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Women warned against spending money on ‘unnecessary’ menopause services

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Women going through the menopause are being cautioned against spending money on direct-to-consumer menopause services that may provide little benefit.

A group of doctors raised concerns about overstated hormone therapy claims, aggressive promotion of supplements and tests, and marketing presented as advocacy.

They argue that commercial menopause services raise questions about reliability and the risk of bias in the information given to women seeking symptom relief.

Dr Marie K Christakis of the University of Toronto, Dr Taylor Roebotham of Sinai Health, Dr Stephanie Sterry, an NHS GP, and Dr Olexandra Koshkina of the University of Toronto, highlighted hormone panel testing as “one of the most troubling trends”.

Christakis said: “We wrote this piece because although we are excited by increasing discussion around menopause care, we are seeing a surge of confusing and sometimes misleading information.

“This leaves many women unsure of what to believe and can result in either undertreatment or use of unproven approaches.

“We wanted to encourage and support healthcare professionals in providing evidence-based care.”

Hormone panel tests can cost hundreds of US dollars and are promoted as essential for tailoring hormone therapy.

But doctors say they have limited clinical use because there is no clearly defined treatment range for menopausal hormone therapy (MHT), and some testing methods do not accurately measure hormone levels.

Christakis said: “Testing can be expensive, misleading and may push women toward unnecessary treatments.

“Alternatively, it can be used as a justification to withhold treatment from women with debilitating perimenopausal symptoms before they experience a steep, steady drop in their hormone levels.”

Hormone testing cannot reliably identify who will benefit from treatment, when a final menstrual period will occur, or when contraception can safely stop.

Clinical guidelines from the British Menopause Society, National Institute for Health and Care Excellence, American College of Obstetricians and Gynecologists, The Menopause Society and Endocrine Society agree: for women over 45 with recognised menopausal symptoms such as menstrual irregularity, diagnosis should be clinical and testing is not needed.

Despite this, many women purchase detailed hormone panels from wellness clinics or online providers.

Results are often used to justify custom-made hormone preparations or supplements based on small differences in hormone levels that lack an evidence base.

Christakis added: “Commercial bias arises when products or services are marketed under the guise of advocacy or education.

“This can mislead women into thinking something is evidence-based or endorsed by experts when it isn’t backed by guiding medical organisations.”

Custom-made hormone preparations, known as compounded bioidentical hormone therapy, are not regulated like standard MHT.

The authors warned that inconsistent doses of oestrogen or progestogen could lead to endometrial hyperplasia – abnormal thickening of the womb lining – or even cancer, particularly in women with an intact uterus given inadequate progestogen.

Christakis stressed the importance of tailored care: “This means taking time to listen to each woman’s symptoms, medical history, and preferences, then tailoring care accordingly.

“We hope to encourage primary care providers to engage in shared decision-making with women and to integrate best available evidence.

“Lab results don’t capture the full experience of menopause.

“Listening allows clinicians to understand the impact symptoms are having on a woman’s daily life and wellbeing.

“Effective treatment starts with that conversation, then uses evidence-based options to support her needs.”

Diagnosis

Lung cancer drug shows breast cancer potential

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Ovarian cancer cells quickly activate survival responses after PARP inhibitor treatment, and a lung cancer drug could help block this, research suggests.

PARP inhibitors are a common treatment for ovarian cancer, particularly in tumours with faulty DNA repair. They stop cancer cells fixing DNA damage, which leads to cell death, but many tumours later stop responding.

Researchers identified a way cancer cells may survive PARP inhibitor treatment from the outset, pointing to a potential way to block that response. A Mayo Clinic team found ovarian cancer cells rapidly switch on a pro-survival programme after exposure to PARP inhibitors. A key driver is FRA1, a transcription factor (a protein that turns genes on and off) that helps cancer cells adapt and avoid death.

The team then tested whether brigatinib, a drug approved for certain lung cancers, could block this response and boost the effect of PARP inhibitors. Brigatinib was chosen because it inhibits multiple signalling pathways involved in cancer cell survival.

In laboratory studies, combining brigatinib with a PARP inhibitor was more effective than either treatment alone. Notably, the effect was seen in cancer cells but not normal cells, suggesting a more targeted approach.

Brigatinib also appeared to act in an unexpected way. Rather than working through the usual DNA repair routes, it shut down two signalling molecules, FAK and EPHA2, that aggressive ovarian cancer cells rely on. FAK and EPHA2 are proteins that relay survival signals inside cells. Blocking both at once weakened the cells’ ability to adapt and resist treatment, making them more vulnerable to PARP inhibitors.

Tumours with higher levels of FAK and EPHA2 responded better to the drug combination. Other data link high levels of these molecules to more aggressive disease, pointing to potential benefit in harder-to-treat cases.

Arun Kanakkanthara, an oncology investigator at Mayo Clinic and a senior author of the study, said: “This work shows that drug resistance does not always emerge slowly over time; cancer cells can activate survival programmes very early after treatment begins.”

John Weroha, a medical oncologist at Mayo Clinic and a senior author of the study, said: “From a clinical perspective, resistance remains one of the biggest challenges in treating ovarian cancer. By combining mechanistic insights from Dr Kanakkanthara’s laboratory with my clinical experience, this preclinical work supports the strategy of targeting resistance early, before it has a chance to take hold. This strategy could improve patient outcomes.”

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Higher nighttime temps linked to increased risk of autism diagnosis in children – study

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Nighttime temperatures during pregnancy may be linked to a higher chance of an autism diagnosis in children, a recent study suggests.

The research tracked nearly 295,000 mother-child pairs in Southern California from 2001 to 2014 and linked warmer overnight temperatures with higher risk in early and late pregnancy.

Children of mothers exposed to higher than typical nighttime temperatures during weeks one to 10 of pregnancy had a 15 per cent higher risk of an autism diagnosis.

Exposure during weeks 30 to 37 was linked to a 13 per cent higher risk.

 Lead author David Luglio, a post-doctoral fellow at Tulane University, said: “A key takeaway is that we identified specific windows when a mother and her developing child can be most affected by exposures to higher nighttime temperatures.

“This is critical and hopefully can help mothers prepare accordingly.”

The study is described as the first to examine how temperature may affect fetal neurodevelopment, the process by which a baby’s brain and nervous system form during pregnancy.

Extreme temperatures linked to increased risk were classified as above the 90th percentile, meaning 3.6°F hotter than average, and the 99th percentile, 5.6°F above average.

The association held even after researchers accounted for factors such as neighbourhood conditions, vegetation and fine-particle air pollution.

The study could not account for other factors such as access to air conditioning. Researchers did not find the same association with daytime temperatures, potentially because people spend more time away from home during the day.

“Heat waves are becoming more frequent, and people may only think of the dangers of daytime heat exposure,” said Mostafijur Rahman, assistant professor of environmental health sciences at Tulane University.

“These results indicate a strong association between high nighttime temperatures during pregnancy and autism risk in children and show that we need to think about exposure to heat around the clock.”

The study did not examine how higher temperatures at night might affect prenatal development, though Luglio said it is possible that warmer nights disrupt sleep for pregnant mothers.

Previous research has suggested insufficient sleep during pregnancy may be linked to a higher risk of neurocognitive delays in children.

“Extreme heat exposure during pregnancy has been linked to a range of adverse health outcomes, including prenatal neurodevelopment delays and complications with an embryo’s development of a central nervous system,” Luglio said.

“The goal of our study was to specifically explore the link between prenatal heat exposure and autism diagnoses for the first time.”

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Entrepreneur

Kindbody unveils next-gen fertility platform

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Kindbody has launched a fertility platform integrating AI with clinical care and patient support for employers and health plans.

The platform will enter a pilot with select Kindbody employer clients in 2026, covering over three million lives, ahead of wider availability in 2027.

Building on the company’s clinical model, the platform aims to improve outcomes and cost efficiency across family-building journeys. It connects Kindbody-owned clinics, partner clinics and an integrated clinical app.

The app offers virtual care across conception, pregnancy and reproductive health, extending through the menopause transition.

Launch features include updates in medication management, third-party reproduction, adoption, pregnancy, men’s health and global programme design.

David Stern, chief executive of Kindbody, said: “With our next-generation fertility platform, Kindbody is redefining what comprehensive, intelligent and affordable family-building care looks like for employers, health plans and patients.

“By unifying best-in-class clinical care, AI-driven intelligence and whole-person support, we are making it easier and more cost-effective for more people to build the families they envision.”

Kindbody has expanded access via its national network of IVF centres, including IVIRMA, Inception Fertility and Ivy Fertility.

A new Fertility Medication Portal is designed to streamline authorisations so medicines can be dispensed on time, giving patients visibility from prescription to coverage, pharmacy fulfilment and delivery tracking.

Through KindMan, men’s health education, digital resources and integrated clinical care are expanding, including hormone management programmes.

Services cover andropause (age-related testosterone decline), erectile dysfunction, low testosterone and other male reproductive conditions.

Specialist fertility care includes semen analysis, diagnostic testing, male hormone panels, genetic testing, surgical sperm extraction and sperm cryopreservation.

Launching in the second quarter, a pregnancy support app will act as a digital companion for expecting and new parents, with resources, interactive tools and clinical assessments to identify social drivers of health and mental health needs during pregnancy and beyond.

Kindbody’s physician-led menopause programme provides consultations with board-certified obstetricians and gynaecologists to diagnose, treat and manage menopausal symptoms, including hormone replacement therapy where appropriate, with support from nutritionists, mental health therapists and pelvic floor specialists.

AI and analytics will be embedded across the care journey. An AI care navigator will guide employees from benefit activation through intake, triage and scheduling.

Tools will track benefits and treatment plans, showing coverage and expected out-of-pocket costs at each step.

AI-supported scribing will assist clinicians with documentation, and a predictor tool will estimate a patient’s likelihood of having a baby across different treatment paths.

In 2027, Kindbody plans a savings model for eligible large employers that it says will guarantee lower total fertility spend while improving clinical efficiency and patient experience.

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