According to new study from the Brigham and Women’s Hospital and Harvard Medical School, consuming tea and citrus juices could correspond to a lower risk of developing ovarian cancer. This was the first large-scale study to determine the role of flavanoids on ovarian cancer, and followed 172,000 patients over three decades. The research team found that women who consumed flavonols and flavanones, which are two sub-types of flavanoids, experienced much less of a risk of developing epithelial ovarian cancer. Since these flavanoids are found in tea and citrus juices and fruits, it is fairly easy to incorporate them to get the associated benefits. This was a promising find, as roughly 20,000 women are diagnosed with ovarian cancer in the United States each year and it also happens to be the fifth leading cause of death from cancer among women. What other dietary sources of flavanoids do you recommend to your patients for health benefits?
A completely new form of birth control is currently being developed. A company called MicroCHIPS has created a birth control microchip that will be embedded into the arm, buttocks or abdomen of a patient. Upon a remote signal from the patient or provider, the microchip will release a 30 microgram dose of levonorgestrel. The company has already seen success in clinical trials for a similar microchip that released teriparatide, a drug to treat osteoporosis in postmenopausal women, and the Bill and Melinda Gates Foundation plans to commit funding in order to get the birth control version into a preclinical trial. If the chip succeeds in clinical trials, it would allow women 16 years of protection, with the ability to turn off the chip whenever they decide that they would like to conceive. How attractive do you think the patients will find this alternative to the existing birth control methods?
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The Journal of the American Medical Association published a new study affirming the increased risk of serious health diseases associated with long-term use of hormone replacement therapy in postmenopausal women. The study involved 27,347 U.S. women from the Women’s Health Initiative studies initiated in 1992 between the ages of 50 and 79. These subjects who were randomized to receive either estrogen, estrogen and progesterone, or a placebo, stopped in 2002 due to the termination of the trial but were followed until 2010. The study mainly found that there was short-term benefit from use of hormone therapy as it relieved menopausal symptoms during the study period, but there was also an increased risk of stroke and breast cancer during that period as well in patients on both estrogen and progesterone. Furthermore, the risk of breast cancer remained high after discontinuation of hormone therapy whereas the risk of stroke decreased. Overall, the investigators concluded that although hormone therapy may be beneficial for menopausal symptoms in early menopause, it should not be used long term. How often are you asked about hormone replacement therapy? How would you recommend controlling vasomotor symptoms in post-menopausal women?
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A new report by the CDC has identified an alarming increase in the number of women dying from prescription painkiller overdoses. Between 1999 and 2010 an estimated 48,000 women died from prescription painkiller overdose, representing a400% increase. Reasons given for this problem are that women are more likely to experience chronic pain, receive prescription painkillers in higher doses, use them for a longer duration, are more likely to become dependent, and are more likely to engage in doctor shopping compared to men. How can we as healthcare providerseducate women about the proper use of these medications?
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A new study published in the British Medical Journal followed 61,433 women from a Swedish mammography cohort study over a period of 19 years to determine if an association exists between long-term calcium intake and death, cardiovascular disease, ischemic heart disease, and stroke. Total calcium intake included both diet and supplement use as reported through food frequency questionnaires. An overall calcium intake greater than 1,400mg/day was associated with a higher risk of mortality including death from cardiovascular and ischemic heart disease, but not stroke. How will the results of this study affect how you counsel patients on their daily calcium intake?
For more information, please see originial article in BMJ
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A recent five-year follow-up population-based cohort published in Neurology evaluated the risk of developing of Alzheimer’s Disease in 1,768 women ages 65 years and older who were on hormone replacement therapy during menopause. Researchers concluded that women who used hormone replacement therapy within 5 years of menopause for at least 10 years had 30% less risk of AD. However, there was a higher risk of the development of AD associated with the use of a combination of estrogen and progestin. How will this information effect prescribing of HRT in menopausal women?
For more information, please read the abstract in Neurology.
A recent open-label, randomized controlled trial published in the BMJ evaluated the long-term effect of hormone replacement therapy (HRT) on heart disease and cardiovascular events in postmenopausal women. Roughly 1,000 women were randomized to receive either HRT or no treatment for about 11 years, with 5 years follow-up after stopping the intervention. Researchers concluded that early initiation of HRT after menopause reduced the risk of cardiovascular events without increasing the risk of other diseases such as breast cancer. What important counseling points would you provide to women on HRT?
For more information, please read the article in BMJ.
According to a large cohort study published in the NEJM, researchers found an increased risk of heart attack and stroke associated with various estrogen-progestin birth control pills. The risk increased with pills that contained more estrogen. The risks were small overall and virtually non-existent with the progestin only formulations . Which oral contraceptives do you see prescribed most often?
http://www.nejm.org/doi/full/10.1056/NEJMoa1111840?query=featured_home&
The combination known as T-DM1 offers hope for the 20-25% of women with HER2-positive breast cancer. In a three-year clinical trial, women in the experimental arm had a 3 month longer survival time compared to standard treatment. Women also reported an improved quality of life with none of the significant side effects seen with chemotherapy. What are the usual side effects of Herceptin?
http://www.cnn.com/2012/06/03/health/breast-cancer-drug/index.html?hpt=he_c2
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