Wednesday Bubble: just the facts, Jack.
Today’s Bubble carries a warning that we all need to heed: results of one study cannot be applied to another.
Repeat after me: results of one study cannot be applied to another.
Last year, I wrote about an interesting study out of Baylor University showing that hypnotic therapy was effective for decreasing the frequency and severity of hot flashes among women with breast cancer. Because the results were so favourable, researchers received a sizable grant from the National Institutes of Health for a much broader study to examine the potential role of hypnosis in post-menopausal women experiencing hot flashes, but in comparison to another mind-body intervention.
Now mind you, there is evidence that hypnosis is a promising intervention among non-breast cancer patients but the studies that have been conducted have been small and have not specifically examined its therapeutic role in women entering menopause naturally.
Let’s look at the facts, shall we?
The Baylor study enrolled 51 breast cancer survivors, 25 of whom received hypnosis for their hot flashes and 26 who did not. Women receiving treatment experienced an impressive 68% reduction in a hot flashes while women receiving no treatment did not experience any relief. Expectations of relief, better known as a placebo effect, cannot be ruled out in terms of skewing the results, which is why the larger study is comparing treatments. Again, this study showed that women who experienced chemotherapy-induced menopause experienced some relief from hot flashes by undergoing hypnosis.
That brings me to the extrapolation part.
The Hot Flash Relief program is an audio program that theoretically relieves hot flashes; all that you have to do is listen to a 20 minute audio CD for 21 days. It claims to based on results of the Baylor study, and tested under questionable study conditions. Hot Flash Relief bills itself as an amazing breakthrough to help you get relief from hot flashes and night sweats without pills, hormones or risk. If you are not entirely satisfied, Hot Flash Relief will refund your money.
I’d like to point a few things out:
- The Baylor study was conducted under controlled conditions
- The Baylor study was not carried out among women who had undergone natural menopause
- Hypnosis was carried out in person and under the guidance of a trained professional
- The efficacy of hypnosis looks good but further study is required
Let’s look at Hot Flash Relief:
- Hot Flash Relief claims that it can help any woman with hot flashes
- Hot Flash Relief bases its effectiveness on a “study” in which women were sent the CD and then asked to report back on it via testimonials
- Hot Flash Relief was developed by a top US hypnotist, Tom Nicoli, whose voice you will hear on the audio CD. Although he is certified and is reputable in the weight loss field, research is not his game
- Audio hypnosis has not proven as effective as self-hypnosis for women with menopause
I want to believe, I really do. But the folks at Hot Flash Relief may be considerably more out of their minds than most of us menopausal midlifers. Before you drink kool aid, on this or any other strategy, just take a look at the facts. Money guarantee or not, you will be glad that you did!
Read MoreMenopausal…pregnancy?
I ran across a piece on MSNBC.com over the weekend, in which a U.S. fertility doctor defends his decision to treat older recipients of fertility treatments. The result? Pregnancies well into a time in life when a woman is typically experiencing the cessation of reproduction and moving into menopause.
Unfortunately, the mother featured in the story died at age 69, leaving behind two-year old twins.
While the doctor states that he would prefer to treat women who are likely to live long enough to parent their children, he also asks the following: “How old is too old to become a mom?”
Ironically, a little over a month ago, researchers presented data at meeting of the European Society of Human Reproduction and Embryology outlining successes in ovarian transplants. These procedures involve removing the ovaries and then freezing and preserving them for implantation at a later date.
Although this technique has traditionally been used to preserve ovarian function among women undergoing chemotherapy, the option is now being extended to women with other illnesses. However, before ovarian transplant becomes more widely available, for example, to women in their 20s or 30s who might want to delay childbirth until later in life, researchers say that they need to determine how the ovary will function, e.g. as a 30 year- old ovary in a 45 year- old woman or as a 45-year old ovary?
Both of these reports strike me as Frankensteinian, playing with nature in the most unnatural way to delay an event, reproductive decline, that has long defined human evolution.
Are fertility and ovarian treatments for the menopausal set poised to replace HRT as the panacea for aging? How old is too old? Like Dr. Frankenstein, have we gone too far?
Read MoreWednesday Bubble: What did I forget/hear/see/say…
If you’re anything like me, you are starting to forget things. Things you need to do, why you walk into rooms, shopping lists, things you said, the whole nine yards. For me, it’s become the norm, not the exception and while I spend a lot of time making jokes about it, it also drives me crazy.
Yet, today’s Bubble is not one that I’m likely to forget. I’d like to think of it as one part inspiration and one part WTF? And it leaves me with a whole lot of questions to boot.
Study findings suggest that gaining weight during menopause may increase the risk for loss of gray matter. Gray matter refers to the cortex of the brain, which contains nerve cells. It is involved in muscle control, sensory perception (seeing/hearing), emotions, speech and finally, memory.
In this study, which was published in the online edition of the journal Psychosomatic Medicine, researchers evaluated brain imaging data, demographic information (height, weight) and behavioral measures (perceived psychiatric stress) obtained from 48 healthy postmenopausal women. Data were collected over a 20-year period.
The findings showed a unique association between increase in body weight during the transition from peri- to post-menopause (as measured by body mass index or BMI) and a 22% reduction in grey matter volume. These findings occurred in women who were otherwise healthy, had no history of heart disease or psychiatric illness and did not meet the threshold for obesity (>30 BMI). All women had also undergone natural menopause.
The researchers suggest that weight gain during menopause is a “highly modifiable risk factor” that may help to prevent or slow “potential alterations in brain function that are important to quality of life.”
I’ve written previous posts on cognitive issues during menopause, whether they be linked with life stressors, HRT or aging. Now it seems that researchers are telling us that weight gain may also be a risk factor.
Less clear is how much weight gain and what we should do about it. In general one solution to combating weight gain in midlife is restraint. Coupled with exercise, this may just be the magic formula. In the meantime, I think that we need a few more studies to take a closer look at brain matter changes in midlife.
What do you think?
I just forgot why I’m asking you that…!
Read MoreThree’s a charm…breast cancer, lung cancer deaths and ovarian cancer
More news on the hormone therapy horizon. Not only has HRT been shown to increase breast cancer risk and death from lung cancer, but now researchers are reporting that it also increases the risk of ovarian cancer. Wow – three’s a charm, eh? And yet, many in the medical community continues to support its use in perimenopausal and menopausal women.
In this latest study, published in the Journal of the American Medical Association, researchers evaluate data from 909,946 Danish women between the ages of 50 and 79 who had not previously developed hormone sensitive cancer or had had hysterectomies.
Compared to women who never took hormones, current hormonal therapy users had 1.38 greater incidence of all types of ovarian cancers and and 1.44 greater incidence of cancer affecting the surface of the ovaries (i.e. epithelial ovarian cancers) regardless of type of hormone therapy, administration or duration of use. Notably, risk declined with years since stopping hormone therapy.
Ovarian cancer accounts for about 4% of all cancers in women in the US. Yet, it is one of the most lethal types and often symptomless in the early stages. Roughly half of the women it affects die within five years. In this study, hormone therapy increased the risk for developing ovarian cancer by 38%.
Like any, this study had limitations that might have affected the results, such as not adjusting for age during menopause, or use of birth control pills (which have been shown to reduce ovarian cancer risk). Still, it is one of the largest studies to date examining this issue and the results do not fare well for use of hormones during menopause.
If I seem a bit angry about this; I am. Repeatedly, data show that hormone replacement, albeit an effective solution for declining hormones and their effects, is dangerous. I wonder how many women need to get sick or die before someone takes notice and removes hormones from the market.
Read MoreWednesday Bubble: close to the bone
Let’s be honest; bone loss is a natural part of aging.
As I’ve written previously, women are at particularly high risk for bone loss as they age because of declining estrogen levels, and in turn, a reduced ability to prevent an increase in net bone resorption (or bone loss due to the activity of bone cells). Although isoflavones (plant derived compounds with estrogen-like properties) have been reported to protect bone from deficiencies in estrogen, there have been little data that show that they can specifically influence resorption.
Hence, I was interested in a small study published in the online edition of the Journal of Clinical Endocrinology & Metabolism examining of four different types of isoflavone supplements on bone resorption. In it, researchers compared supplements containing the isoflavones soy cotyledon (derived from the leaf coating around the seed of the soybean), soy germ (the embryo of the soybean), kudzu and red clover to 1 mg estradiol plus 2.5 mg medroxyprogesterone or 5 mg/day of the anti-osteoporosis agent Actonel®.
Study findings showed that the hormones plus progesterone or Actonel significantly decreased net bone resorption by as much as 22% and 24%, respectively. In comparison, only soy isoflavones derived from the cotyledon and germ had a significantly modest effect on reducing bone resorption (by 9% and 5%, respectively), while kudzu and red clover did not.
Clearly, this study, while small, shows that isoflavones can help to prevent bone loss during menopause. However, not all isoflavones are created equal, and source appears to as important as insuring that the product is standardized and manufactured in a licensed facility. What’s also notable about this study is that the researchers did not examine whether or not ingesting the specific isoflavones via food sources would have an equally beneficial effect.
Because it can be difficult to discern which products contain which types of isoflavones and the amounts, it’s best to speak to a nutritionist or a naturopath before supplementing your diet. No bones about it though; the results are promising enough to warrant further study.
What steps are you taking to prevent bone loss as you age? And if you use soy, in what forms are you taking it?
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