Posts Tagged "menopause"

Breathe. What you need to know about asthma and HRT

Posted by Liz on Sep 30, 2011 in asthma, HRT, menopause | 0 comments

If you suffer from asthma, you will want to take note: researchers presenting at this week’s European Respiratory Society AnnualConference have shown that female asthmatics have an increased risk of landing in the hospital if they take hormone replacement therapy (HRT). Yet another nail in the HRT coffin, once again demonstrating that the health risks of taking hormone replacement may outweigh the benefits.

Notably, studies have shown that asthma risk increases in women after puberty. Moreover, hormones, most specifically fluctuating estrogen levels, can impact airways as much as allergies and hay fever (fluctuating estrogen levels can produce an inflammatory response and exacerbate breathing difficulties). On average, asthma symptoms develop in about 21% of menopausal women and more than twice as many using hormone therapy.

In this study of over 23,000 Danish women with documented asthma, researchers looked specifically at hospitalizations for severe reactions. They also collected information on smoking, exposure to smoke, body mass index, level of physical activity, history of hysterectomy and use of HRT.  The findings? Using HRT increased the risk for hospitalization for severe asthma reactions by as much as 40% compared to not using hormone therapy. What’s more, the longer the women used HRT, the higher their risk of ending up in the hospital; for example, if they used it for less than 3 years, they have a 29% increased risk and if they used it for more than 10, a 51% increased risk. Even more troubling was the fact that women didn’t smoke appeared to have the highest risk for being hospitalized in association with their HRT use.

Although this isn’t a randomized trial, and more information is needed, the researchers still recommend that practitioners be made aware of these findings. They say that the relationship between asthma and female sex hormones is hardly new, but that their findings confirm the relationship and further our understanding of it by showing the extent of severe asthma reactions that occur when women take hormones. “If a patient develops asthma or has a severe worsening of symptoms after taking HRT, they may need to stop hormone therapy altogether,” they add.

Wednesday Bubble: chase the midlife blues away with a cup of java?

Posted by Liz on Sep 28, 2011 in aging, depression, emotions, menopause | 8 comments

Coffee. The morning elixir that oh, so many of us rely on. Did you know that caffeine is the world’s most frequently ingested psychoactive substance?!

We’ve heard a lot about the blues and depression during midlife and menopause, with some experts saying that the two are connected and others, that they are not. However, regardless of whether or not menopause increases the risk for depression, it is clear that depression affects twice as many women as men, and at least 20% of all US women at some point during their lifetime. Hence, if there is an easy way to boost the success of antidepressants or behavioral or other strategies, I’m all for it. And it appears that coffee may be the part of the solution.

Coffee? Really?

In a newly published study in the esteemed Archives of Internal Medicine, researchers say that they followed over 50,000 women and examined their food intake including how often they drank caffeinated and decaffeinated coffee, tea and soft drinks and and ate chocolate. During the 10 years of the study, researchers identified slightly over 2,000 cases of depression. However, it appeared that drinking two to three cups of coffee daily reduced the risk of developing depression by 15% compared to drinking one cup a day or less. Women who drank four or more cups a day had a decreased risk of 20%. And decaffeinated beverages? No dice.

In so far as this study goes, it’s not conclusive and it could be possible that mildly depressed women drink less coffee. And keep in mind that  too much of a good thing is well, too much. Studies have shown that long-term consumption of caffeine can lead to tolerance, meaning that you need greater amounts to achieve the effects that many of us crave.  Nevertheless, so far, the results show that  coffee may very well be mildly protective against depression.

English playwright and theatre director John Van Druten once  said, “I think if I were a woman I’d wear coffee as a perfume.” I think I’d rather just drink it than wear it!

Menopause: the symptom? Or, the disease?

Posted by Liz on Sep 23, 2011 in emotions, estrogen, menopause, women's health | 4 comments

A few years ago, I ran across the following story 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 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? Aren’t these conclusions an example of how the Menopause Industrial Complex perpetuates 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. Isn’t it time we start fighting back?

Wednesday Bubble: More on maca – not ready for prime time

Posted by Liz on Sep 14, 2011 in herbal medicine, menopause, sexual health | 0 comments

Remember maca? The aphrodisiac of the Andean plains that is even used in fjords of Norway? When it comes to menopausal symptoms and female hormonal balance, it seems that maca is not all it’s cracked up to be. In fact, before you spend your hard earned dollars on this Andean wonderherb, you may want to hear more.

In case you are unfamiliar with maca, it is a plant indigenous to South American countries that has been used for centuries by Peruvians and other cultures to manage conditions such as anemia, infertility and as mentioned, hormonal imbalances in women. More recently, it’s been introduced in Europe, the US and Asia as a potential treatment for impaired sexual function and desire.

However, despite its touted benefits and burgeoning marketing buzz, maca may not be “all that.”

In the scientific world, researchers often look at published studies and data in composite in order to evaluate the effectiveness or worthiness, if you will, of a product or strategy. These efforts are call meta-analysis, and consist of culling, pooling and then evaluating information that was collected over certain time periods. Importantly, when they tried to do this with maca, searching 17 international databases for studies up to June of this year, they discovered the evidence was lacking, forcing them to synthesize or qualitate what they were able to find based on the strength of the evidence that did exist. In summary:

• Out of 17 scientifically rigorous studies that they were able to locate, only four held up to standards and therefore, worthy of inclusion.
•  In total, 202 healthy pre- or post-menopausal women took pre-gelatinized or dried commercial maca or placebo, in different doses (1.0 to 3.5 gram daily) for up to 2 months.
• Various menopausal symptoms were studied using scientific indices. They ranged from vasomotor and mental health to sexual dysfunction and overall wellbeing.

Although three of the four studies showed that maca had positive and even significant effects on menopausal symptoms compared to placebo, the researchers emphasize that “perhaps the most important finding of this systematic review is that there have been very few rigorous trials examining the effects of maca on menopausal symptoms.” Given that maca has been marketed as effective for the treatment of menopausal symptoms, they find the lack of data surprising. Moreover, the studies were so disparate in terms of how maca was used that it’s difficult to draw any worthwhile conclusion about its effectiveness. In fact, the optimum amount of maca is still not known.

Tell me, how can you treat your symptoms effectively if you don’t know what dose to use?

Experts also don’t know how maca works; theories include that it may stimulate the production of estrogen or that it fortifies the body’s ability to maintain hormonal balance. Nevertheless, others argue that despite the clear evidence, maca appears to cause fewer side effects than conventional drugs for menopause. In fact, none of the studies examined in the review showed any adverse events (some claim that there are no reports of adverse effects whatsoever, although Peruvian authorities recommend that it is boiled before consumption to insure safety, and Australian authorities report attention disturbances, weight loss, agitation, nausea, vomiting, abnormal liver function, abdominal pain and oral tissue bleeding). The reason it’s so important to clarify this particular safety profile is that if maca has an estrogen effect, it might be contraindicated in women with conditions that are sensitive to estrogen, such as endometriosis and breast cancer.

The bottom line is that we need more scientific studies and a heck of a lot more information. Meanwhile, although it’s definitely affordable (a quick Google search shows that pricing per bottle or in bulk ranges from $4 to $23), there doesn’t seem to be enough evidence to support regular use of maca for menopausal symptoms and sexual function. This is definitely a path wrought with lots of questions. Buyer beware. Maca isn’t ready for prime time, at least not yet.

Be still my beating heart?

Posted by Liz on Sep 12, 2011 in heart disease | 4 comments

Menopause causes a woman’s risk for dying from heart to disease to spike, correct? If you take a look at the studies I’ve been writing about since starting this blog, the answer would be an unequivocal “yes.”

What we do know to be true is that risk for heart disease increases with age and that heart disease is a leading cause of death among women. Yet, symptoms can be different in women and may even show up at a later age compared to men. Still, the long-held theory that menopause acts as an accelerator and an equalizer has just been turned on it’s toes by a newly published study in the British Medical Journal.

The study authors say that clinical and epidemiological data that demonstrate that menopause is key culprit are simply not there. Rather, they believe that women’s increase in deaths from heart disease can be attributed to a gradual decline of cells that act to repair and replenish our circulation. To prove their point, they reviewed death from heart disease over time in three different cohorts based on the time period when they were born (i.e. 1916-1925, 1926-1935 and 1936-1945).

Indeed, what they found was that none of the groups of women had any sort of significant upswing in heart disease deaths around the time of menopause. Instead, deaths from heart disease increased exponentially over time — by 7.9% per age year. In contrast, death from heart disease in men increased by about 30% per year up to age 45 and then slowed to about 5.2% per year thereafter.

When it comes to heart disease, the great equalizer between women and men appears to be age and not hormones. Even then, more men can be expected to die from heart disease than women, at least until an advanced age.

The reason this is so important is that the focus in women has long been on menopause and efforts to improve heart health based on that time period. The findings imply that we need a wake up call and that efforts to improve our hearts should be based on lifetime risk rather than the time from menopause and beyond.

The time is now ladies. Be kind to your heart; focus on diet, exercise and weight. And truly, still the risk for heart disease before it stills your beating heart for good.