The article below was recently released by the National Institutes of Health.  It is important information but I post it with caution because it could make some people panic before the facts are in.    It is somewhat alarming if you do have symptoms of early menopause----but it doesn't always mean you have a serious health condition.     I went into menopause at age 41 when my children were teenagers and, and while it was concerning,  it was just early menopause.     Of course, any atypical health symptoms need to be  checked out, no matter how old you are!

NIH News:   Hot flashes, night sweats, loss of regular menstrual periods and sleep problems. These familiar symptoms of menopause appear in most women around age 50. But if they arise before age 40—which happens for about 1 in 100 women—it’s a sign that something’s wrong. Early symptoms like these could be a sign of a little-understood condition called primary ovarian insufficiency (POI).

Most women with POI are infertile. They’re also at risk for bone fractures and heart disease. And many aren’t aware they have POI.

“Symptoms of POI can be missed because young women may not realize they’re having symptoms similar to menopause. They may not think hot flashes are worth mentioning to a doctor,” says Dr. Lawrence M. Nelson, a researcher and physician at NIH. “Some teens and young women think of the menstrual cycle as a nuisance, and they don’t mind missing periods. They don’t take it seriously, and that’s a mistake.” Missing or irregular periods are a major sign of POI.

When young women have POI, their ovaries don’t work normally. They stop regularly releasing eggs and cut back production of estrogen and other reproductive hormones. These same things happen when older women go through menopause, which is why the symptoms are similar. As with menopause, POI symptoms can often be relieved by hormone replacement therapy, usually an estrogen patch. And as with menopause, POI puts women at risk for bone loss. But with a proper diagnosis of POI and early treatment, bone health can be protected.

POI was previously known as “premature menopause” or “premature ovarian failure.” But research has since shown that ovarian function is unpredictable in these women, sometimes turning on and off, which is why many physicians now prefer the term primary ovarian insufficiency. Many aspects of POI remain mysterious—including its cause. Only 10% of cases can be traced to either to a genetic condition or to autoimmunity—a disorder in which the immune system attacks the body’s own tissues.

Nelson’s research has shown that the unexpected loss of fertility often leads to grief and symptoms of anxiety and depression in women with POI. But a recent study from his lab suggests that most young women and teens with POI still have immature eggs in their ovaries. The finding raises the possibility that future treatments might be developed to restore fertility to some affected women. Even without treatment, up to 1 in 10 women with POI may unexpectedly become pregnant after their condition is diagnosed.

Irregular or stopped periods might be a sign of other conditions, including eating disorders or too much exercise. A simple blood test for elevated levels of a molecule called follicle stimulating hormone (FSH) can help to confirm a diagnosis of POI.

“Having regular menstrual periods is a sign that the ovaries are working properly,” says Nelson. “If that isn’t happening, it’s important for girls and young women to talk to their health care provider and find out why.   Nelson is now looking for 18- to 42-year-old women with POI to enroll in clinical studies at NIH. For more information, visit http://poi.nichd.nih.gov.

The New York Times has recently reignited a hypothesis made by Lawrence Summers, Director of the White House's National Economic Council, about the ratio of males to females in the STEM (science, technology, engineering, and mathematics) fields. Despite inroads, females make up a minority in these historically males-populated occupations. In the article “Daring to Discuss Women in Science” John Tierney addressed the gender gap in these fields. Like Summers, he suggested that males have higher mathematical abilities than females, at the extreme high end of the intelligence scale, resulting in an overrepresentation in STEM fields.

Tierney’s article was based on a new study that followed standardized test scores of the top fifth percentile of 7^th graders for 30 years. It found that while the gender gap in mathematical and scientific reasoning narrowed over that time, it has not decreased in the last two decades. The authors state, “this does not mean that biases and lack of role models have been eliminated.” Thus, girls are likely to be influenced by societal norms to avoid math and science.

The argument that society does not bias girls away from math and science results in a culture that does not advance women in these occupations either. A similar argument has been made in the bias against women in medical research. According to that thinking, if there is no bias in research, there is no reason to increase the participation of women in studies, despite their increased risk of drug complications and disease misdiagnosis, compared to men. Both of these cases shortchange women, in their education, profession, and health. The Institute for Women’s Health Research counteracts these biases by investigating the educational and medical differences between men and women.

Pop culture interpretations of such research also consistently ignore the other measurements of cognitive abilities. Young women consistently outperform boys in verbal reasoning and writing tests. By parallel logic, women should therefore make up the majority of people in professions with heavy verbal components: attorneys, political speechwriters, and journalists. This is not the case, indicating that professional gender inequality is still a reality across professions. Efforts by parents, teachers, and children will be needed to propel all young people in the sciences.

Today, the scientific  journal, Nature, released a Commentary by Institute Director Teresa Woodruff and two of her post doctorate students that we hope will open up the dialogue about the current status of women's health research.  For the reader's convenience, the entire press release is listed below as well as a link to the article.  More examples of sex bias will be featured on this blog over the next two weeks, so we hope you will tag this site!

CHICAGO --- Women remain vastly underrepresented in biomedical research despite significant differences in the way they experience many diseases, medications and therapies compared to men. Despite federal mandates to include women in studies, there is much that still needs to be done, says Teresa Woodruff, a leading women’s health scientist at Northwestern University Feinberg School of Medicine, in a June 9 commentary in the journal Nature.

“It’s time for the sex bias in basic research and clinical medicine to end,” writes senior author Woodruff, executive director of the Institute for Women's Health Research and the Thomas J. Watkins Professor of Obstetrics and Gynecology at Feinberg. This bias, she says, has an enormous effect on women’s health, resulting, for example, in delayed diagnosis of cardiovascular disease, the leading killer of women, and in adverse reactions to medication. Alison Kim and Candace Tingen, post-doctoral fellows at Feinberg, are coauthors on the paper.

Women need to be adequately represented in studies, and results need to be specifically designed and analyzed to determine sex differences, the authors note, in order for both men and women to receive more tailored care. Understanding sex as a determinant of disease and care is the first step towards personalized care for every patient. Sex differences in the incidence, prevalence, symptoms and severity of disease have already been shown in autoimmune diseases such as rheumatoid arthritis and multiple sclerosis; in psychological disorders including depression, autism, eating disorders and schizophrenia; and in asthma and several types of cancer.

“Differences are particularly acute in cardiovascular disease, the leading cause of death for both men and women,” Woodruff writes. Women in the early stages of cardiovascular disease may experience fatigue, abdominal discomfort and back, jaw or neck pain, all of which are considered atypical because diagnostics were mainly established from research conducted primarily on men. “As a result, women can be subject to potentially life-threatening delays before crucial diagnostic tests are administered,” she said. And some of those tests, like exercise electrocardiography, can’t detect cardiovascular disease as well in women as in men.

Northwestern is a good example of making significant strides in treating women with heart disease and in sex-balanced health research, Woodruff noted. She pointed to Feinberg’s Institute for Women’s Health Research, which supports clinical research trials that focus on women’s health and sex-balanced research, and the institute’s Illinois Women’s Health Registry, a growing database of 4,500 potential study subjects, that has encouraged Northwestern researchers to do more research in sex differences. About 1,000 of these women have participated in trials.

In addition, the Center for Women’s Cardiovascular Health at the Bluhm Cardiovascular Institute of Northwestern Memorial Hospital has a unique clinical program focusing on women’s heart health.   Women also respond differently to medication than men, yet drugs are rarely prescribed accordingly, according the Nature article. “This may be part of the reason why women are 1.5 times more likely to develop an adverse reaction to prescription drugs than men,” Woodruff notes. For example, a 2005 study of new drug applications found that even the drugs that had substantial differences in how they were metabolized by women and men did not have sex-specific dosage recommendations on the labels.

How to fix the void? Among the authors’ suggestions:

• Journals should indicate if results are in male or female animal models.

• Regulatory and funding agencies should require appropriate representation of both sexes in human and animal trials and require researchers to consider sex differences when they analyze data.

• Educate doctors in the clinical importance of sex differences. The Food and Drug Administration also should mandate that medication dosages be sex-specific based on clinical studies.

To read the complete article, click here.

NORTHWESTERN NEWS: www.northwestern.edu/newscenter/

Biological differences between the sexes could be a significant predictor of responses to vaccines, according to researchers at the Johns Hopkins Bloomberg School of Public Health. They examined published data from numerous adult and child vaccine trials and found that sex is a fundamental, but often overlooked predictor of vaccine response that could help predict the efficacy of combating infectious disease. The review is featured in the May 2010 issue of The Lancet Infectious Diseases.

“Sex can affect the frequency and severity of adverse effects of vaccination, including fever, pain and inflammation,” said Sabra Klein, PhD, lead author of the review and an assistant professor at the Bloomberg School’s W. Harry Feinstone Department of Molecular Microbiology and Immunology. “This is likely due to the fact that women typically mount stronger immune responses to vaccinations compared to men. In some cases, women need substantially less of a vaccine to mount the same response as men. Pregnancy is also a factor that can alter immune responses to vaccines.”

Researchers conducted a review of existing literature on several vaccines including yellow fever, influenza, measles, mumps and rubella, hepatitis and herpes simplex to obtain evidence of the difference in responses between women and men. They also examined the effect hormonal changes that occur during pregnancy have on vaccine efficacy. Researchers found that despite data supporting a role for sex in the response to vaccines, most studies did not document sex-specific effects in vaccine efficacy or induced immune responses.

“Understanding the biological differences between men and women to vaccines could have led to better distribution of the 2010 H1N1 vaccine during the early months. Our review of the literature found that healthy women often generated a more robust protective immune response to vaccination when compared to men,” said Andrew Pekosz, PhD, associate professor at the Bloomberg School’s W. Harry Feinstone Department of Molecular Microbiology and Immunology. “An understanding and appreciation of the effect of sex and pregnancy on immune responses might change the strategies used by public health officials to start efficient vaccination programs, optimizing the timing and dose of vaccines so that the maximum number of people are immunized.” added Klein.
“The Xs and Y of Immune Responses to Viral Vaccines” was written by Sabra L. Klein, Anne Jedlicka and Andrew Pekosz.

Source:   Johns Hopkins Newscenter