Effects of Hormone Levels on Cognition after Menopause
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.

Hypertension during Pregnancy May Mean Hot Flashes later
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.

 

 

 

Hormones affecting Quality of Life during Menopause
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/

Endometrial Cancer: What Not to Eat and How to Lower Your Risk
Posted by on December 13, 2013 - 4:26pm

We all know that eating sweet and starchy foods is not the best for our health: but did you know that these foods have been found to increase a woman’s risk of endometrial cancer?  Endometrial cancer begins in the uterus and, if it progresses, can lead to a hysterectomy, or even death.  Dr. Bandera, of Rutgers University, found that foods containing refined sugar or white flour (found in sweet and starchy foods) can increase one’s glycemic load, which can greatly increase one’s risk for endometrial cancer.  The American Institute for Cancer Research (AICR) estimated that 59% of endometrial cancer cases could be prevented in the United States if women exercise for at least 30 minutes daily and maintained a healthy body weight.  Estrogen is a known cause for endometrial cancer, and as fat cells secrete estrogen, obesity has been shown as a major cause of this cancer.

Bandera states, “women who are obese have two to three times the rate of endometrial cancer” than those who exercise and maintain a healthy body weight. Bandera also revealed an unexpected piece of research that points to how a certain beverage can protect a woman against endometrial cancer.  Interestingly, eight studies have found that coffee can actually lower this risk.  Coffee helps regulates insulin and is loaded with antioxidants—both of which can reduce one’s risk of this type of cancer.  While Bandera stresses other not-so-positive side effects of coffee (“everything in moderation!”), the decrease in endometrial cancer risk is pretty exciting.

Source: Today Health

 

Who should decide what birth control you use?
Posted by on November 5, 2013 - 10:30am

According to the National Women's Law Center,  "During the debate over the government shutdown, leaders in the House of Representatives passed legislation to exempt bosses from complying with the part of the Affordable Care Act, that gives women access to preventive services like birth control and well-woman visits with no co-pays or deductibles — if those employers oppose it for "religious or moral" reasons.    This means bosses could impose their religious beliefs on their employees or even block their employees' access to needed health care for vague and undefined "moral" reasons. The Senate rejected the House's plan — but this isn't the first time lawmakers have tried this trick, and it likely won't be the last."

Should your boss decide if and what birth control should be available to you through your plan???  Women need to remain vigilant as this debate continues!

Relaxation for Hot Flashes
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.

Joint Relief with Estrogen
Posted by on October 19, 2013 - 1:01pm

Hormone therapy can be used to ease the many symptoms of menopause, including night sweats, hot flashes, and mood swings. New research indicates that hormone therapy, specifically estrogen, can also be used towards joint pain.

Estrogen therapy improves joint pain in post-menopausal women who have had a hysterectomy. Studies looking at the Women's Health Initiative (WHI) trial analyzed 10,000+ post-menopausal women. 77% of these women reported join pain and 40% experienced joint swelling. After just one year, frequency of joint pain was lower among women who received estrogen-only therapy, compared to women who were in the placebo group (76.3% s. 79.2%) After three years, the subset of women who received estrogen continued to have joint pain less frequently than the placebo group.

The difference was seen only in women who received estrogen alone, vs. women with intact uteruses who took estrogen-progesterone combination therapy. Regardless, these findings give light to the many potential therapeutic values of estrogen. Post-menopausal women who are thinking about estrogen to alleviate their joint pain should consult their healthcare providers, and they should still follow the lowest dose of estrogen for the shortest amount of time needed to achieve the therapeutic goals desired. To understand more of the potential benefits (and risks) of estrogen or estrogen-progesterone therapy, visit our menopause website here.

FDA Gives Hot Flashes a Chill Pill
Posted by on August 26, 2013 - 11:00am

The United States Food and Drug Administration recently approved the first non-hormonal solution to hot flashes associated with menopause; it is the drug Brisdelle.  Nearly 75% of menopausal women experience hot flashes, which are extreme feelings of warmth accompanied with redness and sweating.  While hot flashes can spread over the entire body, they are mostly concentrated in the face and neck. Hot flashes are the most common side effect of menopause, and while the exact cause of hot flashes is unknown, a great deal of research is conducted on alleviating this discomfort for women. This new drug Brisdelle offers a non-hormonal alternative to the hormone therapy options currently available.

Brisdelle contains paroxetine mesylate, a serotonin reuptake inhibitor, which differs from other FDA-approved hot flash treatments that contain the hormones estrogen and progestin. Brisdelle underwent two randomized, double-blind, placebo-controlled studies with 1,175 postmenopausal participants and was found to produce positive results compared to the placebo control. The drug is taken once a day and some side effects include nausea, vomiting, fatigue, and headache.  The director of the Division of Bone, Reproductive and Urologic Products in the FDA’s Center for Drug Evaluation and Research, Hylton V. Joffe, M.D., M.M.Sc., expressed that Brisdelle is a breakthrough product for women “who cannot or do not want to use hormonal treatments” for hot flashes associated with menopause. Brisdelle can now be added to the many treatment options available to women who experience symptoms related to menopause.

To read more about Brisdelle, click here.

 

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.

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