First day highlights from the International Menopause Society conference 2014
2 May 2014
Can ovaries be reawakened?
Ovarian failure may not be irreversible after all, with the finding of ovarian stem cells (oocyte producing oogonial stem cells) which, in mouse models, have been shown to be able to be reactivated so that new egg cells can be produced. With continuing ovarian function, mice have been shown to age better. Much work still to be done in researching this potential in humans, but this exciting finding may completely change the way we view ovarian function and may offer hope to women with premature ovarian insufficiency.
Effect of HRT on the arterial wall.
Much interest continues to surround the effect of estrogen in the form of HRT on blood vessel walls and its role in the potential prevention of atherosclerosis (narrowing of the blood vessels by fatty plaques leading to cardiovascular disease). Part of the process of developing the fatty plaque requires oxidation of the fatty molecules LDL (Low Density Lipoproteins). It appears that estrogen prevents this process at the vessel wall and so may indeed be important in preventing cardiovascular disease, as has been predicted for many years.
Walking is best.
While debate continues around effects on cardiovascular risk for differing types and routes of HRT, exercise as simple as walking can make a difference - Cardiovascular risk in women can be reduced by 30 to 40% by 30 minutes of exercise, 3 days per week and by 60% from 30 minutes, 6 days per week.
Window of opportunity theory confirmed.
The role of HRT in cardiovascular prevention continues to cause confusion. Preliminary results from the ELITE trial, looking at the thickness of the vessel wall in the carotid artery, a marker of cardiovascular disease, has shown that when women start HRT within 6 years of the menopause, they have a 50% statistically significant reduction in the thickness measured compared to women who take no HRT, suggesting a significantly protective effect. Women who did not start HRT until more than 10 years after the menopause did not demonstrate this protection. This result is another important piece in the jigsaw of the topic of HRT and cardiovascular protection but what this means in terms of reducing risk of heart disease is still unclear. It is though, consistent with the window of opportunity whereby evidence increasingly is showing that when HRT is started within the early years of the menopause, it is likely to be protective and confer reduced risk of cardiovascular disease, a benefit which is not seen when it is started more than 10 years after the menopause.
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