HRT

Newsflash! U.S. Preventive Services Task Force Weighs in on HRT

Posted by Liz on Jun 4, 2012 in estrogen, HRT | 2 comments

Just like the Energizer bunny. HRT and bad news. When are women and practitioners going to believe the data and stop trying to find the silver lining?

This month’s news is from the U.S. Preventive Services Task Force, who issued a recent update of the evidence for or against the use of hormone replacement for menopausal symptoms; that update appears in the online edition of Annals of Internal Medicine.

Rather than bore you with the details, I’m going to cut to the chase and get to the heart of their findings:

• Estrogen plus progestin or estrogen alone provides significant protection against hip and vertebral fractures that result from osteoporosis and aging.
• Contrary to initial results from the Women’s Health Initiative study, use of estrogen plus progestin significantly increases the risk for invasive breast cancer.  Estrogen alone offers some protection against invasive breast cancer.
• Updated analyses also demonstrate that combination HRT also significantly increases risk for stroke, blood clot events, death from lung cancer, gallbladder disease and urinary incontinence.
• Estrogen alone increases the risk for stroke, blood clot events, gallbladder disease and urinary incontinence.

One of the primary arguments that proponents of hormone therapy have used consistently is that these data are restricted to women who are older and are not applicable to women who are perimenopausal or in the earliest stages of menopause. And yet, a variety of medical organizations caution against using HRT as a chronic disease prevention strategy, including the Canadian Task Force on Preventive Health Care, American Heart Association and American College of Obstetricians and Gynecologists.

Even the FDA posits that if you are going to use hormone replacement, you should use it in the short-term and only for ameliorating menopausal symptoms or preventing bone loss. And yet, if you read through four years of Flashfree or click on the tag cloud, you’ll find a number of alternative strategies to offer relief without the slippery risk slope.

What more can I say? Be informed so that you can make informed decisions. If a few less hot flashes or night sweats in the short term means a potential road of illness in the long-term, the benefit-risk ratio may not be worth it. Then again? Only you can decide.

Your Weather Forecasting is Spot On! Guest post by Susie Hades, Founder, Personally Cool, Inc

Posted by Liz on May 7, 2012 in hot flash, HRT | 0 comments

You may recall that about a week ago, I took the mick out of ColdFront, a new personal cooling system designed to cool those hot flashes. The day that the post ran, ColdFront inventor and Personally Cool Founder Susie Hades posted a comment with an offer to provide with me a sample so that I could try it for myself. Although I turned Susie’s offer down, I did reach out to her via email and phone and we had a lengthy conversation about her vision and the product. And you know what? I was impressed by her philosophy and approach, so much so that I offered her a guest spot on Flashfree.

Part of my mission is to reveal products and agents that work and that don’t, to uncover snake oil approaches and provide data-driven alternative solutions. Mostly though, I believe that information is truly power AND empowering, and that by educating ourselves, we are in a better position to play a role in driving and shaping decisions about our health and our healthcare.

Susie’s goal is not unlike mine and I encourage you to show some love. And Susie? I am glad that we had a chance to exchange ideas and start what is certain to be more than one conversation. We need more of those exchanges if we are ever going to move menopause out from under the Menopause Industrial Complex and into the hands of women who want viable and safe solutions.

I founded Personally Cool in 2007 because I couldn’t find what I call an “and” product for hot flash relief: drug-free; AND effective; AND safe; AND convenient; AND discreet; AND elegant; AND eco- and wallet-friendly.

I must have bought and tried one of almost every type of hot flash relief product available with the exception of bio-identical or hormone replacement therapy (HRT). Even though the efficacy was unquestionable, the data tell a larger story for HRT.

In 2002, increased risks of breast cancer, stroke, and a number of other side effects were widely expressed across various studies. As a result, prescriptions of Prempro (a leading Wyeth/Pfizer HRT product) dropped 80% by the fourth quarter of 2003.[1] Women, frightened and confused by the findings of these studies, wanted other choices.

Our own research (both initial and a just-completed survey of 300 women) confirms that women are still looking for safe alternatives to HRT. We also learned a number of other interesting facts – from how often and with what severity women hot flash, to how they handle them. Two poignant realities were derived from this last point. First, more than 80% of the women we surveyed had either never used HRT or they stopped at the advice of doctors or of their own volition. Second, more than 55% of the women currently experiencing hot flashes – given the choices they’ve faced until now – deliberately choose to do nothing at all. In other words, they literally sweat them out.

I invented coldfront to be the “AND” product that other products aren’t, and I am proud to say that it is. A test panel conducted late in our product development to make sure that we got it right was critically helpful. We abandoned certain product features that we loved but that our intended audience didn’t. After testing coldfront for three days, over 80% of our panelists reported that they’d never use anything other than coldfront to relieve their hot flashes. This was huge!

Yes, coldfront is great at cooling a hot flash, but we couldn’t ignore larger forces at work – the enormous need for psychological and social relief from the stigma of menopause. Although we’re living up to a third of our lives post-menopause, our society still sees menopausal women in an unflattering light. Among women my age, there is a growing desire to reassert control over our own lives and bodies, and to put a stop to allowing other people to define for us what this time of life should mean. Personally Cool wants to change the perception of midlife women and create our own conversation. When we say, “we make menopause cool,” we mean it – on a number of levels!

With coldfront, we are encouraging women to take charge of their own relief, which – in our case (pun totally intended!) – is no farther away than your handbag and no more complicated than what we already know works – cold – especially when it’s in the palm of your hand. It is so discreet and convenient that it allows most women to get through a hot flash without letting anyone know they’ve even had one.

And this, ultimately, is what sets coldfront apart from every other cold therapy product available today:

1. coldfront was designed in every way to be compatible with the life of a menopausal woman who defines herself, simply, as a woman. It is the least intrusive, most effective, complete, and portable cold therapy system for hot flashing women on the market.
2. coldfront can go right from the freezer to your bag because it was engineered to be condensation-free. Your bag, phone, or iPad will not get wet; you won’t be uncomfortable; and you don’t have to worry about batteries or enlarging your “carbon footprint.”
3. Each woman experiences hot flashes differently and in different parts of their bodies. The two palm packs are formulated to last the average length of a hot flash, 1-3 minutes, and they can go wherever a woman needs them. After replacing them back in the case, within 20 minutes they will be cool again and ready for use.
4. Hot flashes make you sweat! The antimicrobial super absorbent cloth wicks away moisture and is easily washed.
5. Your day is long, and you’re not always near a freezer. coldfront will continue re-cooling the palm packs for up to 12 hours.
6. Unlike one-time use cold packs, which can create over 600 pounds of toxic waste over the course of five hot-flashing years, and literally cost thousands of dollars, coldfront is phthalate-free, non-toxic, and costs less than $100 over the life of the product.
7. Everything in the system is reusable and is designed to last.

Liz, thank you for the opportunity to contribute to your community and to speak about our product. Because women all experience menopause and hot flashes differently, we know that coldfront won’t be for everyone. But, we believe deeply that coldfront is something special – not just because it works, but because it speaks to a societal issue we believe we can change.

Here’s to a new kind of coldfront moving in!

Susie

Forecast: there’s a Coldfront moving through

Posted by Liz on Apr 23, 2012 in hot flash, HRT | 2 comments

“Cold front” you say? But it’s Spring in the Northeast and temps have been pretty warm.

Nope, not Cold Front, but Coldfront®, a new personal cooling system designed to cool flashes when they hit.

Coldfront is not unlike Cleavage Coolers, the revolutionary product that fits right into your bra like rubber chickens. However, these nifty little Coldfront packs fit into a container the size of a sunglass case, are the size of your palm and reportedly soft to the touch and stay cold all day because of a built-in cooling core. When those hot flashes hit, just pull one of these babies out and palm those sweats right out of your life. No drugs and a reusable cloth that wicks moisture away. The company describes Coldfront as “safe, effective, discreet, convenient, mess free, environmentally friendly” and best of all: “elegant.”

I’m not entirely sure about the last adjective and hardly believe that the carrying case would easily double as a purse on a night out on the town. Still, Coldfront is not the first product based on cold technology to address the body’s sudden inability to regulate its internal thermometer. And yet, at a pricepoint of $50, it seems like a reasonable investment compared to other HRT alternatives that require a bit more of a time and financial commitment.

I have not seen the product nor do I know anyone who’s used it. Personally, I am a bit skeptical but it’s my job to be. And, I never truly believe testimonials on a website; what company publishes negative feedback? What’s more, the product, like cleavage coolers, the bedfan, the chillow, chillipads and gelmats, all rely on a woman who wants some ice, ice, baby! I dunno, but I run hot/cold on this whole approach.

Have you heard of Coldfront? Have you personally used the product? Inquiring minds need to know!

Newsflash! Trust your gut: HRT and ulcerative colitis

Posted by Liz on Apr 20, 2012 in estrogen, HRT | 2 comments

Ulcerative colitis is a type of inflammatory bowel disease that causes inflammation and sores in the lining of the large intestine. The disease affects men and women in equal numbers and risk is higher among Caucasians and Jews. Yet, although it most commonly develops between the ages of 15 and 30, ulcerative colitis has a brand new bag, so to speak: women in menopause taking hormone replacement therapy (HRT). Yikes! Another nail in that HRT coffin. And this time, both combination hormone therapy (i.e. estrogen plus progesterone) and estrogen only appear to play a role.

Investigators will be reporting study findings (which are derived from following more than 108,000 postmenopausal women enrolled in the Nurses Health Study) at the American Gastrointestinal Association’s Annual meeting next month. Information on this group of women was updated every two years for 32 years, including menopausal status, use of hormones and medical diagnoses. The findings? Compared to women who never used hormones, women who did, regardless of type, had a 1.7 times greater risk for developing ulcerative colitis. Notably, this risk increased with longer duration of hormone use and decreased the longer the time period since stopping hormones. In fact, risk declined by almost 25% in women who had discontinued hormones for five or more years.

It was once believed that stress caused ulcerative colitis but experts now hypothesize that it’s triggered by a virus or bacteria that attacks the immune system, or is hereditary. So where do hormones come into play? Apparently, estrogen may play a role in controlling how the lining of the intestine functions to keep out toxins but let in nutrients, electrolytes and water as well as inflammation. Replacing estrogen with hormone therapy may act to create an imbalance that sends the system into overdrive but researchers are still not clear how and why.

Meanwhile? Hormone replacement therapy may increase your risk for developing ulcerative colitis as you age. You should always trust your gut. What is it telling you about HRT?

Newsflash: Estrogen only joins “avoid long-term hormone therapy use” recommendations

Posted by Liz on Apr 2, 2012 in breast cancer, estrogen, HRT | 8 comments

How many times does one need to get hit over the head before they have that “ah-ha” moment?

That’s pretty much the party line when it comes to hormone replacement therapy, or HRT. I’ve been writing about HRT  since I started this blog. And I have been reading study after study that ultimately come to the same conclusion: long-term use of any hormones is unsafe.

I know that there are naysayers out there who don’t want to believe. Even the International Menopause Society continues to dispute the link between combined hormones and breast cancer.  Yet, I wholeheartedly believe in free will and choice, informed decision-making needs to lead the way when it comes to your health.

And so, in the latest wrench to be thrown into the HRT argument, researchers from Brigham and Women’s Hospital in Boston, reporting from the annual American Association for Cancer Research meeting, that the longer that any hormone replacement is used, regardless of whether or not it is estrogen plus progesterone or estrogen alone, the higher the risk for developing breast cancer. 

Did you read that?

Lead researcher Wendy Y Chen is quoted in the Association’s newsrelease as saying that while it’s “already been confirmed that patients shouldn’t be undergoing estrogen plus progesteron hormone therapy for the long term,” (you can read about that here), “what we found is that people should also be careful about longer-term use of estrogen-alone [hormone therapy].”

Chen and her team evaluated data collected during the Nurses Health Study over a period of 28 years. They found that of the 121,700 women who took part in the study who were between the ages of 30 and 55 in 1976, and used combined hormones for 10 to 14.9 years, had an 88% higher risk of developing breast cancer than women who did not use HRT. Moreover, this risk increased to more than two-fold in women using it up to almost 20 years. And although the risk was comparatively lower for women who used estrogen only, they still had an 22% increased risk for up to 14.9 years and a 43% increased risk for up to 20 years compared to non-users.

Importantly, when the researchers restricted the population to the same that was observed in the Women’s Health Initiative study (i.e. healthy, active postmenopausal women ages 50 to 79 with an intact uterus), they observed a decline in breast cancer risk among women who used estrogen only therapy for less than five years but continued to observe an increased risk among women currently using estrogen fo 15 to 20 years.

Chen emphasizes that the data do not demonstrate an increased risk for dying from, although they continue to study this particular factor for additional clues.

So, what’s the upshot?

Long-term use of any kind of hormone therapy, estrogen alone or in combination with progesterone, significantly increases the risk for developing breast cancer. Is this increased risk worth a decline in hot flashes, night sweats, mood swings and vaginal dryness? Only you can decide.

Wednesday Bubble: is DHEA the path towards a better sex life?

Posted by Liz on Dec 21, 2011 in estrogen, HRT, sexual desire, sexual health | 2 comments

Today’s Bubble is a doozie that can one of two ways: in the yes(!) column or in the no (!) column. I’ll leave it to you to decide.

DHEA is the most abundant sex hormone in circulation and is mostly secreted by the adrenal glands. Research has shown that low DHEA levels in pre- and postmenopausal women may negatively affect sexual functioning, while ample blood levels may enhance sexual functioning, cognitive functioning and wellbeing. Yet, whether or not DHEA really works continues to be controversial. And the reason behind the burgeoning interest is the quest to find a suitable replacement for HRT. The thing is? There are lots of suitable, evidence-based replacements that are not broadly accepted by many medical professionals and many of these are discussed regularly on this blog. Nevertheless, here’s what researchers have just discovered about DHEA.

The researchers, from Pisa, Italy, followed 48 healthy, postmenopausal women for a year. During this time, they divided 36 women who were experiencing troublesome menopausal symptoms and requesting hormone replacement into three groups:

• 12 women who received 10 mg daily of DHEA
• 12 women who were given combined HRT
• 12 women who received the synthetic hormone, tibolone, daily

The fourth group was comprised of 12 women who did not wish to use HRT. They received daily vitamin D (400 IU) and calcium to help combat osteoporosis.

At the start of the study, all of the women reported similar sexual activity. However, after a year of treatment, women taking DHEA had significant increases in sexual interest and activity scoring almost 14 points higher on a questionnaire used to measure sexual interest, satisfaction, vaginal lubrication, orgasm and sexual partner. The women taking HRT experienced similar benefits, and women in both of these groups reported engaging in more sexual intercourse compared to women taking Vitamin D and calcium. Women taking the synthetic hormone also had increased sexual interest scores but they were not as high as the other two hormone groups. The magnitude of improvements in menopausal symptoms was also similar between the DHEA, HRT and tibolone groups.

The reason for this improvement appears to be the effect that DHEA has in terms of improving blood levels of the hormones estradiol and progesterone, both of which decline during menopause. It also appears to positively affect adrenal functioning.

What to think? Well, the study didn’t include any information on side effects. This is what Mayo Clinic has to say in that regard:

“No studies on the long-term effects of DHEA have been conducted. DHEA can cause higher than normal levels of androgens and estrogens in the body, and theoretically may increase the risk of prostate, breast, ovarian, and other hormone-sensitive cancers. Therefore, it is not recommended for regular use without supervision by a licensed health professional.”

Another important fact, acknowledged by the researchers, is that DHEA was only studied in 12 women, hardly enough to draw any firm conclusions. But they do believe that the findings, albeit preliminary, are encouraging, especially for women who “may have problems in taking more conventional HRT.”

Personally, I believe that it’s waaaaay too early to even consider DHEA as an alternative to HRT and in particular, to androgen therapy for sexual health. I want to see more information on side effects before it’s even on the radar. Meanwhile, I would love to hear what you think:

Yes!?

or,

No!?