Category: Made For Science

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

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

Debunking the Myth: No Link Between Cellphone Use and Cancer?

Steven Shin
September 2024

The rapid increase in cellphone usage over the past few decades has sparked significant public concern about potential health risks, especially the risk of developing brain cancer. Considering the usage of cell phones, even a slight increase in cancer risk could have significant public health implications. This concern has been particularly serious regarding brain and central nervous system cancers, as phones are often used close to the head. However, recent research offers stunning news: there is no conclusive link between cellphone use and brain cancer (Karipidis,  2024, p.33-39). 

The potential danger of cellphone radiation originates from the fact that these devices emit radiofrequency energy, a type of nonionizing radiation. Nonionizing radiation is low-frequency and low-energy, so it is known to damage DNA and increase cancer risk, unlike ionizing radiation such as X-rays and cosmic rays. 

The research suggests that energy from cellphone radiation is too weak to cause DNA damage,  which is a key mechanism through which cancers can develop. The biological effect of radiofrequency radiation on the human body is a slight heating of the tissue in the area where the phone is held, but this heating is minimal and not sufficient to increase core body temperature or cause harm. Additionally, no increase in the incidence of leukemia or brain cancer was observed in children exposed to radio or TV transmitters or cellphone towers (Karipidis, 2024).  

These findings are significant in of the fears that have lingered since 2011 when the International  Agency for Research on Cancer (IARC) classified radiofrequency electromagnetic fields as a possible factor that causes cancer. This past result is thought to be a bias that arose from distorted result analysis when individuals with brain cancer compared to those without. Nowadays, the newer generation of cellphone networks like 3G and 4G plays a role in reducing potential risks because they emit significantly lower levels of radiofrequency radiation compared to older networks (Karipidis, 2024, p.45). Moreover, the presence of more cellphone towers shows a decrease in the amount of radiation emitted from individual cell phones. 

Over the years, cohort studies and case-control studies have been the primary methods used to conduct the experiment. Case-control studies compare cellphone use between individuals with tumors and those without, while cohort studies follow large groups of people over time to observe tumor development among cellphone users and non-users. 

Another important aspect of the research is its consideration of the lack of evidence regarding the health effects of 5G networks. While no major studies have specifically examined the long-term effects of 5G, existing research on radar technology, which operates at similar frequencies, has not shown an increased risk of cancer (Safari Variani, A, 2019, p.7-9). This comparison provides additional reassurance to the public as new technologies continue to emerge and spread rapidly. 

These findings emphasize a trend that the introduction of new technologies often initiates public fears about potential health danger. The most recent example of this phenomenon was the widespread but unproven belief during the COVID-19 pandemic that 5G cellphone towers were spreading the virus. This once led to attacks on cell towers in a few regions. Long-term research about new technologies can change the rapidly created fear and bias of crowds.  

In conclusion, concerns about the potential link between cellphone use and cancer due to the widespread use of these devices arose, but recent research shows that this is not true. The WHO commissioned research including epidemiological studies has found no conclusive evidence that cellphone use increases the risk of cancer. The radiofrequency radiation emitted by cell phones is nonionizing and too weak to damage DNA. Plus, advances in cellphone technology, such as lower emissions from newer networks and the increased presence of cellphone towers, decrease any potential risks. As new technologies like 5G continue to appear, further research is essential to monitor long-term health effects.

References 

[1] Karipidis, K., Baaken, D., Loney, T., Blettner, M., Brzozek, C., Elwood, M., … & Lagorio, S.  (2024). The effect of exposure to radiofrequency fields on cancer risk in the general and working population: A systematic review of human observational studies–Part I: Most researched outcomes. Environment International, 108983. 

[2] Safari Variani, A., Saboori, S., Shahsavari, S., Yari, S., & Zaroushani, V. (2019). Effect of  Occupational Exposure to Radar Radiation on Cancer Risk: A Systematic Review and Meta Analysis. Asian Pacific Journal of Cancer Prevention, 20(11), 3211-3219. doi:  10.31557/APJCP.2019.20.11.3211

Balancing Minds and Hormones: Unraveling the Impact of Contraceptives on Young Girls’ Mental Health

The growing association between mental health and hormonal contraceptive use is becoming an issue of rising concern for young girls. Due to the wide scope of benefits provided from hormonal birth control, ranging from acne management to pregnancy prevention, the utilization of this medicine has become more prevalent among adolescents. As a consequence, the mental health implications of these medications have come under growing inspection. This article focuses on the relationship between hormonal contraceptives and mental health disorders in young adolescents, further highlighting the significance of well-informed decisions for the betterment of young girl’s healthcare. 

The Impact of Hormonal Contraceptives on Mental Health

Hormonal contraceptives, including birth control pills, injections, and implants, are put into effect by changing the body’s natural hormone levels in attempts to avoid accidental pregnancies. These methods, despite having a high efficiency rate, have the potential to affect the brain’s chemistry. This could cause alterations in the adolescents mood as well and negatively impact their mental health. The two main hormones that are influenced by contraceptives are estrogen and progesterone, which are responsible for inflicting changes to the mental health of the individual. 

A study published in JAMA Psychiatry led to the conclusion that young girls that utilize hormonal contraceptives were 80% more likely and in greater risk of being diagnosed with depression in comparison to those who did not use these methods. ^[1] In addition, a separate study brought awareness to the unfavorable consequences that resulted from the usage of these medications by highlighting that young adolescents who used combined oral contraceptives had a 70% increased risk of developing symptoms of anxiety compared to those who did not. ^[2]

Risk Factors Involved 

Various factors can increase the risk of experiencing mental health issues from hormonal contraceptives. This includes pre-existing mental health conditions, such as a previous experience or history with depression or anxiety. In addition, genetic proneness, such as a family history of mental health disorders, can also influence the extent to which a girl’s body reacts in a negative manner to these hormones.

Research that was conducted by the University of Copenhagen found that teenage girls who possessed a history of mental health issues had almost double the risk of experiencing worsening symptoms after starting hormonal contraceptives. ^[3] To expand, a longitudinal study expressed that those with a family history of depression had a higher likelihood of developing symptoms related to depression following the introduction of hormonal birth control into their system. ^[4]

Conclusion

The correlation between mental health disorders and hormonal contraceptives for adolescent girls is a complex and highly prevalent issue in today’s society. Despite the benefits that result from taking these medications, the potential negative consequences on mental health for those who take them cannot be overlooked. It is important to understand that great consideration must  go into deciding whether or not hormonal contraceptives are the best route for young girls. 

References

[1] Skovlund, C. W., Morch, L. S., Kessing, L. V., & Lidegaard, Ø. (2016). Association of hormonal contraception with depression. JAMA Psychiatry, 73(11), 1154-1162.

[2] Zettermark, S., Perez Vicente, R., & Merlo, J. (2018). Hormonal contraceptive use among adolescent girls and subsequent depression: A nationwide population-based cohort study. BMJ Open, 8(11), e024813.

[3] University of Copenhagen. (2017). Impact of hormonal contraception on mental health in young women. Scandinavian Journal of Public Health, 45(5), 483-491.

[4] Bratke, S., & Sundström, A. (2020). Hormonal contraception and the risk of mental health disorders: A systematic review. Journal of Psychiatric Research, 126, 75-85.

The Silent Toll: How Workplace Stress Disrupts Women’s Menstrual Health in High-Pressure Careers

The workplaces in today’s modern society stand responsible for stimulating high stresses and intense pressures in their employees. Despite the shared experiences of tension among both men and women, demanding professions inflict unique challenges particularly for females in regard to their menstrual health. Research depicts a strong correlation between workplace stress and menstrual irregularities that are highly prevalent in female employees who are placed in demanding positions in their field of labor. This article delves into the specifics of these consequences while simultaneously highlighting the need for better support systems for women placed in these high-pressure environments. 

The Connection Between Stress and Menstruation

Stress can be responsible for a variety of hormonal changes that occur within the body. This can be initially stimulated by the release of cortisol, which can be otherwise referred to as the “stress hormone”. As the levels of cortisol rises, it impedes a region of the brain primarily known for its regulation of the menstrual cycle: the hypothalamus. Disruptions to this section can stimulate imbalances in hormones including estrogen and progesterone. This further links to menstrual inconsistencies, such as missed periods, unpredictable cycles, and intensified symptoms.^[1]

A study conducted by the American Psychological Association illustrated that women who are involved in work atmospheres with intense pressure are more likely to experience menstrual irregularities. The research further reported an approximation of 40% claiming to have pissed periods and 25% possessing an experience with significantly heavier menstrual bleeding during periods of high stress. ^[2] In addition, another study put forth the notion that women participating in high-pressure areas of work, such as medicine and law, had a 33% higher chance of experiencing extreme menstrual cramps in comparison to women who were involved in fields that were less demanding. ^[3]

Nurturing a Healthier Work Environment 

In order to alleviate the stress that the workplace imposes on menstruation for women in high stress jobs, employers must take measures to create a healthy atmosphere. This may include promoting flexible work policies, such as remote work positions, which can assist women in managing their stress with greater care. A study published in the Journal of Occupational Health Psychology further explored how flexible work patterns diminished menstrual interferences in 60% of women participants. [4]

Conclusion

Workplace stress is difficult to avoid in modern life and fields of work, however its impact on women’s menstrual health should not be left unnoticed. Through efforts to understand the association between stress and menstruation as well as fostering supportive work environments, employers can help reduce some of the burdens placed on women active in high-stress jobs. 

References

[1] Chandraratna, S., & Harlow, S. D. (2022). Stress and menstrual cycle irregularity: A prospective study of the effect of workplace stress. Journal of Women’s Health, 31(3), 300-306.

[2] American Psychological Association. (2023). Stress and menstrual health: How workplace pressure affects women’s cycles. APA Research, 45(2), 112-119.

[3] Cousins, S., & Maguire, K. (2021). The impact of occupational stress on menstrual health among women in high-stress professions: A review. Women’s Health Issues, 31(6), 452-460.

[4] Allen, R., & Parker, J. (2022). The effect of flexible work policies on women’s health outcomes in high-stress jobs. Journal of Occupational Health Psychology, 27(3), 205-213.

Amenorrhea: How The Absence of Menstruation Can Be a Problem

Gabriela Castro
May 2024

If you have a uterus, there’s a chance your period has not always come on a regular monthly basis. The chronic absence of a period can be indicative of a medical condition called amenorrhea. There are two types of amenorrhea–primary and secondary.^[4] Primary amenorrhea refers to those with uteruses who have not had their first period (also known as “menarche”) by age 15.^[3] Secondary amenorrhea is the absence of 3 or more consecutive periods by someone who has begun to menstruate previously.^[3] 

Symptoms

The central feature of amenorrhea is a lack of menstruation. Other symptoms associated with amenorrhea can vary in part due to its causes, including::

• Milky nipple discharge^[3]
• Hair loss^[3]
• Headache^[3]
• Vision changes^[3]
• Excess facial hair^[3]
• Pelvic pain^[3]
• Acne^[3]

Primary Amenorrhea Causes

• Primary amenorrhea is caused primarily by hormonal imbalances and genetic abnormalities.^[5] 
• Having hypothalamic issues can prevent the onset of menstruation.^[5] 
• Issues with the pituitary gland such as pituitary tumors can inhibit menstruation.^[5] 
• Low body weight, excessive exercise, and eating disorders can cause stress which affects hormone production (particularly in the pituitary gland or hypothalamus leading to amenorrhea).^[3]
• Genetic abnormalities such as a lack of reproductive organs or a structural abnormality obstructing the vagina can block visible bleeding.^[3] Chromosomal issues such as Turner syndrome–which is caused by a missing or partly missing X chromosome–or genetic disorders like androgen insensitivity syndrome–often characterized by high testosterone levels–may affect menstruation.^[5]

Secondary Amenorrhea Causes

Secondary amenorrhea has a wider variety of causes. 

• It can be brought on naturally through pregnancy, breastfeeding, or menopause.^[5] This type of amenorrhea can be brought on by hormone imbalance in ways similar to primary amenorrhea. 
• Hypothalamic amenorrhea–associated with low body weight, body fat, high stress, extreme exercise–can result in secondary amenorrhea.^[5] Other hormonal imbalances that result in amenorrhea can be overactive or underactive thyroid, or pituitary tumors.^[5][3] 
  • Gynecological issues such as polycystic ovarian syndrome (PCOS) as well as premature menopause (which is associated with fragile X-associated primary ovarian insufficiency (FXPOI)) are tied to amenorrhea. ^[5][3][4]
• Uterine scarring as a result of various medical interventions (including dilation and curettage (D&C), cesarean section, or treatment for uterine fibroids) may cause amenorrhea.^[5][3]
  • Medications such as contraceptives, antipsychotics, antidepressants, blood pressure medications, chemotherapy radiation, and allergy medications are also known to cause secondary amenorrhea.^[5][3]

Prevalence

With the wide array of underlying causes, you might be wondering, how common is amenhorrea? When focusing on women who menstruate, the American College of Obstetricians and Gynecologists estimated that 1 in 25 women who are not pregnant, breastfeeding, or going through menopause experience amenorrhea at some point in their lives.^[1] If you struggle with amenorrhea, you should know you are not alone. 

Treatments

If you or someone you know is struggling with amenorrhea, it can be a sign of a deeper issue especially if it is not because of natural causes like pregnancy or menopause. That is why it is important to discuss your menstrual cycle with your healthcare provider, including any other symptoms you’ve been experiencing. Depending on the root cause of amenorrhea, treatment can vary from psychological therapy, stress management, eating disorder treatment, changing medications, surgery, chemotherapy, or radiation.^[2] Whatever the cause is, you do not have to endure amenorrhea without help or guidance. Taking the first step by sharing your concern with your health care provider and a trusted loved one will ensure you are in good hands and supported in your recovery.

References

[1] Amenorrhea: Absence of periods. (2020, October). https://www.acog.org/womens-health/faqs/amenorrhea-absence-of-periods

[2] Amenorrhea—Diagnosis & treatment. (2023, February 9). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/amenorrhea/diagnosis-treatment/drc-20369304

[3] Amenorrhea—Symptoms and causes. (2023, February 9). Mayo Clinic. https://www.mayoclinic.org/diseases-conditions/amenorrhea/symptoms-causes/syc-20369299 

[4] Fragile x-associated primary ovarian insufficiency (Fxpoi) | nichd—Eunice kennedy shriver national institute of child health and human development. (2021, August 19). https://www.nichd.nih.gov/health/topics/fxpoi

[5] What causes amenorrhea? | nichd – eunice kennedy shriver national institute of child health and human development. (2017, January 31). https://www.nichd.nih.gov/health/topics/amenorrhea/conditioninfo/causes

Reviving Passion: Exploring Causes and Solutions for Low Libido 

Paz Etcheverry, MS, PhD
May 2024

Low libido means having a low appetite for sex and, just like vaginismus, it falls under the category of sexual disorders that afflict women. When coupled with elevated stress levels attributed to diminished libido, the condition is known as hypoactive sexual desire disorder.^[19] 

Low sex drive is the most common sexual issue reported by women.^[18] Research reveals that low sexual desire impacts 26 out of every 100 premenopausal women,^[10] while the prevalence increases to 52 out of every 100 menopausal women in the US.^[19] And while low sex drive can affect women of all ages, studies suggest that younger women find low libido to have a greater lifestyle effect.^[1] 

There are several causes for low libido. 

• Age is one major factor that can contribute to low libido. Starting at the age of 45, there is a decrease in sex hormones, primarily estrogen and testosterone. Low estrogen levels lead to vaginal dryness, which can make penetrative sex particularly painful, a condition known as dyspareunia. Furthermore, low estrogen levels lead to reduced sensitivity in the genital area, which can impede a woman’s ability to actively respond to sexual expression and cues.^[1] 

• Testosterone is a major driver of sex as it enhances sexual desire and behavior. By the time women reach menopause, between ages 40 and 60, their testosterone levels are almost a quarter of what they used to be during their 20s.^[1] Weight gain and depression can also decrease libido.^[17] Relationship difficulties can have a considerable effect on sexual desire, along with emotional stress, the health of the partner, and family conflicts. Moreover, surgical procedures (like oophorectomies, which involve removing one of the two ovaries responsible for estrogen and testosterone production), health conditions, and certain medications such as SSRIs (selective serotonin reuptake inhibitors), can contribute to a diminished libido. These factors may result in the absence of sexual fantasies and a reduced desire for sexual activity.^[1][10] 

Treatment options for this condition include hormonal treatments and pharmaceutical drugs.

Estrogen 

Possible options are oral and local estrogen, such as patches, creams, and rings inserted in the vagina. A caveat with oral estrogen: they lower levels of testosterone, which we know is a major driver of sexual desire. Hence, local estrogen options, which have minimal effects on testosterone levels, might be more suitable. Vaginal moisturizers, as well as water, oil, or silicone-based lubricants, can be used when vaginal dryness is suspected.^[10] 

Testosterone 

Oral testosterone is not an option for women because of the effects it has on blood lipid levels. Instead, patches are recommended. Frequent adverse effects associated with testosterone patches include a rise in body hair or hirsutism (observed in 7% compared to 5% in controls), acne (reported in 9% compared to 7% in controls), and irritation at the patch site affecting up to 30% of participants. These effects resolve, however, following discontinuation of treatment.^[10] Additionally, there are testosterone creams and gels that, when applied to the upper thighs, abdomen, and forearms, can enhance sexual desire without significant side effects,^[6][7][16] although the risk of acne and hirsutism remains possible. 

Tibolone 

For menopausal women, tibolone may be a beneficial treatment option.^[5][8] As a synthetic steroid, tibolone is marketed as hormone replacement therapy. However, there are concerns regarding the potential risk of stroke in older women using tibolone, despite its positive effects on breast cancer, fracture risk, and possibly colon cancer.^[4] 

Dehydroepiandrosterone or DHEA 

Touted as the “elixir of youth”, DHEA is converted in various body tissues into estrogen and testosterone.^[3] DHEA is available over-the-counter, but its safety remains unclear.^[11]It is also unclear to what extent DHEA is beneficial, particularly for libido and general well-being..^[12][20] 

Flibanserin 

Flibanserin is a drug that selectively influences neurotransmitter pathways that are associated with sexual desire.^[10]In studies, a daily dose of 100 mg improved sexual desire in women.^[9][15] However, the drug has some unwanted side effects such as nausea, dizziness, fatigue, and insomnia.^[2] 

Bupropion 

Bupropion is a drug that enhances sexual desire.^[13] Psychiatrists commonly recommend bupropion for the treatment of SSRI-induced low libido due to studies demonstrating its positive impact on desire, arousal, lubrication, orgasm, and satisfaction in women with SSRI-induced sexual dysfunction.^[10][14] 

There are multiple causes of low libido that may be physical, emotional, medical, or due to relationship conflicts. Treatment options are available to reignite sexual desire. Work with a trusted healthcare provider to explore the various options available and get back to feeling like you. 

References 

[1] AlAwlaqi, A., Amor, H., & Hammadeh, M. E. (2017). Role of hormones in hypoactive sexual desire disorder and current treatment. Journal of the Turkish German Gynecological Association, 18(4), 210–218. https://doi.org/10.4274/jtgga.2017.0071 

[2] Baid, R., & Agarwal, R. (2018). Flibanserin: A controversial drug for female hypoactive sexual desire disorder. Industrial Psychiatry Journal, 27(1), 154–157. https://doi.org/10.4103/ipj.ipj_20_16

[3] Buffington C. K. (1998). DHEA: elixir of youth or mirror of age?. Journal of the American Geriatrics Society, 46(3), 391–392. https://doi.org/10.1111/j.1532-5415.1998.tb01062.x 

[4] Cummings, S. R., Ettinger, B., Delmas, P. D., Kenemans, P., Stathopoulos, V., Verweij, P., Mol-Arts, M., Kloosterboer, L., Mosca, L., Christiansen, C., Bilezikian, J., Kerzberg, E. M., Johnson, S., Zanchetta, J., Grobbee, D. E., Seifert, W., Eastell, R., & LIFT Trial Investigators (2008). The effects of tibolone in older postmenopausal women. The New England Journal of Medicine, 359(7), 697–708. https://doi.org/10.1056/NEJMoa0800743 

[5] Davis S. R. (2002). The effects of tibolone on mood and libido. Menopause (New York, N.Y.), 9(3), 162–170. https://doi.org/10.1097/00042192-200205000-00004 

[6] El-Hage, G., Eden, J. A., & Manga, R. Z. (2007). A double-blind, randomized, placebo-controlled trial of the effect of testosterone cream on the sexual motivation of menopausal hysterectomized women with hypoactive sexual desire disorder. Climacteric: The Journal of the International Menopause Society, 10(4), 335–343. https://doi.org/10.1080 

[7] Goldstat, R., Briganti, E., Tran, J., Wolfe, R., & Davis, S. R. (2003). Transdermal testosterone therapy improves well-being, mood, and sexual function in premenopausal women. Menopause (New York, N.Y.), 10(5), 390–398. https://doi.org/10.1097/01.GME.0000060256.03945.20 

[8] Kamenov, Z. A., Todorova, M. K., & Christov, V. G. (2007). Effect of tibolone on sexual function in late postmenopausal women. Folia Medica, 49(1-2), 41–48.

[9] Katz, M., DeRogatis, L. R., Ackerman, R., Hedges, P., Lesko, L., Garcia, M., Jr, Sand, M., & BEGONIA trial investigators (2013). Efficacy of flibanserin in women with hypoactive sexual desire disorder: results from the BEGONIA trial. The Journal of Sexual Medicine, 10(7), 1807–1815. https://doi.org/10.1111/jsm.12189 

[10] Maclaran, K., & Panay, N. (2011). Managing low sexual desire in women. Women’s Health (London, England), 7(5), 571–583. https://doi.org/10.2217/whe.11.54 

[11] Omura Y. (2005). Beneficial effects and side effects of DHEA: true anti-aging and age-promoting effects, as well as anti-cancer and cancer-promoting effects of DHEA evaluated from the effects on the normal and cancer cell telomeres and other parameters. Acupuncture & Electro-therapeutics Research, 30(3-4), 219–261. https://doi.org/10.3727 

[12] Panjari, M., & Davis, S. R. (2007). DHEA therapy for women: effect on sexual function and wellbeing. Human Reproduction Update, 13(3), 239–248. https://doi.org/10.1093/humupd/dml055

[13] Razali, N. A., Sidi, H., Choy, C. L., Roos, N. A. C., Baharudin, A., & Das, S. (2022). The Role of Bupropion in the Treatment of Women with Sexual Desire Disorder: A Systematic Review and Meta-Analysis. Current Neuropharmacology, 20(10), 1941–1955. https://doi.org/10.2174/1570159X20666220222145735 

[14] Segraves, R. T., Clayton, A., Croft, H., Wolf, A., & Warnock, J. (2004). Bupropion sustained release for the treatment of hypoactive sexual desire disorder in premenopausal women. Journal of Clinical Psychopharmacology, 24(3), 339–342. https://doi.org/10.1097/01.jcp.0000125686.20338.c1

[15] Simon, J. A., Thorp, J., & Millheiser, L. (2019). Flibanserin for Premenopausal Hypoactive Sexual Desire Disorder: Pooled Analysis of Clinical Trials. Journal of Women’s Health (2002), 28(6), 769–777. https://doi.org/10.1089/jwh.2018.7516 

[16] Singh, A. B., Lee, M. L., Sinha-Hikim, I., Kushnir, M., Meikle, W., Rockwood, A., Afework, S., & Bhasin, S. (2006). Pharmacokinetics of a testosterone gel in healthy postmenopausal women. The Journal of Clinical Endocrinology and Metabolism, 91(1), 136–144. https://doi.org/10.1210/jc.2005-1640 

[17] Stanikova, D., Zsido, R. G., Luck, T., Pabst, A., Enzenbach, C., Bae, Y. J., Thiery, J., Ceglarek, U., Engel, C., Wirkner, K., Stanik, J., Kratzsch, J., Villringer, A., Riedel-Heller, S. G., & Sacher, J. (2019). Testosterone imbalance may link depression and increased body weight in premenopausal women. Translational Psychiatry, 9(1), 160. https://doi.org/10.1038/s41398-019-0487-5

[18] Sutherland, S. E., Rehman, U. S., & Goodnight, J. A. (2020). A Typology of Women with Low Sexual Desire. Archives of Sexual Behavior, 49(8), 2893–2905. https://doi.org/10.1007/s10508-020-01805-9

[19] West, S. L., D’Aloisio, A. A., Agans, R. P., Kalsbeek, W. D., Borisov, N. N., & Thorp, J. M. (2008). Prevalence of low sexual desire and hypoactive sexual desire disorder in a nationally representative sample of US women. Archives of Internal Medicine, 168(13), 1441–1449. https://doi.org/10.1001/archinte.168.13.1441 [20] Wierman, M. E., & Kiseljak-Vassiliades, K. (2022). Should Dehydroepiandrosterone Be Administered to Women?. The Journal of Clinical Endocrinology and Metabolism, 107(6), 1679–1685. https://doi.org/10.1210/clinem/dgac130

The Gender Gap in Alzheimer’s: Why Women Are at Higher Risk 

Jessica Luu
May 2024

Picture yourself in a room surrounded by people. If each person were to raise their hand to indicate they have Alzheimer’s, you might notice that more women would raise their hands than men. This isn’t a coincidence. Surprisingly, almost two-thirds of Americans living with Alzheimer’s are women.^[1] But why is this the case? To understand this gender gap, we need to look at various factors that make women more susceptible to this neurodegenerative disease. 

Biological and Hormonal Factors 

One of the most prominent theories explaining the higher incidence of Alzheimer’s in women involves hormonal changes, particularly those associated with menopause. Estrogen, a hormone that declines sharply during menopause, is believed to play a protective role in brain health. Estrogen receptors are found throughout the brain, and this hormone is known to have neuroprotective properties, including reducing inflammation, promoting synaptic growth, and enhancing cerebral blood flow.^[2] This dramatic loss of estrogen during menopause could therefore, make women more vulnerable to the onset and progression of Alzheimer’s disease. 

Genetics: The Inherited Risk 

Genetics also plays a critical role in the risk of developing Alzheimer’s. The presence of the APOE-e4 allele, a variant of apolipoprotein E gene, is a well-known risk factor for Alzheimer’s disease.^[5]Interestingly, research shows that women who carry the APOE-e4 allele are at a higher risk compared to men with the same genetic variant. The reasons behind this heightened vulnerability are not entirely understood, but they may involve differences in how the gene interacts with female-specific factors, such as hormonal changes and other epigenetic mechanisms.^[5] 

Social and Lifestyle Factors 

Women have historically been primary caregivers, which can lead to chronic stress—a known risk factor for Alzheimer’s. Chronic stress elevates cortisol levels, and prolonged exposure to cortisol can cause damage to the hippocampus (the brain region responsible for memory consolidation)^[3]. Additionally, women are more likely to experience depression and anxiety,^[4] both of which are linked to an increased risk of Alzheimer’s. When you combine these mental health issues with the stress of caregiving and hormonal changes from menopause, it becomes clear why women are more disproportionately affected by the disease than men. 

Building Resilience 

However, there is hope. By understanding these factors, women can take proactive steps to reduce their risk: 

• Physical Activity: Engaging in regular exercises and strength training can increase blood flow to the brain and promote the health of brain cells, which may reduce the risk of Alzheimer’s.^[1] 

• Healthy Diet: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins can provide essential nutrients that support brain health and may prevent progression of Alzheimer’s.^[6] 

• Mental Stimulation: Keeping your brain active with activities like reading, puzzles, learning new skills, and socializing may build up mental stamina, which in the long run, can delay the onset of Alzheimer’s symptoms. ^[1] 

• Quality Sleep: Try to get 7-9 hours of sleep per night, as quality sleep is crucial for memory consolidation and brain health.^[1] 

Ultimately, by incorporating these changes into one’s daily routine, women can enhance their overall well-being all while mitigating their risk of Alzheimer’s. 

As we continue to research more about Alzheimer’s and its effect on women, advocating for greater awareness and support is essential. By doing so, we can ensure that women everywhere can live their life to fullest, today and for generations to come. Together, we can work towards a healthier and brighter future where Alzheimer’s is better understood, prevented, and ultimately cured. 

References: 

[1] Alzheimer’s Association. (2024). “Alzheimer’s disease facts and figures.” Accessed 22 May 2024, Alzheimer’s Association. https://www.alz.org/alzheimers-dementia/facts-figures 

[2] Alzheimer’s Society. (n.d.). “Hormones and Dementia Risk.” Accessed 22 May 2024, Alzheimer’s Society. https://www.alzheimers.org.uk/about-dementia/managing-the-risk-of-dementia 

[3] Browning, M.E., Hocking, C., Hunter, M., Khan, Z., Middleton, C., (2022). “Increased Cortisol and Altered Dehydroepiandrosterone Sulfate Levels in Alzheimer’s Disease. Alzheimer’s Research and Therapy. Accessed 22 May 2024. https://alzres.biomedcentral.com/articles/10.1186/s13195-022-01139-9 

[4] Fisher Center for Alzheimer’s Research. (2020). “Depression Increases the Risk for Alzheimer’s.” ALZinfo.org. Accessed 22 May 2024. 

[5] National Institute on Aging (2023). “Alzheimer’s Disease Genetics Fact Sheet.” U.S. Department of Health and Human Services. Accessed 22 May 2024 . https://www.nia.nih.gov/health/genetics-and-family-history/alzheimers-disease-genetics-fact-sheet

[6] Robbins, R. (2020) “What to Eat to Reduce Your Risk of Alzheimer’s Disease.” Harvard Health Blog. https://www.health.harvard.edu/blog/what-to-eat-to-reduce-your-risk-of-alzheimers-disease-20200508197 74