Soy-ta interesting….
A new study suggests that a key component of an isoflavone found in soy, confers significant improvements in mood-related symptoms in perimenopausal and postmenopausal women who lack the ability to produce this component on their own. The component, which is called S-equol, is involved in the metabolism of an isoflavone known as daidzein.
In this study, which appears in the online edition of the journal Menopause, researchers randomly and blindly assigned 134 women to daily placebo, 10 mg of equol daily or 10 mg equol three times a day. All study participants also completed questionnaires at the study’s start and after the completion of the study on menopausal symptoms and moods. Additionally, they underwent physical exams and urine testing.
The results showed that women taking equol experienced significant declines in all menopausal mood symptoms except depression (although compared to women who were assigned placebo, the decline in depression was significant).
Overall, women taking equol showed significant declines in tension-anxiety and fatigue, and improvements in vigor scores. No side effects were noted, except for a rash in one woman taking equol.
These data suggest that supplementation with S-equol may help to improve mood-related symptoms in peri- and post-menopausal women. What’s more, the team concluded that equol supplementation may offer a promising alternative to estrogen therapy.
Sorta interesting, right?!
Wednesday Bubble: I’d walk a mile
Fact or fiction? I’ve written previously about the link between cigarette smoking and hot flashes. In fact, the association consistently arises in many of the studies I’ve run across. When I first posted about this, it seemed to push a lot of buttons, primarily because many of my contemporaries, myself included, smoked at one point in our lives.
Hence, I was intrigued when I found this study in the journal Obstetrics and Gynecology discussing the underlying cause of the association between cigarette smoking and hot flashes.
In the study, perimenopausal women who were either experiencing or not experiencing hot flashes were asked to complete a questionnaire and provide a blood sample so that researchers could measure their hormones.
The results showed that women who were current smokers had significantly higher levels of androstenedione (a precursor to sex hormones) and higher ratios of androgens to estrogens than women who never smoked. Additionally, current smokers had significantly lower levels of progesterone than never smokers.
Nevertheless, while both former and current smokers had increased odds of experiencing hot flashes (1.4 times greater for former and 2.4 times greater for current) than never smokers, this link was not altered or influenced in women who were also taking hormones.
Researchers have long believed that factors that influence estrogen levels, such as a higher body mass index (which increases them) or cigarette smoking (which decreases them) protect against or lead to vasomotor symptoms, respectively. Yet, in this particular study, hormone changes did not weaken the effect of smoking on hot flashes.
These results suggest that the effect of cigarette smoking on hot flashes, while very real and relevant, is not influenced by hormones.
Unanswered questions. Undoubtedly the bottom line is to stop smoking if you continue to do so, not only for heart and lung health, but also, to help avoid those troublesome hot flashes.
Breast cancer risk and HRT – what matters most?
Data from the San Antonio Breast Cancer Symposium last month provided definitive evidence that HRT increases the risk of breast cancer by 26% in menopausal women. However, does route of administration (e.g., patch, oral) or type of HRT matter?
According to a study in the journal Breast Cancer Research and Treatment, route of administration does not matter. But the progestagen component does.
Data were extrapolated from 80,377 postmenopausal women living in France and participating in E3N (a study designed to investigate risk factors for cancer) between 1990 and 2002. At the study’s start, the average age of participants was 53 years. HRT types included estrogen only and estrogen plus progesterone, dydrogesterone combinations or other types of progesterone.
Over the study period 2,354 cases of invasive breast cancer occurred. Compared with women who never used HRT, women using estrogen alone had a 1.29-fold increased risk of developing breast cancer. However, breast cancer risk varied significantly depending upon the type of progestagen:
- Risk was significantly lower with estrogen-progestagen HRTS containing progesterone or dehydrogesterone than with estrogen combinations involving other types (e.g., nomegestrol acetate, norethisterone acetate, medroxyprogesterone acetate)
- The aformentioned combinations Ii.e. estrogen plus progesterone or dehydrogesterone) were associated with no or only a slight increase in breast cancer risk (1 fold greater or 1.16 fold greater, respectively).
- The results remained the same when analysis was restricted women whose age at the start of menopause could be most accurately determined.
Although the effect of progestagen remains somewhat unclear, and factors such as experimental conditions, length of time taking them and dose can influence results, the researchers did conclude that some HRT combinations may be safer than others.
Researchers also emphasize that further study is needed, and that medical experts are still unsure how HRT combinations affect other disease risks, such as heart disease, stroke and colorectal cancer.
Meanwhile, if you are taking HRT, talk to your health practitioner and find out which progestagen you’re taking. Better safe than sorry, right?!
Burp
I wanted to apologize for the slight interruption in Flashfree. Back on track on Monday!
Speaking of blondes…Hot flashes and 20 other symptoms of menopause
Have I got your attention yet?
Since this is a week of change, I thought I’d swap Wednesday’s Bubble out for a guest post by my Twitter friend, The Daily Blonde, known to her friends as Cheryl Phillips. I caught this post on Cheryl’s blog and knew it was a winner. Enjoy!
I got the good news about a year ago. My doctor told me that I was in “perimenopause.” Peri meaning what? I’m only going to be on the big old mood swing occasionally? Far be it for me to say, but I like some consistency in my life. I don’t want to do things half-assed. I want my mood swings to be on a regular basis so they don’t sneak in and scare me…or anyone else for that matter.
Menopause. Figures there’s the word “men” in it. They’ve always caused me to pause. Never mind the pausing, they’ve caused me sweat, anxiety, mood swings and general pain. But then there have been a few who’ve just made me hot. Those are the men worth pausing for.
Back to me. (I like it when it’s back to me. With five children I only get a few “me” moments…mostly when I lock the bathroom door and hide.) OK, I keep digressing. I thought I’d do a search on the symptoms of menopause (since apparently that’s where I’m headed). I think I had one of the major symptoms today in the supermarket. As I paid for my items the sweat poured down my face and pooled in my ever so sexy sports bra. I was trying to look very “together” in my puddle of sweat. It was 20 degrees outside and not much warmer in the market. I felt like I was on fire.
The clerk was about 17 years old. I told her that she’d be just like me in about 30 years and to enjoy her inner air conditioning. Mine just seemed to stop working. She didn’t make eye contact with me after I scared her. Poor thing.
I love to research things. Usually things more pleasant than menopause, but hell, this is REAL life. The first website I came across about menopause had a list of twenty symptoms. Twenty?? Isn’t one symptom enough? As I perused the list, I was so hoping to find nausea, vomiting and occasional diarrhea. Aren’t those typical side effects for just about every medication on the market? It must be the same for menopause. Sure enough, that’s #18 on the list.
Here goes….oh so much to look forward to!
- Hot flashes, flushes, night sweats and/or cold flashes: OK, I’ve got that!
- Clammy feeling: Not yet…can’t wait!
- Irregular heart beat: Only if my phone rings at 3am
- Irritability: This has been going on for one day a month since I was eleven years old.
- Mood swings, sudden tears: I’m a pretty chipper chick. I do like a good cry though. Mood swings? Me? What are YOU TALKING ABOUT??? I am PERFECTLY FINE!!!! OK??????? Hey, want to snuggle?
- Trouble sleeping through the night: I am an insomniac. I wouldn’t know the difference.
- Irregular heavier periods or shorter periods: Of course, I got a combination…shorter, heavier. Hey, that sounds like me aging–shorter and heavier.
- Loss of libido: This will never happen to me. I keep repeating this and believing in it. Losing my sense of humor and my libido would be dreadful.
- Hair Growth: Not sure what this is about but there is a three letter word ladies: WAX
- Crashing fatigue: Got it. Got it. Got it.
- Anxiety, feeling ill at ease: Yes…I’m extremely anxious about getting all of these symptoms.
- Feelings of dread, apprehension, doom: This is why people get feelings of doom…because they read these lists and panic. Not me. I write about them and laugh. Sort of.
- Difficulty concentrating, disorientation, mental confusion: I’ve given birth to five children in 24 years. These symptoms were part of the parenting package.
- Disturbing memory lapses: I’ve had this for years. I just make lists now and try to keep track of where I put them.
- Incontinence, especially upon sneezing, laughing: I laugh often and haven’t peed my pants yet.
- Itchy, crawly skin: I only get this when I see my ex-husband.
- Aching, sore joints, muscles and tendons: This is the result of having my knee sliced open three times this year, not menopause.
- Gastrointestinal distress, indigestion, flatulence, gas pain, nausea: I will not allow this to happen. Ever. OK, I’ll pick nausea if I have to pick one. That’s it.
- Weight gain: This is something to look forward to!
- Changes in body odor: I assume this doesn’t mean I’ll be smelling like Chanel No.5 ??
Change
[credit: Bella, T-shirt mojo http://tinyurl.com/7jyss5]
It’s all in the spin
I’d like to believe that researchers have patients’ best interest at heart but an article in this month’s British Medical Journal’s Drug and Therapeutic Bulletin has led me to believe that objectivity can be difficult.
The piece, entitled “Herbal medicine for menopausal symptoms,” positions itself as a review of the effectiveness and safety of herbal medicines commonly used for relief of vasomotor symptoms, including hot flashes and night sweats. The herbs covered within the piece include black cohosh, red clover, dong quai, evening primrose, ginseng, and briefly wild yam, chaste tree, hops, sage leaf and kava kava.
However, within the first two paragraphs, it becomes abundantly clear that the review is aimed at attacking the validity of so-called “alternative” therapies and consequently, attempts to provide the evidence that does so.
The author correctly points out that the consumer might automatically deem such products safe since they are natural, and that many products on the shelves do not comply with good manufacturing standards. In fact, I’ve written on these very essential considerations.
However, s/he blatantly (and incorrectly) states that “there has been a lack of studies of herbal medicines for menopausal symptoms,” emphasizing in particular (but not defining) the following: faults in study design, number of participants and length of study. The author also criticizes the use of traditional herbal systems (e.g., Traditional Chinese Medicine), which s/he says has little published research that supports its use in treatment of menopausal symptoms.
Although I did not review each study individually, I would like to point out that the author’s claim of a lack of published studies can be easily disputed. Using the search term:
- “Herbal medicine for menopause,” I pulled 6 pages (104 studies) of scientifically-designed, herbal medicine trials on the National Institute of Medicine’s Pub med database
- With the term “black cohosh,” I pulled 20 pages or 431 studies
- With the term “red clover,” I found an additional 76 studies
- Ginseng and menopause – 20 studies
- Traditional Chinese medicine and menopause – 47 studies
- Dong Quai – 24 studies
- Evening Primrose – 25 studies
Notably, I did not search databases that specialize specifically in complementary therapies or more importantly, the Traditional Chinese Medicine database.
The gist of the data cited within the DTB Review suggest that save for black cohosh, there is little or no evidence to support the utility or effectiveness of herbal medicines for relief of menopausal symptoms. Claiming that the “efficacy and safety of such products is under researched and information on potentially-significant herb-drug interactions is limited,” the author urges healthcare professionals to routinely ask their female patients if they are using such preparations.
A few bones to pick:
1) The author has reviewed only 8 trials on black cohosh, one meta-analysis of 30 trials on red clover, 1 trial of don quai, 1 trial in evening primrose, and 1 trial of ginseng. Yet, ten minutes on Pub Med revealed over 700 published trials.
2)The author has provided no indication of which database(s) s/he searched, which begs the question, is the identification of well-designed trials with ample numbers of participants been thoroughly conducted? What’s more, definitions of “well-designed” or “ample numbers” are not addressed within the entire review, leading one to believe that this assessment is subjective.
Give me a well-designed, well-defined review of the evidence and let’s talk. Think about the following and let’s have an intelligent dialogue. And in the interim, check out the topics in this blog. I think that you’ll find plenty of evidence to support the utility and safety of alternative therapies to address menopausal symptoms.
It’s all in the spin, isn’t it?
What do you think?
A new equation for midlife: calcium+vitamin D+physical activity+better eating =
Weight gain. Data abound that show that women between the ages of 50 and 79 experience age-related changes in body composition, metabolism, and hormones, often accompanied by a decline in physical activity. This leads to a propensity for fat and weight gain.
Okay, so that’s the not-so-good news.
The good news is that daily calcium (1000 mg) plus 400 IU of vitamin D may have a small effect on the risk of weight gain. Even better, coupled with other dietary and lifestyle changes (nutrition counseling, physical activity), weight gain may be a thing of the past, or at least, something that is a lot more controllable than we think!
In one study, 36,282 women who were already participating in the Women’s Health Initiative trial and undergoing dietary modification or hormone replacement therapy were assigned to 1000 mg calcium plus 400 IU vitamin D or placebo daily. Weight and height were measured annually for seven years.
Study results, which were published in the May 2007 edition of Archives of Internal Medicine, suggest that women taking daily calcium plus vitamin D supplementation were 11% less likely to experience modest weight gain (2 to 6 pounds) and also 11% less likely to gain more than 6 pounds. Interestingly, a reduced risk was seen in women who were ingesting less than 1,200 mg calcium daily, which is the recommended daily amount (RDA) by the Food and Nutrition Board of the National Academy of Sciences. Notably, the researchers do caution that the findings do not alter the RDA and that women should still aim for the 1,200 mg daily RDA of calcium.
In a second, more recent study published in the online edition of Maturitas, 101 postmenopausal women were assigned to dietary intervention (1200 mg calcium plus .75 mc vitamin D plus fortified dairy products daily), 1200 calcium daily or placebo. Women in the dietary intervention also attended biweekly dietary and lifestyle intervention sessions.
Similar to results of the first study, women receiving dietary interventions had significantly lower increases in skin thickness measures and experience declines in fat mass compared to the other two groups.
In concert, these results suggest that daily intake of calcium plus vitamin D, coupled with dietary restrictions and physical activity, may help to stave off the extra pounds in midlife. As with any regimen, it is essential to discuss a new regimen with your healthcare practitioner before taking the leap.
I’ve written previously about the value of calcium, dietary restrictions and physical activity to overall health, preventing osteoporosis and heart disease, and lowering the risk of weight gain. The addition of vitamin D appears to make the equation even more effective.
Although there have been many articles written of late that tout the benefits of vitamin D, like anything, it’s not the panacea for all that ails. Good health starts with thoughtful, well-informed choices. But it’s inspiring to know that there are positive steps you can take to feel good and look even better!
Wednesday Bubble: The incredible shrinking brain
WHAT?!
New research from the Women’s Health Initiative Memory Study hormone trials demonstrates that HRT may shrink women’s brains. No wonder I can’t forget where I placed those files..
The data, which are reported in the January 13 edition of Neurology, show that women who took hormone replacement comprising estrogen with or without the addition of progesterone had an increased risk for dementia and overall decline of cognitive function.
Researchers measured brain volume and size of microscopic brain lesions in 1,403 women who took estrogen therapy for 18 months or combined estrogen/progesterone for three years or a placebo. The women who participated in the study were on average, about 77 years old.
The findings showed that women who took HRT had brains that were several centimeters smaller than women who took placebo.
The areas of the brain that were most affected by therapy? The hippocampus, which is involved in memory formation, and the frontal lobe which is involved in memory recall. However, no differences were seen in the sizes of brain lesions, which negates the possibility that HRT is leading to tiny strokes that cut off the brain’s blood supply and affecting memory.
When I looked into other reports of this study, I found quotes from the researchers that suggest that the greatest risk may be in women who already have memory problems. More importantly, the findings imply that the risks of postmenopausal hormone therapy may greatly outweigh the benefits.
These data do potentially provide some explanation as to why many women going through menopause experience increased forgetfulness. However, it is clear that the story is not yet complete, as many of us not taking hormones still seem to go through weekly, if not daily memory lapses.
Now…where did I put that….
Pink elephant
In 1980, I worked as an intern on the municipal bonds floor of a well-known brokerage/financial institution. Although it was certainly not my “thang,” I learned a tremendous amount about how the business world operated, and most importantly, about the games that people play.
One thing that struck me in particular at that time was the role of women in this business and how they dressed and behaved. Women were not abundant in positions of power, and those who were, well, in some respects, they emulated men; they were aggressive, competitive and not particularly kind to one another.
Clearly, things have changed drastically in the almost three decades that have followed. But one thing that hasn’t changed much is how sisters act in the workplace.
A line from this wonderful article that appeared in yesterday’s New York Times made me realize that certain stereotypes continue to perpetuate bad behavior. And, that as Author Peggy Klaus so aptly writes, “the pink elephant is lurking in the room and we pretend it’s not there.”
The pink elephant is lurking in the room.
Klaus’ point is that rather than help build each others career, women often work to derail each other, engaging instead in “verbal abuse, job sabotage, misuse of authority and destroying of relationships.” She cites data suggesting that this type of behavior is directed from women to women >70% of the time, while the men who are “bullies in the workplace,” direct their aggression equally to both genders.
Klaus offers numerous reasons why women become aggressors in the workplace: scarcity of positions, bootstrap (I pulled myself up, why should I help you?) and hyperemotionality that leads to an overinvestment in workplace occurrences that cause them to hold grudges.
Her point, however, is not to determine the why but rather, engage one another to put an end to this type of behavior.
I’ve written previously that as we grow older, friendships and support of one another are essential to our overall wellbeing. Regardless of whether its in the workplace or in our personal lives, supportive relationships allow the soul to flourish and grow. Personal resources as they pertain to social support also help see us through the rougher aspects of menopause.
Should women give preferential treatment to one another? No, absolutely not. But as Klaus says, perhaps we should start treating one another as we want our “nieces, daughters, granddaughters an sisters to be treated.” We should simply… acknowledge the pink elephant in the room. And show it the door.
