Science-y science type stuff
• More motivation to get nourishing nutrition going: a pro-inflammatory diet (fried foods, sodas, processed food etc) prior to and during perimenopause was found to increase the risk of future fractures, according to new data from the long-term, large-scale Study of Women’s Health Across the Nation published in the Journal of Clinical Endocrinology and Metabolism. Just one index point on 2 different measurement scales (one for diet, one for diet and supplements) increased the risk of future fracture by 28 percent, even after adjusting for a variety of factors, including age, BMI, smoking status, race/ethnicity and medication and more.
• Score one more for the Mediterranean diet, which was associated with an up-to 23 percent lower risk of developing dementia in an observational study of 60,000 adults conducted over nine years. The UK Biobank study results were published in BMC Medicine journal. And as study investigator Oliver Shannon, from Newcastle University, Newcastle Upon Tyne, told Medscape Medical News, the results were evident “even for those with higher genetic risk”.
• While awaiting news from the FDA about its non-hormonal drug for hot flashes, fezolinetant, the results of Astellas Pharma Inc’s Phase 3 clinical trial on the drug have been published in The Lancet. The company’s summary of the findings included “significant” reductions in the frequency and severity of hot flashes as early as the first week, meeting targets at four and 12 weeks of the study compared to a placebo on the 30 or 45mg doses, demonstrated across the 52 weeks of the study. There were also indications of improved sleep, but they weren’t found to be statistically significant. (I don’t have access to that study myself yet, so I am not able to answer the pivotal question of how many less severe and frequent hot flashes per day is considered a significant reduction)
• Declining hormone levels did not predict sleep disruption during the menopause transition, but night sweats did, according to data collected from 700 women over four years as part of the US Midlife Women’s Health Study, published in the Journal of Women’s Health.
• A new study examines evidence that the profound reproductive and hormonal changes in perimenopause create a “systematic inflammatory phase” that enables later neurodegenerative disease, published in the Journal of Neuroinflammation.
UK testosterone news
• In a followup to their piece on the 10-fold increase in testosterone prescribing in the UK, The Pharmaceutical Journal looks at why women are having a hard time getting it: a surge in demand, no dedicated product for women, making it hard to prescribe and monitor and as always, a lag in research are among the factors. Also, Australian professor Susan Davis at Monash University, a leader in the field who in 2019 published the most comprehensive review of all the research to date (finding evidence for libido), is studying testosterone for a lot more than libido, including the relationship to bone health, cognition, muscle and heart.
• “It’s worrying because many private firms are some of the biggest champions of the use of testosterone for menopausal symptoms.” Glasgow GP Dr Punam Krishan: “Patients are shouting at me if I don’t prescribe testosterone for menopause – it’s a worrying trend” iNews
• UK ob-gyn Dr Michelle Griffin writes a thoughtful response to the fallout from the original article in The Pharmaceutical Journal, and the resulting media coverage, with Ignore the Davina McCall Effect: Why testosterone is not a menopause wonder drug: “libido is a complex multifactorial function, not ruled solely by hormones. It involves physical, psychological and practical aspects. Taking testosterone will alter the biological state, but is commonly insufficient on its own - as typically there are many other issues involved such as low self-esteem, relationship problems, time alone without children interrupting, and certain medications”. BBC Science Focus
Giveaway time
Don’t miss the great giveaway Become Clothing has organized for National Sleep Week. It’s a sleep bundle worth US$650 featuring products from Wile, Midday, Pause Well-Aging, Become and a one-year paid subscription to Substack from moi! Contest ends tomorrow, Sunday, March 19, so head over to the post and follow the instructions to get in on it.
With so much hype surrounding menopause hormone therapy today, it’s very hard to know what or who to believe.
There is a big push to portray HRT not only as helpful for menopause symptoms, but also as a preventative for cardiovascular disease. But does this bear out in the research we have so far? Enter the latest literature review published in the American Heart Association’s journal Circulation – Rethinking Menopausal Hormone Therapy: For Whom, What, When, and How Long? – that looked at 96 papers, articles and studies. The authors included gynecologists, women’s health internists, endocrinologists, as well as Stephanie Faubion, medical director for the North American Menopause Society, all members of the American College of Cardiology Cardiovascular Disease in Women Committee.
Kathryn Lindley, an MD and clinical investigator in the Division of Cardiovascular Medicine at Vanderbilt University Medical Center and one of the authors of the paper, is my guest on the Hotflash inc podcast this week to break down these findings.
Highlights:
• why cardiologists have shied away from the topic of HRT
• why HRT isn't recommended for prevention of cardiovascular disease (even if it seems like it should be)
• the case for HRT to help symptoms
• calculating the of using HRT for symptoms ("it's not zero but...")
• why other health conditions matter
• when it comes to vaginal estrogen...
• respecting the HRT "the window of opportunity"
• so, what can you do to prevent heart disease and stroke?
• the case for assessing reproductive risk factors (and what you need to tell your doctors about your previous reproductive life – even if she doesn't ask)
• the importance of taking in medical news in the media with "skepticism"
• the case for keeping top of your health during perimenopause and taking action early for your future health
Click, read, listen, watch + follow
• “Needless to say, getting diagnosed with menopause was an uphill battle — even if you don't identify as female, it affects everyone with ovaries”. I’m a 37-year-old non-binary person going through menopause Insider
• Consume the entire piece of content, then decide what to think for yourself. That’s informed criticism. The podcast heard round the world, featuring the woman everyone loves to hate. Gwyneth Paltrow: Her Wellness Protocol for Longevity and Gut Health, Keyboard Warriors, Conscious Uncoupling and Medical Gaslighting. The Art of Being Well with Dr Will Cole podcast
• UK digital healthcare provider Livi has some interesting data: ‘Vaginal odour’ and ‘perimenopause’ among most-searched women’s health topics Independent
• Congrats to Sally Mueller and Michelle Jacobs for their appearance on ABC’s The View. Breaking the stigma around menopause: 'Women do want to talk about it' Also, I love this piece by Gabriella Espinosa wrote for Womaness: 5 Ways To Awaken Pleasure In Menopause
• Coverage of “MANopause” is shifting from the “is andropause even real?” variety: Male menopause is treated as a joke, but there's nothing funny about the misery it causes for millions Daily Mail
• Omisade Burney-Scott says “there’s a huge beautiful community of people trying to figure this thing out together”, but the disparities and inequities in treatment options persist, as do the tendency to earlier menopause and more severe symptoms: What You Should Know About the Non-White Experience of Menopause Katie Couric Media
Editor’s note:
Now here is an angle you don’t hear every day: My wife's sex drive has increased due to the perimenopause and I can no longer satisfy her, courtesy of iNews (with a paywall). This poor fellow who can’t keep up is a nice counterpoint to all the “my libido dropped through the floor” stories we hear. Just a reminder that this is different for everyone; and that what makes headlines are the rare cases (because no one would be interested otherwise, certainly not the editors).