Posts Tagged "menopause"

Omega-3s and depression

Posted by Liz on Nov 12, 2010 in depression | 4 comments

According to recent estimates, more than 20% of women undergoing menopause have major depressive disorder. In fact, mood disorders and depression affect a disproportionate amount of women in the peri- and postmenopausal stages compared to women in pre-menopause. Moreover, these mood disorders tend to occur in conjunction with hot flashes.

While researchers have yet to discover the cause of the depression/mood surge during menopause, they continue to explore therapeutic strategies that might help to take the edge off. And surprisingly, numerous studies actually point to the value of omega-3 fatty acids — eicosapentaenoic acid (EPA) and docosahexaenoic acid (DHA) — for alleviating depression. Besides wellbeing, one of the reasons this is so important is that research has linked depression with other serious conditions including heart disease and stroke. The one thing that all these conditions have in common is that they are believed to be caused, at least in part, by an inflammatory response by the body. One particular action of omega-3 fatty acids is that they have been shown to lower inflammation, which makes them potentially useful in treating disease.

So, can omega-3s help stave off depression in menopausal women? In a very small study published in the online edition of Menopause, peri- or postmenopausal taking daily omega-3 fatty acids  (Lovaza, 2 g daily) for 8 weeks had significant declines in depression scores, number of daily hot flashes and hot flash interference scores.  During the course of the study, 70% of women responded, and those whose depressive symptoms declined also experienced declines in hot flashes, indicating both a connection between the two and a possible role for omega-3s in menopause.

However, this study was very small, enrolling only 20 women and more evidence is needed with larger numbers of women before omega-3s can be recommended as a treatment for mood and hot flashes during menopause. Moreover, it’s essential to note that a thorough analysis of scientifically sound studies has recently pointed to the EPA component as driving as much as a 56% reduction in depressive symptoms, that is, if the supplements used contain more than 50% of standardized EPA or pure EPA. Therefore, when it comes to fish oils, the ratio of EPA to DHA may play an important role.

I’m excited because this study brings us another step closer towards demonstrating that menopausal symptoms can indeed, be effectively alleviated without hormonal therapy.

Is your sleep elusive?

Posted by Liz on Nov 5, 2010 in sleep disturbance | 6 comments

Ever since I discovered Zeo, I’ve become pretty interested in sleep and in discovering the reasons why my sleep (and so many other women’s that I know) is lousy. What I’ve learned is that it’s while it’s easy to define the problem, it’s not so easy to assign an overriding factor. In fact, it appears that the more researchers delve into this elusive but necessary component of our lives, the less they truly understand.

Sleep issues tend to plague both men and women as they age. Indeed, deep sleep (or at least its electrical representation, also known as “electroencephalographic wave amplitudes”) has been shown to dwindle was we grow older, resulting in lighter and frequently interrupted sleep. Add factors such as hormones, health, life strain/midlife issues and psychological stress and you may end up exacerbating an already existing sleep deficiency or creating an entirely new problem. Moreover, researchers have shown that distinct sleep patterns might be associated with different influencing factors. For example:

• Difficulty falling asleep may be associated with menopausal symptoms in general, stress, and lower stress hormone levels.
• Awakening during the night might be associated with age, being late in the menopausal transition (before moving into full-blown menopause), having had early menopause, hot flashes, depressed mood, joint pain and stress.
• Early morning awakening may be associated with age, hot flashes, depressed mood, anxiety, joint pain, stress, and lower estrogen/higher fallopian stimulating hormone (FSH)  levels.

Let’s add to the confusion, shall we?

In a study appearing in the upcoming November/December Menopause journal, researchers evaluated health, menopausal status and sleep difficulties in 962 women who were assessed annually from birth through the ages of 48 to 54. The findings?

• The percentage of women experiencing moderate (trouble sleeping a little) or severe (trouble sleeping a lot) sleeping difficulties increased by more than 10% between the ages of 48 and 54.
• Menopause status (i.e. perimenopausal, postmenopausal, perimenopausal, early menopause due to hysterectomy or initiation of hormone therapy) appeared to be related to the presence/severity of sleeping difficulties. In fact, women who had had a hysterectomy, were postmenopausal or had started hormone therapy in the previous year had 2 to 3.5 times greater odds of severe sleep difficulty compared to premenopausal women. Of note, some of these women had not experienced poorer physical or psychological stress than their peers.
• However, with regard to moderate sleep difficulties it becomes more difficult to pin down: once the researchers accounted for certain factors that might skew the results, such as psychological stress, vasomotor symptoms/hot flashes and depression, only women who had had a hysterectomy remained at risk. Although the reasons for this are not entirely clear, the researchers say that sleep difficulties among these women in particular may be related to underlying health before they entered menopause.

The key take-away of this study is that for some women, menopause transitions (i.e. hormonal shifts as they go from pre to perimenopause, and then from peri to postmenopause) influence the severity of sleep disturbances regardless of age or other life or emotional factors. This finding is in line with findings from other studies, which have linked specific hormone-related symptoms such as night sweats to sleep disturbance/fragmented sleep.

However, having had a hysterectomy appears to lead to moderate interruptions in sleep, possibly as a result of prior health issues. So, severe sleep issues = menopause, and moderate sleep issues = ???

The downside of this research truly lies with semantics: how do you define moderate sleep disturbances and in turn, treat them? Do you look for  and address the cause or influencing factors? As noted in an accompanying editorial, multiple factors in various combinations in certain women may very well contribute to overall sleep quality.

In other words, when it comes to sleep, treat the individual, not the masses. Aging, life, hormones all come into play in certain individuals at certain times.

When it comes to sleep, one size does not fit all.

It’s World Menopause Day! Chew on this.

Posted by Liz on Oct 18, 2010 in Uncategorized | 6 comments

For two years, I’ve run the same piece on World Menopause Day. That post remains one of my favorites and I encourage you to check it out. This year, however, I’d rather call attention to the fact that having only one day devoted to menopause seems to run counter to the marketplace. Just check out the endless Wednesday Bubbles on Flashfree and you’ll realize that menopause is big business. Recent estimates place the market for hot flashes alone as high as $8B and that doesn’t necessarily focus on new applications for existing treatments, for example,  antidepressants for hot flashes. With a market this huge and the shrinking HRT market as the result of potential risks exposed in the Women’s Health Initiative, no wonder menopause has become such a hot commodity. Hell, there’s even a burgeoning market for male menopause, an oxymoron if I’ve ever heard one.

• Feeling old? There’s a pill for that.
• Flashing? There’s a gum AND a drink for that.
• Wrinkly skin? Try this wonder cream!
• Don’t like your vaginal appearance? How about some rejuvenation? Better yet, get a two for one and a few botox shots while you’re at it.

…Tapes, magnets, ‘all-in-one’ supplements, everything for anything and everything that ails.

Beneath the hype, marketers are actually saying us that they don’t want us to look or be our age. But don’t try to look younger or date younger because then you are just inappropriate or better yet, a Cougar. In fact, just don’t exist. You’re over the hill, washed up, invisible. Call it a day.

But wait!

Why not have a ‘World Menopause Don’t Call it a Day… Yet?’ The old fat lady dressed inappropriately still has a few tunes left in her.

Rather than celebrate a year or hum a new menopause jingle, can we just find a way to embrace ourselves and what we are going through? We did great in our 40s, comfortable in our skins, more beautiful than ever. And then 50+ or its precipice started to get in the way and here we are, with a day on a the calendar and nothing to wear. How about wearing ourselves for a change or for the change?

Just a wee bit of fodder on yet another day of the year, week, month. Chew on this, won’t you?

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.

Got Zzzzz’s? And the winner is….

Posted by Liz on Oct 12, 2010 in sleep disturbance | 1 comment

Last week I posted about sleep and a new personal sleep coach that I’m trying out – Zeo. I offered to give away a bedside monitor in exchange for a blog comment about sleep, and a willingness to share your thoughts about Zeo on Flashfree in a month’s time. I only received a few comments but I did the old hat trick and pulled out one name:

Meryl K. Evans! Congratulations Meryl – send me your mailing address and I will ship the unit out to you this week.

As a special thank you to Peg and Heather, Zeo has graciously offered free shipping on all units ordered through October 31. Just use FREESHIP at checkout for ground orders.

I’ve got one more night of collecting baseline data and then I start the regular program. So far, I am fascinated and hopeful that it may identify specific factors that are screwing up my sleep. Stay tuned.