menopause treatment online

Expert Review of Neurotherapeutics has published a supplementary series of articles focusing on symptoms during the menopausal transition and the challenging treatment issues for the women involved. The reviews are currently freely available to any clinician at http://www.future-drugs.com/r/meno.

Some 42 million American women will be aged between 45 and 64 years by 2010, and this figure will rise to 47 million in 2050. Menopause is a natural phase of female development, which is uncomplicated in most women. However, it is estimated that at least 7 million women in the USA alone will present to primary care or gynecology for help with the more distressing symptoms of menopausal transition over the intervening 40-year period.

The ten-article collection has been compiled by, and contributed to, by Dr Jeanne Leventhal Alexander, Director, Northern California Kaiser Permanente Psychiatry Women’s Health Program, and Founder of the Alexander Foundation for Women’s Health, a not for profit organization, http://www.afwh.org. The focus of the clinical review collection is to address the likely etiology and treatment of midlife patients who have new complaints or complain of an exacerbation of preexisting complaints in the context of their menopausal transition. The reviews highlight somatic symptoms of depression, the depression continuum and its impact on morbidity and functioning, treatment issues related to remission of depression, cognitive decline or impairment secondary to mood disorder, sleep problems in women and their impact on well-being and functioning, and attention and working memory problems in the vulnerable woman patient. (more…)

Few women are consulting their doctors before opting to use herbal therapies and soy products to treat their menopausal symptoms, researchers at the Stanford University School of Medicine have found.

The trend is of particular note because growing numbers of women are turning to alternative therapies to relieve such symptoms as hot flashes, headaches, mood swings and sleep disruptions because of concerns about health risks associated with hormone therapy, which is still considered the most effective way of treating such difficulties. The researchers recommend that physicians learn more about these products so that they can help their patients choose safe, effective methods of treating their symptoms.

“We’re not promoting the use of these alternative therapies,” said lead author Jun Ma, MD, PhD, research associate at the Stanford Prevention Research Center. “We’re just saying that the demand for these therapies is growing and that physicians should be prepared to talk to their patients about it.”

The study appears in the May/June issue of The Journal of the North American Menopause Society. The study was funded by GlaxoSmithKline Consumer Healthcare, which had no role in the study design, data collection or preparation of the manuscript for publication. The pharmaceutical company manufactures the herbal product RemiFemin Menopause.

The study was based on a 2004 online survey of a random sample of 781 U.S. women between the ages of 40 and 60. Because the sample size was small, Ma cautioned that the findings may not accurately represent all women, but said the data provide useful insights into women’s attitudes toward menopause treatments and how much physician guidance they have received in deciding which therapies to use.

Among the women surveyed, nine out of 10 reported having experienced at least one menopausal symptom at some point. When it came to treating their symptoms, 37 percent reported using hormone therapy while slightly less than that – 31 percent – used herbal products. Soy supplements were used by 13 percent. (more…)

The risks associated with hormone replacement therapy are not as great as commonly believed, and women in the early stages of menopause should not worry about taking the drugs, according to Amos Pines, chair of the International Menopause Society, who issued a consensus statement from a team of experts who reviewed the safety and effectiveness of HRT in early menopause, Reuters reports. The statement was issued at a global summit in Madrid on Tuesday (Kahn, Reuters, 5/20).

NIH researchers in July 2002 ended the Women’s Health Initiative study of combination HRT three years earlier than scheduled because they determined that the treatment might increase the risk for heart disease, invasive breast cancer and other health problems (Daily Women’s Health Policy Report, 3/5). The results of the study, which also found HRT increased the risk of ovarian cancer and strokes, caused millions of women to end their use of the drugs.

Pines said that he and colleagues reviewed nu (more…)

3rd European Menopause Survey also highlights loss of confidence in HRT and resultant suffering -

More than four out of five women (84%) believe that menopausal symptoms require treatment and should not simply be accepted, according to a survey of over 4200 European women aged 45 to 60 years. However the research – Organon’s 3rd European Menopause Survey – also shows that less than half of women have a positive opinion about hormone replacement therapy (HRT) today and many are unaware of its established benefits.

The survey also reaffirms that the menopause has far-ranging and considerable consequences on women’s lives and indicates that women may be suffering menopausal symptoms but are too concerned about the risk of breast cancer to seek treatment. Women are also unaware of differences between menopausal therapies in relation to the breast.

“These findings provide a fascinating snapshot of women’s views and experiences today. Overall, they highlight the extent of the loss of confidence in HRT, yet clearly demonstrate that the need for treatments to relieve menopausal symptoms is as great as ever,” said Dr Nick Panay, consultant gynecologist, Queen Charlotte’s Hospital, London, UK. “Clearly more must be done to explain both the benefits of therapies and the true risks in order to rebuild women’s confidence in the appropriate use of HRT.”

The European Menopause Survey interviewed more than 4200 women in detail to provide current insights into their views, experiences and needs during and after the menopause. It reaffirms that menopausal symptoms continue to impact the lives of many women. In all, 94 % of women report menopausal symptoms in the last five years, and 64 % report one or more severe menopausal symptoms. Hot flushes were the most common symptom reported by 74 % of women, and have the most impact on women’s lives.

Although most women were aware of HRT, the majority of women have a negative feeling about it. Awareness of their benefits is low. One in five (21%) were unable to name any benefits. By contrast when asked about the main risk factors, 61 % of women say risk of developing breast cancer and 22 % cancer in general.

Half of the women who were on treatment stopped HRT. However, of those who stopped their treatment 42% restarted largely in response to the return of menopausal symptoms. At the same time, 19% of women are currently using natural, herbal or homeopathic treatments including plant estrogens of which clinical effectiveness has never been proven in meta-analysis.

Finally, the findings indicate that one in eight women may be suffering from menopausal symptoms but not using HRT most commonly because of fears about the risk of breast cancer. The proportion of the population suffering without treatment is greatest in Belgium (19%) and France (17%) and lowest in the Netherlands and Spain (both 7%).
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For many women, the word “menopause” means living with innumerable symptoms which can alter the course of their lives. Menopause affects nearly 40 million women in the United States and while it is a natural time of physical and emotional change, it can also be a time of confusion and worry. Common symptoms include hot flashes, night sweats, insomnia, irritability, low libido, and depression. Hot Flashes are the most common symptom experienced by menopausal women.

ChiliPad™, a revolutionary mattress pad with both heating and cooling functions, reduces the severity of hot flashes by allowing consumers to adjust the entire surface of their bed to the desired temperature. ChiliPad cools and warms a bed from 48 to 118 degrees F.

“Often if a room is too cold for one person it is too warm for the other,” said Todd Youngblood, president and co-founder, ChiliTechnology, LLC. “Some couples resort to opening windows or turning on the AC all night to stay cool. Instead of cooling the whole house to get a comfortable night’s sleep, you can just cool the bed. This is especially helpful for women experiencing hot flashes and night sweats or anyone who just needs to cool their body down to get a good night’s sleep.” (more…)

In middle-aged women, visceral fat, more commonly called belly fat, is known to be a significant risk factor for cardiovascular disease, but what causes visceral fat to accumulate?

The culprit is likely not age, as is commonly believed, but the change in hormone balance that occurs during the menopause transition, according to researchers at Rush University Medical Center.

“Of all the factors we analyzed that could possibly account for the increase in visceral fat during this period in a woman’s lifetime, levels of active testosterone proved to be the one most closely linked with abdominal fat,” said Imke Janssen, PhD, assistant professor of preventive medicine and the study’s lead investigator.

The study, which has been published early online in the medical journal Obesity, included 359 women in menopausal transition, ages 42 to 60, about half black and half white. Fat in the abdominal cavity was measured with CT scans, a more precise measurement than waist size. Blood tests were used to assess levels of testosterone and estradiol (the main form of estrogen). Medical histories covered other health factors possibly linked with an increase in visceral fat.

Statistical analyses showed that the level of “bioavailable” testosterone, or testosterone that is active in the body, was the strongest predictor of visceral fat. (more…)

The menopause marks the time in a woman’s life when her menstruation stops and she is no longer fertile (able to become pregnant). In the UK the average age for the menopause is 52 (National Health Service), while in the USA it is 51 (National Institute of Aging). About one fifth of women in India experience menopause before the age of 41, a study found. The menopause is a normal part of like – it is a milestone, just like puberty – it is not a disease or a condition. Even though it is the time of the woman’s last period symptoms may begin many years earlier. Some women may experience symptoms for months or years afterwards.

According to Medilexicon’s medical dictionary, the menopause is the “Permanent cessation of the menses due to ovarian failure; termination of the menstrual life.” (menses = shedding of blood during a woman’s menstrual period). The peri-menopause is the 3 to 5 year period before the menopause when a woman’s estrogen levels begin to drop. Let’s recap the meaning of these two words:

* Menopause – when periods (menstruation) stop forever.
* Peri-menopause – the years before the menopause when estrogen levels start to drop

A study revealed that some British women are in denial when it comes to the menopause.
What are the symptoms of menopause and peri-menopause?
Experts say that technically the menopause is confirmed when a woman has not had a menstrual period for one year. However, the symptoms and signs of menopause generally appear well before the one-year anniversary of the final period. They may include:

* Irregular periods – this is usually the first symptom; menstrual pattern changes. Some women may experience a period every two to three weeks, while others will not have one for months at a time.

* Lower fertility – during the peri-menopausal stage of a woman’s life her estrogen levels will drop significantly, lowering her chances of becoming pregnant.

* Vaginal dryness – this may be accompanied by itching and/or discomfort. It tends to happen during the peri-menopause. Some women may experience dyspareunia (pain during sex). The term vaginal atrophy refers to an inflammation of the vagina as a result of the thinning and shrinking of the tissues, as well as decreased lubrication, caused by a lack of estrogen. About 30% of women experience vaginal atrophy symptoms during the early post-menopausal period, while 47% do so during the later post-menopausal period. There are cases of women who experience vaginal atrophy more than a decade after their final period. The majority of post-menopausal women are uncomfortable talking about vaginal dryness and pain and are reluctant to seek medical help, a study found.

* Hot flashes (UK term: hot flushes)  – this is a sudden feeling of heat in the upper body. It may start in the face, neck or chest, and then spreads upwards or downwards (depending on where it started). The skin on the face, neck or chest may redden and become patchy, and the woman may start to sweat. The heart rate may suddenly increase (tachycardia), or it may become irregular or stronger than usual (palpitations). Hot flashes generally occur during the first year after a woman’s final period.
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Older women who take hormone therapy to relieve menopausal symptoms may get the added benefit of reduced body fat if they are physically active, according to a new study. The results were presented at The Endocrine Society’s 91st Annual Meeting in Washington, D.C.

The study provides new information on the health benefits of any type of physical activity, not just exercise, said the presenting author Poli Mara Spritzer, MD, PhD, a professor at the Federal University of Rio Grande do Sul in Porto Alegre, Brazil, and chief of the Gynecological Endocrinology Unit at the university’s Hospital de Clinicas de Porto Alegre.

After menopause, a woman’s percentage of body fat tends to increase and redistribute to the abdomen, Spritzer said. Excess belly fat is a risk factor for diabetes and heart disease. Postmenopausal women who exercise have a lower percentage of body fat than sedentary women, past research shows. However, Spritzer said less is known about the influence on body fat composition of physical activity in women receiving hormone replacement therapy, or HRT. Some data suggest that estrogen treatment may add to the effect of exercise in reducing fat.
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During menopause, lack of oestrogens increases the risk of suffering cardiovascular diseases. For her doctoral thesis, University of the Basque Country researcher, Ainhoa Ruiz del Agua, studied the effects of substitute treatments and the genetic factors influencing the response to these therapies.

Menopause is a natural period in the ageing process of a woman. On ceasing the ovary function, the body gradually stops producing eggs and female sex hormones (amongst these being oestrogen and progesterone), responsible for regulating the menstrual cycle. Lack of oestrogens increases the risk of very important diseases with respect to premenopause, amongst these being osteoporosis and illnesses related to the cardiovascular system. Amongst these heart diseases atherosclerosis is the most important, being an illness characterised by the presence of plaques full of lipids (fats) along the walls of the arteries, and which restricts the blood flow, causing high blood pressure. If these plaques break, the result is a thrombosis that can block the artery, causing, amongst other things, heart attack.

To slow down the natural drop in oestrogen level and thus prevent associated problems, substitutive hormonal therapies are prescribed during the menopause, either orally or subcutaneously (with patches), as well as by treatments based on substances that modulate the oestrogen receptor, amongst these being raloxifene. However, the effects of these therapies are disputed, given that there are no definitive conclusions about their usefulness: research carried out to date shows their efficacy in preventing osteoporosis, but it has not been clarified if they are capable of reducing the risk of contracting heart disease. Moreover, the response amongst different women to the same treatment can vary according to environmental factors, population, diet and, of course, as a function of genetic factors.

Ms Ainhoa Ruiz del Agua’s PhD thesis addressed these questions when she recently defended it at the University of the Basque Country (UPV/EHU): Oxidative stress biomarkers during postmenopause: effect of substitutive treatments. Dr Ruiz del Agua is a biochemistry graduate who is currently working as a researcher contracted by the Department of Physiology in the Faculty of Medicine and Odontology of the UPV/EHU. Her work was led by Ms María Begoña Ruiz Larrea and Mr José Ignacio Ruiz Sanz. Treatment with diverse effects

The principal aim of the research is to determine the effect of substitutive treatments normally administered during postmenopause. Moreover, it aims to define the genetic markers that condition the response to each of the treatments. To this end, Doctor Ruiz del Agua analysed the response by a group of women from Bizkaia to two treatments: on the one hand, to raloxifene and, on the other, to a substitutive hormonal treatment combining estradiol (a type of oestrogen) and progesterone (another female sex hormone). (more…)

Acupuncture cannot be shown to have any positive effect on hot flushes during the menopause. This is the conclusion of a systematic review of literature by three groups in Daejon, Busan (South Korea) and Exeter (UK), published in the current edition of the peer-reviewed journal Climacteric.

Many women are concerned by the unfavourable publicity given to HRT use, but still have to deal with the symptoms which can occur during and after the menopause. A significant minority of women look for alternatives to HRT to deal with these symptoms. Often these alternatives are untested, and it can be impossible to balance the risks and benefits of these treatments against the risks and benefits of conventional treatments or the discomfort of untreated menopause.

The researchers reviewed studies on the use of acupuncture for the relief of hot flushes during the menopause. They identified 106 studies in total, which they eventually narrowed down to the six most relevant to the study. These six studies were randomised controlled trials (RCTs), which included testing the effects of real acupuncture against the effect of sham acupuncture. Only one RCT reported favorable effect of acupuncture on the frequency and severity of hot flush after 4 weeks follow-up, while the other five RCTs demonstrated no such effects.

Researchers caution that the quality of good studies is not great, and that because of this the use of acupuncture cannot be completely ruled out. However, the available literature indicates that acupuncture does not seem to be effective in the treatment of menopausal hot flushes.

Lead researcher, Dr Myeong Soo Lee (Korea Institute of Oriental Medicine, South Korea) said

Although the availability of good Randomised Controlled Trials is too small to draw any firm conclusion, in general the evidence from sham-controlled RCTs for the effects of acupuncture for treating menopausal hot flush is not convincing. We would always recommend that women wanting relief from menopausal symptoms consult their clinician before undertaking any course of treatment.
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