Tag Archive for: aging

2024 Women’s Health Research Symposium: Advancing Women’s Health Through Menopause Research

Author: Shayda Swann | Editors: Romina Garcia de leon (Blog Co-coordinator) and Katherine Moore (Director of Operations)

Published: April 4, 2024

On International Women’s Day (March 8th 2024), the Women’s Health Research Institute hosted the 9th annual Women’s Health Research Symposium, titled Midlife Women’s Health Research: Unpacking the Science of the Menopause Journey and its Health Impacts. In this blog, we’ll be highlighting the work shared by the keynote speaker, Dr. Susan Reed (MD, MPH). 

Why menopause matters

Perhaps the most obvious reason why menopause matters is because half of the world’s population will experience it. This ubiquitous experience brings bothersome symptoms that can reduce women’s quality of life, lead to work absences, and reduce overall productivity. Despite this, only a fraction of health funding goes towards menopause research. For instance, of the ~9,000 grants funded by the Canadian Institutes of Health Research from 2009-2020, only 5.9% evaluated female specific outcomes, let alone menopause-focused work. We encourage readers to review our three-part menopause series where we cover many of these topics in depth (Part 1, Part 2, and Part 3). 

Reviewing landmark studies in menopause research

The Study of Women’s Health Across the Nation (SWAN) began in 1994 and was a US-based cohort of 3,000 women aged 42-52. They identified that “menopause transition symptoms”, such as menstrual irregularity and vasomotor symptoms (i.e., hot flushes and night sweats) peaked between ages 46-56 and that most people experience menopausal symptoms for up to 10 years. They also reported that symptoms were typically most bothersome in the two years before and after the final menstrual period. Additionally, the SWAN study identified important predictors of vasomotor symptoms, such as adiposity (body fat), having less than a college education, stress, depression, and anxiety. The SWAN study also reported key findings around sleep, mood, cognition, cardiovascular disease, metabolic health, bone health, and sexual health. For instance, they found that low libido was associated with vasomotor symptoms and that bone loss is most rapid in the year preceding the final menstrual period.  

Another study, called MsFLASH, further advanced our understanding of this important phase in women’s lives, with a focus on alleviating menopause symptoms. First, they found that selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrin reuptake inhibitors (SNRIs) have a modest benefit of reducing vasomotor symptoms in women who cannot or prefer not to take hormonal therapies. Unfortunately, exercise, omega-3s, and yoga were not found to be beneficial therapies. Similarly, they found that neither vaginal estrogen nor vaginal moisturizer decreased the number of moderate-to-severe vulvovaginal discomfort episodes compared to placebo. 

What do we know about treating menopause?

From the studies cited above and others, Dr. Reed shared the current evidence for menopause treatment options. This is a very brief overview and we encourage all women to discuss specific treatment approaches with a trusted health care provider. First, menopause hormone therapy can be initiated in most women with symptoms between ages 50-59 who are 1) low risk for cardiovascular disease, breast cancer, or venothromboembolism (blood clots) or 2) moderate risk based on informed decision-making. Treatments should be initiated within 10 years of the final menstrual period or before age 60. 

Knowledge translation

Dr. Reed also shared several useful patient-centred resources to help women navigate the menopause transition. For instance, the Menopause Priority Setting Partnership has a survey where women can share their priorities for future menopause research projects. The MsFLASH study also developed a fantastic website which includes a primer on menopause, an overview of treatment options, and a tool to build a personalized “menoplan”. 

Thanks to the organizers of the Women’s Health Research Symposium for another excellent meeting and for prioritizing mid-life women’s health! 

Spot the Difference: Menopause or Endometrial Cancer?

Author: Malak Ibrahim, MSc Student in the Department of Obstetrics and Gynecology, University of British Columbia | Editors: Romina Garcia de leon, Shayda Swann (Blog Coordinators) 

Published: July 21, 2023

All women* and individuals with a uterus will inevitably experience menopause during their lifetime; however, the stigma around menstruation, aging, and women’s health makes it difficult to have open conversations about menopause. Almost half of women in Canada feel unprepared for perimenopause and menopause, and 54% believe the topic is still taboo.

“Menopause is seen as something women must endure, like a woman’s burden.” 

– Dr. Wendy Wolfman, MD, FRCS(C), FACOG, NCMP, President of the Menopause Society of Canada

Menopause is defined as the time period after a woman has gone 12 consecutive months without menstruating. The time period leading up to menopause when women experience a range of symptoms is called perimenopause. During perimenopause, women may experience changes in their menstruation, hot flashes, sleep disruptions, cold sweats, depression, and many more symptoms. There are more than 30 symptoms that can occur as a result of hormonal changes during perimenopause, and although many women are aware of a few common symptoms such as hot flashes and night sweats, awareness of other symptoms such as depression and anxiety remain low. 

So how does this relate to endometrial cancer? Endometrial cancer occurs in the inner lining of the uterus, called the endometrium. It is the most common type of uterine cancer and the most commonly diagnosed gynecologic cancer in the developed world. Unlike most cancers, the number of new endometrial cancer cases continues to rise each year. Endometrial cancer incidence increases by almost 2% each year in women under 50 years old, and 1% in women over 50 years of age. For most patients diagnosed with endometrial cancer, abnormal uterine bleeding is the first noticeable symptom. Abnormal uterine bleeding is defined as any bleeding or spotting during menopause, or any unpredictable pre-menopausal vaginal bleeding such as changes in regularity, frequency, volume, or duration. Even though abnormal uterine bleeding can prompt earlier detection of endometrial cancer, it is not specific to endometrial cancer and can indicate a number of gynecologic conditions. Up to 30% of women will experience abnormal uterine bleeding in their life, and it is especially common during perimenopause. Almost half of women experiencing abnormal uterine bleeding will delay or not seek medical care, resulting in a delayed diagnosis or leaving the underlying cause undiagnosed. 

Because changes in menstruation are very common and normal during perimenopause, it can be difficult to differentiate between what is regular reproductive aging and early signs of endometrial cancer. So how can you tell the difference between perimenopausal changes in menstruation, and abnormal uterine bleeding that may indicate endometrial cancer? Unfortunately, there is no way to determine if changes in menstruation are associated with perimenopause or more serious pathologies without an endometrial biopsy. However, by raising awareness of both endometrial cancer and menopause, women can be empowered to better understand their health and identify which symptoms of concern need medical attention based on their personal risk of developing cancer. Some risk factors for uterine cancer are obesity, age, diabetes, estrogen only hormone replacement therapy, and genetic predisposition. Open conversation about menstruation and menopause with family, friends, and most importantly, healthcare providers is needed. Women who have an increased risk of uterine cancer should be especially aware of abnormal uterine bleeding and engage in conversation with their health care providers as soon as possible if they experience any unusual uterine bleeding. 

To learn more about symptoms and risk factors of uterine cancer, visit UBC’s own Uterine Health Research Lab website and follow us on social media! 

The Uterine Health Research Lab is currently conducting the RESToRE Study to assess the feasibility and acceptability of early cancer screening and prevention methods. We are recruiting postmenopausal people with a uterus to fill out a risk questionnaire – those who are found to have increased risk factors will be invited to continue in further aspects of the study. For more information or to participate in the RESToRE Study, please click here. 

Facebook: Uterine Health Research Lab

Instagram: @uterinehealth

Twitter: @uterinehealth 

Website: uterinehealth.ca