Posts Tagged "estrogen"

Wednesday Bubble: HRT? Everybody must get kidney-stoned

Posted by Liz on Oct 13, 2010 in HRT, Uncategorized | 0 comments

[youtube=http://www.youtube.com/watch?v=skOKkBqxGcE]

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.

Stressed out? No wonder you can’t remember…

Posted by Liz on Sep 24, 2010 in estrogen, memory/learning | 7 comments

I have a friend on Twitter who coined the phrase “can’t remember shit.” This phrase greets me throughout the day because I am constantly forgetting even the simplest things. Why did I enter this room? What was I going to look up?  How did I get here? Why can’t I focus?  And lists? Fuggedaboutit – they don’t do squat; even when I have them, I forget.

I blame  my memory and focus problems on hormones all the time. However, if this were true, then the addition of hormones, in particular estrogen, would balance out the forgetting and boost my attention and focus, right?

Hence, I was intrigued when I ran across a small study in Menopause looking at cognition and stress, which seemed to back an earlier contention that stress plays a huge part in recall ability in menopausal women.

In this rather small trial, 22 postmenopausal women  (50 to 83 years) took either placebo or an estrogen tablet (1 mg estradiol daily for one month and then 2 mg daily for two months). After three months, they were asked to ingest a substance that depleted certain compounds (called monoamines) that the body manufactures and uses to stabilize mood, perform a mildly stressful test, and then undergo a series of tests on stress levels, mood, anxiety and cognition.

It appears that at least in this small group of women, taken estrogen was actually linked with poorer cognition following a stressful event, including the ability to recall words and slower reaction time. Because this occurred independently of the depletion of  mood compounds or negative mood, the researchers say that the effect of estrogen, which has been shown in some studies to improve cognition, is not as straightforward as previously believed. What’s more, the significant increase in stress and stress reactions during menopause may actually interfere with estrogen benefits in so far as memory and recall go.

Our lives are increasingly busier, especially now that we can be connected 24/7. Personally, I can’t even get a work out into my day without some sort of interruption. That’s why it’s so important to figure out  how hormones interact with stress, so that we can make informed decisions — not only about menopausal decisions — but also about general life decisions.

Look, memory recall and attention are undoubtedly linked to aging, at least to some extent. But now? Stress may be playing a role in how hormones impact our reactions, focus and attention span, and memory. So the next time you can’t remember shit? Maybe a few deep breaths can help.

No wonder!

Wednesday Bubble: R.I.S.E and shine: help me help you burst the mysteries of soy

Posted by Liz on Sep 22, 2010 in Uncategorized | 2 comments

Should you try soy for menopausal symptoms?

Soy isn’t for everyone and as the comments from Monday’s post show, it may be downright dangerous for some populations. However, my goal is to present you with invaluable information about options for addressing troublesome menopausal symptoms — information that isn’t always readily available or accessible, — which is why posts about the evidence for potential benefits (and risks) of soy are so important.

That’s why I’m reaching out to you today. I want you to help me help you burst the mysteries and controversy surrounding the use of soy isoflavones for menopausal symptoms like hot flashes or mood swings.

Here’s how:

The University of Illinois at Chicago Center for Women’s Health is looking for healthy, perimenopausal women between the ages of 40 and 55 to take part in a research study. Sponsored by the National Institutes of Health, The R.I.S.E. (Research Investigation of Soy and Estrogen) study will compare a soy tablet  (Novasoy® ) to estrogen and placebo in order to evaluate the effect on hot flashes and other menopausal symptoms.  You  can learn about the specifics of the study at the RISE website.

Why it’s important to spread the word.

We will never know if phytoestrogens like soy, and other alternative therapies are truly effective without having ample evidence to back claims. Many Western practitioners, including former editor of the Journal of the American Medical Association, George Lundberg (who recently wrote that “there is no alternative medicine, only unproven medicine”) continue to argue against inclusion of alternatives in our medical system. My mandate and promise to you has always been to provide you with sound strategies that will empower you to make the best decision about your physical and mental health and wellbeing. Navigating the midlife transition — whether it’s menopause, general health issues, career changes or relationships isn’t easy — but it can be less challenging with the proper tools and roadmap to make decisions that work best for you.

We will never be able to take control of our journey without fully engaging in the process. Not only does this include educating ourselves but also taking responsibility  for the changes we wish to see.

Let’s face it; participating in a research study isn’t everyone’s cup of tea. However, the University of Chicago needs your support and so do I.

Let’s rise to the occasion shall we? Won’t you help spread the word?

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.

Wednesday Bubble: Is S-equol the next big thing?

Posted by Liz on Jul 14, 2010 in new approaches | 5 comments

Last year I wrote a few posts about the potential of the isoflavone S-equol for addressing menopausal symptoms, including hot flashes and mood swings.

If you are unfamiliar with S-equol, it is actually a metabolite of a one of the three soy isoflavone compounds (i.e. daidzein), and is produced by bacteria that live in the intestines. One of the most interesting things about S-equol is that is one of the principal types of isoflavones that are found in soybeans and most soy foods. However, up to 80% of the U.S. population and about half of the Japanese population (who consume inordinate amounts of soy) cannot manufacture S-equol on their own and need to obtain it in supplement form.

This month’s Journal of Nutrition has devoted an entire supplement to S-equol research, and I’ve been fortunate to take a more detailed look at the evidence supporting the role of S-equol for menopausal symptoms. Notably, some of the  researchers actually say that “to conduct menopausal medical care appropriately [which, in their opinion, should be geared towards a better quality of life on an individual basis), it is necessary to provide evidence-based alternative medicines as much as possible.” It is wonderfully refreshing to find such esteemed colleagues backing my view of how menopause should be approached.

Hence, without further ado, following is what you need to know about the recap of study findings, and what still needs to be explored before we all start taking S-Equol.

In three randomized studies conducted in pre-, peri- and menopausal Japanese women who were or were not able to produce S-equol naturally, researchers found specific benefits in three areas:

• Mood improvement: 134 women who produced S-equol naturally and took a 10 mg daily S-equol supplement had significant reductions in anxiety; those who took 10 mg three times a day had significant declines in tension-anxiety and fatigue, and an increase in overall energy. Note that these women also limited their daily intake of soy products to no more than 20 mg/day.
• Hot flashes and other symptoms: In 320 women taking 10 mg S-equol daily or placebo for 12 weeks, S-equol supplements reduced the frequency of hot flashes by as much as 58%. Decreases in muscle and neck stiffness were also reported.
• Bone health: In 54 women who had undergone menopause within 5 years of the study, those who were able to produce S-equol naturally and took 75 mg  isoflavones daily supplement (mostly consisting of daidzein) lost a significantly lower percentage of bone in their hip area than women who were not able to produce S-equol naturally but also took the daily supplement. Researchers believe that S-equol actually mimics the action of estrogen in the body in terms of its ability to maintain bone mass and the balance between the build up of bone (bone formation) and the loss of bone (bone resorption). However, studies looking at how it acts in the body have only been conducted in mice and at relatively high doses. Information reported in the Journal supplement does show that at higher dosages, S-equol can negatively affect the tissues lining the uterus.

A few key take-away points to think about when we think about S-equol:

Researchers believe that the research in S-equol helps to show that soy isoflavones work best in individuals whose bodies are able to produce S-equol naturally. However, you’ve read the stats – the majority of people who live in the US do not produce S-equol naturally. Dosing and the exact type of S-equol may also influence outcomes. Likewise, They still aren’t sure how bacteria in the intestines influence S-equol’s effects and wonder if somehow, some other mechanism is at play. Further research is also needed to see if the beneficial effects of S-equol on menopausal symptoms can be extended to women who do not produce it naturally.

It’s too early to boost this bubble and I’m excited by this evidence-based alternative. Naysayers love to point out that alternative therapies are sham and snake oil. While this may be true of some preparations, it’s clear that researchers are taking natural substances to a higher level to see if they offer efficacy without the risks of hormone replacement.