The Menopause Minute - Volume 65

Dear Red Hot Mamas,

Menopause is a girl’s only club and there are many of us out there.  In 2005, the total estimated postmenopausal women worldwide was 477 million.  It is predicted, that by 2025, the total number of postmenopausal women will be 1.1 billion. These women, like you, want to continue to feel good as they grow older.

It's important for all women not to wander blindly through the menopause transition. But, rather, gather information about the menopause process, understand what to expect when it arrives, how to manage its course, and have a clear understanding of health vulnerabilities women face as they enter their postmenopausal years.

By educating yourself, the journey through menopause will not catch you by surprise. It's important to be proactive in your health, especially at menopause. Our risks of age related diseases, including heart disease and osteoporosis greatly increases during the menopause, so preventative health care becomes exceedingly important.

Red Hot Mamas hopes that we can provide you with information and support.  Good decisions involve gathering information, evaluating information as it implies to your health, then discussing this information with your clinician.

I have exciting news to share this month! First, I attended the North American Menopause Society's 20th Annual Meeting held on September 30-October 3rd in San Diego. Dr. Wulf Utian founded NAMS in 1989.  And he is, without doubt, one of the most significant authorities in the world on menopause. At this meeting, Dr. Utian retired his position as Executive Director from NAMS. He has been a sturdy fixture of NAMS.

His vigor,  loyal service rendered, the understanding he has shown to all the complex issues surrounding menopause, and the wise counsel he gave to all of the 2,000 members of NAMS, will greatly be missed.  In saying farewell to Dr. Utian,  I personally hope that it will not be good-bye, but as they say in Italian, ci vediamo (see you soon).  And that, Dr. Utian will continue to provide us his insights on how we can take care of our lives now and in the future.  On behalf of Red Hot Mamas, and our website partners Vibrance Associates,  I send, Dr. Utian and his wife, Moira (the 1st Lady of Menopause), wishes that they both may continue to enjoy life at its best. 

Secondly, I'd like to make you aware of Red Hot Mamas on QVC. On September 21st, I launched the first Red Hot Mamas show on QVC!  QVC loved Red Hot Mamas so much that they've tapped into my wisdom and now have branded products for women under Red Hot Mamas Outsmarting Menopause label.  These products were introduced on our first show and served as the launch of our first line of products.  There are many more products now in development which appear in future shows.

This October, the Red Hot Mamas Program Spotlight is on Carilion New River Valley Medical Center (CNRVMC) in Christiansburg, VA. In February 2006, CNRVMC launched Red Hot Mamas to a standing room only room full of sassy, energetic, focused, and VERY motivated women! As they prepare to schedule the fifth year of meetings, Mary Arnold, Women’s Health Navigator and RHM Program Director at CNRVMC, is pausing to reflect on the success and continued interest in this vital program. According to Mary, “the women of the New River Valley have spoken; verbally through their topic suggestions and non-verbally via their attendance.” 

“They want information and they want to be actively involved in the management of their menopausal transition,” says Mary. “They want validation that their experience is real and that their concerns hold value and merit,” adds Mary. In closing, Mary shared that it’s an honor to host the programs and to meet the needs of the women who participate.  Mary, we thank you for all of your hard work to provide menopause education and support to women in your community.  We hope that the fifth year will be the best yet!

This month, we would like to welcome Heart of Lancaster Regional Medical Center (Lititz, PA) and Porter Adventist Hospital (Denver, CO) – two new healthcare facilities that will be providing free monthly Red Hot Mamas menopause education and support in the upcoming months. We would also like to thank Alton Memorial Hospital in Alton, IL for showing tremendous commitment to providing women and their friends and families with important menopause healthcare information by renewing their Red Hot Mamas program. Here's to another successful year! Please be sure to view the complete online list of our programs to find a location near you.

And, we always like hearing from you, so please don't forget to:

1. Tell us if you would like a Red Hot Mamas program in your area
2. Log onto our Bulletin Board - chat with others experiencing menopause
3. Ask the experts - get answers to your health related questions

Good Health To You All,

Karen Giblin
Founder and President
Red Hot Mamas

Written by Menopause Minute^® Editors

October is National Breast Cancer Awareness Month (NBCAM) and it is difficult to believe it is merely a coincidence that World Menopause Day falls right smack in the middle of it!  Every year, the International Menopause Society designates October 18th to promote menopause education and challenge women to use this day to have an important conversation with their doctors. That conversation should encompass steps to take charge of your health, including how to take advantage of early detection of breast cancer.

Since the inception of the NBCAM program in 1985, mammography rates have more than doubled for women age 50 and older and breast cancer deaths have declined. But, there are still women who do not take advantage of early detection at all and others who do not get screening mammograms and clinical breast exams at regular intervals.

• Women age 65 and older are less likely to get mammograms than younger women, even though breast cancer risk increases with age.
• Hispanic women have fewer mammograms than Caucasian women and African women.
• Women below poverty level are less likely than woman at higher incomes to have had a mammogram within the past two years.
• Mammography use has increased for all groups except American Indians and Alaska Natives.

“If all women age 40 and older took advantage of early detection methods –mammography plus clinical breast exam – breast cancer death rates would drop much further, up to 30 percent,” says Red Hot Mamas Founder and President, Karen Giblin.

It is very fitting that World Menopause Day coincides with Breast Cancer Awareness Month. Although breast cancer risk increases with age, it is not specifically affected by menopause. Nearly one half of all breast cancer cases occur in women aged 65 years and older. The average age of the onset of menopause is around age 51; give or take 5 years.

And, of course, with menopause usually comes some form of a hot flash firestorm, along with the other 7 Menopausal Dwarfs. Currently, hormone therapy (HT) is the most effective way to relieve moderate to severe menopausal symptoms, such as hot flashes, night sweats and vaginal dryness, not to mention the great improvement it has on quality of life for many women.

The most widely discussed serious adverse effect of HT is breast cancer. In fact, the Women’s Health Initiative (WHI) study has shown that the risk of breast cancer increases with use of EPT (not to be confused with estrogen-only therapy), beyond 5 years. But, most women who start HT to quell hot flash flames are relieved of their symptoms and can taper off well before breast cancer risk increases.

Every woman should have a breast exam and mammogram prior to starting HT and at regular intervals thereafter. “The key to mammography screening is that it be done routinely – once is not enough,” says Giblin. “Women need to know their personal health risks, and women need to discuss their options with their doctors, including those of nutrition, exercise and hormone therapy.”

For World Menopause Day this year, of course remember your Important Tests at Menopause. Make a note to have the important discussion with your doctor about your health at menopause, especially about your annual mammogram beginning at age 40 (in the absence of unusual findings) and before initiating HT.

For more information:
International Menopause Society – World Menopause Day
National Breast Cancer Awareness Month
North American Menopause Society

Written by Katherine Corso, MPH, Dana Farber Cancer Institute

Understanding Your Cancer Risk

Every woman has some chance of developing breast or ovarian cancer in her lifetime, but some individuals have a higher risk than others. Risk factors include age, family cancer history, reproductive factors, a personal history of breast abnormalities, and levels of physical activity. 

What You Can Do

If you or your doctors think you may have a high cancer risk, the team of specialists at the Friends of Dana-Farber Cancer Risk and Prevention Clinic can provide you with a thorough cancer risk evaluation and discuss the steps you can take to help lower your risk of developing cancer.  

• We provide thorough evaluation and risk assessment, including genetic testing for cancer susceptibility
• Education about cancer risk
• Clinical research studies 

Here’s a brief description of two of our studies:

PACE is a six-month pilot exercise intervention study for women at increased breast cancer risk. Studies have found that regular exercise and having a healthy weight are associated with decreased risk of getting breast cancer in both pre-menopausal and post-menopausal women. We are conducting this study to help determine whether women who are at high breast cancer risk will take part in an exercise intervention study to help them become more physically active.

ExCel is a five year phase III breast cancer prevention clinical trial. It is a trial designed to determine whether the medication exemestane can prevent breast cancer in healthy post-menopausal women who have an increased risk for developing breast cancer.

The ExCel research study is coordinated by the NCIC Clinical Trials Group in cooperation with healthy women and cancer centers in the United States, Canada, Spain and France. The NCIC CTG is funded by the Canadian Cancer Society Research Group.

Contact Us

If you have questions about the clinic, or would like to schedule an appointment, please call 617-632-2178. 

Please also visit our website: www.dana-farber.org/cancerriskandprevention

Written by Menopause Minute^® Editors

Not only am I an insomniac with a hot flash problem, but recently, I find myself sneezing and itching more than usual. What is going on? After some complaining and discussion with my doctor, I found out this is a common question for peri-post menopausal women.

So, what exactly is an allergy?  An allergy is a reaction of the immune system which is responding to certain substances called allergens. Most allergens are harmless to non-allergic people, but in allergic people they can produce serious immune system reactions.  The severity of an allergic reaction may depend on the type of allergen, the level of exposure and each individual's immune response.

When an allergic person’s immune system encounters an allergen, it may cause an increase in the production of IgE antibody in their body.  IgE antibodies cause cells to release a chemical called histamines into the bloodstream. Histamine is responsible for the symptoms that you may feel (stuffy nose, itchy eyes, etc.), when you have an allergic reaction.  Also, this is why antihistamine drugs are used to control the symptoms of allergy.

As more medical professionals further their research in the occurrence of allergies at menopause, it may be helpful for you to understand the link between the two.  

The Hormone – Allergy Connection
Hormones play an important role within our body’s immune system. As a woman experiences hormonal fluctuations during menopause, it may compromise her immune system, making her more susceptible to suffer ailments that she may have never suffered before, including allergies. 

Many women report that they experience symptoms of allergies for the first time in their lives as they approach menopause.  Mild to severe allergic symptoms can even appear for the first time during menopause.

Common allergens include pet dander, pollen, dust mites, molds and certain types of foods. But almost anything can cause an allergy in a person. Some allergic reactions may appear in the form of a rash, acne, rosacea, psoriasis, seborrheic dermatitis, eye discomfort, congestion, sneezing, abdominal pain, vomiting, diarrhea, mental confusion, hives, and in rare cases anyphylaxis shock.

One reason for hormonally-driven fluctuations in allergies and asthma is a reduction in cortisol (an immune regulator and anti-inflammatory agent). When this occurs, the body compensates by producing more adrenalin, causing inflammation and hence, an increase in allergic and asthma symptoms.

Can Hormone Therapy (HT) Help Allergies?
Although some studies show that HT can worsen asthma, in some women, HT actually can improve asthma. Studies have produced mixed results, resulting in a lack of consensus.

As we all know, during menopause, estrogen and progesterone levels decline. Some researchers believe these hormonal changes can really exacerbate an allergy and asthma. According to Dr. Francisco Gomez Real of the University of Bergen in Norway, “Asthma risks double during menopause.”  Dr. Real’s research suggests the women who go through menopause have nearly, “…double the risk of suffering respiratory diseases such as asthma, but could protect themselves by taking hormone therapy."

On the other hand, an ongoing Harvard Nurses’ Health Study found that women on HT for ten years or more years are twice more likely to develop asthma than women who never used HT. The use of HT in this study actually made asthma symptoms worse for menopausal women, causing inflammation that precipitated symptoms of adult-onset asthma. The risk of asthma increased with the use of high doses and longer use of estrogen.
Overall, keep in mind that although HT use in the women increased their incidence of asthma, the overall chance of developing asthma is very low, only about 1 percent or less. And the risk applies only to women who have gone through natural menopause and not those who have had their ovaries removed through surgery.

Controlling Asthma and Allergies
Without a doubt, the role of hormones and allergies is a complex issue with more research needed. We can all agree that women’s bodies react differently to hormonal fluctuations. For this reason, if you are experiencing allergic symptoms, an allergist may be able to help you. Treatments can vary from lifestyle changes to alternative therapies and prescription medications. Finding out what you are specifically allergic to is most helpful. Discuss your symptoms with your healthcare provider.

For More Information:
Take a Deep Breath, Red Hot Mamas; Menopause and Asthma
Eye Concerns
Dr. Oz Discusses Asthma and Allergies on Discovery Health

References:
"Adult Onset of Asthma." Asthma and Allergy Foundation of America. 2005. Web. 13 Oct 2009. <http://www.aafa.org/display.cfm?id=8⊂=16&cont=36>.

"Allergies Symptom Information." 34 Menopause Symptoms. Web. 13 Oct 2009. <http://www.34-menopause-symptoms.com/allergies.htm>.

Dzung Price, Dr "Can Hormone Balancing Improve Allergies Or Asthma?." Can Hormone Balancing Improve Allergies Or Asthma?. 1 Sep. 2009. EzineArticles.com. 13 Oct 2009 <http://www.ezinearticles.com/?Can-Hormone-Balancing-Improve-Allergies-Or-Asthma?&id=2851824>.

"Section E: Disease Risk." 161, Menopause Practice: A Clinician's Guide. 3rd ed. Cleveland, OH: The North American Menopause Society, 2007. Print.