Posts Tagged "menopause"

Danger! Danger! HRT prescribing lagging behind recommendations

Posted by Liz on Dec 6, 2010 in HRT | 0 comments

[youtube=http://www.youtube.com/watch?v=RG0ochx16Dg]

Here’s a disturbing piece of news:

Stanford University School of Medicine researchers are reporting that when it comes to prescribing practices, physicians across the country continue to lag behind recommendations from FDA and other organizations cautioning that hormone replacement therapy (HRT) should be used at the lowest dose and shortest period of time possible or only as a last resort. This, despite accruing evidence warning of the dangers of hormone therapy.

While use of hormonal therapy has gradually declined ,some 6 million women continue to place themselves at risk annually. This risk appears to be somewhat exacerbated by the fact that that their doctors, especially ob/gyns, have not changed their prescribing habits very much. Indeed, less than a third of hormone therapy users surveyed in the IMS National Disease and Therapeutic index (which formed the basis for this latest bit of information) were given prescriptions for lower-dose hormone pills, vaginal suppositories or patches. Especially at risk are women old than 60 years in whom the risk/benefit of HRT is very unbalanced, more than a third of whom continue to use hormonal therapy to address symptoms. Thankfully, however, women younger than 50 and up to age 59 appear to be paying attention to the headlines and giving up hormones altogether.

Although the reasons that doctors aren’t paying attention are unclear, the researchers suggest that perhaps clinical practice has not caught up with data or that older women in particular, are satisfied with symptom control and don’t want to rock the boat.  Or perhaps many women in this age group remain unaware of the increased risk of heart disease and breast cancer (among others) associated with menopausal hormonal therapy. Regardless, the message isn’t getting through.

How do you change prescribing habits when there’s a breakdown in communications or when study investigators suggest that “it takes a huge event to change clinical practice?”  A huge event? I don’t know about you but I think that increases in heart disease and cancer risks are pretty big events. Ladies – it’s time to take this matter into your own hands. Speak up. Work with your doctor, discuss the treatment strategy he or she is recommending and especially when it comes to HRT, ask the hard questions.

Right now, like Robot from ‘Lost in Space,’ I don’t think that we can accept any other course of action other than to take action.

Wednesday Bubble: all juiced up and ready to go

Posted by Liz on Dec 1, 2010 in heart disease, physical fitness, weight | 0 comments

Did you catch last week’s news about pomegranate juice and kidney disease? It seems that pomegranate juice just might be the next best thing… or not. The same holds true for orange juice, weight loss and heart disease. So before you get too excited about the wonders of the orange, let’s take a look at what research is telling us.

Middle-age is associated with a slow down of metabolism, distribution of weight and of course, an increase in risk for certain diseases, in particular heart disease. For women specifically, hormonal changes – namely a steeply progressive increase in testosterone, can contribute to a risk of developing metabolic syndrome (i.e. the cluster of risk factors — abdominal fat, high blood pressure and cholesterol levels and insulin resistance –that increases the likelihood of developing heart disease and diabetes). In fact, data from the Study of Women’s Health Across the Nation has shown that women have a a 1.45 times increased risk of developing the metabolic syndrome in perimenopause and a 1.25 increased risk after menopause. So, the cards are automatically stacked against us. Let’s add overweight and obesity, poor eating habits and sedentary behavior to the mix and we have a veritable “heart condition in the making” cocktail.

Wondering where this is going?

Across the board, the key ways to improve one’s risk of developing disease include a balanced diet rich in fruits, vegetables, whole grains and good fats and regular physical activity. The formula isn’t a magic one and but it’s been shown time and again to improve the odds. However, we are a society of instant gratification so it’s easy to fall into the trap of a quick fix, whether that entails botox, diet pills, diet plans, sweating or the like without paying much attention. Hence, when I saw a study setting the stage for the latest and greatest answer to our problems, i.e. orange juice, I had to take a closer look.

Like pomegranate juice, orange juice is rich in flavonoids, naturally-occurring plant and vegetable compounds that have both antioxidant and anti-inflammatory properties. Orange juice is also an important source of vitamin C, folate and potassium, which have been shown to help protect cells from bad, LDL cholesterol, reduce the risk of atherosclerosis and possibly help lower blood pressure. But, can drinking orange juice help prevent heart disease in middle-aged women who are already at risk?

When researchers compared 26 premenopausal women between the ages of 30 and 48 who were considered overweight or obese, and asked them to engage in a 1-hour aerobic exercise (running) 3 times a week and either drink 2 glasses (16 oz) of orange juice daily or not, they observed the following:

• Regular aerobic exercise led to an average loss of 11% to 15% of fat and 1.2% to 2.5% of BMI depending on the group that women were assigned to.
• Women who drank orange juice along with their thrice-weekly exercise had as much as a 15% decline in LDL-cholesterol and an 18% increase in HDL (good) cholesterol.
• Daily orange juice intake also led to less muscle fatigue and better overall responses to aerobic training.
• Although drinking orange juice added to daily caloric intake, it actually led to a decreased consumption of other foods.

Should you start drinking orange juice to lose weight and save your heart? Not so fast. This study simply shows an potential associated benefit and does not prove that drinking orange juice causes a reduced risk in heart disease,; mind you, these women were only studied for three months. Moreover, the study was small and a much larger group is needed to demonstrate proof of a benefit. Additionally, the results did not show which components in orange juice are specifically linked to a potential risk reduction, or if there are components in the juice that are shared by other juices. On a more positive side, it did demonstrate the benefit of a balanced diet, regular physical activity and improvements in performance, perhaps as a result of extra nutrients and energy provided by the juice.

Time to juice up? Nope, just time to start opening your eyes a bit wider when you see headlines touting the amazing benefits of a quick fix. Rule number 1? There are no quick fixes.

Monday Musings: who are you wearing?

Posted by Liz on Nov 29, 2010 in Uncategorized | 6 comments

Labels. Our world’s full of them. And they are no more pervasive than when applied to women, particularly as we age and start to become invisible, not only to others but also to ourselves. In fact, I am becoming acutely aware that some of these labels have slipped into my vocabulary.

That’s why I’m beginning to more fully appreciate the move that Prince made years ago when he changed his name to a symbol and became “the artist formerly known as…”Granted, one can argue that it was a publicity move of epic proportions and it sure did garner a lot of attention. But at the same time, it also shifted control. Perhaps he became himself again.

As of today, I am challenging myself to step outside the comfort zone that labels provide and consider if I am not one of the following, who am I?

• a middle-aged woman
• a Cougar
• menopausal
• a woman ‘of a certain age’
• an old maid?

Better yet? Who are you? Have you, like me, allowed yourself to slip into these labels like a comfortable pair of socks?

Our generation of women came of age on the tails of Gloria Steinem, Shirley Chisolm, Ann Richards and Bella Abzug, women who not only reinforced the message that we should live within our skins but, that we should do so proudly. And yet, many of us have shed that pride and as I wrote last month, have somehow stopped wearing ourselves, as if we’ve somehow crossed into the wardrobe of no return, where invisibility is safer than rebellion.

I’m certainly not going to start burning my bras or marching in Washington for older women’s rights (see, there I go again). But I am going to make damn sure that as I near my 50th year, I start wearing myself again.

What about you? Who are you wearing?

Transition:one pill makes you…

Posted by Liz on Nov 22, 2010 in Uncategorized | 0 comments

I love it when I run across vintage advertising. I featured this ad over a year ago and am reprising today, namely because it speaks to the one-size-fits-all mentality of hormone replacement therapy and addressing the symptoms of menopause and aging.

The rub? We may be women but we have unique needs. Do yourselves a favour: take the time to not only explore but also understand your symptoms. Speak to a practitioner you trust before accepting any prescriptions. And the transition? While it certainly isn’t a picnic, it’s also not all about tears.

Just a few musings for a Monday….

Aging and wrinkles and menopause. Oh my.

Posted by Liz on Nov 15, 2010 in appearance, women's health | 10 comments

In my weekly research, I ran across the following headline:

White women’s skin may show wrinkles sooner

The story? That after menopause, white women develop wrinkles more quickly than their black peers — not as a result of differing levels of estrogen and its decline — but because of aging.

Okay. Um. So what?  Is this really news deserving Google search result after search result? And why does it matter? Is this yet another racial divide we need to concern ourselves with, that is, that my black female friends are going to look better than me in 10 years time? Moreover, do I care?

In all fairness, the news was based on a study of 21 black and 65 white women in their 50s who had gone through menopause. The study’s goal was to evaluate skin elasticity and facial wrinkles. And while skin elasticity, which was found to be equivalent among all women despite race, is thought to be related to estrogen levels, wrinkling, which is at the skin’s surface, is believed to be subject to aging and the environment. This is not conclusive but merely speculation.

The overall message is that younger white women might want to limit sun exposure to stave off some of this wrinkling. Good advice. For black women in particular, it’s not that they won’t wrinkle but that they may not wrinkle as soon as their white friends.

Of note, this small study is part of a larger trial that is examining the effects of hormone therapy on heart disease. And as a substudy, the researchers will be collecting information on how hormones might affect (or benefit) skin aging. However, data have already shown that the reality is inconclusive when it comes to hormones and aging skin.

That’s the scientific part. Now, let’s get the larger issue.

Another wrinkle has developed in the story of discrimination (sorry for the pun): how we can add race to the “aging sucks” equation.

As women, we are already guaranteed the disappearing mirror, invisibility dilemma as we age. It interferes with our self-esteem, our relationships and our careers. So we botox and implant and lift and smooth to keep the ‘dream’ alive. Now, researchers have not even provided another reason to hate ourselves but also, to abhor friends who are racially different than we are and may have an advantage when it comes to their appearance.

Want to hear something really ironic? Research shows that as women, we possess the ultimate weapon against aging: our friends. Black, white, hispanic, asian,  native, round, thin, tall, short…yup, all flavours, all sizes, all colors. Our friends will keep us young and they will keep us healthy too.

So can we spend a bit more money, time and energy on issues that really matter to our health? Wrinkles? They just are.

Next.