AMS HP eNews Bulletin 21 December 2015


  Australasian Menopause Society  
Health Professionals eNews21 December 2015
  Welcome to AMS HP eNews for doctors and other healthcare professionals who have a special interest in women's health. The content covers information and resources relevant to menopause, midlife and the promotion of healthy ageing.


Season's Greetings

The Australasian Menopause Society thanks you for your interest in 2015.

We look forward to a bright and busy 2016.

The AMS office will be closed from 22 December through to 4 January. 

Sex Differences in the Cardiovascular Consequences of Diabetes Mellitus  

Women with Type 2 diabetes are twice as likely to have coronary heart disease compared to men, and may also need more frequent and intense physical activity to lower their risk of having a heart attack or stroke, according to a new American Heart Association scientific statement published in the association's journal Circulation.


The statement notes women with Type 2 diabetes compared with men:

  • have heart attacks at earlier ages
  • are more likely to die after a first heart attack
  • are less likely to undergo procedures to open clogged arteries, such as angioplasty or coronary artery bypass grafting
  • are less likely to be on cholesterol lowering drugs such as statins, take aspirin or useblood pressure-lowering medications
  • are less likely to have their blood sugar or blood pressure under control.

Also women

  • develop Type 2 diabetes based on sex-specific difference 



FDA Approval of Flibanserin - Treating Hypoactive Sexual Desire Disorder     

In a Perspective article in the New England Journal of Medicine the US Food and Drug Administration (FDA) offer an explanation regarding the approval Flibanserin. It opens as follows: 


Was the Food and Drug Administration (FDA) approval of flibanserin (Addyi) for treatment of hypoactive sexual desire disorder (HSDD) in premenopausal women long overdue? Or was it an error? In the face of divergent views, we at the FDA think it's important to clarify why flibanserin was approved after being rejected twice.




Adjuvant hormone therapy in ovarian cancer   

To assess the effects of adjuvant hormone therapy (AHT) on survival and disease outcome in women with epithelial ovarian cancer.


Participants were premenopausal and postmenopausal women who had been diagnosed with epithelial ovarian cancer (any International Federation of Gynecology and Obstetrics stage) 9 or fewer months previously. Ineligible patients included those with deliberately preserved ovarian function, with a history of a hormone-dependent malignancy, or with any contraindications to hormone-replacement therapy. Patients were centrally randomly assigned in a 1:1 ratio to either AHT for 5 years after random assignment or no AHT (control). Main outcome measures were overall survival (OS), defined as time from random assignment to death (any cause), and relapse-free survival, defined as time from random assignment to relapse or death (any cause). Patients who continued, alive and relapse free, were censored at their last known follow-up...   



HRT - more on risks and benefits   

Two articles have appeared recently examining the risk benefit ratio of menopausal hormone replacement.


The first, which constitutes Level 1a evidence, is a meta-analysis of 43 randomised controlled trials of HRT v placebo and effect on mortality [Benkhadra et al J Clin Endocrinol Metab 100: 4021–4028, 2015). This analysis found no effect on menopausal HRT overall on mortality. The authors’ conclusion is that current evidence suggests that HRT does not affect the risk of death from all causes, cardiac death and death from stroke or cancer. In 5 of the 43 trials, menopausal HRT was started at a younger age, i.e. less than 60 years or within 10 years of menopause. The meta-analysis of these 5 RCTs showed a reduction of mortality with HRT (RR 0.70 [95% CI 0.52–0.95]).


The second study, which constitutes a Level 3b study and which has received some recent publicity is a case-control study of patients diagnosed with breast cancer and those who were partners of men with cancer but free of cancer themselves [Salagame et al Int J Cancer doi: 10.1002/ijc.29942 Epub ahead of print]. Menopausal HRT use is documented by recall. This study reports an increase in breast cancer with both oestrogen-only and combined oestrogen + progestin use for participants who were currently using HRT at the time of diagnosis, but not for those who were past users. It examines diagnosis rather than mortality...




Reducing food portion sizes critical to tackle obesity

Reducing the size of large food portions, packaging and tableware could help to tackle obesity, argue experts in The BMJ.


Theresa Marteau from the University of Cambridge and colleagues recently published a Cochrane review that found the "most conclusive evidence to date" that people consume more food or drinks from larger size portions or packages, and when using larger items of tableware.


They showed that eliminating larger portions completely could reduce daily energy intake consumed by 12% to 16% among UK adults, and by 22% to 29% among US adults.


Following on from this, they discuss the policy changes that will likely be required to reduce the size, availability and appeal of large food and drink portions that could help to reduce over consumption, and prevent obesity. 




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Bee pollen and honey for climacteric symptoms in breast cancer patients

Climacteric symptoms including hot flushes, night sweats, pain during sexual intercourse, hair loss, forgetfulness, depression and sleeping disturbances are common complaints among breast cancer patients. Some of them are receiving anti-hormonal treatment and others develop ovarian failure as a consequence of cancer treatment. Among these patients, many therapies for alleviating such symptoms have been tested but the results are conflicting. Recently, Münstedt and colleagues have published an study assessing the role of bee pollen and honey in relieving menopausal symptoms in patients receiving tamoxifen and aromatase inhibitors/inactivators...

Migraine in menopausal women: a systematic review

Evidence suggests that migraine activity is influenced by hormonal factors, and particularly by estrogen levels, but relatively few studies have investigated the prevalence and characteristics of migraine according to the menopausal status. Overall, population-based studies have shown an improvement of migraine after menopause, with a possible increase in perimenopause. On the contrary, the studies performed on patients referring to headache centers have shown no improvement or even worsening of migraine...

Body fat parameters as predictors of mortality

Obesity is a well-known major risk factor for many disease situations as well as for mortality. This risk is easily identified by a simple measurement of weight or of body mass index (BMI). However, there are several additional related parameters, namely lean body mass, total body fat, visceral fat, body composition and distribution of body fat, which have been investigated in light of their potential prognostic values. A recent study presented data from the Women's Health Initiative on associations between BMI, body composition, and incident mortality...

IMS Our Menopause World November 2015


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