Posted by on November 21, 2014 - 2:08pm

Today, Many women live beyond age 80 and as a result may be postmenopausal for over 30 years. Each woman has a unique range of symptoms.  Hormone therapy has been widely prescribed since the early 60s despite limited research to relieve unpleasant menopausal symptoms.  However,  alarms were raised in the 1990's that have led to a whole battery of new research on hormone therapy that continues to this day.

So what is the current status of hormonal therapy as a treatment option?   Researchers now know that the timing, dosage, path of metabolism, mode of delivery, drug combination, and years of use all matter and need to be measured against each woman’s risk profile.   New genetic and molecular tools enable us to determine how  individuals may respond differently to  the same medications and hormones.     Doctors have better ways to determine risks for the chronic conditions of aging and how they may be impacted when estrogen drops during menopause.   Non-hormonal options are slowly coming on the market, but these, too, may need the test-of-time to determine if they work without side effects and are not always a better alternative.

Doctors do know much more today that they did when hormone therapy was first used and have begun “personalizing” the treatment approach to relieving menopause symptoms as new findings are published.  Individualization is key, and research continues as new diagnostic tools for efficacy and risk are discovered.   In the meantime, women should realize that ALL medicines we take---from aspirin to antibiotics to cold medicine--carry different levels of risk for each person. In fact, many medications beyond hormone therapy, have been studied primarily in males!

In many cases, hormone therapy,  is a relatively safe and effective drug for some women who are experiencing severe symptoms. Learn all you can about your own risk profiles, assess the severity of your symptoms, and find a clinician who keeps up on the latest research to discuss options.    An excellent on-line tool to help you assess your risk and explore the latest interventions can be found at




Posted by on April 22, 2014 - 9:53am

Depression, especially in pregnancy, is a sensitive subject.  It impacts the woman, her child and her family and it affects between 14 and 23% women during pregnancy.  Because of hormonal changes during pregnancy, a woman may not realize she is suffering from depression.  A new, comprehensive guide about this condition that discusses symptoms and treatment to help  women and their family members understand and cope with this issue is now available from the a site called PsychGuides.   For a helpful resource visit   Living with Depression during Pregnancy

Also, if you live in the Chicago area, the Asher Center for the Study and Treatment of Depression and Mood Disorders  has just opened at Northwestern Medicine that provides expertise in hormone-related depression.

Posted by on October 27, 2012 - 7:49am

Conditions that affect the brain can be more complicated in women compared to men, partly because of hormones and reproductive issues.   Did you know:

  • Twenty percent of women have migraines
  • Primary care doctors often ignore sleep disorders in women
  • Epilepsy and its treatment can be impacted by hormonal cyclic changes
  • Neurologic treatments interfere with contraceptive effectiveness and fertility
  • Stroke mortality is higher in women than men but 30% of women are unaware of this fact.

To address these concerns at NorthwesternMedicine, a group of neurology specialists who have a strong interest in women's health and sex-specific care have opened the Women's Neurology Clinic at Northwestern.  The center plans to incorporate integrated medicine approaches and  not rely solely on pharmacologic interventions.    To learn more about this clinic, visit their website.


Posted by on March 30, 2011 - 8:13am
Posted by on October 29, 2010 - 1:05pm

In the largest human study to date on the topic, researchers have uncovered evidence of the possible influence of human sex hormones on the structure and function of the right ventricle (RV) of the heart.

The researchers found that in women receiving hormone therapy, higher estrogen levels were associated with higher RV ejection fraction (ejection refers to the amount of blood pumped out during a contraction; fraction refers to the residue left in the ventricle after the contraction)  with each heart beat and lower RV end-systolic volume — both measures of the RV’s blood-pumping efficiency — but not in women who were not on hormone therapy, nor in men. Conversely, higher testosterone levels were associated with greater RV mass and larger volumes in men, but not in women, and DHEA, an androgen which improves survival in animal models of pulmonary hypertension, was associated with greater RV mass and volumes in women, similar to the findings with testosterone in men.

“This study highlights how little is known about the effects of sex hormones on RV function. It is critical from both research and clinical standpoints to begin to answer these questions,” said Steven Kawut, M.D., M.S.,  director of the Pulmonary Vascular Disease Program at the University of Pennsylvania School of Medicine in Philadelphia.

The study was published online ahead of the print edition of the American Thoracic Society’s American Journal of Respiratory and Critical Care Medicine.

Study participants were part of The MESA-Right Ventricle Study (or MESA-RV), an extension of the Multi-Ethnic Study of Atherosclerosis (MESA), a large, NHLBI-supported cohort focused on finding early signs of heart, lung and blood diseases before symptoms appear. Using blood samples and magnetic resonance imaging (MRI) of the heart, researchers measured sex hormones and RV structure and function in 1957 men and 1738 post-menopausal women. Because the MESA population is ethnically mixed and covers a broad age range of apparently healthy people, the results may be widely applicable to the general U.S. population.

“One of the most interesting things about this research is that we are focusing on individuals without clinical cardiovascular disease so that we may learn about determinants of RV morphology before there is frank RV dysfunction, which is an end-stage complication of many heart and lung diseases,” said Dr. Kawut. “When we study people who already have RV failure from long-standing conditions, the horse has already left the barn. We are trying to assess markers that could one day help us identify and intervene in individuals at risk for RV dysfunction before they get really sick.”

Because the RV plays a critical role in supplying blood to the lungs and the rest of the body, RV function is closely tied to clinical outcomes in many diseases where both the heart and lungs are involved, such as pulmonary hypertension, COPD and congestive heart failure. However, the RV is more difficult to study and image than the left ventricle and comparatively little is known about its structure and function and how to treat or prevent right heart failure.

Corey E. Ventetuolo, M.D., lead author of the study from  Columbia University College of Physicians and Surgeons, reported,  “Our results have generated some interesting questions about RV response to the hormonal milieu. For example, the finding that higher levels of testosterone (and DHEA) were associated with greater RV mass would first appear to have adverse clinical consequences, since increasing cardiac mass is traditionally thought to be maladaptive. However, another study from MESA-RV has shown that higher levels of physical activity are also linked to greater RV mass, which would suggest an adaptive effect. So, whether the increased RV mass seen with higher hormone levels is helpful or harmful is not yet clear. The sex-specific nature of the associations we found was unexpected and reflect the complexity of the actions of sex hormones.”

Sex hormone levels could help explain a key paradox in pulmonary arterial hypertension (PAH), where the RV response is an important determinant of survival.  While women are far more likely to develop PAH, they also have better RV function and may have a better survival than men. “It is possible that hormone balance could predispose them to developing PAH, but confer a protective benefit in terms of RV adaptation,” explained Dr. Kawut.

The ultimate goal would be strategies to treat or prevent RV failure in those at high risk.

Source:   American Thoracic Society

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.