Some counter-narratives coming out of a British Medical Journal seminar called HRT for treating menopause: known unknowns. I sure wish you could read this whole article or watch the video, but since there is a paywall, I’ll give you some worth-it highlights:
• “Coronary heart disease and dementia were previously thought to be prevented by HRT, however recent data appear to show no relationship — perhaps even a slightly increased risk of dementia, said Gillian Reeves, director of the Cancer Epidemiology Unit at the University of Oxford Different randomized studies have returned conflicting results.”
• “It’s easy to see why a pharmaceutical solution is appealing. Not only does it avoid such difficult discussions, Martha Hickey, professor of obstetrics and gynaecology at the University of Melbourne alluded to the financial incentives for the pharmaceutical industry to promote HRT treatment for all — a point raised as far back as 1975 in a Lancet editorial.
• “Margaret McCartney, a GP in Glasgow, says the confusion around the menopause makes it easier to market unnecessary treatments and promise improbable results. McCartney highlights private clinics that claim—without evidence — that HRT can lead to weight loss, glowing skin, and glossier hair, among other things.”
Science stuff
HRT DELIVERY SYSTEMS: An intervaginal ring (IVR) that dispenses bioidentical estradiol and progesterone over a 28-day cycle? The research on this new non-oral, non-daily hormone therapy option is ticking along nicely. It’s been three years since I’ve written about the San Francisco-based company Daré Bioscience, Inc’s research on an IVR, designed to treat hot flashes, genitourinary syndrome of menopause and bone loss, along with (I’m guessing) other symptoms as a matter of course. The company has published the results of its Phase 1/2 clinical trials in Menopause, the journal of the North American Menopause Society. They tested two versions – 80 micrograms of estradiol/4mg progesterone and 160 micrograms of estradiol and 8mg of progesterone – in 21 women over 12 weeks and both were found to be safe and releasing systemic versions of the hormones. On the safety front, the new progesterone delivery system was deemed sufficient to protect the lining of the uterus. That’s cutting edge.
POI + GENES: And this is why we don’t rely on animal, observational or small cohort studies: Because a new study upends the notion that primary ovarian insufficiency (POI) is solely due to genes.
New research, published in the journal Nature Medicine, analyzed exome sequencing data from more than 104,733 women in the UK Biobank. Of that group, 2,231 reported experiencing premature menopause, defined as happening before 40.
Co-corresponding author Anna Murray, professor of human genetics at the University of Exeter's medical school, said that a lot of the information about the 100 genes linked to POI came from mice or too small samples of humans.
"It now seems likely that premature menopause is caused by a combination of variants in many genes, as well as non-genetic factors," she said.
PROGESTERONE + PERIMENOPAUSE: Endocrinologist Dr Jerilynn Prior’s hypothesis is that estrogen has been understudied and oversupplied in perimenopause, and that in many cases, because progesterone starts to delcline first, it might be more suitable. Her research – bolstered by her latest, albeit “underpowered” randomized, placebo-controlled trial that was just published in Nature – suggests progesterone helps hot flashes with no recurrence once discontinued (unlike estradiol), and it also helps sleep.
QUOTE I’M PONDERING
“Why do the scientists of today like to assume that our bodies are broken machines—and not wise wonders that usually do things for a reason?”
Tessa Lina, Epoch Times
Click, read, listen, watch + follow
• What they don’t know about this will make your head spin: Can You ‘Catch’ Alzheimer’s Disease? Epoch Times
• Alanis Morissette on Anger, Anxiety, and Being Multitudinous PsychCentral podcast
• I’m not a big fan of “ultimate” or “definitive” guides, because they really never are, but it’s nice to see someone devoting space to this topic: Your Ultimate Guide to Treating Menopausal Acne Yahoo
• This article is a head-scratcher for a lot of reasons (the British Menopause Society doesn’t see drinking as an issue for women, and there is no mention at all of what might happen when you combine HRT and alcohol) but the core message is worth paying attention to: ‘Quitting drinking helped my menopause symptoms massively – I’m less anxious and sleep better’ iNews
• Critics are loving British comic Bridget Christie’s Channel 4 show The Change. The Guardian
• Menopause could change the way you travel, but there is a way to navigate it Condé Nast Traveller India
• The Sneaky Connection Between Menopause & Chronic Inflammation mindbodygreen
Editor’s note
Author, speaker, podcaster Mel Robbins did a podcast on adult ADHD this week and it had me in sobbing pieces on a morning walk along the Abu Dhabi Corniche. It was like someone describing my entire life, including all the things I never understood and hated myself for. I’m not going to talk a lot about this until I have all the information, a diagnosis, etc. But if there is something you’ve realized about your life lately, and it has you spiraling, my heart goes out to you. There’s a lot of grief in midlife. And what might have been if you’d only known – even if you’ve done pretty damn good – is a biggie to process.
Oh Ann-Marie! I feel you on the ASHD episode that Mel Robbins did. I follow her as religiously as I follow you. I have a younger sister who was diagnosed way back. Why didn’t anyone stop to give it a thought that I too, could he ADHD?!? The good news is that I’m aware of my triggers. Oh well, it just wasn’t in the cards, but I’ll always wonder what my life could have been had I too, been diagnosed.
I'm 42 and was diagnosed with ADHD late last year. Such a validating experience ❤️