Strong Bones with Calcium and Hormones
Posted by on August 13, 2013 - 8:50pm

After the age of 30, the creation of new bone cannot keep up with the rate of bone loss in your body. The estrogen depletion that comes with menopause results in an increased risk for low bone mineral density, osteopenia and osteoporosis. For 5-10 years after menopause, this bone density loss accelerates into a gradual weakening of your bones and can lead to an increase in the risk for fractures and other injuries.

Physicians and organizations left and right have tried to specify a regimen to  help slow down the weakening of bones in postmenopausal women. The National Osteoporosis Foundation states that both types of hormone therapy, Estrogen therapy and combined Estrogen and Progesterone therapy, reduce the risk of osteoporosis. But what about supplements?

This past February, the US Preventive Services Tasks Force (USPSTF) stated there was insufficient evidence regarding calcium and vitamin D supplementation for bone fracture prevention in postmenopausal women. Now, a new analysis shows the evidence that may very well alter this recommendation.

The North American Menopause Society conducted a trial with 27,347 postmenopausal women, of which 8,000 took supplemental calcium (1,000 mg) and vitamin D (400 mg) daily, and 8,000 took look-alike placebos. These women came from all the hormone groups in the study: on HRT combinations, those on HRT estrogen alone, and the rest on hormone look-alike placebos.

Researchers then studied the hip fracture incidents among women who took hormones and supplements, women who took hormones alone, and women who took neither one. Of the women on both hormones and supplements, there were 11 hip fractures per 10,000 women per year. Of the women solely on hormones, there were 18 hip fractures per 10,000 women per year. And of the women who took neither, there were 22 hip fractures per 10,000 women per year.

Although the researchers could not specify how much of calcium and vitamin D should be taken, they concluded that postmenopausal women taking hormone therapy should also take supplemental calcium and vitamin D to reduce the rate of bone loss. The benefits of calcium and vitamin D seem to increase with increasing total intake, but also depend on the side effects of too much calcium, such as constipation.

So consider taking calcium and vitamin D supplements in combination with your hormone therapy, but don't stop drinking your milk! Continue trying to meet your daily calcium needs with your diet. Furthermore, did you know that weight bearing exercise can also improve your bone health? To learn more about how you can manage your bone health and overall health in menopause, visit http://menopausenu.org/

 

Menopause and Memory: Women Know What They Do Not Know
Posted by on August 8, 2013 - 3:24pm

The need for health care varies greatly over a lifespan, with older adults having significantly more health-related needs and costs than younger individuals. Women, in particular, often face a myriad of health problems as they transition through menopause.  Sadly, despite the fact that every woman will go through menopause, very little is understood about the physical and mental changes that occur during this period of life.  In addition, women may struggle to find pharmaceutical solutions, which can safely provide proven relief without the worry that those available will increase their likelihood of other health and mental complications.

Much is misunderstood about menopause and the changes that are associated with the hormonal fluctuations. This is largely due to the fact this inevitable transition is rarely apart of the conversation, particularly in the context of health care. Further, menopause is expected to be merely “bothersome”; not something one could attribute real health problems to. Although maternity care and issues related to younger women are required in the Affordable Care Act as essential health benefits, nothing of legislative note will improve the knowledge and acceptance of this natural life progression.

Most insurance companies do not even cover basic medications associated with menopausal symptoms, and conflicting research has women scared about the potential long-term effects associated with hormone replacement therapy. Negative press, little medical literature and low financial assistance often leaves women to suffer through menopause silently, many of whom worry constantly about memory deficits they experience and potential long term changes.

A recent study focused on the memory complaints of midlife women has been receiving a lot of attention. The study, conducted at the University of Illinois- at Chicago (UIC), attempted to determine if women who are experiencing hot flushes during menopause were able to accurately predict their own memory performance.

According to the principal author, Lauren Drogos, “We found that a one-item question: ‘How would you rate your memory in terms of the kinds of problems that you have?’ was the best predictor of verbal memory performance on a list-learning task.  We also found that many complaints were related to mood symptoms.”

In the US, the average woman becomes postmenopausal around the age of 51.  Common symptoms that occur include hot flushes, sleep disturbances, mood changes and memory problems. However, until recently it was believed that women were unable to accurately describe the current state of their memory and the changes they experience as they progress through menopause.

Despite the difficulty in being taken seriously about the physical and mental challenges that menopause presents, this recent study from Drogos, along with other research, shows that woman are able to accurately describe their current memory abilities. Specifically, a group of sixty-eight women performed a series of memory tests and were then asked, to detail the types of memory problems they were experiencing. The study concluded that women were able to accurately rank themselves on a scale from no memory problems to severe problems.

Using recall of a short story, the deficits seen in memory did not indicate that women were suffering from dementia, nor were they experiencing shortfalls in memory that were impacting daily life. Instead, it was simply indicative that women who experienced memory deficits often recognized the changes occurring.

Previous research focusing on women’s transitions through menopause also found that hot flushes during the nighttime were the best predictors of memory performance in women. This leads researchers within the Women’s Mental Health Research Program at UIC, to believe that sleep disturbances and stress hormones may play integral roles in memory and hot flushes.

The good news for women concerned about the transition through menopause is that the cognitive decline that occurs appears to only be temporary, with performance rebounding early into post-menopause. Further, for those who want to keep both their minds and bodies at peak performance, research indicates that leading a non-sedentary lifestyle, keeping mentally active, and having a healthy diet can be the best preventers of cognitive decline.  To learn more about menopause, visit menopausenu.org, a new web site that helps women evaluate their overall health and menopause symptoms.

Closing Racial and Ethnic Disparity Gaps for Women
Posted by on July 19, 2013 - 11:57am

For all intents and purposes, the Affordable Care Act (ACA), the President’s signature piece of legislation, will provide more health care coverage to poor and underserved populations. Persistently disadvantaged communities have much further to go than those with insurance, and new means of accessing and paying for care will benefit them disproportionately. Nevertheless, with more than 20 percent of the nation’s Black population uninsured, more than 30 percent of Hispanics uninsured and a country still grappling with understanding and properly addressing disparities, just how far does the ACA take uninsured women in the US?

By mandating individual health insurance coverage and expanding the list of covered preventative services, ACA legislation should, theoretically, improve the quality of health care for women at a disproportionate risk of being uninsured and having low incomes. However, research has shown that having health insurance itself does not necessarily have a substantial impact if women cannot find a doctor to see them, do not have proper information about accessing resources, or are not treated in a culturally and environmentally competent manner.

Moreover, when the number of uninsured could be decreased by more than half, but being uninsured is not equitable across racial and ethnic groups in the US, what happens to our countries most vulnerable women and children?

It has been well documented that low-income women and those without employee-sponsored insurance (ESI) are more likely to be women of color. Kaiser and US Census estimates indicate that there are significant differences in insurance rates by race and ethnicity, with national averages approximating there are almost three times as many uninsured Hispanics as Whites. In Louisiana, for example, it is believed that more than 50% of the state’s Hispanics are uninsured, while only 18% of Whites are. In the same state, it is estimated that 30% of Blacks are uninsured, reiterating just how unbalanced our country remains and how terribly far we have to go to eliminate inequalities.

Even in Massachusetts, where health reform has been a success, the number of Blacks and Hispanics that remain uninsured is two and three times that of Whites, respectively.

Although the ACA takes us a step forward in giving many of the countries uninsured woman an insurance card, the US must address what to do about probable provider shortages that will result from a lack of primary care physicians and different utilization in care between races, ethnicities and gender. We must be prepared to understand both to cultural differences in demand and pent-up demand of the previously uninsured, as well as start to really face how to deal with persistent racial and ethnic inequality in this nation that shows itself in our health care system every day.