Category: Made For Science

Advancing Breast Cancer Prevention: The α-LA Vaccine

Carina Garcia
June 2025

Breast cancer is the most frequently diagnosed cancer and leading cause of death in women globally. Current treatments require multidisciplinary care, allowing for personalized therapies and treatments accounting for certain biomarkers.^[3,8] The standard course of treatment for early-stage breast cancer is breast-conserving surgery with radiotherapy or mastectomy, and dependent on the case, may also incorporate adjuvant systemic therapy as needed. Further, the treatment for metastatic breast cancer aims to optimize patient’s quality of life and survival.^[8] Breast cancer care is continuously evolving with new, innovative preventive care and treatments, many of which are currently in development and undergoing trials. Among the advancements underway, a promising vaccine known as the α-Lactalbumin (α-LA) vaccine has drawn interest for its targeted approach, focusing on a breast-specific protein.^[7] This novel approach could pave the way for the future of breast cancer prevention and improve women’s health.

What is α-LA?

α-LA is a breast-restricted protein only expressed during lactation, and it serves as a unique marker for breast cancer.^[5,6] Notably, studies have shown that the highest α-LA expression levels were found in patients with stage IV breast cancer. These levels are comparable to those found in women in the last trimester of pregnancy and patients with gynecological cancers. Moreover, the level of α-LA in pregnant females were significantly higher than women with benign breast tumours or non-gynecological cancers and for non-pregnant females and males. Additionally, it is crucial to note that the level of α-LA in patients with stage IV breast cancer were significantly higher than patients with stage I-III breast cancer.^[6] Given this context, the elevation of α-LA protein in advanced stages of breast cancer makes it a feasible target for a prophylactic cancer vaccination.^[5,7] The groundbreaking concept of an α-LA-targeted vaccine strategy builds upon previous research by the Cleveland Clinic Lerner Research Institute, which successfully found that the α-LA vaccination completely prevented breast cancer growth in mice at risk for the disease.^[4,7] Therefore, further understanding the processes that enable the vaccine to target cancerous cells will provide valuable insights into its potential effectiveness in human patients.

The Inner Workings of the Vaccine 

The α-LA vaccine intends to activate the immune system, forming a protective response against breast cancer cells expressing α-LA.^[1] Studies indicate the viability of clinically-inducing a proinflammatory immune response against α-LA.^[7] Further, this prophylactic vaccine does not cause any significant inflammation in normal, nonlactating breast tissue, thus minimizing the potential risks of the vaccine.^[5] The vaccine also contained an immunologic adjuvant, a drug that enhances the immune response against α-LA to prevent tumor growth.^[4]

The α-LA vaccine is an experimental drug not yet approved by the Food and Drug Administration (FDA).^[2] Recently, Anixa Biosciences, Inc., a biotechnology company, completed a phase-one clinical trial of the α-LA vaccine. This trial focused on individuals who have completed treatment for triple-negative breast cancer (TNBC) as well as those at high risk for the disease or its recurrence.^[1,4] 

The aim of the phase-one trial was to determine the optimal dosage for participants with early-stage TNBC and to enhance the immune response to the vaccine. The study also included cancer-free individuals who are at high risk for developing TNBC or who have chosen to undergo prophylactic mastectomy because they have a high genetic risk for the disease.^[4] 

The three cohorts of this trial included: 

1. Participants with high-risk TNBC.
2. Participants scheduled for prophylactic mastectomy secondary to genetic risk of TBNC.
3. Participants that are post-TBNC treatment and are receiving adjuvant pembrolizumab.^[2]

TNBC is the most aggressive subtype of breast cancer, accounting for 12% to 15% of all breast cancer cases, with a mortality rate of about 25% within five years of diagnosis. At present, the only reliable preventive measure for those at high risk for TNBC is undergoing a mastectomy. Thus, the development of the α-LA vaccine represents a significant step towards alternative preventative care for those affected by or at risk for TNBC.^[4]

Optimism at a Professional Level

“We believe we have made significant progress in the development of this vaccine, having recently completed enrollment in the Phase 1 clinical trial. We look forward to the next stage of development and are optimistic about the impact this vaccine could have in the treatment and prevention of breast cancer,” said Amit Kumar, Ph.D, CEO of Anixa Biosciences, Inc.^[1] 

The innovative vaccine strategy of the α-LA vaccine inspires a hopeful outlook for the future, where scientific advancements can yield transformative solutions for women’s health.

“Long term, we are hoping that this can be a true preventive vaccine that would be administered to cancer-free individuals to prevent them from developing this highly aggressive disease,” says oncologist Dr. G. Thomas Budd in a statement to the Cleveland Clinic.^[4] 

References 

[1] Anixa Biosciences, Inc. (2025, June 3). Anixa biosciences’ breast cancer vaccine featured in NewsNation interview. PR Newswire. https://www.prnewswire.com/news-releases/anixa-biosciences-breast-cancer-vaccine-featured-in-newsnation-interview-302471341.html 

[2] Budd, G. T., & Case Comprehensive Cancer Center. (2025, May 23). Adjuvant Therapy With an Alpha-lactalbumin Vaccine in Triple-Negative Breast Cancer. http://clinicaltrials.gov. https://www.google.com/url?q=https://clinicaltrials.gov/study/NCT04674306&sa=D&source=docs&ust=1749942627723910&usg=AOvVaw3E-6rajBTKUGmPdIiRTpKp 

[3] Burguin, A., Diorio, C., & Durocher, F. (2021). Breast cancer treatments: Updates and new challenges. Journal of Personalized Medicine, 11(8), 808. https://doi.org/10.3390/jpm11080808

[4] Cleveland Clinic. (2023, May 15). Is there a vaccine for breast cancer? https://health.clevelandclinic.org/breast-cancer-vaccine-trial

[5] Jaini, R., Kesaraju, P., Johnson, J. M., Altuntas, C. Z., Jane-wit, D., & Tuohy, V. K. (2010). An autoimmune-mediated strategy for prophylactic breast cancer vaccination. Nature Medicine, 16(7), 799-803. https://doi.org/10.1038/nm.2161

[6] Thean, E., & Toh, B. (1990). Serum human α-lactalbumin as a marker for breast cancer. British Journal of Cancer, 61(5), 773-775. https://doi.org/10.1038/bjc.1990.173 

[7] Tuohy, V., Jaini, R., Johnson, J., Loya, M., Wilk, D., Downs-Kelly, E., & Mazumder, S. (2016). Targeted vaccination against human α-lactalbumin for immunotherapy and primary Immunoprevention of triple negative breast cancer. Cancers, 8(6), 56. https://doi.org/10.3390/cancers8060056

[8] Wang, J., & Wu, S. (2023). Breast cancer: An overview of current therapeutic strategies, challenge, and perspectives. Breast Cancer: Targets and Therapy, 15, 721-730. https://doi.org/10.2147/bctt.s432526

Cervical Cancer and HPV: A Preventable Disease

Ali A. Lateef
June 2025

While breast cancer is linked to a number of genetic and environmental factors, cervical cancer is overwhelmingly a virus-linked condition. Specifically, the human papillomavirus (HPV) is responsible for 95% of cervical malignancies.^[7]  It is this link between HPV and cervical cancer that makes eliminating the latter a possibility by controlling and eradicating the former.

Overview

HPV is not one entity, but instead a group of variant yet similar pathogens. It is linked to many types of cancer in addition to cervical cancer such as vulvar, vaginal, anorectal, oropharyngeal, and penile cancers.

Most infections with HPV are effectively handled by the immune system without any long-term issues and often without the person knowing they were even infected because of a lack of symptoms. If, however, it does persist, and it’s one of the cancer-causing (oncogenic) types, then it becomes a source of concern.

In symptomatic infections with certain HPV types, warts start developing in various areas including the hands and feet, mouth and face, and/or the anal and genital areas, resolving on their own in a matter of 1-2 years. These wart-causing types are not connected to cancers, and the oncogenic types usually cause completely silent infections.

After 15-20 years of infection with an oncogenic type, cancerous development could be seen in the cervix. Early stages are often asymptomatic and only when there’s been significant growth can cancer symptoms usually be seen.^[5]

The Lived Experience

Cervical cancer takes decades to develop, and symptoms can take time to appear, so for most patients hearing the news that they’ve got cancer is often a blindsiding experience, and they have little time to fully digest the news as they must hastily decide upon a treatment plan.

When they arise, symptoms include abnormal vaginal bleeding or discharge (post-menopause, between periods, after sex, or heavier/longer than usual), pelvic pain, and in more progressive disease swelling of the legs and urinary or bowel issues.^[2]

Within weeks, a person can go from believing themself to be completely healthy to possibly preparing to undergo surgery that may approach a radical hysterectomy.

Chemotherapy, radiation, and brachytherapy (internal radiation) can cause a host of side effects: nausea and vomiting, fatigue, anxiety, skin issues, bowel and urinary issues, and loss of appetite/weight, with the whole experience being physically tiring and emotionally draining.

Throughout this journey, support from friends and family provides a lifeline for many patients to not lose themselves in worry and doubt, and support from their partners can help maintain the connection of intimacy between them.^[1]

Prevention, Protection, Treatment

The principal method of HPV control is vaccination, with the American CDC recommending routine vaccination at 11-12 years of age.

The vaccine currently used in the USA is the 9-valent Gardasil®, meaning that it protects against 9 HPV types, most notable among them are types 16 and 18 which alone cause 66% of cervical cancers. Overall, the types covered by the vaccine account for about 81% of all cervical cancer cases.^[6]

Practicing safe sex has some efficacy in protecting against HPV, although condoms don’t offer full skin protection and a significant percentage of the sexually active population is infected at any given time, so the main prevention strategy remains vaccination, accompanied with safe sex and limiting the number of sexual partners.^[4]

If someone gets infected with HPV, there’s currently no cure for it, but that may change in the future as a new vaccine, Vvax001, is being tested as a potential treatment for type 16 positive patients with premalignant developments in their cervix.^[3] Findings from its phase 2 trial were published in March of this year, so there’s still more testing to be done before it becomes available.

Conclusion

While HPV has a tendency towards malignancy, the process occurs at a very slow rate making the development of cancers span decades.

Cervical cancer symptoms can take time to arise, and when they do arise they’re sometimes confused for other conditions which delays proper diagnosis and treatment, making routine Pap smears essential for accurate early diagnoses.

By educating ourselves and future generations about how we can protect ourselves from this disease, sharing the stories of survivors, promoting vaccination, and attending regular screenings, we can become one of the last generations to ever suffer from this disease.

References

[1] Centers for Disease Control and Prevention. (n.d.). Cervical cancer screening and survivor stories. Centers for Disease Control and Prevention. https://www.cdc.gov/cervical-cancer/stories/index.html 

[2] Cervical cancer symptoms: Signs of cervical cancer. Cervical Cancer Symptoms | Signs of Cervical Cancer | American Cancer Society. (2024, October 2). https://www.cancer.org/cancer/types/cervical-cancer/detection-diagnosis-staging/signs-symptoms.html 

[3] Eerkens, A. L., Esajas, M. D., Brummel, K., Vledder, A., van Rooij, N., Plat, A., Avalos Haro, S. B., Paijens, S. T., Slagter-Menkema, L., Schuuring, E., Werner, N., Kosterink, J. G. W., Kroesen, B.-J., Wilschut, J. C., Daemen, T., Bart, J., Nijman, H. W., de Bruyn, M., & Yigit, R. (2025). VVAX001, a therapeutic vaccine, for patients with HPV16-positive high-grade cervical intraepithelial neoplasia: A phase II trial. Clinical Cancer Research, 31(6), 1016–1026. https://doi.org/10.1158/1078-0432.ccr-24-1662 

[4] How to protect against HPV. American Cancer Society. (2024, April 30). https://www.cancer.org/cancer/risk-prevention/hpv/hpv-prevention.html 

[5] HPV and cancer. NCI. (2025, May 9). https://www.cancer.gov/about-cancer/causes-prevention/risk/infectious-agents/hpv-and-cancer 

[6] HPV vaccine administration | CDC. CDC. (2021, November 16). https://www.cdc.gov/vaccines/vpd/hpv/hcp/administration.html 

[7] World Health Organization. (2024, March 5). Cervical cancer. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/cervical-cancer 

The Luteal Lowdown: Hormones, Mood, and the Science of Cycles

Asmita Adya
March 2025

The time between ovulation and menstruation, known as the luteal phase, is often marked by emotional variability and instability in menstruating individuals. Feelings of negative affect, physical discomfort, and general malaise commonly plague individuals as the uterine lining thickens in preparation for pregnancy or, if fertilization does not occur, menstruation.

The Biological Basis

During ovulation, the hypothalamus secretes a surge of gonadotropin-releasing hormone (GnRH) to the pituitary gland. In response, the anterior pituitary gland releases luteinizing hormone (LH), which stimulates the gonads, leading to the luteal phase. During this phase, progesterone reaches its peak concentration. Prior to this, during the follicular phase, the anterior pituitary secretes follicle-stimulating hormone (FSH), which leads to a peak in estradiol levels. Estrogen, an ovarian hormone critical to well-being, plays a key role in mood regulation. Low estrogen levels have been implicated in increased vulnerability to depression and impaired emotional regulation. Thus, during the luteal phase, when estrogen levels decline, studies have shown that women exhibit more frequent negative affect and a heightened stress response [1]. Additionally, estradiol contributes to reward processing, as it has a stimulatory, activational effect and interacts with dopamine [2].

However, this raises the question: does the likelihood of experiencing negative affect stem solely from decreased estrogen, or does progesterone itself play a direct role? The lack of conclusive clinical evidence remains a significant barrier to answering this question.

The Implications of Hormonal Contraceptives

Hormonal contraceptives and their effects may serve as a clue. In the 1960s, ‘the pill’ revolutionized hormonal contraception in the United States. The pill typically contains ethinyl estradiol or mestranol (synthetic estrogen) and progestin (synthetic progesterone), though some formulations are progestin-only. The androgenic properties of different progestins vary, ranging from strongly anti-androgenic to strongly androgenic. The typical dose ranges from 0.1 to 3.0 mg per pill.

Although the exact mechanism of action is not fully understood, hormonal contraceptives are thought to “mimic pregnancy.” During pregnancy, endogenous estrogen and progesterone levels rise, exerting negative feedback on hypothalamic GnRH secretion. Similarly, contraceptives prevent pregnancy by mimicking these negative feedback effects. Exogenous hormones from the pill inhibit GnRH release, thereby suppressing FSH and LH secretion from the anterior pituitary. As a result, follicular development is inhibited due to reduced FSH, and ovulation does not occur due to the absence of an LH surge. While the extent of hormonal suppression varies by contraceptive formulation, this chronic suppression prevents pregnancy. Women using hormonal contraceptives typically have endogenous hormone concentrations equivalent to or lower than those observed in the early follicular phase of naturally cycling women. Although hormone levels usually return to baseline within months after discontinuation, some studies suggest lower levels persist for years [3].

Why does this matter? Women who use hormonal contraceptives often report negative side effects such as mood changes, diminished libido, and exacerbation of underlying psychiatric conditions [4]. Furthermore, contraceptives have been implicated in structural and functional changes in brain regions involved in affective and reward processing [5]. These effects highlight the profound impact of exogenous hormone manipulation. Since many contraceptive methods rely on progestin as a primary component, it is plausible that progesterone plays a key role in negative affect, though further research is needed to establish a definitive correlation.

Plausible Physical and Mental Effects

Possible physical and mental effects of elevated progesterone include fatigue, negative affect, and mood fluctuations [6]. These effects can impair emotional and physical functioning and exacerbate underlying psychiatric conditions. These hormonal fluctuations occur independently of individual control; menstruation follows its cyclical course, only ceasing at menopause. So, never dismiss a woman as “too hormonal”—she is simply functioning as nature intended.

References 

[1] Albert, K. M., & Newhouse, P. A. (2019). Estrogen, stress, and depression: Cognitive and biological interactions. Annual Review of Clinical Psychology, 15, 399–423. https://doi.org/10.1146/annurev-clinpsy-050718-095557.

[2] Beltz, A. M., & Moser, J. S. (Year). Ovarian hormones: A long overlooked but critical contributor to cognitive brain structures and function. Annals of the New York Academy of Sciences, Special Issue: The Year in Cognitive Neuroscience.

[3] Taylor, C. M., Pritschet, L., & Jacobs, E. G. (2021). The scientific body of knowledge – whose body does it serve? A spotlight on oral contraceptives and women’s health factors in neuroimaging. Frontiers in Neuroendocrinology, 60, 100874. https://doi.org/10.1016/j.yfrne.2020.100874

[4] Martell, S., Marini, C., Kondas, C. A., & Deutch, A. B. (2023). Psychological side effects of hormonal contraception: A disconnect between patients and providers. Journal of Women’s Health, 32(1), 45-53. https://doi.org/10.1089/jwh.2022.0467

[5] Brønnick, M. K., Økland, I., Graugaard, C., & Brønnick, K. K. (2020). The effects of hormonal contraceptives on the brain: A systematic review of neuroimaging studies. Frontiers in Psychology, 11, Article 556577. https://doi.org/10.3389/fpsyg.2020.556577

[6] Standeven, L. R., McEvoy, K. O., & Osborne, L. M. (2020). Progesterone, reproduction, and psychiatric illness. Best Practice & Research Clinical Obstetrics & Gynaecology, 69, 108–126. https://doi.org/10.1016/j.bpobgyn.2020.06.001

Exercise Arises as a Key Strategy to Reduce Falls in Polypharmacy for Elderly Women 

Steven Shin
March 2025

Among the elderly, a condition known as polypharmacy became one of the most significant public health concerns. Recent research by the University of Eastern Finland and Kuopio University Hospital has highlighted the effectiveness of structured exercise in reducing fall risks in elderly women.^[3] The study underscores the importance of incorporating physical activity into healthcare strategies aimed at fall prevention. 

The Impact of Polypharmacy on Physical Function 

Polypharmacy, the concurrent use of four or more medications, has been linked to deteriorating physical fitness and an increased risk of falls.^[3] As older adults frequently require multiple medications to manage chronic conditions, this association is concerning. However, while previous studies have suggested a direct correlation between polypharmacy and higher fall risks, the recent findings challenge this notion by demonstrating that targeted exercise programs can mitigate these risks.^[2] 

The Kuopio Fall Prevention Study: A Game-Changer 

The study analyzed data from the Kuopio Fall Prevention Study, a randomized controlled trial involving 914 women with a median age of 76.5 years. Participants were randomly assigned to either an exercise group or a control group. The exercise program consisted of twice-weekly guided exercise sessions, including tai chi and circuit training, for the first six months. Afterward, participants were granted free access to the city’s recreational sports facilities for an additional six months.^[3] Fitness assessments were conducted at baseline, one year, and two years into the study. Medication use was tracked through self-reported questionnaires, and falls were monitored for approximately two years via biweekly SMS queries.^[3] 

The results of the study were compelling. Among participants with polypharmacy, those engaged in the exercise intervention exhibited a 29% lower risk of falls compared to the control group taking zero to one medications.^[1] Additionally, while 1,380 falls were recorded during the study period—739 of which resulted in injury or pain and 63 in fractures—polypharmacy did not increase the likelihood of falls in the control group.^[3] Moreover, fitness tests revealed that participants using zero to one medications generally performed better than those with polypharmacy. However, individuals with the poorest physical fitness at the outset of the study

benefited the most from the intervention.^[2] This finding suggests that physical activity can significantly enhance functional ability, even among those with limited mobility. 

Patient Outcomes and Future Directions 

The study’s findings reinforce the need to integrate structured exercise programs into standard geriatric care. Healthcare professionals should actively encourage physical activity, particularly for elderly patients managing multiple medications. The benefits of tai chi and circuit training extend beyond fall prevention; they contribute to improved balance, strength, and overall quality of life.^[4] 

Additionally, previous research has linked polypharmacy to reduced physical function, further emphasizing the importance of targeted exercise interventions. For example, a systematic review  found a reciprocal relationship between polypharmacy and diminished physical performance in older adults. Similarly, findings from the Medical Research Council National Survey of Health and Development indicated that polypharmacy at ages 60 to 69 was associated with poorer cognitive and physical capabilities, even when accounting for chronic disease burden.^[1] 

Given the significant benefits demonstrated by the Kuopio Fall Prevention Study, exercise should be a cornerstone of fall prevention strategies for elderly individuals, particularly those with polypharmacy. Encouraging participation in structured physical activity programs may not only reduce fall risk but also enhance overall physical well-being. Future research should continue exploring how tailored interventions can further optimize outcomes for older adults managing multiple medications. 

References 

[1] Corbett, A., Stevens, T., Aarsland, D., Day, S., & Ballard, C. (2018). Systematic review of polypharmacy and cognitive impairment in older adults. Journal of the American Geriatrics Society, 66(6), 1071-1080. https://doi.org/10.1111/jgs.15374 

[2] Gutiérrez-Valencia, M., Aldaz-Herce, P., Lacalle-Fabo, E., Larrayoz-Sola, B., Martínez-Velilla, N., & Fernández de Retana-Marín, A. (2018). Relationship between polypharmacy and functional capacity in older adults: A systematic review. Aging & Disease, 9(6), 1014-1022. https://doi.org/10.14336/AD.2018.0611 

[3] Vilpunaho, T., Kröger, H., Honkanen, R., Koivumaa-Honkanen, H., Sirola, J., Kuvaja-Köllner, V., … & Rikkonen, T. (2019). Randomised controlled trial (RCT) study design for a large-scale municipal fall prevention exercise programme in community-living older

women: study protocol for the Kuopio Fall Prevention Study (KFPS). BMJ open, 9(6), e028716. https://doi.org/10.1136/bmjopen-2018-028716 [4] Sherrington, C., Fairhall, N. J., Wallbank, G. K., Tiedemann, A., Michaleff, Z. A., Howard, K., & Clemson, L. (2017). Exercise for preventing falls in older people living in the community: An abridged Cochrane systematic review. British Journal of Sports Medicine, 51(24), 1750-1758. https://doi.org/10.1136/bjsports-2017-098425

Does Menopause Occurring Later In Life Lead To Better Vascular Health?

Julia Palka
February 2025

Menopause is the dreaded cycle of hormonal imbalance, hot flashes, and discomfort. Women of all ages know it will manifest in various stages, with different symptoms and degrees of abruptness. However, first, we must all face the monthly gift of menstruation, but new findings show that if your body’s natural clock is a little late to the initial onset of menopausal symptoms (55 or older), you may have a significantly decreased risk of cardiovascular events!

According to newly published research from the University of Colorado at Boulder, Women who go through menopause at later ages in life have healthier blood vessels than women who go through it earlier. The research, published in the American Heart Association journal Circulation Research¹ arrived just in time for February, which is Women’s Heart Health Month. The findings can help pave the way to new research and advancements in therapies and treatments aimed at reducing heart disease, the leading cause of death in women.

The new insights show that females who stop menstruating at 55 or older are suggested to have a significantly lower risk of heart attacks and cardiovascular events during their postmenopausal years over women who stop menstruation below 55 years of age. To support this claim, studies write that women 55 or older are actually 20% less likely to develop ailments like heart disease than those 54 and younger. Sanna Darvish, a PhD candidate in the Department of Integrative Physiology at the University of Colorado at Boulder is part of a study assessing the vascular health of 92 women and how well their brachial artery dilates with increased blood flow. Darvish and her colleagues also measured the women’s mitochondrial health in relation to the cells lining the women’s blood vessels. The mitochondria, which is considered the powerhouse of energy in the human body, helped the researchers determine what molecules were present in the women’s blood streams.

The study proved that all the postmenopausal women had significantly worse function in their arteries than women who had not yet experienced menopause³. This is because, as women age, they produce less nitric oxide, a chemical compound that helps prevent plaque build up and stiffness as it dilates the blood vessels. The mitochondria in the cells lining the blood vessels also become more dysfunctional with age and generate free radicals; highly reactive and unstable molecules produced naturally by the human body. 

When women go through menopause, the age related decline in cardiovascular health is accelerated. However, the 10% of women who experience a late onset of menopausal symptoms are seemingly less affected by this predicament. Darvish’s study found that vascular function was only 24% worse in the women who experienced menopause later in life compared to the premenopausal women. In contrast those in the normal onset stage had a 51% decline in vascular health. The differences between the groups occurred 5 years or more after the women went through menopause, where remarkably the late onset group had a reported  44% better vascular function than the normal onset group. 

The success of maintaining better vascular health in the late onset group was linked to the women’s better functioning of mitochondria, which decreased the amount of free radicals produced. The circulating blood in the late onset group also generated more favorable levels of different lipid metabolites in their blood. Darvash and her team will next study how early onset menopause might impact heart health and how certain nutritional supplements marketed as targeting free radicals in the blood vessels may reduce heart disease in women at higher risks. Future research is still necessary to solidify the gaps between the studies currently published, and how and if all women will experience the same prognosis. John Hopkins Medicine says;  If cardiovascular disease runs strongly in the family, it’s also important that you see a cardiologist to further assess the likelihood of having cardiovascular disease and to optimize treatment. ² In summary, the important research provided from the University of Colorado at Boulder suggests that women who experience menopause at 55 or older have healthier blood vessels and a 20% lower risk of heart disease compared to those with earlier menopause. This is linked to better mitochondrial function, reduced free radicals, and improved vascular health, highlighting potential new avenues for cardiovascular disease prevention in women. 

References:

Darvish, S., et al. (2025). Preservation of vascular endothelial function in late-onset postmenopausal women. Circulation Research. https://doi.org/10.1161/circresaha.124.325639

Hopkins Medicine. (n.d.). Menopause and the cardiovascular system. Retrieved February 14, 2025, from https://www.hopkinsmedicine.org/health/conditions-and-diseases/menopause-and-the-cardiovascular-system#:~:text=Plus%2C%20studies%20that%20have%20followed,normal%20age%20(around%2050)

News-Medical. (2025, February 4). Late menopause linked to better vascular health in women. News-Medical. Retrieved from https://www.news-medical.net/news/20250204/Late-menopause-linked-to-better-vascular-health-in-women.aspx

Understanding Organ Prolapse: Causes, Symptoms, and Treatment 

Steven Shin
February 2025

Pregnancy is thought of as a joyful experience, but for some women, it can bring life-threatening health challenges. One of the challenges is Peripartum Cardiomyopathy (PPCM), a form of heart failure that occurs during the final stages of pregnancy or in the postpartum period.¹ Recent research has revealed new information in the diagnosis, treatment, and management of PPCM to help women worldwide. 

What is PPCM? 

PPCM affects approximately 1 in 1,500 to 2,000 pregnancies globally with nonspecific symptoms like shortness of breath, exhaustion, and swelling¹. Crucial interventions or treatment are delayed because these symptoms are often dismissed as normal parts of pregnancy. In PPCM, the heart’s left ventricle weakens and impairs its function. While early treatment results in recovery, undiagnosed or untreated PPCM can lead to persistent heart failure or death³. 

Research showed that the hormone prolactin, commonly associated with breastfeeding, plays a significant role in PPCM. In affected women, prolactin is broken down into a harmful material that damages blood vessels and leads to heart failure. Researchers at the Hannover Medical  School found that the drug bromocriptine which is traditionally used to suppress lactation can block this harmful effect and promote heart recovery when used for heart failure therapy³. The safety and efficacy of bromocriptine showed that it can significantly improve maternal cardiac health without increasing the risk of complications such as blood clots². A study based on a global PPCM registry of 500+ patients supports bromocriptine as a recommended treatment for PPCM². 

New Hope for Subsequent Pregnancies 

Historically, women recovering from PPCM were advised against future pregnancies due to the high risk of relapse or worsening heart function. However, new research suggests a more optimistic outlook. A study based on data from the Global PPCM Registry found that even women with mild residual heart failure could safely carry another pregnancy under medical  supervision². 

This represents a major shift that allows women to expand their families without undue fear. Key to this success is interdisciplinary care by cardiologists, obstetricians, and maternal-fetal medicine specialists who ensure both mother and child are monitored closely¹.

PPCM’s impact is not uniform across the globe. A 20-year population study emphasized significant disparities in PPCM incidence and discussed higher rates reported in Black populations compared to White populations¹. These findings underscore the urgent need for targeted healthcare strategies and awareness campaigns in disproportionately affected communities. 

Access to specialized care also varies widely between high-income and low-income regions. In many low-resource settings, limited awareness means that PPCM often goes undetected until it progresses to a critical stage³. International registries and collaborations are vital in bridging this gap by providing data and resources to improve diagnosis and treatment worldwide³. 

Patient Outcomes and Future Directions 

A study published in the Journal of the American Heart Association reported that 6% of PPCM  patients die within six months of diagnosis, with 42% of these deaths attributed to heart failure and 30% to sudden cardiac arrest³. However, timely diagnosis and intervention can significantly reduce these figures. Advanced imaging techniques, the use of cardiac biomarkers, and continued research into genetic predispositions are important steps to improve outcomes¹. 

Additionally, researchers are exploring how to predict PPCM risk in future pregnancies more accurately. Early identification of at-risk women could allow for tailored monitoring and preventative therapies that potentially reduce the burden of this condition². Thanks to research and the dedication of specialized care teams, women diagnosed with PPCM now have access to better treatments and a brighter future. From innovative therapies like bromocriptine to improved management of subsequent pregnancies, advancements in PPCM care are empowering women to navigate motherhood against all odds. Despite the challenges, with early diagnosis and interdisciplinary care, affected women can embrace both recovery and the possibility of growing their families. 

Reference 

[1] Arany, Z., & Elkayam, U. (2016). Peripartum cardiomyopathy. Circulation, 133(14), 1397– 1409. https://doi.org/10.1161/CIRCULATIONAHA.116.018094 

[2] Sliwa, K., Bauersachs, J., van der Meer, P., Petrie, M. C., Hilfiker-Kleiner, D., Hamdan, R.,  & Seferovic, P. (2025). Pregnancies in women after peripartum cardiomyopathy: The global  European Society of Cardiology EuroObservational Research Programme Peri-Partum  Cardiomyopathy Registry. European Heart Journal. https://doi.org/10.1093/eurheartj/ehaf006

[3] Van der Meer, P., Sliwa, K., Bauersachs, J., Hilfiker-Kleiner, D., & Petrie, M. C. (2024).  Bromocriptine treatment and outcomes in peripartum cardiomyopathy: The EORP PPCM  registry. European Heart Journal. https://doi.org/10.1093/eurheartj/ehae559

Fertility Preservation: What is oocyte cryopreservation and why has it increased in popularity?   

Chaimaa Riad
February 2025

What is Oocyte Cryopreservation?

Oocyte cryopreservation is also known as egg freezing. This is a procedure in which a woman’s eggs are retrieved, frozen and stored to preserve her ability to conceive later in life, while she is still of reproductive age.^[1] The eggs are specifically extracted from the body before their fertilization. Once they are ready to be used, the eggs undergo a thawing process to be transferred into the uterus and become fertilized for pregnancy.^[1] Oocyte cryopreservation is considered a form of preventative healthcare.^[2]

The first successful pregnancy recorded via egg freezing was in 1986. ^[3] Oocyte cryopreservation began to combat possible infertility in women with medical conditions like cancer, in which chemotherapy and pelvic radiation could damage their reproductive organs, or autoimmune conditions such as systemic lupus erythematosus. ^[4] However, there has been a large increase in the number of egg freezing procedures in the last six years for more social reasons. An increasing number of women have decided to do this procedure for financial, professional, or simply personal reasons. Studies have shown that many women believed that becoming pregnant before 35 would negatively impact their careers. ^[5] Women have been especially inclined to do this procedure with improvements in medical technology and even the use of AI in improving the freezing and thawing process for optimal fertilization. ^[4]

There are multiple risks of oocyte cryopreservation. Short-term adverse effects include general symptoms such as nausea, headache, irritability, chest pain, pelvic pain, and oliguria (decreased urine output). ^[2] Additionally, there are increased risks that come with assisted reproductive techniques (ART), which include preterm birth. This is one of the more severe risks, which also carries the potential risk of cerebral palsy. ^[5] Furthermore, women who undergo oocyte cryopreservation are more likely to be older. As women age, the complications of pregnancy, such as preeclampsia, gestational diabetes, ectopic pregnancy, and the need for a cesarean section tend to increase. ^[5]

It is also important to consider both the emotional and financial impacts of this procedure on women. This process is invasive and often requires women to undergo multiple cycles of egg freezing.^[3] These procedures can cost anywhere between $5,000-$10,000 per cycle. ^[4]

It is crucial for women to connect to a team of specialists who can thoroughly explain the benefits, drawbacks, and risks of the procedure. Additionally, counselors are essential to support women throughout the process. ^[2] In essence, egg freezing allows women the opportunity to have more flexibility in their family planning. There are ongoing advancements in reproductive medicine that will allow women to preserve fertility based on their own timeline. The most crucial factors to consider when deciding to freeze eggs would be the financial and emotional costs, as well as the possible risks, both long term and short term.

References:

[1] Egg freezing. UCLA Health. (n.d.). https://www.uclahealth.org/medical-services/obgyn/fertility/egg-freezing

[2] Katsani, D., Paraschou, N., Panagouli, E., Tsarna, E., Sergentanis, T. N., Vlahos, N., & Tsitsika, A. (2024, January 10). Social Egg freezing-a trend or modern reality?. Journal of clinical medicine. https://pmc.ncbi.nlm.nih.gov/articles/PMC10816669/

[3] Walker, Z., Lanes, A., & Ginsburg, E. (2022, January 7). Oocyte cryopreservation review: Outcomes of medical oocyte cryopreservation and planned oocyte cryopreservation – reproductive biology and endocrinology. BioMed Central. https://rbej.biomedcentral.com/articles/10.1186/s12958-021-00884-0

[4] Dimitriadis, I., (2024, February 20). Freezing Eggs: Advances in Fertility Treatment. Mass General Brigham. https://www.massgeneralbrigham.org/en/about/newsroom/articles/what-is-cryopreservation#:~:text=In%201984%2C%20the%20first%20baby,longer%20considered%20an%20experimental%20procedure. 

[5] Varlas, V. N., Bors, R. G., Albu, D., Penes, O. N., Nasui, B. A., Mehedintu, C., & Pop, A. L. (2021, July 30). Social freezing: Pressing pause on fertility. International journal of environmental research and public health. https://pmc.ncbi.nlm.nih.gov/articles/PMC8345795/

Understanding the Gender Differences in Post-Traumatic Stress Disorder 

Helena Huynh
October 2024

Post-Traumatic Stress Disorder (PTSD) is a debilitating mental health condition typically following exposure to a traumatic event, with symptoms impacting day-to-day functioning, causing the person to re-experience their traumatic event, and affecting overall cognition and mood.^[1] According to the World Health Organization, over half of the global population–a shocking 70% of people–will experience a potentially traumatic event in their lives, with a minority of that population (5.6%) going on to develop PTSD.^[2] However, women are much more likely to develop PTSD, with lifetime prevalence rates being almost three times as frequent for women than for men.^[3] Why does this happen? 

Types of Trauma 

Women are much more likely to experience high-impact trauma, including sexual-related trauma and sexual assault. The CDC National Intimate Partner and Sexual Violence Survey conducted in 2010 found that 18.3% of women in the United States experienced rape at some point in their lives.^[3] That equates to an alarming rate of about 1 in 5 women. Exposure to sexual violence are associated with higher rates of PTSD.^[2] Additionally, women are also more likely to experience sexual abuse at younger ages compared to men.^[3] Trauma in early childhood has a strong impact on overall neurobiological development^[4] and also serves as a risk factor increasing the likelihood of developing PTSD.^[1] 

Physiological Responses 

Prior research has found several differences when it comes to psychobiological reactions to PTSD^[4]. For one, hormonal responses can potentially play a role in regulating trauma responses. The hypothalamic-pituitary-adrenal (HPA) axis, a neuroendocrine system within the body that regulates responses to stress, has been found to be more sensitive to stress and trauma. Additionally, studies have found that testosterone may possibly work to reduce HPA reactivity.^[5] On top of that, studies have found that women with PTSD are more likely to experience a reduced fear-extinction during the mid-luteal phase of their menstrual cycle, when oestradiol and progesterone levels are lowest.^[5] These hormones are related to cognitive-emotional processes relating to PTSD, and in trauma-exposed women without PTSD, researchers actually found the opposite result.^[5]

Understanding PTSD Symptoms and Comorbidities 

When it comes to PTSD symptom expression, males and females tend to experience PTSD in a similar way.^[3] A study found that male and female veterans were about equally likely to report different PTSD symptoms on the PTSD Checklist^[3], a self-report measure looking at PTSD symptoms. However, when it comes to comorbidities, women are much more likely to experience internalizing disorders, including mood and anxiety-related disorders. Men, on the other hand, were much more likely to experience externalizing disorders, including substance abuse.^[3] 

Overall, previous research has established a number of differences in the development and prevalence of PTSD in males and females. Given that much of the early research surrounding our knowledge of PTSD revolves around male war veterans^[3], we must continue adding to the literature. Increasing our understanding of why these gender differences develop can inform targeted interventions to ultimately help those who need it. 

References 

[1] U.S. Department of Health and Human Services. (n.d.). Post-Traumatic Stress Disorder. National Institute of Mental Health. 

https://www.nimh.nih.gov/health/publications/post-traumatic-stress-disorder-ptsd

[2] World Health Organization. (2024, May 27). Post-traumatic stress disorder. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/post-traumatic-stress-disorder 

[3] Vogt, D. (2007, January 1). Va.gov: Veterans Affairs. Research on Women, Trauma and PTSD. https://www.ptsd.va.gov/professional/treat/specific/ptsd_research_women.asp#four 

[4] Olff, M. (2017). Sex and gender differences in post-traumatic stress disorder: An update. European Journal of Psychotraumatology, 8(sup4). 

https://doi.org/10.1080/20008198.2017.1351204

[5] Christiansen, D. M., & Berke, E. T. (2020). Gender- and sex-based contributors to sex differences in PTSD. Current Psychiatry Reports, 22(4). 

https://doi.org/10.1007/s11920-020-1140-y

Understanding Pelvic Organ Prolapse: Causes, Symptoms, and Treatment 

Steven Shin
October 2024

Pelvic organ prolapse (POP) is a condition seen primarily in elder women. It occurs when the muscles and connective tissues that support the pelvic organs become weakened or damaged.  This weakening allows the organs to drop from their usual positions and cause discomfort that potentially affecting a woman’s quality of life. While pelvic organ prolapse can be distressing,  treatment options exist and this can be managed without surgery [1].

Cause of Pelvic Organ Prolapse 

The causes of pelvic organ prolapse are multifactorial, but pregnancy and childbirth remain the most significant risk factors. During childbirth, the pelvic floor undergoes extreme stress. The levator ani muscles and the connective tissue that secures the vagina to the sidewalls of the pelvis are both vital for maintaining pelvic stability. In a healthy individual, the vagina is positioned horizontally on top of the levator ani muscles, offering robust support to the pelvic organs [2]. However, the levator ani muscles can stretch beyond their normal limits that leads to injury. This overstretching causes the vaginal opening to widen and shifts the burden of support from the muscles to the connective tissues.  

Aging is the second most common cause of pelvic organ prolapse as muscle strength and tissue elasticity naturally decline over time. The lack of estrogen weakens the muscles and connective tissues of the pelvic floor, further exacerbating the risk. Other risk factors of Pelvic Organ  Prolapse include obesity, chronic conditions such as diabetes or constipation, and lifestyle habits  such as smoking [2].

Symptoms of Pelvic Organ Prolapse 

Many women with pelvic organ prolapse may not notice any symptoms. On the other hand,  women may experience a range of symptoms that affect their quality of life. The most common sign of prolapse is a feeling that something is “coming down” or a bulge protruding from the vaginal opening. Some women may feel or see a soft lump while washing themselves, while others might experience discomfort, pressure, or a dragging sensation in the pelvic area. Some may notice difficulty with bowel movements or find it challenging to keep tampons in place. 

Treatments of Pelvic Organ Prolapse

Not all cases of pelvic organ prolapse require medical treatment. Mostly, women with mild symptoms can manage their condition with lifestyle changes and conservative treatments.  However, certain situations, such as sores on the vaginal wall or bladder problems like ureteral kinking may require medical treatment. Regardless, please see your doctor the moment you notice symptoms.  

For women’s non-surgical options, Kegel exercises are often recommended. These exercises target the muscles that support the pelvic organs and can help strengthen them. Working with a pelvic floor therapist improves the effectiveness of these exercises. Pessaries, small silicone devices inserted into the vagina, can provide additional support to the pelvic organs [3]. These devices help relieve symptoms by holding the vaginal walls in place.  

Lifestyle modifications like avoiding heavy lifting, quitting smoking, and managing constipation can also reduce symptoms. Obesity and chronic health issues like diabetes and constipation aggravate prolapse, so managing these factors is crucial. 

For women with more severe prolapse that significantly affects their quality of life, surgery may be necessary. Surgical procedures aim to repair and reinforce the damaged tissues, restoring the organs to their proper positions. Surgery can be performed either through the abdomen or the vagina [3]. In cases where the prolapse causes more serious complications, such as difficulty emptying the bladder or bowel, surgery may be the best option to restore normal function. However, about 25% of women may require additional surgeries later due to the recurrence of prolapse [3].  

Pelvic organ prolapse is a common condition that affects many women. It is often treatable, and many women can manage their symptoms without surgery. Non-surgical treatments, such as pelvic floor exercises and pessaries, can be highly effective. For those with more severe cases,  surgery is an option to improve quality of life. If you suspect you have pelvic organ prolapse, it’s important to consult your healthcare provider to explore the best treatment options for your individual needs.

Reference 

[1] Iglesia, C. B., & Smithling, K. R. (2017). Pelvic organ prolapse. American family physician,  96(3), 179-185. 

[2] Collins, S., & Lewicky-Gaupp, C. (2022). Pelvic organ prolapse. Gastroenterology Clinics,  51(1), 177-193. 

[3] American College of Obstetricians and Gynecologists. (2019). Pelvic organ prolapse.  Urogynecology, 25(6), 397-408.

Polycystic Ovarian Syndrome: Understanding your Symptoms and Knowing your Treatment Options 

Chaimaa Riad
October 2024

Polycystic Ovarian Syndrome (PCOS) is a hormonal disorder that affects around 5-10% of women of reproductive age.^[4]While its prevalence is high, scientists are unsure of the cause of this disorder. Symptoms can often be overlooked, as PCOS can present in a variety of ways with very general symptoms. It is specifically challenging to diagnose PCOS in young girls because symptoms can often be seen as normal signs of puberty.^{[2] [4]}It is important to recognize any signs and symptoms of hyperandrogenism and express concerns to your primary care provider to get the tests necessary to diagnose PCOS. 

Signs and Symptoms to Consider 

Family history is important to consider: 

• Let your doctor know if there is a history of PCOS in the family, or a family history of acne, hirsutism, or obesity.^[2] 

PCOS is strongly associated with metabolic dysfunction: 

• Women should be aware of recent weight gain. While girls going through puberty are likely to gain weight, there should be a discussion of the progression of the weight gain. ^[2] 
• Signs of insulin resistance are also associated with PCOS. The increase in fat associated with hyperandrogenism is likely to cause your body to not be able to respond properly to the insulin created in your body, leading to an increase in sugar levels, leading to type 2 diabetes.^[2] 

Irregular menstrual cycles: 

• Oligomenorrhea (infrequent menstrual periods)^[1] 
• Menorrhagia (heavy bleeding)^[1] 
• Primary amenorrhea (failure to get a first period by 15 years old)^[1] 
• Secondary amenorrhea (not having a period for at least three months)^[1] ○ Infertility^[1] 

Skin changes 

• Hirsutism (excess hair growth on the face or body) ^[2] 
• Abnormal acne or oily skin ^{[1] [2]} 
• Acanthosis nigricans (hyperpigmentation usually in the axilla, groin, and neck secondary to diabetes).^[2][3] 

Cardiovascular concerns

• Although unclear, there have been concerns about atherosclerosis forming in young women who have PCOS. This can increase risk of stroke as well as heart attacks. More studies need to be done to properly assess this risk in women with PCOS.^[1] 

Diagnosis 

According to the World Health Organization, diagnosis of PCOS includes at least two out of three of the following: 

1. Symptoms that suggest high androgens (hirsutism, acne, high testosterone levels on lab testing) with no explanation of why there are high androgen levels ^[5] 
2. Irregular menstrual cycles, as explained above in greater detail ^[5] 
3. Ultrasound imaging showing polycystic ovaries ^[5] 

Laboratory studies are especially important to ensure that other endocrine disorders are ruled out, including: 

• Hypothyroidism: TSH levels ^[3] 
• Hyperprolactinemia: Prolactin levels ^[3] 
• Congenital Adrenal Hyperplasia: 17-hydroxyprogesterone levels ^[3] 

Treatment Options 

After a diagnosis of PCOS is made, there are various methods of management:

• Lifestyle modifications – a healthy diet and increased physical activity are ways that can help manage the comorbidities of PCOS including diabetes and obesity. In addition to this, women should follow up with their PCP to assess for any worsening of diabetes or any development of cardiovascular changes such as hypertension.^[1] 
• Medical management: As discussed, diabetic management can vary, and can be managed with medication, as well as hypertension.^[1] Additionally, oral contraceptives can help with irregular menstrual cycles.^[1] Specific types of medication vary based on the presentation and severity of the specific symptoms. 

There is no specific management for PCOS, but rather symptom-based intervention to help prevent serious complications. It is important to discuss with your PCP to know which specific intervention is right for you based on your symptoms. ^[1][4] 

References 

[1] Hoeger, K. M., Dokras, A., & Piltonen, T. (2020, November 19). Update on PCOS: Consequences, challenges, and guiding treatment. OUP Academic. 

https://academic.oup.com/jcem/article/106/3/e1071/5992309?login=false

[2] Screening and management of the hyperandrogenic adolescent. ACOG. (2024). https://www.acog.org/clinical/clinical-guidance/committee-opinion/articles/2019/10/screening-an d-management-of-the-hyperandrogenic-adolescent 

[3] Teede, H. J., Piltonen, T., Costello, M. F., & Misso, M. L. (2018, August). Recommendations from the international evidence-based guideline for the assessment and management of polycystic ovary syndrome. American Society for Reproductive Medicine. https://www.fertstert.org/article/S0015-0282(18)30400-X/fulltext 

[4] Why polycystic ovarian syndrome is often misdiagnosed. Why Polycystic Ovarian Syndrome Is Often Misdiagnosed: Women’s Healthcare of Princeton: Gynecologists. (n.d.). https://www.princetongyn.com/blog/why-polycystic-ovarian-syndrome-is-often-misdiagnosed [5] World Health Organization. (2023, June). Polycystic ovary syndrome. World Health Organization. https://www.who.int/news-room/fact-sheets/detail/polycystic-ovary-syndrome