Exercise and Menopausal Symptoms

Researchers writing in the British Journal of General Practice say that their study “suggest(s) a positive association between somatic and psychological dimensions of health-related quality of life and participation in regular exercise. Women with BMI scores in the normal range reported lower vasomotor symptom scores and better health-related quality of life scores than heavier women.”

Daley A, Macarthur C, Stokes-Lampard H, McManus R, Wilson S, Mutrie N. Exercise participation, body mass index, and health-related quality of life in women of menopausal age. Br J Gen Pract. 2007 Feb;57(535):130-5.

BACKGROUND: Menopausal symptoms can affect women’s health and wellbeing. It is important to develop interventions to alleviate symptoms, especially given recent evidence resulting in many women no longer choosing to take hormone replacement therapy. Exercise may prove useful in alleviating symptoms, although evidence on its effectiveness has been conflicting.
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Postmenopause and Periodontal Disease

A recent study in the Journal of Periodontology says that in an 11.7 year follow up, 57.5 percent of women lost at least one tooth after menopause.

Bone loss is to blame!

The American Academy of Periodontology’s press release on this study says “Estrogen deficiency after menopause and consequent loss of bone mineral density have been shown to be associated with increased rate of tooth loss. These relationships may be explained by increased severity of periodontal disease in estrogen deficiency.”

Click here to learn about estrogen deficiency

Women With Higher Levels of Estrogen Have Prettier Faces

Researchers at the University of St. Andrews in Scotland announced that women who had higher amounts of estrogen in their urine were found to be more attractive than women who had lesser amounts. READ IT HERE

 

Hormones, Oxidative Stress, Menopause

In the News…
Researchers writing in Clinica Chimica Acta, the International Journal of Clinical Chemistry and Applied Molecular Biology suggest that Hormone Replacement therapy may play a beneficial role in the protection against oxidative stress.

Clin Chim Acta. 2006 Jul;369(1):73-7. Epub 2006 Feb 10.
Unfer TC, Conterato GM, da Silva JC, Duarte MM, Emanuelli T. Influence of hormone replacement therapy on blood antioxidant enzymes in menopausal women. Clin Chim Acta. 2006 Jul;369(1):73-7. Epub 2006 Feb 10.

From the abstract:
BACKGROUND: Natural loss of estrogen occurring in menopausal process may contribute to various health problems many of them possibly related to oxidative stress. Hormone replacement therapy (HRT) is the most common treatment to attenuate menopausal disturbances. This study was aimed at evaluating the influence of HRT on the activity of antioxidant enzymes (superoxide dismutase, SOD; catalase, CAT; and glutathione peroxidase, GPx) and lipid peroxidation (thiobarbituric acid reactive substances, TBARS) in menopausal women.

CONCLUSIONS: HRT antagonizes the decrease of SOD activity that occurs after menopause, suggesting that HRT may play a beneficial role in the protection against oxidative stress.

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Menopause and Heart Disease

Researchers writing in the medical journal Climacteric say that “an ideal hormone replacement therapy that can overcome hypertension, prevent body weight gain and control serum triglycerides offers an important advance in cardiovascular risk management during the menopause.”

Rosano GM, Vitale C, Tulli A. Managing cardiovascular risk in menopausal women.Rosano GM, Vitale C, Tulli A. Climacteric. 2006 Sep;9(5):19-27

From the article abstract:
“Blood pressure control and prevention of glucose intolerance are primary factors in overcoming the increased cardiovascular risks in menopausal women.

This heightened risk may partially be explained by the metabolic syndrome – a precursor of type 2 diabetes – in which the renin-angiotensin-aldosterone system may play a pivotal role.

Once diabetes occurs, the cardiovascular risk is considerably greater in postmenopausal women than in men – especially if hypertension is also present.

An additional risk factor, weight gain, is common in postmenopausal women not treated with hormone replacement therapy.

Rigorous control of blood pressure has been shown to be particularly beneficial in women with metabolic syndrome; a reduction in blood pressure can reduce the mortality rate of ischemic stroke.

The administration of hormone replacement therapy can also reduce the likelihood of coronary heart disease in postmenopausal women; therefore therapy should be started early in the menopausal transition to maximize cardiovascular protection. As such, an ideal hormone replacement therapy that can overcome hypertension, prevent body weight gain and control serum triglycerides offers an important advance in cardiovascular risk management during the menopause.”

Hot Flashes and Sleep

Researchers writing in the medical journal Menopause say that ambient temperature and REM sleep patterns effect sleep in postmenopausal women.

Freedman RR, Roehrs TA.Effects of REM sleep and ambient temperature on hot flash-induced sleep disturbance. Menopause. 2006 Jul-Aug;13(4):576-83.

From the study abstract:
OBJECTIVE:: To determine whether hot flashes produce sleep disturbance in postmenopausal women.

DESIGN:: This study was performed in a university medical center laboratory with 18 postmenopausal women with hot flashes, six with no hot flashes, and 12 cycling women, all healthy and medication free. Polysomnography, skin and rectal temperatures, and skin conductance to detect hot flashes were recorded for four nights.

Nights 2, 3, and 4 were run at 30 degrees C (86 degrees F), 23 degrees C (about 73.5 degrees F), and 18 degrees C (about 64.5 degrees F) in randomized order.

RESULTS:: During the first half of the night, the women with hot flashes had significantly more arousals and awakenings than the other two groups and the 18 degrees C ambient temperature (about 64.5 degrees F) significantly reduced the number of hot flashes.

These effects did not occur in the second half of the night. In the first half of the night, most hot flashes preceded arousals and awakenings. In the second half, this pattern was reversed.

CONCLUSIONS: In the second half of the night, rapid eye movement sleep suppresses hot flashes and associated arousals and awakenings. This may explain previous discrepancies between self-reported and laboratory-reported data in postmenopausal women with hot flashes.

Hot Flashes and Insomnia

Researchers writing in the Archives of Internal Medicine say: “Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.”

Ohayon MM. Severe hot flashes are associated with chronic insomnia. Arch Intern Med. 2006 Jun 26;166(12):1262-8

BACKGROUND: Because hot flashes can occur during the night, their presence has been frequently associated with insomnia in women with symptoms of menopause. However, many factors other than hot flashes or menopause can be responsible for insomnia, and several factors associated with insomnia in the general population are also commonly observed in perimenopausal and postmenopausal women who have hot flashes.

METHODS: A random sample of 3243 subjects (aged >/=18 years) representative of the California population was interviewed by telephone. Included were 982 women aged 35 to 65 years. Women were divided into 3 groups according to menopausal status: premenopause (57.2%), perimenopause (22.3%), and postmenopause (20.5%). Hot flashes were counted if they were present for at least 3 days per week during the last month and were classified as mild, moderate, or severe according to their effect on daily functioning.

Chronic insomnia was defined as global sleep dissatisfaction, difficulty initiating sleep, difficulty maintaining sleep, or nonrestorative sleep, for at least 6 months. Diagnoses of insomnia were assessed according to the Diagnostic and Statistical Manual of Mental Disorders, Fourth Edition, classification.

RESULTS: Prevalence of hot flashes was 12.5% in premenopause, 79.0% in perimenopause, and 39.3% in postmenopause. Prevalence of chronic insomnia was reported as 36.5% in premenopause, 56.6% in perimenopause, and 50.7% in postmenopause.

Prevalence of symptoms of chronic insomnia increased with the severity of hot flashes, reaching more than 80% in perimenopausal women and postmenopausal women who had severe hot flashes. In multivariate analyses, severe hot flashes were significantly associated with symptoms and a diagnosis of chronic insomnia. Poor health, chronic pain, and sleep apnea were other significant factors associated with chronic insomnia.

CONCLUSIONS: Severe hot flashes are strongly associated with chronic insomnia in midlife women. The presence of hot flashes should be systematically investigated in women with insomnia. Treating hot flashes could improve sleep quality and minimize the deleterious consequences of chronic insomnia.

Maintaining Muscle Strength May Counteract Postmenopausal Bone Loss

Sirola J, Rikkonen T, Tuppurainen M, Honkanen R, Jurvelin JS, Kroger H. Maintenance of muscle strength may counteract weight-loss-related postmenopausal bone loss-a population-based approach. Osteoporos Int. 2006 Feb 21.

Researchers writing in the medical journal Osteoporosis International say that maintaining muscle strength may counteract postmenopausal bone loss related to weight loss and that exercise that improves muscle strength may be encouraged for postmenopausal women with weight loss intentions for other health reasons.

From the study abstract:
INTRODUCTION: “Weight loss significantly increases postmenopausal bone loss, but the effects of muscle strength change on weight-loss-associated bone loss remain unclear. The study population, 587 peri- and postmenopausal women, was a random sample of the original Osteoporosis Risk Factor and Prevention Study (OSTPRE) study cohort in Kuopio, Finland.

Bone mineral density (BMD) at the lumbar spine (LS) and femoral neck (FN) was measured with dual x-ray absorptiometry, and grip strength was measured with a pneumatic squeeze dynamometer at baseline in 1989-1991 and at the 10-year follow-up in 1999-2001.

METHODS: Women were divided into three groups according to change in age-grouped grip-strength quartile in both of the measurements: “decreased”, “maintained” , and “improved”.

In addition, the study sample was divided into two groups according to weight change during the follow-up: weight losers and weight gainers.

RESULTS: There were no differences in the change status of grip (muscle) strength between the weight loss and weight gain groups.

Women losing weight during the follow-up and within the improved grip-strength-change group had a significantly lower bone loss rate compared with those in the maintained and decreased grip-strength-change groups.

This was in contrast to women who gained weight during the follow-up (not significant between any grip-strength-change groups). Furthermore, women who lost body weight and were in the improved grip-strength-change group had a bone loss rate comparable with that of the women who gained body weight (not significant).

CONCLUSION: The present study suggests that maintaining muscle strength may counteract postmenopausal bone loss related to weight loss. Accordingly, exercise that improves muscle strength may be encouraged for postmenopausal women with weight loss intentions for other health reasons.”

Menopause and Peri-Menopause Blog

Question from Radio Show Caller
Caller: I entered menopause or peri-menopause just a few years ago, I found some things that worked for me, and now they are no longer working even though I am on bio-identical hormones. I started having the nights sweats, the fatigue, moodiness and things like that. I have tried several estrogens and several different things. So far, no luck, meaning I am experiencing those symptoms still, and I have occasional periods. What do I do?

Dr. Darrow: You need to get your hormone levels checked. If you have occasional periods then you are still peri-menopausal, which is the most difficult phase, because at that stage your ovaries are erratically putting out different amounts of hormones, it is very tough at that stage to really get someone on track.

Progesterone is probably the most important thing that you can have in your system because it is a relaxant, it modulates the amount of estrogen so you don’t get it too high, like those months that you are flaring with estrogen and probably moody and feeling a little bit out of whack and retaining fluids, etc.

The way I like people to take Progesterone is by pill just before they go to sleep, I give it to men and women. For women, it is the most relaxing of all the hormones, it also helps build bone. I don’t know if you had a bone densitometry taken recently but it is something that is very important, if you need one you can always call our clinic because that tells the tale right there if you have enough estrogen, testosterone and progesterone because those hormones build up the bone structure, it is most important to maintain the bones, because if the bones are demineralizing, there is a risk of fracture.

You need to have your hormone levels checked. You also need to have very adequate levels of testosterone, not the levels that a man has, but the upper levels that a strong young women has and if you are peri-menopausal, I am not sure how old you are.

Caller: I am 54

Dr. Darrow: Then your Testosterone level has probably dropped down to nothing, it does for most women, and that, in it of itself, once supplemented, can bring you back into alignment. It is also good for the libido and quality of life and the ability to accomplish things.