What Your Menstrual Cycle Says About Your Overall Health
Cycle lengths are important because a woman with shorter cycles would have more ovulations each year, and therefore would likely have higher estrogen levels in her body. Estrogen has long been known to be important for protecting a womans heart.
Other research in recent years has given doctors a clearer understanding of the links between aspects of menopause and the risk of future cardiovascular disease. They now know, for instance, that women who go through early menopause have a heightened risk, as do those experiencing more hot flashes.
Since cycle length is a useful indicator in younger women, what about those in midlife? the researchers wondered. A similar association had not been assessed in women transitioning through menopause who experience multiple changes that increase their risk for cardiovascular disease later in life. Understanding risk factors for cardiovascular disease is important because this disease is the number one killer of women, Dr. El Khoudary says.
Changes In Hdl With Menopause
Most studies show that total HDL levels fall slightly with menopause , whereas others reveal no changes . Menopausal changes in HDL metabolism are more complex than the measurement of total HDL reveals, because the more antiatherogenic HDL2 levels decrease , whereas HDL3 levels increase . HDL2 particles are the large, buoyant, and more cardioprotective subspecies of total HDL. The strong inverse relationship between HDL cholesterol and abdominal adiposity appears to be largely dependent on variations in HDL2 levels .
Changes In Proteins Of Lipid Metabolism With Menopause
Proteins of lipid metabolism underlying the menopausal change in lipids have been evaluated in few studies. The increased prevalence of small, dense LDL with menopause may be explained by higher HL activity in postmenopausal women . Endogenous estrogen levels are inversely associated with HL activity . HL hydrolyzes the TG and phospholipid in LDL and HDL and is one factor that determines the size and density of LDL and HDL particles . The higher the HL activity, the more TG and phospholipid hydrolyzed, resulting in smaller, denser more atherogenic lipoprotein particles. Lipoprotein lipase hydrolyzes TG in triglyceride-rich lipoproteins, generating FFA that can serve as an energy source or can be stored in adipocytes. We have recently shown a small, but significant, rise in lipoprotein lipase activity with the transition through menopause . Cholesteryl ester transfer protein catalyzes the exchange of cholesterol ester in HDL and LDL particles for TG in VLDL, and high CETP concentrations are associated with reduced HDL levels. Menopausal status does not appear to affect CETP activity . The mechanisms underlying the menopausal changes in lipid metabolism are not clear and require further study.
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Changes In Ldl With Menopause
Postmenopausal women have higher total cholesterol, LDL cholesterol, triglycerides , and lipoprotein levels and lower HDL cholesterol levels than premenopausal women . Although elevated LDL is not a component of the metabolic syndrome, LDL levels increase by 1020% with menopause, and the greatest change in LDL concentration appears to occur early in the transition from premenopause to postmenopause . Apo B, the primary apolipoprotein of LDL particles, and other apo B-containing particles are also higher in postmenopausal compared with premenopausal women .
LDL particle composition also changes with menopause. The prevalence of small, dense LDL is low in premenopausal women , but increases to 3049% in postmenopausal women . LDL are comprised of a spectrum of particles that vary in size, density, chemical composition, and atherogenic potential. A preponderance of small, dense LDL is associated with an increased risk of myocardial infarction as well as the severity of CVD . The risk of CVD is 3-fold higher in women with small, dense LDL than in those with large, buoyant LDL . Mackey et al. recently showed by electron beam CT that postmenopausal women with high coronary calcium scores had smaller LDL particle size, higher LDL levels, and fewer large HDL2 particles than postmenopausal women with low coronary calcium scores.
Associations Between Biomarkers And Cognition
There were no significant differences in cognitive scores between MT groups , or between each MT group and the corresponding age-matched male group . As shown in Supplementary Table S13, in the POST group, precuneus GMV was positively associated with memory scores at cross-section and longitudinally . ATP/PCr in temporo-parietal regions was positively associated with global cognition . There were no significant associations between cognitive scores and regional biomarkers among PRE and PERI groups .
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Menopause As A Marker
Q: Thats a very important distinction that you made for us that menopause doesnt actually cause cardiovascular disease but it is an important marker. It can be sometimes confusing because we often tend to believe that menopause causes osteoporosis, or it causes cardiovascular or heart disease.
Yes, it is a marker. The decline in estrogen that happens during menopause is driving the poor health outcomes. I think thats really important to understand. There might be some genes that affect both the age of menopause and cardiovascular disease. So it is the genes that are making both things happen, but we see it as menopause causing cardiovascular disease. It is the third party that we need to constantly be aware of. In epidemiology, this is what we call a common cause factor.
Chemical And Molecular Analyses
High performance liquid chromatography was used to quantify SCFAs in fecal samples. The organic acids were separated and identified by using a Bio-Rad column at 65°C, 5 mM H2SO4 as mobile phase, and a 0.6 mL/min flow rate that was increased to 0.8 mL/min at 30 minutes.
DNA extraction, 16S rRNA gene amplicon sequencing using the illumina platform and sequence analysis with Qiime2 was conducted as described before . Sequence quality control was performed with DADA2 . Based on the unsatisfactory quality of the reverse reads, which would prevent a sufficient merging, only the forward reads were used throughout the sequence analysis. The rarefaction analyses revealed that most of the phylotypes were targeted , indicating a reliable representation of the community diversity. Seven single samples were eliminated from the sequence analysis since these samples had less than 13,000 reads and thus a compromised phylotype assignment-quality and quantity . Taxonomic assignment was realized with Greengenes database considering 99% OTU similarities . The taxonomic identity of the closest related species of a significant phylotype was determined by BLAST using the currently available database at NCBI . Alpha diversity analysis was calculated with Faiths PD . Beta diversity analysis was calculated with both weighted and unweighted Unifrac distance metrics .
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Women Who Reach Menopause Before Age 40 Face Higher Risk For Future Heart Disease
Black women are 3 times more likely to experience early menopause compared with white women, research suggests.
Could premature menopause be a predictor of heart trouble? New research hints at a link.
Women who reach menopause, defined as no menstrual periods for 12 consecutive months, before they reach the age of 40, have as much as a 40 percent increased risk of developing coronary heart disease compared with women who dont go through the transition early, according to preliminary research presented on May 20 at the American Heart Associations Epidemiology, Prevention, Lifestyle, and Cardiometabolic Health Conference 2021.
Premature menopause was independently associated with a higher long-term risk of coronary heart disease, even when adjusting for major risk factors for heart disease, says Priya M. Freaney, MD, a third-year cardiology fellow at Feinberg School of Medicine at Northwestern University in Chicago and lead author of the study.
Whats more, Black women were shown to be more 3 times more likely to experience early menopause than white women.
Nice Guidance On Menopause
In November 2015, NICE Guideline 23 on Menopause: diagnosis and management was published, providing recommendations for healthcare professionals who care for women in menopause.1 NICE NG23 also includes a section with information for the public, which provides women with information about what to expect from a healthcare professional if they have menopausal symptoms.
NICE Quality Standard 143,4 published in February 2017, distils the key points from NICE NG23 into measurable statements that can be used to assess the quality of care provided and quantify potential improvements to clinical practice. The five quality statements that make up NICE QS143 are listed in Table 1 and discussed in detail below.
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Migraine And Hot Flashes Are Connected Data Confirms
A new study from Mayo Clinic confirms a link between a history of migraine and hot flashes and highlights the association of both phenomena with an increased risk of heart disease.
A prior study from SWAN showed a connection, and we wanted to see if our data would corroborate that finding, says Faubion, the lead author of the study.
What’s new We found that the correlation between hot flashes and migraine was significant, and the correlation with the severity of hot flashes was significant: The more severe your hot flashes were, the more likely you were going to report severe migraines, says Faubion.
Research details The cross-sectional analysis used the Data Registry on the Experiences of Aging, Menopause, and Sexuality , which was completed by women ages 45 to 60 who visited one of the Mayo Clinic locations in Minnesota, Arizona, and Florida. A total of 3,308 women were included the population was 94.5 percent white, 93 percent had at least some college, and 27 percent reported a history of migraine.
The nature of the relationship is still unknown, Faubion says. Its also unclear migraine and hot flashes are separate things that are both tied to heart disease risk or if they share a common pathophysiology, says Faubion.
Venous Thrombosis And Hrt
Venous thromboses are blood clots that form inside veins. Women under 50 years of age, and women aged 50 to 60, face an increased risk of venous thrombosis if they take oral HRT. The increase in risk seems to be highest in the first year or two of therapy and in women who already have a high risk of blood clots. This especially applies to women who have a genetic predisposition to developing thrombosis, who would normally not be advised to use HRT.
Limited research to date suggests the increased risk of clots is mainly related to combined oestrogen and progestogen in oral form, and also depends on the type of progestogen used. Some studies suggest a lower risk with non-oral therapy or tibolone.
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What The New Research Shows
Much of what we know about how we experience menopause comes from the largest ongoing study of women and menopause, the Study of Women’s Health Across the Nation , which began in 1996. Its a multi-site, longitudinal, epidemiologic study focused on the physical, biological, psychological, and social changes during menopause. Women from a variety of socioeconomic and ethnic backgrounds have participated, giving researchers a glimpse into possible differences in how we all experience the transition.In the US, the median age for reaching menopause is 51. The research in SWAN shows that Black women reach menopause at 49, two years earlier than the national median age. Other SWAN data shows Latina women reach menopause two years earlier than the median age as well. It also appears that Black women spend more time in the menopause transition than white women do.And then there are the differences in hot flashes, one of the most common discomforts of the transition. More Black and Latina women report experiencing vasomotor symptoms than white women do, and Latina women experience more vaginal dryness than other women.
Among the women who report vasomotor symptoms, white women experience hot flashes for around 6.5 years, while for Latinas its 8.9 years, and for Black women its 10 years. Research from the University of Washington shows that Native American women may experience the worst perimenopausal hot flashes of all.
Box : Potential Improvements Following Implementation Of A Local Menopause Specialist Service
Implementation of a local menopause specialist service could lead to improvements in:
- diagnosis of perimenopause and menopause through
- a reduction in FSH testing for diagnosis of menopause in women over 45 years
- use of electronic prompts for FSH laboratory requests
- liaison with local pathology optimisation groups
FSH=follicle-stimulating hormone POI=premature ovarian insufficiency HRT=hormone replacement therapy
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Myth: Menopause Ends Sexual Pleasure
The facts: Menopause does bring certain changes that can negatively impact the physical aspect of sex, including:
- Loss of natural vaginal lubrication due to decreased estrogen production, which can make sexual intercourse painful
- Vaginal atrophy due to declining estrogen production, which may cause discomfort during sexual intercourse as well as urinary incontinence, vaginal infections, and other troublesome conditions
Fortunately, many effective treatments exist that can help restore your vaginal health, improve arousal, and increase your sexual pleasure.
We may recommend:
- A vaginal lubricant to ease dryness and discomfort during sexual intercourse
- Estrogen applied to the vaginal area via cream, suppositories, or a vaginal ring, to help repair and rebuild tissue
- Hormone replacement therapy to treat various symptoms associated with menopause, including the physical changes in your vaginal area
Interestingly, once weve eliminated your physical discomfort, regular vaginal sexual activity may help as well, since it increases blood flow to your vagina, keeps your vaginal muscles toned, and helps maintain vaginal elasticity.
Hrt For Breast Cancer Survivors
It is advisable for women with a history of breast cancer to avoid HRT unless other treatments are ineffective, and their quality of life is made intolerable by menopausal symptoms. In these circumstances, HRT should only be prescribed in consultation with the womans breast surgeon or oncologist.
Evidence has not conclusively shown that HRT will increase the risk of breast cancer recurring in a woman with a history of the disease. However, oestrogen and progestogens may stimulate some types of cells in the breast and some types of HRT use have been associated with an increase in the risk of breast cancer in women without a history of breast cancer.
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Why Is Gut Health So Important For Menopausal Women
Dr Federica explains
Good gut health is important throughout your life, but it is especially impactful in protecting womens wellbeing during and after the menopause.
The close link between gut microbiome diversity and hormone regulation has led to research focusing on what is known as the Estrobolome the microbial control centre in our gut that regulates estrogen levels in the body. To touch on the science behind it, a healthy Estrobolome secretes -glucuronidase to metabolize inactive estrogens and phytoestrogens back to available circulating estrogens, which can then act on estrogen receptors all over the body, reducing the symptoms associated with menopause but also with a range of diseases. Still with me?!
After the menopause, women are at a higher risk of obesity, certain types of cancer, cardiovascular disease and decreased cognitive function, all of which are associated with an increase in inflammation and changes in the diversity of our gut microbiome. Changing our diet to support gut microbiome diversity effectively improves markers of inflammation and improves estrogen circulation, making it a promising and exciting new approach to improving postmenopausal womens wellbeing.
What are the best foods to eat to help mitigate the symptoms of menopause?
Which supplements should I take and why?
Indi Body contains a selection of beneficial fibres and probiotics to support the variety you can consume each day.
The Difference Between Perimenopause And Menopause
Perimenopause and menopause are two commonly used terms to describe stages to the end of a woman’s reproductive years. Diagnosing these two transitional stages can be a tricky ordeal. Hopefully, after reading this column the mystery of how physicians diagnose perimenopause and menopause won’t be such a mystery anymore!
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Talk To A Women’s Health Expert About Menopausal Symptoms
- Women may present to their primary care physicians, their gynecologist or their advanced practice registered nurse seeking relief from these signs and symptoms.
- A physician can clinically diagnose menopause and perimenopause although both can be tricky. Your clinician should review your signs and symptoms, medical history, medication list, and perform a physical exam if indicated.
- At times, the diagnosis is not clear cut as other medical conditions mimic menopause such as thyroid dysfunction, depression, and anemia. Besides, irregular menses are challenging to investigate with a history of uterine ablation or dilatation and curettage.
The Secret Power Of Menopause
Why the end of fertility doesnt mark the start of declineand may even help explain our success as a species.
Dont try to tell this to a mother sitting in the bleachers during a four-hour swim meet or enduring a birthday party involving toddlers and craft projects or resting in an armchair on a peaceful evening, savoring the heft of a tiny body and the scent of an infants freshly washed hair. Interminable or sweetly languid though they may feel in the moment, the childbearing years are startlingly brief. Fertility, which typically ends in a womans mid-40s, occupies less than half of her adult life. And then, if shes lucky, she has 30 or 40 years in which to do something else.
Most people dont realize how unusual humans are, in the way that nonreproductive females persist. Females of most other species can bear young until they die, and many do, or at best enjoy a brief respite from breeding before death. This is true not only of creatures you might expect, such as rabbits, but also of long-lived mammals such as Asian elephants, and of primates such as gorillas and chimps. The odd exceptionsthe Japanese aphid, for example, enters a glue bomb stage after her reproductive phase, ready to immobilize a colony intruderonly prove the rule.
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