Arthritis Prevalence Higher in Women than Men
Posted by on August 31, 2010 - 10:24am

In 2006, the Center for Disease Control and Prevention (CDC) reported that 21.6% of the US adult population reported arthritis, with significantly higher prevalence in women than in men (24.4% vs. 18.1%). Arthritis prevalence increased with age and was higher among women than men in every age group.    With the aging of the US population, the prevalence of doctor-diagnosed arthritis is expected to increase in the coming decades.   By 2030, it is estimated that 67 million adults age 18 and older will have arthritis, compared with the current 46 million.  Also, by 2030 an estimated 25 million adults will report arthritis-attributable activity limitations.

Functional limitations in routine activities are common among adults with arthrtis:   40% report it is "very difficult" or they "cannot do" at least 1 of 9 important daily functions which include their ability to stoop, bend, grasp, kneel or walk 1/4 mile.  Obesity is a known risk factor for the progression of knee osteoarthritis and possibly of other joints.   Reducing body weight may result in significant improvement in the health-related quality of life of people with arthritis.

Although physical activity and exercise have been shown to benefit people with arthritis by improving pain control, function, and mental health, many people with arthritis report no leisure time physical activity. Low levels of physical activity place individuals with arthritis at further risk of inactivity-associated conditions such as cardiovascular disease, diabetes, obesity, and functional limitations.

Some interesting research is currently taking place at Northwestern U. that is looking at knee alignment and its role in progression of knee osteoarthritis that could lead to earlier and novel interventions that could decrease or prevent arthritic disability in the future.  Many Illinois women who are part of the Illinois Women's Health Registry are participating in those studies.

In the meantime, women (and men) who have arthritis could benefit from keeping their weight down and keeping physically active!!!   As we age, it is even more important that we develop a lifestyle that includes healthy eating and exercise.


Stress and Infertility
Posted by on August 30, 2010 - 8:47am

A study by researchers at the National Institutes of Health (NIH) and the University of Oxford supports the widespread belief that stress may reduce a woman's chance of becoming pregnant.  The study is the first of its kind to document, among women without a history of fertility problems, an association between high levels of a substance that is indicative of stress and a reduced chance of becoming pregnant.

The researchers showed that women who had higher levels of alpha-amylase were less likely to get pregnant than were women with lower levels of the substance.   Alpha-amylase is secreted into saliva by the parotid gland, the largest of the salivary glands.    Although alpha-amylase digests starch, in recent years it has been used as a barometer of the body's response to physical or psychological stress.  The substance is secreted when the nervous system produces catecholamines, compounds that initiate a type of stress response.

Researchers tracked the ovulation cycles of 274 English women ages 18-40 who were trying to conceive.  On the sixth day of their cycles, each woman collected a sample of her saliva, which was subsequently tested for alpha-amylase.  The researchers found that, all other factors being equal, women with high alpha-amylase levels were less likely to conceive than were women with low levels.  A larger study is currently underway to confirm these findings.  If these finding hold up, health providers will need to find appropriate ways to help women alleviate stress while trying to conceive.

To view the NIH Press release, click here.

Scientists as Role Models for Girls
Posted by on August 27, 2010 - 9:51am

Results of a recent poll by ICM, a public opinion research firm from England, two thirds of the British public and nearly nine out of 10 (88%) of 18-24 year olds are unable to name a single famous female scientist, despite scientists being viewed as a good role model.   The Royal Society , the national academy of science, requested the poll of public attitudes regarding women in science.

Just 12% of 18-24-year-olds polled were able to name a female scientist such as Marie Curie while nearly half (47%) were able to name a male scientist such as Albert Einstein. However, while women are currently less well-known for science, public attitudes to women becoming scientists appear to be relatively progressive. Overall scientists were seen as good role models for girls, proving far more popular than celebrity chefs and popstars.

From a choice of six role model types for a daughter, 47% of respondents chose ‘life-saving doctor’ while ‘Nobel prize-winning scientist’ came second with 20% of first mentions. ‘Olympic gold medallist’ was third (14%) and ‘best-selling novelist’ fourth (9%) with only 5% of respondents choosing a celebrity chef or chart-topping pop star as a suitable role models for young girls.

When asked what career they would like their daughter (real or imagined) to pursue, scientist was the first choice for 18% of respondents compared to 27% for lawyer, 26% for teacher, 17% for nurse, 4% for chef and 2% for builder.

Knowledge of the role played by women in major scientific breakthroughs was also low. Just 6% of those polled by the Royal Society knew that a female scientist (Jocelyn Bell Burnell) played a major part in the discovery of pulsar stars, and only 18% were aware that another woman - Dorothy Hodgkin - discovered the structure of insulin.   Ninety-six% of respondents thought men and women were equally well-suited to a career as a scientist.

Evamist: Keep Children and Pets Away.
Posted by on August 26, 2010 - 2:57pm

A recent Food and Drug Administration (FDA) MedWatch Safety Alert warns women to make sure children and pets do not come into contact with Evamist that they have sprayed on their skin.    Evamist is a transdermal spray containing estradiol, a form of estrogen. It is sprayed inside of the forearm between the elbow and wrist to reduce hot flashes during menopause. Each squirt of spray delivers 90 mcL which contains 1.53 mg of estradiol and is FDA approved for this use.

The FDA has received reports of side effects in children who were unintentionally exposed to Evamist.   Side effects include:

  • nipple swelling and breast development in girls
  • Breast enlargement in boys

FDA has also received reports of unintentional exposure in pets, which may show signs of mammary/nipple enlargement and vulvar swelling.

The FDA recommends that you do not allow children to come in contact with area of the arm where Evamist was sprayed.  If a child is exposed to Evamist, wash the child's skin with soap and water as soon as possible.      Contact the child's health professional if nipple or breast swelling or breast tenderness occurs in girls, or breast enlargement occurs in boys.    Do not allow pets to lick or touch the arm where Evamist was sprayed.   Small pets may be especially sensitive to Evamist.   Contact a vet if your pet shows any signs of illness, including enlargement of the nipples or vulva.

Women who use Evamist should wear clothing that covers the arm sprayed with the drug if they cannot prevent accidental contact.

The FDA

Stress could Worsen Premenstrual Symptoms
Posted by on August 24, 2010 - 9:34am

Study finds association between stress level in early cycle, severity of symptoms

Women who report feeling stressed early in their monthly cycle were more likely than those who were less stressed to report more pronounced symptoms before and during menstruation, according to a study by researchers at the National Institutes of Health and other institutions. The association raises the possibility that feeling stressed in the weeks before menstruation could worsen the symptoms typically associated with premenstrual syndrome and menstruation.

Women who reported feeling stressed two weeks before the beginning of menstruation were two to four times more likely to report moderate to severe symptoms than were women who did not feel stressed.

Premenstrual syndrome is a group of physical and psychological symptoms occurring around the time of ovulation, which may extend into the early days of menstruation. Symptoms include feelings of anger, anxiety, mood swings, depression, fatigue, decreased concentration, breast swelling and tenderness, general aches, and abdominal bloating.

The study was conducted by researchers in the NIH's Eunice Kennedy Shriver National Institute of Child Health and Human Development (NICHD), the University of Massachusetts-Amherst, and the State University of New York, Buffalo. The study was published online in the Journal of Women's Health.

To read more on the study, click here.

Male Menopause
Posted by on August 23, 2010 - 9:15am

No, you did not open the wrong page.   Yes, this blog is posted by the Institute for Women's Health Research at Northwestern. As an advocate for better  sex and gender based research, we support all avenues that increase our knowledge about sex differences and that includes  a better understanding of  hormone changes in women AND MEN.

Furthermore, women are generally the source of health information for their families and that includes their male partners! So, women and men, read on!

Low testosterone levels to blame for low libido, fatigue and weight gain

While most frequently associated with women’s health, age-related hormone changes, often dubbed menopause, can occur in men as well, causing symptoms of fatigue, mood swings, decreased desire for sex, hair loss, lack of concentration and weight gain. Experts estimate that more than 5 million men are affected, yet worry the number may be considerably higher since symptoms are frequently ignored.  Male hypogonadism, as it’s referred to in the medical community, occurs when the testicles do not produce enough testosterone, the hormone that plays a key role in masculine growth and development. When hormone levels drop, men can experience significant mental and physical changes.

“This is a highly prevalent disorder,” said Robert Brannigan, MD, urologist at Northwestern Memorial Hospital. “Unfortunately, we estimate that 95 percent of cases are undiagnosed and therefore untreated. When ignored, symptoms can seriously disrupt one’s quality of life.”

Brannigan explains hormone variations are a normal aspect of getting older. “In females, ovulation comes to an end and hormone production declines in a relatively quick period of time, whereas men experience hormone shifts more slowly, with testosterone levels dropping around one percent each year beginning in a man’s late thirties,” adds Brannigan. He goes on to explain that by age seventy, the reduction in a male’s testosterone level could be as high as fifty percent or more compared to baseline levels, but notes that aging men are not the only ones at risk. A number of genetic causes can impact males from birth and are usually diagnosed with failure to progress normally through puberty during the teenage years.

Treatment options for male hypogonadism include hormone replacement therapy (HRT) via absorbable pellet implants, topical gels, patches, and injections. Through HRT, doctors can restore sexual function and muscle strength. In addition, men often experience an increase in energy and an improved overall sense of well-being.

“We are seeing more men affected by male hypogonadism than we saw ten years ago,” said Brannigan. “However, many men continue to suffer in silence due to a lack of awareness surrounding the disorder. Because male hypogonadism can significantly impact the quality of one’s life, it’s important that men pay attention to their body and openly discuss symptoms with their physician in order to prevent overlooking the cause and avoid missing an opportunity for appropriate therapy.”

Although research to determine the exact association continues, doctors also warn that male hypogonadism has been linked to chronic medical conditions such as high cholesterol, diabetes and cardiovascular disease. It’s also closely associated with infertility.

“This disorder is not something that should be ignored,” said Brannigan, who is working to educate patients and physicians about the symptoms and treatments available in order to ensure therapies are made available to men in need.

Male hypogonadism is most commonly diagnosed through a simple blood test. Brannigan notes hormone replacement therapy is not appropriate for all patients especially those with history of prostate and breast cancer and men trying to conceive. He suggests consulting your doctor if you are experiencing symptoms.

Chocolate May Lower Risk of Heart Failure
Posted by on August 20, 2010 - 10:04am

Benefits shown in middle-aged and elderly women

Middle-aged and elderly Swedish women who regularly ate a small amount of chocolate had lower risks of heart failure risks, in a study reported in Circulation: Heart Failure, a journal of the American Heart Association.  The nine-year study, conducted among 31,823 middle-aged and elderly Swedish women, looked at the relationship of the amount of high-quality chocolate the women ate, compared to their risk for heart failure. The quality of chocolate consumed by the women had a higher density cocoa content somewhat like dark chocolate by American standards. In this study, researchers found:

  • Women who ate an average of one to two servings of the high-quality chocolate per week had a 32 percent lower risk of developing heart failure.
  • Those who had one to three servings per month had a 26 percent lower risk.
  • Those who consumed at least one serving daily or more didn’t appear to benefit from a protective effect against heart failure.

The lack of a protective effect among women eating chocolate every day is probably due to the additional calories gained from eating chocolate instead of more nutritious foods, said Murrray Mittleman, M.D., Dr.P.H., lead researcher of the study.  “You can’t ignore that chocolate is a relatively calorie-dense food and large amounts of habitual consumption is going to raise your risks for weight gain,” said Mittleman, director of the Cardiovascular Epidemiology Research Unit at Harvard Medical School’s Beth Israel Deaconess Medical Center in Boston. “But if you’re going to have a treat, dark chocolate is probably a good choice, as long as it’s in moderation.”

High concentration of compounds called “flavonoids” in chocolate may lower blood pressure, among other benefits, according to mostly short-term studies. However, this is the first study to show long-term outcomes related specifically to heart failure, which can result from ongoing untreated high blood pressure.   In the observational study, researchers analyzed self-reported food-frequency questionnaire responses from participants 48-to-83-years-old in the Swedish Mammography Cohort. Combining the results with data from national Swedish hospitalization and death registries between 1998 through 2006, the researchers used multiple forms of statistical modeling to reach their conclusions on heart failure and chocolate consumption.

Mittleman said differences in chocolate quality affect the study’s implications for Americans. Higher cocoa content is associated with greater heart benefits. In Sweden, even milk chocolate has a higher cocoa concentration than dark chocolate sold in the United States.    Although 90 percent of all chocolate eaten across Sweden during the study period was milk chocolate, it contained about 30 percent cocoa solids. U.S. standards only require 15 percent cocoa solids to qualify as dark chocolate. So, by comparison, American chocolate may have fewer heart benefits and more calories and fat per equivalent amounts of cocoa content compared to the chocolate eaten by the Swedish women in the study.   Also, the average serving size for Swedish women in the study ranged from 19 grams among those 62 and older, to 30 grams among those 61 and younger. In contrast, the standard American portion size is 20 grams.

“Those tempted to use these data as their rationale for eating large amounts of chocolate or engaging in more frequent chocolate consumption are not interpreting this study appropriately,” said Linda Van Horn, Ph.D., R.D., immediate past chair of the American Heart Association Nutrition Committee and professor in the Department of Preventive Medicine at Northwestern University’s Feinberg School of Medicine in Chicago. “This is not an ‘eat all you want’ take-home message, rather it’s that eating a little dark chocolate can be healthful, as long as other adverse behaviors do not occur, such as weight gain or excessive intake of non-nutrient dense ‘empty’ calories.”

Heart failure occurs among about 1 percent of Americans over age 65. A condition in which the heart can’t pump enough blood to the rest of the body, heart failure rates are increasing as our aging population grows.“Anything that helps to decrease heart failure is an important issue worth examining,” Mittleman said.

Co-authors are Elizabeth Mostofsky, M.P.H.; Emily Levitan, Sc.D.; and Alicja Wolk, Dr.Med.Sci. Author disclosures and funding support are on the manuscript.

Source: Press release prepared by the American Heart Association

Circadian Rhythm and Breast Cancer
Posted by on August 16, 2010 - 10:38am

All living organisms have a circadian clock, sometimes called a biological clock, that is an important part of maintaining optimal health.   The circadian rhythm is a roughly 24-hour cycle in the biochemical, physiological, or behavioral processes of living things.   Although  circadian rhythms originate from within our bodies, they are synchronized to the environment by external cues, including the day-night cycle caused by the Earth's rotation.  Researchers are looking more closely at the role circadian rhythms play in the development of diseases such as breast cancer and also how factors such as hormones affect this biological clock.

Carla Finkielstein, a molecular biologist at Virgina Tech, has launched a research project to study how changes in circadian rhythms may contribute to the development of breast cancer in women.   According to Finkielstein, "There are a number of epidemiological studies that show women working night shifts have a higher incidence of breast cancer."  The question she asks is:   Can working odd hours actually alter a women's body chemistry--turning healthy cells into cancer cells?

With support from the National Science Foundation, she is using frog embryos to help figure out on a molecular basis the physiological changes in women who work night shifts.   She says studies show that night workers have abnormal levels of specific protein in their cells, which act by turning on and off genes that regulate how cells grow and divide.  Proper timing of cell division is a major factor contributing to the regulation of normal cell growth and is a fundamental process in the development of most cancers.  She explains," Our research explores ways in which the loss of circadian function impairs the death of cells in the cell cycle and leads to the accumulation of damaged, or cancerous, cells."

Where is this leading us, what is the clinical application?   "If we were to generate a panel of markers that we can follow regularly for women who works night shifts, it would enable us to record changes in circadian-controlled genes and thus predict whether a person is at risk of developing breast cancer, " Finkielstein said.   "If we see abnormal changes, all we may need to do is to alter this person's work schedule."

This study reinforces the important role circadian rhythm plays in sex and gender-based research.  In another example,  researchers at Northwestern University who are working in the lab of Dr. Fred Turek have determined that sex differences in hormone status in female mice are critical to better understanding stress or sleep deprivation.  There is growing evidence that circadian rhythm may play a part in other health issues like cardiovascular disease and diabetes.

Hypertension in Women
Posted by on August 13, 2010 - 9:49am

Postmenopausal women have an increased risk of hypertension (high blood pressure), and among older adults, more women than men have hypertension.   As with many other health issues, hypertension research has been conducted predominately in males, and little is known about how women's bodies manage blood flow.   Research conducted by Heidi A. Kluess at the University of Arkansas is focusing on a  better understanding of hypertension in women by using a new technique to examine the release of a neurotransmitter in small blood vessels.

Kluess, an exercise scientist, believes the answer seems to be in the "synapse".  The synapse is the space between the nerve and the vascular smooth muscle, the place where the nerve and blood vessel interact.   A neurotransmitter crosses the "synapse" to activate a receptor, which then causes the artery to constrict.   "There's been a little evidence to say that some of the neurotransmitter breakdown is different in women.   It suggests that when we've been looking at receptors on the smooth muscle, we may have been missing a big part of the story, particularly in women," Kluess said.

The team measured the neurotransmitter adenosine triphosphate (ATP) coming from the small blood vessels (arterioles).  ATP plays a key role in controlling blood flow and blood pressure by causing the diameter of blood vessels to change.   Thus, the constriction of veins associated with hypertension could be related to relatively high levels of ATP in arterioles. So this raises the questions:   Where is the ATP coming from, what tissues are releasing it and how does this change with aging?

To study this,the researchers had to overcome the difficulty of working with very small blood vessels that produced minute amounts of ATP.   A biosensor that was only previously used in brain researcher was utilized that uses a set of enzymes to indirectly measure ATP as it is released.

The research findings suggest that ATP from small arterioles can be measured and that the arteriole wall plays an important role in release and management of ATP. The researchers found that ATP is released mostly from the sympathetic nerves in the arteriole wall and that only a small part comes from the smooth muscle. Considerable research suggests that having a lot of ATP floating around in the blood vessels is not a good thing. The upside of this finding is that the nerve releases ATP in response to nerve signals. However, the mechanisms involved in the release of ATP by smooth muscles are less well understood, Kluess explained, and may result in chronically high ATP release.

The researchers found that the ATP overflow varied considerably with age. Because ATP is associated with vascular growth, it is important during early development when blood vessels are growing, but levels generally decline when people reach their twenties. Elevated levels can be a bad sign during aging when the body is no longer growing and may be a predictor of vascular changes that can be detected years before hypertension is a problem.

Some previous research had suggested that the endothelium – the outer layer of the smooth muscle – produced ATP. However, Kluess’ research showed that the endothelial tissue did not produce ATP. Rather, it decreased levels of ATP and potentially plays a positive role in controlling ATP levels.

“That’s an interesting finding because we know that as people age or develop disease that their endothelium doesn’t work as well,” Kluess said. “That may be a way that ATP increases during aging because the endothelium doesn’t function as well and so can’t buffer ATP quite as well.”

More research is needed to investigate the factors that control ATP overflow and metabolism to reveal the mechanisms associated with age-related change. “We are very much at the beginning of this story,” Kluess said.

Source:   University of Arkansas

Kluess HA, Stone AJ, Evanson KW. ATP overflow in skeletal muscle 1A arterioles. J Physiol.

Women and Sleep
Posted by on August 12, 2010 - 2:46pm

The most recent statistics on the women who participate in our Illinois Women’s Health Registry, indicate that sleep is a significant issue in their lives.  Among the most current women who are enrolled in our registry, 11% report difficulties getting to sleep, 12% have a hard time staying asleep, 15% wake up feeling fatigued, 13% report they are getting too little sleep for what they need, and 8% wake too early and cannot get back to sleep.

Our limited knowledge in sex differences is due to the fact that women are underrepresented in studies of sleep and its disorders.  The National Sleep Disorders Research Plan, released in 2004 by the National Center on Sleep Disorders Research reported that 75% of sleep research has been conducted in men.   While more recent sleep studies have included women, the small sample sizes limit sex comparisons.  However, there is a growing body of evidence that sex hormones influence sleep and circadian rhythms, and further neuroendocrine studies are needed.

To read more on women and sleep on the Institute for Women's Health Research, click here.

Pages