In this section, The North American Menopause Society (NAMS) features the latest research news, along with expert commentary that places the news into perspective.
NAMS requests commentary from experts in the clinical practice and research communities on subjects of interest to its constituents. Oversight for First to Know is provided by Peter F. Schnatz, DO, FACOG, Chair-Elect, 2008-2009 NAMS Professional Education Committee. Opinions expressed in the commentaries are those of the authors and are not necessarily endorsed by NAMS or Dr. Schnatz. Disclosures are available on request.
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Aspirin use after colorectal cancer
Chan AT, Ogino S, Fuchs CS. Aspirin use and survival after diagnosis of colorectal cancer. JAMA 2009;302:649-658. Level of evidence: II-2.
SHBG to predict diabetes
Ding EL, Song Y, Manson JE, et al. Sex hormone-binding globulin and risk of type 2 diabetes in women and men. N Engl J Med 2009;361:1152-1163. Level of evidence: II-2.
Estrogen exposure time and coronary artery disease
Merz CN, Johnson BD, Berga SL, et al, for the Women’s Ischemia Syndrome Evaluation Study Group. Total estrogen time and obstructive coronary disease in women: insights from the NHLBI-sponsored Women’s Ischemia Syndrome Evaluation (WISE). J Womens Health (Larchmt) 2009;18:1315-1322. Level of evidence: II-2.
Effect of exercise and diet on Alzheimer’s disease
Scarmeas N, Luchsinger JA, Schupf N, et al. Physical activity, diet, and risk of Alzheimer disease. JAMA 2009;302:627-637. Level of evidence: II-2.
Lung cancer and EPT in the WHI
Chlebowski RT, Schwartz AG, Wakelee H, et al, for the Women’s Health Initiative Investigators. Oestrogen plus progestin and lung cancer in postmenopausal women (Women’s Health Initiative trial): a post-hoc analysis of a randomized controlled trial. Lancet 2009 Sep 18. [Epub ahead of print] Level of evidence: I.
Mammogram recalls not affected by HT suspension
Buist DS, Anderson ML, Reed SD, et al. Short-term hormone therapy suspension and mammography recall: a randomized trial. Ann Intern Med 2009;150:752-765. Level of evidence: I.
Denosumab for postmenopausal osteoporosis
Cummings SR, San Martin J, McClung MR, et al, for the FREEDOM Trial. Denosumab for prevention of fractures in postmenopausal women with osteoporosis. N Engl J Med 2009;361:756-765. Level of evidence: I.
Bazedoxifene/conjugated estrogens for osteoporosis prevention
Lindsay R, Gallagher JC, Kagan R, Pickar JH, Constantine G. Efficacy of tissue-selective estrogen complex of bazedoxifene/conjugated estrogens for osteoporosis prevention in at-risk postmenopausal women. Fertil Steril 2009;92:1045-1052. Level of evidence: I.
Revisiting benefits & risks of HT soon after menopause
Prentice RL, Manson JE, Langer RD, et al. Benefits and risks of postmenopausal hormone therapy when it is initiated soon after menopause. Am J Epidemiol 2009; 170:12-23. Level of evidence: I.
Ovarian cancer risk higher with HT
Morch LS, Lokkegaard E, Andreasen AH, Kruger-Kjaer S, Lidegaard O. Hormone therapy and ovarian cancer. JAMA 2009;302:298-305. Level of evidence: II-2.
Causal relationship of CRP and CVD
Elliott P, Chambers JC, Zhang W, et al. Genetic Loci associated with C-reactive protein levels and risk of coronary heart disease. JAMA 2009;302:37-48. Level of evidence: II-2.
Diabetes protection with HT
Pentti K, Tuppurainen MT, Honkanen R, et al. Hormone therapy protects from diabetes: the Kuopio osteoporosis risk factor and prevention study. Eur J Endocrinol 2009;160:979-983. Level of evidence: II-3.
Bisphosphonate use and BMD monitoring
Bell KJ, Hayen A, Macaskill P, et al. Value of routine monitoring of bone mineral density after starting bisphosphonate treatment: secondary analysis of trial data. BMJ 2009; 338:b2266. Level of evidence: I.
Cognition, menopause, and HT
Greendale GA, Huang MH, Wight RG, et al. Effects of the menopause transition and hormone use on cognitive performance in midlife women. Neurology 2009;72:1850-1857. Level of evidence: II-2.
Psychosocial influences on sexual function
Hess R, Conroy MB, Ness R, et al. Association of lifestyle and relationship factors with sexual functioning of women during midlife. J Sex Med 2009;6:1358-1368. Level of evidence: II-3.
Is atherosclerosis affected by prolactin levels?
Georgiopoulos GA, Stamatelopoulos KS, Lambrinoudaki I, et al. Prolactin and preclinical atherosclerosis in menopausal women with cardiovascular risk factors. Hypertension 2009;54:98-105. Level of evidence: II-3.
Mammographic density unchanged by isoflavones
Maskarinec G, Verheus M, Steinberg FM, et al. Various doses of soy isoflavones do not modify mammographic density in postmenopausal women. J Nutr 2009;139:981-986. Level of evidence: I.
Ovarian conservation versus oophorectomy in the NHS
Parker WH, Broder MS, Chang E, et al. Ovarian conservation at the time of hysterectomy and long-term
health outcomes in the Nurses’ Health Study. Obstet Gynecol 2009;113:1027-1037. Level of evidence: II-2.
Does depression affect menopausal symptoms?
Reed SD, Ludman EJ, Newton KM, et al. Depressive symptoms and menopausal burden in the midlife.
Maturitas 2009;62:306-310. Level of evidence: II-3.
Ovarian cancer screening: no basis for optimism
Partridge E, Kreimer AR, Greenlee RT, et al, for the PLCO Project Team. Results from four rounds of ovarian cancer screening in a randomized trial. Obstet Gynecol 2009;113:775-782. Level of evidence: II.
Homocysteine levels associated with hip fracture
LeBoff MS, Narweker R, LaCroix A, et al. Homocysteine levels and risk of hip fracture in postmenopausal women. J Clin Endocrinol Metab 2009;94:1207-1213. Level of evidence: II-2.
Exercise-induced quality of life
Martin CK, Church TS, Thompson AM, Earnest CP, Blair SN. Exercise dose and quality of life: a randomized controlled trial. Arch Intern Med 2009;169:269-278. Level of evidence: I.
Do macronutrients affect weight loss?
Sacks FM, Bray GA, Carey VJ, et al. Comparison of weight-loss diets with different compositions of fat, protein, and carbohydrates. N Engl J Med 2009;360:859-873. Level of evidence: I.
Depression and coronary heart disease
Whang W, Kubzansky LD, Kawachi I, et al. Depression and risk of sudden cardiac death and coronary heart disease in women: results from the Nurses’ Health Study. J Am Coll Cardiol 2009;53:959-961. Level of evidence: II-2.
Resting heart rate as predictor of coronary events
Hsia J, Larson JC, Ockene JK, et al, for the Women's Health Initiative Research Group. Resting heart rate as a low tech predictor of coronary events in women: prospective cohort study. BMJ 2009 Feb 3 [Epub ahead of print]. Level of evidence: II-2.
Association of age at menopause and stroke risk
Lisabeth LD, Beiser AS, Brown DL, Murabito JM, Kelly-Hayes M, Wolf PA. Age at natural menopause and risk of ischemic stroke. The Framingham Heart Study. Stroke 2009 Feb 20 [Epub ahead of print] Level of evidence: II-2.
BTMs to predict BMD response
Burnett-Bowie SA, Saag K, Sebba A, et al. Prediction of changes in bone mineral density in postmenopausal women treated with once-weekly bisphosphonates. J Clin Endocrinol Metab 2009 Jan 13 [Epub ahead of print] Level of evidence: II-2.
Estrogen plus testosterone and breast cancer risk
Ness RB, Albano JD, McTiernan A, Cauley JA. Influence of estrogen plus testosterone supplementation on breast cancer. Arch Intern Med 2009;169:41-46. Level of evidence: II-2.
Effect of multivitamins on cancer and CVD
Neuhouser ML, Wassertheil-Smoller S, Thomson C, et al. Multivitamin use and risk of cancer and cardiovascular disease in the Women’s Health Initiative cohorts. Arch Intern Med 2009;169:294-304. Level of evidence: II-2.
Does hormone therapy decrease colorectal cancer risk?
Johnson JR, Lacey JV Jr, Lazovich D, et al. Menopausal hormone therapy and risk of colorectal cancer. Cancer Epidemiol Biomarkers Prev 2009;18:196-203.
Long-term alendronate use and osteoclast increase
Weinstein RS, Roberson PK, Manolagas SC. Giant osteoclast formation and long-term oral bisphosphonate therapy. N Engl J Med 2009;360:53-62.
Treating urinary incontinence with weight loss
Subak LL, Wing R, West DS, et al, for the PRIDE Investigators. Weight loss to treat urinary incontinence in overweight and obese women. N Engl J Med 2009; 360:481-490.
Marked decline in breast cancer risk after stopping EPT
Chlebowski RT, Kuller LH, Prentice RL, et al, for the WHI Investigators. Breast cancer after use of estrogen plus progestin in postmenopausal women. N Engl J Med 2009;360:573-587. Level of evidence: I.
Two WHIMS papers show HT does not increase cerebrovascular disease but shrinks brain volume
Coker LH, Hogan PE, Bryan NR, et al. Postmenopausal hormone therapy and subclinical cerebrovascular disease: the WHIMS-MRI Study. Neurology 2009;72:125-134. Level of evidence: I.
Denosumab important agent to treat postmenopausal osteoporosis
Miller PD, Bolognese MA, Lewiecki EM, et al, for the Amg Bone Loss Study Group. Effect of denosumab on bone density and turnover in postmenopausal women with low bone mass after long-term continued, discon-tinued, and restarting of therapy: a randomized blinded phase 2 clinical trial. Bone 2008;43:222-229. Level of evidence: I.
Is alcohol consumption associated with atrial fibrillation in women?
Conen D, Tedrow UB, Cook NR, Moorthy MV, Buring JE, Albert CM. Alcohol consumption and risk of incident atrial fibrillation in women. JAMA 2008;300:2489-2496. Level of evidence: II-2.
Ginkgo biloba does not prevent dementia
DeKosky ST, Williamson JD, Fitzpatrick AL, et al, for the Ginkgo Evaluation of Memory (GEM) Study Investigators. Ginkgo biloba for prevention of dementia: a randomized controlled trial. JAMA 2008;300:2253-2262.
Level of evidence: I.
Cigarette smoking and hot flashes
Cochran CJ, Gallicchio L, Miller SR, Zacur H, Flaws JA. Cigarette smoking, androgen levels, and hot flushes in midlife women. Obstet Gynecol 2008;112:1037-1044. Level of Evidence: II-2.
Raloxifene has lower odds of endometrial cancer
DeMichele A, Troxel AB, Berlin JA, et al. Impact of raloxifene or tamoxifen use on endometrial cancer risk: a population-based case-control study. J Clin Oncol 2008; 26:4151-4159. Level of evidence: II-2.
Ultralow-dose vaginal tablet improves vaginal atrophy
Simon J, Nachtigall L, Gut R, et al. Effective treatment of vaginal atrophy with an ultra–low-dose estradiol vaginal tablet. Obstet Gynecol 2008;112:1053-1060. Level of Evidence: I.
Testosterone improves sexual function in women not taking estrogen
Davis SR, Moreau M, Kroll R, et al, for the APHRODITE Study Team. Testosterone for low libido in postmeno-pausal women not taking estrogen. N Engl J Med 2008;359:2005-2017. Level of evidence: I.
HT regimen and route modify effect on MI risk
Lokkegaard E, Andreasen AH, Jacobsen RK, Nielsen LH, Agger C, Lidegaard O. Hormone therapy and risk of myocardial infarction: a national register study. Eur Heart J 2008;29:2660-2668. Level of evidence: II-2.
In BRCA1 mutation carriers, no increased risk for breast cancer with HT use
Eisen A, Lubinski J, Gronwald J, et al, and the Hereditary Breast Cancer Clinical Study Group. Hormone therapy and the risk of breast cancer in BRCA1 mutation carriers. J Natl Cancer Inst 2008;100:1361-1367. Level of evidence: II-2.
Nurses’ Health Study: healthy lifestyle lowers mortality in middle-aged women
Van Dam RM, Li T, Spiegelman D, Franco OH, Hu FB. Combined impact of lifestyle factors on mortality: pro-spective cohort study in US women. BMJ 2008 [Epub ahead of print]. Level of evidence: II-2.
Exogenous hormones increase gastroesophageal reflux symptoms
Jacobson BC, Moy B, Colditz GA, Fuchs CS. Postmeno-pausal hormone use and symptoms of gastroesophageal reflux. Arch Intern Med 2008;168:1798-1804. Level of evidence: II-2.
Wiley protocol breaches research, clinical, and professional ethics
Rosenthal MS. The Wiley Protocol: an analysis of ethical issues. Menopause 2008;15:1014-1022. Level of evidence: III.
Genetic linkage study finds no loci specific to bone loss
Yan H, Liu YJ, Zhou Q, Xiao P, Recker RR, Deng HW. Comparison of whole genome linkage scans in pre-menopausal and postmenopausal women: no bone-loss-specific QTLs were implicated. Osteoporos Int 2008 [Epub ahead of print]. Level of evidence: II-2.
Cancer risk 5 years after normal colorectal screening extremely low
Imperiale TF, Glowinski EA, Lin-Cooper C, Larkin GN, Rogge JD, Ransohoff DF. Five-year risk of colorectal neoplasia after negative screening colonoscopy. N Engl J Med 2008;359:1218-1224. Level of evidence: II-3.
Limit smoking, sweets, and alcohol to lessen menopause-related symptoms
Sabia S, Fournier A, Mesrine S, Boutron-Ruault MC, Clavel-Chapelon F. Risk factors for onset of menopausal symptoms: results from a large cohort study. Maturitas 2008;60:108-121. Level of evidence: II-2.
Low-dose oral or nonoral EPT does not adversely affect cardiovascular risk in younger
postmenopausal women
Casanova G, Radavelli S, Lhullier F, Spritzer PM. Effects of nonoral estradiol-micronized progesterone or
low-dose estradiol-drospirenone therapy on metabolic variables and markers of endothelial function in early postmenopause. Fertil Steril 2008 [Epub ahead of print]. Level of evidence: I.
Menstrual cycle irregularities early in menopause transition correlate with anovulation
Van Voorhis BJ, Santoro N, Harlow S, Crawford SL, Randolph J. The relationship of bleeding patterns to daily reproductive hormones in women approaching menopause. Obstet Gynecol 2008;112:101-108. Level of evidence: II-2.
Low-fat dietary pattern does not lower risk for diabetes
Tinker LF, Bonds DE, Margolis KL, et al. Low-fat dietary pattern and risk of treated diabetes mellitus in postmenopausal women: the Women’s Health Initiative randomized controlled Dietary Modification Trial. Arch Intern Med 2008;168:1500-1511. Level of evidence: I.
Incidence of metabolic syndrome increases in menopause transition
Janssen I, Powell LH, Crawford S, Lasley B, Sutton-Tyrrell K. Menopause and the metabolic syndrome: the Study of Women’s Health Across the Nation. Arch Intern Med 2008;168:1568-1575. Level of evidence: II-2. |