Posts Tagged "perimenopause"

Three’s a charm…breast cancer, lung cancer deaths and ovarian cancer

Posted by Liz on Jul 17, 2009 in HRT, ovarian cancer | 0 comments

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.

Feeling irritable?

Posted by Liz on Jun 12, 2009 in Uncategorized | 5 comments

You’re not alone. Data from a National Consumers League survey suggest that as many as 40% to 60% of menopausal women feel irritable or moody (depending on the severity of their symptoms). Consequently, it’s not surprising that results of a recent study that appeared in the March issue of Psychotherapy and Psychosomatics suggest a medical reason for irritability during menopause as well: fluctuating hormones.

Researchers evaluated irritability and depression, vasomotor symptoms and insomnia in 163 peri- and post-menopausal women attending a clinic. Participants had either never used hormones or were taking Livial. Irritability was defined as either outwardly directed (towards another person) or inwardly directed (towards oneself). They also examined the presence of high blood pressure, heart disease, diabetes or thyroid disease.

The results? According to study findings, outward but not inward irritability was significantly associated with follicle stimulating (FSH) and luteinizing hormone (LH) levels (which are markers of aging ovaries).

Women with chronic disease (about a third of those participating) tended to have significantly higher irritability scores, which the researchers attributed at least partially, to aging (and its association with illness) and not to menopause specifically. Like their healthier peers, outward irritability was found to be related to FSH and LH levels.

No association was found between irritability and vasomotor symptoms or insomnia.

So, there appears to be a medical reason for being outwardly irritable during menopause, one that has more to do with hormone levels and less, with hot flashes, night sweats and insomnia. If you aren’t willing to get on the HRT train, you might want to look into some alternatives, such as progesterone cream or soy. Self-deprecation, on the other hand, requires a bit more finesse and self-awareness to get the bottom of what ails.

Regardless of how you choose to address your irritability, a general rule of thumb applies: put down the knife and breathe!

Bad to the bone

Posted by Liz on May 8, 2009 in bone health | 0 comments

[youtube=http://www.youtube.com/watch?v=_7VsoxT_FUY]

Are hot flashes and other vasomotor symptoms an indication of adverse bone health? According to data coming out of the Study of Women’s Health Across the Nation, they might possibly be. Notably, while studies have examined the association between vasomotor symptoms and bone mineral density (BMD) previously, they have not followed women as they undergo the menopausal transition and rather, focused on women after they completed menopause.

Here are some of the study’s highlights:

• 2,213 women, ages 42 to 52, were included in the five year study. all had a uterus, were not using hormones, and had not yet entered menopause (i.e. still had their periods)
• Menopause stage and degree of vasomotor symptoms were assessed each year by questionnaire
• Bone mineral density was measured at the study’s start and each year. Dimensions were taken at the spine, hip, and pelvis

Study findings, which were published this past March in Menopause, showed that bone mineral density was lower in women with vasomotor symptoms compered to those without. What’s more, these effects varied depending in the stage of menopause. For example, women in pre- and early perimenopause with vasomotor symptoms had lower bone density measures in their pelvic areas, while women in postmenopause with vasomotor symptoms had lower BMD in their spine and hips. Overall, bone mineral density was consistently lower in women who experienced frequent vasomotor symptoms versus those who did not. In these cases, lower bone density was more evident in the lumbar spine in early peri- and postmenopause, and in the pelvis among early pre-menopausal women.

Whew! What does it all mean?

According to researchers, the findings suggest that vasomotor symptoms in menopause are linked to bone density deficits, which vary depending on the severity of symptoms and menopausal stage. This may help women and their practitioners devise more targeted strategies to protect bone health at appropriate times, and potentially encourage regular screening to prevent osteoporosis, fractures and related problems. The National Osteoporosis Foundation’s Bone Tool Kit includes information on calcium, vitamin D and exercise. Yoga Journal also has some great advice regarding safe and helpful postures.

Hot flashes and night sweats may be bad for the bones. But there are many positive steps we can take to protect them. Afterall, we only have one set. There’s no time like the present to take better care!

Onions and bones…nothing to cry about

Posted by Liz on Apr 17, 2009 in bone health | 0 comments

I love onions. Red onions, scallions, yellow onions, spring onions, shallots; you name it. Sauteed, raw, caramelized, fried, baked. Yum! So, imagine my pleasure when I stumbled across an interesting study in the July issue of Menopause that shows a link between onion consumption and increased bone density. Yowza!

Okay, so your breath might be a bit ripe but your bones will love you for it!

Although calcium, vitamin D supplements and exercise are effective prevention tools against osteoporosis, they have not been shown to add much in the way of slowing bone loss. To address this hole in therapy, researchers have been looking towards phytochemicals, i.e. natural compounds in plants, to examine if they might increase the activity of bone building cells (osteoblasts) and decrease the activity of cells the breakdown bones (osteoclasts).

Spurred by studies in rats, researchers analyzed the bone density (repeated five times) and onion consumption (from 2 or more times daily to 1 to 6 times a year to never) in 507 perimenopausal and postmenopausal non-Hispanic white women, age 50 and older, participating in the National Health and Nutrition Examination Study. Women were divided  into four groups based on their onion consumption:

• Less once/month
• 2 times a month to 2 times a week
• 3 to 6 times a week
• Once a day or more

Because certain variables are considered risk factors for osteoporosis and could influence study findings, the researchers also measured age, smoking status, calcium intake, use of vitamin D supplements, thyroid hormone levels, intensity of exercise regimens (i.e. none, moderate, vigorous), use of estrogen, and body mass index.

The findings? The more onions the women ate, the greater the increase in their bone density. In fact, women who consumed onions at least once daily had an overall bone density of their spine that was 5% greater than women who consumed onions once a month or less.

What the study didn’t tell us was the quantity (e.g. one cup) and type of onions consumed.

Studies comparing the bone density of smokers and non-smokers at different ages have shown that a bone density difference of 4% can confer a 41% greater risk of hip fracture. So while a 5% difference seems marginal at best, the potential reduction in the risk of fractures is great.

The researchers caution that certain compounds in onions, such as quercetin, have been associated with cancer causing properties. However, they note that animal studies have found no evidence of such problems. Although further study is needed to determine if women who ate onions also consume foods other than onions that might contribute to their reduced risk for osteoporosis, they believe that onions hold great promise as an addition to other measures that prevent osteoporosis.

Me? I’m all for erring on the side of onions. Tears and all!

Sticks and stones

Posted by Liz on Apr 6, 2009 in bone health | 0 comments

Remember that nursery rhyme from days gone by? It appears that vasomotor symptoms, including hot flashes and night sweats, may be as powerful in contributing to breakage as sticks and stones. Or at least in contributing to a lower bone mineral density (BMD). BMD reflects the strength of an individual’s bone, usually in relation to calcium content.

Researchers analyzed data for 2,213 women participating in the Study of Women’s Health Across the Nation. At the time of the study, all participants had their uteri intact, were not using hormones and were determined to be in pre- or perimenopause.  Menopausal stage and vasomotor symptoms were assessed via questionnaire and BMD was analyzed at yearly follow up visits.

The results, which are published in the March/April edition of Menopause, showed that BMD was consistently lower among women who had had vasomotor symptoms than among women who had not. These findings remained even after researchers adjusted for factors such as age, time within each menopausal stage, race/ethnicity, study site, and stage of menopause at the time that the study began.

Additionally, BMD was even lower among women who had more frequent night sweats and/or hot flashes than those who did not.

Notably, these effects varied by anatomic site and were most prevalent in the lumbar spine and hip in postmenopausal women, and at the femoral neck (pelvic region) among pre and perimenopausal women. More troubling, even women in the earliest stages of menopause also experiencing vasomotor symptoms  had lower bone mineral density than those who did not.

According to the National Osteoporosis Foundation, it is never too late to start a program aimed at halting bone loss and preventing future fractures. Because data are now suggesting that vasomotor symptoms may be linked to lower bone mineral density, it might be worthwhile to speak to your doctor to determine if you should undergo BMD testing. Other important steps include making sure that you are getting adequate amounts of vitamin D and calcium, engaging in weight-bearing activity, avoiding cigarettes and minimizing alcohol intake.

There is not time like the present to avoid potential pitfalls (no pun intended). Only you and your health practitioner can determine the proper steps to take. I’d also encourage you to read more about osteoporosis at the National Osteoporosis Website. The information is thorough and easy to navigate through.

Sticks and stones may break your bones. And hot flashes and night sweats might hurt you? Yikes!