Lose Weight And Reduce Hot Flashes

A new study has found that overweight postmenopausal women who lose weight can reduce hot flashes. Thus, reduction of troublesome hot flashes could serve as a motivation to enter into a weight loss program. The findings were published online on June 23 in the journal Menopause.

How to Lose Weight After Menopause

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According to the American Congress of Obstetrics and Gynecology (ACOG), the most common symptom of the menopause is hot flashes. Approximately 75% of menopausal women in the United States experience them. Most women who have them are well aware of the symptoms: a sudden sensation of heat that rushes into the upper body and face. The skin may redden like a blush and a woman may break out in a sweat. A hot flash may last from a few seconds to several minutes or longer. Hot flashes can cause lack of sleep by frequently waking a woman from a deep sleep. Lack of sleep may be noted by a woman as the most troublesome of the menopause.

The study authors note that being overweight has been considered to be protective against hot flashes, newer data suggest a positive relationships between hot flashes and overweight. They explain that, to date, no studies have been specifically designed to evaluate whether weight loss reduces hot flashes. Therefore, they conducted a study with the foal of evaluating the feasibility, acceptability, and initial effectiveness of weight loss for reducing hot flashes.

The study group comprised 40 overweight or obese women who suffered from hot flashes (four or more hot flashes per day). The women were randomized to either a behavioral weight loss intervention group or wait-list control group. Hot flashes were evaluated before and after intervention with physiologic monitoring, diary, and questionnaire. Changes in hot flowers were evaluated via statistical analysis.

The investigators found that 83% of the women completed the study and 94% reported a high degree of satisfaction with the intervention. The majority of the women (74%) reported that hot flash reduction was a major motivator for losing weight. Women randomized to the weight loss intervention group lost more weight (8.86 kilograms or 19.4 pounds weight loss) than did women in the control group (0.23 kilogram or 0.5 pound weight increase). Women in the weight loss intervention group also reported greater decreases in questionnaire-reported hot flashes (two week hot flashes were –63.0), compared to women in the control group (two week hot flashes were -28.0; P = 0.03) Reductions in weight and hot flashes significantly correlated.

Weight Loss Helps to Reduce Hot Flashes

The authors concluded that a behavioral weight loss program is practicable, acceptable, and effective in producing weight loss among overweight or obese women with hot flashes. They recommend that a larger study should be conducted to further confirm their findings. They noted that hot flash management could motivate women to engage in this health-promoting behavior.

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Do Women Without Hot Flashes Benefit From Hormone Replacement Therapy?

The most common symptom of the menopause is hot flashes; however, not all women entering the menopause experience them. According to the American Congress of Obstetrics and Gynecology (ACOG), approximately 75% of menopausal women in the United States experience them. Hormone replacement therapy (HRT) can relieve hot flashes as well as other menopausal symptoms. A new study evaluated the benefits from HRT on quality of life among women who do not suffer from hot flashes. The findings were published on July 1 in the journal Menopause.

Symptom of the Hotflash and Menopause

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The researchers conducted a study that evaluated the impact of hot flashes and various forms of hormone therapy on health-related quality of life as well as sexual well-being in women who had recently become menopausal. The study group comprised 150 healthy women who were interviewed regarding hot flashes and health-related quality of life with the Women’s Health Questionnaire and the McCoy Female Sexuality Questionnaire). They were also asked about menopause-related symptoms, and general health. The women were divided into two groups: those with (72 women) and those without (78 women) hot flashes. All women were prescribed with a six month regime with transdermal estradiol (skin patch; 1 mg/day), oral estradiol (2 mg/day) with or without medroxyprogesterone acetate (5 mg/day), or a placebo.

The investigators found that at the beginning of the study, hot flashes most strongly affected sleep quality, bodily symptoms such as muscle pains, menstrual cycle–resembling complaints, anxiety and fears, decreased memory and concentration, and sexual behavior The different hormone therapy regimens all relieved hot flashes with equal effectiveness; therefore, the different regimens were combined into a single group for further investigation. Among the women with baseline hot flashes, six months of HRT significantly improved the scores for sleep, memory and concentration capacity, as well as anxiety and fears. HRT use was found to have no significant impact on these factors in women without baseline hot flashes.

The researchers concluded that hot flashes contribute differently to various factors that affect health-related quality of life shortly after menopause. Estradiol or an estradiol–medroxyprogesterone acetate combination were equally effective for alleviating hot flashes and improvement in health-related quality of life factors that were related to the elimination of hot flashes. The noted that HRT use does not offer any detectable quality-of-life benefit over placebo in women without disturbing baseline flashes.

Most women who suffer from hot flashes are well aware of the symptoms: a sudden sensation of heat that rushes into the upper body and face. The skin may redden like a blush and a woman may break out in a sweat. A hot flash may last from a few seconds to several minutes or longer. As noted by the study authors, hot flashes can cause lack of sleep by frequently waking a woman from a deep sleep. Lack of sleep may be noted by a woman as the most troublesome of the menopause.

After Hormone Replacement Therapy is Better Health for Woman

Take home message:

The lack of quality of life benefits from HRT among women without hot flashes is an interesting finding. Further evaluation of this group of women should be done to determine whether they are equally susceptible to other postmenopausal conditions such as osteoporosis or vaginal dryness. Six months of HRT for a woman just entering the menopause is inadequate to determine bone loss.

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Estradiol-based hormone therapy lowers risk of cardiovascular mortality

A variety of estrogen products are available for use as hormone replacement therapy (HRT), and thy have different chemical structures. All of them can treat symptoms of menopause such as hot flashes and vaginal dryness. The majority of studies are based on conjugated equine estrogens (Premarin); however, a new study evaluated the health benefits of estradiol. The findings were published in the September issue of the journal Menopause by Finnish researchers.

Many women are not aware that Premarin is an acronym for pregnant mares urine. The medication is extracted and purified from the urine and include a variety of estrogens, including a small amount of estradiol. Estradiol is the predominant female sex hormone and is synthesized in the body; it can also be synthesized in the laboratory for preparations including tablets, injection, and skin patches.

Estradiol-based hormone therapy

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The study authors note that estradiol-based regimens have a different risk-benefit profile than conjugated equine estrogens. Therefore, they assessed the risk of death caused by coronary heart disease, stroke, or any disease among users of estradiol-based hormone therapy regimens in a nationwide study in Finland.

The study group comprised 489,105 women who used HRT from 1994 through 2009 (3.3 million HRT exposure years). The data was derived from the nationwide reimbursement register and the national Cause of Death Register. A total of 28,734 HRT users died during the follow-up period; among the deaths, 3,843 were caused by coronary heart disease and 2,464 were caused by stroke. The mortality risk of HRT users with varying duration of exposure (less than 1 year, 1 to 3 years, 3 to 5 years, 5 to 10 years, or more than 10 years) was compared with that in an age-matched background population.

The investigators found that the risk of coronary heart disease was significantly reduced by 18% to 54% in HRT users and positively correlated to duration of HRT exposure. The risk of death from stroke was also reduced by 18% to 39%; however, this reduction was not clearly related to HRT exposure duration. Risk of all-cause mortality (death from any cause) was also reduced in HRT users by 12% to 38%; the longer the duration of HRT exposure, the greater the decrease in mortality. All these risk reductions were comparable in women initiating HRT before age 60 years and women initiating HRT at age 60 years or older.

cardiovascular mortality

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Are you taking bioidentical hormone therapy?

Many women taking compounded bioidentical hormone therapy are not aware that these products have not been evaluated or approved by the US Food and Drug Administration (FDA). A new study has found that the use of these products is on the rise. The findings were published in the September issue of the journal Menopause by researchers at the University of Virginia Health System, Charlottesville, VA; and University of Colorado School of Medicine, Aurora, CO.

The study authors note that hormone replacement therapy (HRT) is effective for the treatment of vasomotor symptoms (hot flashes), vaginal atrophy, and prevention of postmenopausal osteoporosis in women who are entering or beyond the menopause. The use of commercially manufactured HRT to treat menopausal symptoms has decreased during the past 12 years in response to the findings of the Women's Health Initiative trials; however, the use of custom compounded hormone therapy (CHT; bioidentical hormone therapy) appears to have increased. The researchers note that, apparently do not apply their concerns about the risks of HRT to CHT products.

After hormone therapy

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The researchers explain that, fueling the increase in usage of CHT appears to be the absence of regulation governing product advertising, which allows manufacturers of CHT to make unsubstantiated claims about their safety and effectiveness. In addition, high-profile celebrities such as Oprah Winfrey and Suzanne Somers have promoted CHT to postmenopausal women. In addition, doctors and pharmacists who derive economic benefits from the sales of CHT may also have encouraged its use.

The authors note that two surveys, the Harris and Rose surveys, were conducted to quantify the use of CHT among perimenopausal and postmenopausal women in the US, to examine women's knowledge of CHT versus FDA–approved hormone therapy, and to compile information on menopausal experience. The Harris survey was administered to 801 women aged 45 to 60 years who had experienced at least one menopausal symptom. The Rose survey was administered to 2,044 women aged 40 years or older who had used hormone therapy on at least one occasion. The women were asked about menopausal symptoms, hormone therapy use, and knowledge of CHT. Findings from the Rose survey were expanded by the use of US Census Bureau data and prescription claims for FDA-approved hormone therapy to estimate the prevalence of CHT use.

The researchers found that, according to expansion of the Rose data, up to 2.5 million US women aged 40 years or older may use CHT annually, accounting for 28% to 68% of prescriptions for hormone therapy. The Harris data revealed that 86% of women surveyed were unaware that CHT products are not FDA-approved. The Rose survey asked a subgroup of 1,771 women whether their hormone therapy had been personalized based on hormone levels; 378 (21%) answered “yes”, and 476 (27%) did not know. In both surveys, most hormone therapy users responded that their doctor had recommended the treatment.

hormone therapy replacement

The authors estimated that 1 million to 2.5 million US women aged 40 years or older use CHT. They concluded that the study suggests that many women are unaware that compounded hormones have not been evaluated or approved by the FDA. They stressed that healthcare providers should ensure that women considering hormone therapy understand the risks and benefits of inadequately regulated CHT.

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