Fabulous summary of lots of important health topics - thank you!
Picking up on a couple of points, I noticed this little study recently which showed an association (caveat that correlation does not equal causation) between increased purchasing of indigestion remedies/painkillers in the 8 months before diagnosis by women then found to have ovarian cancer - definitely not always silent. https://publichealth.jmir.org/2023/1/e41762
I am wondering about that theory though - the timing doesn't make sense to me. Here in the UK most women taking the combined oral contraceptive pill are in their 20s or 30s, and the peak incidence of ovarian cancer is age 75-79 - by preventing 10-15 years of ovulation we're reducing the risk 50 years later? Possible but seems odd. Though might explain the protection from the pill lasting about 30 years ..
And I'm interested by your speaker's take on weight loss (and what their background is?) - I know there was the consensus professional endorsement of bariatric surgery for Type 2 diabetes, but there's been great debate about why the diabetes reverses so quickly, before any significant weight loss and some studies suggesting it's the enforced extreme calorie control which has that effect - like actual fasting for days, more than time-restricted eating.
Personally, as a superbusy working mum, I'm thrilled by the data beginning to suggest that HIT and isometric exercise can be as beneficial for blood pressure as cardio - I don't have time to go to the gym or for 45 minute runs, but I can't afford for my health not to exercise, so something which I can do in my own home in 15-20 minutes before the kids wake up - chef's kiss!
The exercise/diet which works is the one you can stick to ..
There are loads of great strength training programs that you can do at home and upload videos to have someone check on your form. One good thing about COVID is that those offerings became much better because they had to.
I liked that slide as well. And the speaker mentioned doing puzzles, so I'm going to keep up with my crosswords! I also read somewhere that bridge is amazing for mental stimulation.
Thank you so much Dr Jen, I really appreciate everything you do. The ovarian cancer update is interesting. My maternal grandmother died at 52 from ovarian cancer. Luckily my mother and her sister (77 and 79) have been healthy. I'm 57 and was put on oral contraceptives at 19 and transitioned to MHT once I was mid-perimenopause. It always frustrated me that there aren't proper screening methods (I spent decades being terrified that my mother would get it). My grandmother was a daily talcum powder user, so it's possible that contributed.
Great information! I am Canadian and listen to the CBC Podcast 'White Coat, Black Art' and they recently did a show on ovarian cancer and the removal of fallopian tubes, (June 17/23). The study involves standard removal of fallopian tubes if a woman is already undergoing some kind of pelvic surgery. Basically, if they are already in the area, remove the tubes as a preventative measure for ovarian cancer as it often starts in the fallopian tubes and then spreads to the ovaries. The research is very new so I don't think any significant findings have come out yet but the hypothesis certainly makes a lot of sense. Interesting stuff!
Thanks for sharing about the ovarian cancer screening. My mom died of ovarian cancer at 71 within 6 months of diagnosis, and her symptoms were all GI-related. I have no other female relatives, and grandmothers died young of other causes, so family history is not useful for me. I am planning to have an oophorectomy eventually, but my ovaries are still producing a lot of hormones and I don't have the BRCA gene. My doctor would rather I do it sooner than later, even though my CA-125 and ultrasounds were clear (not reliable, I know). He did an OVA-1 test (again, not recommended for screening, it's for people who have a mass and need to know if they should see a cancer specialist). It was borderline so he wants to do it again in a couple of months in addition to an MRI. Sooo ... none of this is really helpful and I am not expecting medical advice, I am just putting out there how frustrating this is for people who are higher risk but don't have a known genetic marker (I am also higher risk due to having no pregnancies and having infertility). I feel like we are left to either do unnecessary surgery or twist in the wind.
Re: breast density, aside from limiting alcohol and doing the other dietary/lifestyle things we can do, does MHT also increase breast density? I worry about this since I’m on MHT — fairly low dose though (.0375mg patch) — and am just getting 3D annual screenings for now. So I wonder about risks of MHT and also the best types of screening.
Could you post links to the referenced clinical trials and research studies from this meeting? I am clinical research coordinator and I would love to read them. Thanks
Thank you for the summary! I was caught off guard a bit by the weight loss section when the presenter jumped right to bariatric surgery for weight loss in menopause. Am I missing something? At 49, I am a healthy weight for my height and eat a healthy diet, but am noticing some increasing weight around my middle without any diet or exercise changes. So was this presenter saying we either restrict calories or have surgery if we want to combat this gain? I have a feeling that's not what was intended, but that's how I'm reading it.
The speaker said that diet, exercise, and lifestyle modifications are the backbone of weight management, but the most effective long-term therapies for obesity (as defined by a BMI ≥ 30) it is the new medication and bariatric surgery. That doesn't mean people need to jump to those interventions or even consider them at all.
Wow! I’m so thankful to have someone like you report /share this info with us!! Reducing my alcohol as well...we’ll see how that affects my next mammo as well.
Heh. I literally wrote in my Substack today about my experience with supplements from a functional medicine doctor. I talked about magnesium. I didn't talk about DHEA, which was also prescribed. Also tagged you because of the 'sports enhancer' study you wrote about. Just hammers home the point about misleading labels.
This is so awesome - thanks for the fantastic summary. Interesting notes on 1) DHEA - I see more and more promoting this as a miracle cure - so good to know it doesn't work, 2) dementia - as someone who has a mother with Alzheimer's, I was a little bummed to see there is no correlation to lower risk of dementia with HRT, 3) interesting on diet - again, we hear that the Meditteranean diet is best, but maybe doesn't lead to weight loss, just good eating habits in general, 4) more should be communicated on the signs of ovarian cancer so women don't ignore these, 5) I too have dense breasts and am looking forward to better screening here, 6) anything new on testing to confirm menopause - I know it's mainly based on symptoms, but women seem determined to have labs that confirm :)
Love this update! What do you think of the study that linked statin use to increased diabetes risk, especially in women with lower BMIs? I ask because I have strong familial risk factors for both CHD and DM. Reference:
Diabetes Care. 2013 Jul; 36(7): e100–e101. Published online 2013 Jun 12. doi: 10.2337/dc13-0490
PMCID: PMC3687308PMID: 23801803
Relationship of Sex to Diabetes Risk in Statin Trials
Mark O. Goodarzi, MD, PHD,corresponding author1,2 Xiaohui Li, MD, PHD,2 Ronald M. Krauss, MD,3 Jerome I. Rotter, MD,2 and Yii-Der I. Chen, PHD2
I have dense breasts…or al least I did on my recent mammogram. It has never come up before.
I have been alcohol free for 10 years. I feel like my n = 1 would say alcohol and breast density are not correlated. That said, alcohol is a known carcinogen, so none is safest!
Fabulous summary of lots of important health topics - thank you!
Picking up on a couple of points, I noticed this little study recently which showed an association (caveat that correlation does not equal causation) between increased purchasing of indigestion remedies/painkillers in the 8 months before diagnosis by women then found to have ovarian cancer - definitely not always silent. https://publichealth.jmir.org/2023/1/e41762
I am wondering about that theory though - the timing doesn't make sense to me. Here in the UK most women taking the combined oral contraceptive pill are in their 20s or 30s, and the peak incidence of ovarian cancer is age 75-79 - by preventing 10-15 years of ovulation we're reducing the risk 50 years later? Possible but seems odd. Though might explain the protection from the pill lasting about 30 years ..
And I'm interested by your speaker's take on weight loss (and what their background is?) - I know there was the consensus professional endorsement of bariatric surgery for Type 2 diabetes, but there's been great debate about why the diabetes reverses so quickly, before any significant weight loss and some studies suggesting it's the enforced extreme calorie control which has that effect - like actual fasting for days, more than time-restricted eating.
Personally, as a superbusy working mum, I'm thrilled by the data beginning to suggest that HIT and isometric exercise can be as beneficial for blood pressure as cardio - I don't have time to go to the gym or for 45 minute runs, but I can't afford for my health not to exercise, so something which I can do in my own home in 15-20 minutes before the kids wake up - chef's kiss!
The exercise/diet which works is the one you can stick to ..
There are loads of great strength training programs that you can do at home and upload videos to have someone check on your form. One good thing about COVID is that those offerings became much better because they had to.
This is such helpful information! I especially appreciated the breakdown list of dementia factors. And the benefits of exercise! Very empowering.
I liked that slide as well. And the speaker mentioned doing puzzles, so I'm going to keep up with my crosswords! I also read somewhere that bridge is amazing for mental stimulation.
I suspect keeping up to date with the gynaecological literature counts as brain stimulation also ... especially if you crunch the stats yourself!
Ha!
Thank you so much Dr Jen, I really appreciate everything you do. The ovarian cancer update is interesting. My maternal grandmother died at 52 from ovarian cancer. Luckily my mother and her sister (77 and 79) have been healthy. I'm 57 and was put on oral contraceptives at 19 and transitioned to MHT once I was mid-perimenopause. It always frustrated me that there aren't proper screening methods (I spent decades being terrified that my mother would get it). My grandmother was a daily talcum powder user, so it's possible that contributed.
Great information! I am Canadian and listen to the CBC Podcast 'White Coat, Black Art' and they recently did a show on ovarian cancer and the removal of fallopian tubes, (June 17/23). The study involves standard removal of fallopian tubes if a woman is already undergoing some kind of pelvic surgery. Basically, if they are already in the area, remove the tubes as a preventative measure for ovarian cancer as it often starts in the fallopian tubes and then spreads to the ovaries. The research is very new so I don't think any significant findings have come out yet but the hypothesis certainly makes a lot of sense. Interesting stuff!
Thanks for sharing about the ovarian cancer screening. My mom died of ovarian cancer at 71 within 6 months of diagnosis, and her symptoms were all GI-related. I have no other female relatives, and grandmothers died young of other causes, so family history is not useful for me. I am planning to have an oophorectomy eventually, but my ovaries are still producing a lot of hormones and I don't have the BRCA gene. My doctor would rather I do it sooner than later, even though my CA-125 and ultrasounds were clear (not reliable, I know). He did an OVA-1 test (again, not recommended for screening, it's for people who have a mass and need to know if they should see a cancer specialist). It was borderline so he wants to do it again in a couple of months in addition to an MRI. Sooo ... none of this is really helpful and I am not expecting medical advice, I am just putting out there how frustrating this is for people who are higher risk but don't have a known genetic marker (I am also higher risk due to having no pregnancies and having infertility). I feel like we are left to either do unnecessary surgery or twist in the wind.
Re: breast density, aside from limiting alcohol and doing the other dietary/lifestyle things we can do, does MHT also increase breast density? I worry about this since I’m on MHT — fairly low dose though (.0375mg patch) — and am just getting 3D annual screenings for now. So I wonder about risks of MHT and also the best types of screening.
I'll be writing more about estrogen and breast density in the next post on hormone therapy.
Could you post links to the referenced clinical trials and research studies from this meeting? I am clinical research coordinator and I would love to read them. Thanks
Thank you for the summary! I was caught off guard a bit by the weight loss section when the presenter jumped right to bariatric surgery for weight loss in menopause. Am I missing something? At 49, I am a healthy weight for my height and eat a healthy diet, but am noticing some increasing weight around my middle without any diet or exercise changes. So was this presenter saying we either restrict calories or have surgery if we want to combat this gain? I have a feeling that's not what was intended, but that's how I'm reading it.
The speaker said that diet, exercise, and lifestyle modifications are the backbone of weight management, but the most effective long-term therapies for obesity (as defined by a BMI ≥ 30) it is the new medication and bariatric surgery. That doesn't mean people need to jump to those interventions or even consider them at all.
Thank you! That makes more sense.
I added clarification to the post as someone else asked as well
Thank you so much, I was debating if I was going to stop my statins. After reading this, I’ll stay on the statins!
Wow! I’m so thankful to have someone like you report /share this info with us!! Reducing my alcohol as well...we’ll see how that affects my next mammo as well.
Heh. I literally wrote in my Substack today about my experience with supplements from a functional medicine doctor. I talked about magnesium. I didn't talk about DHEA, which was also prescribed. Also tagged you because of the 'sports enhancer' study you wrote about. Just hammers home the point about misleading labels.
This is so awesome - thanks for the fantastic summary. Interesting notes on 1) DHEA - I see more and more promoting this as a miracle cure - so good to know it doesn't work, 2) dementia - as someone who has a mother with Alzheimer's, I was a little bummed to see there is no correlation to lower risk of dementia with HRT, 3) interesting on diet - again, we hear that the Meditteranean diet is best, but maybe doesn't lead to weight loss, just good eating habits in general, 4) more should be communicated on the signs of ovarian cancer so women don't ignore these, 5) I too have dense breasts and am looking forward to better screening here, 6) anything new on testing to confirm menopause - I know it's mainly based on symptoms, but women seem determined to have labs that confirm :)
Love this update! What do you think of the study that linked statin use to increased diabetes risk, especially in women with lower BMIs? I ask because I have strong familial risk factors for both CHD and DM. Reference:
Diabetes Care. 2013 Jul; 36(7): e100–e101. Published online 2013 Jun 12. doi: 10.2337/dc13-0490
PMCID: PMC3687308PMID: 23801803
Relationship of Sex to Diabetes Risk in Statin Trials
Mark O. Goodarzi, MD, PHD,corresponding author1,2 Xiaohui Li, MD, PHD,2 Ronald M. Krauss, MD,3 Jerome I. Rotter, MD,2 and Yii-Der I. Chen, PHD2
That isn't my area of expertise, sorry. But I assume if that were a concern it would be in the guidelines so you can probably find out more there
You mentioned that oral DHEA is not effective. Was there any discussion of Intrarosa, which I understand is localized DHEA?
I have dense breasts…or al least I did on my recent mammogram. It has never come up before.
I have been alcohol free for 10 years. I feel like my n = 1 would say alcohol and breast density are not correlated. That said, alcohol is a known carcinogen, so none is safest!
Would love to know more about vaginal topical DHEA! Is it in an old post I can't find? Will it be forthcoming? Excited to learn more! clearly.