Posts Tagged "hot flashes"

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?

Soy! Everything you wanted to know. Or should.

Posted by Liz on Sep 20, 2010 in hot flash, HRT | 6 comments

Confusion about soy abounds. Does it help hot flashes, improve bone health or prevent heart disease by lowering cholesterol? Or it is no more effective than placebo?  Does its effectiveness rely upon the ratio of certain isoflavones — the plant-based estrogen-like components, which in soy include  genistein (50-55% of total isoflavone content of soy), daidzein (40% to 45% of total isoflavone content) and glyceitein (5% to 10% of total isoflavone content) — or is the metabolite S-equol the only component that will yield estrogen-like benefits without negative health risks?

Are you perplexed? I sure am, which is why this particular post may be a bit to scientific for a few and too long for others. however, it’s important to understand some of the reasons why soy continues to intrigue, baffle and well, show differing results in terms of benefits for menopausal symptoms. So I encourage you to bear with me.

I’ve written previously that there are several key reasons why researchers have yet to make any any definitive conclusions about soy during menopause, such as poorly designed studies, small number of study participants, wide range of ages and years from menopause, and the fact that the pros and cons of an agent or strategy are not being studied for a long enough period of time. In other cases, there is an inconsistency in the soy preparation being studied and the ratio of isoflavones may differ; alternatively, researchers have not accounted for the presence of other isoflavones in the diet, which may influence results.

Does a new study that appears in the advanced online edition of Maturitas journal, comparing low-dose hormone therapy to soy powder in women with hot flashes, offer any anything more definitive or different than what’s gone before?

Briefly:

The 16-week study enrolled 60 women between the ages of 40 and 60, all of whom had had their last period at least 12 months, had the same frequency of hot flashes (more than 8 per 24 hours), had not used any hormonal treatment in the 6 months leading up to the study period, and were not currently using any drugs that lower blood fats, treat diabetes, taking other soy-based products or using herbal supplements.

Women participating in the study were randomly assigned:

1. low-dose hormone therapy (a Activelle ®tablet daily, better known as Activella® in the US) plus a placebo powder or
2. 2 portions daily of dietary soy supplementation powder (comprising 45 mg isoflavone per dose) plus a placebo tablet, or
3. 1 placebo tablet/2 portions placebo powder.

All women were first screened  for  current hormone levels, reproductive history, age at menopause, time since menopause, medication use and cigarette/alcohol consumption. During the study, they were asked to use a standardized scale to evaluate menopausal symptoms (hot flashes, heart discomfort, sleep, and muscle and joint problems) mood (depression, irritability, anxiety, physical/mental exhaustion) and sexual problems, bladder problems and vaginal dryness.

The results?

Both hormone therapy and soy supplementation were associated with significant improvements in hot flashes and joint/muscle pain (which declined by about 45.6% in the hormone group and 49.8% in the soy group) and in vaginal dryness (which decline d by 38.6% in the hormone group and 31.2% in the soy group) compared to women who took placebo. Improvements in mood scores were consistent between the three groups, indicating that other factors, such as caring and attention by medical practitioners throughout the study, may have played some role in wellbeing. Moreover, both treatments were considered safe with few side effects.

These results are quite promising, as they indicate that soy may indeed, offer an alternative to hormone therapy in menopausal women seeking relief. However, it’s important to consider the following:

• Like many of its predecessors, the study is a small one.
• The study length was short, lasting only 16 weeks, which some critics might say is too short a time period to elicit a satisfactory clinical response.
• The researchers did not analyze whether or not the women actually took the drugs or soy consistently, and relied on their self-reports.

On the other hand:

• The study followed strict Western scientific guidelines and the women and the researchers did not know who was taking what.
• Symptoms were measured using a common quality of life scale whose goal it is to diminish errors by healthcare practitioners when analyzing results of questionnaires. This particular scale, better known as the MRS, is widely used and allows researchers to evaluate symptoms and treatment over time.

There has been a lot of criticism geared towards alternative treatments, such as acupuncture, herbs and Chinese medicine, as being shams, especially because there is no evidence supporting their use for addressing troublesome menopausal symptoms. Others will claim that the placebo effect is at play, i.e. a situation in which symptoms are relieved by an otherwise ineffective treatment due to expectations or beliefs. However, the researchers of this particular study point to the placebo effect in studies comparing estrogen to placebo, demonstrating for example, a 75% reduction in hot flashes among hormone users compared to a 57% reduction in hot flashes among women taking placebo.

The most important conclusion to be drawn is that there is early evidence that soy supplementation may be as effective as low-dose hormonal therapy in relieving certain vasomotor symptoms and possibly, vaginal dryness. We need more studies like this one, enrolling larger numbers of women, in order to definitively demonstrate benefit. Dollar for dollar, the monthly difference between the two treatments may only be about $30.  Yet, this is one of the first studies I’ve seen that followed enough rules to quiet the rioters. And that alone, is worth the price of admission.

Stay tuned. The fat lady hasn’t sung her soy aria as of yet.

[Special thanks to Reuters Health Executive Editor Ivan Oransky, for your continued support of my mission to provide timely, evidence-based information on menopause and midlife to my readers.]

Feeling anxious? It may be those hot flashes!

Posted by Liz on Sep 13, 2010 in anxiety, hot flash | 15 comments

Researchers say that there may be a link between hot flashes and certain types of anxiety. In fact, hot flash symptoms — increased heart rate and feeling flushed — have been shown to mimic feelings associated with somatic anxiety, i.e. butterflies in the stomach and tension (as opposed to affective anxiety, which people feel panicked or afraid or nervous).

Importantly, data have shown that as much as 8 months before premenopausal women start experiencing or reporting hot flashes, their scores on an anxiety index are off the charts, which means that constant butterflies or tension may be predictive of the move into menopause. The reason this is important is that they may be steps you can take now to address symptoms as they start to emerge, yoga and deep breathing for example, which not surprisingly, are often recommended to address anxiety symptoms.

The latest bit of information to hit research circles involves a study of 80, healthy, well-functioning menopausal women who were asked to keep a daily diary on hot flashes or night sweats (defined as a feeling of warmth or heat accompanied by sweating, pressure or rapid heartbeat occurring while awake or during sleep). In the diary, participants were asked to record how often hot flashes occurred over a one-week period as well as their severity. They were also asked to rate any symptoms of anxiety based on how often they occurred.

The results?

Higher scores of anxiety related to tension and butterfly-like feelings but not to panic or nervousness were significantly associated with more severe and frequent hot flashes or night sweats, even when factors such as sleep quality, age and education levels, all which might affect anxiety levels, were factored in. Age in particular is important because hot flashes tend to wean through the menopause as women grown older.

The reason this preliminary research is important is that it is possible that anxiety that women experience during menopause is actually related to hot flashes, rather than a specific mood disorder. By shifting the viewpoint to the true culprit, healthcare practitioners and women alike, might be able to better diagnose and more appropriately address anxiety symptoms, rather than leaning towards prescription mood treatments that are uncalled for.

At the same time, more research is needed. This was a small group of healthy, white women who were asked to self-report hot flashes/night sweats and anxiety symptoms. Although most of the research on hot flashes does rely on self-report, objectivity can be lost. What’s more, because these women were psychologically healthy, it’s hard to apply any conclusions to older women who might be seeking assistance specifically for anxiety.

So, are you feeling anxious? Depending on your age and menopausal status, it might be a harbinger of the flash or due to the flash. Either way, it’s worth considering.

Women, O, pause! The book

Posted by Liz on Sep 3, 2010 in menopause | 4 comments

If you’ve ever visited the ‘About’ section, you know that a key reason I started this blog was that I took a look around the interwebz to see what was being written about menopause and it gave me “pause.”  I felt that there were voices that were being ignored or talked down to. And, I felt that the information was too limiting, too medical, not broad enough.

Hence, when I was approached by the publicity folks at Planned Television Arts/Ruder Finn to examine a new self-help book on menopause: Womenopause: Stop Pausing and Start Living (Authors Lovera Wolf Miller MD and David C Miller, MD), I thought, “sure, why not?”

Womenopause has an interesting approach in that it encourages women to be proactive rather than reactive to menopause.  This philosophy is one that I’ve long ascribed to because I do believe that prevention is often the best medicine. In fact, when younger women tell me that this blog is not for them, I usually tell them that there are steps that they can take now to prevent some of the challenges that accompany the transition, such as weight gain/redistribution, bone loss and heart disease.

Moreover, I love that the authors acknowledge menopause as a milestone, not for its finality but for the fact that is simply another stage that “transforms women within the context of an already convoluted life and within the complexities of a marriage and/or dynamic relationships.” I love that Womenopause offers thorough, readable information about the processes that are going on in a woman’s body to cause various symptoms of menopause, an area that I’ve been hesitant to approach simply because I feel that there is a lot of good information out there, if you know where to look (for example, check out the Flashfree Blogroll on the home page).  And I applaud the authors for their inclusion of real-life cases.

However, this is where my love affair with the book ends and the questions begin.

The authors of Womenopause ask their readers to chart their baseline symptoms and basic health and then record their course through four weeks using something they have named the ‘ωScore.’ Theoretically the goal is to help identify health problems, for example, the severity and emotionality of hot flashes, sexual or skin issues or sleep problems to raise awareness and potentially, spark conversations with their healthcare practitioners. Each of these areas is thoroughly discussed in the book in both a serious and thoughtful fashion, accompanied by an attempt at a lighter side. Although I think that records can help identify issues and promote helpful dialogue, I know that personally, I don’t want to take a quiz, keep a journal or score a “hot dread.” Huh? Hot dread is defined as emotional components – aura and anxiety, that may accompany a hot flash. The overall tone of the Womenopause interactive program — “fit, feminine and fabulous in four weeks,” feels a wee bit touchy feelie, “woo woo” to me, and frankly, when I am night sweating or flashing, I’m really not feeling my fabulosity or my femininity.  As I’ve mentioned time and again, this ain’t no tropical vacation and I’m not really interested in ‘Menopauseland,’ the theme park.

When it comes to physical information, Womenopause is truly, a great guide. However, buyer beware! The majority of solutions to the common problems of menopause are medically/pharmaceutically-based and in fact,  the authors repeatedly dismiss alternative and complementary therapies as unproven and no better than placebo. As someone who is well-versed in reading and analyzing data, and who has devoted the past two years to examining and sharing the evidence behind alternatives to hormone replacement, I take great issue with this approach and it makes me pause; by not taking adequate time to thoroughly explore studies on alternative approaches, the authors have truly done a huge disservice to women who are hungry for information and need to be empowered to make the right decision for themselves, even if that decision does not involve HRT. Moreover, for a book that devotes more than on thorough discussion to sexual desire and other menopausal issues, I am very surprised not to find Christiane Northrup, MD, listed in the Recommended Books section.

Overall, I would encourage readers of this blog to take a look at Womenopause, with the full understanding that this may not be your cup of tea. It certainly is not mine. However, if you are looking for concise medical information about the changes that are occurring in your body during the transition, and a wee smattering of helpful advice, Womenopause is a great resource. Just be mindful that fab, fabulous and fit in four weeks sounds like a dream, not a reality.

Tell me, what are your favourite resources or reads?

[Disclosure: I was not paid to review Womanopause. However, the publicity folks did send me a free copy of the book.]

Wednesday Bubble: The “De’s” have it

Posted by Liz on Sep 1, 2010 in new approaches | 0 comments

This week’s Bubble is truly straight out of bubble-land. Flashing? There’s a drink for that. Not on your game? There’s a drink for that. Finding that you can’t handle the demands of daily life? There’s a drink for that too?

Sigh.

Yes ladies, you can ‘deFlash,” deBug” and “deCompress” with EYL – Enrich your Life drinks.

Look, I’m a huge supporter of alternative therapies, Traditional Chinese Medicine, herbal remedies, etc, so long as they are thoroughly studied. But time and again, we see enriched nutritional products that are long on promises and short on delivery. And while functional foods — foods that deliver more than nutritional benefits — are certainly the wave of the future, I do believe that these foods need regulation and evidence behind them. Japan may be one of the few countries that actually regulates functional foods.

So before you spend your hard-earned dollars on drinking your flashes away, why not do some research and see which alternatives actually pack a powerful punch beyond their marketing claims?

The “De’s?” How about “deceptive?”