The number of peer-reviewed papers covering the vast field of women’s health is huge, to such an extent that it is frequently difficult for healthcare professionals to keep up with the literature. As a special service to our readers, IHE presents a few key literature abstracts from the clinical and scientific literature chosen by our editorial board as being particularly worthy of attention.
Estrogen therapy and cognition: a review of the cholinergic hypothesis.
by GB Gibbs
Endocr. Review Dec 2009
The pros and cons of estrogen therapy for use in postmenopausal women continue to be a major topic of debate in women’s health. Much of this debate focuses on the potential benefits vs. the harm of estrogen therapy on the brain and the risks of cognitive impairment associated with aging and Alzheimer’s disease. Many animal and human studies suggest that estrogens can have significant beneficial effects on brain aging and cognition and reduce the risk of Alzheimer’s-related dementia; however, others disagree. Important discoveries have been made, and hypotheses have emerged that may explain some of the inconsistencies. This review focuses on the cholinergic hypothesis, specifically on evidence that beneficial effects of estrogens on brain aging and cognition are related to interactions with cholinergic projections emanating from the basal forebrain. Evidence suggests that many of the effects of estrogens on neuronal plasticity and function and cognitive performance are related to or rely upon interactions with these cholinergic projections; however, studies also suggest that the effectiveness of estrogen therapy decreases with age and time after loss of ovarian function. The author proposes a model in which deficits in basal forebrain cholinergic function contribute to age-related changes in the response to estrogen therapy. Based on this model, it is proposed that cholinergic-enhancing drugs, used in combination with an appropriate estrogen-containing drug regimen, may be a viable therapeutic strategy for use in older postmenopausal women with early evidence of mild cognitive decline.
Women bound to be active: one year follow-up to an innovative pilot
intervention to increase physical activity and self-worth in women.
by JL Hubert, et al.
Women’s Health 2009; 49(6): 522.
The purpose of the study reported in this paper was to assess the effectiveness of a lifestyle intervention (a women’s book club; Women Bound to be Active) in promoting long-term physical activity. Thirty-five women (26-70 years; mean age 50.6 years) completed the 8-month intervention and participated in the one-year follow-up. At follow-up, physical activity returned to baseline levels; however, self-worth and body mass index significantly improved. Women were more knowledgeable about physical activity at follow-up; however, they failed to maintain physical activity after the intervention. To enhance long-term physical activity adherence, continued research and intervention modifications are needed.
The “Acupuncture on Hot Flashes Among Menopausal Women” study: observational follow-up results at 6 and 12 months.
by EK Boroud et al.
Menopause Dec 2009
The previously published “Acupuncture on Hot Flashes Among Menopausal Women” study compared the effectiveness of individualized acupuncture treatment plus self-care versus self-care alone on hot flashes and health-related quality of life in postmenopausal women. This paper reports on the observational follow-up results at 6 and 12 months. The study was a pragmatic, multicenter randomized controlled trial with two parallel arms. The 267 participants were postmenopausal women
experiencing, on average, 12.6 hot flashes per 24 h. The acupuncture group received 10 individualized acupuncture treatments during 12 weeks and advice on self-care, whereas the control group received only advice on self-care. Hot flash frequency and intensity (0-10 scale) and hours of sleep per night were registered in a diary. Health-related quality of life was assessed by the Women’s Health Questionnaire. From baseline to 6 months, the mean reduction in hot flash frequency per 24 hours was 5.3 in the acupuncture group and 5.0 in the control group, a nonsignificant difference of 0.3. At 12 months, the mean reduction in hot flash frequency was 6.0 in the acupuncture group and 5.8 in the control group, a nonsignificant difference of 0.2. Differences in quality-of-life scores were not statistically significant at 6 and 12 months. The statistically significant differences between the study groups found at 12 weeks were no longer present at 6 and 12 months. The study showed that acupuncture can contribute to a more rapid reduction in vasomotor symptoms and increase in health-related quality of life in postmenopausal women but probably has no long-term effects.
Is green tea drinking associated with a later onset of breast cancer?
Q Dai et al.;
Ann Epidemiol 2010 Jan; 20(1): 74 -81
Studies have found that tea polyphenols inhibit aromatase. Because of the substantial difference in levels of estrogens between premenopausal and postmenopausal women, the relationship between tea consumption and breast cancer risk may depend on menopausal status. The authors examined this hypothesis in the Shanghai Women’s Health Study, a population-based cohort study of 74,942 Chinese women. A time-dependent interaction between green tea consumption and age of breast cancer onset was found (p for interaction, 0.03). In comparison with non-tea drinkers, women who started tea-drinking at 25 years of age or younger had a hazard ratio (HR) of 0.69 to develop premenopausal breast cancer. On the other hand, compared with non-tea drinkers, women who started tea drinking at 25 years of age or younger had an increased risk of postmenopausal breast cancer with an HR of 1.61. Additional analyses suggest regularly drinking green tea may delay the onset of breast cancer but that further studies are needed to confirm the findings.
