Do your bit for menopausal women….

Kings College

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Have you been diagnosed with premature ovarian failure (early menopause) within the last three years? If so, you could help to find a treatment for future generations… and maybe improve your own life a little!

Premature ovarian failure affects one in 20 women under 45.  It is estimated that there are more than 7,000 women with premature ovarian failure living in the London boroughs of Lambeth and Southwark alone. . 

It is a devastating diagnosis because it causes unpleasant menopausal symptoms, long term health risks, and greatly reduces the chance of becoming pregnant naturally.  Very little research into the condition has been carried out.

The female hormone Oestrogen is used as a ‘replacement’ treatment, to boost low levels in the body, which in turn alleviates symptoms of the menopause. However, it is not known what the ‘best’ treatment is and the effects of taking no treatment are also unknown.

But that is about to change…

Doctors and researchers at Guy’s Hospital and King’s College London are looking for women aged between 18-44 years who have been diagnosed with premature ovarian failure (early menopause) within the last three years, to participate in a research study to help find out more about the best treatment for the condition and the exact effects of no treatment.

The study at Guy’s Hospital will compare the effects of active treatment with either hormone replacement therapy or the combined oral contraceptive pill, or no treatment, and will involve approximately 70 women.

Katy Hayward from Lancashire is one of the women taking part in the study.  She was diagnosed with premature ovarian failure last year at 28 years old.  She said:  “I discovered I had gone through an early menopause a year ago and found myself searching for answers.  I realised that by participating in research I can help researchers find the best ways to manage premature ovarian failure, and hopefully help improve health care services provided for women in my position in future.”

Details of the study and how to take part

Dr Beth Cartwright, from the Menopause Research Unit at Guy’s Hospital said: “Local women can help us to extend understanding of the early menopause by taking part in this important research study.  They can choose whether to take treatment or not. 

Through a number of tests, scans and questionnaires over a two year period, we will compare the effects of the different treatments and the no treatment option on bone health, cardiovascular health, sexual function, symptom control, psychological wellbeing and overall quality of life. 

All women taking part will receive comprehensive care relevant to their premature ovarian failure and their participation will help in the treatment of early menopause in the future.”

Participation in the study involves seven visits to the Menopause Research Unit at Guy’s hospital over a two year period.

This includes;

– a screening visit to check eligibility to enrol
– DXA bone scans to monitor bone density
– ultrasound scans to look at the ovaries
– blood tests 

These investigations are carried out at enrolment and after six, 12 and 24 months. 

The DXA bone scan involves a very small amount of radiation which is similar to two days’ exposure to everyday background radiation.  The blood test and ultrasound scan may cause slight discomfort.

For further information about the study, contact Dr Beth Cartwright in the Menopause Research Unit at Guy’s Hospital on 020 7188 3024 or email: beth.cartwright@kcl.ac.uk.  By contacting the unit you are not obliged to take part.

Grapefruit increases risk of breast cancer in older women

Los Angeles: Grapefruit raises levels of oestrogen and could increae the risk of breast cancer by nearly a third, says a joint study from the universities of Southern California and Hawaii.

Raised levels of the mainly female hormone oestrogen have been implicated in an increased cancer risk for women.

According to the researchers, eating as little as a quarter of a grapefruit a day raises the danger by 30 per cent among older post-menopausal women.

This is the first report of a commonly consumed food that may increase the risk of breast cancer among post-menopausal women.

The report published in the British Journal of Cancer says: “Whole grapefruit intake was significantly associated with breast cancer in the present study generally a 30 per cent increase among women who consume the equivalent of one quarter of a grapefruit or more per day. There is evidence that grapefruit increases plasma oestrogen concentrations.

“Since it is well established that oestrogen is associated with breast cancer risk, it is plausible that regular intake of grapefruit would increase a woman’s risk of breast cancer.’ The study, carried out by the universities of Southern California and Hawaii, was based on more than 50,000 postmenopausal women from five ethnic groups, including 1,657 with breast cancer.”

A number of lifestyle factors are also linked to breast cancer risk. For example, alcohol. fat and junk food consumption are said to increase the risks.

Premarin creates new low dose HRT pill

London: A new low-dose hormone replacement therapy for women who go through an early menopause after a hysterectomy may soon be available.

The oestrogen- only pill has been launched for women under 50 who face a premature menopause because of womb surgery. It contains half the hose of the oestrogen – the hormone responsible for most of the potential negative side-effects of earlier HRT including heart disease and cancer.

The new low-dose pill Premarin contains 0.3mg of oestrogen, less than half the standard HRT preparation of 0.625mg. The hormone combats symptoms such as hot flushes and night sweats. It also fights bone thinning which affects women after the menopause and can lead to osteoporosis and broken bones.

HRT is thought to offer a degree of protection to women from many of the diseases of ageing including heart disease, osteoporosis, hairloss and even Alzheimer’s Disease.

Soya supplement proven to relieve menopause symtoms without dangerous side effects, reveal two new studies

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London: Two new studies, each involving 400 menopausal women, who were given a natural soya supplement has shown that it did not cause the potential dangerous side effects sometimes associated with oestrogen such as a thickening of the womb lining or breast cancers.

The studies were carried out by the French pharmaceutical company Arkopharma in relation to its supplement Phyto Soya, which helps relieve menopausal symptoms such as hot flushes by boosting levels of the hormone oestrogen naturally.

Nearly 400 women took part in each of the studies. The first looked at the effects of Phyto Soya on the endometrium – the lining of the womb – in women aged 45 to 65 years old. In this case the 310 biopsies that were available for evaluation at the end of the trial showed no cases of hyperplasia – an abnormal increase in the number of cells or cancer.

Separately, in another international study, which hasn’t yet been published, the women who were taking Phyto Soya were checked for changes in their breasts with mammography and breast ultrasounds. It found no changes at all in any of the subjects, and therefore no risks of breast cancer associated with the supplement. This study also confirmed that it caused no cases of endometriosis.

The studies’ authors are keen to point out that their results only apply to the brand of soya known as Phyto Soya and do not apply to any other soya isoflavone extract.

The good news for women is that a third study showed that trialists taking Phyto Soya experienced significantly fewer hot flushes a day, with two-thirds of them saying their number of hot flushes had been halved and 73% rating it as good or excellent.

The study concludes that menopausal women worried about the long-term effects of taking HRT now have a new, safe alternative in the form of soya extract.

The low incidence of menopausal symptoms in countries like Japan, where people eat a lot of soya, has long caused some experts to claim that soya extracts could do the same job as HRT. However, there was no proof that it was any less risky to take – until now, that is. But these new clinical studies have shown that Phyto Soya not only significantly reduces hot flushes but also is definitely safe when taken over long periods of time.

Soya is one of a number of plants that includes extracts called phytoestrogens, which are chemicals that act like oestrogens in animal cells. Isoflavones, which are found chiefly in soybeans, are specific phytoestrogens that have a chemical structure that is very similar to human oestrogen. This means that they can affect the way that women’s bodies produce oestrogen, if the right types and amounts are used.

Phyto Medicines Fact Sheet

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Medicinal plants and their preparations belong to the oldest known health-care products that have been used by human beings all over the world. The World Health Organization (WHO) estimates that up to 80% of the population of most developing countries use plant-based medicines. Between 25 and 50% of all modern drugs are derived from plants.

According to IMS research in 1995, the European Market for herbal medicinal products was estimated to be worth US $ 5,600 million. The leading countries are Germany (44 %) and France (28 %), followed by Italy, United Kingdom, Spain, Netherlands, Belgium and others.

According to the Allensbach study natural medicines helped people to alleviate various disorders such as cold, flu, digestive troubles, headache, insomnia, stomach trouble, nervousness, circulatory disorders, bronchitis, skin disease and exhaustion.

People are turning to natural and alternative treatments more and more as they become more health-intelligent and aware about what they put into their bodies. The medical profession in the UK is also becoming more accepting of these kinds of treatment as clinical evidence and patient experience is recognised. Alternative therapies are now available on the NHS in many parts of the country.

The Menopause – the facts

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The menopause occurs in all women. It can occur when the ovaries spontaneously fail to produce the hormones oestrogen and progesterone, when the ovaries fail due to specific treatment such as chemotherapy or radiotherapy, or when the ovaries are removed, often at the time of a hysterectomy.

For most women, the menopause occurs when the ovaries naturally fail to produce oestrogen and progesterone when they have few remaining egg cells. At that stage, the ovaries become less able to respond to the pituitary hormones: follicle stimulating hormone (FSH) and luteinising hormone (LH) and less oestrogen is produced. Levels of FSH and LH subsequently rise. The resulting low, and changing levels of ovarian hormones, particularly oestrogen, are thought to be the cause of menopausal symptoms in many women.

The average age of the natural menopause is 51 years, but can occur much earlier or later. Menopause occurring before the age of 45 is called early menopause and before the age of 40 is premature menopause.

Menopausal symptoms affect about 70% of women, are believed to be due to the changing hormone levels, particularly oestrogen. For some people, life-style factors such as reducing/stopping smoking, reducing alcohol intake, reducing caffeine intake, reducing stress, eating healthily and taking regular exercise can considerably help the symptoms of menopause.

When do menopausal symptoms begin?

Many women notice early symptoms while still having periods, when the hormone production is declining very gradually. This stage of gradually falling and fluctuating hormone levels is often called the “climacteric”, the “change” or the pre-menopause and often begins when a woman is in her 40s and can last for several years. Because ovarian function fluctuates, women may experience menopause symptoms intermittently.

What are the symptoms of menopause?

There are many potential symptoms of the menopause and no two women’s experiences are the same. Common symptoms are:

• hot flushes
• night sweats
• dizzy spells
• headaches
• swollen breasts and tummy
• weight gain
• fatigue
• insomnia
• nervousness
• anxiety
• irritability
• depression
• a decrease in sex-drive
• vaginal dryness
• urinary disorders
• increase in the risk of heart disease
• osteoporosis

The hot flush, or flash, is well known as the classic menopausal symptom and affects 60–85% of menopausal women. Hot flushes and sweats are called vasomotor symptoms and vary immensely in both their severity and duration.

For about one in five women, these can be very severe and cause significant interference with work, sleep and quality of life. Women are affected by vasomotor symptoms on average for about two years but, for about one in ten, symptoms can continue for more than 15 years. Each hot flush usually lasts 3–5 minutes and is thought to be caused by a change in the temperature-controlling part of the brain. A menopausal woman may flush with every temperature rise – for example, moving between areas of different temperature or having a hot drink – because of a change in the setting of the temperature control centre in your brain; your body thinks that it is overheating even when it isn’t.

Other factors that can also cause flushes include being overweight, alcohol, excess caffeine, spicy foods, monosodium glutamate and some medications. Eating a healthy diet and losing weight if necessary can be helpful. Other simple measures that can help include:

• wearing cotton clothing, rather than man-made fibres
• wearing loose thin layers of clothing rather than thick tight-fitting clothes
• keeping your bedroom temperature fairly cool at night – either leave a door or window open or consider a fan (partner permitting of course!).

Even before the menopause is reached, the first changes in the body begin to make themselves felt. This transitional phase, known as the pre-menopause, gradually sets into a woman’s life at around the age of 45. Symptoms can be similar to those felt during the menopause itself, but are usually not as frequent or severe.

For every woman, there is help available if she needs it – diet, exercise, alternative therapies or even HRT can help to ease the symptoms and make this key life-stage more bearable.

Low oestrogen linked to hip fractures in men

New York: Low levels of the hormone oestrogen have been linked to an increased risk of hip fractures in older men, a new study in the US reveals.

The new study which is published in the May issue of the American Journal of Medicine, also states that those with low levels of oestrogen and testosterone are at the greatest risk. This study is the first to report the link between low estrogen and hip fracture in a study group of men from the general population followed over time.

It also found that men with low estrogen levels have an increased risk for future hip fracture, and those with both low estrogen and low testosterone levels have the greatest risk.

The study, of 793 men who had their hormone levels measured nbetween 1981 and 1983 and had no history of hip fracture, was conducted by Shreyasee Amin, MD at the National Heart, Lung and Blood Institute’s Framingham Heart Study www.framingham.com/heart. The men were monitored until 1999.

Thirty-nine men in the study experienced a low trauma hip fracture, such as that sustained by a fall. Those with low estrogen levels had 3.1 times the risk of hip fracture compared to men with high estrogen levels. There was no significant increase in hip fracture risk for men with low testosterone levels alone. But those both low estrogen and low testosterone levels had the greatest risk, with 6.5 times the risk of hip fracture compared to the men who had both estrogen and testosterone levels in the high range or midrange.

Though many people associate testosterone with men and estrogen with women, men possess both hormones, according to Dr Amin, who now works at the Mayo Clinic.

The researchers who undertook this study knew that low estrogen levels had been associated with low bone mineral density in elderly men, but any link to hip fracture, an important health risk in the elderly, was unknown. Hip fractures are worrisome in the elderly, especially in men, explains Dr. Amin. Up to 50 percent of men require institutionalized care after the fracture. Hip fracture also is linked to higher levels of mortality: up to 37 percent of men die within one year of fracture.

Routine tests on hormones are not performed in most countries and this study indicates the importance of such testing.

Older mothers live longer, say doctors

London: Older mothers may live longer because of the hormone oestrogen and because they don’t have lots of children, according to doctors in a TV programme on the National Geographic Channel programme called Animal Ageing Secrets (12 March 2pm UK).

Larger amounts of the hormone oestrogen are released when a women becomes pregnant helping extending lifespan by protecting the body from various diseases of ageing such as osteoporosis. Normally the hormone declines from around the age of 30.

Oestrogen is given to women as part of hormone replacement therapy to relieve some of the effects of the menopause which can lead to loss of skin elasticity, hair loss and othe symptom such as hot flushes and obesity.

The bodies of older mothers are also likely to suffer less wear and tear than younger mothers because they tend to have fewer children, say scientists from the University of Manchester. Dr Dawn Skelton said: ‘After 30, there is a dramatic reduction of oestrogen in women.

‘By leaving it longer before having our first child, we’re giving ourselves a big burst of oestrogen, which helps in all sorts of ways – muscle, bone, nervous function.

‘It also helps that the later we reproduce, the less we reproduce.

‘It means that we’re not going to have lots of babies – the more children we have, the bigger toll it takes on our bodies.’

A good love life may also increase life expectancy.

‘A healthy sex life can have enormous benefits,’ added Dr Skelton, who is to feature on a
‘Testosterone levels drop in men and women as they grow older. But sex produces more testosterone, which may help keep our hearts in good shape. Those people who maintain a healthy sex life have a better outlook on life.

‘And trials of the oldest among us – 90-year- olds and above – show that 20 per cent are still actively engaged in sex.

‘That activity increases heart rate and the metabolism and decreases stress.’

In the UK in 2004, 22,700 women over 40 became pregnant, up by 1,800 on 2003 – the highest number since the post-war baby boom of the early 1960s. The figures follow growing concern of a ‘baby gap’ caused by women putting their career and financial security ahead of starting a family. And sn estimated 92,000 planned babies a year are never born because women who choose to delay motherhood have fertility problems.