Search results for womens health initiative

Personality and hormone replacement. Give me an “A!”

Posted by Liz on Jul 9, 2012 in HRT | 4 comments

Researchers say that personality plays a role in driving health beliefs, taking medication as directed and ultimately, health outcomes. However, does it also drive treatment choice?

Evidently yes, at least according to a fascinating study published online in Fertility and Sterility journal. In fact, if you are a type A (i.e., possess a sense of time urgency, are a high achiever, ambitious and competitive), you may be likelier than other personality types to make the choice to use hormone replacement therapy (HRT) during menopause. Although the reasons may be more complex than laid out in this article, they appear to be related to the desire to be self sufficient, rely on problem-solving coping strategies and a tendency to disregard threatening information when making decisions. In other words, women with type A personalities may choose hormone therapy over other options in order to attain immediate relief rather than focusing on the future and longer term delayed ramifications.

They came to this conclusion by reviewing ongoing questionnaire data over a period of 18 years that measured both personality type and hostility.  Among the 1,800 or so women who completed the surveys over this time period, 51% used hormone therapy within a year of starting menopause. Despite the fact that the researchers accounted for factors such as age, psychological factors like depression and hostility, and even factors such as education, the frequency of seeing a gynecologist or degree of menopausal complaints, personality type was the only variable significantly associated with hormone replacement. Additionally, they did not find any link between hormone use before or after 2002 when the Women’s Health Initiative results were unveiled and personality type.

The researchers say that the link between hormone use and personality type may exist because menopause threatens a type A’s goals and lifestyle and the need for achievement and power, dominance and self-confidence. In order to maintain an active lifestyle and problem-solving focus, overachievers naturally reach for concrete, immediate solutions such as hormones.What’s more, the tendency to minimize information that threatens ones core belief system may also influence how one interprets benefit-risk, and the interpretation of short-term gains over long-term dangers. They also say that physicians may be more motivated to prescribe HRT to type A women because they interpret them as being “responsible, committed, decision-prone and persistent.”

I am not sure what to make of this research as I consider myself and many of my friends to be type A, driven women who make choices based less on haste and more on education. The question remains as to whether or not we are the exception or actually the rule.

What drives your health decisions? Is it an “A?”

Hormone therapy and bones – fuggedaboutit

Posted by Liz on Aug 16, 2010 in bone health, breast cancer, HRT | 1 comment

Another HRT-busting post…straight from the archives of  the Ahead-of-Print edition of Menopause. I’m afraid to say that yet, another analysis of the now infamous Women’s Health Initiative Trial, you know, the one that was halted due to links between HRT and significant increases in breast cancer, suggests that hormones might not be so great after all, especially when it comes to bone protection.

The loss of lean body mass as we age contributes to redistribution of fat and  apparently contributes to falls and fractures in the later years. This is one reason why many physicians prescribe hormones. However, in the latest nail in the HRT coffin, it appears that despite earlier reports of significant reductions in fractures among women taking HRT based on body mass index, age and bone mineral density, the ability of hormones to preserve lean body mass is a fallacy. In fact, when researchers looked at almost 2,000 women who had been enrolled in the trial who were assigned estrogen plus progestogen, estrogen alone or placebo, they were unable to find any differences in lean body mass after six years, even though there was some indication of protection at the three year mark. What’s more, the researchers say that although women who took most of their hormone medication before the trial was halted seemed to fall less, it wasn’t because their lean body mass was preserved.

The main point in relaying this bit of information is experts want us to believe that HRT is the panacea for everything that ails as women age –from bone health to heart disease to dementia. And despite evolving evidence to the contrary, they continue to seek reasons why the data are wrong and look for ways to question every negative finding. Some Associations whose mandate it is to defend women’s health, like the Society for Women’s Health Research, take money from companies whose hormone products have been found to cause significant adverse effects in certain populations of women and yet, they continue to lead the charge favoring hormone therapy.

In general, I take no issue with Western medicine or pharmaceutical companies. If you look at my background, I have spent years writing favorably about many products and the research that backs them. But I maintain a standard of transparency and don’t choose to hide who’s paying the bills, And, when it comes to hormone therapy, I continue to smell a rat. Be assured that  I will continue to write about what’s really going on until more women understand how fucked up HRT really is.

If you choose to take HRT and it works in alleviating your flashes, sweats, mood swings, headaches, sex life and the like, more power to you. I support your right and decision to take HRT. But like any drug, be sure you know the facts before you believe the hype. Be certain to be diligent and ask the hard questions, even when the information comes out of seemingly expert sources or associations. Always, always, follow the trail. You might be surprised at what you learn.

This particular trail, the lean body mass trail? It’s a dead end. Fuggedaboutit.

Next.

Talking the talk: hormone therapy

Posted by Liz on Feb 23, 2009 in health, general, HRT | 2 comments

Is your healthcare provider more or less likely to suggest hormone therapy (HT, estrogen only) when you see them for menopausal symptoms? What’s more, how do you know?

Results of a study in the Ahead of Print edition of the journal Menopause suggest that certain factors do influence prescriber habits.

Researchers measured how often 249 primary care (i.e. internists and family practitioners) and ob/gyns prescribed HT to their patients (ages 45 to 80) in a given year based on electronic pharmacy data. In addition to examining information on the providers themselves, data on perceptions of patients’ views on the Women’s Health Initiative trial results (WHI, which examined the link between HRT and heart disease), provider views on the WHI study and how prepared they felt to counsel patients were also analyzed. 57% of the providers in the study were women.

The findings? How often HT was prescribed appeared to vary by geographical location and the number of years a provider had been at a specific organization (which may reflect the age of the provider). More than half of those surveyed believed that they had expert knowledge about data coming out of recent HT trials.

In fact, primary care providers who felt that they had this degree of knowledge were significantly more likelier than their colleagues who did not to recommend hormone therapy.  In contrast, ob/gyns who were more likely to prescibe HT were those who believed that they well prepared to counsel their female patients on hormone therapy. These practitioners also tended to believe that the results of the trials had been exaggerated.

Regardless of specialty,  younger patients and patients who did not have other diseases that may exacerbate risk were most often prescribed HT.

So, what do these study results mean exactly?

The researchers write that HT prescribing may be “driven by factors outside of evidence-based medicine,” such as prescriber self-perception and age. If this is true, then the lack of provider bias could potentially influence prescribing habits and in turn, exposure to HT.

As the researchers say, “women, who when inquiring about HT risk and benefits, deserve unbiased and well informed counseling to make informed decisions.” And that it “is likely that some doctors need additional training to ensure this level of advice.”

For you, this means to be sure to be prepared when you make that first appointment to discuss therapeutic options for troublesome menopausal symptoms. Do the homework before you enter your provider’s office so that you are ready to ask the right questions.

In addition to the link provided above, which discusses the WHI data in detail, I encourage you to visit the following sites for unbiased information about menopause and its treatment:

Women to Women

Dr. Christiane Northrup, M.D.

Health E Woman

Consumer Reports Health.Org

The bottom line is that if your provider is talking the talk, be sure that you know why you’re going to walk the walk.