Baby’s [got] back… just because
True confessions.
I love this post. Which I originally ran in January of ’10.
The reason I love it?
I am tired of hearing that women need to do something about their bodies, especially as they age. So this one is for you, and you and you. Because if you’ve got ‘back,’ good on ya!
[youtube=http://www.youtube.com/watch?v=2ImZTwYwCug]
Maybe Sir Mix-a-Lot has a point. It seems that a large derriere and thighs may actually extend your life. The reason? Researchers say that fat particles that end up in these areas help trap harmful fatty acids in our diet.
Although they are unsure of the exact reasons why, researchers do say that unlike abdominal fat, which has been linked to metabolic syndrome, lower body fat, i.e., fat that accumulates in the thighs and backside, has actually been confirmed to play a protective role in the body. In fact, it not only stores unhealthy fatty acids, but may also release harmful compounds more slowly than say, abdominal fat.
So if you’ve got back, are you in the clear to eat whatever you want? Not so fast. Even though “back” may offer a protective role, there are other reasons to eat and stay healthy – not only to maintain optimal cholesterol levels, but also to counteract some of the natural effects of declining estrogen, such as weakening bones.
(The study appeared in the January 12 online edition of the International Journal of Obesity.)
Read MoreNewsflash: International Menopause Society has issued updated guidelines on HRT
Got news?
I sure do!
The International Menopause Society has issued updated recommendations on the use of hormone replacement therapy (HRT, a term that they use to refer to estrogen, progesterone, combined therapies, androgens and tibolone). They note that the current guidelines are similar to those issued in 2007 but “include additional clinical data where needed.” And while they claim that there are “no reasons to place mandatory limitations on how long HRT is used (which by the way, runs counter to current recommendations of several major national and international medical associations), they do emphasize that HRT “should not be recommended without a clear indication for use, i.e. significant symptoms or physical effects of estrogen deficiency.”
The following are some highlights of the updated report:
- HRT should be used at the lowest effective dose to effectively reduce symptoms and maintain life quality
- Women who enter early menopause either spontaneously or due to hysterectomy or other condition before age 45 and particularly before age 40 may be at increased risk for heart disease, osteoporosis, mental disorders or dementia. Notably, the evidence of reduction of this risk via HRT is limited but is nevertheless recommended to preserve bone and reduce symptoms, at least until they enter the average age for menopause (i.e. ~52)
- Progestogen should be added to estrogen in all women with an intact uterus to prevent endometrial malignancies and cancer (except for in the case of low-dose estrogen)
- HRT is recommended to preserve bone health although it should not be started after age 60 and loses its effectiveness once therapy is stopped.
- Despite the controversy as to whether or not HRT is heart protective, the IMS says that it has the potential to boost or improve one’s risk profile because of how it affects the vascular system, metabolism of blood sugar, blood pressure and cholesterol levels. However, this recommendation is also framed within the recommendation that women adopt major primary prevention measures, such as stopping smoking, regular exercise, weight control, blood pressure reduction, and control of diabetes and blood pressure.
So, what about the risks of HRT that I’ve long written about on this blog? The convened panel disputes the conclusion of the Women’s Health Initiative (due to average older age of participants and when they started HRT) as well as data that have come down the pike since 2002. In fact, they say that the link with breast cancer is controversial and that HRT doesn’t initiate cancer (but rather, promotes an existing tumour). They also concur that data are still lacking with regards to type of HRT, doses, and administration type and incidence of breast cancer. And, with regards to endometrial cancer or stroke? They write that women with a uterus should be certain to add a progesterone component to their hormones to counteract any undue stimulation of their endometrium, and that stroke risk is related to increasing age and obesity, noting that risks may be avoided by using an estrogen patch or stopping use of hormones after the age of 60.
In general, the conclusion of the panel is than “most menopausal women have little to fear from the adverse effects of HRT” and that the benefits of hormone therapy outweigh the risks. Still, they do suggest that the decision to take HRT should be discussed with a physician and reviewed annually.
Not surprisingly, alternative therapies are completely
discounted in the IMS guidelines and they do not support the use of any bioidentical hormones whatsoever. Moreover, they make a point to place blame on the media without providing clear examples of their claims for “superficial and uncritical evaluations” of HRT, as if all media were one and the same.
I am not quite sure what to make of these recommendations. On one hand, they claim to have reviewed all the data since WHI but this panel convened four years ago. And while they are sure to promote HRT within a cautious framework, menopause continues to be positioned as a disease requiring treatment.Indeed, one of the report authors, Dr. Roger Lobos (Columbia University, New York), says that “the bottom line is that most doctors nowadays should feel comfortable about prescribing HRT to most women going through the menopause [but] like most medicines, you need to look at individual circumstances before deciding to taken it.”
Notably, media are once again positioned as the big bad wolf that misconstrue findings and attack pharmaceutical companies for their profit motivations.
Has anything really changed except the date of the report? Well, the good news is that the IMS acknowledges that there are risks associated with HRT, at least for some women. And yet, the report still appears lack objectivity.
Do yourself a favour. Speak to your practitioner. HRT will shut down your symptoms. Period. But you must ask yourself, at what cost? Do your research. Ask the hard questions. And then ask them again.
You may be sweating. But the issue is greater than the sum of all sweats.
Read MoreWednesday Bubble: wrinkles and bone density – what’s the connection?
There’s a connection between wrinkles and bones? When I caught wind of the research, I thought immediately of a Wednesday Bubble. But this one appears to be the real deal.
Researchers presenting at The Endocrine Society’s Annual Meeting this past weekend say that severity of facial wrinkles during the early years of menopause may indicate a low bone density (thereby leading to an increased risk for osteoporosis). Wow!
This information comes out of the ongoing Kronos Early Estrogen Prevention Study (KEEPS), which is looking at the effect of oral and transdermal estrogen therapy on measures of the carotid artery that might indicate thickening of the arteries (and eventual heart disease) as well as the build up of calcium in the blood. A subgroup of 114 women in their late 40s and early 50s and within three years of starting menopause were examined for this part of the trial.
The researchers looked at and scored severity and depth of skin wrinkling based on number of sites on the face and neck. They also measured skin rigidity (or firmness) on the forehead and cheek. Additionally, they evaluatd total body bone mineral density as well as at the lumbar spine and left hip.
The findings? Higher wrinkle scores (meaning more severe wrinkles) were associated with lower bone density measures at all sites, while firmer skin on the forehead and face were related to greater bone density, especially at the hip and spine.
The connection? Pun unintended but the researchers say that collagen, protein that naturally occurs in connective tissue in tendons, ligaments and even bones, is the common factor. They add that as women age, changes in collagen not only contribute to sagging skin and more facial lines but may also negatively affect both the quality and quantity of bone.
Although more research is needed, it might be worthwhile to obtain a dermatologic and bone density assessment at the start of menopause to see where you stand. And then speak to your health practitioner about the need for regular follow up and monitoring to insure that fragile bones don’t lead to fractures. Ultimately, if the link between wrinkling and bone quality is proven, it might eliminate or at least lessen the need for costly DEXA ( dual energy X-ray absorptiometry) that are currently used to measure how tightly calcium and other minerals are packed into bone.
Who would thunk that wrinkles could actually be useful?!
Read MoreWomen’s health: “it’s a spiral, not a bulls-eye.”
“A spiral is the path; it is the journey. I walk it with you, and do not do it to you. It represents life. It represents women…”
My friend and colleague Regina Holliday wrote these words about a jacket that she has painted on my behalf, a jacket that represents women’s struggles to overcome the restrictions that challenge their right to adequate healthcare and a jacket that I will be honoured and privileged to wear this coming Tuesday during The Walking Gallery. She has depicted this struggle within the framework of a triskelion symbol, three interlocked spirals that is used to depict three reproductive cycles in a woman’s life (maiden, mother, crone). In the Celtic belief system, the three-legged triskelion represents:
- personal growth
- human development
- spiritual expansion
as well as the phases of the moon, i.e. waxing, waning and full. I relate to this concept mostly because of its fluidity and the creative way in which Regina has characterized a woman’s struggle throughout her lifetime.
The jacket that I will wear is dedicated to all of my readers and to women everywhere who are under attack strictly because of their gender and their ability to reproduce. It seems sort of ridiculous doesn’t it? And yet, as I wrote last year in Disruptive Women in Healthcare, the other side of the aisle is not a political party but rather, women, gender bias and reproductive rights biases.
If you are local, I hope that you will come out and support the event (there are free tickets available), a wake up call that the patient struggle is very real and affects all of us. Regina describes this as follows:
If you can’t make it, I do hope that you’ll start paying attention to Regina because she is a patient advocate of the first degree and her generosity of spirit and pureness of heart is virtually unsurpassed. Trust me; she is someone you want fighting for you when the healthcare chips are down.
Thank you Regina…from my heart. I can’t wait to represent!
Read MorePuffing away the years: smoking and early menopause
A few years ago, I wrote a post linking cigarette smoking to early menopause. And yet, questions remained about duration of smoking and the quantity of cigarettes in terms of their influence on timing. Hence, I thought that it might be worthwhile to take a closer look at the issue and see if there was more information.
A few facts:
It’s estimated that by the year 2030, there will be over 1 billion menopausal women in the world, with roughly 47 million women entering menopause annually. Yikes! That’s a whole lotta hot flashes, night sweats, mood swings and the like. And, what this means is that information is power (and empowering). Importantly, research has also shown that early menopause is associated with greater mortality, heart disease cases and osteoporosis. In fact, for every year that menopause is postponed, there is a 2% reduced chance of death due to heart disease. On the other end of the spectrum is late menopause, which is also associated with health issues, including an increased risk for breast, ovarian and uterine cancer.
So, what are the factors that appear to determine the timing of menopause? Well, things like obesity, alcohol consumption, mother’s age, social class, long menstrual cycles, multiple childbirths, oral contraceptive use and even exposure to pesticides have been linked to later menopause, while smoking has been shown in multiple studies to increase the likelihood for early menopause. This issue may be even more relevant for the late Boomer generation who came to age in the 70s, a time when cigarette and marijuana smoking were the norm and not the exception. That generation, by the way, is my generation.
Here’s what we know:
In a thorough review of 109 published studies, researchers have found the following:
- Current smokers appear to enter menopause anywhere from 2.5 months to 2.5 years earlier than non-smokers and have 1.3 to 1.7 times greater odds for early menopause
- Former smokers appear to start menopause as much as 2 years earlier than non-smokers, with the risk ranging from 30% to as high as 80%
- Although there is not a lot of information on the severity of smoking habit and menopause (i.e. number of cigarettes smoked daily), there is some indication that women who smoked more than 20 cigarettes daily were likely to start menopause as much as 2 years earlier than women who smoked 11 to 20 cigarettes daily
- The relationship between number of years having smoked and early menopause is unclear
There are numerous reasons why smoking may lead to earlier menopause, including interference with estradiol levels, an increased loss of eggs and an increase in the levels of androgen hormones, which counteract activity of estrogen in the body. And, despite the differences between the studies that the researchers examined, they say that a clear link was demonstrated between smoking and starting menopause at an earlier age. The impact of quantity and time (or years) smoking is less consistent and still not completely clear.
The overriding message is that if, like me, you are a former smoker, you might find yourself in a position of starting menopause a wee bit earlier than expected. Consequently, there’s no time like the present to start taking preventive measures, like increasing calcium intake, changing your dietary habits or improving your exercise regimen. Mind-body exercises like meditation or yoga can ameliorate stress and improve overall wellbeing. And black cohosh? Personally, I swear by it. In concert, these steps might shut down or at least keep the magic menopause dragon at bay.
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