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This piece of news is being reported in major news outlets today as if a cure for cancer was discovered.  Menopausal weight gain is a problem, to be sure. But was a 13-year study necessary to conclude that we need to exercise more as our metabolisms slow down? I wonder if women would choose exercise over a spa treatment if they had an extra hour to spare every day.

Apparently, what’s most critical in evaluating whether you’re really fit or just acceptable is not your BMI score, the traditional measure for obesity,  but how much body fat you’re carrying around. If you don’t have access to a gym that has equipment for measuring your body composition, a simple way to estimate if you are really fit is to measure your waist or use a metric called the waist-to-hip ratio (are you an apple or pear?).  Many research studies have proven that fat stored around the middle (a particular problem for post-menopausal women) doubles the risk of death from stroke, cancer and cardiovascular disease. Why? Dr. Joann Manson, a Harvard endocrinologist explained in an NPR interview that “abdominal fat cells tend to be more active in producing hormones and chemical  messengers that cause inflammation throughout the body.”

So, if you’re on a weight loss diet, be sure to include exercise, particularly weight training, to ensure that you’re building lean muscle as you lose weight. And don’t think you’re sitting pretty just because you’ve reached your ideal weight. If your percentage of body fat is still high, you’re not fit, you’re just at a (barely) acceptable level.

Do taking vitamin D and fish oil really lower the risk of cancer, heart disease, stroke and other illnesses as some research studies (and supplement manufacturers) have suggested?  Beginning in January, researchers at Harvard University and Brigham and Women’s Hospital will begin a double-blind, placebo-controlled study, the gold standard of research, to find out. The new study, called VITAL (VITamin D and OmegA-e TriaL), funded by the National Institute of Health, will involve 20,000 men and women. If you qualify (women must be 65 years or older and have never had a heart attack, stroke or cancer) you can participate too.

For details about the study and eligibility to participate, visit the VITAL website.

Interestingly, more than 80% of the registrants are women with an average age is 45.  Registry members have lost an average of 66 pounds and kept it off for 5.5 years. Duration of successful weight loss has ranged from 1 year to 66 years! According to the registry data, here’s how they did it:

• 45 %  lost the weight on their own, while the other 55%  had help from some type of program.
• Nearly all of the registry participants (98%) report that they modified their food intake in some way to lose weight.
• And, nearly all (94%) increased their physical activity, with the most frequently reported form of activity being walking.
• Most of the registrants continue to maintain a low calorie, low fat diet and doing high levels of activity (90% exercise, on average, about 1 hour per day)

Even if you don’t qualify, you’ll be inspired by the weight loss success stories that are posted on the NWCR website.

If you’ve lost a significant amount of weight, what’s been your secret to success?

A second study evaluated the effect that Black Cohosh, Red Clover and Prempro has on a woman’s cognitive abilities. Again, “none of the botanicals had either a beneficial or a detrimental effect on memory.”  However, “the specific hormone therapy used in the trial, Prempro, had a slight negative impact on memory.”

So, the researchers at the University of Illinois at Chicago concluded that “only hormone therapy had a beneficial effect on vasomotor symptoms, but this benefit was at a cost of a slight decrease in memory.”

You can listen to an explanation of the study’s findings here.

Some women are just plain lucky. They sail through Menopause without a minute of discomfort.  I put them in the same category as super-models.  They’re freaks of nature.  The fact is that most menopausal women experience hot flashes and/or night sweats and they can range from mildly disruptive to downright debilitating.   Hormone therapy will help with the hot flashes (vasomotor symptoms as they are called), but current guidelines recommend that it be taken at the lowest effective dose for the shortest period of time.   So,  in making the decision to take HT, wouldn’t it be a lot easier if women knew how long their hot flashes would last?

Current guidelines state that vasomotor symptoms last anywhere from 6 months to 2 years.  Another report claims that hot flashes resolve in most women within 4 to 5 years.  So, to find an estimate based on real data, researchers at the Melbourne Women’s Midlife Health Project tracked more than 400 Australian women, ages 45-55, from pre-menopause through the menopausal transition.  After thirteen years, they recently reported that hot flashes, for these women, averaged nearly SIX YEARS (!!!) in hormone users and just over FIVE YEARS (!!!) for nonusers.

Two other noteworthy findings:  There was a connection between high exercise levels and shorter hot flash duration;  and the longer women experienced hot flashes, the lower the average positive mood score.  That’s certainly not a surprise.

Sleep disturbances are common complaints of women going through the peri- and post- menopausal transitions and this and other studies have pointed out the consequences of not getting enough shut eye.  If you’re typically getting less than six hours of good quality sleep a night, find a medical professional (such as a naturopathic doctor, internist, acupuncturist) or even a yoga instructor or meditation class to help you solve this problem.

Personally, I have found that a combination of supplements, hormone balancing and exercise (above all) have just about cured me of my night-time anxiety and insomnia.  As a result, I’m more clear-headed, more energetic and I have a much better disposition on life!

I’d be very interested in hearing about what has helped you solve your sleep problems.

After writing about the possible connection between hormones and heartburn (or gastric reflux) earlier this week, I discovered another research report, involving nearly 40,000 patients, that concluded that even short-term use of popular acid-reducing drugs such as Prevacid, Zantac and Tagament may raise the risk of hip fractures. The increased risks appeared two years after patients started taking prescription or over-the-counter anti-reflux medications. Other brands in this category of drugs include; Nexium, Prilosec, Protonix and Aciphex.

So, if these two studies hold up, it’s possible that a perfectly healthy woman, using hormone therapy to alleviate menopausal symptoms, could develop heartburn or acid reflux; this, in turn, could lead to an increased risk of hip fracture if she takes acid-suppressing drugs to ease her discomfort.

The lesson?

Every prescription drug — including hormones — offers benefits and risks.  Don’t take them without being aware of the possible side effects.  In my experience, physicians do not take the time to spell it out for you, so do your own research and then discuss your concerns with your doctor.  I have found that my local pharmacist knows more than my physicians about the properties of the drugs and their possible side effects.

Researchers wrote last year in the Archives of Internal Medicine (9/8/08)  that hormone use was associated with 37% to 66% higher risk for Gerd symptoms, depending on the preparation used.  They concluded that “physicians prescribing hormone therapies should inform patients about possible Gerd symptoms, and those evaluating patients with new Gerd symptoms should ask about hormone therapy use as a possible contributing factor.”  Characteristics of Gerd include:

• Heartburn
• Acid regurgitation
• Chest pain
• Dysphagia (difficulty swallowing)
• Indigestion
• Estraesophageal symptoms (chronic cough, wheeze, laryngitis)

If any of these symptoms look familiar, and you’re using hormone therapies, you should discuss this possible linkage with your physician.

Your claims of brain fog, senior moments, or whatever you want to call the small but frequent memory lapses you experience during the menopause transition are real, according to the findings of a new study just published in Neurology journal.

Researchers spent four years investigating the effects of the menopause transition and hormone use on three areas of cognitive function; processing speed, verbal memory and working memory.  They concluded that mid-life women, particularly those in the late-perimenopause stage (they haven’t have a period in three to 11 months) were not able to learn as well as they had during pre-menopause.  The good news is that their test scores eventually improved and rebounded to pre-menopause levels once they hit post-menopause (no period for 12 months), indicating that “menopause related cognitive difficulties may be time-limited.”

The impact of hormone treatments on cognitive function were also evaluated. They found that if you started taking hormones before your final menstrual period, the hormones had a “beneficial effect” on cognitive function. The opposite was true for women who began hormone therapy during the post-menopause transition. In those cases, cognitive performance was worse!

So, if you’re a mid-life woman (mid 40s to early 50s) who is struggling to learn new computer skills, or returning to school for a degree, cut yourselves some slack and know that your body’s hormones, which have always been in control, will take a temporary performance break as you approach menopause.

Be sure to read (Bay area physician) Doc Gurley’s humorous take on this study:  “Are You Moron-o-pausal? which appears in her City Brights online column for the San Francisco Chronicle.