• SAD REALITIES: There are many ways to promote a narrative about hormone therapy that is not yet demonstrated by a body of scientific evidence. One is to promote studies that support your view, while discrediting those that don’t. This is called cherry-picking, and people who do it don’t understand how research works. Another is to suggest that the guiding societies are behind or ignoring data if they aren’t issuing statements supporting your beliefs. In menopause these kinds of suggestions are made because so many people want to promote HRT for absolute prevention of dementia and cardiovascular disease. British endocrinologist Dr Annice Mukherjee’s Instagram caption on this and other things to watch out for in research including errors and manipulation – “even RCTs can be misleading”, she writes – is a succinct and essential must-read that absolutely nails it and will help you cut through much of the ‘I believe in science’ simpletons out there. Nothing is perfect, and some things are all we’ve got to go on.
• Symptoms as signals: A large cross-sectional study out of Korea found an association between more severe perimenopause symptoms and markers for cardiovascular disease. After adjusting for an assortment of variables, including alcohol use, age and education level, researchers found an association between people reporting the worst vasomotor symptoms and poor cardiovascular metrics. They also found an association between the severity of all menopause symptoms and poor cardiovascular metrics. The study surveyed 4,611 premenopausal women from 42 to 52 years in doctor visits and via standardized questionnaire. “Premenopausal stage women with either vasomotor or nonvasomotor menopausal symptoms have significantly higher prevalence of poor CVH metrics, compared with those without any menopausal symptoms”, researchers concluded. The study was published in the July issue of Menopause, the journal of The Menopause Society.
• NAFLD to MASLD: So 236 panelists from 56 countries got together and then a global consensus panel of hepatology researchers and clinicians came up with a new term for non-alcoholic fatty liver disease (NAFLD) because “non-alcoholic” and “fatty” were considered stigmatizing by a majority of people in a survey. Say hello to metabolic dysfunction–associated steatotic liver disease, or MASLD, in a piece published in the journal Hepatology.
First of all, I suggest we call it NAFLDMASLD for awhile, until everyone catches up.
One thing I do wish is the powers that be focused less nomenclature and more on why perfectly healthy people eating healthy things are also getting NAFLDMASLD, which American estimates put at one-third of the population, not all of them obese. That would be great.
News
• Medical director Stephanie Faubion nails it again: “The lack of training healthcare professionals receive to work with their patients to navigate the challenges of the menopause transition contrasts sharply with the nearly infinite amount of information and misinformation that is available on Google and celebrity websites.” From a press release about the North American Menopause Society rebranding to The Menopause Society. If anyone knows what their new acronym is… Menopause.org
• French skincare brand Vichy has partnered with Embr Labs. Vichy has a line called Neovadiol designed for peri-to-post-menopausal skin, and Embr Labs is a cooling wrist device for hot flashes. The partnership involves digital and social promotions, awareness-raising and gifts and discounts for customers. FemTech Insider
• “Women’s Health Access Matters states that investing just $300 million in health research focused on women across just three disease areas will generate over $13 billion in economic returns through improved quality of life, reduced healthcare costs and more productive years added back to our workforce”: Peppy Is Disrupting The Stigma Around Discussing Women’s Health, Closed $45 Million Series B Forbes
Click, watch, listen and follow
• If you read one article this week, please make it this one. Alcohol and menopause: A balancing act ContemporaryObgyn.net … also I never expected menopause to mess with my sobriety Psychology Today
• Mushrooms for menopause is becoming a thing: 3 Surprising Conditions Psychedelics Might Be Used For Verywell Health
• ‘It seems like everything but breathing might be on this list’: Woman lists 100 perimenopause symptoms in a 7-minute unforgettable viral video’ Upworthy
• Black and menopausal: 3 people share their experiences of this time of transition Women’s Health
• Great explainer of where we are at in research (it’s not great) How male and female hormones influence disease Axios
• Jaycee Dunn, journalist and author of Hot and Bothered, writes compellingly about our collective bad attitude: Our Problematic Perspective of Menopause Can Make Symptoms Worse Katie Couric Media
• Be careful out there: Evidence weighed for suicide/self-harm with obesity drugs Medscape
• Menopause and Voice Changes: What women need to know HealthNews
Hotflash inc podcast
If you haven’t been listening to the Hotflash inc podcast I get it. But last week’s Michelle Aspinwall is a Body Whisperer and this week’s Menopause Vagina Stuff with Dr Burt Webb (dropping this weekend) have been pretty important, pretty disruptive episodes. And if you were going to listen to any of them, I’d suggest these.
Michelle is a strong voice against the trend to victimhood in the peri/menopause space, and I know I needed to hear her to clear my head of all the noise a bit.
Dr Webb is one of a few people talking about how our gut health can impact the state of our vaginas in menopause. Meaning yes, vaginal estrogen is important and one tool, but bigger picture is figuring out the larger systemic problems that are interrupting the blood flow to the region.
Find them wherever you get your podcasts.
Editor’s note
It’s summer and I’m on the road and my time is not my own, so I am giving you paid and free pieces as and when I can. For example I was going to spend Sunday night writing a free newsletter, but instead I decided to use that time to bake a from-scratch vanilla cake with buttercream frosting with my 13-year-old niece. (I think we can all be comfortable with that decision.) She decorated the top with a beach scene, and I can confidently say it was the best cake I’ve ever tasted.
Here’s what I’m trying to do differently right now, in a period of intensity, big feelings, big projects and transition: Intentional boredom. Supporting people without being responsible for them. Regular, deep connection, in person, with trusted friends old and new. Sun and walks and swims every day I possibly can. Listening to the quiet confident voice that says ‘do it’. And being right here in the middle thick of it.
That’s how I think we learn how to run (or at least speed walk) with the wolves, if you know what I mean.
Great roundup today! I think choline plays a key role in the development of NAFLD/MASLD in postmenopausal women because with less estrogen, they synthesize less choline. Here are a couple of studies:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302364/
"Overall, these findings suggest that MHT and increased choline intake may be potential strategies for reducing the risk of NAFLD in postmenopausal women."
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3302364/
"Decreased choline intake is significantly associated with increased fibrosis in postmenopausal women with NAFLD."