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MenopauseTreatment is updated with the most recent articles listed on top. REVIEW our Selected Menopause Articles in 2009. Stay informed and updated! BRAIN FITNESS. Keep your brain healthy by staying updated with our most recent featured articles. Sign up to view our new 2010 weekly Brain site.
MenopauseNIH - Menopause “Menopause is the time in a woman's life when her period stops. It usually occurs naturally, most often after age 45. Menopause happens because the woman's ovary stops producing the hormones estrogen and progesterone. A woman has reached menopause when she has not had a period for one year. Changes and symptoms can start several years earlier. They include • A change in periods - shorter or longer, lighter or heavier, with more or less time in between • Hot flashes and/or night sweats • Trouble sleeping • Vaginal dryness • Mood swings • Trouble focusing • Less hair on head, more on face Menopause is not a disorder. Most women do not need treatment for it. However, if symptoms are severe, medicines may help. After menopause, women are more vulnerable to bone loss and heart disease. Exercise and eating right can help keep women healthy as they age.“ NIH – Menopause “Two common health problems can start to happen at menopause, and you might not even notice. Osteoporosis. Day in and day out, your body is busy breaking down old bone and replacing it with new healthy bone. Estrogen helps control bone loss, and losing estrogen around the time of menopause causes women to lose more bone than is replaced. In time, bones can become weak and break easily. This condition is called osteoporosis. Talk to your doctor to see if you should have a bone density test to find out if you are at risk. Your doctor can also suggest ways to prevent or treat osteoporosis. Heart disease. After menopause, women are more likely to have heart disease. Changes in estrogen levels may be part of the cause. But, so is getting older. As you age, you may gain weight and develop other problems, like high blood pressure. These could put you at greater risk for heart disease. Be sure to have your blood pressure and levels of triglycerides, fasting blood glucose, and LDL, HDL, and total cholesterol checked regularly. Talk to your health care provider to find out what you should do to protect your heart. How Can I Stay Healthy After Menopause? Staying healthy after menopause may mean making some changes in the way you live. • Don’t smoke. If you do use any type of tobacco, stop—it’s never too late to benefit from quitting smoking. • Eat a healthy diet, low in fat, high in fiber, with plenty of fruits, vegetables, and whole-grain foods, as well as all the important vitamins and minerals. • Make sure you get enough calcium and vitamin D—in your diet or with vitamin/mineral supplements. • Learn what your healthy weight is, and try to stay there. • Do weight-bearing exercise, such as walking, jogging, or dancing, at least 3 days each week for healthy bones. But try to be physically active in other ways for your general health. “ NIH – Menopause (Medical Encyclopedia) “Menopause is a natural event that normally occurs between the ages of 45 and 55. Once menopause is complete (called postmenopause), you can no longer become pregnant. The symptoms of menopause are caused by changes in estrogen and progesterone levels. As the ovaries become less functional, they produce less of these hormones and the body responds accordingly. The specific symptoms you experience and how significant (mild, moderate, or severe) varies from woman to woman. In some women, menstrual flow comes to a sudden halt. More commonly, it tapers off. During this time, your menstrual periods generally become either more closely or more widely spaced. This irregularity may last for 1 to 3 years before menstruation finally ends completely. A gradual decrease of estrogen generally allows your body to slowly adjust to the hormonal changes. When estrogen drops suddenly, as is seen when the ovaries are removed surgically (called surgical menopause), symptoms can be more severe. Because hormone levels fall, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue decreases. This is called atrophy of the labia.“ NHS – Menopause “Menopause myths • You can’t get pregnant after the menopause FALSE. It can and does happen so carry on using contraception for two years after your last period if you're under 50 and for one year if you're over 50. • You're going to put on weight FALSE. Middle-age-spread is often linked to the hormonal changes at this time of life but as yet there's no proof. Those extra inches could just be part of growing older and being less active. • Your menopause will be difficult because your mum’s was FALSE. There's no evidence to suggest this, although the age at which your mum went through hers could give you a clue as to when to expect symptoms, as the age of menopause tends to be similar in mums and daughters.” Highlighted Articles
Relationships between menopausal symptoms, depression, and exercise in middle-aged women: A cross-sectional survey (International Journal of Nursing Studies 2008) “Women who were depressed had more menopausal symptoms than women who were not depressed, and women who exercised regularly were less depressed and less symptomatic than women who did not exercise.” Dietary and lifestyle predictors of age at natural menopause and reproductive span in the Shanghai Women's Health Study. (Menopause. 2008) “RESULTS:: Early menarche, younger age at first live birth, older age at last live birth, longer duration of breast-feeding, and higher parity were associated with longer reproductive years (Ptrend < 0.01 for all). Higher body mass index at age 20, mid-life weight gain, and leisure-time physical activity during adolescence and adulthood predicted later menopause and longer reproductive span (Ptrend < 0.01 for all). Total intake of calories, fruits, and protein was positively associated with later menopause (Ptrend < 0.05 for all) and longer reproductive span (Ptrend < 0.05), except for carbohydrates (Ptrend = 0.06), and long-term tea consumption predicted longer reproductive span (Ptrend = 0.03). Vegetable, fat, soy, and fiber intakes did not significantly affect reproductive span or age at menopause. Smoking was inversely associated with both early age at menopause and shorter reproductive span (Ptrend < 0.01). CONCLUSIONS:: In addition to reproductive factors, intake of fruits and protein, smoking, tea consumption, lifetime patterns of physical activity, and weight gain influenced the onset of menopause and/or reproductive span in Chinese women.” Night sweats, sleep disturbance, and depression associated with diminished libido in late menopausal transition and early postmenopause: baseline data from the Herbal Alternatives for Menopause Trial (HALT). (Am J Obstet Gynecol. 2007) "RESULTS: Of 341 women, 64% had diminished libido, 18% had moderate to severe depression, and 43% had poor sleep quality. Women averaged 4.6 hot flashes and 1.9 night sweats per day. Depressive symptoms (P = .003), poor sleep (P = .02), and night sweats (P = .04) were significantly associated with diminished libido." The timing of natural menopause in Poland and associated factors. (Maturitas. 2007) " RESULTS: The overall median age at natural menopause was 51.25 years; 25th percentile 49; 75th percentile 54 years." Severe Hot Flashes May Be Linked to Chronic Insomnia (2007) "Hot flashes occurred in 12.5% of premenopausal women, 79.0% of perimenopausal women, and 39.3% of postmenopausal women. Chronic insomnia occurred in 36.5% of premenopausal women, 56.6% of perimenopausal women, and 50.7% of postmenopausal women (P < .001). Prevalence of symptoms of chronic insomnia increased with the severity of hot flashes. More than 80% of perimenopausal women and postmenopausal women who had severe hot flashes also had symptoms of chronic insomnia." CONTINUE YOUR INFOMEDSEARCH RESEARCH with our previous InfoMedLinks. Start with InfoMedLinks 2009.
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NotesThe 2007 Treatment Guidelines section will contain the 2007 published guidelines. To view Guidelines from previous years, view year 2006 Treatment Guidelines and 2005 InfoMedlinks (Articles section) or our Monthly Online Newsletter (under the Guidelines section). |
MenopauseDaily Treatment ReportCognitive Therapy-CBT-PsychotherapyDevice Therapy
Drug Side-Effects and InteractionsHormone Therapy Increases Risk Of Ovarian Cancer How Does Estrogen-Progestin Hormone Therapy Affect Breast Cancer Mortality? Breast cancer incidence falls after hormone therapy use drops in Canada: study “The first Canadian study of its kind is adding to a growing body of international evidence suggesting that the use of hormone replacement therapy may raise the risk of breast cancer.” Is Risk for Venous Thromboembolism Affected by Route and Type of Menopausal Hormone Therapy? Estrogen-only HRT may increase risk of asthma after menopause “The risk of asthma was significant only among those using oestrogen alone. Among these women the overall risk of asthma was 54% higher than among those who had never used any form of HRT.” WHI Study Data Confirm Short-Term Heart Disease Risks of Combination Hormone Therapy for Postmenopausal Women “New analyses from the Women's Health Initiative (WHI) confirm that combination hormone therapy increases the risk of heart disease in healthy postmenopausal women. Researchers report a trend toward an increased risk of heart disease during the first two years of hormone therapy among women who began therapy within 10 years of menopause, and a more marked elevation of risk among women who began hormone therapy more than 10 years after menopause. Analyses indicate that overall a woman’s risk of heart disease more than doubles within the first two years of taking combination HT.” DrugsHormone Therapy: Is "Natural” Better? ExerciseYoga might be an alternative training for the quality of life and balance in postmenopausal osteoporosis. (Eur J Phys Rehabil Med. 2010) General InformationHip Fractures Soar When Hormone Therapy Stops "This study reinforces something that is very important for people to keep in mind — that there is a very positive effect of estrogen on bone," Steven R. Goldstein, MD, professor of obstetrics and gynecology at New York University Langone School of Medicine in New York City, and current president of the North American Menopause Society, said in an interview with Medscape Medical News. "Estrogen is probably as good a bone drug as anything else that you can be on, and this study underscores that fact. It also underscores the fact that, unlike some of the bisphosphonates that hang around for 6, 10, 19 years, estrogen doesn't hang around. Very soon after you discontinue it, its effects in bone go away. I think that's an important message," he said. Whether or not a woman chooses to take HT will be a matter for each individual woman to decide, he added. "While you take estrogen or while you make estrogen, there's a protective effect on your bones. When you withdraw that estrogen you are going to lose bone at a fairly predictable rate."” Breast Cancer Seen as Riskier With Hormone “Hormone treatment after menopause, already known to increase the risk of breast cancer, also makes it more likely that the cancer will be advanced and deadly, a study finds.” Menopausal Hormone Therapy and Subsequent Risk of Specific Invasive Breast Cancer Subtypes in the California Teachers Study (Cancer Epidemiol Biomarkers Prev 2010) “Conclusions: Breast cancer risks increased with longer duration of ET and EPT use, and risks were highest for continuous-combined EPT use. Furthermore, risks varied by BMI and tumor subtype. Impact: These findings underscore the need for personalized risk-benefit discussions with women contemplating HT use.” Preventing osteoporosis in symptomatic postmenopausal women. (Menopause. 2010) Breast cancer risk varies among different progestins used in hormone replacement therapy “Progestins are used in hormone replacement therapies to counteract the negative effects of estrogen on the uterus and reduce the risk of uterine cancer. However, evidence in recent studies and clinical trials has demonstrated that progestins increase the risk of breast cancer. Now, University of Missouri researchers have compared four types of progestins used in hormone replacement therapies and found significantly different outcomes on the progression of breast cancer in an animal model depending on the type of progestins used.” Testosterone may not help memory after menopause Breast Cancer Metastasis Increases After Estrogen and Progestin Hormone Therapies, Study Finds Estrogen and Progestogen Use in Postmenopausal Women: 2010 Position Statement of the North American Menopause Society (Menopause. 2010) Hormone Therapy for Menopause Reviewed Role of hormone therapy in the management of menopause. (Obstet Gynecol. 2010) HRT, Placebo Each Beats Black Cohosh for Hot Flashes “Black cohosh and red clover are no better than placebo for treating hot flashes and night sweats in menopausal women, according to a randomized control trial. That doesn't mean that they won't be helpful for some women, Dr. Stacie E. Geller, a professor of obstetrics and gynecology at the University of Illinois, Chicago, the study's lead author, told Reuters Health. But, she added, while the herbal extracts they tested were completely safe when taken daily for a year, the same isn't necessarily the case with products available over the counter. "Unfortunately in this country and many others, there's not enough rigorousness around the development, standardization and monitoring of these products," Dr. Geller said. "We developed our own product, so that's why we knew it was safe and pure." About 75% of women will experience some hot flashes and night sweats as they enter menopause, Dr. Geller noted. "There is a small group of women who have pretty severe hot flashes for a long period of time," she added. "It can be incredibly disruptive."” GuidelinesNorth American Menopause Society Issues Guidelines on Hormone Therapy Immunotherapy
Internet SitesTreatment Information Drug-Food-Supplement Information DrugDigest (drug interactions) FDA - Drug Interactions: What You Should Know NIH - Botanical Dietary Supplements: Background Information NIH - Drug, Supplements, and Herbal Information NIH - Herbal Supplements: Consider Safety, Too NIH - Vitamin and Mineral Supplement Fact Sheets NutritionSoy won't reduce cholesterol after menopause “When a woman stops having her period, her estrogen levels plummet, which in turn ups her total cholesterol level and her level of "bad" LDL cholesterol, while reducing her "good" HDL cholesterol levels, Campbell and her team explain in the journal Menopause. Because soy contains estrogen-like substances called isoflavones, it has been promoted as having health benefits for women after menopause, including cutting cholesterol levels and strengthening bones. … Other recent studies have called this benefit into question, the researchers add, and the AHA in 2000 changed its position to say that the benefit of soy protein or isoflavones is "minimal at best." They conclude: "Our results support the large body of literature showing no favorable alterations in the lipid profile as a result of the incorporation of 25 g/day of soy protein in the diet." “ OtherOther Treatments Experimental RadiotherapySupplements-Vitamins-CAMThe Use of Complementary and Alternative Medicines Among a Sample of Canadian Menopausal-Aged Women (Journal of Midwifery & Women's Health 2010) Surgery
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