hormone therapy

When it comes to hormone therapy, you have options

Menopause care may include hormone therapy treatment

Your body’s hormone levels go through significant changes during the menopause transition, and resulting hormonal imbalances can create uncomfortable physical symptoms and mood swings. Fortunately, hormone therapy (HT) enables menopausal women to substitute for the hormones that are reduced during this transition to relieve symptoms and achieve long-term health advantages. Our physicians will talk with you about the risks and benefits of hormone therapy to help you find the options that best fit your individual body and lifestyle.

In recent years, the media has spotlighted menopause and HT helping to increase general awareness, but it is still important to filter the available information in the context of scientific-based research and peer-reviewed evidence from medical professionals.

Quick facts:

  • The term “hormone therapy” covers both traditional hormone therapy (HRT) and natural (bioidentical) hormone replacement therapy (BHRT), as well as estrogen and combined estrogen/progesterone treatment.
  • BHRT makes use of hormones that are identical to human hormones, and HRT makes use of synthetic hormones that have a slight physical variation to bioidentical hormones, but serve the similar purpose of replacing hormones lost during menopause.
  • Nearly all modern hormone medications are derived from the same plant sources.

Your physician at NCMA Women’s OB/GYN Center will personalize your HT treatment after accounting for various health benefits and risks based on your symptoms and lifestyle. Not all women will be candidates for HT, and medications and other health factors can affect eligibility.

Learn more about hormone therapy from National Institutes of Health.

Research addresses concern over hormonal contraceptive side effects

The vast majority of women will use some method of contraception during their lifetime. Despite there being 37 million in the United States who are currently on birth control, many still worry about potential side effects. Women face several options when it comes to birth control, so potential side effects often factor into their decision. Depression is a common concern for many women, but a new study by researchers at The Ohio State University Wexner Medical Center is putting patients at ease. It found there’s no evidence to support a link between hormonal birth control and depression.

“Depression is a concern for a lot of women when they’re starting hormonal contraception, particularly when they’re using specific types that have progesterone,” said Dr. Brett Worly, lead author of the study and OB/GYN at Ohio State Wexner Medical Center. “Based on our findings, this side effect shouldn’t be a concern for most women, and they should feel comfortable knowing they’re making a safe choice.”

Worly and his team reviewed thousands of studies on the mental health effects of contraceptives. They included data tied to various contraception methods, including injections, implants and pills. Similarly, researchers reviewed studies examining the effects of hormonal birth control on postpartum women, adolescents and women with a history of depression, all with the same conclusion: there is insufficient evidence to prove a link between birth control and depression.

“Adolescents and pregnant moms will sometimes have a higher risk of depression, not necessarily because of the medicine they’re taking, but because they have that risk to start with,” said Worly. “For those patients, it’s important that they have a good relationship with their healthcare provider so they can get the appropriate screening done — regardless of the medications they’re on.”

Worly said patient concerns are valid, and he wants women to continue having open and honest discussions with their doctor about which options work for them.

“We live in a media-savvy age where if one or a few people have severe side effects, all of a sudden, that gets amplified to every single person,” he said. “The biggest misconception is that birth control leads to depression. For most patients that’s just not the case.”

Most women have tried at least one method of contraception in their lives, with nearly 37 million women in the United States currently using birth control. Sixty-seven percent of current users have opted for a non-permanent hormonal method such as an oral pill, but among those, 30 percent have discontinued their use due to dissatisfaction with potential side effects.


Story Source: Read this article on Science Daily: The Ohio State University Wexner Medical Center. “No link between hormonal birth control and depression: Research eases fear around hormonal contraceptive side effects.” ScienceDaily. ScienceDaily, 26 February 2018. www.sciencedaily.com/releases/2018/02/180226085756.htm.

Discontinuance of Hormone Therapy May Be Hazardous to the Heart

A new study demonstrates that the risk of cardiac and stroke death actually increases in the first year after discontinuation of HT.
Hormone therapy (HT) continues to be a hotly debated topic. The benefits of estrogen to the heart, however, appear to be universally accepted. A new study demonstrates that the risk of cardiac and stroke death actually increases in the first year after discontinuation of HT. Study results are published online today in Menopause, the journal of The North American Menopause Society (NAMS).

Since publication of the Women’s Health Initiative (WHI) clinical trial data, there has been significant disagreement over the various risks and benefits of HT. What remains relatively unchallenged is the fact that estrogen has rapid beneficial vascular effects and that shorter periods between the onset of menopause and the initiation of HT provide greater protection against cardiovascular disease. This beneficial relationship between HT and protection against heart disease has led to the speculation that withdrawal from HT could result in clinically significant changes in arterial function. Although previous studies have shown that termination of estradiol-based HT led to significant increases in the risk of cardiac and stroke deaths, particularly during the first year, these results were questioned because women with documented heart problems had not been excluded from the study.

This study, however, involving more than 400,000 Finnish women excluded women with prior cardiac or stroke events. The results of the study, published in the article “Increased cardiac and stroke death risk in the first year after discontinuation of postmenopausal hormone therapy,” showed that discontinuation of HT was associated with an increased risk of cardiac and stroke death during the first posttreatment year, especially in women who discontinued HT aged younger than 60 years. This increased risk was not observed in women aged 60 years or older at the time of discontinuation.

“Since the initial Women’s Health Initiative reports, studies have shown that hormone therapy has many benefits and is safer than originally thought. This is especially true for symptomatic menopausal women younger than age 60 and within 10 years of menopause, as these women had fewer heart events and less risk of mortality,” says Dr. JoAnn Pinkerton, NAMS executive director. “This new study suggests that younger women may have a higher risk of heart disease and stroke during the first year of discontinuation. Thus, women and their healthcare providers need to consider the benefits and risks of starting and stopping hormone therapy before making any decisions.”


Story Source:

Materials provided by The North American Menopause Society (NAMS). Note: Content may be edited for style and length.


Read this article on ScienceDaily.com: The North American Menopause Society (NAMS). “Risk of cardiac and stroke death increases after discontinuing hormone therapy: Highest risk occurs in first year after discontinuation, especially in women aged younger than 60 years.” ScienceDaily. ScienceDaily, 8 November 2017. www.sciencedaily.com/releases/2017/11/171108124156.htm.

Diet that includes vegetable protein may protect against early menopause

Eating more vegetable protein may protect against early menopause: Study shows modest but significant lower risk in older women, linking diet menopause.Results of a new study from epidemiologists at the University of Massachusetts Amherst and Harvard T.H. Chan School of Public Health suggest that long-term diet that includes a high intake of vegetable protein from such foods as whole grains, soy and tofu, may protect women from early menopause and could prolong reproductive function. Diet menopause.

Consuming enriched pasta, dark bread and cold cereal were especially associated with lower risk, while they observed no similar relation to eating animal sources of protein.

“A better understanding of how dietary vegetable protein intake is associated with ovarian aging may identify ways for women to modify their risk of early onset menopause and associated health conditions,” write first author and then-graduate student Maegan Boutot, with her advisor, professor Elizabeth Bertone-Johnson. Details appear in the current early online edition of the American Journal of Epidemiology.

Early menopause, the cessation of ovarian function before age 45, affects about 10 percent of women and is associated with higher risk of cardiovascular disease, osteoporosis and early cognitive decline, the authors note. Few studies have evaluated how protein intake is associated with menopause timing, they add, and to their knowledge this is the first to look specifically at early menopause.

Boutot, Bertone-Johnson and colleagues in the School of Public Health and Health Sciences at UMass Amherst, with others, evaluated the relationship between diet and risk of early menopause among members of the Nurses’ Health Study II (NHS2), an ongoing prospective study of 116,000 women aged 25-42 when they entered it in 1989.

Participants were asked to report how often they ate a single serving of 131 foods, beverages and supplements over the previous year, from “never or less than once a month” to “6+ per day.” They observed that women consuming approximately 6.5 percent of their daily calories as vegetable protein had a significant 16 percent lower risk of early menopause compared to women whose intake was approximately 4 percent of calories.

Diet Menopause

For a woman with a 2,000 calorie per day diet, the authors explain, this is equal to three to four servings of such foods as enriched pasta, breakfast cereal, tofu and nuts, or about 32.5 grams a day. They adjusted for age, smoking, body mass index and other possible confounding factors.

Boutot and Bertone-Johnson add, “Though relatively few women in our study consumed very high levels of vegetable protein and our power for analyses of more extreme intake levels was limited, women consuming 9 or more percent of their calories from vegetable protein had a hazard ratio of 0.41 (95 percent confidence interval = 0.19-0.88)” compared to those eating less than 4 percent.

Others on the study team were from Brigham and Women’s Hospital and Harvard Medical School. The study was supported by a grant from NIH’s Eunice Kennedy Shriver National Institute of Child Health and Human Development.

For the NHS2, follow-up questionnaires have assessed nurses’ lifestyle behaviors and medical conditions every two years. Nearly 90 percent have continued to participate in followup. Diet was assessed five times over the 20-year study, allowing the researchers to capture within-person variation in changes in food and nutrient intake over times, Boutot explains. Participants in the study contributed more than 1 million person-years of follow-up, during which 2,041 women experienced early menopause.

Boutot and Bertone-Johnson suggest that more prospective studies of their findings are warranted, including studies that compare soy-based and non-soy vegetable proteins.

Story Source:

Materials provided by University of Massachusetts at Amherst. Note: Content may be edited for style and length. University of Massachusetts at Amherst. “Eating more vegetable protein may protect against early menopause: Study shows modest but significant lower risk.” Read this article on ScienceDaily:  ScienceDaily, 26 June 2017. www.sciencedaily.com/releases/2017/06/170626093604.htm.


The Women’s OB/GYN Medical Group strives to better the lives of all women with a holistic approach to women’s health. Call for an appointment today: (707) 579-1102. Visit our website: www.womensobgynmed.com

Menstrual cycle has no impact on how a woman’s brain functions

Levels of estrogen, progesterone and testosterone in one's system have no impact on the working memory, cognitive bias or ability to pay attention to two things at once.A new study published in Frontiers in Behavioral Neuroscience is setting out to change the way we think about the menstrual cycle. While it’s often been assumed that anyone who’s menstruating isn’t working at top mental pitch, Professor Brigitte Leeners and her team of researchers have found evidence to suggest that that’s not the case. They examined three aspects of cognition across two menstrual cycles, and found that the levels of estrogen, progesterone and testosterone in your system have no impact on your working memory, cognitive bias or ability to pay attention to two things at once. While some hormones were associated with changes across one cycle in some of the women taking part, these effects didn’t repeat in the following cycle. Overall, none of the hormones the team studied had any replicable, consistent effect on study participants’ cognition.

Professor Leeners, team lead, said: “As a specialist in reproductive medicine and a psychotherapist, I deal with many women who have the impression that the menstrual cycle influences their well-being and cognitive performance.” Wondering if this anecdotal evidence could be scientifically proven — and questioning the methodology of many existing studies on the subject — the team set out to shed some light on this controversial topic.

The study published today uses a much larger sample than usual, and (unlike most similar studies) follows women across two consecutive menstrual cycles. The team, working from the Medical School Hannover and University Hospital Zürich, recruited 68 women to undergo detailed monitoring to investigate changes in three selected cognitive processes at different stages in the menstrual cycle. While analysis of the results from the first cycle suggested that cognitive bias and attention were affected, these results weren’t replicated in the second cycle. The team looked for differences in performance between individuals and changes in individuals’ performance over time, and found none.

Professor Leeners said, “The hormonal changes related to the menstrual cycle do not show any association with cognitive performance. Although there might be individual exceptions, women’s cognitive performance is in general not disturbed by hormonal changes occurring with the menstrual cycle.”

Professor Leeners cautions, however, that there’s more work to do. While this study represents a meaningful step forward, larger samples, bigger subsamples of women with hormone disorders, and further cognitive tests would provide a fuller picture of the way that the menstrual cycle affects the brain. In the meantime, Professor Leeners hopes her team’s work will start the long process of changing minds about menstruation.


Story Source:

Materials provided by Frontiers. Note: Content may be edited for style and length.


Journal Reference:

  1. Brigitte Leeners, Tillmann H. C. Kruger, Kirsten Geraedts, Enrico Tronci, Toni Mancini, Fabian Ille, Marcel Egli, Susanna Röblitz, Lanja Saleh, Katharina Spanaus, Cordula Schippert, Yuangyuang Zhang, Michael P. Hengartner. Lack of Associations between Female Hormone Levels and Visuospatial Working Memory, Divided Attention and Cognitive Bias across Two Consecutive Menstrual Cycles. Frontiers in Behavioral Neuroscience, 2017; 11 DOI: 10.3389/fnbeh.2017.00120

See this article on science daily:  Frontiers. “Menstruation doesn’t change how your brain works — period: Normonal changes during the menstrual cycle have no impact on aspects of cognition, study shows.” ScienceDaily. ScienceDaily, 4 July 2017. www.sciencedaily.com/releases/2017/07/170704093610.htm.

Women who enter menopause at or before age 40 more susceptible to bone fracture

If you’re in menopause before the age of 40, you have a higher fracture risk. That fact has already been proven by the Women’s Health Initiative (WHI) clinical trials. Now a new study evaluating the same WHI data further concludes that, even with calcium and vitamin D supplements, your risk of fracture is still higher. The study is being published online in Menopause, the journal of The North American Menopause Society (NAMS).

For years, calcium and vitamin D have been touted for their abilities to increase bone mineral density. Hormone therapy is also recognized for its ability to help ward off osteoporosis. That’s what prompted this latest study to evaluate the effectiveness of calcium, vitamin D, and/or hormones in offsetting the higher fracture risks for women experiencing early menopause. Based on an evaluation of nearly 22,000 women included in the WHI trials, women aged younger than 40 years already in menopause had significantly higher risks for fracture than women who experienced menopause between the ages of 40 and 49 or after 50, regardless of treatment intervention.

Although the findings are disappointing for women experiencing an early onset of menopause, the study did open the door to a number of questions and possibilities. For example, women with early menopause are candidates for hormone therapy until at least the average age of menopause (52 years) to reduce the risks of heart disease, osteoporosis, and cognitive and mood changes. It is possible that earlier initiation of treatment for those with early menopause with calcium, vitamin D, or hormones; more appropriate dosing of young women, longer duration of treatment; or longer duration of follow-up could provide better bone protection and ultimately reduce fracture risk.

“This study highlights the need for healthcare providers to take into consideration a woman’s age at menopause onset when evaluating patients for fracture risk,” says Dr. JoAnn Pinkerton, NAMS executive director. “Women at risk for bone loss need 1,200 mg of calcium per day, with adequate vitamin D, and encouraged to get as much as possible through diet due to concern that too much supplemental calcium may increase atherosclerotic plaque in women. Women with early menopause should discuss whether they are candidates for hormone therapy with their providers, appropriate amount of calcium, vitamin D and hormones.”


Story Source:

Materials provided by North American Menopause Society (NAMS). Note: Content may be edited for style and length.


North American Menopause Society (NAMS). “Link between early menopause, higher risk of fracture, new study confirms.” ScienceDaily. ScienceDaily, 2 November 2016. www.sciencedaily.com/releases/2016/11/161102155224.htm.

Health Conditions Can Lead to Low Libido in Women

sleeping-woman-1432242A woman’s sex drive can often wax and wane over the years due to many complex components. Sexual satisfaction is an important part of a woman’s overall health and well-being.

When problems arise, it is vital to discover what is causing her to have her libido bottom out. There are four areas that play a role in affecting a woman’s desire for sex — physical, hormonal, psychological and relationship issues.

Physical reasons

• Medications such as antidepressants and anti-seizure meds can squelch sex drive.

• Being fatigued or exhausted due to caring for children or aging parents will make her less likely to look forward to sex.

• Surgery or a prolonged illness can affect how she feels about her body and sexual functioning.

• Medical conditions such as arthritis, diabetes, high blood pressure, heart disease or neurological diseases can all put a damper on desire for sex.

• Any type of sexual problems such as pain during intercourse or not being able to achieve an orgasm can drive sex drive into the ground.

Hormonal changes

• Pregnancy and breastfeeding have huge hormonal changes associated with them which can affect sex drive. Add to that, the fatigue, body changes, and becoming a new mom with tremendous responsibility can often put sex at the bottom of her to-do list.

If any of these areas is a source of the problem, a woman should seek out professional help by making an appointment with her primary care doctor or gynecologist. Either one are trained to discuss these issues of intimacy allowing a woman to candidly talk about her sexual concerns. It is better to approach this topic sooner than later before it begins negatively affecting your relationship with your partner.

Read the full story here …

Menopause: an ever changing journey through life

OBGYN picPeople speak about menopause as if it is a fixed thing, but in reality it is anything but. Not only does each woman experience it differently both in terms of actual symptoms and their severity but over time those symptoms may lessen, worsen, or change into something entirely new.

The hormone rollercoaster

We all know that at menopause the levels of oestrogen and progesterone start to drop and something many women notice is that their periods can be closer together or get longer or heavier. This is really common and due to the way that your hormonal balance is starting to change. At this point, your progesterone levels will be falling faster than your oestrogen, so your oestrogen just keeps triggering a menstruation and a bleed, particularly if you are very oestrogen dominant.

Hormones don’t stand still, they respond to the internal stimulus from our ovaries, but also to the external stimulus of stress, medications and environmental factors. That is why however well you may be taking care of yourself, not all factors are able to be under your control and your body cleverly prioritises what is the main thing to deal with. Unfortunately it is your body that decides, not you, so if you are dealing with illness, stress or infection the body diverts its resources to dealing with those.

Read the full story here ….

Other Reasons Women Take Birth Control Pills

woman-1541456You know that birth control pills can keep you from getting pregnant. But the pill can have other benefits, too. One survey found that more than half of women who take birth control pills do so for reasons other than avoiding pregnancy.

It can make your periods more regular. With the pill, you’ll know when you’ll have your period. With traditional birth control pills, you’ll take 3 weeks of hormone-containing active pills, followed by one week of inactive pills. You’ll get your period the week you the inactive pills. Read the full story … 

The Women’s OBGYN Medical Group of Santa Rosa Kicks Off 2015 with “Good to Be You”

OB-GYN facebook masthead

 

A look at how to get healthy and stay healthy for life – The Women’s OBGYN Medical Group invites women everywhere to become involved in the Good To Be You program and create a condition of optimal health and balance in life – discover that it is Good to Be You!

Life expectancy in the U.S. is at an all-time high, as reported by the Centers for Disease Control and Prevention (CDC) last October. While the average expected age is now just under 79 years for both men and women, a female baby born in 2012 can now expect to live to 81.2 years, that’s almost 5 years longer than a male born the same year, who can expect to live just over 76 years. Knowing that we, as women can expect to live a full eight decades – barring accidents or major health issues, it’s a pretty good idea to adopt healthy habits as early in life as possible. A look at the trends to better health reveals that there are some very simple ways to optimize health, and make life worth living.

Living with a Healthy Heart

Some women are surprised to learn that heart disease is the number one killer of women, taking far more lives each year than breast cancer and cervical cancer combined. Regardless of age and fitness level, taking measures to maximize heart health is one of the most important things women can do to stay healthy. While routine preventative care can help, lifestyle changes such as exercising, dieting, and quitting smoking and cutting back on caffeine are all examples of the most effective ways to maintain a healthy heart.

Eating For Health

According to a 2011 study by Lancet, Japanese women can expect to live longer than most other women in the world, and experts believe it might have something to do with diet. The average Japanese diet consists of fish, seaweed, and lots of vegetables. The fact that they eat so much fish means they naturally enjoy high dietary levels of omega-3 fatty acids which is associated with many health benefits.

Including fresh vegetables in the diet is one of the simplest choices to make to improve overall healthfulness. A vegetable-rich diet is believed to help protect the body from arthritis, heart disease, stroke, dementia and a variety of cancers – and it might also slow down the aging process. In fact, one recent study found that people who consume at least seven portions of fresh vegetables and fruit each day have a whopping 42 percent lower risk of dying from any cause, compared to those who eat one portion or less. Additional dietary considerations to make include;

  • Studies also reveal that eating dark chocolate in moderation (two servings per week) is associated with a lower risk of heart failure.
  • People who eat nuts significantly reduce their risk of heart disease, diabetes, cancer, lung diseases, and others. In fact, people who consume nuts as part of their daily diet were 20 percent healthier than non-nut-eaters according to at least one study.
  • In a review of 24 studies, researchers found that women with low-to-moderate alcohol consumption had a lower risk of all-cause mortality (moderate drinking is defined as up to one drink per day for women).

Boost your happiness quotient

The happiest people are three times less likely to die over a given period than the least happy people, according to a 2012 study. It’s not just about attitude either, as happy people have lower levels of the stress hormone cortisol, and they seem to have lower blood pressure which lessens the threat of cardiovascular issues such as heart disease and stroke.

According to a 2010 study at Brigham Young University friends are also part of the happiness equals long life factor as people with strong social connections are reported to have a 50 percent lower chance of untimely death than those with few social ties. Research shows that strong partnerships can also help people avoid illness.

A strong (emotionally supportive) partnership is also apparently helpful when it comes to adopting healthier habits, which of course leads to living healthier longer. Although we might think that intimacy is the key to a happy partnership, sex isn’t the only type of physical contact that can lower stress and improve health. In a 2004 study conducted by the University of North Carolina researchers discovered that both men and women had higher blood levels of oxytocin—a hormone believed to ease stress and improve mood—following a simple hug. The women in particular, had lower blood pressure after receiving a hug and lower levels of the stress hormone cortisol.

Ditch Bad Habits

Habits can actually be beneficial to overall health, because they’re automatic and they don’t require a whole lot of thinking, which frees our brains up to focus on other things. Good habits, like being punctual or maintaining a sense of optimism, or being courteous, or getting enough sleep and maintaining an exercise routine can provide motivation for healthy living. However, bad habits can also happen without thinking and can be damaging to health and increase stress, all without us being aware of them. Some of the basic bad habits that can be changed to increase overall well-being may include;

  • eating junk food
  • procrastinating
  • overspending
  • being late
  • staying up to watch TV or to play on the computer

There is one bad habit that has a very negative impact on health and that’s smoking. Never starting this habit is the best route to take but even long time smokers can benefit from ditching the habit as research finds that women who quit before age 40 live as much as a decade longer than those who quit later on.

Exercise – Get Moving!

Sitting for prolonged periods at a desk or in front of the computer may be necessary for many people’s livelihood, but it’s not good for the body. Research shows that women who sit for more than six hours a day have a 40 percent higher risk of dying from any cause than those women who sit for fewer than three hours—regardless of their fitness levels.

Exercise is hands-down one of the best things women can do to improve health. Exercise keeps the body fit, increases energy and releases endorphins—which in turn increases the happiness quotient. A number of studies indicate that staying active is associated with a longer life expectancy.

We might think that a “real” workout needs to be strenuous. But the fact is that simply walking, running, biking or swimming are all activities that are extremely beneficial to overall healthfulness. Just 2.5 hours weekly (about 20 minutes a day) of moderate aerobic exercise such as walking provides all the major health benefits a body needs to stay healthy.

Breast Health

Routine breast exams and general awareness of how to maintain breast health are important elements in living a healthy lifestyle for women. Screening methods such as regular self-breast exams, breast checks during routine gynecologic exams, and screening mammographies can all help to detect breast problems early-on. Early treatment of breast problems can contribute to the success of any treatment that is needed.

Self-check breast exams are easy to perform in the home and should be conducted monthly in addition to annual breast exams with your physician at Women’s OB/GYN Medical Group. Depending on your age and individual health, your physician may recommend a more frequent interval of regular check-ups with your health care provider.

About Women’s OBGYN Medical Group

The provider team of expert OB/GYN physicians, certified nurse midwives, family nurse practitioners, and medical assistants provides unmatched care to patients in our region. As women proudly serving women, we understand the needs and expectations of our patients. For more information call (707) 579-1102 or visit our website.