HRT and heart disease. And the beat goes on….
Hormone replacement therapy can help prevent heart disease, right?
Think again. Research has shown that use of HRT increases the risk for stroke, blood clots and heart disease. Although increased risk starts to decline within three years of stopping hormone therapy, women are still cautioned to continue rigorous prevention efforts and to see their physicians for any recommended testing.
So, are you asking yourselves why I’m writing about this if doctors know already about the link between HRT and heart disease? Well it appears that in the early 200s, and despite a marked decline in the use of HRT among women following confirmation of the risk, as many as 8% of women with existing heart disease and 14% with two or more identifiable risk factors were still prescribed hormones by their doctors. Writing in the American Journal of Public Health, investigators of a newly-published analysis said that although the reasons are unclear, women continued to receive HRT for heart risks, even though it “was never proven for this indication and ultimately found to be ineffective.”
To add insult to injury, the International Menopause Society, in concert with the European Society of Cardiology, has just issued a statement staying that hormone therapy, in limited doses, does not increase the risk of heart disease and may even decrease risk in younger women.What’s more, they are now saying that in some cases, HRT may even lower blood pressure. Conversely, they recommended that HRT should not be used in women with a history of heart attack, stroke or pulmonary embolism (blockage of one or more lung arteries).
Are you confused yet?
Some experts have questioned the results of the Women’s Health Initiative studies, which were the first to raise the flag about the dangers of HRT. Some argue that the studies looked at women who were older, i.e. 50 to 79 and not menopausal or perimenopausal. However, others have determined that both the timing (i.e. when HRT is started) and length of time on HRT can affect disease risks, as can type of hormone used.
In some respects, these confusing recommendations echo the recent controversy over mammography, in which medical experts have taken sides, some agreeing the screening is overrated and even dangerous, and others, saying that even the small numbers of lives saved make mammography worthwhile in younger women. That, however, is a post for another time.
Meanwhile, what should you do when it comes to HRT and heart disease risk?
As always, I urge women to err on the side of caution and do their due diligence: make an appointment with an informed health provider and discuss the risks and the benefits. There’s no way to make an informed decision without all the facts and information about how they apply specifically to you, your family and personal medical history and your unique set of needs and symptoms. At the same time, the evidence is pretty darn strong that HRT does not protect your heart and may in fact, exacerbate other risk factors for developing a heart attack or stroke.
Is it worth it? Only you and your practitioner can decide.
Wednesday Bubble: Male menopause gets the test
Regular readers of this blog know that I take issue with the term “male menopause,” (aka, andropause) not only because it’s a misnomer but because, in my opinion, it is an overdiagnosed syndrome that may indeed, be a natural part of the aging process in men. So I was heartened to read that University of Pennsylvania researcher Peter Snyder is recruiting men for a new study — the T Trial – that will investigate whether or not declining energy and physical function, along with a low libido and memory issues are related to low testosterone levels or to the aging process itself.
According to the trial’s primary sponsor, the National Institute on Aging, a key impetus for this study was the burgeoning marketing of male hormone products as treatment for a variety of conditions. In fact, the market topped out at a whopping $809 million last year alone. “We hope this trial will establish whether testosterone therapy results in clear benefits for older men,” said Evan C. Hadley, M.D., director of NIA’s Division of Geriatrics and Clinical Gerontology.
Although there are questions whether or not the study is of long enough duration to really evaluate if testosterone therapy is valuable, needed or safe, the study is the largest of its kind. Importantly, according to an article last Sunday’s Philadelphia Inquirer, some endocrinologists believe that andropause is more of a marketing tool than an actual syndrome. One is even quoted as saying that the best remedy for andropause is exercise.
So, what do you think? Is it time to burst this bubble or not?
The Roundup: November news and tidbits
[Credit: Special thanks to artist Darryl Willison of whimsicalwest.com. Please visit his site and support his work.]
Time for November highlights. A new feature, a few guest posts and lots of controversy in this month’s mix:
- Introducing….It’s raining men. It’s a new month and a new feature on Flashfree. I am looking for men to lend their perspectives. Here’s one guys’ take.
- Wednesday Bubble: Equol-ity. Can the plant-based S-equol alleviate hot flashes? The evidence continues to mount in its favor.
- Oh, baby – a new glam parent is born. Forty Weeks’ Julia Beck provides some important tips for Boomer grandparents on breastfeeding and support.
- Be still my heart. When it comes to heart disease, knowledge is power. Heart attacks are on the rise in midlife women. Wondering why?
- Wednesday Bubble: Bifocals, babies, hot steamy flashes of perspective. It is enough. Author Patti Digh graces the pages of Flashfree with her insight and wisdom: time to call in the dumpster.
- Hip fracture, early menopause and age. Researchers show that early menopause is not a risk factor for hip fracture. Here’s what you can do right now to keep your bones in good shape.
- Viva la sweats! Forget the sheets! Who knew that night sweats might actually save your life?
- Wednesday Bubble: One pill makes you…. Coming to bedrooms soon: the new Viagra-like compound for women.
- Dem bones were made for dancing. Who says you can’t have fun while boosting your bone health? ‘Dancing with the Stars,’ are you listening?
- New Flash! Just a spit away… Is comprehensive non-invasive testing on the horizon for women? Researchers say that your saliva may hold important clues to illnesses as you age.
- Wednesday Bubble: NutraFem promises much. Will it deliver? There’s a novel multi-botanical on the market and it’s looking promising for controlling hot flashes and night sweats.
- Battle of the middle-aged bulge: pick your poison. That abdominal donut may cause you to lose your mind, if you don’t have a heart attack first. Time to get moving!
Wednesday Bubble: Nutrafem promises much…will it deliver?
Not gonna burst this one. At least not yet. Because there’s a new botanical formulation in town and the evidence supporting its effectiveness looks pretty strong!
Nutrafem® is a supplement containing a proprietary blend of phytoestrogens – namely Eucommia ulmoides bark (a deciduous rubber tree whose bark has been used in Traditional Chinese Medicine practice for centuries) and Vigna radiata (mungbeans).
In a study that appears in the Advanced Online Edition of Menopause, Nutrafem was shown to reduce the number of hot flashes and night sweats that women were experiencing by 26% over a 12-week time period. What’s more, among the 156 postmenopausal women studied, symptoms were reduced in almost half of the women. At the start of the study, participants were reportedly experiencing at least 21 or more hot flushes or night sweats weekly, and at least a third of these were described as being severe to moderate.
Earlier studies have also been favourable, suggesting that Nutrafem also leads to significant improvements in general health, body aches/pains, energy and fatigue, and emotional wellbeing.
This formulation appears to be safe and reported side effects during use have been minimal. Importantly, both of the key ingredients have a long history of as food or herbal medicines; the mung bean in particular has been used to address effects of radiation during breast cancer therapy, such as headache, fatigue or sleeplessness. Additionally, while Nutrafem appears to activate estrogen receptors, it does not promote the proliferation of breast cancer cells.
I have high hopes for Nutrafem. Have you tried it?
News Flash! Just a spit away…
Have you ever wondered if joint aches, memory lapses, dry mouth and other disorders are signs of aging or actually signs of pending illness? Take heart. Scientists have learned that the protein content of the saliva changes as women age and that some of these changes may actually be markers of disease, in particular, diseases in which the immune system attacks itself, such as lupus.
In a study published in a recent issue of the Journal of Proteome Research, researches analyzed proteins in saliva samples taken from 532 healthy women between the ages of 20 and 30 and 55 and 65. They found that about half of the protein types were unique in the particular age group. What’s more, older women had almost twice as many immune-type proteins in their saliva than their younger peers. The results remained even after the researchers factored in such things as age, time that the saliva was collected and whether or not the women were menopausal.
Not only researchers hope that proteins in saliva will prove to be useful in diagnosing risk of certain diseases, but they are also investigating ways in which they might be used in tests that will make diagnosis and treatment of certain age-related diseases in women easier. Saliva for example, is far more accessible and less invasive than a blood prick.
Could easier disease diagnosis be only a spit away? What a salicious thought.
Dem bones were made for dancing!
Get on your dancing shoes!
I was inspired to read that professional dancer Erin Boag from Strictly Come Dancing (the UK’s version of Dancing with the Stars), has teamed up with the International Osteoporosis Foundation to inspire all those armchair dancers to get off their butts and work their bones a bit. In fact, many bone experts agree that dancing may be an excellent (and non-boring) way to strengthen bones and muscle, prevent or at least slow osteoporosis.
Mind you, this program is being funded by DAIICHI SANKYO, a pharma company that manufactures drugs that treat osteoporosis. Nevertheless, it’s an important first step towards taking a cheesy premise that attracts millions of television viewers and repackaging some of its basic elements to help people who don’t normally like to exercise to change their habits. Currently available only in Europe and through doctors’ practices, the ‘Improvement through Movement’ DVD offers some easy waltz, rumba and quick step moves.
Osteoporosis is a tremendous problem as we age. In the US, it affects approximately 10 million people, 8 million of whom are women. Worldwide, more than 200 million women suffer from osteoporosis.
I’ve long been a proponent of more natural approaches to solving what ails. And bone health is one of those things that can be easily preserved through weight-bearing physical activity and a healthy diet that incorporates vitamin D and calcium-rich foods and isoflavones. You can read more about bone health in these posts.
In the meantime, this program sounds like a terrific idea that could be easily reproduced in this country as well. What say you ‘Dancing with the Stars?‘ Can we take a page from our European friends on behalf of our US bones?
Wednesday Bubble: one pill makes you…
Have you heard about Flibanserin? Pharma Giant Boehringer-Ingelheim is entering the bedroom with an antidepressant (with a new moniker) that may change the sex lives of women everywhere!
Sorry for the sarcasm but this Bubble has “Viagra for women” written all over it. In fact, the U.S. market for sexual desire is estimated to exceed a whopping $3.5 billion a year. No wonder other companies are so eager to market testosterone to women.
So what’s the story behind Flibanserin?
Flibanserin is an antidepressant compound that is is believed to affect brain receptors and neurotransmittors that play a role in sexual response. Data presented at the European Society for Sexual Medicine conference show that in clinical studies, flibanserin significantly improved desire, sexual experience and sexual functioning in women when taken for at least six months. The majority of the women participating were pre-menopausal and had been diagnosed with hypoactive sexual desire disorder (HSDD), a condition that is characterized by a decline in sexual desire, a loss of intimacy, and distress.
Declines in sexual desire at any point in life are terrible and not to be taken lightly. Should flibanserin becomes available in the United States, it is likely to be prescribed along with sex therapy, a move, that the company disagrees with. In fact, the company is quoted in Bloomberg News as saying that it hopes that the drug can be prescribed by itself and not as a complement to therapy. Importantly, this is where one has to start questioning the value of this drug and how it will ultimately be marketed should it ever be approved by the US Food & Drug Administration.
Many behavioral and mental health specialists will argue that “a pill has no place in the bedroom” and that sexual dysfunction is linked to factors other than physical ones, factors that need to be thoroughly explored and addressed. This holds true in particular, for menopausal women. Indeed, evidence does show that t sexual desire in women can be affected not only by physiology but also, may vary depending on personal attitudes, experiences and context.
I don’t take issue with drugs when they are prescribed and used responsibly. But the answer to everything that ails is not a pill. With regards to sexual desire, this could not be truer.
Sex is big business. This has been borne out by the incredibly success of drugs geared towards erectile dysfunction. Companies have been racing to find an equivalent for women. Looks like Boehringher might have just gotten the gold ring.
What do you think?
Viva la sweats!
Night sweats, that is! I never thought that I’d write that but it does seem that having night sweats may actually save your life someday.
Reporting in the September/October issue of Menopause, Norwegian researchers followed up on over 800 women in menopause who had previously provided information about lifestyle and menopausal history (including vasomotor symptoms). Of the 73% of women who reported having hot flashes, 39% also reported night sweats. Women reporting both were shown to have a 28% lower risk of dying from any causes over the next 20 years. A reduced risk of dying remained even after the researchers made adjustments for past or current hormone use, body mass index, physical exercise and smoking.
Will these data make me stop the herbs and start sweating away my nights? No. But it’s good to know that vasomotor symptoms, such as night sweats, may have a role beyond “nuisance,” “disruptive,” “mood changing” and sheet-ruining!
Hip fracture, early menopause and age
Good news for you early menopausers: Australian researchers say that early menopause does not increase the risk for hip fractures due to weaker/lower bone density.
Bone density or bone mineral density (BMD) refers to the individual strength of bones, generally in relation to their calcium content. BMD is known to decline rapidly during the time period that immediately follows menopause, leading to osteoporosis and hip fractures. Because there have been lingering questions regarding how early menopause influences fracture risk, researchers decided to undertake a study that would sort out the relationship of age, menopausal status and age at menopause to hip fractures. Over 561,000 pre-, peri- and postmenopausal women who had never used hormone replacement therapy participated in the study (which lasted, on average, 6 years).
They found that hip fractures were about twice as likely in postmenopausal versus premenopausal women. But more importantly, when age was factored in, this relationship dropped out. In fact, rates of hip factors was as much as seven times higher among women who were between the ages of 70 and 74 compared to women between the ages of 50 and 54. What’s more, age at menopause had little effect on fracture risk.
What you can do now…..
- Calcium - OHC is a formulation that has recently been shown to impart greater protection against bone loss than calcium carbonate.
- Isoflavones – Here, type/source may be important.
- Exercise - Including weight bearing, resistance and strength-training.
Meanwhile, if you are in early menopause, here’s one risk you don’t have to worry about. It’s no reason not to take preventive measures to prevent bone loss in older age. But it is a reason to breathe a bit easier.
