Blog of the Society for Menstrual Cycle Research

Some recent news about Hot Flushes and Night Sweats

October 25th, 2011 by Chris Hitchcock

Prevalence of Hot Flushes and Night Sweats in UK women 54-65

In a new, large (over 10 000 women)  survey of UK women aged 54-65, Myra Hunter and colleagues reported on the proportion of women who have hot flushes and night sweats (HF/NS), and on how frequent and bothersome they found them. Surprisingly, they did not find a difference across ages; 54% of women reported that they currently experienced hot flushes and/or night sweats, and this was as true for women in their mid-60′s as in their mid-50′s. Current users of hormone therapy were less likely to have current HF/NS, while those who had discontinued hormone therapy were more likely to have HF/NS compared with never users. It is common to think that HF/NS last for 2-5 years in a woman’s early 50′s. This study suggests that there is a need for therapies that are effective and can be used safely for a much longer duration.

FDA says no to Pristiq for (Post)Menopausal Hot Flushes

In early September, the US FDA (Food and Drug Administration) turned down Pfizer’s request to market it’s antidepressant drug, Pristiq, as a treatment for hot flushes in menopausal women. Pfizer inherited Pristiq when it acquired Wyeth (makers of the hormone therapy medication PremPro).  This is the first anti-depressant to seek official approval for this indication, although there has been research and promotion of antidepressants as alternative, non-hormonal, off-label medications for vasomotor symptoms (hot flushes and night sweats) for some time.

Perhaps not surprisingly, there has been little coverage of this in the media, as contrasted with the coverage of the various steps towards this point.

I have noticed that when a drug therapy is approved or takes a step along the path towards approval, news coverage is general and widespread. When there is a hitch in the approval process, often only the financial markets pick up the story, because it affects share values. However, there is an article in Medscape that provides more background on the history of this application.

 

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I’ll read for the cure, but I won’t drink the pink Kool-Aid

October 19th, 2011 by Laura Wershler

OPINION

Every October it’s the same thing:  Buy pink, think pink, drink the pink Kool-Aid.  All in pursuit of (mostly) the cure for breast cancer.

Forget the cure. I’m much more interested in preventing the disease. As such, I’ve refused for years to walk or run for the cure to breast cancer. Not only am I concerned that too little of the money raised by such events is being spent on prevention research, I also don’t like what can only be called the commodification of breast cancer.  For more on this check out thinkbeforeyoupink, a program of Breast Cancer Action.

In addition to these concerns, I find some of the breast-cancer fundraising and awareness-building activities being promoted this year to be nothing short of cringe-worthy.

I certainly won’t be attending boobyball 10 next month.  This auspicious event is put on by Rethink Breast Cancer, a Canadian non-profit geared to building awareness in the under-40 crowd. Too bad Rethink’s booby fetish seems more appropriate for the under-12 set.

And I won’t be wearing an “I love boobies” bracelet anytime soon.  Nor will students at a middle school in Kelowna, British Columbia, where the bracelets were recently banned because the message was deemed “offensive.” I’d ban the $3.99 over-priced plastic wristbands just for being silly.

The bracelets, along with other silly “I love boobies”  promotional products, are sold by keep-a-breast.org, the mission of which “is to help eradicate breast cancer by exposing young people to methods of prevention, early detection and support.”

Although I’m sure both of these organizations mean well, I want to scream, “Enough already!”  I know I don’t fit either org’s demographic, but still, enough already.

What I will attend, this evening, and with some hesitation, is the inaugural Read for the Cure event in Calgary.  For $90 I’ll enjoy wine and nibbles, hear three Canadian female authors read from their work, and take home three books by these featured writers.

Marina Endicott is one of three featured authors at Read for the Cure in Calgary, Alberta on October 19.

Read for the Cure is a Canadian endeavor launched in Toronto in 2006 by two women from the same book club who had recently completed treatment for cancer.

“Acknowledging the important role of reading in their lives, and the wonderful support they had received from their fellow members during their treatment, they saw an opportunity to harness the energy of enthusiastic book clubs and readers to raise funds for cancer research.”

I love books, I love my own book club, and I’m going to the event with a dear friend whose mother died of breast cancer.

While breaking my self-imposed boycott of cancer-related fundraising events, I plan to ask a few questions of my fellow attendees:

What’s your take on the mammography screening controversy?

Are you aware of the connection between healthy ovulatory menstruation and breast health?

What do you know about vitamin D and cancer prevention?

I’m also hoping to engage representatives from the Alberta Cancer Foundation and the Cancer Research Society — the two recipients of the event’s proceeds — in discussions about the current research projects they’re funding.  Do they know about the Breast Cancer Prevention Study being conducted by Grassroots Health to explore the association between vitamin D levels and breast cancer?

Tonight, my drink of choice will be red wine. Here’s to a fun evening.

 

 

 

 

 

 

 

 

 

 

 

 

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Cardiovascular deaths increase with steady aging, not menopause

September 27th, 2011 by Chris Hitchcock

Earlier this month, researchers published a statistical analysis of mortality data in England, Wales and the United States, disproving the common statement that, after menopause, women face increased rates of mortality from heart disease. There are other studies that have come to similar conclusions, but there are a few things that make this study different. One is that it drew on epidemiological data from three different parts of the world, which reduces the likelihood of a local coincidence. A second is that they took care to create longitudinal data sets, comparing women born in different birth decades with the appropriate mortality over time. In doing so, they avoided the problems of cross-sectional data.

The authors found that there was a steady exponential increase in risk with age, and that there was no sign of accelerated risk at the typical age of menopause (50). They compared different versions of mortality curves, and were able to show that a two-stage model of mortality with a hinge at menopause was not a good fit to the data.

These findings have received national and international coverage, and are a major blow to the argument that menopausal women require premenopausal hormones to retain premenopausal protection from cardiovascular risk. Menopausal women are older than premenopausal women, and that is why they are more likely to die from cardiovascular disease, not because of the hormonal changes of menopause.

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Vitamin D and Early Onset of Menstruation

September 21st, 2011 by Laura Wershler

Could vitamin D deficiency in young girls contribute to early onset of menstruation?  

A study conducted by the University of Michigan School of Public Health suggests this may be the case.  Blood vitamin D levels were measured in 242 girls between the ages of 5 and 12 in Bogota, Colombia. The girls were then followed for 30 months.

“Compared to girls in the vitamin D-sufficient group who first menstruated at the age 12.6 years, those in the vitamin D-deficient group started menstruating at11.8 years. (Epidemiologist Eduardo)Villamor says that although 10 months may seem like a small gap, the difference is momentous because at that age, a young girl’s body may undergo many changes rapidly.”

The findings are significant because of other research suggesting links between early onset of menarche, or first menstruation, before the age of 12 and serious health concerns later in life such as cardiovascular disease and breast cancer. Vitamin D deficiency is also associated with poor bone health and osteoporosis.

This study showing an association between vitamin D deficiency and early menarche raises many questions. Should mothers be asking their doctors to test their daughters vitamin D levels? How might vitamin D supplementation prevent future health concerns now associated with early menarche? What blood level for vitamin D is optimal?

Grassroots Health, a non-profit advocacy organization promoting optimal vitamin D levels for the prevention of disease and maintenance of good health, has recently launched a study on breast cancer prevention with vitamin D. The group also has an initiative called D*Action involving a consortium of scientists, institutions and individuals committed to solving what they consider to be a worldwide vitamin D deficiency epidemic.

Might the girls in Colombia lead the way for vitamin D supplementation to begin at a young age to protect the bones, breast and hearts of the next generation?

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Tampon Wars

August 12th, 2011 by Elizabeth Kissling

Remember back in February when I made fun of Tampax for explicitly comparing their Tampax Pearl to U by Kotex in their newest print ads? Such direct comparison to the competitor’s product is not a trendy marketing strategy; it hearkens back to the days when Darrin Stephens was a copywriter. (You young-uns can look up that reference.)

I wasn’t the only one who noticed: a recent article in Ad Age says the “30% better protection” strategy has not been used in femcare marketing since Rely tampons were withdrawn from the market in 1980. Not coincidentally, that was the last time Tampax picked up significant market share — a lot of those former Rely users switched to Tampax (Tampax was not owned by P&G at the time, but Rely was).

With the U by Kotex brand apparently winning new customers as well as winning others away from Tampax, how successful will “30% better protection” be as a persuasive strategy? Jack Neff (author of the Ad Age piece) points out that it’s pretty challenging “in a category where absorbency has been tightly regulated by the Food and Drug Administration in the wake of the Rely withdrawal.”

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New versions of menstrual suppression drugs on the way?

August 4th, 2011 by Elizabeth Kissling

Successful tests on rhesus monkeys are a long way from clinical trials on women, but this is interesting to those of us following the conversations and debates about cycle-stopping contraceptives: new research testing progestin antagonists indicates that the drug can be successful in suppressing menstruation without necessarily suppressing ovulation. Another variant of the drug can suppress both menstruation and ovulation.

Dr. Robert Brenner, who is the lead researcher conducting these studies in the Division of Reproductive Sciences at Oregon Regional Primate Research Center, notes that this has potential beyond just a new lifestyle drug:

I would emphasize that we are not talking here only about lifestyle choices but also about the potential to bring relief to the many women who suffer years of misery from distressing complaints such as endometriosis, and painful and excessive monthly bleeding. In fact, excessive bleeding is one of the major reasons that women undergo hysterectomy, and this treatment may also reduce the need for this surgical procedure, with all its attendant risks and costs.

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New Collection of Research on Menstruation and Representation

March 11th, 2011 by Elizabeth Kissling

A special issue of the scholarly journal Women’s Studies: An Interdisciplinary Journal has just been published, featuring several pieces about menstruation, media representation, and the ways we talk about it. You can see the table of contents here, as well as purchase individual articles (or the whole collection, for $146.17). Several of these papers were presented at the 2009 meeting of the Society for Menstrual Cycle Research, and the special issue also includes several new poems, visual work, and book reviews.

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Newsflash: Women threaten men

February 22nd, 2011 by Chris Hitchcock

The NYT article title reads The threatening scent of fertile women. I’ve felt it for years, and I still haven’t quite figured out why I react this way to this kind of article. Certainly it echos the age-old misogynistic discomfort of learned men for their own sexual urges, projected onto women. I’m trained in evolutionary biology, I believe that humans, like other animals, are subject to natural selection, and I believe that there are things that affect our behaviour that are not processed by our consciousness. But, for some reason, I feel a visceral reaction when I read discussions about the sex-related behaviours of women and men around ovulation.

Some of it is that I’m still annoyed that Nancy Burley’s American Naturalist article has been pretty much ignored. Yes, it’s well cited, but the fundamental conclusions seem to have been lost. In 1979, Burley proposed that so-called “concealed ovulation” is a mystery not just because it is concealed from men, but because it is also concealed from the ovulating woman. And she argued that the leading male-centred hypotheses did not account for this. Burley proposed that ovulation is unmarked because humans are smart and can count, and if they had a choice, many women would choose not to go through childbirth, or do so less often. She argued that natural selection acted to make it harder for women to know when to abstain from sex to avoid pregnancy. In other words, maybe concealed ovulation is not all about men, maybe it’s all about smart women.

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Menstrual Pain Hurts because It’s Cyclic

February 16th, 2011 by Elizabeth Kissling
Photo by Abbey Hambright under Creative Commons 2.0

Photo by Abbey Hambright under Creative Commons 2.0

A new study published in the Journal of Experimental Psychology reports that menstrual pain — like annoying noises and tedious computer tasks — hurts more in retrospect, if we anticipate experiencing it again:

In the culminating field study of 180 women (average age 29), those whose menstrual periods had ended fewer than three days earlier or who expected their periods within three days remembered their last period as significantly more painful than women in the middle of their cycle (none were currently menstruating).

Oddly enough, I found this information about the study in article in Computers, Networks and Communication. They report that “[i]n a series of eight studies exposing people to annoying noise, subjecting them to tedious computer tasks, or asking them about menstrual pain, participants recalled such events as being significantly more negative if they expected them to happen again soon.”

The researchers suspect that this is an adaptive reaction; that is, people use the memory to steel themselves against future pain.


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Herbal treatments for PMS — what works?

February 7th, 2011 by Elizabeth Kissling

Given the variety of symptoms of PMS (more than 150), it’s not surprising that no single treatment is effective for all cases, or that women would seek remedies in alternative medicine. A new review of 30 years of literature on herbal remedies sought to discover if randomized clinical trials (RCTs) on these alternatives found any of them effective. However, of the 102 articles identified, only 17 were RCTs and only 10 were included in the study: the researchers report that “the heterogeneity of population included, study design and outcome presentation refrained from a meta-analysis.” Based on this limited study, here are the findings:

Vitex agnus castus was the more investigated remedy (four trials, about 500 women), and it was reported to consistently ameliorate PMS better than placebo. Single trials also support the use of either Gingko biloba or Crocus sativus. On the contrary, neither Evening primrose oil nor St. John Worth show an effect different than placebo. None of the herbs was associated with major health risks, although the reduced number of tested patients does not allow definitive conclusions on safety.

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Don’t Ask, Don’t Smell

January 27th, 2011 by Elizabeth Kissling

female-minority-happy-military-wide-horizontalGuest Post by Emily Swan, Marymount Manhattan College

With the military’s history of suppressing minority groups, its new effort to conceal and terminate menstruation comes as no surprise. Hopefully, the menses will be able to come out of the closet soon enough.

I recently wrote a paper about menstruation in the military and was excited to see this recent post at re:Cycling. Researchers have suddenly become sensitive to the “devastating” effects of menstruation on women in combat and training, citing a potential link to iron-deficiency, among other things. (Might I add that, while the article identifies menses as the culprit, the actual data suggest no correlation between the loss of menstrual blood and the low iron levels of the participants.) Researchers have also conducted studies and interviews to determine the level of difficulty menstruation adds to a variety of physical activities and expose reported difficulty in obtaining, storing, transporting, changing, and disposing of “sanitary products” (Note the hygiene-promoting terminology). These reports have indicated a significant struggle with menstrual management, giving grounds to the military’s new encouragement for women to use continuous oral contraceptive pills (OCPs) to “temporarily” induce amenorrhea.

What’s happening here is not simply a conquering of the menses but an overpowering of women as a whole. The article about iron deficiency says it best, with its opening paragraph explaining the biological disadvantages of women: women’s lower levels of physical strength, inferior aerobic performance, and a number of other physical and mental “shortcomings” that include the ability to menstruate. It states, “the physical differences between genders in the military setting should be minimized as much as possible” (866). They’re not trying to make women more comfortable by stopping their periods; they’re using men to set the physical and mental performance standard for which women must strive. The failure of women to meet this standard lies in their very biology; the study directly blamed their femaleness as the source of this imbalance. It’s not, “Stop menstruating because it will help you.” It’s, “Stop menstruating because it will get you that much closer to being a man.” Oh joy.

The misogyny embedded within this move toward menstrual suppression does not discount the results of the studies; menstrual management poses a serious issue for most military women! In addition to the difficulty reported in transporting, obtaining, and storing products, another article relayed the troubling results of interviews from women of the Air Force, Army, and Navy regarding personal hygiene and field menstrual management.4 These interviews told of highly unsanitary bathroom facilities in combat environments, lack of privacy for the use and changing of menstrual products, and bathrooms that rarely contained receptacles for disposing of the products. The women reported collecting used products in Ziploc bags to either bury them in the secrecy of night or to keep them in their luggage until they returned to the U.S. Because of the hot, moist climates inhabited during deployment; the heavy, reused, and unwashed clothing; and the frequent lack of water or time to wash up, the interviewees reported constant awareness and humiliation surrounding menstrual odor. Most of the women also admitted hesitancy toward utilizing the clinic for menstrual health issues because they were made to feel that their menstrual symptoms were not worthy of care. They also reported that gynecological exams were excluded from their general deployment health examinations.

Great New Article about How Boys and Men Learn about Menstruation

January 17th, 2011 by Heather Dillaway

Since we’re often talking about the lack of attention to men’s attitudes about menstruation, I thought I’d post the abstract of a great new piece in the Journal of Family Issues, due out in February 2011! Kudos to Katherine Allen, Christine Kaestle, and Abbie Goldberg, for getting their great work published! Here’s the title and abstract for their work:

Title: “More than just a punctuation mark: How boys and young men learn about menstruation”

Abstract:
Parents, peers, schools, and the media are the primary contexts for educating young people about sexuality. Yet girls receive more sex education than boys, particularly in terms of menstruation. Lack of attention to how and what boys learn about menstruation has consequences for their private understanding about the biology of reproduction and also for social and cultural ideologies of gendered relationships. In this qualitative study, 23 written narratives from male undergraduates (aged 18-24 years) were analyzed using grounded theory methodology to explore how young men perceive their past and present learning about this uniquely female experience. Findings suggest that most boys first learned about menstruation in their families, primarily through their sisters’ menarche; menstruation is experienced—in boyhood at least—as a gender wedge; and most men described a developmental process of moving from a childish attitude of menstruation as “gross” to seeing themselves as maturing through the experience of an intimate relationship.

Where to find this piece: Journal of Family Issues, vol 32 (Feb 2011), pp. 129-56.

Here’s the link to the abstract page: http://jfi.sagepub.com/content/32/2/129.abstract

Happy reading!

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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.