Posts Tagged "menopause"

Looking through the window: depression and menopause

Posted by Liz on Dec 27, 2010 in depression | 2 comments

There’s a new term that’s being kicked around in medical circles: ‘windows of vulnerability.’

It appears that a growing body of evidence supports the fact that during times of hormonal flux or reproductive cycle “events,” women become increasingly vulnerable to mood swings, anxiety and depression. And while this is certainly not news for many women, it still requires some attention because among the many windows that women may go through, the menopausal transition is evidently one of the most complex. The reason? This is a time when hormones interact with aging, sexuality, life stressors, self-esteem and general health issues.

The subject of depression and menopause is not new to this blog, nor are statistics suggesting that as many as 20% to 40% of women are believed to suffer major depression or at the very least, depressive symptoms during the peri/postmenopausal years. Moreover, women may have as much as a two- to four-times increased risk of developing depression as they transition from pre- to perimenopausal status. Among the multiple factors at play, estrogen is one of the most important; estrogen has been shown to promote the amount of the mood neurotransmitter serotonin available to the body, thereby providing an important antidepressant effect. However, a recent review suggests that the role that hormones like estrogen play in depression is directly related to their wide fluctuations rather than the fact that they are becoming deficient.

So, why is this important? For one, it highlights that hormone replacement is not the only answer for depression during menopause but rather, that it’s critical to pay attention to timing, i.e. when preventive strategies, including exercise, behavioral therapy and antidepressants might yield the greatest long-term benefits. Yet, it also suggests that estrogen-based therapies may indeed have a role in depression during menopause. And, since estrogen alone therapy has been shown to up the risk for ovarian cancer except for in women who’ve had hysterectomies, it also helps supports the need to explore the role plant-based estrogens in treating menopausal depression; fortunately, S-equol has already shown promise in this regard.

Feeling the window of vulnerability? There’s no time like the present to insure that you aren’t simply looking through the window but actually seeing that there’s hope and help on the other side. There are a lot of resources and strategies available to address depression during this time of life. While depression may be a “menopause-associated risk,” like others, it can be successfully ameliorated.

Thank you to Dr. Claudio Soares from McMaster University for an excellent review of depression in menopause and the inspiring, succinct “windows of vulnerability” terminology.

Monday A-Musings…It’s a pillow. No. It’s Chillow!

Posted by Liz on Dec 20, 2010 in hot flash | 2 comments

Newsflash: hot flashes and soy…more on genistein

Posted by Liz on Dec 17, 2010 in hot flash | 0 comments

There’s some exciting news on the soy isoflavones front: for the first time, researchers have shown that a synthetic formulation of genistein, a plant-based estrogen component of soy, may actually reduce both the frequency and severity of hot flashes. Genistein is an interesting isoflavone, in that studies have linked it to some truly potentially important benefits, including preventing or reducing heart disease risk and attenuating bone loss in menopausal women. While the verdict is still out on its role in these conditions, it does appear to influence hot flashes and only in the best way possible! Moreover, this is the first time that a synthetic formulation has shown to have some degree of benefit in this regard.

Granted, this is a small study of only 84 menopausal women, 40 of whom took synthetic genistein for 12 weeks and 40 who took a sugar placebo tablet. The results? By the study’s end, women taking 1, 30-mg capsule daily reduced the number of hot flashes by half (51%, from about 10 per day to 5 per day) and also experienced significant declines in how long they lasted. The synthetic formulation, which was standardized, was also shown to be safe and did not detrimentallly impact the lining of the uterus. Notably, however, the researchers did note that there are not enough data to recommend isoflavones to women who’ve had breast cancer or at high risk for developing, even though current data suggest that exposure does not adversely affect breast tissue density or cancer cell proliferation, meaning that it is likely that with more study, they will ultimately prove safe for use in breast cancer patients.

Your key take-away is that there may be a viable option for women who are flashing but want to stay away from hormones. However, this is what we still need to know:

• Will genistein work on larger groups of menopausal women?
• Is formulation important?
• Is the 30 mg dose the lowest dose that will confer these sort of benefits?
• Are there any other factors that these women had in common that might be influencing outcomes?

As with any novel data like these, it’s great to be cautiously enthusiastic. Stay tuned!

Musings: Menopause ain’t nothing but a…

Posted by Liz on Dec 10, 2010 in menopause, musings | 2 comments

Number?

Sometimes it is just that. And sometimes it’s not.

I’m reposting this piece, which first ran in June 2009, because a reader recently challenged me on my consistent opinion that menopause is not a disease.

“Menopause is truly a disease. There are many so called true diseases that cause far less damage to a womens body.”

Actually, the conditions that wreak the most havoc on a woman’s body as she grows older appear to more closely associated with aging than with menopause. Theoretically, this would mean that our best strategy to address prevention or risk reduction, right?

Here are the facts:

Australian researchers suggest that many of the more common complaints of menopause may be possibly related to aging in general and not specifically the transition. In fact, in a study presented during last month’s 8th European Congress on Menopause, they reported that menopause is strongly associated with some but not other common complaints.

So what about the other symptoms? After reviewing data from 58,724 women (ages 45 to 50) participating in the Australian Longitudinal Study on Women’s Health, the strongest associations were seen between menopause and hot flashes/night sweats. These findings remained after adjusting for age during the study, age at menopause, smoking history, body mass index, sociodemographics (i.e. education, income, marital status and geographic location) and other factors that might influence outcomes. Other symptoms, including difficulty sleeping, stiff/painful joints and poor or fair self-reported health were also associated with menopause but to a much lesser extent. Headaches, migraines and incontinence appeared to be more strongly related to the aging process.

The researchers say that treatment (in this case, HRT) should be geared primarily towards alleviating vasomotor symptoms. Less clear, however, is how long therapy should be continued, since some symptoms can last for more than seven years. This study is scheduled to appear in Menopause.

Last September, I wrote a post about a survey being reported at the North American Menopause Society’s Annual meeting suggesting that women can actually discern the symptoms of menopause from those of aging.  Interestingly, many of the symptoms overlapped; in fact, 84%, 72%, and 77% of respondents associated vaginal dryness, urinary stress incontinence and weight gain, respectively, strictly with menopause, even though they can also be caused by aging as well.

So, what’s the primary point? It can be difficult to tease apart the effects of aging and the effects of menopause. Clearly, these new Australian data add a bit more to the confusion, and reinforce the point that more research and funding is needed in this particular area.

When I write that “menopause is not a disease and should not be treated like one,” what I am really saying is that disease, especially when it’s chronic can stigmatize, frighten and even create self-loathing. By offering up hormone replacement therapy as the only viable “solution” to preventing and ameliorating the symptoms of menopause and outrightly dismissing gentler alternative strategies, the medical community takes on the stance that Author Louise Foxcroft has written about:  “fear of the menopause is something we have learned, and it has grown out of a general, male and medical distaste for the idea of the menopause perceived as an end to viability, fertility, beauty, desirability and worth. Since the French physician de Gardanne coined the new term ‘ménépausie’ in the early nineteenth century, an onslaught of opinion, etiology, treatments, and not least and lest we forget, profit has followed. Women need to unlearn their dread and recognize that menopause is not, of itself, dread-full; that we are merely the victims of our biological process.”

So which comes first? Menopause and disease or aging and disease? Regardless, we can go out fighting or we can give in.

in all, a good thing, right?

Wednesday Bubble: Don’t Pause!

Posted by Liz on Dec 8, 2010 in menopause, musings, new approaches | 0 comments

Hey, stop the presses! There’s a brand new, one-size-fits-all solution to menopause – Don’t – as in,  Don’t Pause. Billed as a breakthrough advancement in treating early menopause symptoms (according to the press release), Don’t Pause contains a proprietary mixture of pomegranate extract, green tea, chromium and selenium especially geared towards helping you ‘grow young responsibly.’

Um, okay. So what does that mean? It appears to mean that this wonder formulation will not only halt symptoms of menopause but also improve youthfulness and sexuality, reduce the risk of cancer, osteoarthritis, heart disease and epilepsy and enhance the effects of exercise on weight distribution. Wow! All that in a single pill. Have I mentioned that it’s also Hallal and Kosher?

There is one bit of messaging surrounding this wonder product that I believe is responsible and right on: the time to start addressing menopausal symptoms is before they start. That means you – 30 some year-olds and 40 some year-olds – there is no time like the present to build bone and preserve bone health, get into shape and start managing your weight, eat healthy, address stress and build those support networks. These are the type of steps that can go a long way to addressing menopause symptoms and also to take poetic license, truly help you grow older responsibly.

Don’t pause? What do you think?