Category Archives: Hormone Replacement Therapy

In plain white text atop a blue-to-pink gradient, Solace greets new users with a dictionary definition of its name: comfort or consolation in a time of distress or sadness. Its a fitting name for an app that aims to give trans people more information about various aspects of transitiona one-stop resource for people who know they are trans, but dont know how to be trans.

After entering some basic informationtheir name, their pronouns, and their location by statethe user is presented with some common transition goals, as Solace terms them. These include all of the major transition milestones like beginning hormone replacement therapy and updating the name and gender marker on ones passport, as well as seemingly mundane (but surprisingly difficult) tasks like buying the right bra.

The goal, according to Solace co-founder Robbi Katherine Anthony, is to help users make their transitions as easy as possiblesomething she wished she could be able to say about her own.

Transition is beautiful, but its also incredibly hard, Anthony told VICE.

Born in New Mexico, the 27-year-old software developer now lives in Spokane, Washington. She came up with the idea and designs Solace with fellow developer Patrick McHugh, and turned to Crowdbotics, a software company in Berkeley, to build out the app. As Solaces only full-time employees, Anthony and McHugh run an extraordinarily lean operation, bouncing between Anthonys home, her 1998 blue Honda CR-V, and whatever coworking space they might be working in on a given day. Its fly or die every single day here, said Anthony. But shes committed to making something that she hopes makes transition a little less confusing, a tool she would have appreciated if it had existed all those years ago.

My transition has been rough, she told VICE. But Ill be damned if I dont do everything in my power to help others avoid that.

Solace co-founders Patrick McHugh (L) and Robbi Katherine Anthony (R). Photo courtesy of Robbi Katherine Anthony.

Anthony said that one of the biggest hurdles she faced in the early stages of her transition was finding out how to transition in the first place. She blamed a lot of this inaccessibility on gatekeeping, a term that, in a trans context, often refers to the many ways in which a health care professional can refuse gender-affirming care to a trans patientsay, a doctor who wont prescribe hormones, or surgeon who wont operate on a woman he doesnt find attractive or cis-passing enough for his standards. Anthony told VICE that she experienced this kind of medical gatekeeping firsthand, but she also used the term to describe her experiences with other trans people.

Certain people in the community become gatekeepers of information, Anthony said. Transition is a model of oral tradition, but if you have to meet people in order to transition, that inherently limits transition to people who can access that network. Some people physically cannot do that or dont want to. That information is also highly anecdotal, which she said is a problem because it ignores how one persons circumstances are not analogous to another persons.

Solace disrupts that model, she continued. If the process could be reduced from finding the right gatekeepers to having a compendium that allows you to proceed on your own terms, I think it would be healthier.

I asked Anthony if creating Solace, an app designed to circumvent community gatekeepers, might turn her into the very trans community gatekeeper she set out to circumvent.

Thats a really fair question, Anthony said. Gatekeeping, in its most nefarious forms, requires folks to do some interaction in order to get information. Whether its being approved by a moderator to join a group, seeking out a time or space or venue based on terms dictated by someone else, or being forced to curry favor with someone for them to share informationthats gatekeeping in my book.

Solace, which launched in December 2019, is quite unlike any of the other trans-specific apps available through Apples App Store. Searching for trans or transgender on my iPhone turns up an endless scroll of dating apps for cis men trying to meet trans women and crossdressers with nearly illegibile, knockoff brand names like Tinded, Sinder, and Transdr. Theyre mostly godawful, Anthony said. Fetishizing trans people... transsexual dating dot this, and stuff. There are a few practical options that actually seem to have been designed with a trans user in mind, like audio recording apps to practice voice modification, crowdsourced safe restroom finders, and a selfie-driven transition tracker. But nothing is quite as comprehensive as Solace, which contains more than 180,000 words of text, according to Anthonys estimate.

The app gives users the ability to curate a custom checklist of transition tasks, which are divided into three categories: legal (updating your birth certificate, what you can do about workplace discrimination); lifestyle (coming out to your family, connecting with other trans people); and medical (facial feminization surgery, laser hair removal, family planning). Every item is comprehensive, containing lots of actionable information about the task at hand. The coming out to family entry, for example, includes both tips on what to do (write a coming out letter to each and every family member, ask to be called by your name and pronouns, be ready to explain what transgender means) along with general advice (make sure you are sober when you come out, be prepared to lose your housing or financial support).

Many of the resources are tailored to the users gender identity and location, as non-discrimination laws and the legal hoops one has to hop through in order to change the name and gender marker on their state-issued documents vary by state. For example, the page for updating your birth certificate in Arizona correctly notes that youll need an affidavit, a certified copy of a court order, a photo copy of a valid government-issued ID, a signed letter from your physician verifying that youve undergone a sex change operation, and a small fee. The page for Washington is significantly shorter, as the Evergreen State doesnt require surgery or a fee.

Solace is free to download and the creators have no intention of selling user data to third parties. We will never charge a penny, Anthony said. Were currently donor supported. We tap into foundation support, sometimes as grants. Were structured as a nonprofit. This community faces a disproportionate amount of poverty, so putting a paywall on this thing felt counterintuitive to what we were trying to do. And data-mining, she paused. Our stomachs turn at the thought of it.

Anthony declined to share how many people have downloaded Solace since launch, though she said she and McHugh are currently halfway to reaching their 2020 user goal. The app has had a number of updates since its December launch, like the addition of more detailed information regarding Medicaid coverage for trans care in different parts of the country. Anthony said that she also plans to integrate a news aggregator with articles about a variety of trans topics, implement dynamic pronouns within the apps copyto match the pronouns the user enters, and launch a mode for parents and guardians of trans kids.

Listening to Anthony talk, I couldnt help but think about how different my experience with transitioning has been. Its not that I havent had to seek out other trans people to find out who they see for laser hair removal or whether progesterones really worth the hype; Ive had to do all of those things. The difference is that I view them as positives rather than negatives. Ive found a lot of value in talking to other trans people about their experiences and sifting through their anecdotal experiences to figure out what might be right for me. Im deeply grateful for all the friendships Ive made and communities Ive joined after putting myself in uncomfortable, new social situations. I asked Anthony if she was concerned that an app like Solace might lead trans people away from their local communities. Its a byproduct were aware of, she said, but I wouldnt say that its a goal of ours.

Our entire ethos is about providing this community with agency, and part of agency is allowing people to access information on their own terms, she said.

Solace might not be of that much use to me, an extrovert in a major city whos already in community with other trans people (and my questions at this point of my transition are more existential than they are practicalless about how do I do this or how do I do that, and more about what do I do now). But it could be useful to people who dont know any trans people, or live in a part of the country with no visible local community, and might be particularly helpful for early transitioners or trans people who havent come out yet and are still trying to figure out where to begin.

Regardless of who makes use of Solaces many comprehensive resources, Anthony was clear about one thing: she doesnt want anyone to rely on the app forever. The ultimate sign of Solaces success is that the user deletes the app because they dont need it anymore, she said.

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Want to Transition? There's an App for That - VICE

Anti-Osteoporosis Therapy And Fracture Healing Market (2018) Report Provides an in-depth summary of Anti-Osteoporosis Therapy And Fracture Healing Market Status as well as Product Specification, Technology Development, and Key Manufacturers. The Report Gives Detail Analysis on Market concern Like Anti-Osteoporosis Therapy And Fracture Healing Market share, CAGR Status, Market demand and up to date Market Trends with key Market segments.

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Leading manufacturers of Anti-Osteoporosis Therapy And Fracture Healing Market:

The following manufacturers are covered:NovartisJohnson and JohnsonGlaxoSmithKline PLCRochePfizerMERCKAMGEN

Segment by RegionsNorth AmericaEuropeChinaJapanSoutheast AsiaIndia

Segment by TypeBisphosphonatesCalcitoninEstrogen or Hormone Replacement TherapyBiologicsAnabolics

Segment by ApplicationHospital PharmaciesPrivate ClinicsDrug StoresRetail PharmaciesE-Commerce

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Table of Content of The Report

Chapter 1- Anti-Osteoporosis Therapy And Fracture Healing Industry Overview:

1.1 Definition of Anti-Osteoporosis Therapy And Fracture Healing

1.2 Brief Introduction of Major Classifications

1.3 Brief Introduction of Major Applications

1.4 Brief Introduction of Major Regions

Chapter 2- Production Market Analysis:

2.1 Global Production Market Analysis

2.1.1 Global Capacity, Production, Capacity Utilization Rate, Ex-Factory Price, Revenue, Cost, Gross and Gross Margin Analysis

2.1.2 Major Manufacturers Performance and Market Share

2.2 Regional Production Market Analysis

Chapter 3- Sales Market Analysis:

3.1 Global Sales Market Analysis

3.2 Regional Sales Market Analysis

Chapter 4- Consumption Market Analysis:

4.1 Global Consumption Market Analysis

4.2 Regional Consumption Market Analysis

Chapter 5- Production, Sales and Consumption Market Comparison Analysis

Chapter 6- Major Manufacturers Production and Sales Market Comparison Analysis

Chapter 7- Major Classification Analysis

Chapter 8- Major Application Analysis

Chapter 9- Industry Chain Analysis:

9.1 Up Stream Industries Analysis

9.2 Manufacturing Analysis

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Anti-Osteoporosis Therapy And Fracture Healing Market : Trends and Future Applications - News Times

Eon Market Research currently generated a research report titled, Global Hormone Replacement Therapy Market Research Report 2020. The studies report represents the ability growth opportunities that prevail within the worldwide market.The document is analyzed on the idea of secondary research methodologies acquired from historic and forecast data. The global Hormone Replacement Therapy marketplace is predicted to grow significantly and thrive in terms of quantity and price all through the forecast period. The record will provide an perception approximately the growth possibilities and restraints that construct the marketplace. Readers can benefit significant comprehension approximately the destiny of the marketplace.

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Estrogen Replacement TherapyThyroid Replacement Therapy

By Application:

OralParenteralTransdermal

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Global Hormone Replacement Therapy Market 2025 Forecasts and Analysis with Top Key Players like - Merck Serono, Novo Nordisk, Eli Lilly - Fashion...

ATLANTA, Feb. 24, 2020 (GLOBE NEWSWIRE) Today, the American College of Rheumatology (ACR) published the . This is the first, evidence-based, clinical practice guideline related to the management of reproductive health issues for all patients with rheumatic diseases. With 131 recommendations, the guideline offers general precepts that provide a foundation for its recommendations and good practice statements.

This guideline is paramount, because it is the first official guidance addressing the intersection of rheumatology and obstetrics and gynecology (OB-GYN), said Lisa Sammaritano, MD, lead author of the guideline. Rheumatic diseases affect many younger individuals; however, little education has been provided to rheumatology professionals on current OB-GYN practices. The guideline [and more detailed ] presents vital background knowledge and recommendations for addressing reproductive health issues in the full spectrum of rheumatology patients, with additional focus on specific diagnoses that require more detailed recommendations such as (SLE) and (APS).

The guideline provides 12 ungraded good practice statements and 131 graded recommendations that are intended to guide care for rheumatology patients except where indicated as being for patients with specific conditions or antibodies present. Good practice statements are those in which indirect evidence is compelling enough that a formal vote was considered unnecessary; these are ungraded and are presented as suggestions rather than formal recommendations. The recommendations were separated into six categories: contraception, assisted reproductive technology (fertility therapies), fertility preservation with gonadotoxic therapy, menopausal hormone replacement therapy, pregnancy assessment and management, and medication use.

While some of the recommendations are strong, many of the recommendations presented are conditional due to a lack of data. Pregnant women are not generally enrolled in clinical studies; and few maternal health studies focus on rheumatology patients. A few notable recommendations from each category include:

Contraception

Strong recommendation for women with rheumatic disease who do not have lupus or APS to use effective contraceptives with a conditional recommendation to preferentially use highly effective IUDs or a subdermal progestin implant.

Strong recommendation against using combined estrogen-progestin contraceptives in women who test positive for anti-phospholipid autoantibodies (aPL) or APS.

Assisted Reproductive Technology (Fertility Therapies)

Strong recommendation for fertility therapy in women with uncomplicated rheumatic disease who are receiving pregnancy-compatible medications, whose disease is stable, and who test negative for aPL. Specific recommendations also address patients testing positive for aPL and suggest an anti-blood clotting procedure.

Conditional recommendation against increasing prednisone dosage during fertility therapy procedures in lupus patients.

Fertility Preservation

Conditional recommendation against testosterone co-therapy in men with rheumatic disease receiving cyclophosphamide (CYC) and a good practice suggestion to cryopreserve sperm before CYC treatment in men who desire it.

Conditional recommendation for monthly gonadotropin-releasing hormone agonist co-therapy for premenopausal women with rheumatic disease who are receiving monthly CYC injections/infusions to prevent premature ovarian insufficiency.

Pregnancy Assessment and Management

Strong good practice suggestion to counsel women with rheumatic disease, who are considering pregnancy, on the improved maternal and fetal outcomes associated with entering pregnancy during low disease activity.

Conditional recommendation to treat lupus patients with low-dose aspirin daily (81 to 100 mg) starting in the first trimester. For women testing positive for aPL who do not meet the criteria for obstetric or thrombotic APS, it is conditionally recommended to preventatively treat with a daily aspirin (81 to 100 mg) starting early in pregnancy and continuing through delivery.

Menopause and Hormone Replacement Therapy

A good practice suggestion to use hormone replacement therapy in postmenopausal women with rheumatic disease who do not have lupus or have a positive aPL test; and who have severe vasomotor symptoms, have no contraindications, and desire treatment.

A conditional recommendation for hormone replacement therapy in women with lupus and without aPL.

Conditionally recommend against treating with hormone replacement therapy for women with asymptomatic aPL, and strongly recommend against hormone replacement therapy for women with any form of APS.

Medication Use (Paternal and Maternal)

Strongly recommend against use of CYC and thalidomide in men prior to attempting conception.

Strong recommendation against the use of NSAIDs in the third trimester.

Individuals involved in the development of the new guideline included rheumatologists, obstetrician/gynecologists, reproductive medicine specialists, epidemiologists, and patients with rheumatic diseases. ACR guidelines are currently developed using the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, which creates rigorous standards for judging the quality of the literature available and assigns strengths to the recommendations that are largely based on the quality of the available evidence.

This guideline should open avenues of communication between the rheumatologist and the patient, as well as between the rheumatologist and the OB-GYN, said Dr. Sammaritano. A better understanding of the risks and benefits of reproductive health options will enhance patient care by providing safe and effective contraception, improving pregnancy outcomes by conceiving during inactive disease periods, and allowing for continued control of rheumatic diseases during and after pregnancy with the use of well-suited medications.

A draft of the guideline was presented during the 2018 ACR/ARP Annual Meeting in Chicago. Since that time, the guideline team has condensed the original three-part draft into a single, concise manuscript, with detailed background and discussion now available . The guideline development team also incorporated color-coded flow charts to highlight common decision-making points to make it user friendly.

The paper containing the full list of recommendations and supporting evidence is available at

###

About the American College of Rheumatology The American College of Rheumatology (ACR) is an international medical society representing over 8,500 rheumatologists and rheumatology health professionals with a mission to empower rheumatology professionals to excel in their specialty. In doing so, the ACR offers education, research, advocacy and practice management support to help its members continue their innovative work and provide quality patient care. Rheumatologists are experts in the diagnosis, management and treatment of more than 100 different types of arthritis and rheumatic diseases. For more information, visit .

Monica McDonald American College of Rheumatology ext. 332 mmcdonald.org

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American College of Rheumatology Releases First Guideline to Address Reproductive Health for Patients with Rheumatic Diseases - Myers Messenger

COLUMBIA, S.C. Theres no mystery. The risk of developing heart disease increases for everyone as they age. This is no different for women and yet many people still believe it is a mans disease.

The American Heart Association (AHA) says it is the leading killer in women. In fact, one in three adult women, thats over 30 percent of the adult female population, have some form of cardiovascular disease.

Midlife is not just a period where women have hot flashes and experience other menopausal symptoms. For women, the risk of developing cardiovascular disease goes up about 10 years after menopause.

Remember, menopause is not a disease, it is a natural part of aging and does not cause cardiovascular disease, however hormone fluctuations in midlife may play a part.

What are midlife women at risk for heart disease?

Estrogen, the primary female sex hormone, has a positive effect on your blood pressure and cholesterol, and both are beneficial when it comes to heart disease.

Heart doctors believe healthy levels of the natural hormone estrogen keep blood vessels flexible. That means the blood vessels can relax and expand to accommodate healthy blood flow. When estrogen decreases during menopause, blood vessels tend to get stiff. Women no longer have their natural protection against heart disease and stroke. Doctors believe this is the reason why women tend to develop heart disease ten years later than men.

According to a research team led by scientists at the University of Pittsburgh Graduate School of Public Healththere is also evidence suggesting the changes that affect the heart may occur earlier in black women than white women.

How can women decrease their heart disease risk?

Less estrogen is not the only reason women are at risk. Estrogen does help protect the body but there can be other changes that happen during menopause.

Blood pressure and cholesterol tend to increase as well. Combine those changes with other lifetime bad habits like smoking cigarettes and vaping, a diet high in fat and cholesterol, or a family history of heart disease and there can be trouble ahead.

Despite the benefits of natural estrogen, The American Heart Association does not recommend postmenopausal hormone replacement therapy (HRT). Heart doctors say there is not enough proof HRT helps reduce the risk of heart disease. Instead they say the opposite has been shown. HRT could increase your risk of blood clots and cancer.

The American Heart Association does say it is reasonable to appreciate the benefits of estrogen and recommend helping your heart be healthy. The ticket to that includes behavior that can contribute to overall good health and delay the onset of menopause. Quitting smoking, getting regular exercise and eating a nutritious diet are all steps that are proven to significantly reduce the risk of heart attack.

The American Heart Association does recommend establishing a plan of action with your health care provider.

More:
Why your heart needs extra love and care during menopause - WLTX.com

Dr. Fulton is dedicated to providing all of his patients with a superb level of care.

Dr. Fulton is dedicated to providing all of his patients with a superb level of care. He emphasizes using the most effective health techniques to ensure that his patients are in the best position to resolve their health issues. Dr. Fulton is also very accomplished in several medical fields. He is a Diplomate of the American Academy of Anti-Aging Medicine and the American Board of Phlebology and board-certified in Emergency Medicine.

Speaking upon his work, Dr. Fulton stated, I have a passion for exploring new ways to help people feel better. Thats what originally drew me to becoming a doctor and continues to drive me. He also stated that My mission is to deliver the best care using the most advanced technology and techniques to give every client the best possible outcome.

Since adding Simpatra's BHRT and technology services to his practice, Dr. Fulton has been able to provide his patients with more options to relieve their health issues. The addition of Simpatras Technology suite to his practice allows Dr. Fulton to go the extra mile to ensure that his patients are receiving the highest quality of care. His practice SKINovative located in Gilbert, Arizona provides hormone replacement therapy for both men and women.

Doctor Contact:William Fulton, MD2557 South Val Vista Drive, Gilbert, AZ 85295https://simpatra.health/listing/william-fulton-md-hormone-replacement-therapy/

About Simpatra.Health:

Providers investing in Patients with Simpatra.Health

Simpatra.Health, working hand in hand with your provider to enhance every aspect of your patient journey. The goal is to use unique technologies to elevate patient outcomes and to improve patient outreach. Ranging from complex algorithms used during procedures, simple emails informing you of your appointment, or aftercare articles to make you feel more comfortable about the treatment you just received. Whatever your visit might entail, we are firmly committed with your provider in ensuring that every patient has a consistent medical experience and receives the highest quality of care.

Contact:Simpatra.Health15210 N. Scottsdale Rd. - Suite 210pr@simpatra.com480-682-4850https://www.simpatra.health

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Dr. Fulton - Providing a High-Quality of Care for His Patients for Over 20 Years -Simpatra.Health - PR.com

CHARLESTON, W.Va. Delegate S. Marshall Wilson, I-Berkeley, today announced the introduction of a bill to limit gender reassignment surgeries and hormone replacement therapies to consenting adults in this state.

House Bill 4609 would create new code stating that any minor seeking gender reassignment surgery before 18 years of age shall be denied any such request on the basis that the minor cannot provide consent for gender reassignment surgery by any licensed healthcare provider that provides services in this state.

It is my belief that its simple common sense to recognize that irreversible, life-altering decisions such as permanently changing the appearance and function of ones body or losing the ability to procreate should be made by thoughtful adults rather than by adolescents, said Delegate Wilson.

Additionally, the bill states parents, guardians, or other legal custodians of a minor child seeking gender reassignment surgery may not substitute his or her consent for that of the minor child for purposes of circumventing this proposed new law, if passed.

House Bill 4609 was introduced Jan. 30 and was referred to the House Judiciary Committee.

Tyler Barker is currently the News Director and Digital Content Manager for WOAY-TV. He was promoted to this job in Mid-November. He still will fill in on weather from time to time. You can Follow Tyler on Facebook and Twitter @wxtylerb. Have any news tips or weather questions? Email him at tbarker@woay.com

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Delegate Wilson Introduces Bill to Limit Gender Reassignment and Hormone Therapy for Minors - WOAY NEWSWATCH

Breast cancer is the most common cancer in women. Also, it is a cancer that, after treatment, can recur more often, even after many years of remission. In the light of this, it is important to consider any factor that increases the risk.

A meta-analysis published in the medical journal The Lancet last August has added to the body of evidence which highlights the risk of breast cancer with hormone replacement therapy (HRT).

The meta-analysis points to an excess breast cancer risk associated with the use of all types of HRT, except vaginal oestrogens.

It also found that the excess risk of breast cancer with systemic HRT persisted after stopping HRT for more than 10 years, when compared with newer users.

The potential harm may outweigh the potential benefits for women who are using HRTs for the long-term prevention of osteoporosis. There are other non-HRT therapies for the treatment and prevention of osteoporosis.

Also, HRT does not protect post-menopausal women against cardiovascular events and heart disease, and hence should not be used for this purpose.

After the publication of studies highlighting the risk in 2002 and 2003, the use of HRT declined for a while.

However, there seems to be a resurgence in the use of HRT, with doctors dismissing the risk as minimal and communicating that HRT use for a short time is relatively safe.

In the light of the Lancet publication, there needs to be an evaluation of such a stance, especially as breast cancer is not a cancer to be taken lightly.

Quek Koh Choon

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Forum: Evaluate stance on hormone replacement therapy due to risks - The Straits Times

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Women going through the menopause face more shortages of hormone replacement therapy drugs.

Health Secretary Matt Hancock has pledged to intervene but drugs companies admit some treatments will be out of stock until later this year.

Munira Wilson, the Lib-Dem MP for Twickenham, said the lack of availability of HRT drugs for some women was critical. She challenged Mr Hancock in Parliament to address the shortages, which first emerged about a year ago.

She told the Standard: Anecdotal evidence I have picked up from talking to people, and what Ive found out, has concerned me. HRT helps manage a lot of difficult symptoms of the menopause.

One London woman said she began experiencing problems obtaining Elleste Duet pills almost a year ago. She suffered extreme tiredness, night sweats and sleep deprivation after having to switch medications.

Health Secretary Matt Hancock said shortages of HRT therapies were an incredibly important issue (AFP via Getty Images)

She had to find the next best alternative herself because her GP had little knowledge of the menopause and HRT.

If you find the drug you have tried and tested is no longer available, it is quite difficult, the woman said. You cant just instantly swap to another one [without side-effects]. My experience was when I went to the pharmacist, they were not able to tell me why it was out of stock. They just say its not available.

She added: People think the menopause is something old ladies have. But there will be millions affected.

Andre Frieze, a mother of two and councillor in Richmond, said she had been unable to obtain Evorel patches since the start of the month.

She said they had dramatically improved her quality of life when she started taking them last summer.

How will UK healthcare change after Brexit?

I was sleeping a lot of the time, which is unlike me, she said. Im normally somebody who has quite a lot of energy. Emotionally I would say I was a bit all over the place. My husband started to say he was slightly scared of me.

The day after I had the first patch I just felt myself again. This [supply shortage] is not just about the headaches. It seriously impacts on my ability to live my life as a working woman.

Mr Hancock said shortages of HRT therapies were an incredibly important issue and stemmed from problems with factories abroad. Last October the Government imposed restrictions on exports of UK-manufactured HRT medications in a bid to shore up supplies.

The British Menopause Society this week warned that Indivina tablets will be out of stock until the end of next month, some Evorel patches will not be available until March and some FemSeven patches may be unavailable until next year. Problems are said to include manufacturing issues, shortages of raw ingredients, regulatory issues and some firms withdrawing products.

The Department of Health and Social Care believes supplies will improve by the end of February. It did not know how many women had been unable to receive HRT.

A spokesman said: We understand how distressing the HRT shortage is for women who need these medicines and we have been doing everything we can to ensure they can access them as soon as possible We are working closely with all suppliers to resolve this issue as soon as possible.

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Women faces months waiting for out-of-stock hormone replacement therapy treatments - Evening Standard

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Arteriosclerosis, Thrombosis, and Vascular Biology; U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495; HL065581, HL065591

Newswise PITTSBURGH, Feb. 3, 2020 A marker for heart disease risk considerably worsens as women transition through menopause, according to a new analysis from the largest and longest running study of womens health in midlife, the Study of Womens Health Across the Nation (SWAN). Black women experience this accelerated decline earlier in menopause than their white counterparts.

According to the research team, led by scientists at the University of Pittsburgh Graduate School of Public Health, the findings add to growing evidence that menopause is a critical time for changes in cardiovascular health and underscore the importance of women and their doctors focusing on heart health during the menopausal transition. The results are reported online and will appear in the March issue of Arteriosclerosis, Thrombosis, and Vascular Biology, a journal of the American Heart Association.

Midlife is not just a period where women have hot flashes and experience other menopausal symptoms said senior author Samar R. El Khoudary, Ph.D., M.P.H., associate professor of epidemiology at Pitt Public Health. Its a time when their cardiovascular disease risk is increasing as we see significant changes in multiple clinical measures of their physical health.

El Khoudary and her team used a subset of data from SWAN Heart, an ancillary study that enrolled women from Pittsburgh and Chicago between 2001 and 2003 and included two examinations of early markers of cardiovascular health over time. Ultimately, 339 women were included in this study, 36% black and the rest white.

The study focused on how arterial stiffness changes as women transition through menopause. Arterial stiffness refers to the elasticity of arteries and is measured by looking at how fast blood flows through arteries. Stiffer arteries can lead to dysfunction in how well the heart pumps and moves blood, and damage to the heart, kidneys and other organs.

The researchers tracked the women through SWAN for up to 12.5 years, or until they reached menopause, allowing them to confidently anchor the arterial stiffness measure to the menopausal transition.

On average, as women went through menopause, their arterial stiffness increased by about 0.9% up to one year before their last menstrual period to about 7.5% within one year before and after their last period, a considerable acceleration. The black women in the study experienced greater increases in arterial stiffness earlier in the transition than white women, more than a year before menopause. The findings held after adjusting for numerous factors that could affect heart health, including waist circumference, blood pressure, lipids, smoking status, physical activity levels and financial stress.

SWAN is a unique source of data on changes in womens health over several decades, and this is the latest in a long line of research by our team and others that indicates the menopausal transition is a very important time for heart health, said lead author Saad Samargandy, M.P.H., a Ph.D. student at Pitt Public Health. While there are limitations to our study, including that a sizeable minority of the women had their arterial stiffness measured at only one time point, we were still able to see that major changes to cardiovascular disease risk happen around menopause.

This study follows several others that link the menopausal transition to the accumulation of heart fat, changes in cholesterol, inflammation and coronary artery calcification, among other heart disease risk factors.

Our study is not able to tell us why were seeing these changes during the menopausal transition, El Khoudary said. But we speculate that the dramatic hormonal changes accompanying menopause might play a role by increasing inflammation and affecting vascular fat deposition, a hypothesis that we would like to test in future studies.

Clinical trials will be needed to test if lifestyle interventions, such as changes to diet or physical activity; medications, such as statins or hormone replacement therapy; or even increased screening and tracking of measures of heart health could be beneficial as women go through menopause, she said.

But we can say, right now, that women should be made aware that their cardiovascular health is likely to worsen as they go through menopause, El Khoudary said. Therefore, frequent monitoring of cardiovascular risk factors may be prudent, particularly in black women who are at even greater risk earlier in the menopausal transition.

Additional authors on this research include Karen A. Matthews, Ph.D., Maria M. Brooks, Ph.D., Emma Barinas-Mitchell, Ph.D., and Jared W. Magnani, M.D., M.Sc., all of Pitt; Imke Janssen, Ph.D., of Rush University; and Steven M. Hollenberg, M.D., of Cooper University Hospital.

This research was funded by National Institutes of Health grants U01NR004061, U01AG012505, U01AG012535, U01AG012531, U01AG012539, U01AG012546, U01AG012553, U01AG012554, U01AG012495, HL065581 and HL065591.

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Link:
Heart Disease Risk Grows as Women Move Through Menopause - Newswise