Nutra Femin For
Woman
Eases Menopause Symptoms
The Menopause Reporter
Become a STAR Become a STAR Washington, DC October 12, 1999 --
call the National Cancer Institute's Cancer Information Service at: 1-800-4-CANCER (1-800-422-6237) New York, N.Y. October 5, 1999 -- If your menses are occurring sooner than 21 days it may be perimenopause or a more serious gynecological condition and you need to be evaluated by your health care provider. Menses occurring later than 45 days is more consistent with menopause or perimenopause. If physical symptoms predominate, especially hot flashes, vaginal dryness and night sweats, and if they last throughout the month unrelated to menses think more about menopause. Remember menopause before the age of 40 is called premature menopause and is rare. However perimenopause can begin before age 40. Surgical removal of the ovaries is the most common cause of premature menopause. Hopefully you know if your ovaries have been removed, but you may not. Years ago doctors routinely removed ovaries in women undergoing a hysterectomy (removal of the uterus). Now many gynecologists do not remove the ovaries. Until you are firmly in menopause, that is, no periods for one year, you can still get pregnant. If you don't smoke, low dose oral contraceptives can be used right up to menopause. Hopefully your calendar will help you become more familiar with your symptoms. From here you can design a PMS / perimenopause / menopause treatment plan. Perimenopause, a Hot Topic for U.S. Doctors (Part Two)New York, N.Y. September 28, 1999 -- You start with your past. The age your mother or older sisters began menopause can have a bearing on when you will begin menopause. If your mother went through menopause in her late 40's and you're 34 it is most likely PMS. If your mother suffered from PMS then you are more likely to suffer as well. However, your mother might not remember when she went through menopause and your older sister may not admit to it. The only other reliable factor is if you smoke. If you smoke, you can count on menopause starting 1-2 years earlier than if you don't. Pregnancies, birth control pills, your age when you first began menses or breast-feeding have no impact on the age of menopause. If you are on oral contraceptives or other hormones such as Depo-Provera or estrogen, these can have an effect on mood, irritability, hot flashes, depression and your periods. Women who can't tolerate birth control pills are more likely to develop PMS and have a difficult perimenopause. Adjusting the dose, brand or time you take these medications can sometimes relieve unwanted side effects. Some of the symptoms of depression are found in both PMS and perimenopause. Depression is not caused by menopause, but it can run in families. If feelings of depression, loss of appetite, insomnia, and general loss of interest or pleasure in life are at the top of your list you may be suffering from clinical depression. These feelings should be brought to the attention of your health care provider. Depression and PMS can occur together and it's not uncommon for anxiety or depressive disorders to worsen during the week before your period and at menopause. Sound confusing? Well, it can be. All of the above statements are generalizations but you have to remember that you are a unique individual. Watch for part three here next week.Perimenopause, a Hot Topic for U.S. Doctors New York, N.Y. September 21, 1999 -- Perimenopause is defined as the TRANSITIONAL period from normal menstrual periods to no periods at all. The transition can, and usually does, take up to ten years. During the perimenopausal transition you may experience a combination of PMS and menopausal symptoms or no symptoms at all. Check back next week for the latest from New York on the perimenopause. Protect Yourself from Gynecological Cancer Chicago, IL. September 14,1999 -- September is gynecological cancer awareness
month. Every 64 minutes a women is diagnosed with gynecological cancer. The most
common female reproductive system cancers are cervical, ovarian and uterine.
September is Menopause Awareness Month New York, NY. September 7, 1999 -- Since September is menopause awareness
month I thought a little historical perspective might be appropriate. Menopausal
women have been neglected and ridiculed by society and generally under-served by
the medical community. Women going through "The Change" have been
characterized by society as raving and frantic or muddleheaded and oblivious.
The following is a quote taken from an 1887 neurological textbook:
"The ovaries, after long years of service, have not the ability of retiring in graceful old age, but become irritated, transmit these irritations to the abdominal ganglia, which in turn transmit the irritation to the brain producing disturbances in the cerebral tissue exhibiting themselves in extreme nervousness or in an outburst of actual insanity." This unsympathetic attitude has mellowed somewhat. Today women live to an
average age of seventy-eight. They may spend as much as a third of their lives
in menopause! One hundred years ago, most women saw menopause as the end of
their life and IT WAS! Life expectancy in the 19th century was age fifty. Once a
woman reached menopause, it was expected that she would soon die. Well, some
women still feel that way. Usually by the age of fifty-one the ovaries run of
eggs (ova) and stop making estrogen. This loss of estrogen causes the typical
symptoms of menopause. Premature or early menopause can be the results of surgery although not
from a simple hysterectomy (removal of the uterus) but a surgery called an
oophorectomy (removal of the ovaries). This often accompanies a hysterectomy,
especially if the woman is over forty years old. Radiation and/or chemotherapy
for the treatment of cancer can also throw a woman into a premature menopause.
In some cases a gender disorder, which can be handed down from mother to
daughter, can cause premature ovarian failure. Menopause is a natural transition and the more people who are made aware of
this fact the better for all of us. Boston, MA. August 31, 1999 -- Brisk walking is associated with a decrease in
heart disease according to a recent study in the August 26 issue of The New
England Journal of Medicine. Walking was compared with vigorous exercise in
72,488 female nurses who were 40 to 65 years old. The nurses have been studied
for the past 8 years. Those women who walked at a brisk pace for three or more
hours a week had a significant reduction in their risk of heart attack. The
walkers risk of heart attack was reduced practically as much as those women who
engaged in regular vigorous exercise. Another encouraging finding is that
sedentary women who become active even later in life can lower their risk of
heart attack. For the prevention of osteoporosis it is still necessary to do
some resistive exercise. Weight lifting even with light weights can go a long
way towards bone health. So during your brisk hour walk use hand and ankle
weights for a more complete workout. (N Engl J Med 1999;341:650-8.) Bologna, Italy. August 24, 1999 -- We have a good mystery for those of you
who have increased your intake of soy. University researchers from Italy and
Wales have just published another soy study in the August issue of Obstetrics
and Gynecology. They revisited the 104 postmenopausal women in their original
study. The women had supplemented their diet with 60 g of soy powder a day and
reported a 45% decrease in frequency of hot flushes. This finding along with
previous studies showing soy's ability to reduce hot flushes has prompted
millions of women to add soy to their diet. It has always been assumed the
active ingredients are phytoestrogens. Phytoestrogens are natural, mild
estrogen-like compounds. They are found in soy and many other herbs used for
menopause. The doctors were looking at blood levels of phytoestrogens. Everyone
thought the level of phytoestrogens would be highest in the women with the
lowest frequency of hot flushes. Asian women who eat soy products every day have
high phytoestrogen levels and few hot flushes. They were surprised to find the
women with the highest levels of phytoestrogens did not necessarily have the
fewest hot flushes. So what is it in soy that works on those flushes? Dr.
Albertazzi the principle investigator at Bologna University is not sure. He and
others will keep looking for the answer as they feel soy may also decrease the
chance of developing breast cancer and osteoporosis. ObstetGynecol 1999;94:225-8. Bethlehem, PA. August 17, 1999 -- Doctors at the Department of Obstetrics and
Gynecology and Pathology at St. Luke's Hospital report that using a progesterone
cream may decrease the number of menopausal hot flashes you experience. They
studied 102 menopausal women who were divided into two groups. One group used
1/4 tsp. of natural progesterone cream on their skin daily. The other group used
a placebo, after one year both groups were compared. The researchers found that
83% of the group that used the progesterone cream reported less hot flashes.
Only 19% of the placebo group reported any benefit. Progestogens have been used for years in infertility treatment and to replace
the natural progesterone in women with premature ovarian failure. Progestogens
are used to treat abnormal uterine bleeding and for contraception in birth
control pills and in Depo-ProveraŇ the every 3 month
contraceptive injection. They are also used to prevent the negative effects of
estrogen on the uterus when used for hormone replacement therapy and they are
used for the treatment of PMS. There are problems with using progesterone cream for hot flashes.
"Natural progesterone cream" has been sold for years as a menopause
remedy, to cure wrinkles, osteoporosis, fatigue etc. ObstetGynecol 1999;94:225-8. Tampere, Finland. August 9, 1999 -- A new study sheds light on sleep problems
in menopause. Researchers in Finland studied 63 menopausal women in their sleep
lab. They report several things we already knew. Insomnia increases with age.
Women are more likely to suffer from insomnia than men. After hot flashes,
insomnia is the most often complained about symptom of menopause. But does
menopause and the resulting low estrogen cause sleeplessness? The scientists
conclusion was no. Menopause per se with the resulting low estrogen levels did
not cause changes in sleep patterns. What did cause insomnia was being
overweight and being old. If you suffer from insomnia every night or most nights for a period of one
month then you have chronic insomnia. If you're not having hot flashes or night
sweats then it's time to look for other causes of sleeplessness. Depression and
anxiety disorders are the most common causes of chronic insomnia. If you feel
depressed you need to be evaluated by a qualified health care provider. Movement
disorders such as restless leg syndrome are second on the list of causes of
insomnia for them; there are new medications that may help. Other common causes
are shift working, respiratory disorders and pain. In up to 30% of people with chronic insomnia no cause can be identified.
Medical treatment of these people has generally been with hypnotic drugs
(sleeping pills). It is estimated that 25% of the adult population in America
took some type of medication for sleep last year. It is generally agreed that
sleeping pills should only be in the lowest dose and for the shortest possible
time. The recommendations are;
(BEDS) Bibliographic Electronic Database of Sleep (NAPS) New Abstracts and Papers in Sleep Senate Votes Against Womens HealthWashington, DC. August 2, 1999 -- The U.S Senate still seems to be siding Senate Votes Against Womens HealthWashington, DC. August 2, 1999 -- The U.S Senate still seems to be siding
with the big HMO's when it comes to women's health. The Senate passed what they
call a "Patient's Bill of Rights". A more accurate name would be the
"Insurance Companies Bill of Wrongs". Women are still not given the
right to go directly to their ob/gyn if they find a breast lump. They must still
go through a primary care "gatekeeper". We know that a significant
delay in the diagnosis and treatment of breast cancer can result in women dying. The House is trying to organize a full scale debate. They need to here from
you. Contact your Senators and Representative at their web sites to let them
know how you feel. Your Senators
San Diego, CA. July 26, 1999 -- The Human diet contains foods that may have an influence on menopause and menopausal symptoms. Some foods have high levels of phytoestrogens, or plant estrogens. These compounds are found in soy foods, flax seeds, and some herbs. The phytoestrogenic compounds are called isoflavones and lignans. One of the first phytoestrogens to be studied was red clover. In years past it was noted that when female sheep ate a diet high in red clover, their menstrual cycles became irregular. Dr. Lisa B. Nachtigall, of Tufts University, Boston, Massachusetts, reported at The Endocrine Society meeting in San Diego last week, on a study of 16 women using a red clover based supplement for menopausal symptoms. The supplement is called Promensil by (Novagen, Inc.),and after 8 weeks patients reported a greater than 50% decrease in hot flashes and night sweats. Another clue to the fact that plant's contained estrogen-like compounds was that women in Asia, where the diet is high in soy foods, reported less menopausal symptoms and had a lower incidence of breast cancer. However when Asian women cane to America and adopted the traditional American diet their postmenopausal symptoms increased as did their incidence of breast cancer. This generated interest and further studies were undertaken. A 1990 study of 23 women showed that a diet high in soy food and flax or linseed meal reversed the atrophic changes seen in the vagina after menopause. A 1995 study of 58 post menopausal women showed that a diet high in soy
decreased postmenopausal hot flashes. There have been several studies showing a
protective effect of soybean products against the development of breast cancer.
The protective effect may be due to the fact that phytoestrogens can act both as
weak estrogens and weak anti-estrogens. It is presumed the anti-estrogen effect
on the breast confers protection against breast cancer. New York, N.Y. July 19, 1999 -- This weekend a group of scientists and
physicians gathered in New York City to discuss a new study on the problem of
vertebral fractures in postmenopausal women. The study is named PROOF and shows
how a drug called miacalcin can prevent these fractures. Your vertebra are the many small bones that form your backbone. When
osteoporosis develops these are the first bones to loose strength and this can
result in them collapsing. Vertebral fractures are a national epidemic there are
over 700,000 new fractures a year and in the past these were ignored by most
doctors. Patients were told there was nothing to be done just take pain
medication. Many vertebral fractures do not cause terrible pain they may just
cause a worsening of chronic back pain, a stooped over posture or a protuberant
abdomen. One third of women over the age of 65 suffer a vertebral fracture.
There are well established risk factors for osteoporosis. Being white or Asian
with a thin or small build are risk factors as well as being menopausal, not
getting enough calcium or taking steroids. For more information visit the National
Osteoporosis Foundation's Web site Milan, Italy July 12, 1999 -- An international panel on Hormone Replacement
Therapy (HRT) has just finished reviewing 50 years of data. They looked at the
risks and benefits of estrogen therapy for menopausal symptoms and concerns. The
panel felt that the evidence was overwhelming for the use of HRT as "first
line" therapy for menopausal symptoms such as hot flashes. The evidence
looks very good for the use of HRT for the prevention and maybe even the
treatment of osteoporosis. There is strong evidence that HRT has a protective
effect on heart disease and encouraging evidence for it's role in slowing the
onset of Alzheimer's disease and colorectal cancer. This is good news for the
millions of women now taking HRT or considering it. However there is nothing new
here. Read
the article here Miami, FL. July 5, 1999 -- Corporate America has recognized several women's
issues recently. Extended maternity leave, child care and even paternity leave
have been addressed . Menopausal issues in the work place have not been dealt
with yet. These are real concerns, hot flashes can disrupt meetings and lack of
sleep can effect performance. The workplace may be a good place for support
groups to form and educational seminars to be held. "My generation is
finally coming out and saying that it's OK to go through menopause . That's
going to make a difference, because not being able to talk about menopause is
the worse thing that a women can do." said Jane Elaine Taulé , president
of the National Association of Women Business Owners. The LifeLines Institute is a new group formed by two pharmaceutical
companies, Noven Pharmaceuticals, Inc and Novartis Pharmaceuticals Corporation.
The institute has been charged with the job of "educating corporate America
about menopause". Along with this noble pursuit they will help Novogyne
sell it's new product the Vivelle dot™. Also known as the world's smallest
estrogen replacement therapy patch, the dot has been on the market since January
and will face steep competition from the numerous other patches available. Let's
hope LifeLines keeps it's promise to bring corporate America up-to-speed on
menopause. San diego, CA June 28, 1999 -- Loss of interest in sex is a common complaint
of postmenopausal women. Testosterone is the most common androgen, and it has
been shown in several studies to improve libido ( sex drive ) when taken by
mouth. Dr. Glenn Braunstein, of Cedars-Sinai Medical Center-UCLA, Los Angeles,
California, has been studying a new testosterone patch. He has reported his
preliminary findings last week at the annual meeting of the The Endocrine
Society. The study was conducted on 75 surgically menopausal women. They used
the patch for three months, then switched to either a placebo (patch with no
medication) or a higher dose patch for three months. Overall, there was little
improvement except for those on the high dose patch who reported an increase in
sexual activity. Should you be taking an androgen product? Possibly, if any of the following
apply to you. There are other questions you must answer with your physician. What is your
risk for osteoporosis? What is your cholesterol HDL ratio? There are still
unanswered questions concerning androgens. What effect will androgens have on
heart disease and breast cancer over the long term? More long range studies are
needed. For now if you think you might be a candidate for androgen therapy, take
the information you have and discuss it with your physician Washington, D.C. June 21, 1999 -- Vice President Al Gore met recently with
the Older Women's League (OWL). The Older Women's League - let's update the
name. Even if you don't like the name you may agree with their cause. As
explained on their web site. "OWL seeks comprehensive, preventative, acute
and long-term care accessible to all, which recognizes the specifics of women's
health care profiles." In a recent conference sponsored by the OWL,
Medicare reform was discussed and a new report was made public. These are
important issue for menopausal women. Politicians know there are twice as many
women over age 85 as men, these women are more likely to be poor and have higher
health care costs than men. Fortunately they are also more likely to vote than
men. The most heated discussions centered on prescription coverage. Medicare
does not cover prescriptions, yet 80% of menopausal women are taking some
prescription medications which they have to pay for out-of-pocket. Since half of
older women have incomes less than $10,000 and drugs are notoriously expensive,
this is a hardship for many. The President of the Older Women's League Betty Lee
Ongley, summed it up by saying, "Understanding who Medicare serves and what
they need is essential as Congress begins to look at changing the
program..." Another change in the works is lowering the age of buy-in
coverage from 65 to 62. And watch out for those legislators who would like to
raise the age of eligibility from 65 to 67. It may seem a long way off, or you
may be involved with Medicare now, either way make your voice heard. Keep
informed and let your congressman and senator know your watching them. Call the OWL Congressional Information Line.
June 14 1999 -- As many of you may painfully be aware of, menopause is
associated with unwanted weight gain. Women on hormone replacement therapy don't
gain as much weight but they still may gain more than they want. Xenical, also
known by its brand name Orlistat, has just received FDA approval for weight
loss. The drug acts by blocking up to 30% of the fat you eat. Xenical works in
the intestines and is not absorbed into the blood stream. Since it is not
absorbed, there should not be any life threatening side effects. You may
remember Redux, one of the components of Fen-Phen, that caused heart valve
defects, prompting the FDA to remove it from the market. Xenical's side effects
as reported by the company "...may include oily spotting, gas with
discharge, urgent need to go to the bathroom, oily or fatty stools, increased
number of bowel movements, and inability to control bowel movements. Due to the
presence of undigested fat, the oil seen in a bowel movement may be clear or
have a coloration such as orange or brown." It may be messy but not life
threatening. For more details about
Xenical and to figure out your BMI Click Here. Boston, MA. June 7, 1999 -- Researchers at Harvard University have reported
new evidence that links early menopause and smoking to heart disease. The report
is based on the ongoing Nurses Health Study. For the past 18 years scientists
have been keeping track of over 35,000 women as they went through menopause. Dr.
Frank B. Hu has published their findings in the latest edition of the
Archives of Internal Medicine. What Dr. Hu and his associates have
discovered is that if you smoke and go through an early menopause before age 40
your risk of heart disease increases by over 53%. Menopause between age 40 and
44 increases your risk of heart disease by 42%. The problem is compounded by the
fact that smoking is known to bring on an earlier menopause. Smokers go through
menopause an average of one year earlier than nonsmokers. So now we have two
more reasons not to smoke. Not only do you risk going through an early menopause
if you smoke this study shows that your early menopause will be associated with
a higher risk of heart disease. Click
Here to read the study. Philadelphia, PA. June 1, 1999 -- Preliminary reports presented at the
American College of Obstetrics and Gynecology's annual meeting show that if
you're on the standard dose of HRT (hormone replacement therapy) you may benefit
by cutting the dose in half. Dr.Bruce Ettinger and colleagues at the Kaiser
Permanente Medical Care Program in Oakland CA. studied 138 postmenopausal women
who were on the standard dose of HRT (0.625mg) all of which had some monthly
bleeding. Bleeding is the side effect most responsible for women discontinuing
HRT. The women were switched to a half strength estrogen (0.3mg) and a progestin
used only every six months. The women have been followed now for 6 months and
they have experienced a decrease in the amount of bleeding and no worsening of
menopausal symptoms. Previous studies have shown that the half strength estrogen
confers the same protection from osteoporosis as the standard dose. This lower
dose may also provide the same protection from heart disease (studies are
underway). We may also expect to see less estrogen associated breast cancer with
this lower dose. If continued monthly bleeding is a concern, or if you're on HRT
and considering going off because of bleeding ask your doctor about lowering
your dose. Austin, TX -May 24, 1999 -- Black Cohosh or Remifemin™ is the most popular
herbal treatment for menopausal hot flashes. It has been available in Germany by
prescription since the mid 50's. The American Botanical Council and the Herb
Research Foundation have just published a 15 page literature review on black
cohosh in the journal HerbalGram. This is the most comprehensive review
available and includes a description, history, safety profile and a review of
the eight clinical studies done to date. A copy of the literature review is available from the American Botanical
Council by calling 800/373-7105 or visit their web site at HerbalGram New York, NY. - May 17, 1999 -- Viagra has FDA approval for the treatment of
sexual impotence in men only. Ever since hitting the market in 1998 Viagra has
seen unprecedented success even at $10 a tablet men are lining up at their
doctor's offices for prescriptions. But what about the millions of
perimenopausal women with sexual dysfunction? Dr. Steven Kaplan was interested
he has just published the first study of Viagra in women. Researchers at
Columbia University looked at the effect of Viagra on 33 menopausal women who
complained of decreased sex drive, painful intercourse, vaginal dryness,
difficulty achieving orgasm or inability to achieve orgasm. The women took 50mg
of Viagra one hour before intercourse. That came out to an average of three
times a week for 12 weeks. Only 7 women (21%) noticed an improvement with
Viagra. According to Dr. Kaplan "That's equal to the placebo (sugar pill)
response in men receiving Viagra. So that response might be a placebo effect
rather than a true improvement in sexual function due to the drug" Urology 53[3];481-86, 1999. Cincinnati, OH, - May 9, 1999 -- Finally after many years of court battles,
suits and counter suits the FDA has approved a plant based estrogen combination
that is virtually identical to Premarin. Wyeth-Ayerst, had for many years
successfully blocked the approval of a synthetic replacement for Premarin. Their
drug is the most prescribed estrogen on the market today and is the third most
prescribed medications of all time. It has been available since 1942 and about 9
million women take it. Many women are surprised to find out that Premarin stands
for PREgnant MARes urINe, and in fact is made from horse urine. Moreover many
horse enthusiasts including the Equine Advocates organization claim that horses
used in the manufacturing process are mistreated. Because of this many women
want to get off Premarin but there hasn't been a comparable product until now. Boston, MA, - May 2 1999, -- Vitamin D deficiency is more common than
previously thought. If you live in the northern latitudes (most of the US)you
may be at risk. Each year in the US, hip fracture results in approximately
300,000 hospital admissions. Close to 40% of all women will suffer some type of
fracture after age 50. Most of these fractures result from osteoporosis among
women who experience accelerated bone loss after menopause. A hip fracture can
be worse than you may think, 20% of women die as a result of the fracture, 25%
end up in a long care facility and less than 50% recover fully. JAMA1999;281:1505-1511. National Institutes of Health Recommendations
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