Wednesday Bubble: sexual desire in midlife

Since I’ve embarked on this blog, I’ve run across numerous studies and articles discussing sexual dysfunction and the lack of/declining sexual desire in women entering midlife and menopause. I’ve written quite a few posts about data that suggest that ingesting hormones can help to reverse these trends as well as a post that focuses on the often overlooked health aspects. If you’ve not read them, I encourage you to do so.

However, this post is not about me; it’s about you. It’s also excellent fodder for your partners and I hope that they derive some important tidbits.

I ran across some fascinating research in the online ahead of print edition of the Journal of Sexual Research that will hopefully burst a few bubbles about desire, more specifically, how women (versus researchers) define and characterize sexual desire and whether there is a huge difference between women with and without female sexual arousal disorder (FSAD, the inability to attain or maintain a sexual excitement (genital lubrication, swelling etc.).

The researchers, who based their study on one-one-one interviews with 22 women, mean ages 45 to 55, noted several challenges when characterizing sexual desire:

• Is it a  state or action?
• Is it spontaneous and responds to a stimulus?
• Does it  precede, follow or is it indistinguishable from sexual arousal?

They added that for women in midlife, social context is also important; mass media, for example, creates unrealistic expectations and culturally perfect images that are not easily recreated in real life or in midlife. Notably, the distorted views that midlife women have towards their bodies have been shown to influence sexual response more than menopausal status.

Here are some key findings:

• Both women with and without FSAD expressed that physical touch was a common trigger or enhancer  of sexual desire. Physical proximity was also important, that is, feeling comfortable or safe. Additionally, visual stimuli (e.g. seeing their partner or appealing aspects of their partner, watching erotic films) were common stimulators
• One of the most recurrent themes was that perceived desirability was important: if women felt desired by their partners, they felt more desire. However, their desire was also influenced by their partners’ desire, sexual response, and emotional state of mind, such as depression
• Nearly all the women said that experiencing an emotional and intellectual connection to their partner was essential and the “goal of her desire” (as opposed to simply reaching orgasm or having intercourse)

Overall, the researchers found that women’s descriptions of sexual desire varied little regardless of  arousal difficulties. They noted that current measures of sexual desire in clinical studies do not take into account factors such as emotional influences, responsive desire and the importance of context. Rather, they assess how frequently women experience spontaneous sexual desire.

They concluded that  “what is deemed dysfunction on a questionnaire might not be dysfunction in reality.”

The key take-away from this study is that women have varying definitions of desire that only become clear when they reflect on them for a period of time. The answers, rather than divergent based on medical conditions, actually converge the longer that women reflect on their experiences.

I am not suggesting that hormones have no role to lay in how we perceive sex and respond to sex as we age. But I find it heartening to see that there are other controllable essential factors that come into play. Be open to the experiences before you and don’t take the answers as THE answers.

And the day came when the risk to remain tight in a bud was more painful than the risk it took to blossom.

Anais Nin

Erring on the side of black cohosh

I’ve written quite a few posts about black cohosh over the past year. Black cohosh (better know in the plant circles as Actaea racemosa and cimicifuga racemosa) is an herb shown to treat vasomotor symptoms such as hot flashes, night sweats and mood swings. Yet, concerns have been raised about its possible link to liver disease and toxicity.

Thus far, the evidence against black cohosh has been pretty lean. I’m happy to add a few more coals to that particular fire.

In a case report published in the Ahead of Print section of Menopause, researchers present evidence on nine cases of suspected liver toxicity in women who had used black cohosh.

The result: they excluded an potential link between the women’s symptoms and ingestion of black cohosh in eight of nine cases. In one case, they reported a possible association to liver disease for an unknown brand of black cohosh taken for two months but also state that the woman had factors that might have skewed the results.

They concluded that significant circumstantial evidence linking black cohosh to liver toxicity is missing.

Although this is a very small study, this is not the first time that upon examination, a lack of causality was found between black cohosh and liver disease. Of course, standardized formulations are a must, as is guidance from a healthcare professional who is well-versed in the use of herbs for menopause. Nevertheless, I am hopeful that eventually, black cohosh will become a respectable player in the field.

And the beat goes on

More interesting news on the HRT front. Study findings reported in the May issue of the journal Medical Care suggest that a decline in the use of hormone replacement therapy (HRT) may be associated with a decrease in heart attacks among women.

In this trial, researchers examined data from various national databases  on causes of death,  hospitalizations  and population size and combined it with information on HRT use.

Although declines in HRT use were not associated with decreases in stroke deaths or hospitalizations, the data did demonstrate 25 fewer heart attacks for every 10,000 women not using HRT.  In contrast, findings from the Women’s Health Initiative (WHI) study found an increase of seven heart attacks  for every 10,000 women on HRT. (Note, however, that a more recent analysis of the 2002 WHI data showed that heart attack risk from hormones may not be increased in women who start the hormones less than 10 years after menopause, but  is increased in women more than 10 years out.)

In the press release distributed along with the study, a cardiologist from Total Heart Care is NYC is quoted as saying that lower heart attacks rates may be associated with better screening and greater awareness of heart disease in women, and attributable to declining HRT use.  Study researchers say that more research is needed to verify their findings.

So far as I am concerned, it’s a win-win. Screening or less HRT. And the beat goes on…

Wednesday Bubble: I’ve got the blues and it’s all good!

I’ve got the blues this week; blueberries that is. And the news is all good!

Researchers at the University of Michigan at Ann Arbor are reporting that eating a diet rich in blue berries might reduce heart disease, protect against diabetes, and get rid of belly fat! Is this too good to be true? And what does this have to do with menopause anyway?

I’ve written previously on increased risk of heart disease and increased likelihood of gaining weight around the abdominal region as we age. So, if blueberries can potentially help to stave off both, that’s great news, right?

The research team studied the effect of a blueberry-enriched powder added to either a low-fat or high-fat diet in laboratory rats and compared them to rats receiving no blueberry powder.  The rats were of a particular breed that are prone to weight gain and being severely overweight.

After 90 days, rats receiving the blueberry powder (which comprised 2% of their total diet)  had less abdominal fat, and lower triglycerides and cholesterol levels. They also showed improvements in  fasting blood glucose and insulin sensitivity, which measures the risk for diabetes and heart disease (namely metabolic syndrome), respectively.

What’s more, the benefits were even greater among rats fed the powder along with a low-fat diet: they had lower body weight, lower total fat mass, and reduced liver mass (which has been linked to obesity and insulin resistance) than rats in the other study groups. The researchers also reported positive changes in measures such as fat muscle tissue (which relates to fat-burning and storage) in rats fed the blueberry powder and a high-fat diet.

The beneficial effects of blueberries are believed to be possibly related to inherently high levels of an antioxidant  known as anthocyanins, which is responsible for blueberries’ colour.

Clearly, further research, is needed, particularly in humans. In the interim, eat some blueberries: they’re high in flavor, a great source of fiber and vitamins C and K, and low in fat. And may help combat some of the less attractive pitfalls of mid-life.

Whole body vibration, positive vibrations!

Whole body vibration. Whoa! What comes to mind are those machines from the 30s and 40s with the vibrating belt. Although they didn’t work very well, it seems the principle behind them might not have been so far-fetched after all. In fact, whole-body vibration appears to enhance the positive effect that resistance training has on body composition.

Whole body vibration (WBV) was evidently based on ancient Greek principles but more recently developed by the Russians to rehabilitate astronauts who may have lost muscle and bone mass during space missions. Around for centuries, it’s currently being embraced by sports medicine clinics and fitness facilities. A quick search on the National Library of Medicine’s PubMed database also shows that it’s caught the eye of researchers as well.

So what does WBV have to do with menopause?

In a small study that appears in the journal Maturitas. researchers examined the effects of WBV added to resistance training in sedentary  postmenopausal women. For eight months, 55 participants engaged in one of the following, three times a week:

• Resistance only training (weight training at 80% strength, 3 sets, 10 repetitions)
• Resistance training (as above)  plus WBV using a powerplate vibration platform
• No exercise

Study findings showed that while both resistance training alone and resistance training with WBV led to significant increases in total, arm and trunk lean body mass, only the combination of training and WBV actually significantly decreased total body fat percentage.

Clearly, larger studies are needed. But this does lend hope for accessible, safe and effective ways to combat the natural loss of lean body mass/ redistribution of body fat as we age.

As Bob Marley said…positive vibrations!

Onions and bones…nothing to cry about

I love onions. Red onions, scallions, yellow onions, spring onions, shallots; you name it. Sauteed, raw, caramelized, fried, baked. Yum! So, imagine my pleasure when I stumbled across an interesting study in the February 20 Ahead of Print online edition of Menopause that shows a link between onion consumption and increased bone density. Yowza!

Okay, so your breath might be a bit ripe but your bones will love you for it!

Although calcium, vitamin D supplements and exercise are effective prevention tools against osteoporosis, they have not been shown to add much in the way of slowing bone loss. To address this hole in therapy, researchers have been looking towards phytochemicals, i.e. natural compounds in plants, to examine if they might increase the activity of bone building cells (osteoblasts) and decrease the activity of cells the breakdown bones (osteoclasts).

Spurred by studies in rats, researchers analyzed the bone density (repeated five times) and onion consumption (from 2 or more times daily to 1 to 6 times a year to never) in 507 perimenopausal and postmenopausal non-Hispanic white women, age 50 and older, participating in the National Health and Nutrition Examination Study. Women were divided  into four groups based on their onion consumption:

• Less once/month
• 2 times a month to 2 times a week
• 3 to 6 times a week
• Once a day or more

Because certain variables are considered risk factors for osteoporosis and could influence study findings, the researchers also measured age, smoking status, calcium intake, use of vitamin D supplements, thyroid hormone levels, intensity of exercise regimens (i.e. none, moderate, vigorous), use of estrogen, and body mass index.

The findings? The more onions the women ate, the greater the increase in their bone density. In fact, women who consumed onions at least once daily had an overall bone density of their spine that was 5% greater than women who consumed onions once a month or less.

What the study didn’t tell us was the quantity (e.g. one cup) and type of onions consumed.

Studies comparing the bone density of smokers and non-smokers at different ages have shown that a bone density difference of 4% can confer a 41% greater risk of hip fracture. So while a 5% difference seems marginal at best, the potential reduction in the risk of fractures is great.

The researchers caution that certain compounds in onions, such as quercetin, have been associated with cancer causing properties. However, they note that animal studies have found no evidence of such problems. Although further study is needed to determine if women who ate onions also consume foods other than onions that might contribute to their reduced risk for osteoporosis, they believe that onions hold great promise as an addition to other measures that prevent osteoporosis.

Me? I’m all for erring on the side of onions. Tears and all!

Wednesday Bubble: Sham?

Today’s Bubble troubles me because it’s a bit personal. You see; I want to believe.

Reporting in the Climacteric journal of the International Menopause Society, researchers say that a thorough review of scientific studies examining acupuncture and hot flashes failed to reveal any specific effects.  So, is acupuncture no more effective than sham acupuncture, i.e. placebo?

In this report, which appeared in the February 2009 edition of the journal, researchers searched studies published in 17 databases in different languages. Of the six well-designed trials that were ultimately included in their review, four compared regular acupuncture with sham acupuncture, in which a practitioner will insert needles on acupuncture points that are not relevant for treating hot flashes. The results: none of these trials showed any benefit of acupuncture in terms of frequency or severity of hot flashes.

Only one trial showed any favorable effects: this particular study tested acupuncture against needles that were place on non-relevant points but not inserted into the skin.

So, what can we conclude from these findings?

The researchers say that controlled studies, in which the environment is scientifically designed to mimic real life, fail to show any specific effects of acupuncture for controlling hot flashes. However, they do not appear to believe that this is the end all to be all. Instead, they call for more rigorous trials to further investigate the use of acupuncture for hot flashes.

Perhaps the ACUFLASH trial will shed more light.

What are your experiences with acupuncture? Have you used it specifically to treat hot flashes?

More joys of soy

More news on soy. Researchers have discovered yet another component of soy isoflavones that may prove useful in improving symptoms of menopause: soy aglycons of isoflavones (SAI). Soy aglycons are a group of chemicals found in fermented soybeans and comprise a great portion of diets for Chinese and Japanese individuals. Of note, high cholesterol, coronary heart disease, and menopausal symptoms are often seen in a smaller percentage of these women than their European and American counterparts.

Among the various chemical molecules of soy, SAI are absorbed faster and more efficiently than other components.

In this particular study, which was just published in Nutrition & Metabolism, researchers fed rats whose ovaries had been removed either high or low doses of SAI-supplemented diets. These animals were then compared to rats with intact ovaries who were fed a regular diet.

The researchers found that rats fed supplemental SAI had significantly lower cholesterol and low-density lipoprotein (LDL)  values , higher high-density lipoprotein (HDL) levels and faster liver metabolism.  The lining of the uterus was also enhanced by dietary SAI supplementation.

They said that these results suggest that SAI may help protect against or lessen symptoms during menopause that are associated with the natural decline of estrogen.  SAI might also be an effective and safe alternative to HRT, which has been linked to breast and uterine cancers. In general, SAI may protect against menopausal heart disease.

Tick, tock…

I ran across an interesting study the other day that suggests that a simple blood test can predict when women will enter menopause.

Although the test is used primarily in the fertility setting (to measure the size of the ovarian follicle pool, if you will), it got me thinking: could it be useful during pre-menopause to predict timing and allow for ample time to, say, engage in more healthy bone-building or heart-strengthening habits or start developing mind-body strategies that reduce stress and promote the production of nitric oxide? Better yet, is this blood test a tool or  marker of time that a major life transition is upon us and prompt us to pay attention to ourselves and start doing things that not only benefit our loved ones but also ourselves?

Reporting in the Journal of Clinical Endocrinology last year, researchers said that they have developed a blood test that measures a hormone known as “anti-Mullerian hormone” (AMH). AMH correlates to immature follicles in the ovaries whose role it is to house mature eggs. The greater the number of these follicles, the more likely it is that a woman will conceive.

In the study, AMH levels were measured in 144 fertile women between the ages of 26 and 46. Researchers then set a baseline level and compared them to the AMH levels in women who had undergone menopause. They were then able to observe that there was a close correlation between declining AMH levels and the age that which menopause began.

Although additional studies are clearly needed to support these findings, some infertility clinics are evidently already using AMH as a marker for a patient’s fertility “potential.” According to an article on the study that appeared in Time magazine last year, the blood test might also be useful in cancer patients to measure the impact of chemotherapy on fertility.

In the interim, it is interesting to consider the utility of the AMH blood test for women in midlife so that they can take steps to insure wellbeing and optimal health during the menopause.

Food for thought.

Wednesday Bubble: Promises, promises

Have you heard of Lyriana?

Billing itself as ‘The World’s Most Powerful Sexual Enhancement Product Designed Specifically for Women,” Lyriana promises to:

• Make sex a lot better
• Increase your desire to have sex
• Increase sensitivity, lubrication and…”that rip his clothes off feeling.”

All with a money-back guarantee.

Lyriana is an over-the-counter product containing extracts from the Amm Visnaga plant Visnadine, which evidently was used in ancient Egypt to widen the blood vessels and promote blood flow. Theoretically, the use of visnadine in this matter will improve blood flow to the labia and clitoris to enhance sensitivity, promote lubrication  and improve th overall sexual experience.

According to the product website, clinical studies demonstrated the Lyriana effectively improved vaginal dryness in postmenopausal women and did so without irritation or other adverse reactions. Notably, only 27 women were enrolled in their key outcomes study.

So, what do you think? Can Lyriana effectively address sexual issues associated with menopause, including declining desire and lubrication? Or is it just a bunch of promises, promises; another bubble waiting to be popped?

Anyone?!