Hot flushes and night sweats linked to 70% increase in cardiovascular disease
July 2, 2020
Science Daily/University of Queensland
New research from The University of Queensland has found that women who have hot flushes and night sweats after menopause are 70 per cent more likely to have heart attacks, angina and strokes.
School of Public Health PhD student Dr Dongshan Zhu has found women of any age who experience hot flushes and night sweats, also known as vasomotor symptoms or VMS, are more likely to experience non-fatal cardiovascular events.
"Until now, it's been unclear if VMS is associated with cardiovascular disease, but now we know it to be true," Dr Zhu said.
"Further, VMS before menopause increases a woman's chance of cardiovascular events by 40 per cent."
Dr Zhu also found that the risk of cardiovascular events was more related to the severity of the hot flushes and night sweats rather than the frequency or duration.
"We found that women with severe VMS were more than twice as likely to experience a non-fatal cardiovascular event compared with women who had no symptoms," he said.
Dr Zhu used data from InterLACE, a major collaboration of 25 studies of more than 500,000 women around the world.
Senior author on the study Professor Gita Mishra said the findings may have important clinical implications.
"This research helps to identify women who are at a higher risk for the development of cardiovascular events and who may need close monitoring in clinical practice," Professor Mishra said.
https://www.sciencedaily.com/releases/2020/07/200702113707.htm
Hot flashes impair memory performance
New study suggests hot flashes may alter hippocampal and prefrontal cortex function to decrease verbal memory
January 23, 2020
Science Daily/The North American Menopause Society (NAMS)
If you're having difficulty identifying the right word to express yourself clearly or remembering a story correctly, you may blame menopause. A new study suggests that physiologic hot flashes are associated with decreased verbal memory and with alterations in brain function during encoding and retrieval of memory, especially in the hippocampus and prefrontal cortex. Study results are published online in Menopause, the journal of The North American Menopause Society (NAMS).
Previous studies have already shown that women experience a decline in memory for verbal material, such as words and stories, as they transition through menopause. In this new study, functional magnetic resonance imaging (MRI) was used to document the occurrence of physiologic hot flashes and their specific effect on hippocampal and prefrontal cortex function during encoding and recognition conditions of a memory task. The strengths of this study are in the use of physiologic hot flash monitoring to confirm the hot flash versus relying on patient recall and the use of functional MRI to specifically evaluate real-time changes occurring within the brain during the memory testing.
Although larger studies are needed to fully evaluate the reliability of the relationship between hot flashes and altered brain function, this study provides new insights into specific areas in the brain involved in memory that appear to be adversely affected by hot flashes.
The study results appear in the article "Hot flashes are associated with altered brain function during a memory task."
"The findings of this preliminary study, although small, support an association between objectively monitored hot flashes and adverse functional changes in the brain that affect memory. Further study is needed to determine whether hot flashes actually cause these brain changes and whether treatment of hot flashes will prevent or normalize them," says Dr. Stephanie Faubion, NAMS medical director.
https://www.sciencedaily.com/releases/2020/01/200123095859.htm
Having less sex linked to earlier menopause
January 14, 2020
Science Daily/University College London
Women who engage in sexual activity weekly or monthly have a lower risk of entering menopause early relative to those who report having some form of sex less than monthly, according to a new UCL study.
The researchers observed that women, who reported engaging in sexual activity weekly, were 28% less likely to have experienced menopause at any given age than women who engaged in sexual activity less than monthly. Sexual activity includes sexual intercourse, oral sex, sexual touching and caressing or self-stimulation.
The research, published in Royal Society Open Science, is based on data from the USA's Study of Women's Health Across the Nation (SWAN). It's the largest, most diverse and most representative longitudinal cohort study available to research aspects of the menopause transition.
First author on the study, PhD candidate Megan Arnot (UCL Anthropology), said: "The findings of our study suggest that if a woman is not having sex, and there is no chance of pregnancy, then the body 'chooses' not to invest in ovulation, as it would be pointless. There may be a biological energetic trade-off between investing energy into ovulation and investing elsewhere, such as keeping active by looking after grandchildren.
"The idea that women cease fertility in order to invest more time in their family is known as the Grandmother Hypothesis, which predicts that the menopause originally evolved in humans to reduce reproductive conflict between different generations of females, and allow women to increase their inclusive fitness through investing in their grandchildren."
During ovulation, the woman's immune function is impaired, making the body more susceptible to disease. Given a pregnancy is unlikely due to a lack of sexual activity, then it would not be beneficial to allocate energy to a costly process, especially if there is the option to invest resources into existing kin.
The research is based on data collected from 2,936 women, recruited as the baseline cohort for the SWAN study in 1996/1997.
The mean age at first interview was 45 years old. Non-Hispanic Caucasian women were most represented in the sample (48%), and the majority of women were educated to above a high school level. On average they had two children, were mostly married or in a relationship (78%), and living with their partner (68%).
The women were asked to respond to several questions, including whether they had engaged in sex with their partner in the past six months, the frequency of sex including whether they engaged in sexual intercourse, oral sex, sexual touching or caressing in the last six months and whether they had engaged in self-stimulation in the past six months. The most frequent pattern of sexual activity was weekly (64%).
None of the women had yet entered menopause, but 46% were in early peri-menopause (starting to experience menopause symptoms, such as changes in period cycle and hot flashes) and 54% were pre-menopausal (having regular cycles and showing no symptoms of peri-menopause or menopause).
Interviews were carried out over a ten-year follow-up period, during which 1,324 (45%) of the 2,936 women experienced a natural menopause at an average age of 52.
By modelling the relationship between sexual frequency and the age of natural menopause, women of any age who had sex weekly had a hazard ratio of 0.72, whereas women of any age who had sex monthly had a hazard ratio of 0.81.
This provided a likelihood whereby women of any age who had sex weekly were 28% less likely to experience the menopause compared to those who had sex less than monthly. Likewise, those who had sex monthly were 19% less likely to experience menopause at any given age compared to those who had sex less than monthly.
The researchers controlled for characteristics including oestrogen level, education, BMI, race, smoking habits, age at first occurrence of menstruation, age at first interview and overall health.
The study also tested whether living with a male partner affected menopause as a proxy to test whether exposure to male pheromones delayed menopause. The researchers found no correlation, regardless of whether the male was present in the household or not. Last author, Professor Ruth Mace (UCL Anthropology), added: "The menopause is, of course, an inevitability for women, and there is no behavioural intervention that will prevent reproductive cessation. Nonetheless, these results are an initial indication that menopause timing may be adaptive in response to the likelihood of becoming pregnant."
https://www.sciencedaily.com/releases/2020/01/200114224451.htm
Half of women with heart failure get the wrong treatment
January 6, 2020
Science Daily/The University of Bergen
More women than men die of heart failure. The reason is that only 50 per cent of the heart failure cases among women are caused by having a heart attack, which can be treated with modern methods.
For the other 50 per cent of women experiencing heart failure the cause is generally related to having untreated high blood pressure levels over time, which leads to progressive stiffening of the heart. There is no effective treatment for this kind of heart failure yet.
"Men and women have different biologies and this results in different types of the same heart diseases. It is about time to recognise these differences," says Professor Eva Gerdts, Department of Clinical Science, University of Bergen.
"Another important point concerning how to avoid heart disease is to ask about what the national health service is doing on this issue. Heart disease remains among the most common cause of death and reduced quality of life in women. Medically speaking, we still do not know what the best treatment for heart- attack or -failure is in many women. It is an unacceptable situation," Gerdts claims.
Gerdts has recently published an invited review paper in Naturetogether with Professor Vera Regitz-Zagrosek ved Charité Universitätsmedizin.
The researchers have compared common risk factors for heart disease and how these affect men and women differently. They have, among other things, focused on the sex differences in the effect of obesity, high blood pressure and diabetes.
Women gain more weight
According to The World Health Organization (WHO) 11 per cent women and 15 per cent men are obese (BMI over 30 kg/ m2) globally. In Norway one in five adults are obese.
"If we see this from a life span perspective, we can see that obesity increases with age, and that this trend is greater for women than men. Obesity increases the risk of having high blood pressure by a factor of three. This, in turn, increases the risk of heart disease," Gerdts points out.
According to Gerdts, obesity also increases the risk of diabetes 2. A woman with diabetes has a much higher relative risk of heart complications and death than a man.
"We know that women with diabetes 2 are usually obese and some of this fat is stored in the heart, which makes it more vulnerable for disease."
Oestrogen influence heart risk
Gerdts explains that many of the differences between woman and men when it comes to heart disease are connected to the sex hormone, oestrogen. The hormone prevents the formation of connective tissue in the heart, which makes it harder for the heart to pump. In men the effects are the opposite.
"We see that obese men store oestrogen in their fat cells in the abdomen, which has a bad effect on the heart."
After menopause, women lose the oestrogen advantage. Their arteries becomes stiffer and more vulnerable for disease. We see this in the fact that for persons under 60, high blood pressure is most common amongst men. For persons over 60, it is the opposite.
"We think that this is part of the explanation for why high blood pressure seems to indicate higher risk of heart disease amongst women."
Women smoke more
In addition, smoking is also a part of the risk scenario for women. During the past decades, more women have started smoking than men.
"Many women start smoking to reduce their appetite and to control their weight. However, this is not a good choice from a health perspective."
"For women, the effects of risk factors such as smoking, obesity and high blood pressure increase after menopause," says Eva Gerdts.
https://www.sciencedaily.com/releases/2020/01/200106103444.htm
Why sex becomes less satisfying with age
July 10, 2019
Science Daily/The North American Menopause Society (NAMS)
The number of women regularly having sex declines with age, and the number of women enjoying sex postmenopause is even lower. Although these facts are not surprising, the causes for these declines may be because previous research focused largely on biological causes only. However, a new UK study identifies psychosocial contributors. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).
It's hard to pick up a woman's magazine or ob/gyn journal anymore without reading an article about how and why a woman's libido and level of sexual satisfaction decline during and after menopause. Substantial research has been conducted into biological reasons such as hot flashes, sleep disruption, vaginal dryness, and painful intercourse. Much less is known about the effect of various psychosocial changes that are common postmenopause. These include body image concerns, self-confidence and perceived desirability, stress, mood changes, and relationship issues.
Of the research that has been conducted regarding psychological influences, most of it has focused on quantitative results. A study of nearly 4,500 postmenopausal women involved in the UK Collaborative Trial of Ovarian Cancer Screening (UKCTOCS), however, looked at free-text data to better understand why women felt a certain way and the depth of those feelings.
Among other things, the UKCTOCS sexual activity data showed that, at baseline, before the start of annual screening, approximately half of the women were sexually active. A decrease in all aspects of sexual activity was observed over time: sexual activity was less frequent, not as pleasurable, and more uncomfortable. The primary reason for absence of sexual activity was the lack of a partner, mainly because of widowhood.
Other commonly cited reasons for decreased activity included (in rank order) a partner's medical condition, a partner's sexual dysfunction, the woman's own physical health problems, menopause-related symptoms, and prescribed medication. Contributing most often to low libido were relationship problems, logistics, and perceptions of aging. Only 3% of participants described positive sexual experiences, whereas only 6% sought medical help for sexual problems.
Study results appear in the article, "Sexual functioning in 4,418 postmenopausal women participating in UKCTOCS: a qualitative free-text analysis."
"Sexual health challenges are common in women as they age, and partner factors play a prominent role in women's sexual activity and satisfaction, including the lack of a partner, sexual dysfunction of a partner, poor physical health of a partner, and relationship issues," says Dr. Stephanie Faubion, NAMS medical director. "In addition, menopause-related problems such as vaginal dryness and pain with sex have been identified as problems affecting sexual function, yet few women seek treatment for these issues, despite the availability of effective therapies."
https://www.sciencedaily.com/releases/2019/07/190710103140.htm
Why some women are more likely to feel depressed
New study links duration of estrogen exposure with increased vulnerability to depression: Longer exposure to estrogen shown to provide protection
July 19, 2017
Science Daily/The North American Menopause Society (NAMS)
It's no secret that the risk of depression increases for women when their hormones are fluctuating. Especially vulnerable times include the menopause transition and onset of postmenopause. There's also postpartum depression that can erupt shortly after childbirth. But why do some women feel blue while others seem to skate through these transitions? One answer is provided through new study results.
The article "Lifelong estradiol exposure and risk of depressive symptoms during the transition to menopause and postmenopause" includes data from a study of more than 1,300 regularly menstruating premenopausal women aged 42 to 52 years at study entry. The primary goal of the study was to understand why some women are more vulnerable to depression, even though all women experience hormone fluctuations.
Previous studies have suggested a role for reproductive hormones in causing an increased susceptibility to depression. This study focused largely on the effect of estradiol, the predominant estrogen present during the reproductive years. Among other things, estradiol modulates the synthesis, availability, and metabolism of serotonin, a key neurotransmitter in depression. Whereas fluctuations of estradiol during the menopause transition are universal, the duration of exposure to estradiol throughout the adult years varies widely among women.
A key finding of this study was that longer duration of estrogen exposure from the start of menstruation until the onset of menopause was significantly associated with a reduced risk of depression during the transition to menopause and for up to 10 years postmenopause. Also noteworthy was that longer duration of birth control use was associated with a decreased risk of depression, but the number of pregnancies or incidence of breastfeeding had no association.
"Women are more vulnerable to depressive symptoms during and after the menopause transition because of fluctuating hormone changes," says Dr. JoAnn Pinkerton, executive director of NAMS. "This study additionally found a higher risk for depression in those with earlier menopause, fewer menstrual cycles over lifespan, or more frequent hot flashes. Women and their providers need to recognize symptoms of depression such as mood changes, loss of pleasure, changes in weight or sleep, fatigue, feeling worthless, being unable to make decisions, or feeling persistently sad and take appropriate action."
https://www.sciencedaily.com/releases/2017/07/170719084710.htm
Yoga, exercise fail to improve sleep in midlife women
Objective sleep outcomes were unchanged in women experiencing hot flashes during the menopausal transition or after menopause
January 23, 2017
Science Daily/American Academy of Sleep Medicine
Yoga and aerobic exercise interventions did not significantly reduce objectively measured sleep disturbances among midlife women who were experiencing hot flashes, suggests new research.
Secondary analyses of a randomized controlled trial show that neither 12 weeks of yoga nor 12 weeks of aerobic exercise had a statistically significant effect on objective measures of sleep duration or sleep quality recorded by actigraphy. Although the women had no difficulty falling asleep, disturbed sleep was common at baseline and remained after each intervention, with women in all groups waking during the night for an average of more than 50 minutes.
According to the authors, previously published analyses of the same trial had found that the yoga and aerobic exercise interventions were associated with small but statistically significant improvements in subjective, self-reported sleep quality and insomnia severity.
"Our primary findings were that the two study interventions had no significant effects on objective sleep outcomes in midlife women with hot flashes. The main implication of this finding is that other behavior treatments with the potential for effectively improving sleep in this population should be examined," said lead author Diana Taibi Buchanan, associate professor of Bio-Behavioral Nursing and Health Informatics at the University of Washington in Seattle.
Study results are published in the Jan. 15 issue of the Journal of Clinical Sleep Medicine.
The authors analyzed data from the Menopause Strategies: Finding Lasting Answers for Symptoms and Health (MsFLASH) network. The study involved 186 late transition and postmenopausal women with hot flashes who were between 40 and 62 years of age. Study subjects had an average of 7.3 to 8 hot flashes per day. Participants were randomized to 12 weeks of yoga, supervised aerobic exercise, or usual activity.
Sleep measures were evaluated using wrist actigraphy, and bedtimes and rise times were determined primarily from the participants' sleep diaries. Mean sleep duration at baseline and after each intervention was less than the 7 or more hours of nightly sleep that is recommended by the American Academy of Sleep Medicine for optimal health in adults.
According to the authors, future research should explore other approaches for improving sleep quality in midlife women, such as cognitive behavioral therapy for insomnia.
Science Daily/SOURCE :https://www.sciencedaily.com/releases/2017/01/170123162409.htm