Posted by on April 15, 2014 - 6:52pm

Loss of bladder control, or urinary incontinence, is a problem that millions of women face. The involuntary loss of urine can range in presentation; it can be minimal, from a few drops when you laugh, exercise, or cough. Or, it can be an accident when you suddenly urge to urinate and can't keep it in. Most episodes of urinary incontinence are the result of altered pressures or stress on the muscles and nerves that help you pass or hold urine in. Hormone changes can also affect muscle strength. Like your vaginal tissue, the muscle tissue in and surrounding the bladder and urethra (the short tube that passes urine from the bladder out the body) requires estrogen to remain supple and strong. When estrogen levels drop in menopause, the tissue around the bladder and urethra thin and weaken,which can lead to incontinence.

The most common types of urinary incontinence include stress incontinence and urge incontinence. Stress incontinence occurs when the pressures from activities such as laughing, coughing, and sneezing cause leakage. Urge incontinence occurs when you have the urge to urinate and your bladder squeezes at the wrong time. Often, these two types can create a mixed picture. Other bladder problems that can happen are nocturia, when you must wake up multiple times throughout the night to urinate, and dysuria, painful urination.

If you think you have incontinence, visit a professional to learn more about the variety of options you have for treatment. A professional can be your primary care physician, gynecologist, urologist, and even a urogynecologist. Your physician may recommend lifestyle changes such as limiting alcohol or caffeine intake, recording a voiding diary, or strengthening your pelvic floor muscles with Kegel exercises. Beyond this, therapies also include devices inserted into the vagina to hold up the bladder (pessaries), a variety of medications, and surgery if necessary. Your physician will also be the one to exclude other potential causes of bladder problems including infection and neurological damage.

To learn more about urinary issues or other symptomatology that arise during menopause, visit Northwestern's menopause website here.

Posted by on April 7, 2014 - 8:41pm

Drinking milk is not just for kids but also for post-menopausal women, new research shows. A new study from the Women's Health Initiative just published by the North American Menopause Society, reveals that calcium and vitamin D after menopause can improve women's cholesterol profiles.

Over 600 women took either a supplement containing 1,000 mg of calcium and 400 IU of vitamin D3, or a placebo, daily. Women who took the supplement, unsurprisingly, were two times more likely to have sufficient vitamin D levels (at least 30 ng/mL), in comparison to the women were taking placebo. Women who were taking supplements also had LDL (the "bad" cholesterol) numbers that were 4 to 5 points lower than the women taking placebo. The women on supplement also had higher levels of HDL (the "good" cholesterol) and lower levels of triglycerides.

Researchers agree that more work needs to be done to see whether or not supplementing one's diet with calcium and vitamin D can lower cholesterol levels and ultimately improve rates of cardiovascular disease in women after menopause. These results, however, show that there may potentially be extra benefits for those with calcium and vitamin D deficiencies to start supplements. Supplementing may be key for strengthening both the heart and bones after menopause. To learn more about healthy choices you can make after menopause, visit Northwestern's menopause website here.

“Calcium/vitamin D supplementation, serum 25-hydroxyvitamin D concentrations, and cholesterol profiles in the Women’s Health Initiative calcium/vitamin D randomized trial,” will be published in the August 2014 print edition of Menopause.

 

Posted by on April 2, 2014 - 2:55pm

Prentice Women’s Hospital: Under the Northwestern Memorial Hospital Chicago, was recently named one of the top ten women's health providers by HealthCare Global Magazine.   It was noted that the hospital  provides a wide variety of services and specialized care just for women, through all stages of their lives- from gynecologic and pregnancy care to menopause and bone health.   The Women's Health Research Institute has worked with Prentice on several programs including:

  • Advocacy and promotion of specialty clinics in neurology, depression, cardiology, skin health, sleep disorders, and pelvic health that are described HERE
  • The creation of an interactive menopause website that provides the latest options for menopause symptom management.
  • Provided professional education on sex differences beyond reproductive and maternal health.

To learn about the entire top ten, visit Healthcare Global.

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 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

Posted by on January 2, 2014 - 11:23pm

Do hormone levels in postmenopausal women affect cognitive function? New research sheds light on the postmenopausal brain.

In a recently published study, researchers found that estrogen levels after menopause may have no impact on cognitive skills, but progesterone levels might. Progesterone had some association with global cognition and verbal memory among newly postmenopausal women.

643 healthy postmenopausal women were part of the study, ranging from 41 to 84 years old. Neuropsychological tests were done to assess cognition and memory, and hormone levels were determined including estradiol, estrone, progesterone, and testosterone. The findings showed no association between estrogen and cognitive skills. However, women with higher levels of progesterone had better outcomes on the verbal memory and global cognition tests, particularly in those who had started menopause less than six years prior. None of the hormones appeared to have any association with depression or mood either.

More research must be done to confirm the new findings regarding progesterone levels. Also, there is no way to directly measure hormone concentrations at the brain level, but this research implies that estrogen therapy may not have a significant effect on cognitive skills. To learn more about when hormone therapy is beneficial , visit Northwestern's menopause website here.

 

Source reference: Henderson VW, et al "Cognition, mood, and physiological concentrations of sex hormones in the early and late menopause" PNAS 2013; DOI: 10.1073/pnas.1312353110.

Posted by on December 30, 2013 - 1:11am

New research shows that women with high blood pressure during pregnancy may be at higher risk of having troublesome menopausal symptoms in the future. A research study from the Netherlands examined the relationship between hypertensive diseases and hot flashes and night sweats.

Investigators looked at 853 women who regularly visited a cardiology clinic. Among these women, 274 had a history of high blood pressure during their pregnancy, such as preeclampsia. Participants were classified as having hypertension (high blood pressure) if her systolic blood pressure was 140 mmHg or higher, if her diastolic was 90 mmHg or higher, or if she took antihypertensive medication.

The study revealed that women with a history of hypertensive pregnancy disease were more likely to have vasomotor symptoms of hot flashes and night sweats during menopause. Hot flashes and night sweats are considered vasomotor because of sudden opening and closing of blood vessels near the skin. 82% women with history of hypertension during pregnancy had hot flashes and night sweats, compared to 75% women without. Moreover, women with hypertension during pregnancy reported experiencing hot flashes and night sweats for a longer time period.

Researchers concluded that the findings were modest but more research needs to be done to establish a definite association. One must also consider that every woman experiences menopause differently; you  might have symptoms that are barely noticeable, while your friends could experience almost all of them. To learn more about the different types of symptoms during menopause, visit the Women's Health Research Institute's menopause website here.

 

 

 

Posted by on December 20, 2013 - 8:36pm

Women undergoing menopause experience symptoms including hot flashes, sleeplessness, depression, joint pain, and poor concentration, to name a few. Hormone therapy has proven to improve some of these symptoms in menopausal women, but new research shows that treatment may only improve quality of life in those who undergo a significant number of hot flashes.

A recently published study done in Finland, looked at use of hormone therapy in women who had recently gone through menopause. 150 women were divided into two groups, those with seven or more moderate to severe hot flashes per day, and those with three or fewer mild hot flashes per day. In each group, half the women used hormone therapy and half received only a placebo.

All women were asked to track their hot flashes as well as their additional menopausal symptoms. After six months, hormone therapy improved the overall health of women with moderate to severe hot flashes in symptoms including sleep, anxiety, memory and concentration, joint and muscle pain, and hot flashes. Hormone therapy made no difference in those with mild or no hot flashes.

Though the Finland study may not apply to women of other ethnicities, the research demonstrates how treatment must be personalized for women undergoing menopause. Physicians should take into account the different symptoms that a woman is experiencing when recommending treatment. Women should also always consider all the options in improving symptoms, from lifestyle to herbs to hormones. To read more about the different treatments available to minimize menopausal symptoms, visit http://menopause.northwestern.edu/

Posted by on November 1, 2013 - 12:49pm

Hot flashes: most menopausal women have them, and all menopausal women hate them. For one in ten women, hot flashes occur for five years or longer, signicantly affecting multiple aspects of their lives including relationships and sleep. While hormone replacement therapy has largely addressed the issue of hot flashes in many women, other women have sough alternatives. Alternatives including yoga, acupuncture, exercise, and applied relaxation have all been helpful in women undergoing menopause.

Applied relaxation, in particular, has recently been studied in a small Swedish pilot study and proven to be beneficial. 60 women were divided into two groups: one was given relaxation exercises  to practice daily at home, and the other received no treatment whatsoever. After three months the treatment group lowered their number of hot flushes per day from an average of 9.1 to 4.4. The control group also noticed a decrease in hot flashes per day, but only from an average of 9.7 to 7.8.

Relaxation techniques include breathing exercises, guided imagery exercises, and calming music. Consider applying relaxation in replacement of or in addition to your hormone replacement therapy. For more information on how to incorporate relaxation into your therapy for hot flushes, visit our Northwestern menopause website here.

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