estrogen

A doc and a diva walk up to the rooftop

Posted by Liz on Jan 25, 2010 in bioidentical hormones, estrogen, menopause | 4 comments

Taking the mystery out of menopause, one rooftop conversation at a time. Drifters optional.

Yup ladies, the Nation’s own ‘Red Hot Mama’s”, THE source for everything menopause, has teamed up with Novagyne Pharmaceuticals to promote VIVELLE-Dot®, a hormone replacement topical patch. Perched up on the roof, the doc and diva discuss the changes of menopause, hot flashes and more. The conversation is lively and takes the “pause” out of menopause, so much so that makes you wonder what the heck you’re doing up on a roof with these two ladies.

Better yet, why are they up on a roof?!

Let’s talk about Vivelle for just a minute.

VIVELLE-Dot is a patch that is applied to the skin. It delivers a constant dose of a form of a natural (as opposed to synthetic) estrogen called estradiol, which enters the body through a very small skin patch. VIVELLE-Dot is applied twice weekly.

Granted, transdermal, or ‘through-the-skin’ delivery of medications is generally associated with fewer side effects than oral medications since the drug bypasses the liver and directly enters the blood stream. Still, although estradiol is a bioidentical hormone, with the same molecular structure as estrogen found naturally in the body, potentially seriously risks associated with taking estrogen, endogenous or not, include:

• a 2- to 12-fold risk of developing endometrial cancer, depending on length of time taken and dose
• breast cancer
• dementia
• a 2- to 4-fold increased risk for gallbladder disease
• increased risk of heart attack, stroke and blood clots

Note that using bioidentical hormones is not the same as using bioidentical hormone replacement that is customized to your needs. This is an important distinction to keep in mind the next time that you see the phrase.

Here’s my question: still hanging on the roof with the doc and the diva? Or do you want to drift away?

Menopause isn’t something to “fix,” it’s something to address with safe, effective strategies that don’t turn women into long-term guinea pigs.  Do you want to be a Red Hot Mama? Or do you want give the Mama’s a run for their money?

This ain’t your mama’s menopause, it’s yours.’

Preventing heart disease in menopause. It’s as simple as L-D-L

Posted by Liz on Jan 15, 2010 in estrogen, heart disease | 7 comments

Aging. It’s associated with all sorts of diseases. In women in particular, heart disease is a big red flag since there is a lot of evidence showing that after age 40, risk for developing heart disease rises and continues to rise.

So, is increased risk due to to aging in general or to menopause in particular? Moreover, is there anything you can do now to reverse the trend?

Researchers have recently solved an important piece of the puzzle, discovering that significant increases in cholesterol coincide with the period right before and immediately after menopause sets in. Coincidentally, at the same time, women experience significant declines in estrogen. In this particular trial, which involved over a thousand women, researchers examined various factors that might contribute to increased heart disease risk (e.g. blood fat levels, blood sugar and blood pressure). They then compared changes in these factors over time and whether they were more in sync with aging or with ovarian changes associated with menopause.

Over the course of three to five years before menopause, a year after, and then three to five years thereafter, substantial changes were noticed in blood fats, namely low-density lipoprotein (LDL) cholesterol, which rose as average of 12 points between the first two time periods and then leveled off a few points higher (from 113 and 116, to 125 to 130. Current guidelines suggest that optimal LDL levels are below 100 and that at the very least, individuals attain LDL cholesterol levels of <130 if they have two more heart disease risk factors (and preferably, lower).

So, what are the take-away messages?

• First, declining levels of estrogen place women at risk for heart disease as they approach menopause, namely due to significant increases in LDL and total cholesterol.
• Second, women nearing menopause need to know their cholesterol numbers and insure that that becomes a priority during a normal checkup.
• Lastly, exercise and diet are key to lowering cholesterol levels, at least initially.

Both the National Lung Blood and Lung Institute and the American Heart Association recommend diets low in saturated fat, trans fat and cholesterol, and rich in whole grains, fiber, fish, lean meats and poultry. Exercise is essential, at least 30 minutes worth daily. Finally watch those risk factors and talk to your practitioner about those that may be problematic and what you can do to address them.

We may not be able to control declining estrogen but we can take positive steps to make sure that it doesn’t affect our risk for heart disease.

NewsFlash! Estrogen, the “split-personality” chemical

Posted by Liz on Dec 27, 2009 in estrogen | 1 comment

Move on over estrogen! The game is up. Researchers have discovered that estrogen acts like the middlewoman when it comes to certain activity in the body.  What this means for you: the potential of developing new agents that act like estrogen in the body but avoid all the negative bits, like breast cancer, ovarian cancer, heart disease and deaths from lung cancer.

The study, which was conducted in rats, showed that estrogen appears to stimulate a brain protein (i.e. calpain) that is critical to learning and memory. When it acts through calpain, it doesn’t act like a hormone (and its “wreak havoc” types of effects) but rather, like a power surger that boosts the ability to process and retain information. Researchers compare this to adrenaline, which acts like a hormone in most of the body but in the brain, helps transmit nerve signals across cells (i.e. a “neurotransmitter”).

Not only do these findings (which were published online in the Proceedings of the National Academy of Science) change the way that scientists look at estrogen, but as mentioned, they may eventually lead to strategies that allow the medical community who espouses HRT to look elsewhere for solutions to troublesome menopausal symptoms.

Wednesday Bubble: blame it on…

Posted by Liz on Sep 23, 2009 in emotions, estrogen, menopause, women's health | 4 comments

I was struck by the following story that appeared two weeks ago on the BBC:

“Woman’s Death Blamed on Menopause.”

“A woman who refused to take hormone replacement therapy died while suffering a menopausal episode, an inquest had heard. Margaret Drew…was killed when she walked out of her family home on to a nearby railway line and was hit by a train…There is no trigger to this at all, except hormones making her do things that she normally wouldn’t do, Dr. Carlyon [Cornwall Coroner) concluded…”

Menopause. The silent killer. Oh really?  Drew’s husband claims that his wife was “delightful, lovely and friendly” 99% of the time; the other 1% she’d become “totally irrational.” Yet, she refused to try HRT, he says. On the day of her suicide, he said that his wife was “clearly angry about something.”

Something.

Obviously, the conclusion is that that the “something” is hormones. This reminds me of vintage advertising copy that conveys the simple message that a pill a day can cure all that ails, wipe away the tears, mood swings and instability so that women can “transition without tears” (or better yet, without killing themselves).

Notably, a search in the National Library of Medicine’s PubMed database turned up only one recent study specifically dealing with suicide ideation across reproductive stages. In it, researchers compared data in 8,794 women, and found an increased risk of thinking about suicide among women during perimenopause, not before or after entering menopause. These findings remained after controlling for risk factors such as anxiety and mood disorders. HOWEVER, the researchers noted that the study design did not allow them to form any definitive conclusions about the specific reasons for thinking about suicide.

Another search yielded information that the risk for a major depression increases during perimenopause, primarily as the direct result of vasomotor symptoms. The same does not hold true for women before menopause begins or once they enter menopause. Note that while major depression is a risk factor for suicide, not everyone who is depressed will actually kill themselves.

So, are hormonal fluctuations the sole cause of such deep unhappiness that women want to kill themselves?

Interestingly, just a week after the menopause/train suicide story hit the interwebz, a rather controversial set of data also emerged: since 1972, women’s overall level of happiness has dropped. These findings held true regardless of child status, marital status and age. Researcher Marcus Buckingham, writing in the Huffington Post, said that women are not more unhappy than men because of gender stereotyping and related attitudes, due to working longer hours or because of the inequality of housework/responsibilities at home, but rather, the hormonal fluctuations of menopause may be to blame. What’s more, he leaves us hanging so we’ll tune in for part two of the piece to learn the true cause of our declining happiness or better yet, read his book (which evidently guides women through the process of finding the true role that they were meant to play in life).

Importantly, reactions to this study (and various pundits’ assessment of it) have been mixed. One of the most poignant comments I’ve read asks the question “how is happiness measured? What does it mean?”

I have no idea what caused Mrs. Drew to walk into a train two weeks ago and kill herself. Perhaps she was depressed. Clearly she was suicidal.

I have no idea why research shows that women are less happier than they were three decades ago.

However, is menopause the cause? Don’t these conclusions only serve to perpetuate societal myths that menopause is a disease that requires treatment? That as women, our attitudes, belief systems and actions are hormonally-based and driven? That we are hysterical beings who need guidance on how to find our way and fulfill our dreams, realize our paths, but only if we calm down?

Feeling angry? Blame it on menopause. Unhappy? Blame it on menopause. Not realizing your dreams? Blame it on menopause. Overworked, overstressed, undervalued? Blame it on menopause.

Blame it on menopause.

I don’t know about you but I’m tired, tired of hearing that menopause is not the symptom but the disease.

There’s no time like the present to burst this bubble.

A B C…

Posted by Liz on May 26, 2009 in estrogen, memory/learning | 3 comments

Study results reported in the May 26 issue of  Neurology suggests that the menopause transition negatively affects women’s ability to learn.

Researchers evaluated 2,362 women between the ages of 42 and 52 for verbal memory, working memory and the speed at which they proceesed information. All study participants were tested through the four stages of the menopause transition:

1. premenopause (no change in menstrual periods)
2. early perimenopause (menstrual irregularity, no gaps in period for 3 months)
3. late perimenopause (having no period for 3 to 11 months)
4. postmenopause (no period for 12 months)

The results showed improvements in processing speed during pre- and early perimenopause and postmenopause that were 28% larger compared to those in late perimenopause. Improvements in  verbal memory were 29% larger in permenopause than in  early or late perimenopause, and and become 36% larger compared with postmenopause.

The researchers said that it appears that during the late and early menopause, women do not learn as well as they do during other stages. What’s more, these findings support prior self-reports that suggest that as many as 60% of women have memory problems during the menopause transition. (Notably, there have been some studies that suggest that this is a fallacy.) The study authors add that this lapse in learning ability tends to be temporary and returns during the postmenopause stage. They also point to findings that show that taking estrogen or progesterone before menopause may help to improve verbal memory or processing speed but this effect can be reversed if hormones are taken after the final menstrual period.

This is an interesting study and the findings seem to jive with personal experience, especially with regards to what sometimes appears like a diminishing abilty to process information.  It makes me wonder if taking classes as I go through menopause is a good idea or not! And it equally makes me question the endless havoc that hormones appear to take on our bodies and our minds.

What about you? I’d love to hear your experiences and where you are in the transition, that is, if you can remember to comment after reading this (!)

Wednesday Bubble: Reproductive cancers and estrogen

Posted by Liz on Mar 25, 2009 in estrogen | 1 comment

I’ve written previously about HRT and its definitive link to increased breast cancer risk. But how much of a role does natural estrogen play? Moreover, is exposure time important?

I ran across an interesting study in the the journal Cancer Epidemiology, Biomarkers and Prevention that suggests that the amount of time a woman spends in the transition to menopause may influence risk for reproductive cancers. The reason: overall exposure to total levels of natural estrogen and unopposed estrogen (i.e. estrogen with little or no progesterone as the result of aging).

In this study, researchers collected daily urine samples from 108 women (ages 25 to 58 years)  for 6 months annually over a total of 5 years and tested them for total estrogen levels.  Using models that evaluated variations in the length of the participants’ menstrual cycles, they also estimated where study participants were in the menopausal transition.

The findings

The results showed that mean levels of total estrogen increased with age in the pre- and peri-transition stages and decreased in the late transition stages. What’s more, the number of days of exposure to unopposed estrogen was higher during the transition to menopause compared with the pre-transition period; it also did not decline until after the menopause.

What these results mean

In general, the study results indicate that women are spending more time exposed to both total levels of estrogen and unopposed estrogen than previously thought. However, because the time spent in perimenopause varies from women to women, exposure to natural estrogen also varies.

The bottom line? Because studies have linked reproductive cancers to lifetime exposure to estrogen, determining the length of time that a women spends in perimenopause may  help researchers determine cancer risk.

Stay tuned – these findings could ultimately  impact how we go through the menopause and what we can do to conquer our risk of developing certain cancers afterwards!