Blog of the Society for Menstrual Cycle Research

Of Hot Flushes, Lie Detectors, and Stress

March 7th, 2010 by Elizabeth Kissling

Guest Post by Jerilynn C. Prior, Centre for Menstrual Cycle and Ovulation Research

A hot flush causes failure on a lie detector test! The same galvanic skin response (in simple terms—clammy skin) is positive in both. Why? Because—with every flush—there is massive dogs’ breakfast of neurotransmitters and brain stress hormones released. These are the same brain chemicals that are produced as we struggle to create a plausible falsehood. Both arise from a fundamental, brain pathway that mediates both our physical and emotional responses to “threats” (be they nutritional, emotional, physical or some combination of stressors).

Some years ago a psychologist from London Ontario showed that menopausal women’s hot flushes were increased by stressful environment (1). Menopausal women who regularly experienced eight hot flushes a day attended two randomly-ordered 4-hour sessions a week apart. During the sessions they had flushes objectively documented by galvanic skin response. When they were forced to experience a chaotic environment, loud noises, unpleasant videos and bright lights, each of these women experienced more hot flushes; they did not in the alternative calm and pleasant session (1). Likewise, the large Study of Women Across the Nation showed that perimenopausal women who reported “trouble paying for basics” (like food and shelter) had more hot flushes than did those with economic and social security (2).

New Technique for Management of Hot Flashes

March 4th, 2010 by Elizabeth Kissling

The Indianapolis Star has a short interview today with Professor Janet S. Carpenter of Indiana University’s School of Nursing. Dr. Carpenter is conducting a study of whether menopausal women can control hot flashes through breathing techniques.

She told the Star:

Breathing techniques are something nurses use all the time. After surgery, we teach patients to inhale and take deep breaths to clear the lungs of anesthesia. We also teach patients slow, deep breathing to decrease anxiety. Because the study is blinded, I can’t talk specifically about what the two breathing programs are.

Some research seemed to show that it helped hot flashes. We actually think breathing techniques change a woman’s physiology so she will have fewer hot flashes, and if she has the same number of hot flashes, she will cope with them better.

I’ll look forward to seeing the results of her study (maybe I can talk her into presenting them at the next meeting of the Society for Menstrual Cycle Research!). If her hypothesis is correct, we’ll have an easy, cheap, and medication-free method for helping women cope with the discomfort of hot flashes.


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Menstruation, Menopause, and HIV

March 1st, 2010 by Elizabeth Kissling

Menopausal women seeking relief from hot flash in front of electric fan.

POZ magazine and poz.com claim to be the leading publication and website in the U.S. about HIV/AIDS. The March 2010 issue has a great article by Suzanne Bopp about menstruation, menopause, and HIV. As with medical and cultural knowledge about HIV itself, understanding of how HIV affects menstruation continues to evolve. Irregular menstruation is a common complaint of women with HIV, but

“[Today] we have a better grasp of factors associated with abnormal menstrual cycles: substance abuse, AIDS, wasting disease—it relates more to overall nutritional status,” says Kristine Patterson, MD, clinical assistant professor at the University of North Carolina School of Medicine in Chapel Hill. “If the body doesn’t have enough fat, production of estrogen and progesterone shuts down,” Patterson says. This can happen anytime a woman loses too much weight, and it is exacerbated by advanced HIV disease, which causes the body to burn calories more rapidly.

. . . .

Researchers do know, however, that female hormones affect the virus—and that sex hormones generally have an impact on immunity. “We know that where a premenopausal woman is in her menstrual cycle affects her infectiousness,” Patterson says. “Estrogen plays a role—not only in HIV and the interplay of HIV and meds, but also in [the likelihood of] women transmitting and acquiring HIV.” Estrogen’s role may explain why women progress to AIDS at lower viral loads than men.

Highly recommended. Read the whole thing.


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Another Risk Associated with Hormone Therapy

February 7th, 2010 by Elizabeth Kissling

A study to be published in the British Medical Journal’s Thorax,* which focuses on respiratory medicine, finds that estrogen-only hormone treatment for menopause symptoms is associated with higher risk of asthma. The study involved nearly 58,000 women over 12 years. The researchers compared women who had never used any form of hormone treatment, women who used estrogen plus progestin, and women who used estrogen only treatment.Cartoon drawing of human lungs

The women who had used hormone treatments were 21% more likely to develop asthma; those who had used estrogen-only treatments showed a 54% higher overall risk of asthma.

Asthma is generally more common in young women after menarche, and more severe in women than in men.

*Neither the study nor the abstract appear to be available online.

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Menstruation and Music Don’t Mix

January 29th, 2010 by Elizabeth Kissling

Cartoon illustration of opera singerThat’s the report from this arts blogger at the New York Times. Yesterday, doctors from the Methodist Center for Performing Arts Medicine of the Methodist Hospital in Houston held a daylong symposium on the management of medical problems among musicians specifically and performing artists more generally. Performing-arts medicine is a relatively new specialty, and frankly, I’m not surprised by the need for it. (I know a drummer who has ongoing neck and back problems caused – or at least aggravated – by his art.)

But I was surprised to see a blanket recommendation that female vocalists use oral contraceptives to suppress menstruation. According to Keith O. Reeves, the deputy chief of Gynecology at the Methodist Hospital and a professor at Weill Cornell, premenstrual syndrome “brings vocal fatigue, decreased range, loss of power and loss of some harmonics.” Continuous use of synthetic hormones is quite an extreme remedy for an illness without a clear definition or etiology.

But apparently menopause is much harder on the vocal folds – our intrepid blogger can’t even tell us:

As for menopause, you don’t want to know. As Dr. Reeves quotes the great mezzo-soprano Christa Ludwig, “It was a hell of some years.”


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Definitions That Fall Short

January 11th, 2010 by Chris Bobel

The Boston Women's Health Book Collective, 2005. Simon & SchusterThe definitive women’s health sourcebook, Our Bodies, Ourselves written by the Boston Women’s Health Book Collective  is undergoing revisions for its 40th anniversary (and 9th) edition. Lots of folks in the women’s health community are involved in the revision and that’s a good thing—multiple voices, multiple perspectives.

I am among those reviewing  the chapter on Sexual Anatomy, Reproduction, and the Menstrual Cycle in collaboration with others, such as health educator and activist,  Esther Morris Leidolf, founder of  the MRKH organization (MRKH=Mayer Rokitansky Kuster Hauser Syndrome, a.k.a. congential absence of the vagina) For years, Esther has been nudging me to be more inclusive in my research, writing and teaching of people with variant sexual anatomy. And she did it again.

While reviewing the content on MENOPAUSE in this chapter, she questioned the definition of this biosocial transtion used (that is, the cessation of menstruation, specifically, 12 months after the last menstrual period (LMP)).

She asked: What about women who don’t menstruate?

What about women who may not have vaginas or others with variant sexual anatomy that prevents menstuation. Many of these women still  experience other menopausal symptoms, such as hot flashes and mood swings.

Newsflash: Women get older with or without hormone therapy

January 5th, 2010 by Elizabeth Kissling

Cover of journal MENOPAUSEAs we have often noted here, one of the key reasons the marketing of hormone therapy for menopausal women has been so successful is the misguided belief that menopause is an estrogen-deficiency disease. Among other purported disadvantages of the decline in estrogen that accompanies normal aging was the belief that this decline caused muscle loss and other declines in physical functioning. (Muscle cells have receptors for estrogen, and recent research has linked higher blood levels of the hormone to greater muscle strength in elderly women.)

But the Women’s Health Initiative (WHI) is still providing new information about the lack of benefits of HT. (For those who are new around here, the WHI is a large US clinical trial begun in 1991, in which thousands of postmenopausal women were randomly assigned to take either HT or placebo pills. The study was abruptly ended ahead of schedule in 2002, when researchers discovered that the women taking the hormones had higher risks of heart attack, stroke, breast cancer, and blood clots – the very conditions the drugs were assumed to prevent – than placebo users.) In a new study based on a subgroup of 2400 women to be published in a forthcoming issue of Menopause (February 2010), both the women using HT and the placebo groups showed similar dips in muscle strength and walking speed over six years. In other words, women get older and show physical indications of aging with or without hormone therapy.





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Bioidentical Balderdash

January 1st, 2010 by Chris Hitchcock

The bioidentical hormone therapy industry has been getting a bad rap lately in the US, and this press release is an example of why. Among other things, the writer confuses estrogen and progesterone, in one paragraph saying their product is a “safe and scientifically-proven, all-natural estrogen delivery cream[]“, and in the next describing it as a “natural progesterone cream” (emphasis is mine). Moreover, the press release springboards from another estrogen-positive press release that claims that estrogen may be the cure for female depression, citing an ob/gyn author of a book, and promoting a soon-to-be-launched web page.

So, in one breath the product is an estrogen delivery cream that will help with low estrogen, but in the next breath (on the linked product page) it is argued that it will help with estrogen that is too high (which is more accurate). The product website emphasizes that  it is “without dangerous pharmaceuticals”:

This remarkable product contains NO risky synthetic estrogens or progestins. [Product] Cream is similar to the progesterone your body naturally produces, so there are no worries about dangerous interactions or nasty side effects.

MANopause; or, Hello, God, It’s me, Mel Gibson

December 22nd, 2009 by Elizabeth Kissling
Mel Gibson claims his work has suffered due to male menopause.

Mel Gibson claims his work has suffered due to male menopause.

Guest Post by David Linton, Marymount Manhattan College

An earlier re: Cycling post about a clever viral marketing strategy that exploited the notion of male cramps reminded me of some other ways that men have tried to appropriate aspects of the menstrual mythos for their own interests.

Gender jealousy was spelled out by Freud with his concept of “penis envy” and rebutted by Karen Horney who claimed that “womb envy” was an even stronger psychosocial phenomenon that expressed male anxiety at their inability to give birth.  Then the term “menstrual envy” came along in an attempt to explain a variety of male attractions to behaviors including sports and war.

Recently there has been a rise in use of the term “male menopause,” probably a reflection of demographic shifts and concern for the well being of the aging American male.  An early advocate of this syndrome was Jed Diamond whose 1998 book, Male Menopause, claims that the purpose of the hypothesized phenomenon (also called viropause or andropause) “is to signal the end of First Adulthood and prepare men for Second Adulthood.”

Another web site identifies eight “symptoms of male menopause,” but reading the list reveals that what is now being called male menopause used to be called simply “getting old,” as it includes items such as declining sex drive, forgetfulness, weight gain, and irritability.


FOX News "SEXpert"The Fox news network has also gotten behind the idea with testimony from the “Foxsexpert,” Yvonne Fulbright, who sports a sexy pose to support her title under a headline that reads, “NOT SUCH A MYTH: MALE MENOPAUSE”  The Sexpert goes on to state, “He’s feeling hot flashes — and they have nothing to do with desire. Like a woman, his body is letting him know it’s going through “male menopause.” Far from being a myth, this hotly debated experience really does exist. Yet few people know about the condition more formally known as andropause.”

Actually, once the article turns its attention to the medical circumstances surrounding andropause, it raises some very important issues that men would be well advised to know about.



(more…)

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Who Lacks Health Literacy?

December 18th, 2009 by Elizabeth Kissling

You may have heard the news that 23 hormone replacement therapy lawsuits filed by women diagnosed with breast cancer were dismissed by a New York judge this week. Judge Martin Shulman granted Pfizer’s motion to dismiss for two reasons: the plaintiff’s delayed filing exceeded the the three-year statute of limitations in New York, and that “the potential risk of contracting breast cancer from taking HRT medication was well known at all times out there in the stream of public information.” Oddly, Judge Shulman simultaneously asserted “that the debate over HRT health problems has not yet been settled.”

I can’t argue about exceeding the statute of limitations, but it’s difficult for a judge to assert that breast cancer risk of hormone therapy is well known public information. The Lancet reported today that up to half of US adults have trouble interpreting medical information, displaying low levels of health literacy. Health literacy, according to The Lancet, is the ability to comprehend and use medical information that can affect access to and use of the health-care system. Health literacy is more than reading and comprehending news reports of medical issues (which are often of poor quality – see Health News Review for sharp analysis of health news); one must also know how to navigate the complexities of the health care system, including knowing how and when to question one’s physicians and pharmacists.

“You can’t bias a jury with the truth”

December 16th, 2009 by Elizabeth Kissling

That was Zoe Littlepage’s response to Pfizer’s request to a judge that her law firm remove this video press release about Pfizer’s malfeasance regarding cancer risk of Prempro, their menopause hormone therapy drug. The motion reads, in part, “Plaintiff’s counsel should be compelled to remove this video from the Internet and refrain from making any further inflammatory and prejudicial public statements.”

No word on when the court will make its decision, but Oscar Chase, a professor of legal ethics at New York University School of Law, said a lawyer’s use of YouTube videos to promote his or her case isn’t all that different from a press release.

“We might say it is typical lawyer grandstanding,” Chase said in an interview. “The danger of jury tainting is outweighed by the public’s right to know.”

(Alert readers may recall seeing this video at re:Cycling last month.)

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Marketing Menopause

December 13th, 2009 by Elizabeth Kissling

popupThere’s a pretty good essay in this weekend’s New York Times (online here Saturday, in print Sunday in the Business section) about how hard Big Pharma has worked to market menopause as an estrogen deficiency disease. In addition to discussion of Wyeth’s advertising campaigns, the article mentions the firm’s contract with DesignWrite, a company drug makers pay to develop manuscripts for publication in medical journals, to prepare at least 60 articles for publication in medical journals on the potential benefits of hormone therapy for cardiovascular disease, Alzheimer’s disease, diabetes, colon cancer, vision loss and other health problems.

The article also includes access to PDFs of some of the thousands of pages of documents from Wyeth that were requested by plaintiffs in the lawsuits against the drug manufacturer. (To date, more than 13,000 people have sued Wyeth claiming that they developed breast cancer and other health problems after taking the company’s menopausal hormone drugs. As we reported three weeks ago, in ten of the twelve verdicts so far, juries have awarded significant sums to plaintiffs. ) The documents available at the New York Times include a publication plan for Wyeth from DesignWrite, a 1995 product launch speech from Wyeth’s marketing director proclaiming the company’s mission of bringing to fruition Dr. Bernadine Healy’s vision of “a world in which the vast majority of women would begin taking HRT, and we know that means Prempro, at menopause and continue on for the rest of their lives.” There’s also this handwritten note from a 1996 meeting about how to respond to a new study raising breast cancer concerns (red markings added by me):

Readers should note that statements published in re: Cycling are those of individual authors and do not necessarily reflect the positions of the Society as a whole.