Memory Changes Tied to Menopause

Posted by Brigham and Women's Hospital November 14, 2016

Many women experience changes in memory as they get older, and according to a study conducted by Brigham and Women’s Hospital (BWH) researchers, these changes are impacted by their menopausal status and not simply chronological age.

New research shows transition to menopause causes changes in memory circuitry.

New research shows transition to menopause causes changes in memory circuitry.

The study’s investigators found that women participating in the study who had lower levels of the sex hormone, estradiol – known to decline during the menopausal transition – performed more poorly on a verbal memory task than those who had higher levels regardless of age. Participants with lower estradiol levels also showed more changes in the brain circuitry that controls memory.

“Our findings underscore the incredible variability of the brain as we age and the critical importance and complexity of the impact of sex on aging, including the unique role of sex steroid hormones in memory function,” said senior author Jill Goldstein, PhD, director of Research at the Connors Center for Women’s Health and Gender Biology at BWH. “Maintaining intact memory function with age is one of the greatest public health challenges of our time, and applying a sex-dependent lens to the study of memory circuitry aging will help identify early antecedents of future memory decline and risk for Alzheimer’s disease.” Read More »

Mobile Menopause App Guides Hormone Therapy Decisions

Posted by Brigham and Women's Hospital December 16, 2014

The free MenoPro mobile app is a decision-support tool for women facing menopause.

For women facing menopause, the choice to take – or not to take – estrogen or other prescription medications can be overwhelming, complicated, and downright stressful. It turns out that clinicians often struggle with the decision-making process, too. Now, a new mobile app could help both women and their clinicians navigate this important health care decision.

The app, called MenoPro, was developed by JoAnn Manson, MD, MPH, DrPH, Chief, Division of Preventive Medicine at Brigham and Women’s Hospital, and her colleagues at the North American Menopause Society (NAMS).

It is designed to help clinicians and patients work together to personalize treatment decisions based on patients’ own preferences (hormonal vs. non-hormonal therapies) and to take into account their health risks (such as diabetes, high blood pressure, high cholesterol, and cardiovascular disease). The app features two modes, one for health care providers and another for patients.

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A Link between Insomnia and Depression?

Posted by Brigham and Women's Hospital September 4, 2014

People with insomnia are twice as likely to develop depression compared to those without insomnia.

Contributors: John Winkelman, MD, PhD, studies restless legs syndrome (RLS), insomnia, mood disorders, and sleep-related eating disorders within the Division of Sleep and Circadian Disorders at Brigham and Women’s Hospital (BWH). Hadine Joffe, MD, MSc, is Director of the Women’s Hormones and Aging Research Program in BWH’s Department of Psychiatry and studies depression in women.

According to the National Institute of Mental Health, nearly seven percent of adults in the U.S. experienced at least one major depressive episode during 2012. Women, in particular, are twice as likely as men to experience depression. Therapy and antidepressant medications are common treatments for depression, but can treating insomnia be another route to combating the mood disorder?

People with insomnia are twice as likely to develop depression compared to those without insomnia. Chronic primary insomnia, which is defined as sleep problems not associated with other health conditions, may increase a person’s risk for depression later in life. So what makes a person with insomnia more susceptible to future depression?

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New Research Clarifies Role of Hormone Replacement Therapy

Posted by Brigham and Women's Hospital October 9, 2013

The benefits of hormone therapy for relieving menopause symptoms may outweigh the risks.

If you’re a woman nearing or beginning menopause, you probably have questions about whether to use hormone replacement therapy for relief of menopause symptoms such as hot flashes or night sweats. Recent findings from the Women’s Health Initiative (WHI), published in October 2013, may help you and your doctor evaluate the benefits and risk of hormone therapy in the context of your own health history.

Researchers analyzed more than 27,000 postmenopausal women, ages 50-79, in two hormone therapy trials (estrogen plus progestin and estrogen alone) over a 13 year period. They concluded that hormone therapy is helpful in managing the symptoms of menopause (such as hot flashes or night sweats) in younger women (ages 50-59); however, they cautioned against the use of hormone therapy to prevent chronic diseases, particularly in older women, due to an increased risk of adverse events.

Among women in the 50 to 59 year age group, researchers found that fewer than 1 in 100 had adverse events during five years of hormone therapy use, while the risk of adverse events were four to five times higher among the older women.  Furthermore, because younger women were more likely to experience menopausal symptoms that were relieved by hormone therapy, the quality-of-life benefits outweighed the risks of adverse events in these women.

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Women’s Sleep Across a Lifetime

Posted by Brigham and Women's Hospital July 25, 2013

There are things that women of all ages can do to get a good night's sleep.

Today’s post is written by Dr. Sandra Horowitz, a neurologist who specializes in sleep disorders at Brigham and Women’s Hospital.

Women lead busy lives: we work, have babies, raise families, and take care of our sick and elderly family members. Juggling these numerous roles, combined with hormonal changes due to menarche, menopause, and pregnancy, as well as other health conditions, can affect a woman’s ability to fall asleep and stay asleep.  Despite these challenges, there are things women of all ages can do to get a good night’s sleep.

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Women’s Health Week: Take Charge of Your Health

Posted by Brigham and Women's Hospital May 13, 2013

National Women’s Health Week (May 12-18), encourages women to take control of their health. We’ve assembled a collection of HealthHub posts focused on health issues for women of all ages.


Attention All Women, Do You Experience Mittelschmerz?

If you have regular pain in your lower abdomen, you may be experiencing mittelschmerz, a German word used to describe pelvic and abdominal pain around the time of ovulation, usually in the middle of your menstrual cycle. Learn when your should consult your doctor about pelvic and abdominal pain.


Young Female Athletes in Danger of Osteoporosis?

Stress fractures are common sports injuries in women. They also are a potential warning sign of the female athlete triad, a disorder characterized by inadequate nutrient intake, irregular menstrual cycles, and premature bone loss (osteoporosis). This can result in long-term loss of bone density among competitive and recreational female athletes.

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Benefits of Hormone Therapy for Early Menopause Symptoms

Posted by Brigham and Women's Hospital December 28, 2012

Hormone therapy during early menopause can help reduce the most bothersome symptoms.

Many women experience bothersome symptoms during menopause, such as hot flashes, night sweats, and vaginal dryness.  Hormone therapy (HT) can provide relief from the symptoms of menopause, but studies have shown that these benefits of HT may come with added risks, especially if hormone therapy is started more than 10 years after the onset of menopause. For example, in the Women’s Health Initiative (WHI), in which women were an average age of 63, the risks of combination estrogen plus progestin (stroke, heart attacks, venous blood clots, and breast cancer) outweighed the benefits. As a result, there was a sharp decrease in the number of women using HT, leaving them with few options for symptomatic relief.

Now a new study called KEEPS (Kronos Early Estrogen Prevention Study), finds that women can experience the benefits of HT while minimizing the health risks, provided therapy is given early in menopause and at low doses for up to four years.  JoAnn Manson, Chief of Preventive Medicine at Brigham and Women’s Hospital, one of the KEEPS and WHI principal researchers, said “Many newly menopausal women will be using hormone therapy for only four to five years , so these findings will have great relevance to them.”

The study included 727 women ranging in age from 42 to 58. Some of the women were randomized to estrogen pills and others to estrogen patches, both combined with natural progesterone pills taken 12 days a month. They were compared with women using placebo patches and pills.

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Landmark Women’s Health Study on Hormone Therapy Marks 10-Year Anniversary

Posted by Brigham and Women's Hospital October 9, 2012

Dr. JoAnn Manson is one of the principal investigators for the landmark Women's Health Initiiative study.

In the past decade, the Women’s Health Initiative (WHI) Hormone Therapy Trial, for which Brigham and Women’s Hospital was one of the centers,  has revealed much about the benefits and risks associated with hormone therapy for menopausal women and has changed the way women around the world manage their symptoms.

The findings from the hormone trial that included estrogen plus progestin were monumental in demonstrating a link between hormone therapy and increased risks of heart disease, stroke, pulmonary embolism, and breast cancer in postmenopausal women.

The trial was initially designed to assess the role of hormone therapy in the prevention of heart disease and chronic diseases. During the trial, the researchers discovered that overall risks of hormone therapy exceeded benefits, especially for older women in the study. Given this, the two hormone therapy trials ended early to protect study participants.

The estrogen plus progestin trial was stopped three years early because the risks clearly outweighed the benefits. The estrogen-alone trial (for women with hysterectomy) showed fewer risks but was stopped one year early due to an increased risk of stroke.

“The WHI deserves credit for stopping the growing clinical practice of prescribing hormone therapy to older women who were at very high risk of heart disease,” wrote JoAnn Manson, MD, MPH, DrPH, BWH Chief, Division of Preventive Medicine and one of the principal investigators of the WHI, in a co-authored editorial for the medical journal, Menopause. “In fact, these women did not have a reduced risk of heart disease from hormone therapy and may even have suffered harm.”

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