Experts list year’s top findings in menopause, women’s health

PHILADELPHIA — At the Annual Meeting of the North American Menopause Society, leaders in the field presented recent standout articles in the field of menopause and women’s health research.

The topics ranged from new treatments, updates on the Women’s Health Initiative data and potential new therapeutic options.

Endocrine Today compiled a list of the presented articles, which have shaped the field of menopause and women’s health.

Lisa Astalos Chism, DNP, APRN, NCMP, FAANP , clinical director of the Women’s Wellness Clinic, sexual health counselor and educator at the Karmanos Cancer Institute and adjunct assistant professor in the department of surgery at Wayne State University School of Medicine in Detroit, Mich., presented Labrie and colleagues’ paper on the efficacy of intravaginal dehydroepiandosterone (DHEA) on dyspareunia and vaginal dryness.

The researchers found that DHEA decreased parabasal cells and vaginal pH and increased superficial cells, vaginal secretions and epithelial integrity. These results are significant because they confirm the benefits of DHEA as a treatment for vaginal atrophy, Chism said.

Stephanie S . Faubion , MD, FACP, NCMP, IF , executive director and international medicine director of the office of women’s health at Mayo Clinic in Rochester, Minn., highlighted Prague and colleagues’ paper on the phase 2 results of neurokinin 3 receptor antagonism as a novel treatment for menopausal hot flashes.

An experimental NK3 receptor agonist significantly reduced the number and severity of hot flashes and was found to be well tolerated in this proof-of-concept study. Further study is needed to fully understand the effectiveness of this treatment, according to Faubion. Read more.

Andrew M Kaunitz , MD, NCMP, associate chairman in the department of obstetrics and gynecology at the University of Florida College of Medicine, Jacksonville, and director of menopause and gynecologic ultrasound services at Southside Women’s Health, presented on

Imtiaz and colleagues’ research on the association between menopausal hormone therapy and Alzheimer’s disease.

The findings suggest short-term use of HT has no impact on Alzheimer’s disease risk; however, when systemic HT is initiated early in menopause and continued long-term, HT was found to have a potential protective association, Kaunitz said. Read more.

JoAnn E. Manson, MD, DrPH, NCMP, chief of the division of preventive medicine at Brigham and Women’s Hospital and the Michael and Lee Bell Professor of Women’s Health at Harvard Medical School, Boston, was asked to present her recent paper on follow-up from the Women’s Health Initiative.

Manson and colleagues found that HT for 5 to 7 years was not associated with risk for long-term all-cause mortality, and in women aged 50 to 59 years are baseline, HT lowered risk for all-cause mortality by 31%. Read more.

Gloria RichardDavis, MD, NCMP, FACOG, division director of reproductive endocrinology and infertility at the University of Arkansas Medical Sciences, presented Fagan and colleagues’ paper on telomere length in late maternal age women.

These findings show an association between longer leukocyte telomere length and a later maternal age at birth of last child, suggesting that extended maternal age at last childbirth may be a marker for longevity, according to Richard-Davis. The results suggest there may be a genetic basis for reproductive lifespan and longevity.

Jan L . Shifren , MD, NCMP, director of the Midlife Women’s Health Center at Massachusetts General Hospital and professor of obstetrics, gynecology and reproductive biology at Harvard Medical School, presented Mytton and colleagues research on the removal of all ovarian tissue vs conserving ovarian tissue at time of hysterectomy in premenopausal women with benign disease. The researchers found that conserving one ovary was associated with lower rates of ischemic heart disease and all-cause mortality.

These results are significant because bilateral salpingo-oophorectomy, or the removal of both ovaries, is still being performed despite guideline,s and consistent evidence suggesting improved outcomes with ovarian conservation, Shifren said.

Ann L . Steiner, MD, NCMP, FACOG, clinical professor of obstetrics and gynecology and director and founder of the Menopause Clinic at Dickens Center for Women at the University of Pennsylvania, presented results from Melisko and colleagues’ randomized controlled trial on vaginal testosterone cream and an estradiol vaginal ring in women on aromatase inhibitors for early-stage breast cancer.

The researchers concluded both vaginal testosterone cream and the estradiol vaginal ring improved vaginal dryness and sexual desire and dysfunction in this subgroup. This is significant because aromatase inhibitors are associated with urogenital atrophy, which can cause decreased quality of life and even discontinuation of therapy, according to Steiner. Read more.

Cynthia A . Stuenkel , MD, NCMP, clinical professor of medicine of the University of California, San Diego, concluded the presentation by highlighting findings from Kohrt and Wierman on preventing fat gain from blocking follicle-stimulating hormone. FSH was found to regulate energy homeostasis in mice, which could have clinical implications for metabolic changes and weight gain in postmenopausal women, Stuenkel said.

If a therapeutic could be developed that would target FSH, it could diminish bone loss and fat gain related to menopause, according to Stuenkel. by Cassie Homer

References:

Fagan E, et al. Menopause. 2017;doi:10.1097/GME.0000000000000795.

Imtiaz B et al. Neurology. 2017;doi:10.1212/WNL.0000000000003696.

Kohrt WM and Wierman ME. N Engl J Med. 2017;doi:10.1056/NEJMcibr1704542.

Labrie F, et al. Menopause. 2016;doi:10.1097/GME.0000000000000571.

Manson JE, et al. JAMA. 2017;doi:10.1001/jama.2017.11217.

Melisko ME, et al. JAMA Oncol. 2016;doi:10.1001/jamaoncol.2016.3904.

Mytton J, et al. BMJ. 2017;doi:10.1136/bmj.j372.

Prague JK, et al. Lancet. 2017;doi:10.1016/S0140-6736(17)30823-1.