Pain and Sex drive
Posted by on April 23, 2014 - 2:08pm

Pain from inflammation may greatly reduce sexual motivation.   The direct impact of pain on sexual behavior was studied, possibly for the first time in any species,  and reported by researchers in Canada.   They found that pain due to inflammation greatly reduced sexual motivation in female mice in heat--but had no such effect on male mice.

"Chronic pain is very often accompanied by sexual problems in humans," says Professor Yitzchak Binik at McGill University.  This animal study creates a model for exploring pain-inhibited sexual desire that can help researchers eventually apply to human research.

The study is a classic example of why sex-based research should start at the animal level (when it is cheaper) to determine if a condition may have underlying sex differences that can apply to humans.  The Women's Health Research Institute at NU has been an outspoken advocate for sex based research from the bench to the bedside!

Source:  McGill University

 

 

Bladder Control Problems during Menopause
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.

Alcohol related risk may be more deadly for women
Posted by on April 9, 2014 - 8:26am

The increased risk of death associated with alcohol intake is not the same for men and women. A study that compared the amount of alcohol consumed and death from all causes among nearly 2.5 million women and men showed that the differences between the sexes became greater as alcohol intake increased, as described in an article in Journal of Women’s Health, a peer-reviewed publication from Mary Ann Liebert, Inc., publishers. The article is available free on the Journal of Women’s Health website.

In the article “Effect of Drinking on All-Cause Mortality in Women Compared with Men: A Meta-Analysis,” Chao Wang and coauthors, Chinese Academy of Medical Sciences and Peking Union Medical Sciences (Beijing, China), modeled the relationship between the dose of alcohol consumed and the risk of death, comparing the results for drinkers versus non-drinkers and among male and female drinkers. Females had an increased rate of all-cause mortality conferred by drinking compared with males, especially in heavy drinkers.

“While alcoholism is more common in men than women, female drinkers face greater risks to their health compared with male drinkers,” says Susan G. Kornstein, MD, Editor-in-Chief of Journal of Women’s Health, Executive Director of the Virginia Commonwealth University Institute for Women’s Health, Richmond, VA, and President of the Academy of Women’s Health.

New Rochelle, NY, April 9, 2014

60 Minutes Feature a Success for Women's Health Advocates
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.

Upcoming 60 Minutes Features Importance of Sex-Specific Research
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.

Temporomandibular disorder screening guidelines
Posted by on February 3, 2014 - 5:41pm

The first ever Recommendations for Diagnosing TMD have been published with support from NIH. Despite a prevalence rate of 2:1 women to men, there was no mention of the sex differences for TMD in the abstract, NIH press release or accompanying editorial.   This continues to frustrate the women's health research community who are actively advocating for more sex based research.  This latest announcement indicates we must continue to be vigilant and work with funders and journals to ensure that sex differences become part of the research equation.   Temporomandibular disorders (TMD) occur as a result of problems with the jaw, jaw joint and surrounding facial muscles that control chewing and moving the jaw. These disorders are often incorrectly called TMJ, which stands for  temporomandibular joint.

Source:   Sex and Gender Women's Health Collaborative.

FDA Advocates for Sex as a Research Variable
Posted by on January 24, 2014 - 3:14pm

Men and Women are physiologically different, and it is essential to ensure adequate participation of both sexes in research studies in order to determine sex-based differences in disease presentation, prevalence, and treatment. A press release from Mary Ann Liebert, Inc. Publishers revealed a study that tested the participation rate of women in post-approval studies mandated by the Food and Drug Administration (FDA). Out of their sample size, researchers found that only 14% of studies “included a multivariate analysis that included sex as a covariate” and a meager 4% “included a subgroup analysis for female participants.” These shocking results mean that women are not getting adequate attention in clinical trials, which may result in harmful drug or device reactions in women.

Women vary from men in genetics, hormones, body size, sex-specific physiology, diet, sociocultural issues, and more—therefore, it is incorrect to assume that women and men will react the same way when tested for medical devices and drugs. Most researchers limit sex-based research to areas that are inherently sex-biased, for instance obstetrics and gynecology more often involves women, while urology more often involves men. However, men and women differ in nearly everything from their hearts to their knees—and research needs to keep these differences in mind. If researchers neglect to include sex as a variable in their research, devices and drugs can be approved for public use without fully understanding the reaction such drugs could have on women.

In response to this growing concern, the FDA has implemented new procedures to ensure participation by sex is evaluated in post-approval study reviews. This is certainly a step in the right direction towards recognizing and evaluating sex-specific health responses to new research.

Source: Journal of Women's Health

CDC Announces Decrease in New Lung Cancer Incidence Rates
Posted by on January 10, 2014 - 3:37pm

In the January of 1964, the Surgeon General made its first report linking cigarette smoking to lung cancer. Yesterday, the CDC announced a new triumph in the war against lung cancer by announcing that the rate of new lung cancer cases have decreased among men and women in the United States since 2005. Lung cancer incidence rates decreased 2.6% per year among men, and 1.1% per year among women. While, generally, this is a significant victory, the differing rates between men and women are troubling.

For many years, the female population was not smoking at the same rate as the male population, but the CDC stated, “smoking behaviors among women are now similar to those among men,” so “women are now experiencing the same risk of lung cancer as men.” If women have the same risk as men, it is troubling, therefore, that efforts to decrease new cancer incidences in women is declining at a slower rate than in men. Lung cancer is the leading cause of cancer death among men and women in the United States, and sex-based research must be conducted to determine why women seem to be lagging behind men in these decreased incidences.

The CDC attributes these decreased rates to tobacco prevention and control programs. The CDC calls for a continued emphasis on local, state, and national tobacco prevention strategies to mitigate future lung cancer diagnoses. Some strategies that have been accredited to this reduced incidence rate are increased tobacco prices, smoke-free laws, restricted tobacco advertising, and a slew of mass media campaigns against smoking.

Source: Centers for Disease Control and Prevention

Male and female cells can behave differently!
Posted by on September 11, 2013 - 3:39pm

Even at the most basic molecular level sex matters---and it's not just about hormones.   Did you know that muscle stem cells from female mice regenerate new muscle faster than cells from male mice?  And cells from male and female mice respond to stress differently.  Yet most researchers who use basic cell cultures in their work do not even identify the sex of the cells they use.

We already know that this lack of sex identification can have serious consequences when we study new therapeutics.   Most adverse drug effects reported occur in female humans!  Since most basic drug studies start with cell cultures, shouldn't we be comparing the two sets of cells at the start of the "experiment" before it reaches humans???  It certainly would be cheaper and may prevent serious consequences once the drug is used in humans!

At first, it is easy to blame hormones for the differences but researchers have found that hormones may not always  be the culprit.  The way a cell metabolizes its food (energy) may be different by sex and other biologic functions could be affected by sex.  A recent commentary by Elizabeth Pollitzer explores this issue and makes a plea for researchers to include the sex in their publications on all studies--cellular, animal and human.

Weight Management v. Weight Loss: Why Some Women Respond to the Former and Not the Latter
Posted by on September 3, 2013 - 1:30pm

A recent study published by researchers at Duke University highlighted the fact that some populations of women are more receptive to weight-management interventions than programs advertising weight loss. Weight loss is difficult across all populations and many programs aimed at reducing the pounds may end up providing only a temporary reprieve.  As weight gain and obesity are ever-increasing concerns, some researchers have tried to tackle this problem from another angle.  Instead of designing weight loss programs, health enthusiasts should focus on weight management initiatives for certain populations.

Duke University researcher Gary Bennett, PhD, who headed this study, found that African-American women responded more favorably to a weight control program than the traditional weight loss regime. On average, premenopausal African-American women have more weight gain per year than women of other racial and ethnic groups.  Furthermore, by the time African-American women are 59, twice as many “have class 2 obesity as do white women and three times have the prevalence of class 3 obesity.”  Current obesity treatments are not as effective for this population of women, and their underrepresentation in clinical trials studying weight loss interventions points to a dire need for understanding and implementing positive approaches to fight obesity. Re-angling the strategy towards prevention of weight gain requires a less-intensive intervention strategy, which many women are more responsive to.

The clinical trial involved overweight and class 1 obese women between the ages of 25 to 44.  The women were randomly placed in either a health clinic’s usual care cohort or the experimental “Shape Program.” The intervention program had five primary components: tailored behavior modification goals, weekly self-monitoring by interactive voice response, 12 monthly counseling calls by a registered dietitian, tailored skills training, and a 12-month YMCA membership. After the 18 month trial, patients in the “Shape Program” had a “mean weight loss of more than 2 pounds versus continued weight gain” in the control group. These positive results have inspired Duke researchers to continue unlocking the motivations behind weight management and weight loss in women. Furthermore, this research provides an opportunity for clinicians to breach the subject of weight management with their patients through a new lens.

To read more about this study, please click here.

 

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