Posted by on February 20, 2014 - 10:31pm

New research proves yet another reason for women to quit smoking: smoking may cause earlier signs of menopause. Heavier smokers may enter menopause up to nine years earlier compared to nonsmokers.

In the United States, the average age for menopause is 51. Previous studies have already showed that smoking can hasten menopause by one to two years, regardless of race or genetic background. New research shows that menopause can happen much quicker specifically in white female smokers who are carriers of two different gene variants.

Over 400 women ages 35 to 47 from the Penn Ovarian Aging Study were compared. Heavy smokers, light smokers, and nonsmokers who were carriers of the CYP3A4*1B variation had an average time-to-menopause of 5.09 years, 11.36 years, and 13.91 years, respectively, after entering the study. This suggests that certain white females with a specific genetic make-up may enter menopause up to nine years earlier than nonsmoking females.

The average time-to-menopause for white carriers of the CYP1B1*3 variation, was 10.41 years, 10.42 years, and 11.08 years among heavy smokers, light smokers, and nonsmokers, respectively. The results were statistically significant but the discrepancies were obviously not as huge as the CYp3A4*1B variant.

The variations of the genes, specifically CYP3A4*1B and CYP1b1*3, were not shown in the research as the cause of earlier menopause, but there is no doubt that an association exists. The research did not examine the implications of smoking on menopause in other populations including African Americans. Regardless, all women should understand how smoking may affect their menopause and health in general, and they should consider quitting smoking. To learn about other lifestyle and menopause associations, visit Northwestern's menopause website here.
Reference: Samantha F. Butts, Mary D. Sammel, Christine Greer, Timothy R. Rebbeck, David W. Boorman, Ellen W. Freeman. Cigarettes, genetic background, and menopausal timingMenopause, 2014; 1 DOI: 10.1097/GME.0000000000000140

 

Posted by on February 19, 2014 - 4:17pm
Vulvovaginal atrophy (VVA) or atrophic vaginitis is a medical challenge because it is under-reported by women, under-recognized by health-care providers and, therefore, under-treated according to a new study out of Italy. More or less 50% of postmenopausal women experience vaginal discomfort attributable to VVA. Surveys suggest health-care providers should be proactive in order to help their patients to disclose the symptoms related to VVA and to seek adequate treatment when vaginal discomfort is clinically relevant. Women are poorly aware that VVA is a chronic condition with a significant impact on sexual health and quality of life and that effective and safe treatments may be available. Indeed, female sexual dysfunction and genitourinary conditions are more prevalent in women with VVA. That being so, it is very important to include VVA in the menopause agenda, by encouraging an open and sensible conversation on the topic of intimacy and performing a gynecological pelvic examination, if indicated. According to very recent guidelines for the appropriate management of VVA in clinical practice, it is essential to overcome the vaginal ‘taboo’ in order to optimize elderly women's health care. To learn more about menopause, visit menopause.northwestern.edu or read the full article : http://informahealthcare.com/doi/abs/10.3109/13697137.2013.871696
Posted by on February 14, 2014 - 2:04pm

With the recent controversy surrounding Rachel Frederickson’s extreme weight loss on The Biggest Loser, it’s time to shed light on the proper (and safe) way to lose weight. For those unfamiliar with reality television, The Biggest Loser centers around overweight contestants attempting to lose weight to win a cash prize. The winner, whoever loses the highest percentage of weight, is given the title “the Biggest Loser,” along with a cool cash prize of a quarter million dollars. This past season’s winner, Rachel Frederickson, has stirred up much press when she dropped 60% of her bodyweight, going from an original weight of 260 lbs. down to a meager 105 in roughly 7 months—a new record for the show.

Rachel reportedly exercised for at least six hours a day and ate a diet of only 1,600 calories per day. Despite her claims that this workout/diet routine mimicked that of an athlete—did she go too far? Perhaps. This extreme decrease in weight certainly points to unhealthy habits. Each body is unique and it’s important to be aware of what you can and cannot handle when trying to lose some pounds. WebMD advises aiming to lose 1-2 pounds per week—if you’re looking to shed weight—anything extremely more can be too much, too fast. Fad diets are inadvisable, as they can often be unhealthy and don’t usually last. Burning 500 more calories than you eat every day for a week should be sufficient to help you lose 1-2 pounds safely. Doing slightly more to lose weight, such as eating 1,200 calories a day and exercising for one hour each day could help you lose 3 or more pounds a week—but this can be inadvisable for many people, depending on their unique health conditions.

Eating healthily is a key component to losing weight properly. Focusing on fruits, vegetables, egg whites, soy products, poultry, fish, nonfat dairy, and 95% lean meat is a great start. Drinking plenty of water, eradicating tempting foods from your home, not skipping meals, and staying busy are all other tips to help you reach your goal. While it is unclear if Rachel Frederickson lost weight healthily, it is important to monitor the limits of your body closely. Consulting with your doctor and devising a healthy weight loss or weight management plan will help ensure you’re losing the weight in a proper and safe way.

Sources: CBS News and WebMD

Posted by on February 13, 2014 - 3:59pm

A recent report in Fertility & Sterility has indicated that among women between the ages of 18 and 40, there is a significant amount of misconception regarding fertility and becoming pregnant. Dr. Illuzzi, an OB/GYN at Yale University School of Medicine, led a study in which 1,000 women of various ages and backgrounds completed a survey about their knowledge of reproductive health. The results showed a lack of knowledge across the board, with higher educated women knowing only slightly more than less educated women.

Over one-third of the women surveyed believed that specific positions during intercourse, such as elevating the pelvis, increase the odds of conception, although there is no scientific evidence to back this up. Additionally, only 10 percent of women know when the best time of the month to conceive is. The majority of women thought that sex must take place after ovulation to become pregnant, while in reality, pregnancy is most optimal when intercourse occurs 1 to 2 days prior to ovulation.

Other notable findings in the study include women’s thoughts on what can decrease fertility and prevent conception. Around 25% of surveyed women were unaware that factors such as obesity, smoking, and a history of sexually transmitted disease can cause infertility. In fact, the number one factor women cited as causing infertility was stress. Stress can have many negative side-effects, but according to Dr. Illuzzi, research does not currently support that it leads to infertility. While most of the women surveyed were aware that conception becomes more difficult with age, many did not know that later pregnancies are also more likely to result in miscarriage and chromosomal defects.

If you are concerned about fertility, or have questions about becoming pregnant, it is best to talk to your doctor, but you can get more information on websites such as the American College of Obstetricians and Gynecologists.

Source: Doucleff, Michaeleen. “You’d Think We’d Have Baby-Making All Figured Out, But No.” NPR. 27 January 2014.

Posted by on February 12, 2014 - 9:33am

In the late 1800's there was a growing interest among women in sport, especially cycling, actually leading to some modification in clothing (bloomers!).   However, then and even now, there is an undercurrent of discrimination in sport.  For example, 19th and 20th century physicians linked athletics to childbirth complications, infertility, mannish characteristics and "heterosexual failure" (lesbianism).  In 2009, the  International Ski Federation voted against the inclusion of women in the 2010 Winter Olympics because the sport could cause "damage to their uteri or lead to infertility" (what about male fertility?!!).  Today, after a 90 year wait, women are allowed to complete in the 90m ski jump.

A newer, more troubling  phenomenon has raised its sexist head at this year's Olympics:   the sex appeal of female athletes!  Why is it necessary for female athletes to appear in photos wearing minidresses and lingerie?  Why are fashion models participating in the march of the athletes?   Glamorous female athletes get a lot of screen time during the Olympics but rarely during the rest of the year.

In order to raise sponsorships, athletes have to capitalize on media exposures but should "glam" outweigh "athleticism"?  According to a Chicago-based agency, Engage Marketing, "For male athletes, it's primarily about their performance.   And for female athletes it's definitely as much about their looks as it is about their performance."

We teach our children-- male and female-- that they can participate in any sport they want.   Despite the passage of Title IX in 1972 requiring female sports to get equal public funding, female athletes are still encourage to flaunt their sex rather than their power as they earn endorsements.

To learn more about the history of women in sports, visit Bad Girls Can't Win, an article that can be found  on page 14 of the magazine ATRIUM, a publication by Northwestern Medical Humanities and Bioethics Program.

BLOG UPDATED 2/13/2014

Posted by on February 10, 2014 - 4:01pm

60 Minutes' Sunday feature "Sex Matters: Drugs Can Affect Sexes Differently" put a huge splash in the medical drug industry! Consulting researchers from Northwestern University, the University California Irvine, and the Food and Drug Administration (among others), reporters at CBS News tracked the real story of gender inequity at the research level. Using the recall dosage of Ambien in women as a springboard to their discussion, the piece then launched into the need to not only examine sex as a research variable moving forward, but also to potentially re-examine previously approved drugs to test for potential harmful effects in women.

All researchers in the feature admitted that their attention to the research variances by gender was not initially intuitive to them as scientists. Despite the knowledge of sex differences in drug reaction being known for nearly 50 years, it was a commonly held belief that the primary differences between men and women were in regards to their reproductive organs and cells. Dr. Teresa Woodruff, of the Women's Health Research Institute, however, has been advocating for the study of sex as a variable since her very first years in the field--continually arguing that every cell has a sex--from skin, to liver, to heart, to bones. It's refreshing that increased publicity on this issue can finally propel this knowledge to the masses in a way that can no longer be swept aside.

This is truly a victory for the Women's Health Research Institute and women's health in general. The Institute's collaboration with those at 60 Minutes has provided much needed exposure to this inequity in women's health, and it's exciting to be consulted as a leader in this field. Browse the 60 Minutes website to watch clips from Sunday's show--including segment extras featuring Northwestern's Dr. Teresa Woodruff and Dr. Melina Kibbe.

Posted by on February 7, 2014 - 4:21pm

Dr. Teresa Woodruff of the Women’s Health Research Institute has been a consistent voice advocating for sex-based research.  Recently, Dr. Woodruff consulted with CBS on an upcoming feature to shed light on the importance of sex as a research variable—due to the imbalances between male and female research subjects resulting in inadequate health care for women. In a reaction to the FDA recalling the recommended dosage for women taking Ambien, CBS announced today that their 60 Minutes feature this Sunday will investigate drug dosage differences between men and women. Ambien, a popular sleep drug, was discovered to have adverse effects in women last year. Researchers found that women metabolize Ambien differently than men, which leads to a higher percentage of the drug in the female body. The FDA responded to this incident by halving the previously recommended dosage, just in women.

Last year’s Ambien debacle is merely the tip of the iceberg; it is just one example of the importance of sex differences in research! The truth is, little is actually known or studied about how drugs affect women differently than men. Despite ever-growing evidence of sex differences in health research and care, there are no official standards mandating the observation of sex as a variable in drug and device studies. A report on the incidence of adverse drug reactions published at Johns Hopkins Hospital in 1965 revealed “a striking correlation between incidence and the sex of the patient.” This 49-year-old study revealed that women accounted for 73% of the adverse drug reactions tested—and numbers have hardly improved in the half a century since this study was published. This is appalling. The knowledge of adverse drug reactions in women has been publically stated for nearly 50 years! We have this knowledge. We've known this for half a century. It is time to act on this knowledge.

Dr. Woodruff and the Women’s Health Research Institute as a whole are thrilled that 60 Minutes is broadcasting about the potentially catastrophic events that can occur if drugs are not moderated for use on female patients. Dr. Woodruff and colleague Dr. Melina Kibbe were honored to serve as crucial collaborators on this CBS feature. It’s critical that discussion sparks action on this issue. Addressing the differences between men and women at the research level will lead to more accurate science and better-tailored health care for women. Be sure to tune into CBS on Sunday, February 9th at 7:00pm ET to get the full story!

Watch a preview of the feature HERE.

Posted by on February 7, 2014 - 11:54am

The American College of Emergency Physicians recently found an increase in children requiring medical intervention in states that have decriminalized marijuana. The call rate in theses states have increased by more than 30% per year between 2005 and 2011, while the call rate in non-legal states has not changed. There are currently 18 states and the District of Columbia that have passed legislation allowing medical marijuana, including edible products. George Sam Wang, MD, of the Rocky Mountain Poison and Drug Center in Denver states that these edible marijuana products may be the culprits to increased exposure in children. He states “kids can’t distinguish between products that contain marijuana and those that don’t,” and since edible marijuana tends to “contain higher concentrations of the active ingredient, tetrahydrocannabinol,” adverse effects are more likely to result when children ingest these products.

These pediatric exposures lead to medical evaluations, clinical effects, and critical care admissions. Researchers say neurologic effects are most common and therapies usually involve administering intravenous fluids. As states continue to decriminalize marijuana, it’s important to advocate for the safety of children who may unknowingly ingest this drug. Requirements such as child-resistant packaging, warning labels, and public education are needed to help mitigate this crisis and keep young children safe.

Source: Science Daily

Posted by on February 6, 2014 - 2:30pm

If you live in a northern climate, winter increases your risk of the flu, head colds, and respiratory illnesses.   These are somewhat expected.   But winter also brings some less considered infections that you may get if you are lucky enough to go on a winter vacation in a warm climate.  For example:  Leptospirosis is endemic to Hawaii especially from October to February and is harmful to animals and humans.   Coccidioidomycosis (valley fever) is a fungus found in the southwest U.S. and Mexico.   Both of these areas are popular winter vacation spots.

In addition, there is an increase in aseptic meningitis causes by the Lymphocytic choriomeningitis (LCMV) virus  which is mostly carried by the common house mouse (who gravitates inside for the winter).    There is a strange norovirus (called the 'winter vomiting disease') that was described in 1929 in children and seems to peak between December and February.

While I don't want to be Debby Downer (a character on SNL), it is important to be aware of these rare but significant possible exposures.   The take-home message???  Have a flu shot, be alert to high risk areas, remember to wash your hands a lot, and avoid sick animals!!!

Source:  Wintertime Infections, Beyond the Usual Suspects.   edscape.  Jan. 13, 2014.

 

 

Posted by on February 5, 2014 - 5:53pm

New long-term research shows that hot flashes continue, on average, for five years after menopause. More than a third of women can experience hot flashes for up to ten or more years after menopause.

A recent study evaluated 255 women in the Penn Ovarian Aging Study who reached natural menopause over a 16-year period. The results indicate that 80 percent reported moderate to severe hot flashes, 17 percent had only mild hot flashes, and three percent reported no hot flashes.

Hot flashes are momentary episodes of heat that can occur with other symptoms including sweating and flushing. Changing hormone levels after cessation of menses are believed to cause hot flashes as well as other menopausal symptoms including insomnia, anxiety, joint and muscle pain, and memory problems.  Hormone therapy repletes the hormones estrogen and progesterone the body stops making during menopause, and it has been proven an effective treatment for hot flashes.

Although hormone therapy is highly effective, it is not recommended for all women. In addition, concerns about health hazards linked to hormone therapy have made some physicians hesitant to prescribe it, or to adhere strictly to recommended duration guidelines; current guidelines suggest that exogenous hormones should not be taken for more than five years. This new research on the long-term persistence of hot flashes suggests that women should collaborate with their physicians to determine the risks and benefits of different hormonal and nonhormone therapies available for menopausal symptoms. Women should be able to individualize their treatment to appropriately minimize the the symptoms they may have, no matter how severe or how persistent. To learn more about the variety of treatments available for menopausal symptoms, visit Northwestern's Menopause website here

Source: Ellen W. Freeman, Mary D. Sammel, Richard J. Sanders. Risk of long-term hot flashes after natural menopause. Menopause, 2014; 1 DOI:10.1097/GME.0000000000000196

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