June 16, 2008
The Endocrine Society
June 16, 2008
In young girls at risk of early puberty and insulin resistance, the diabetes drug metformin delayed the onset of menstruation and decreased the development of insulin resistance, a risk factor for type 2 diabetes, according to a new study. The results were presented Monday, June 16, at The Endocrine Society’s 90th Annual Meeting in San Francisco.
“The findings indicate that we can slow down puberty,” said the study’s senior author, Lourdes Ibanez, MD, PhD, of the University of Barcelona in Spain. “This is important because when puberty is faster in girls, the appearance of menses occurs earlier, and this sequence of events may ultimately result in a shorter adult height.”
Also, getting a first menstrual period before age 12 has been linked to an increased risk of breast cancer. Early puberty (breast development) is a risk factor for polycystic ovary syndrome (PCOS), especially if the girl is overweight, she said. PCOS is a common cause of infertility.
All 38 girls in the study had not yet reached puberty at the start of the study but had developed pubic hair abnormally early—before the age of 8 years. These girls typically start puberty earlier than their peers, Ibanez said.
The study patients had another risk factor for early puberty. All had been born small and experienced rapid catch-up growth during infancy, thus developing more fat than normal. This fat tends to be around the middle, which increases the risk of developing type 2 diabetes and heart disease in adulthood. Belly fat also is a marker of insulin resistance, in which the body needs more insulin than usual to clear glucose, or sugar, from the blood. Girls who are the most insulin resistant begin menstruating much earlier than their peers, Ibanez said.
Therefore, Ibanez and her co-workers studied whether a low dose of metformin, a drug that improves insulin resistance, would slow the transition through puberty by decreasing insulin resistance and abdominal fat. The girls had an average age of nearly 8 when they started the study. They randomly received either no treatment (19 girls) or treatment with low-dose metformin once a day (19 girls) for 4 years.
The metformin-treated girls started puberty and menstruation later than the untreated girls, the authors found. After 4 years of treatment, they also gained about 50 percent less fat—especially abdominal fat—and became less insulin resistant, compared with girls who did not receive the drug, according to Ibanez. They also had fewer risk factors for future heart disease, including better cholesterol levels, she said.
Bone mineral density testing showed no harm to bone development in the treated girls. At 4 years, treated patients continued to grow taller, but most untreated girls had already stopped growing.
Use of metformin in this patient population is experimental. Metformin is approved for treatment of type 2 diabetes in people 10 years or older.
###
Researchers from the University of Girona’s Doctor Josep Trueta Hospital, Spain; the Hospital of Terrassa, Spain; and the University of Leuven, Belgium, collaborated on this study. Carlos III Institute of Health in Madrid, Spain, funded the study.
Founded in 1916, The Endocrine Society is the world’s oldest, largest, and most active organization devoted to research on hormones, and the clinical practice of endocrinology. Today, The Endocrine Society’s membership consists of over 14,000 scientists, physicians, educators, nurses and students in more than 80 countries. Together, these members represent all basic, applied, and clinical interests in endocrinology. The Endocrine Society is based in Chevy Chase, Maryland. To learn more about the Society, and the field of endocrinology, visit our web site at www.endo-society.org.\
Contact: Aaron Lohr
alohr@endo-society.org
240-482-1380
The Endocrine Society
May 19, 2008
By Marcelle Pick, OB/GYN NP
Women to Women
Fatigue is one of the most common symptoms I hear about from my patients at the clinic.
And when I ask these women to tell me about what’s going on in their lives, all too often the answers include more responsibility than seems humanly possible. They’re waking up still tired, unable to think straight in the morning without caffeine; needing high-carb snacks, more caffeine, or a nap to get through the afternoon; then burning the midnight oil because they’re too wired to sleep. Pretty soon these women are in a seemingly unending cycle of exhaustion and poor nutrition — and feel desperate for the energy they once had.
Science tells us that if you experience stress on a chronic basis, the tiny adrenal glands that moderate your stress response and balance many other hormones in your body will suffer. Adrenal fatigue is what develops. And as the adrenal glands become increasingly compromised, women end up with excess abdominal weight, decreased immunity, lack of concentration, irritability, disrupted sleep, and ultimately, pure exhaustion. But the upside is: adrenal fatigue can be prevented and reversed. I’ve seen it time and again. And one of the best places to start is by paying closer attention to the choices you make about food — and not just what you eat, but when you eat it and how.
From my own experience and that of my patients, I know it’s difficult to make good nutritional choices when we’re going through periods of stress. Not only are our minds preoccupied with the stressor at hand, but our bodies are telling us they desperately need support, so we reach for foods that provide quick energy. Particularly at the end of a stressful day as the body is entering a period of recovery, overeating or making poor choices can be easy to do.
I know it feels overwhelming to think about changing your eating patterns, but believe me, small, incremental changes can really support better adrenal gland function and your daylong energy reserves. You don’t have to drag through the long days or dread your alarm clock every morning. Let’s look at some options for eating to support your adrenals — so you can enjoy good energy all through the day, and get a great night’s sleep. The difference can be like night and day!
To continue reading:
http://www.womentowomen.com/adrenalfatigue/adrenalglandnutrition.aspx
April 9, 2008
Yahoo News
Wed Apr 9,2008
WASHINGTON - Add another risk to hormone therapy after menopause: Benign breast lumps. One type of hormone therapy — estrogen plus progestin — already is well-known to increase the risk of breast cancer. But a major study of women able to use estrogen alone didn’t find that link.Tuesday, researchers reported a new wrinkle: Those estrogen-only users doubled their chances of getting non-cancerous breast lumps. That’s a concern not only because of the extra biopsies and worry those lumps cause, but because a particular type — called benign proliferative breast disease — is suspected of being a first step toward developing cancer 10 years or so later.
About one in five women undergo a breast biopsy within a decade of starting annual mammograms, and most are of those abnormalities turn out to be benign. Yet under a microscope, there are different types, from simple fluid-filled cysts to what’s called proliferative breast disease because it’s made of growing cells.
The latest work, published in the Journal of the National Cancer Institute, re-examines data from the landmark Women’s Health Initiative that found a variety of health risks from long-term hormone therapy.
Only women who have undergone hysterectomies are able to use estrogen-only therapy, and the WHI originally included more than 10,000 of those women, who were given either estrogen or a dummy drug and tracked for about seven years.
Now, a team led by Dr. Tom Rohan of the Albert Einstein College of Medicine in New York has reviewed breast biopsies done on those women — and identified 232 cases of benign proliferative breast disease. Women given the estrogen-only therapy had twice the risk of developing these abnormalities compared with women given a placebo.
WHI participants are still being tracked, allowing scientists to eventually tell if the benign breast problems were a signal of more trouble to come, Rohan concluded.
http://news.yahoo.com/s/ap/20080409/ap_on_he_me/estrogen_breast_lumps
March 6, 2008
By LINDSEY TANNER, AP Medical Writer
Tue Mar 4, 6:39 PM ET
CHICAGO - The first follow-up of a landmark study of hormone use after menopause shows heart problems linked with the pills seem to fade after women stop taking them, while surprising new cancer risks appear.
That heart trouble associated with hormones may not be permanent is good news for millions of women who quit taking them after the government study was halted six years ago because of heart risks and breast cancer.
But the new risks for other cancers, particularly lung tumors, in women who’d taken estrogen-progestin pills for about five years puzzled the researchers and outside experts.
Those risks “were completely unanticipated,” said Dr. Gerardo Heiss of the University of North Carolina in Chapel Hill, lead author of the follow-up analysis.
The analysis focused on participants’ health in the first two to three years after the study’s end. During that time, those who’d taken hormones but stopped were 24 percent more likely to develop any kind of cancer than women who’d taken dummy pills during the study.
“There’s still a lot of uncertainty about the cause of the increased cancer risk,” said analysis co-author Dr. JoAnn Manson, chief of preventive medicine at Harvard’s Brigham and Women’s Hospital.
The cancers included breast tumors, which also occurred more frequently in hormone users during the study.
The researchers noted that the increased risks for all cancers amounted to only three extra cases per year for every 1,000 women on hormone pills, compared with nonusers.
Still, Heiss said the results suggest that former hormone users need to be vigilant about getting cancer screening including mammograms.
“Vigilance is justified,” he said. “No alarm, but vigilance.”
The initial study of 16,608 postmenopausal women was designed to examine pros and cons of taking pills long thought to benefit women’s health. It was halted in 2002 when more breast cancers, heart attacks and related problems were found in hormone users versus nonusers.
There were some health benefits — decreased risks for hip fractures and colorectal cancer — but the follow-up found those also faded after women stopped the pills.
Some data suggest that U.S. breast cancer rates have declined since the study’s end. But that likely reflects fewer women starting on the pills rather than any decline in breast cancer risk among past users, said Dr. Michael Lauer of the National Heart, Lung and Blood Institute at the National Institutes of Health, which conducted and funded the landmark research.
The authors said the new results send the same message they’ve been advocating ever since the study ended: Health risks from estrogen-progestin pills outweigh their benefits, and they should only be used to relieve hot flashes and other menopause symptoms, in the lowest possible dose for the shortest possible duration.
The new analysis appears in Wednesday’s Journal of the American Medical Association.
To continue reading:
http://news.yahoo.com/s/ap/20080304/ap_on_he_me/hormone_risks
