News & Research

Keep up to date with all the current news and research surrounding menopause and women’s health issues.

Is there a connection between hot flashes and heart disease?

A small study looking at the connection between hot flashes and heart disease has just been published in the online journal Menopause. According to the findings of the study conducted by the North American Menopause Society (NAMS) frequent hot flushes during menopause could be a sign of increased risk of heart disease. The study examined 272 women between the ages of 40 and 60 who reported having hot flashes either daily or not at all. The women did not smoke and had no history of CVD (cardiovascular disease). Although the study is small it is an important one with a serious message. Hot flashes/flushes are one of the most common symptoms of menopause. New data has indicated that hot flashes can start much earlier than previously thought, beginning during the late reproductive years. They can continue for ten years and longer, vary in severity and can have an impact on health and quality of life. The study shows younger midlife women (age 40-53 years) having frequent hot flashes may also signal emerging vascular dysfunction that can lead to heart disease. This is due to the hot flashes impacting on the ability of blood vessels to dilate among younger women. Women aged between 54 and 60 do not seem to have this issue which would indicate that when hot flashes occur earlier they could have an effect on a women’s heart disease risk. The study looks at the association between hot flashes and endothelial function. The endothelium is a layer of cells that line the inside of the blood vessels. The assessment of endothelial function is considered a key factor in predicting atherosclerosis...

The Evidence Base for HRT: what can we believe?

Professor Robert D Langer’s paper, ‘The evidence base for HRT: what can we believe?’ is a review of the 2002 Women’s Health Initiative (WHI) clinical trial of hormone replacement therapy (HRT). The study and its findings, you may recall, emphasised the risks of HRT causing worldwide concern and led to many women refusing or stopping treatment. Professor Langer’s paper highlights the serious errors that were made during the WHI study including:- Publication of results with very little involvement from the key investigators. Reported conclusions that did not accurately reflect the scientific findings Although the study was designed to test the effects of HRT in older women – the conclusions applied the exaggerated risk to all women. As a consequence many women who needed HRT have avoided it and subsequently suffered unnecessarily. Since then many clinicians have been trying to disprove the findings of the report. Professor Langer says “in the years since the first WHI report, we have learned much about the characteristics of women who are likely to benefit from HRT. The range of HRT regimens has also increased. Not all women have indications for HRT, but for those who do and who initiate within 10 years of menopause, benefits are both short-term (vasomotor, dyspareunia), and long-term (bone health, coronary risk reduction).”   Things have indeed moved on a great deal since this study. In November 2015, NICE (National Institute for Health and Clinical Excellence) UK, issued the first guideline on diagnosis and management. You can find the guideline for professionals and a simplified version for women patients here.   See Professor Robert D Langer’s paper: ‘The evidence...

Getting your period at a young age may mean early menopause, too

Can getting your period at a young age play a role in when you reach menopause? The average age of menopause is 51, however, for some women this can vary widely from between the age of 40 and 55. A study has found that those women who had started menstruating at 11 or younger were 80 percent more likely to have experienced early menopause than women who were 13 or over when their periods began. The risk was heightened among women who started their periods early and subsequently had no children; they had a fivefold increased risk for premature menopause and double the risk of early menopause compared with women whose periods had started at 12 or later and who had had two or more children.   Sources: Gita D. Mishra et al (Jan 2017) Early menarch, nulliparity and the risk for premature and early natural menopause. Retrieved on 6 February 2017. Retrieved from https://academic.oup.com/humrep/article/2937790/Early-menarche-nulliparity-and-the-risk-for      ...

Effect of HRT on Sleep Quality

Extract from The British Menopause Society. “Many women experience disturbed sleep as a menopausal symptom which can have a significant effect on mood and energy levels and cause distress. In addition poor sleep can lead to increased risk of cardiovascular disease, diabetes and obesity. The role of HRT in improving sleep quality is unclear but a recently published review provides some clarity. The authors reviewed 42 trials which included 15,468 women. It was found that use of hormone therapy was associated with improved sleep quality in women who experienced vasomotor symptoms (flushes and sweats) but not in women who did not have such symptoms. This could mean that it is the vasomotor symptoms which may lead to disturbed, or poorer quality sleep, rather than estrogen deficiency in the absence of symptoms. Hence treatment of the vasomotor symptoms leads to improved sleep as a secondary effect. Since sleep complaints are reported by 40% to 60% of menopausal women, more research would be helpful”. Reference: Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis. Cintron D, Lipford M, Larrea-Mantilla L et al. Endocrine, 2016 Related Articles: Menopause Insomnia Hot Flushes and Night Sweats Sources: Effect of HRT on Sleep Quality (Nov 2016) Retrieved on 28 November 2016. Retrieved from  https://thebms.org.uk/2016/11/effect-hrt-sleep-quality/ Efficacy of menopausal hormone therapy on sleep quality: systematic review and meta-analysis. (Retrieved Nov 2016) Retrieved from https://mayoclinic.pure.elsevier.com/en/publications/efficacy-of-menopausal-hormone-therapy-on-sleep-quality-systemati    ...

Are Hot Flashes Genetic?

A team of UCLA-led researchers may have found a clue in a first-of-its-kind study: genes could be a factor in determining which women get hot flashes. It appears that women who have gene variants that affect a receptor in the brain that regulates estrogen release are more likely to have hot flashes than women who lack them. The study published in the Menopause Journal is a step that could lead to new treatments to relieve the symptom of hot flashes. Dr Carolyn Crandall, professor of medicine in the division of general internal medicine and health service research at the David Geffen School of Medicine at UCLA and the study’s principal investigator said “no previous studies have focused on how variants in women’s genes may be linked with hot flashes, and these results were highly statistically significant.” Furthermore, Dr Crandall said “these associations were similar across European-American, African-American and Hispanic-American women, and they persisted even after we accounted for other facts that might influence hot flashes.”   Sources: Rivero, E., (Oct 2016) Are hot flashes genetic? First-of-its-kind study finds gene variant linked to the symptom in menopausal women. Retrieved from http://newsroom.ucla.edu/releases/are-hot-flashes-genetic. Crandall, Carolyn J. MD, MS; Manson, JoAnn E. MD, DrPH; Hohensee, Chancellor MS; Horvath, Steve PhD, ScD; Wactawski-Wende, Jean PhD; LeBlanc, Erin S. MD, MPH; Vitolins, Mara Z. DrPH; Nassir, Rami PhD; Sinsheimer, Janet S. PhD. (Oct 2016) Association of genetic variation in the tachykinin receptor 3 locus with hot flashes and night sweats in the Women’s Health Initiative Study. Retrieved fromhttp://journals.lww.com/menopausejournal/Abstract/publishahead/Association_of_genetic_variation_in_the_tachykinin.97898.aspx    ...

Effect Of Combined HRT On Breast Cancer Risk

A Breast Cancer Now Study finds the effect of Combined HRT on breast cancer risk is likely to have been underestimated. The effect of combined hormone replacement therapy (HRT) in increasing a woman’s risk of breast cancer is likely to have been underestimated by a number of previous studies, according to a new prospective study published in the British Journal of Cancer, highlighted on the British Menopause Society Website on 23 August 2016. Women taking combined HRT are 2.7 times more likely to develop breast cancer than non-users, with risk increasing with longer HRT use, Breast Cancer Now Generations Study finds Study comprehensively updated information about women’s HRT use and analysed accurately to allow for age at menopause Research suggests many previous investigations which did not do so may have underestimated the increased risk of breast cancer by up to 60% The new research was part of the Breast Cancer Now Generations Study – a major prospective study led by scientists at The Institute of Cancer Research, London, following more than 100,000 women for 40 years to investigate the causes of breast cancer. Some 39,000 women with a known age at menopause were identified and monitored for six years, with follow-up questionnaires gathering comprehensive data on any HRT use (type and duration) as well as their general health and lifestyle. During this time, 775 of these women developed breast cancer, with the researchers finding that women using combined HRT (for a median duration of 5.4 years) were 2.7 times more likely to develop breast cancer during the period of HRT use than women who had never used HRT. You...

What’s New About Menopause 2016?

  Written by Dr Karen Morton, consultant obstetrician and gynaecologist and Founder of Dr Morton’s – the medical helpline. Congratulations to the organisers of the British Menopause Society’s 26th Annual Conference at the Royal College of Physicians on Thursday and Friday 19 and 20 May 2016. Both content and organisation were excellent, and I am sure every one of the delegates: GPs, gynaecologists and Specialist nurses, will all have left London inspired to give their patients the most up to date advice and to become evangelists for optimising the health of women in their middle years and beyond. So What’s New About Menopause in 2016? What were the take-home messages? The title of the conference was ‘NICE Menopause Guideline: from publication into practice’, so clearly time was spent looking at the key messages from the 29 page NICE recommendation document which was published in the Autumn of 2015. But there were also several lectures on the periphery of what NICE looked at which gave out clear messages for change or enhancement of practice. For me the striking messages were: Women should talk about their problems and get help. Awareness of women’s needs at this time in their lives should have prominence in the workplace. More about this later. Good diet and lifestyle with regular exercise, moderate alcohol intake and not smoking are more important than anything else. OF course! Oestrogen-only HRT (only suitable for women who have had their uterus removed) causes no significant increase in breast cancer. If you have a uterus it must be protected with progestogen and after several years of taking it, this combination probably...

What Selective Estrogen Receptor Modulators (SERMS) Can Do For You

There are many alternatives to hormone therapy for the treatment of hot flashes and other menopause symptoms. One you may not have heard about are Selective Estrogen Receptor Modulators (SERMS). According to the North American Menopause Society NAMS, SERMS selectively activate or block estrogen receptors in certain areas of the body and not others which can make them safer than estrogen alone. There are currently FDA approved SERMS to selectively target, prevent and treat several diseases including breast cancer, osteoporosis and vaginal atrophy. At the time of writing SERMS for menopause have been launched in the US but not in the UK or the EU. Currently, there is no SERM that alone can relieve hot flashes, however, there is a SERM combination being used for hot flashes that combines estrogen with the SERM bazedoxifene. These drugs may be helpful for women with health concerns about hormone therapy but need relief from hot flashes, low bone mineral density, vaginal atrophy and bleeding. As with all medical treatment you should discuss any possible side effects with your Healthcare Professional. Here you will find a video of JoAnn Pinkerton, Executive Director of the North American Menopause Society NAMS discussing what SERMS are and how they can help you. You will also find a SERM’s FAQ page at this source.   Sources: The ABCs of SERMS. Retrieved from http://www.menopause.org/for-women/menopause-take-time-to-think-about-it What Selective Estrogen Receptor Modulator (SERMS) Can Do For Your. Retrieved from...

Blood Clot Risk is lower for Estrogen-Only, Transdermal and Vaginal Estrogen Hormone Therapy

New research has found that blood clot risk is lower for estrogen-only, transdermal and vaginal estrogen hormone therapy, which is great news as the risk of blood clots in women increases with age. Menopause, The Journal of North American Menopause Society (NAMS)  has published new research from the Karolinska Institute in Stockholm led by Dr. Annica Bergendal, which found that overall, estrogen-only therapy carries a lower risk of blood clots than treatment with a combination of estrogen and progestin, the synthetic version of progesterone. According to Science Daily the study highlights that the way estrogen is delivered may impact the risks.  There was no increased risk of VTE (venous thromboembolism) in this study for women who used transdermal estrogen (such as patches), either alone or in combination with a progestogen. And women who used vaginal estrogen alone to ease vaginal dryness and other symptoms of genitourinary syndrome of menopause (GSM) also had no increased risk of VTE. Many menopause experts don’t expect vaginal estrogen to raise the risk because absorption into the bloodstream is small and results in levels similar to those in postmenopausal women who use no hormones. But studies on this question have been rare, noted the authors, so this finding is a big help for decision making. This study adds to current knowledge that transdermal estrogen therapies are safer than oral and that different estrogen or progestogen combinations may have different risks.   Sources: Bergendal. A, MD., et al, (March 2016) Risk of venous thromboembolism associated with local and systematic use of hormone therapy in peri and postmenopaual women and in relations to type and route of administration. (Retrieved May...
Page Last Updated on February 6, 2017