both sleep apnea and periodic limb movements syndrome increase with age. Menopausal women are espeically at risk due to declining progesteron levels and increased body mass index (and associated increases in neck circumference). Both sleep apnea (in which the airways become partially or totally obstructed) and periodic limb movements obviously interefere with sleep quality. In fact, sleep researchers have documented apnea, restless leg syndrome or both in up to 53% of women between the ages of 44 and 56.

The evidence is less certain for mood disturbances and sleep, although studies have shown clear links between reproductive hormonal changes and clinical depression in women going through menopause. What’s more, women in menopause who are clinically depressed have reported more frequent and longer times awake than those who do not have any mood disturbances.

Steps to take

I’ve written previously on this issue and there are a variety of non-pharmacologic steps that might improve sleep quality including standardized herbs and acupuncture.

Hypnosis, relaxation techniques that include breathing and/or biofeedback) may also assist. These strategies are part of a larger approach called cognitive-behavioral therapy for insomnia (CBT-I) which in a small study, was found to significantly improve anxiety, depression, partner relationships, sexuality and hot flashes in menopausal women.

Notably, the benefit of HRT for sleep/mood disturbances remains unclear and studies are inconclusive.

As with any issue associated with menopause, it’s critical to speak to a health practitioner about the issue so that the course of therapy can be safely individualized and personalized.

What about you? How’s your sleep? And what are you doing about it?

Wednesday Bubble: Risk

Posted by Liz on Mar 11, 2009 in breast cancer | 0 comments

Do data justify routine assessments of breast cancer in older women? According to a study published in the March 10 online edition of the Journal of the National Cancer Institute, the answer is a resounding “yes!”

Researchers from the California Pacific Medical Center Research Institute in San Francisco systematically reviewed published literature and meta-analyses of various aspects of breast cancer risk and prevention, including risk assessment models, breast density measurements and lifestyle factors.

While the results showed that measures of breast density (which can be determined in mammograms) were very strong predictors of a woman’s risk for developing breast cancer, risk assessment models, which use medical history and demographics (e.g. race, age, income, socioeconomic status, etc) were only moderately accurate in predicting risk.

Yet, when combined, the risk of developing breast cancer could be determine more accurately in  roughly a third of women.

Study Implications

The researchers note that “for women at high risk of developing breast cancer, the findings are very significant.” For example, women who learn that they are at high risk might want to consider more frequent mammograms or digital scans such as MRIs.  They also say that treatments such as raloxifene and tamoxifen, when used for five years, confer roughly 15 years of protection. Conversely, women at low risk may be able to reduce the frequency of mammograms.

Importantly, lifestyle factors such as regular exerise, losing weight, a low-fat diet and reducing alcohol intake appeared to lower breast cancer risk in women of all ages. However, eating more fruits and vegetables did not seem to make any difference. This is not to say, however, that women should eliminate fruits and vegetables from their diet as studies do suggest that these foods are protective against other forms of cancer, such as colon cancer.

In a time when evidence is accruing against HRT and its health ramifications, it’s assuring to know that there are ways to determine if we’ve placed ourselves at greater risk of disease and strategies to counteract our missteps.

ACUFLASH

Posted by Liz on Mar 9, 2009 in hot flash | 0 comments

Researchers are studying whether or not Traditional Chinese Medicine acupuncture care plus self-care can effectively relieve hot flashes.

The ongoing study, known as the ACUFLASH trial, is examining acupuncture as a complete treatment package, a standardized (rather than haphazard) approach in which following diagnosis, the patient receives treatment in specific points. Each practitioner is also free to add individualized points to treat other symptoms related to the menopause, such as depression, anxiety and  insomnia. Treatment will comprise up to 10 sessions over 12 weeks, and may also include soy, dietary supplements and herbal medicine.

Study participants will receive either acupuncture treatment as described or self care alone (over the counter drugs, self-provided interventions such a soy and herbal supplements). Participants may also  use any additional care such as massage or prescribed medications but these interventions will be followed up, registered, and analyzed accordingly.

Traditional Chinese Medicine Acupuncture uses diagnostic methods according to principes of Traditional Chinese Medicine. Acpunture is believed to affect the autonomic and central nervous systems which directly influence hot flash activity.

Early data looking at patient experiences demonstrates that many women receiving acupuncture treatment have reported substantial impact in terms of a reduction in the frequency and severity of their hot flashes both during the day and at night. They also report better sleep, and improvements in mood.

Sounds very promising, doesn’t it? What’s your experience with acupuncture? Care to share?