In this
latest video, Hormone Therapy and Cognition, Dr. Shapiro interviews Dr. Pauline
Maki, Past President of NAMS, Professor of Psychiatry and Psychology, Director
of Women’s Mental Health Research, and Research Director at UIC Center for
Research in Women and Gender at the University of Illinois at Chicago. Dr. Maki
discusses the hormone therapy timing hypothesis and cognition, the relationship
between cognition and cardiovascular protection, and the latest cognition
trials and studies.
Timing of
initiation of hormone therapy in relation to age or time since final menstrual
period modify the effect of hormone therapy on cognition as documented now by
three very well-known clinical trials. Dr. Maki explains the timing hypothesis
very well in this latest NAMS video.
HRT if used
properly and under expert care have the potential to offer multisystem benefits
at relatively low cost. But, sadly the acceptance of HRT is quite low in
society because of risk of breast cancer and is frequently discontinued because
of breakthrough bleeding.
The
acceptance further dropped after the results of Women's Health Initiative study
(WHI) in 2002 found that it actually increased a woman's risk of heart disease,
stroke, dementia and breast cancer.
Within
months a 50% drop was noticed in women using HRT.
But a final
comprehensive report published in JAMA and took a deeper look at the WHI study
and the results were broken down according to age and number of years elapsed
since menopause.
The key
findings were HRT is appropriate for younger women who are in early menopause because
the Quality of life benefit derived will be much more as compared to the adverse
effects. In older women who are 60+ the risks are entirely different and outweigh
the harm.
The dilemma
has since continued about initializing or extending HRT in women who are 60+
years. Some women still want to continue using hormones because of the ‘feel
good factor’ or because the menopausal symptoms of hot flashes and urogenital
syndrome of menopause still continue bothering her.
The North
American Menopause Society (NAMS) thinks that women should be evaluated
according to circumstances and risk/benefit ratio. They should use the lowest
possible dose under strict monitoring.
This latest
video, Extended Hormone Therapy Use, Dr. Shapiro interviews Dr. Cynthia
Stuenkel, Past President of NAMS, an internist, endocrinologist, and
reproductive endocrinologist at the University of California, San Diego. Dr.
Stuenkel discusses the safety and risk for hormone therapy use in women 65
years of age and older.
Dr Stuenkel
discusses risk and benefits of hormone therapy for women 65+
The North
American Menopause Society (NAMS) has started comprehensive video series for
clinicians about important midlife health topics. All the interviews in the
series are hosted by NAMS Board of Trustees Member and President Dr. Marla
Shapiro, a Canadian physician, who led this exciting initiative.
In this
monthly series, the latest video is “A Clinician's Guide to Bone Drug Holidays”,
Dr. Shapiro interviews Dr. Michael McClung, NAMS Board Member and Founding
Director of the Oregon Osteoporosis Center in Portland, Oregon. Dr. McClung
discusses the right timing for drug holidays from bisphosphonates for women at
low risk and as well as follow-up procedures. He discusses those who should not
consider a drug holiday.
Dr Michael
McClung discusses a clinician's approach to bone drug holidays
