Hot takes and new research at The Menopause Society annual meeting

I got press releases about 7 interesting studies and I'm telling you about them

Photo by sk on Unsplash

The annual meeting of the Menopause Society of North America kicks off today in Chicago. There are more than 80 sessions on everything from cannabis use to AI in diagnosis to preserving ovarian tissue to delay menopause. I can’t clone myself and be there, but I am getting press releases about some of the compelling studies that will be presented, things that make me go hmmm.

I am impressed that the Menopause Society is publicizing hypnosis, CBT and hormone therapy. Sometimes when you look out into the menoverse, it seems like there is only one way of doing this.

We contain multitudes, and our research should too. I'll be watching out for more news and following up on some of the most interesting researchers and findings. 

HT rates are dropping 

One question that is mighty hard to get an answer to is this: how many women take hormone therapy, anyway? Despite what you hear on social and mainstream media, for two decades now US rates for women 40-59 on 'estrogen-containing' hormone therapy have been dropping steadily, some cases by half. 

The fresh figures refer to women taking HT with estrogen (alone or combined), oral or transdermal use, ages 40-59 broken down into categories.

The baseline criteria was established as 180 days of a filled prescription.

More details will be dropping this week (like where and how this data was collected), but here is what we know so far about what happened from 2007 to 2023: 

>> HT use in women aged 40 or older dropped from 4.6 percent to 1.8 percent

>> HT use in women 45-49 dropped from 3.2 percent to 1.5 percent 

>> HT use in women 50-54 dropped from 6 to 3.6 percent 

>> HT use in women 55-59 dropped from 7.3 to 3.8 percent

Dr Stephanie Faubion, medical director for The Menopause Society, and lead author of the HT use study, had this to say: "Unfortunately, we have not seen HT use increase in the two decades since the publication of the WHI trial results. In fact, usage rates remain under 4 percent, even in women under the age of 60 years who are typically the most symptomatic. These findings suggest that substantial barriers to HT use remain, and additional efforts are needed to educate women and clinicians about menopause management and HT use more specifically.”

Hotflash inc hot take: Why only 'estrogen-containing' hormone therapy? Do these researchers not consider progesterone hormone therapy? Testosterone? Vaginal estrogen? Pregnanalone? DHEA? It's hard to watch archaically designed research try to come out with modern results. And when are we going to survey women not on hormone therapy to find out why not, adjusting for confounding factors? Or will we just keep assuming that there the major reason is there is something keeping them from the hormone therapy?

HT for IR?

One of the biggest new studies to drop this week is a meta-analysis of randomized, controlled trials that found hormone therapy can significantly reduce the risk of insulin resistance. 

Women are more vulnerable to insulin resistance in perimenopause, which happens when hormones fluctuate and recede and the body's cells become less responsive to the  insulin – leading to higher blood sugar. Left unchecked, this is the runway to prediabetes, Type 2 diabetes, and a range of other illnesses, both chronic and fatal, often preventable if action is taken at this early stage.

Researchers at Reading Tower Health and Drexel University College of Medicine in Pennsylvania conducted the meta-analysis of 17 studies in a search for clarity where previous results have been mixed. 

How they did it:

>> Estrogen or combination hormone therapy: 15,350 participants 

>> Placebo: 13,937 participants

>> Average age: 47 to 75 

>> Duration: Eight weeks to two years

>> Length of study: 1998 and 2024

Although more details will be presented at the meeting, Dr Xuezhi Jiang, lead researcher, said both oral and transdermal hormone therapy significantly reduced insulin resistance. Estrogen-only therapy yielded even greater reductions.  

Dr Stephanie Faubion, medical director for The Menopause Society, said the findings show hormone therapy could have a beneficial application for addressing insulin resistance. 

Hotflash inc hot questions: Any distinctions were made between progestin and progesterone? And would that have any affect on the higher impact found in the estrogen-only camp? Also, who would like to see a study comparing the efficacy of hormone therapy to lifestyle interventions when it comes to reducing the risk of insulin resistance?