Wednesday Bubble: HRT? Everybody must get kidney-stoned
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Everybody must get stoned? If you are using HRT, this may be the case. Straight out of the headlines of the American Medical Association’s Archives of Internal Medicine: Healthy women who use HRT may be at increased risk of kidney stones.
You hear about them. But what are kidney stones?
Kidney stones are hard masses the develop when crystals separate out from the urine. Many factors interact to form stone and they are influenced by both genetics and the environment. Although they are often prevented by naturally occurring chemicals before they actually form, when they occur, they can cause extreme pain. Over time, they may actually damage the kidneys. And while kidney stones more commonly affect more men than women up to a certain age, by the time a woman reaches 50, this discrepancy balances out, possibly because estrogen may have a protective effect up until this time.
So, if estrogen is good and protective, what goes wrong when you add it back to the mix?
The findings...In the latest analysis of what is now becoming the infamous Women’s Health Initiative Study, researchers evaluated over 10,000 women in natural menopause who had taken estrogen only (Premarin), estrogen plus progestin (Preempro) or placebo. After an average of 5 to 7 years (depending on which agent the women were taking), women taking hormones, either alone or in combination, had a 21% increased risk of developing kidney stones. When the researchers excluded women who stopped using hormones during the actual trial from the analysis, the likelihood of developing kidney stones increased to 39%. Moreover, study researchers were unable to attribute the increased risk to any other factors, including age, ethnicity, BMI, prior use of hormones or intake of coffee or thyroid medication. Writing in Annals, however, they did note that the way that kidneys stone are formed is complex, and that estrogen may play a role in several stages of that formation and requires further study.
According to the researchers, about 5% to 7% of women reaching menopause will develop kidney stones. My friends over at Reuters health, who did an excellent recap of this study, note that in combination with hormone therapy, this risk increases up to 10%, despite that addition of progestin.
In addition to avoiding hormone therapy, the best thing to do to prevent kidney stones is to hydrate! If you have a tendency to form stones, the National Institute of Diabetes and Digestive and Kidney diseases recommends that you drink enough fluids, preferably water, to produce about 2 quarts of urine a day. Changing your diet can help too: some experts recommend limiting dairy and proteins that are high in calcium. The best thing to do, as always, is to do some preliminary research and then contact your health practitioner.
So getting stoned? How about losing the HRT? Another bubble burst for a failed therapy.
Read MoreGot Zzzzz’s? And the winner is….
Last week I posted about sleep and a new personal sleep coach that I’m trying out – Zeo. I offered to give away a bedside monitor in exchange for a blog comment about sleep, and a willingness to share your thoughts about Zeo on Flashfree in a month’s time. I only received a few comments but I did the old hat trick and pulled out one name:
Meryl K. Evans! Congratulations Meryl – send me your mailing address and I will ship the unit out to you this week.
As a special thank you to Peg and Heather, Zeo has graciously offered free shipping on all units ordered through October 31. Just use FREESHIP at checkout for ground orders.
I’ve got one more night of collecting baseline data and then I start the regular program. So far, I am fascinated and hopeful that it may identify specific factors that are screwing up my sleep. Stay tuned.
Read MoreFuturistic Monday: hot AND cold creature comforts
True confession: I love heated car seats. My last boyfriend won my heart with his heated car seats (okay, not really, but it helped!). For me, heated car seats represent the gold ring of driving comfort, especially when the weather is cold or damp and nasty. Consequently, I was intrigued by a call I received last week from a friend of mine who, like me, is contending with a few menopausal symptoms. The call was car seats for the menopausal set.
“Got a sec?” she asked. “I was just driving down to the road and started thinking about heated car seats. The biggest problem,” she explained,” is that they are only designed with one thing in mind: heat.” (Hence their name, but that’s besides the point.) “Why don’t they make car seats that can heat or cool, depending on the temperature (or temprament) of the passenger? ”
Hmmm, sort of like cleavage coolers but for your derriere. Got me thinking and looking around the interwebz. And what I discovered is that the future is now. In fact, cooled seats are often part of optional packages in a variety of premium and luxury cars with leather upholstery. Experts recommend that you test drive them yourself, since some come with a ventilation system while others actually have separate cooling elements.
If all else fails, there’s always the ‘Amazing SummerSeat Self-Cooling Car Seat Cushion’ (can’t make this stuff up)!
Ladies, when those internal fires get burning, it’s okay to start your engines in comfort.
Be still my heart. I think I’ve just fallen in love again.
Read MoreGot Sleep? Zeo Personal Sleep Coach helps with those Zzzz’s. Want one?
Did you know that sleep problems have been reported in as many as 40% of women in the late perimenopausal stage and as many as 35% to 50% of women in postmenopause? The culprit? In addition to vasomotor symptoms, i.e. hot flashes and night sweats) lower estradiol and fallopian stimulating hormone levels can interfere with both falling and staying asleep. Add stress, emotional arousal, environment and alcohol or caffeine to the mix and you’ve got a woman on the verge. Personally? My sleep stinks; I wake up several times a night and regularly early in the morning, even though I rarely have trouble falling asleep. In fact, I don’t recall the last time I slept through the entire night.
So, how can I get more of those much needed Zzzzs? Well, I am hoping that Zeo can help.
Zeo is a home-based tool that uses SoftWave™ technology to track sleep patterns. The Zeo system is geared towards helping individuals understand how they are sleeping so that they can address factors (e.g. diet, stress, or environment) that may be profoundly hindering or interfering with their sleep.
Zeo collects information that summarizes the previous night’s sleep, including time spent in each sleep phase (i.e. light, deep and REM sleep), total time asleep, time it takes to fall asleep, and number of times awakened during the night, and displays it in a graph at bedside monitor.This information can then be uploaded so that sleep patterns can be tracked and trended along with individualized input about environmental and social factors that might disrupt sleep from night to night. Zeo also includes personalized sleep coaching. As the company says, the power of Zeo lies in its personalization, so that you can scientifically track your sleep phases and correlate them to the impact that daily habits have on your sleep. What’s more, I have looked at the scientific studies and the technology it uses to track your sleep not only favorably compares with what experts consider the gold standard for measuring sleep (polysomnography) but also does so in a range of healthy and “disordered” sleepers.
I’ve used Zeo for two nights so far. And guess what? It’s telling me that the fatigue I’ve been feeling is truly due to the fact that I’m not getting the restful sleep that I need. So, I am going to collect six nights of sleep information to create a foundation or baseline of my sleep pattern, and then undergo the Personal Sleep Program to see what I can change to optimize my sleep health.
I met a Zeo, Inc co-founder at last week’s epatient conference and after a conversation regarding sleep and menopause, he graciously sent me two units to share with my readers. I’ve given one of these units to a reader who is an insomniac and who is perimenopausal. But I’d like to give another Zeo to you. Here’s how:
Tell me in the comments section about your general sleep and how your symptoms or habits might be affecting it, along with steps you’ve taken or not taken to deal with the problem. The caveat? You must be experiencing some sort of menopausal symptoms or be in menopause and be willing to share your experience (anonymously) on Flashfree after a month’s use. If I get enough comments, I will randomly choose one winner to receive a Zeo Personal Sleep Coach monitor. What’s to lose? How about one more night’s sleep?!
[Disclosure: Zeo, Inc. provided me with three Zeo Personal Sleep Coach monitors – one via the epatient conference and two directly. Although this post was neither paid for or solicited by the company, I have eagerly agreed to write a post on menopause and sleep for their blog.]
Read MoreWednesday Bubble: Will LibiGel liberate testosterone for women?
Female sexual disorder, also known as hypoactive sexual desire disorder (HSDD, i.e. lack of sexual desire) is big business and the race for the gold ring continues. While the FDA effectively put a halt to the antidepressant flibanseran only months ago, testosterone therapy continues to drive the march towards finding a cure for a low libido. The question remains, however, is this a good or bad strategy? And how about risks and benefits of adjunctive testosterone? Is it safe?
HSDD is a disorder that robs a woman of her libido and sexual desire. It is believed to affect up to 36% of women between the ages of 20 and 70, although slightly higher numbers of women with some degree of lowered sexual desire have been reported. Especially affected are women who have had their ovaries removed and have entered menopause as a result; these women in particular, have low testosterone levels. Notably, however, not all women who experience diminished sexual desire have low testosterone levels and the cause of HSDD is unknown. In addition to physical causes, relationship and interpersonal/psychological issues are also believed to play a role, making the condition even more difficult to treat. And while testosterone may be helpful for boosting libido, it has also been linked to side effects that include acne, excessive hair loss or growth, hoarseness, weight gain, insomnia, voice deepening and migraines. More importantly, use of testosterone has also been shown to increase cholesterol levels in some women, thereby raising the risk for heart disease.
According to research, the HSDD market ranges from $2 to $5 billion. Even more troubling is the fact that in 2009 alone, physicians wrote more than 4 million prescriptions for testosterone to treat HSDD even though it’s not approved as a therapeutic strategy.
LibiGel® is a topical testosterone gel that is applied to the upper arm. Thus far, it has been shown in short-term, 3 month clinical trials, to significantly increase the number of “sexually satisfying” events by as much as 238% without serious side effects. Since these early trials, the company has been studying over 2,000 postmenopausal women over the age of 50 with an elevated risk for heart disease to observe how well the gel does over the long-term (i.e. 3 years). Thus far, the manufacturer BioSante reports that the rates of reported cardiovascular events and breast cancer are very low and plans to present interim data later this week at this year’s North American Menopause Society Meeting.
Is LibiGel going to liberate sexually dysfunctional women? And what about the other factors that affect desire, such as relationship status, self-esteem, stress and anxiety? Should we be concerned that physicians already prescribe testosterone ‘off-label’ for millions of women and that the company actually reports that over 90% of women using testosterone unapproved for this use would switch to LibiGel once it’s approved?
I am not quite sure if this is an example of irresponsible medicine or an untapped need. I would like to believe that LibiGel might be effective for certain women who have been forced into menopause due to physical conditions. On the other hand, doesn’t the medical treatment of HSDD ignore the obvious: that there are behavioral, social and environmental factors at play that testosterone therapy won’t and can’t address?
What do you think? Is this a bubble to be burst or the “re-desire” revolution? Only time will tell.
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