Posts made in December, 2009

HRT – the cat’s outta da bag

Posted by Liz on Dec 14, 2009 in HRT | 0 comments

Does Wyeth’s hormone replacement therapy agent Prempro cause breast cancer? Yes, according to a jury, who recently awarded Connie Barton $75 million in punitive damages.

According to a statement quoted in a New York Times expose, a spokesperson for the pharma giant Pfizer (which recently merged with Wyeth) emphatically claims that Preempro is “a safe, federally approved drug that did not cause [the woman’s] breast cancer.”And yet, Preempro is the very same drug caused the abrupt halt of the Women’s Health Initiative trial when it was found to double the risk for breast cancer as well as increase the risk for heart attack, stroke and blood clots. Moreover, later analysis of the Women’s Health Initiative data showed that hormones also increased the risk for dementia in a subset of women. Still, the company plans to fight every Preempro award, maintaining that it has acted responsibly and has posted every warning in line with FDA guidelines.

So what do you do when a drug has known dangers, a warped risk-benefit ratio and is still widely marketed? As I’ve written time and again on this blog, many in the medical profession continue to believe in HRT and  prescribe it regularly,  not for “good health” or to slow the aging process but to control the more troublesome symptoms of menopause (e.g. hot flashes, night sweats and vaginal dryness). And thousands of women continue to toe the party line, believing that that hormone replacement is essential to easing the aging journey (as the article’s author so aptly points out, the term “replacement” implies that it is something that is needed).

Interestingly the article maps out strategies that have been used to influence physicians, professional societies and women so as to deflect attention away from cancer concerns towards the positive, risk-preventive properties of hormone therapy. And while this piece makes me want to jump on my soapbox, I won’t attempt to dissect it further because it’s one of the most thorough and well-researched articles I’ve read in some time.  The only thing I will leave you with is that Wyeth’s actions are a true reflection of everything that’s wrong with the modern view of menopause, from menopause as a disease to waning estrogen as a symbol of all that is unattractive about an aging woman.

Rather than “rebalancing” our bodies through modern medicine, shouldn’t we be focusing on what we can do to balance the transition as we move through our lives by focusing on our relationships, our activity levels, our psyches, our connections and our diets? You can’t fix something when it’s not broken. And the only thing that appears to be broken here is the hype.

Yes, the HRT cat’s outta da bag. What do you think?

Move over, red clover

Posted by Liz on Dec 11, 2009 in depression, herbal medicine | 1 comment

There’s interesting news on the red clover front.

Although red clover may have questionable value when it comes to hot flashes (the verdict is still out with regards to whether or not it is effective) researchers are now saying that this isoflavone may be useful for reducing depression and anxiety in menopausal women.

In a study published in the online edition of Maturitas journal, over 200 menopausal women received 2-80 mg red clover capsules or sugar tablet for 90 days, took a break, and then were assigned the opposite medication for another 90 days. The researchers measured anxiety and depression at the study’s start, at 90 days and at the study’s completion.

Taking red clover reduced total anxiety and depression by as much as 77%, compared to declines following placebo (which overall, declined about 21%). This decline could likely be attributed to what is known as the placebo effect, in which some an improvement is perceived to be real.

About red clover

Red clover is a perennial whose flowers have long been dried and used therapeutically in complementary medicine. It’s a known source of calcium, chromium, magnesium, niacin, phosphorus, potassium, thiamine, and vitamin C. Researchers have studied its utility in heart disease, cancer, osteoporosis and of course menopause. Herbalists also use red clover topically for eczema, psoriasis and other rashes. Although most people tolerate red clover very well, it has been associated with headache, nausea and rash. Animals who graze on large amounts of red clover have also become infertile. It can also interfere with certain drugs that are metabolized by the liver and can enhance the effects of estrogens, birth control and blood thinners.

Should you take red clover for anxiety and depression? The verdict is early but it is looking promising. As always, peak to a licensed, knowledgeable practitioner before using red clover with any regularity for any condition.

Wednesday Bubble: there ain’t no men in menopause, part two

Posted by Liz on Dec 9, 2009 in Uncategorized | 13 comments

This saddens me greatly but maybe it’s true after all. It is really all about us.

But is it?

In early November, I put out a call for male contributors, hoping to find some male voices to fill the obvious void on this blog and lend their perspectives — not just on menopause — but on midlife. I was hoping to find men of all ages who could share their experiences with crazy moms going through hormonal mood swings, partners flashing night and day and in general, this time of life means for the other half of the equation, i.e. men. Let’s face it, we’re not going to come to the table if we don’t understand the issues, right? However, thus far, I’ve had only one courageous man willing to share his POV and another contact me to discuss possibly topics. And the slots remain empty.

Recently, I had a back channel conversation on Twitter with a young male blogger about men’s general lack of interest in discussing the female anatomy or so-called “female problems.” His take? That men are generally apathetic and unaware when it comes to this stuff. And while I know plenty of men, sensitive or not, who would welcome an opportunity to speak their peace in their relationships,  I can’t seem to find any takers for this challenge. Perhaps it’s the term “menopause” in the tagline that causes men to approach trepedatiously.

I thought I’d try again. Three’s a charm, right? I’m not looking for just a discussion on menopause, but a discussion on what it’s like to deal with a woman going through such a drastic transition in her life. I’d eve love posts on what you might imagine it might be like, or how your female partners can change the way that they communicate with you now so that some of the issues that might arise later can be averted or avoided altogether. Anything and everything.

So are there men in menopause? Send me your ideas.  OR  comment and let me know WHY you don’t want to post.

I need you. I really really do!

Seeds of change, part 2: flaxseed oil and bone health

Posted by Liz on Dec 7, 2009 in bone health | 0 comments

Last year I wrote a post about the promising effects of flaxseed — a plant-based estrogen–  on hot flashes.  Flaxseed contains antioxidants with weak estrogen properties (lignans) and omega-3 fatty acids. It is also an excellent source of fiber. In addition to its potential ability to reduce the frequency and severity of menopausal hot flashes, it might also be a valuable tool for both heart disease prevention and  boosting the effects of breast cancer therapies.

Another potential use of flaxseed, namely the oil, is to reduce osteoporosis risk. In an animal study published in the International Journal of Food Safety, Nutrition and Public Health, researchers analyzed how the addition of flaxseed oil to the diet of 70 diabetic rats (30 of which had had their ovaries removed) might affect bone health. Note that while studies have shown a clear link between type 1 diabetes and osteoporosis, the evidence is not quite as clear for type 2. Nevertheless, both types of diabetes have been linked with an increased risk for fractures.

After two months, insulin-like growth factor and osteocalcin ( a bone-creating protein) were increased in rats who received the flaxseed oil in their diet. In fact, the levels of these two markers actually reached normal. On the other hand, levels of a marker that actually breaks down bone, fell. The research team attributed the positive effects of flaxseed oil to its omega-3 component.

Certainly, studies are needed in humans to truly determine if flaxseed oil can have a beneficial effect on bone health, especially in post-menopausal women who also have diabetes. In the meantime, it can’t hurt to add a bit of flaxseed oil to your diet. A little prevention may go a long way towards protecting those bones!

HRT and heart disease. And the beat goes on….

Posted by Liz on Dec 4, 2009 in heart disease, HRT | 0 comments

[youtube=http://www.youtube.com/watch?v=ySaHZZhSwXE]

Hormone replacement therapy can help prevent heart disease, right?

Think again. Research has shown that use of HRT increases the risk for stroke, blood clots and heart disease. Although increased risk starts to decline within three years of stopping hormone therapy, women are still cautioned to continue rigorous prevention efforts and to see their physicians for any recommended testing.

So, are you asking yourselves why I’m writing about this if doctors know already about the link between HRT and heart disease? Well it appears that in the early 200s, and despite a marked decline in the use of HRT among women following confirmation of the risk, as many as 8% of women with existing heart disease and 14% with two or more identifiable risk factors were still prescribed hormones by their doctors. Writing in the American Journal of Public Health, investigators of a newly-published analysis said that although the reasons are unclear, women continued to receive HRT for heart risks,  even though it “was never proven for this indication and ultimately found to be ineffective.”

To add insult to injury, the International Menopause Society, in concert with the European Society of Cardiology, has just issued a statement staying that hormone therapy, in limited doses, does not increase the risk of heart disease and may even decrease risk in younger women.What’s more, they are now saying that in some cases, HRT may even lower blood pressure. Conversely, they recommended that HRT should not be used in women with a history of heart attack, stroke or pulmonary embolism (blockage of one or more lung arteries).

Are you confused yet?

Some experts have questioned the results of the Women’s Health Initiative studies, which were the first to raise the flag about the dangers of HRT. Some argue that the studies looked at women who were older, i.e. 50 to 79 and not menopausal or perimenopausal. However, others have determined that both the timing (i.e. when HRT is started) and length of time on HRT can affect disease risks, as can type of hormone used.

In some respects, these confusing recommendations echo the recent controversy over mammography, in which medical experts have taken sides, some agreeing the screening is overrated and even dangerous, and others, saying that even the small numbers of lives saved make mammography worthwhile in younger women. That, however, is a post for another time.

Meanwhile, what should you do when it comes to HRT and heart disease risk?

As always, I urge women to err on the side of caution and do their due diligence: make an appointment with an informed health provider and discuss the risks and the benefits. There’s no way to make an informed decision without all the facts and information about how they apply specifically to you, your family and personal medical history and your unique set of needs and symptoms. At the same time, the evidence is pretty darn strong that HRT does not protect your heart and may  in fact, exacerbate other risk factors for developing a heart attack or stroke.

Is it worth it? Only you and your practitioner can decide.