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Hormonal health

Weight loss jabs ease depression and migraines in menopause – study

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Wegovy is linked to lower risks of migraine and depression in menopausal women than hormone therapy alone, a study has found.

Women across all menopause stages taking semaglutide had a 42 to 45 per cent lower risk of migraine six months after starting the medication and a 25 per cent lower risk of depression than those who took menopausal hormone therapy alone.

The findings are based on a one-year real-world study of more than 34,000 menopausal women in the US who took hormone therapy, Wegovy or a combination of both.

They were announced by Wegovy manufacturer Novo Nordisk, alongside data from the randomised, double-blinded STEP UP and SELECT trials, at the European Congress on Obesity in Istanbul last week.

Semaglutide is the active ingredient in Wegovy, a weight-loss drug.

Dr Emilia Huvinen, a gynaecologist researcher and associate professor at the University of Helsinki, who was involved in two of the three studies, said: “Menopause, associated weight gain and unwanted changes in cardiometabolic markers can significantly impact long-term health and wellbeing of women.

“Still, they remain one of the most neglected areas in obesity research.

“Whether we look at cardiovascular outcomes or weight loss across menopausal stages, semaglutide appears to offer meaningful benefits for women with obesity that extend well beyond weight loss alone.”

Cardiometabolic markers are measures linked to heart and metabolic health, such as blood pressure, blood sugar, cholesterol and waist size.

Analysis of the STEP UP trial found that premenopausal women with obesity lost an average of 22.6 per cent of their body weight when taking a once-weekly dose of Wegovy compared with placebo.

A placebo is a dummy treatment used to compare results against an active medicine.

Researchers said the average waist circumference reduction in premenopausal, perimenopausal and postmenopausal women was 17.5 per cent, 15.6 per cent and 15.3 per cent respectively, indicating a major loss of dangerous visceral fat.

Visceral fat is fat stored around internal organs and is linked to a higher risk of heart and metabolic disease.

The STEP UP trial involved 1,407 adults with a body mass index, or BMI, of 30 or above and investigated the efficacy and safety of Wegovy 7.2mg jabs.

BMI is a measure that uses height and weight to estimate whether a person is in a healthy weight range.

The SELECT trial involved 17,604 participants aged 45 or older with a BMI of 27 or above and assessed the impact of Wegovy on cardiovascular health compared with placebo.

A post-hoc analysis of the SELECT trial found that perimenopausal and postmenopausal women with obesity and heart disease had a reduced risk of heart attacks, strokes and cardiovascular death.

A post-hoc analysis is carried out after a study has finished and can help identify patterns, although it is generally seen as less definitive than the original planned analysis.

Novo Nordisk said obesity affects nearly one in five women globally, and the burden intensifies during menopause because hormonal changes accelerate weight gain, redistribute fat to the abdomen and increase cardiometabolic risk.

It added that the three studies show that when women with obesity lose weight with Wegovy, they improve their body composition with reduced waist circumference, indicating less visceral fat, and also reduce their risk of heart attacks and strokes while improving quality of life, from migraine burden to depression and menopause symptoms.

Hormonal health

Navigating the summer heat with a new sense of control

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By Nolynn Palmer, science and partnership lead, EmaEQ and Heather Ritchie, COO, Embr Labs

Summer is reminiscent of many things: the smell of sunscreen, longer evenings, dedicated family time, vacations finally on the calendar, maybe even a wardrobe refresh.

There’s a particular kind of joy that settles in this time of year, a collective breath of excitement.

But for people living with Postural Orthostatic Tachycardia Syndrome (POTS), summer’s signature feature, heat, can turn that joy and excitement into something much harder to navigate.

POTS is a form of dysautonomia that disrupts the body’s ability to regulate blood flow when moving from lying down to standing.

Temperature dysregulation and heat intolerance are core symptoms in POTS.

Heat makes symptoms worse: blood vessels dilate, blood pressure drops, and symptoms like dizziness, fatigue, and heart palpitations intensify. What feels like a beautiful day to most can feel like an obstacle course to someone with POTS.

POTS affects an estimated 0.2 per cent to 1 per cent of the North American population, according to a 2020 NIH study; a figure that’s almost certainly undercounted, and one many researchers believe has grown significantly in the wake of COVID-19.

Roughly 75 per cent to 85 per cent of POTS diagnoses are female, and the average time from symptom onset to formal diagnosis is four to six years.

These individuals spend years researching their symptoms, becoming fluent in their own condition long before receiving a diagnosis.

Since launching its first-generation Embr Wave device, Embr has consistently heard from those with POTS looking for a solution for temperature intolerance and the symptoms that result.

Embr Wave’s temperature delivery system, providing immediate wearable cooling relief, maps directly to one of POTS’s most consistent symptoms, heat intolerance.

Embr’s implementation of Tempura, Embr’s app-based AI Assistant, has provided Embr with even more clarity on the impact Embr Wave can have in this statistically small population.

In the last 90 days, nearly 3 per cent of conversations with Tempura have touched on POTS. Relative to population prevalence, that’s a significant overrepresentation, confirming that individuals with POTS are actively seeking tools that are designed for their symptoms.

Embr Wave provides a model for how designing products for one use case, menopausal women managing hot flashes, can be found to have tremendous benefits for other populations.

The influx of advocacy by those with POTS led to a research study published this year that measured the improvement in Quality of Life factors when supported by thermoregulation wearables.

The product design by its nature, and how customers are using and talking about it, has had a snowball effect in the POTS community, amplifying awareness of a safe, always-available solution for this unmet need.

For someone with POTS, temperature isn’t a minor variable but a sizable trigger. Giving someone a way to manage temperature response hands them back a measure of control they didn’t have before.

Those in the Embr community living with POTS describe using their Wave devices both proactively and in-the-moment: some turn on their Wave’s cool-down signals before leaving the house or entering a crowded event, knowing what’s ahead.

Others use it reactively, when they feel their body beginning to respond poorly, and bring themselves back in balance.

Either way, Embr Wave provides its users with a sense of control around something they cannot control, their environment, allowing one to focus on and enjoy the moment.

No one should have to skip the places or events they love because their body can’t handle the heat. The goal is to help people stay in their lives fully, with less friction and more confidence in what their bodies can handle.

Nolynn Palmer holds a Masters of Global Public Health & Policy with a focus in Sexual & Reproductive Health & Rights. As the Science & Partnership Lead at EmaEQ, she leverages her knowledge of health policy and clinical science to advance AI safety and accuracy across the healthcare industry.

Heather Ritchie has a decades-long background in product management, launching enterprise and consumer solutions that improve health and wellness management. At Embr Labs, she serves as COO and leads the user design and market launch of Embr Wave (2nd Gen).

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Menopause

Statins may worsen menopause symptoms, study suggess

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Statins have been linked to more severe menopause symptoms and a higher risk of muscle loss in postmenopausal women, a study suggests.

The medicines are among the most widely prescribed in the world, with strong evidence supporting their use to lower cholesterol and reduce cardiovascular risk.

However, some recognised side effects may resemble symptoms associated with menopause, raising questions about how the two could interact.

The US Food and Drug Administration has flagged potential adverse effects linked to statin treatment, some of which overlap with menopausal complaints.

Researchers examined data from 1,184 postmenopausal women across nine Latin American countries, assessing menopausal symptoms, sarcopenia risk and cognitive function.

They compared women taking statins with non-users after accounting for factors including age and body weight.

As the study was cross-sectional, meaning it examined information collected at one point in time, it could identify associations but could not prove that statins caused the outcomes.

Women taking statins were 56 per cent more likely to have severe menopausal symptoms than those who were not using the medicines.

The difference remained after researchers accounted for other variables.

Statin users were also 65 per cent more likely to be at risk of sarcopenia.

Sarcopenia is the gradual loss of muscle mass and physical function, which tends to accelerate after menopause.

Declining oestrogen levels already make muscle loss a concern at this stage of life. It is linked to a higher risk of falls, fractures and reduced quality of life.

Musculoskeletal symptoms were reported by 53.1 per cent of statin users, compared with 33.9 per cent of non-users.

Researchers said this was separate from the finding on sarcopenia risk and may point to a wider pattern of physical discomfort among women taking the medicines.

Women taking statins also recorded slightly lower scores in tests of delayed memory recall and visuospatial function.

Visuospatial function is the ability to understand the position of objects and their relationship to one another.

The study found no overall association between statin use and mild cognitive impairment, so the differences in individual tests are early signals rather than firm conclusions.

Researchers said effects associated with statins may overlap with menopausal symptoms and add to the overall symptom burden during midlife.

This means symptoms attributed to menopause and possible statin side effects may look similar and, in some cases, could compound one another.

Further research is needed to separate the possible effects of the medicines from symptoms linked to menopause.

The findings are not a reason for women to stop taking statins.

Their cardiovascular benefits are well established, and stopping treatment without medical guidance can carry serious risks.

The study provides more information about what statin treatment may mean specifically for postmenopausal women, who have historically been under-represented in cardiovascular research.

Women who notice more severe menopausal symptoms or changes in muscle strength or physical function while taking statins should discuss them with a doctor.

A healthcare professional may consider whether the symptoms could be related to the medication and whether screening for muscle loss is appropriate.

They may also review whether the current statin remains the most suitable option, as different statins can have different side-effect profiles.

Resistance training and consuming enough protein are well-supported ways to help preserve muscle mass during midlife.

Statins can be life-saving, but the findings suggest their possible side effects should receive greater attention in postmenopausal women.

The study adds to evidence supporting more individualised care for women during midlife.

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Hormonal health

Hormone therapy users report healthier lifestyles

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Menopausal women using hormone therapy reported healthier diet, exercise and sleep habits than non-users in a study of more than 10,000 women.

The menopause transition is associated with a higher risk of chronic health conditions and symptoms including hot flushes and problems affecting the urinary and genital systems.

Hormone therapy is often used to manage these symptoms, but it remains unclear whether it affects health outcomes directly or indirectly through changes in health behaviours.

Previous research has produced mixed results, with some studies suggesting that postmenopausal women pay greater attention to maintaining a healthy lifestyle.

 

The cross-sectional analysis examined whether menopause status and hormone therapy use were linked to diet, physical activity and sleep duration.

A cross-sectional study assesses participants at one point in time. It can identify associations but cannot establish whether one factor directly caused another.

Diet, exercise and sleep are described as modifiable health behaviours because people may be able to change them to improve their health.

The researchers found that postmenopausal women who had never used hormone therapy reported eating less fruit and vegetables.

Women who had never used the treatment were also 19 per cent less likely to meet guidelines for muscle-strengthening activity.

Sleep duration was shorter among postmenopausal women who had never used hormone therapy.

Compared with premenopausal and perimenopausal women, the likelihood of meeting sleep guidelines was 14 per cent lower among never-users, 26 per cent lower among current users and 24 per cent lower among past users.

Perimenopause is the transitional period before menopause, when hormone levels and menstrual periods can change.

Researchers said these findings may be linked to higher levels of follicle-stimulating hormone among postmenopausal women who do not use hormone therapy.

They may also relate to lower levels of oestradiol, a form of oestrogen, which have previously been associated with poorer sleep.

Hot flushes and urogenital symptoms can also disrupt sleep, although hormone therapy may ease these symptoms.

Dr Stephanie Faubion, medical director for The Menopause Society, said: “This large observational study underscores that women who use hormone therapy tend to adopt overall healthier lifestyles.

“Although this association may partly reflect better symptom control enabling healthier behaviours, healthy-user bias is likely a significant contributor.

“Women who choose to use hormone therapy are often more proactive in their healthcare and may systematically differ from nonusers in socioeconomic resources, access to care, and health literacy.

“This largely explains why early observational studies of hormone therapy suggested cardiovascular benefits that were not confirmed in subsequent randomised, controlled trials.”

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