Health News for Women
October 14, 2009 Written by JP [Font too small?]Menopause is a time when many women begin to think about health issues that extend well beyond “hot flashes”. Every woman experiences this time of life in a different way. For some, the hormonal shift that occurs can profoundly influence quality of life in waking hours and even during sleep. Others are more fortunate and get through this period with only mild “reminders”. But what all women have in common are the physiological changes that are taking place, whether they feel them or not.
There are plenty of alternatives to the conventional treatment of menopause via hormone replacement therapy (HRT). However, there are still questions about the efficacy and safety of these natural remedies. Several recently published studies can help doctors and patients alike determine whether a holistic approach is appropriate during this transitional period.
A meta-analysis in the October edition of the The American Journal of Medicine investigated the safety profile of a class of “nutraceuticals” known as phytoestrogens. These are naturally occurring chemicals, found in a variety of foods, herbs and plants, that possess some degree of estrogenic activity. A diet rich in phytoestrogens has been traditionally used to reduce menopausal symptoms in many parts of the world. In this most current review, 92 scientific studies involving 9,629 women were examined for evidence of adverse effects relating to the use of phytoestrogens from foods and supplements. The researchers determined that these plant-based estrogens were not responsible for any “gynecological, musculoskeletal, neurological and unspecific side effects” – as compared to placebos. However, they did note a higher rate of digestive upset that was attributable to phytoestrogen intake. In conclusion, the study’s lead author stated, “based on our findings, they (women) can be assured that there is no indication of serious unwanted side effects of phytoestrogen treatment such as those found in women on hormone replacement therapy, for example, thrombosis, myocardial infarction, stroke or breast cancer”. In addition, the European Food Safety Authority recently concluded that isoflavones (a type of phytoestrogen) appear to provide “modest, but valuable, benefit for menopause relief”. (1,2)
One of the greatest concerns for women in mid-life is the loss of bone mineral density. In its mildest form, this is commonly referred to as osteopenia. As the bones become more porous and fragile, the term osteoporosis is typically used. A trial presented in the September 2009 edition of the American Journal of Clinical Nutrition suggests a non-hormonal approach to supporting skeletal health. In that research, it was determined that inadequate intake of folic acid and Vitamin B6 are linked to lower levels of osteocalcin. Osteocalcin is a protein that is vital to maintaining the proper mineralization of bones. Previous studies indicate that sub-par concentrations of Vitamin B12 may also be implicated in osteopenia and osteoporosis. Some scientists theorize that elevated levels of an amino acid known as homocysteine may have detrimental effects on the quality of bones as we age. Folic acid, Vitamin B6 and B12 are a first line approach to lowering high homocysteine, which may also play a role in the progression of cardiovascular disease. (3,4,5)
Heart disease is the number one cause of mortality in postmenopausal women. Any conservative step that can be taken to reduce that risk is highly advisable. One such strategy appears to be eating more strawberries, evidenced in a new experiment involving 16 women that were at high risk for heart disease. Each of the female participants had at least “3 features of metabolic syndrome” – elevated blood pressure, blood sugar and triglycerides, low HDL “good” cholesterol and a waist circumference of over 35 inches. All of the women were asked to drink 25 grams of a freeze-dried strawberry powder in a glass of water over a 4 week period. Blood tests were taken prior to and after the one month trial. The results revealed that the strawberry mixture reduced total cholesterol by 5% and LDL “bad” cholesterol by 6%. Perhaps most importantly, the experimental diet led to a 14% decline in “lipid peroxidation” and a lower level of oxidized LDL cholesterol. This latter finding is important because oxidized cholesterol is a primary factor in the accumulation of plaque in arteries. An interesting side note is that some scientists believe that the high levels of folic acid found in strawberries may be part of the reason for their heart friendly effect. A lack of folic acid has previously been linked to increased cardiovascular risk and, as I mentioned earlier, poor bone density. (6,7,8)
A disappointing study about black cohosh appears in the October 2009 issue of the Journal of Clinical Psychopharmacology. Black cohosh (Cimicifuga racemosa) is perhaps the most widely used herbal remedy by menopausal women worldwide. It’s frequently recommended by naturopathic doctors to help manage hot flashes, mood imbalance, poor sleep and sexual issues relating to mid-life hormonal changes. A trial was recently performed at the University of Pennsylvania to assess the effects of black cohosh in a group of women suffering from menopausal anxiety. Fifteen participants were asked to take a “pharmaceutical-grade black cohosh” supplement and thirteen were given a placebo for 12 weeks. Various measures of anxiety were taken pre and post study (Beck Anxiety Inventory, Green Climacteric Scale, Hamilton Anxiety Rating Scale and Psychological General Well-Being Index). No significant benefits were found in the black cohosh group as compared to the placebo. However, the researchers did comment that these results need to be interpreted with caution because of the “small sample size, choice of black cohosh preparation and dosage used”. (9,10,11,12,13)
The decision about whether to use conventional hormone replacement therapy needs to be carefully evaluated and individually applied. If a patient or physician decides that HRT isn’t an appropriate option, then the next step is to determine whether there’s a viable natural alternative. Knowing that there are safe remedies such as B-vitamins, phytoestrogens and even strawberries can empower women to make the best possible decisions about their own health care.
Note: Please check out the “Comments & Updates” section of this blog – at the bottom of the page. You can find the latest research about this topic there!
Be well!
JP
Tags: Anxiety, Bone and Joint Health, Menopause
Posted in Heart Health, Mental Health, Women's Health
February 11th, 2015 at 9:03 pm
Update: Higher folic acid may lower breast cancer mortality …
http://www.tandfonline.com/doi/full/10.1080/01635581.2015.1002623#abstract
Nutr Cancer. 2015 Feb 3:1-7.
The Association Between Circulating Total Folate and Folate Vitamers With Overall Survival After Postmenopausal Breast Cancer Diagnosis.
We studied the relationship between plasma total folate and folate vitamer concentrations [5-methyltetrahydrofolic acid, pteroylglutamic acid (folic acid) and tetrahydrofolic acid] with overall survival after breast cancer diagnosis. A secondary aim was to assess the relationship between folic acid supplement use with circulating total folate and folate vitamer concentrations. Participants were postmenopausal women diagnosed with breast cancer (n = 498) with an average follow-up of 6.7 yr. Plasma total folate and folate vitamers were measured by isotope-dilution LC-MS/MS in samples collected at or postdiagnosis. Cox proportional multivariate hazards models (controlled for stage, age at diagnosis, body mass index, parity, hormone replacement therapy use, treatment, alcohol use, folic acid use, and energy intake), were used to assess overall survival after breast cancer diagnosis. We found that the relative risk of dying for women with plasma total folate concentrations in the highest quartile was 59% lower (hazard ratio: 0.41, 95% confidence interval: 0.19-0.90) compared with the lowest quartile. Data on supplement use showed that women taking folic acid supplements had significantly higher circulating total folate and folate vitamer concentrations (P < 0.0001), suggesting that increased folate consumption through diet and/or supplementation may improve prognosis after breast cancer diagnosis. Be well! JP
March 26th, 2015 at 1:52 pm
Update: Magnesium citrate protects against potentially dangerous elevations in blood pressure during pregnancy …
http://link.springer.com/article/10.1007%2Fs00404-013-2900-2
Arch Gynecol Obstet. 2013 Dec;288(6):1269-74.
Magnesium supplementation to prevent high blood pressure in pregnancy: a randomised placebo control trial.
PURPOSE: To assess if hypertension during the last part of pregnancy could be prevented by magnesium supplementation.
METHODS: Pregnant primagravida women from a local antenatal care unit were given an oral supply of 300 mg magnesium as citrate or placebo from pregnancy week 25 in a randomised double-blind setup. Blood pressure was recorded during pregnancy as well as pregnancy outcome.
RESULTS: In the magnesium-supplemented group, the average diastolic blood pressure at week 37 was significantly lower than in the placebo group (72/1.4 mean/SEM vs 77/1.4, p = 0.031). The number of women with an increase in diastolic blood pressure of ≥15 mmHg was significantly lower in the magnesium group compared with the women who received placebo (p = 0.011). There was an inverse relation between the urinary excretion of magnesium during pregnancy and the diastolic blood pressure (p = 0.005).
CONCLUSIONS: Magnesium supplementation prevented an increase in diastolic blood pressure during the last weeks of pregnancy. The relation between diastolic blood pressure and urinary excretion of magnesium suggests that magnesium is involved in the regulation of blood pressure and that the increase in diastolic blood pressure in pregnancy could be due to a lack of magnesium.
Be well!
JP
May 18th, 2015 at 5:20 pm
Update 05/18/15:
http://www.ctcpjournal.com/article/S1744-3881%2815%2900041-9/abstract
Complementary Therapies in Clinical Practice – May 11, 2015
A Pilot Randomised Controlled Trial (RCT) investigating the effectiveness of reflexology for managing pregnancy low back and pelvic pain
Many pregnant women with LBPP use pain medications to manage this pain, much of which is self-prescribed and potentially harmful. Therefore, there is a need to find effective nonpharmacological treatments for the condition. Reflexology has previously been shown to help nonspecific low back pain. Therefore; a pilot RCT was conducted investigating reflexology in the management of pregnancy-LBPP. 90 primiparous women were randomised to either usual care, a reflexology or footbath intervention. Primary outcome measures were; the Pain Visual Analogue Scale (VAS). 64 women completed the RCT; retention rates for the reflexology group were 80%, usual care group 83.33% and footbath group 50%. The reflexology group demonstrated a Clinically Important Change (CIC) in pain frequency (1.64cm). Results indicate it is feasible to conduct an RCT in this area, although a footbath is an unsuitable sham treatment. Reflexology may help manage pregnancy-LBPP; however a fully powered trial is needed to confirm this.
Be well!
JP
June 17th, 2016 at 9:32 pm
Updated 06/17/16:
http://journals.lww.com/menopausejournal/pages/articleviewer.aspx?year=9000&issue=00000&article=97995&type=abstract
Menopause. 2016 Jun 13.
Effects of stretching on menopausal and depressive symptoms in middle-aged women: a randomized controlled trial.
OBJECTIVE: Exercise may help alleviate menopausal and depressive symptoms in middle-aged women, but sufficient evidence does not currently exist to fully support this theory. Whereas frequent moderate- to vigorous-intensity exercise may be associated with the risk of menopausal hot flashes, light-intensity exercise, such as stretching, is not likely to increase the occurrence of hot flashes. Little is, however, known about the effects of light-intensity exercise on menopausal and depressive symptoms. We examined the effects of a 3-week stretching program on the menopausal and depressive symptoms in middle-aged, Japanese women.
METHODS: Forty Japanese women, aged 40 to 61 years, were recruited (mean age, 51.1 ± 7.3 y). The participants were randomly assigned to either a stretching or a control group. The stretching group (n = 20) participated in a 3-week intervention program that involved 10 minutes of daily stretching, just before bedtime. The control group (n = 20) was assigned to a waiting list. Menopausal symptoms were evaluated using the Simplified Menopausal Index, which measures vasomotor, psychological, and somatic symptoms. Depressive symptoms were assessed using the Self-Rating Depression Scale.
RESULTS: The compliance rate was 75.8% during the 3-week intervention program. The total Simplified Menopausal Index scores, including the vasomotor, psychological, and somatic symptoms, and the Self-Rating Depression Scale scores significantly decreased in the stretching group compared with that in the control group. No adverse events, including increased hot flashes, were reported by the participants during the study period.
CONCLUSIONS: These findings suggest that 10 minutes of stretching before bedtime decreases menopausal and depressive symptoms in middle-aged, Japanese women.
Be well!
JP
February 9th, 2017 at 1:11 am
Updated 02/08/17:
http://www.tandfonline.com/doi/abs/10.1080/13697137.2017.1281903?journalCode=icmt20
Climacteric. 2017 Feb 1:1-6.
Effect of health education combining diet and exercise supervision in Chinese women with perimenopausal symptoms: a randomized controlled trial.
OBJECTIVE: This study aimed to evaluate the effect of health education combining diet and exercise supervision on menopausal symptoms and diet/exercise habits.
METHODS: The randomized controlled study enrolled 60 patients with perimenopausal syndrome (Kupperman Menopause Index (KMI) score ≥15). The participants were randomized into either an intervention group (n = 30) or a control group (n = 30). Women were interviewed with questionnaires about perimenopausal symptoms, diet pattern and exercise habit. Their height and weight were measured. Women in the intervention group received health education, diet supervision and exercise supervision twice a week while those in the control group continued as normal. The total KMI score, scores of individual symptoms, diet pattern and exercise habit were measured after intervention.
RESULTS: The total KMI score, the individual KMI scores for paresthesia, irritability, depression/suspicious, fatigue, arthralgia/myalgia, and palpitations of the intervention group were significantly lower compared with the control group after intervention. The intake of cereal, meat, fats and oils of the intervention group were significantly lower at week 12 compared with baseline. The percentage of women with a regular exercise habit was significantly higher in the intervention group than in the control group after intervention.
CONCLUSIONS: Twelve weeks intervention of health education combining diet and exercise supervision could improve perimenopausal symptoms and help the patients establish good living habits.
Be well!
JP
March 25th, 2018 at 11:21 am
Updated 03/25/18:
https://www.liebertpub.com/doi/10.1089/jwh.2017.6406
J Womens Health (Larchmt). 2017 Dec 13.
A Randomized Controlled Multicenter Trial of an Investigational Liquid Nutritional Formula in Women with Cyclic Breast Pain Associated with Fibrocystic Breast Changes.
OBJECTIVE: A randomized, multicenter, controlled double-blind trial was performed in women with cyclic breast pain (mastalgia) associated with fibrocystic breast changes (FBCs) to determine whether a nutritional formula reduced breast pain and/or nodularity.
STUDY DESIGN: Women were randomized to receive a specifically designed liquid formulation (n = 93) (1 g gamma-linolenic acid [GLA], 750 μg iodine, and 70 μg selenium) or control formula (n = 95) (without GLA, iodine, and selenium) daily for three cycles. Women recorded breast pain, medications, and menstrual signs daily using interactive voice-response system. Nodularity was determined by physical breast examination.
RESULTS: Breast pain scores decreased similarly in the experimental (-32.2%) and control (-33.1%) groups (p = 0.64). Nodularity was reduced in the experimental, but not the control group (p = 0.03). Among women who continued pain medication, the amount was reduced in the experimental group relative to controls (p = 0.02).
CONCLUSION: Women with FBC using the formula containing GLA, iodine, and selenium experienced reduced nodularity and in those women who took over-the-counter breast pain medication, a decrease in the quantity of pain medication was observed.
Be well!
JP