I’ve spent the last 6 years learning to love my curvy body, so I get it.
It sucks being told to lose weight for your health.
So this is not that, here, now, okay?
This is me telling you that a small study presented at this week’s meeting of The Menopause Society of North America (aka NAMS) found obese women with a BMI over 30 – OH MY GOD WHY ARE WE STILL USING THE BMI – reporting worse menopause symptoms and getting less relief from hormone therapy.
In a week where inflammation emerged as a key theme, this is very interesting. Also: There is no known research looking at the effect of hormone therapy on obese women, while very little research has been done on the impact of comorbidities on the efficacy of HRT during menopause.
(We have 1/10th of the research on menopause that we do on pregnancy, so it’s shocking but not that surprising.)
This is a self-reporting study of 119 women over five years, so small. It was led by Dr Anita Pershad, a medical student at Eastern Virginia Medical School in Norfolk, who sought out underrepresented patient populations.
Look, considering that we shouldn’t even be using BMI as a measurement, what is obese, or overweight? And what other factors are involved? When I look back at pictures from my 40s, I see someone who veered between overweight, medium-sized and sometimes slim – all due to the cumulative effects of IBS, out-of-control stress, drinking, crazy workouts, etc etc. Nutrient and micronutrient deficiencies play a big part in what shape we take. Autoimmune, fatty liver, Vitamin D levels, trauma, socioeconomic factors – the list goes on. And perhaps some people really can be healthy at any size, but maybe not in that vulnerable patch we hit in peri/menopause? And anyway, what can even be done about it if that is true, because one of the problems people encounter in perimenopause is that they put on weight and find it harder to lose. It’s a big mess, really.
Still, as Menopause Society medical director Dr Stephanie Faubion points out, when more than 40 percent of women over 40 in the US can be considered obese according to the Center for Disease Control, these results just might be “meaningful” to consider as they make the transition.
More research this way:
Cannabis is increasingly being used to treat menopause symptoms, according to research presented at The Menopause Society’s annual meeting. Researchers asked 5,000 mostly postmenopausal women how often they use cannabis, what forms they are using, and for what reason. Here are the top lines:
• 28 percent use it for chronic pain, 24 percent for anxiety, 22 percent for sleep problems and 22 percent for stress
• 6 percent of women reported using cannabis specifically for menopause symptoms, to improve mood and sleep
• Of those who used it in the last month, half smoked or used edibles, with 39 percent mixing methods
Dr Carolyn Gibson, lead author and a health services researcher at the University of California, San Francisco: "We know that cannabis products are being marketed to women to manage menopause symptoms, and these findings suggest that midlife women are turning to cannabis for menopause symptoms and other common issues in the menopause transition. But we still do not know if use is actually helping for those symptoms, or if it may be contributing to other challenges."
Well if they are using it, it’s probably helping, no? More research is needed, and when we get it all decades from now, I’m sure it will be very helpful for those people who haven’t hit perimenopause. For the rest of us, here are some resources:
• Episode 53 of the Hotflash inc podcast, with the founders of Hello Again, Carrie Mapes and Patty Pappas
• Queen’s University psychiatry professor Oyedeji Ayonrinde, who told the Menopause Society meeting in 2020 that menopause has been referenced for menopause treatment all the back to the 1899 edition of Merck Manual. His advice: "Go low and slow"
• Episode 76 of the Hotflash inc podcast featuring Dr Mikhail Kogan, geriatrician, professor of medicine at George Washington University School of Medicine & Health Sciences in the US, and co-author of the 2021 guide Medical Marijuana
Any other resources you know of? Hit reply and let me know!
Stress, mental health and perimenopause: Elevated cortisol levels found in hair were significantly associated with problems in attention and working memory in perimenopause, and when found in saliva were associated with severity of depressive symptoms, according to a small study of 43 women also presented at the NAMS annual meeting. Lead author and assistant professor Dr Christina Metcalf of the Department of Psychiatry at the University of Colorado Anschutz Medical Campus in Aurora, said the work provides the first evidence that longer-term activation of the hypothalamus-pituitary-adrenal axis can lead to these sorts of cognitive problems in perimenopause. Next, she plans to look at whether taking interventions to decrease this HPA activation can improve executive functioning.
Covid + post-menopausal bleeding: Post-menopausal women reported a higher rate of unexpected vaginal bleeding in the month after receiving their COVID-19 vaccination, according to a new study out of Norway. The Norwegian Institute of Public Health (NIPH) asked 22,000 women participating in two studies about their menstrual cycles and unexpected bleeding in 2021, the year most people were first vaccinated. They then used a statistical model to extrapolate a two to four-fold increased risk correlation, depending on where they were at in their transition. This article from NIPH has a great rundown on the ‘so far’ on this topic.
The news:
• Midi Health (and midlife women, and holistic care plans) score US$25 million in funding led by GV, former Google Ventures Fierce Health
“It’s clear that menopausal symptoms can derail women’s lives. With far too few practitioners trained in managing menopause, women are underdiagnosed, undertreated, and underserved,” Joanna Strober, Midi Health CEO and founder
• What you should know about colon cancer screening The Vagenda
• Hyaluronic acid suppository improves genitourinary symptom of menopause, but not as much as vaginal estrogen: study Medscape
• This boss sounds extra special: Female office manager, 49, wins £37,000 payout after boss dismissed her menopause symptoms as 'a biddy' having 'aches and pains' Daily Mail
• Why it’s never too late for trauma therapy: No matter your age, identifying trauma and addressing the impact in your life is worth it The Midst
“If you have specific reactions or triggers to certain stimuli and you understand them at a rational level, but you still can’t help feeling triggered, that’s a sign,” Olivia James, a British therapist trained in several trauma modalities
• The UK’s National Institute for Health and Care Excellence (NICE) is updating its guideline on menopause: diagnosis and management. Consults begin November 17 and run until May 1, 2024, with publication expected May 13. Register as a stakeholder, check out other stakeholders and more at: NICE
• Someone reviewed all the menopause apps, with an emphasis on osteoporosis BMC Women’s Health
Embrace with Sophia Cleverly (and me!)
When you watch the video below about my big news, you’ll see I’m in a bit of a place right now. Like I’ve been through something big, and now I see the path unfolding before me. And I know how I want to walk it, but I kind of need someone to hold my hand while I figure it out, you know?
Then along came Sophia Cleverly, who I had already engaged with as one of the loveliest people on Instagram, offering me a spot in her Embrace program.
And I said yes.
Sophia is not a ‘took a weekend course and is now a life coach’ kind of coach. She’s a Certified Professional Co-Active Coach, a qualified Happiness Facilitator, with training in neuroscience, mindfulness and positive intelligence.
Here’s what she says: “If you feel stuck or lonely, like you have tried all the things to get unstuck or haven't got the energy to do so, if you would like a crystal ball to to support you in navigating the challenges of midlife — take my hand and come on board Embrace.”
Here’s what I know: this is eight weeks of live coaching — an hour per week. There is lifetime access to a portal of resources to help lower anxiety, empower and increase energy. And I’m doing it. I’ll definitely want to cancel on the day of the first session. (That’s my MO – it almost happened with my first Padel tennis attempt with a crowd of strangers last Thursday. Almost. I had a ball.)
If you want to join us, there are still spots and Sophia has offered a 25 percent discount for Hotflash inc subscribers: EMBRACE programme details.
Editor’s note:
My big big big news, via video. This was a couple of weeks ago, and the big day was August 24. Still processing. 40 years of fertility – which most of the time I didn’t understand – and now this? At the end I’m talking about how I planned my first Office Hours and told everyone all the wrong times. AMx
I hear you, although I do like small studies as conversation starters. I think they can be somewhat valuable, especially if they are talking about under-represented populations like the weight one was. But what to do about the BMI... when almost all research is still based on the BMI?
I am concerned about a lot of the things that the Menopause Society has put out lately. Using antiquated measurement tools (BMI), combined with a very tiny sample of self-reported data to overgeneralize and say that it could be "meaningful" is very disappointing. How about we get quality research and then use those findings?