Treating the Symptoms of Menopause: How to Guide Your Patients Towards the Best Treatments for Them
Posted by on October 27, 2015 - 2:33pm

The Endocrine Society recently released their guidelines for the treatment and symptoms of menopuse. Chaired by Cynthia A. Stuenkel, MD, these clinical practice guidelines provide new recommendations on the importance of tailoring treatments to suit a woman's individual symptoms, health history, and preferences. Teaching your patients that menopause is a normal, natural transition in life that begins between the ages of 35-55 may help them through this transitional phase. Every woman will experience menopause differently, so your clinical practices must be tailored to each patient. 

Your patients may have heard that one of the ways to manage the symptoms associated with menopause is to replace the hormones they are losing with one of several types of prescription drugs known as hormone therapy (HT)--but they might have some questions about hormone therapy or have heard rumors that it is not safe. There are many types of hormone therapies, and if you are interested in exploring these different options with your patients, please watch the Endocrine Society's online lecture discussing the Treatments of the Symptoms of Menopause (found here!). This lecture, complete with audio and slides will review the primary therapies available to patients so that you might help them decide which option is best in regards to their symptoms, health history, and preferences. Once you learn more about your options as a clinician, you can help your patient make informed decisions as they go through the stages of menopause! Also consider inviting your patients to take the Women's Health Research Institute's Menopause Self-Assessment, as this may help them place their own menopause experience in a personal context.

Teresa Woodruff, PhD Raises Awareness on Sex Inclusion in Basic Science at WHRI October Forum
Posted by on October 26, 2015 - 3:33pm

Last Tuesday, Women's Health Research Institute Director, Dr. Teresa Woodruff launched our 2015-2016 research forum lectures with her presentation entitled "Sex Inclusion in Basic Research: Disruptive Technology, Adaptive Behavior, Sound Investment, Better Medicine." Over 200 people were in attendance as Woodruff gave an overview of sex inclusion from bench to bedside, operating under her hypothesis that the next generation of biomedical advances that improve the lives of all people will require fundamental discovery research that includes sex as a variable. The current climate in science--which operates under the null hypothesis that sex does not matter in care--is upsetting and flawed, seeing as there are several ways sex (whether people or cells are male or female) impacts basic science and clinical care. 

Women in the United States have shorter lifespans when compared to other developed countries. This is in part because the United States has yet to adopt a nation-wide understanding that healthcare for women varies from men in important, life-saving ways. One example is founded in cardiology--where women present symptoms of heart attacks differently than men, and women are more likely to downplay their symptoms in emergency situations, which many care providers may perceive as less critical. An important takeaway from the lecture is that our genes, hormones, environment, and anatomy all play important roles in our health and the sex-inclusion equation. Understanding how our biology impacts our health is a necessary step for the increased inclusion of female cells and animals in basic science, as well as female-inclusion as a variable in clinical science.

Watch the video of Dr. Woodruff's presentation, in case you missed it and check out our October eNewsletter, which outlines ways to get involved in clinical research.

How Women's Pain May Be Taken Less Seriously Than Men's
Posted by on October 23, 2015 - 3:37pm

In a recent editorial in the Atlantic, writer Joe Fassler discusses an experience he had with his wife who needed emergency surgury to remove her ovary--but here's the thing, the ER team didn't believe it was an emergency. After seeing his wife Rachel in excruciating pain one morning, Joe calls the ambulance to rush Rachel to the hospital where they believed she would get immediate treatment--seeing as she described her pain as an "11" on a 1 to 10 scale. However, once they reached the hospitals, nurses told her she would have to "wait her turn" while others dismissed her by saying, “You’re just feeling a little pain, honey." The nursing team and the overseeing physician--who only asked questions and never did a physical examination on Rachel--diagnosed the pain as stones, AKA a "non-emergency" that the CT scan results would most certainly show.

However, after hours and hours of waiting on the CT scan results, the couple learned the doctor who had overseen Rachel's case had left for the day. When a new doctor was brought up to speed--and when Joe demanded the CT scan results be analyzed--the doctor discovered that Rachel did not have stones; she had what is called ovarian torsion--a phenomenon where the fallopian tube twists and cuts off blood flow. This creates a kind of organ-failure pain that is described as excruciating. Rachel was rushed into surgery, 14 and a half hours from when her pain had started.

In typical emergency-room situations, patients are to be immediately assessed and treated according to the urgency of their condition. Most hospitals use the Emergency Severity Index, a five-level system that categorizes patients on a scale from “resuscitate” (treat immediately) to “non-urgent” (treat within two to 24 hours). That being said, there are acute differences in the wait time for men and women in emergency situations. Nationwide, men wait an average of 49 minutes before receiving an analgesic for acute abdominal pain. Women wait an average of 65 minutes for the same thing. 

Writer Leslie Jamison expresses this concept in her essay "Grand Unified Theory of Female Pain" which examines how oftentimes female suffering is minimized, mocked, or coaxed into silence. Researchers at the University of Maryland have also conducted research on this phenomenon and outline their finding is their paper "The Girl Who Cried Pain: A Bias Against Women in the Treatment of Pain." Rachel's experience in the ER unfortunately embodies these biases in a very real way, and hopefully do not reflect the experienes of all women who enter the hospital--but it's a sobering thought. 

Cervical Cancer and Pap Tests--When Should I be Screened?
Posted by on October 21, 2015 - 3:58pm

According to several studies, many women are either receiving unnecessary Pap tests, or smears, to screen for cervical cancer, while others are not receiving the appropriate tests at all. The guidelines for how often women should receive Pap tests need to be widely known. Previously, physicians typically administered Pap tests to women 3 years after they became sexually active, or when they turned 21. After that, women were advised to receive a Pap test once every one or two years.

In March 2012, physicians’ groups released new Pap test guidelines. These recommend that most women do not need a Pap test before age 21, and that between ages 21 and 65, women should typically be tested once every 3 years. However, some women ages 30 to 65 may receive a Pap test in intervals of 5 years, as long as they are being tested for the human papillomavirus (HPV) as well. After age 65, women do not need to receive a Pap test unless they are at a high risk of cervical cancer. Additionally, testing is not recommended for women who have received a hysterectomy and have no history of cervical cancer or abnormal test results. These changes were made because cervical cancer is rare for young women, and grows at such a slow rate, that longer intervals between tests is not harmful.

Recent data shows that although some of these guidelines are being followed, others are not. Looking at positive trends first, the percentage of women aged 18 to 21 who have not received a Pap test has increased from 26% in 2000 to 48% in 2010. Additionally, the percentage of women over age 65 (who have not had a hysterectomy) that have recieved a Pap test has gone down slightly, from about three-quarters in 2000 to two-thirds in 2010.

However, there are also several negative trends visible. The percentage of women between ages 21 and 30 who have never received a Pap test has increased from 7% in 2000 to 10% in 2010. Another shocking statistic indicates that about 60% of women who have had a total hysterectomy, which means they no longer have a cervix, are still receiving Pap tests. While unnecessary tests cost money, they can also produce false results, anxiety, and additional tests and procedures. With increased dissemination and awareness of Pap test guidelines, physicians can work with their patients to provide appropriate care.

Sources:

Questions about Menopause and Beyond? We Can Show You Where to Go!
Posted by on October 20, 2015 - 10:28am

Do you have questions about your health during and after menopause? Try reading Dr. Lauren Streicher's blogs about all aspects of women’s health, particularly menopause and sexual health.

Dr. Streicher is an Associate Clinical Professor of Obstetrics and Gynecology at Northwestern University’s medical school, The Feinberg School of Medicine. Dr. Streicher has appeared in numerous national and local media outlets discussing all aspects of women’s health and is a recurring guest on The Dr. Oz Show, ABC’s Windy City Live!, The Today Show,  The Steve Harvey Show and The Meredith Vieira Show.  She has also appeared on Nightline, Good Morning America, 20/20, The Oprah Winfrey Show, and ABC World News Tonight.

Her blogs can be found on Everyday Health and on Dr. Streicher's website--we hope you check them out!

For more information about menopause--and to take a menopause health self-assessment-- you can also check out the Women's Health Research Institute's menopause website!

Using Hormone Replacement Therapy for Menopause is Safe, New Study Finds
Posted by on October 19, 2015 - 1:11pm

Back in the early 2000s flawed reports surfaced that suggested hormone replacement therapy (HRT) was linked to increased risks of heart disease and breast, ovarian and womb cancers--scientists recently concluded these theories are false. This new research, which followed women for a decade, has found no evidence that HRT is linked to any life-threatening condition! This is good news for the millions of menopausal women who may want to use HRT to control their hot flashes, night sweats, and depression.

HRT boosts levels of estrogen and progesterone and is the most widely recognized therapy to treat severe menopausal symptoms. In the 1940's, the FDA approved the use of estrogen to treat hot flashes associated with menopause. Because women felt better while taking hormones, the list of other beneficial claims relative to the effects of aging grew despite the lack of extensive research. In 1990, the FDA found that the research done to date was not adequate to take hormones to prevent conditions like heart disease. This led to an extensive 15 year, multiphase drug trial called the Women's Health Initiative on hormone therapy for menopausal women, which caused widespread uncertainty for women regarding the safety of hormone therapy and caused many to stop using HRT completely.

Yet this new study by the New York University school of medicine tracked 80 women using HRT for 10 years and compared them with a control group who were not using the medication. The HRT group suffered no more incidences of cancer, diabetes, or heart disease than the control group. Menopausal symptoms can be frustrating and can interfere with daily life. Knowing that there are safe therapies to control these symptoms should be a comfort for women everywhere!

Check out the Women's Health Research Institute's menopause website (menopause.northwestern.edu) to learn more about symptoms and therapy options!

Source: The Telegraph

Raising Awareness for Postpartum Depression
Posted by on October 16, 2015 - 10:35am

Written by Sarah Henning

Actress Hayden Panettiere made headlines this week when it was announced she entered a treatment facility to aid in her recovery from postpartum depression. She has been open about her struggle since giving birth to her first child in December 2014, and in doing so, has been raising awareness about this condition that many mothers experience. The Mayo Clinic defines postpartum depression as a “severe, long-lasting form of depression,” and states that it “isn't a character flaw or a weakness ... it's simply a complication of giving birth.”

Unfortunately, postpartum depression is often overlooked as being fictitious, uncontrollable, or not very serious. Panettiere points out that “there's a lot of people out there who think that it's not real, that it's not true, that it's something that's made up in their minds and, oh, it's hormones,” although in reality it can be painful and debilitating to mothers who experience it.

It is also a common condition. The American College of Obstetricians and Gynecologists estimates that around 15% of new mothers in the United States suffer from a mental illness, such as postpartum depression, throughout or after a pregnancy. This should not be a condition that gets swept under the rug, or that women should be made to feel ashamed of. Rather, as Panettiere stated, “it's something I think that needs to be talked about and women need to know that they're not alone and that it does heal.”

For help coping with postpartum depression, or depression of any kind, reach out to a doctor. For additional resources, visit http://www.postpartum.net/, and know that you are not alone.

Sources:

CNN. (13 October, 2015). Hayden Panettiere enters treatment for postpartum depression. http://www.cnn.com/2015/10/13/entertainment/hayden-panettiere-postpartum-depression-feat/

Mayo Clinic. (2015). Postpartum Depression. http://www.mayoclinic.org/diseases-conditions/postpartum-depression/basics/definition/con-20029130

 

Want to Start Running? Here's Some Advice
Posted by on October 15, 2015 - 2:48pm

Did you catch the Chicago Marathon this past weekend?! Many gathered to watch the 37,000 runners on Sunday's race--and it may have inspired you to start running as well! While running is an excellent form of cardio, you need to be careful with how you begin training so that you don't unintentionally harm your body. Here are five tips to get you started on becoming a "runner":

1. Don't do too much to soon! Running is a very high-impact activity and if you dive into running too quickly, it can lead to injury. Start with a 20 minute run a few times per week and build your routine slowly--no more than 10% every two weeks.

2. Watch your speed--remember, this is a marathon, not a race...when new runners try to outpace their bodies, they can ignore some warning signs telling them to slow down. Maybe your spouse runs, or your friend--don't try to match their pace right away--stick to a personal plan, and your own speed--you'll catch up over time once your body builds the necessary muscles.

3. Invest in reliable shoes. Running shoes are a crucial investment for anyone in training; you need a pair that will support your feet and complement your stride. Try going to a specialty running store to get your stride analyzed (this is free!) and invest in a nice pair that will offer support to your feet.

4.Pair running with other types of exercise. Try to mix up your workout with other activities--such as cycling, swimming, Pilates, etc. This will help keep your running goals fresh (and not monotonous), while also training other muscles that may not be in use as much during a run. This includes strength training and stretching! The more you stretch and tone your muscles, the easier it is to lose weight and accomplish those longer endurance runs.

5. Listen to your body. New runners will start to feel aches and pains in their bodies as new muscles are growing and remaining active--this is normal. Resting for a few days and working through minor aches and pains will help your body adjust to this new regimen. However, if you sense you have sustained an injury, do not attempt to 'power through it'--you'll want to get regular physicals if you sense something abnormal in your body.

It may take months--or even years--before running feels completely natural to the point where you're able to run over 3 miles without stopping--and that's okay! Everyone moves at their own pace, and Rome wasn't built in a day! If you're inspired to start running, and you set your mind to it--you'll be able to accomplish the goals you set.

India's Innovative Approach to Menstrual Pads
Posted by on October 14, 2015 - 1:08pm

Even though it is 2015, there is still a stigma about menstruation in the United States--some people are reluctant to talk about it or find the topic 'embarrassing' or 'gross,' but this is a normal, biological process, and this stigma may be even more pronounced in developing countries. In developing countries women might not have access to sanitary products, there might be a lack of plumbing, or superstitions and religious traditions may leave many women feeling ashamed or isolated because of their periods. Indeed, in India, only 12% of women use sanitary products! It is amid this dire need for more information on menstruation and sanitary practices that Arunachalam Muruganantham created an organic tampon business that is noting short of revolutionary! Muruganantham noticed his wife struggle with menstruation and he dedicated himself to inventing a machine to make low-cost sanitary pads out of pulverized wood fiber. He has more than 100 production sites that serve over a thousand of the poorest and most under-developed regions of India.

Muruganantham's production model has been adopted and tweaked by others to fill the desperate need for sanitary products. Ultimately this works helps young girls not miss school due to their periods and older women feel less isolated when it's their time of the month. All of Murugantham's production sites are managed and staffed by women who make and sell the pads at minimal cost. Normalizing menstruation and making women feel comfortable with this biological process are key factors to improved education and collaboration towards creative solutions such as this!

Source: New York Times

What Happens When You Get Your Period in Space?
Posted by on October 9, 2015 - 11:07am

Back in the day, menstruation was a frequently cited argument for why women shouldn't be allowed to become astronauts--or fly planes of any kind. Some claimed menstruation would affect a woman's behavior and ability--some even blamed plane crashes on menstruating women! In the 1940's this theory was debunked--female pilots are not impaired just because they're on their period; however, fast forward nearly 15 years to the mid 1960's and researchers from the 'Women in Space' program still suggested that "putting a 'temperamental psychophsyiologic human' (i.e., a hormonal woman) together with a 'complicated machine' was a bad idea"--even when absolutely no evidence supported this!

Beyond behavioral concerns, other researchers worried that microgravity might increase the incidence of 'retrograde menstruation'--aka blood might flow up the fallopian tubes into the abdomen--but no one conducted any experiments on this, so there was no data to support or refute these fears. Yet among all these nay-sayers, early female astronauts fought back. Indeed, Rhea Sheddon, one of the first six female astronauts at NASA argued there were plenty of unknowns the first time man went into space, but men went anyway--and she encouraged the research community to consider it a non-problem until it becomes one. It seemed women faced opposition from nearly every outlet--and in 1983, when Sally Ride went into space, the engineers asked her how many tampons should fly on a one-week flight, asking if 100 would be the right number, to which Ride responded, "No. That would not be the right number." Yikes! And amid all of these questions and confusion over what happens when a woman gets her period in space, what's the answer? Well, it's the same thing that happens on Earth!

Source: NPR

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