Sex Drive Killers: 

Causes of Low Libido

 

Sex-Drive Killer: Stress

The body does not react well to stress. Emotional stress may affect physical function, including sexual desire and performance. Realizing what underlying stressors may exist is the first step in treatment. Self-help may work but some people may need to visit a counselor or doctor.
 

Sex-Drive Killer: Partner

Sexual desire requires two to tango. Both partners need to feel connected and women especially need the feeling of being close. Poor communications, a sense of betrayal, lack of trust, and repeated fighting and criticism may create a relationship that lacks closeness and intimacy. Counseling may be the answer if couples find that the issues are too tough to resolve on their own.
 

Sex-Drive Killer: Alcohol

Alcohol is usually not the answer to any problem. While alcohol may decrease inhibitions, it also decreases sexual performance and libido. Your partner may not appreciate a drunken advance and may be turned off by it. Alcohol is an addictive drug and you may need help to quit.

Sex-Drive Killer: Too Little Sleep

As with any physical activity, a rested body increases performance. Lack of sleep, including lack of proper sleep, may be the culprit that decreases sex drive. Sleep apnea is a potential cause for lack of good sleep and lack of libido. Medical help may be needed if you or your partner suspect it.
 

Sex-Drive Killer: Having Kids

Being a parent is a full-time job and you need carve out time without a child or baby around. Planning quiet time for intimacy and sexual desire may require some creative thinking, like having sex when the baby naps, or hiring a babysitter so mom and dad can have a play date.
 

Sex-Drive Killer: Medication

Side effects of many prescription medications include loss of libido and sex drive. Some examples include:

• High blood pressure medications including water pills and beta blockers
• Cold medications that contain antihistamines and decongestants
• Antidepressants
• Birth control pills
• Narcotic pain pills
• Chemotherapy drugs

If this is the cause, your doctor may be able to suggest a medication alternative that might have fewer side effects.

Sex Drive Killer: Poor Body Image

Sexy is as sexy feels. Many people have low self-esteem when it comes to their body shape and this can affect their sex drive and desire. Being happy with yourself is an important first step. A supportive partner always helps.
 

Sex-Drive Killer: Obesity

Obesity affects one-third of all Americans and being overweight can limit desire because of decreased sexual enjoyment, lack of performance, and poor self-esteem. How you feel about yourself goes a long way in affecting how you enjoy sex. Counseling may be helpful.

 

Sex-Drive Killer: Erection Problems

Erectile dysfunction (ED) can not only affect the ability to have intercourse but also how a man feels about his ability to perform. There are many options available to treat ED and your doctor can help find the option that is best for you and your partner.

 

Sex-Drive Killer: Low T

While a man's testosterone level gradually falls with aging, there is not necessarily any relationship between hormone levels and the desire for sex. It is just one potential cause for decreased libido and your doctor may want to look for other causes in addition to just low testosterone (“low T”).
 

Sex-Drive Killer: Depression

Depression affects all facets of life including sex drive. Losing pleasure in daily activities often requires treatment including counseling and perhaps medication. Unfortunately, some antidepressants also depress libido. Your doctor and therapist need to know if low sex drive is one of your symptoms of depression.
 

Sex-Drive Killer: Menopause

Menopause may cause physical changes that affect intercourse, including vaginal dryness and pain with intercourse (dyspareunia). Treatments are available to enhance sexual desire and function after menopause.
 

Sex-Drive Killer: Lack of Closeness

Making love is more than just sex. Intimacy and closeness are important part of a health love life. If sexual desire is waning, it may be time to inject romance back in the relationship. Snuggling, giving each other massages and spending casual time together may help ignite that spark.

Food safety for pregnant women

Pregnancy can be one of the most exciting times in your life. Following a healthy diet is an important way to make sure that you and your baby are getting the nutrients that you need.
However, because of all the changes taking place in your body, both you and your unborn baby are at an increased risk for food poisoning (also known as food-related illness or foodborne illness). This includes your immune system being weakened, which can make it more difficult to fight off infections.
While the food we eat in Canada is among the safest in the world, some food can be contaminated by bacteria, viruses, and parasites (foodborne pathogens). Protect yourself and your baby by following some simple rules and by avoiding some types of food.

Health risks

Some people can get food poisoning and not even know they have it. Food poisoning is caused by eating foods that are contaminated.
Certain bacteria, viruses or parasites can cross the placenta and increase the chance your baby may become infected. Your unborn baby's immune system is not developed enough to fight off harmful bacteria. For you, the mother, food poisoning can cause symptoms that include:

• nausea
• vomiting
• diarrhea
• abdominal pain
• fever
• chills
• headaches
• body aches

Did you know?

Pregnant women are 20 times more likely than other healthy adults to develop listeriosis if they are exposed to the Listeria bacteria.

Foodborne bacteria can be even more dangerous for your baby's health. If you develop food poisoning during the first three months of pregnancy, it can cause a miscarriage. Later on in the pregnancy, your baby could be delivered prematurely. Foodborne illness can also cause a stillbirth or a baby who is born severely ill. Since your baby is dependent on you for all its needs, it is extremely important that you pay close attention to what you eat and apply the following food safety steps.

Safety tips

It is important to separate your raw meat, poultry, fish, and seafood from other food in your grocery cart and in your refrigerator. This is to make sure that you are not cross-contaminating your food.
Heat and proper cooking can kill bacteria, but people often eat raw fruits and vegetables. Because they are not heated or cooked, raw fruits and vegetables that have been contaminated by raw meat, poultry, fish, and seafood may contain bacteria that can be harmful to you.

Shopping

• Buy cold or frozen food at the end of your shopping trip.
• Check the "best before" date on your food.
• Keep your raw meat, poultry, fish, and seafood away from other food in your grocery cart.
• Examine fruits and vegetables carefully and avoid buying items that are bruised or damaged.
• If you use reusable grocery bags or bins, make sure to use a specific bag or bin for meat, poultry or seafood. Label the bag or bin with the type of food it carries.

Did you know?

You can't tell if food is unsafe by its smell or taste. When in doubt, throw it out!

Cleaning

Cleaning your hands, kitchen surfaces, utensils, fruit and vegetables, and reusable grocery bags will help eliminate bacteria and reduce the risk of food-related illness.

• Use regular soap to wash your hands. An alcohol-based hand rub can be used if soap and water are not available.
• Use one cutting board for produce, and a separate one for raw meat, poultry, fish and seafood.
• Use paper towels to wipe kitchen surfaces, or change dishcloths daily to avoid the risk of cross-contamination and the spread of bacteria. Avoid using sponges, as they are harder to keep bacteria-free.
• Sanitize countertops, cutting boards, and utensils before and after preparing food. Use a kitchen sanitizer (following the directions on the container) or a bleach solution (5 ml household bleach to 750 ml of water), and rinse with water.

Chilling

It is important to keep cold food cold and hot food hot, so that your food never reaches the "temperature danger zone." This is where bacteria can grow quickly and cause food poisoning.

• Keep your raw meat, poultry, fish, and seafood cold. Refrigerate or freeze them as soon as you get home from the grocery store.
• Make sure your refrigerator is set at 4 °C (40 °F) or lower and your freezer at -18 °C (0 °F) or lower. This will keep your food out of the temperature danger zone between 4 °C (40 °F) to 60 °C (140 °F) where bacteria can grow quickly.
• Place raw meat, poultry, fish, and seafood in sealed containers or plastic bags on the bottom shelf of your refrigerator so raw juices won't drip onto other food.
• Deli meats can be more risky for older adults to eat. Store deli meats in the refrigerator and use them within four days or, preferably, two to three days after opening.
• Cook raw meat, poultry, fish, and seafood no more than two to three days after purchasing. If you do not intend to cook it within this time, it should be frozen.

Thawing

The safest way to thaw food, especially raw meat, poultry, fish or seafood, is in the refrigerator. Always defrost food in the refrigerator, in cold water or in the microwave - never at room temperature. Don't re-freeze thawed food. Remember, to avoid cross-contamination thoroughly wash your hands and clean and sanitize the sink and all other utensils, surfaces, and dishes that you use when thawing the food.

Did you know?

Colour does not always tell you if your food is safe to eat. Always follow internal cooking temperatures to be safe!

Cooking

Cooking food properly is the best way to make sure it is safe to eat. Bacteria like E. coli, Salmonella, and Listeria are killed by heat.

• Cook food completely, using a clean thermometer to measure the temperature. See Health Canada's safe internal cooking temperatures to learn the proper way of taking measurements and to make sure that the food has been cooked to a safe internal temperature.
• If you are cooking several pieces of meat, poultry, fish or seafood, make sure to check the internal temperature of the thickest pieces because food can cook unevenly.
• Cut away any bruised or damaged areas, since harmful bacteria can thrive in these areas.
• Make sure that cooked foods don't come into contact with any food that hasn't been cooked.
• Keep hot foods at or above 60ºC (140°F). Bacteria can grow quickly in the danger zone between 4°C to 60°C (40°F to 140°F).

Leftovers

• Refrigerate or freeze all leftovers within two hours to minimize the chance of bacteria growing.
• To store leftovers safely, cut and debone the meat from large cooked birds.
• Avoid overstocking the refrigerator, so that cool air can circulate effectively.
• Use refrigerated leftovers as soon as possible, ideally within two to four days.
• When reheating food, make sure it's cooked to a temperature of at least 74°C (165°F). In general, you shouldn't reheat the same leftovers more than once.

Select safer alternatives

Some types of food can be a higher risk for pregnant women because of the way they are produced and how they are stored. You can minimize your chances of getting food poisoning by avoiding some types of food. The following chart can help you make alternative choices when selecting food.
(Always refer to safe internal cooking temperatures.)

Alternative food choices

Type of food	Food to avoid	Safer alternative
Dairy products	Raw or unpasteurized dairy products, including pasteurized soft and semi-soft cheese such as Brie, Camembert, and blue-veined cheese.	Pasteurized dairy products and hard cheeses such as Colby, Cheddar, Swiss, and Parmesan.
Hot dogs	Hot dogs straight from the package without further heating.	Hot dogs thoroughly cooked to a safe internal temperature. The middle of the hot dog should be steaming hot or 74°C (165°F).
		Tip: To help prevent food poisoning, avoid spreading fluid from packages onto other food, cutting boards, utensils, dishes, and food preparation surfaces. Wash your hands after handling hot dogs.
Deli meats	Non-dried deli meats, such as bologna, roast beef, and turkey breast.	Dried and salted deli meats such as salami and pepperoni.
		Non-dried deli meats heated throughout to steaming hot.
Egg and egg products	Raw or lightly cooked egg or egg products, including salad dressings, cookie dough, cake batter, sauces, and drinks such as homemade eggnog.	Egg dishes thoroughly cooked to a safe internal temperature. Eggs should be cooked until the yolk is firm.
		Homemade eggnog must be heated to 71°C (160°F).
		Tip: Pasteurized egg products can be used when making uncooked food that calls for raw eggs.
Meat and poultry	Raw or undercooked meat or poultry, such as steak tartar.	Meat and poultry cooked to a safe internal temperature. (refer to the Internal Cooking Temperatures Chart)
		Tip: To help prevent food poisoning, remember to use a digital food thermometer to check the internal temperature.
Seafood	Raw seafood, such as sushi.	Seafood cooked to a safe internal temperature of 74°C (165°F).
	Raw oysters, clams, and mussels.	Cook until the shell has opened.
	Refrigerated, smoked seafood.	Smoked seafood in cans that do not require refrigeration until after opening.
		Tip: Refrigerated smoked seafood can be eaten safely when fully cooked to a safe internal temperature, such as in a casserole.
Sprouts	Raw sprouts such as alfalfa, clover, radish, and mung beans.	Thoroughly cooked sprouts.
Pâtés and meat spreads	Refrigerated pâtés and meat spreads.	Pâtés and meat spreads sold in cans or those that do not require refrigeration until after opening.
Fruit juice and cider	Unpasteurized fruit juice and cider.	Unpasteurized fruit juice and cider brought to a rolling boil and cooled.
		Pasteurized fruit juice and cider.

Also, it is strongly suggested that you pay attention to food recalls and learn more about general food safety.

How the Government of Canada protects you

The Government of Canada is committed to food safety. Health Canada establishes regulations and standards relating to the safety and nutritional quality of foods sold in Canada. Through inspection and enforcement activities, the Canadian Food Inspection Agency verifies that food sold in Canada meets Health Canada's requirements.

Are attractive men more selfish?

Last updated: 9 February 2015 at 1am PST

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When it comes to attractive men, some women are of the opinion that they are more likely to be selfish. And according to a new study, they may be right. Researchers from Brunel University London in the UK found that attractive men were less generous and were less likely to favor equality, though this was not the case for attractive women.

Men who scored higher on measures of attractiveness were also more selfish and less favorable of equality.

Lead investigator Dr. Michael Price and his team publish their findings in the journal Evolutionary Psychology.
This is not the first time a study has investigated the psychological effects of people's attractiveness. In December 2014, Medical News Today reported on a study suggesting people with average-looking faces appear more trustworthy, while research from September 2013 found men with wide faces may trigger selfishness in others.
In this latest study, the team set out to see how attractiveness influences individual's attitudes and behavior toward inequality and selfishness.
The investigators say the research was inspired by a previous theory suggesting that when it comes to competitions for social status, people who are attractive tend to reign, meaning they have more to gain by bolstering social inequality.
To reach their findings, the team measured the bodies of 63 men and 62 women using a 3D body scanner.
The participants were given attractiveness scores based on their body measurements - including waist-to-chest ratio for men, waist-to-hip ratio for women and slimness.
Participants also completed a personality questionnaire, from which the researchers obtained information on their attitudes and behavior toward selfishness and inequality. As an extra measure, the subjects took part in an experiment, in which they were given money and asked to decide how much they wanted to share with another individual.

The perception of selfishness in attractive men 'may be justified'

From this, the researchers found that men with higher scores on attractiveness were more selfish and less egalitarian than men with lower attractiveness scores. Women with higher attractiveness scores, however, were just as generous and egalitarian than those with lower scores.
Next, the team asked a group of "raters" to look at the body scans of all participants and judge them on attractiveness. Another group of raters was asked to judge how egalitarian and selfless the individuals were likely to be in reality.
The researchers found that the raters thought more attractive men and women would be more selfish and less favorable toward inequality. Dr. Price comments:

"Our results showed that in fact we may be justified in expecting more attractive men to behave in ways that are less favorable to economic and social equality."

He adds that many studies have suggested that wealthier individuals tend to be more selfish, but that these latest findings shed new light, suggesting "attractiveness is at least as important as wealth in influencing these attitudes."
Dr. Price notes, however, that the correlation between attractiveness and selfishness was "nowhere close to being perfect," noting that many attractive men will possess generous traits.
Last month, MNT reported on a study claiming men who regularly post pictures on social media sites are likely to score higher on measures of narcissism and psychopathy.
Written by Honor Whiteman

Unemployment 'a cause of 45,000 suicides each year'

Last updated: 11 February 2015 at 12am PST

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A new study published in The Lancet Psychiatry finds that between 2000 and 2011, unemployment was the cause of approximately 45,000 deaths by suicide around the globe each year, and it accounted for around nine times as many suicides as the recession, which first hit in 2008.

Unemployment was found to account for nine times as many suicides as the economic recession.

Lead author Dr. Carlos Nordt, of the University of Zurich Psychiatric Hospital in Switzerland, and colleagues say the findings indicate that governments need to increase focus on reducing unemployment in order to lower its impact on suicide.
To reach their findings, the researchers assessed data from the World Health Organization (WHO) mortality database and the International Monetary Fund's World Economic Outlook database.
The team used longitudinal modeling to calculate the effect unemployment had on suicide in 63 countries over four world regions between 2000 and 2011. The researchers note that they looked at this period so they could analyze the data in times of economic stability (2000-07) and in times of economic crisis (2008-11).

Suicide interventions required in times of economic stability and economic crisis

The researchers found that over all regions included in the analysis, the rate of suicide associated with unemployment increased by 20-30% in 2000-11.
They estimated that around 233,000 suicides took place each year during this period, and unemployment accounted for around 45,000.
Perhaps most interestingly, the researchers found that unemployment was associated with 41,148 suicides in 2007 and 46,131 in 2009, which suggests that the recession in 2008 was responsible for 4,983 additional suicides. This indicates that unemployment is responsible for nine times as many suicides as the economic crisis.
The team also found that suicide rates tended to increase 6 months before a rise in unemployment rates, and that increasing unemployment rates affected men and women equally - a finding that challenges that of previous studies.
"What is more," the team adds, "our data suggest that not all job losses necessarily have an equal impact, as the effect on suicide risk appears to be stronger in countries where being out of work is uncommon. It is possible that an unexpected increase in the unemployment rate may trigger greater fears and insecurity than in countries with higher pre-crisis unemployment levels."
Based on their findings, the researchers say suicide interventions need to be put in place that focus on the negative health effects of unemployment in times of economic stability and economic crisis. Dr. Nordt adds:

"Besides specific therapeutic interventions, sufficient investment by governments in active labour market policies that enhance the efficiency of labour markets could help generate additional jobs and reduce the unemployment rate, helping to offset the impact on suicide."

Suicides attributable to economic crisis 'just the tip of the iceberg'

In an editorial linked to the study, Roger Webb and Navneet Kapur, both of the University of Manchester in the UK, say the number of suicides resulting from the economic crisis may only be the "tip of the iceberg," noting that it is likely to have caused many other issues.
"Many affected individuals who remain in work during these hard times encounter serious psychological stressors due to pernicious economic strains other than un­employment, including falling income, 'zero­-hour' contracting, job insecurity, bankruptcy, debt and home repossession," they explain.
As such, Webb and Kapur say that as well as understanding the effect of unemployment on suicide, we need a better understanding of other "psychosocial manifestations of economic adversity," such as non-fatal self-harm, stress and anxiety, depression, hopelessness, alcohol abuse, familial conflict and relationship breakdown.
"We also need to know how and why highly resilient individuals who experience the greatest levels of economic adversity manage to sustain favorable mental health and well-being," they add.
Medical News Today recently reported on a study revealing that austerity measures in Greece have led to a significant increase in suicide rates in the country.
Written by Honor Whiteman

Marijuana use could explain excessive daytime sleepiness in some teens

Last updated: 15 February 2015 at 12am PST

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Narcolepsy - extreme bouts of sleepiness that can strike at any time - affects around 1 in 2,000 people in the US. A new study raises concerns about its diagnosis in adolescents, after it identified marijuana in the urine of some teenagers who had symptoms consistent with narcolepsy.

Researchers found that more than 40% of adolescents whose urine tested positive for marijuana had symptoms consistent with narcolepsy.

The researchers, including senior author Dr. Mark L. Splaingard, director of the Sleep Disorders Center at Nationwide Children's Hospital in Columbus, OH, publish their findings in the Journal of Clinical Sleep Medicine.
Onset of narcolepsy is most likely to begin in childhood or adolescence. Excessive daytime sleepiness (EDS) is one of the most common symptoms, whereby an individual suddenly falls asleep, regardless of whether or not they have had sufficient sleep. Other symptoms may include sudden episodes of muscle weakness, called cataplexy, hallucinations and sleep paralysis.
In order to diagnose narcolepsy, a patient will typically undergo an evaluation for EDS before completing a standardized multiple sleep latency test (MSLT). This assesses how quickly the patient falls asleep in a quiet environment during the day.
MSLT also assesses patients' rapid eye movement (REM) sleep; people with narcolepsy tend to enter REM sleep within minutes of falling asleep, while those without the condition usually take around 80-100 minutes to enter REM sleep.
However, according to Dr. Splaingard and colleagues, past research in adults has indicated that if patients have used illicit drugs or a number of different medications - identified through urine samples - this could influence the results of MSLT.

Findings show urine drug screening is important prior to narcolepsy diagnosis

In this latest study, the researchers set out to determine the rate of positive urine drug screens among 383 children and adolescents who were undergoing MSLT for diagnosis of narcolepsy.
Positive urine drug screens were only identified among adolescents over the age of 13.
Of the adolescents whose urine tested positive for marijuana, 43% had MSLT results consistent with narcolepsy or abnormal REM sleep patterns. Males were most likely to have both positive drug screens and narcolepsy-consistent MSLT results.
The researchers say their findings indicate that marijuana use may be linked to EDS in some adolescents, and that urine drug screening should form a part of clinical evaluation for narcolepsy.
Dr. Splaingard adds:

"Our findings highlight and support the important step of obtaining a urine drug screen, in any patients older than 13 years of age, before accepting test findings consistent with narcolepsy, prior to physicians confirming this diagnosis.
Urine drug screening is also important in any population studies looking at the prevalence of narcolepsy in adolescents, especially with the recent trend in marijuana decriminalization and legalization."

In June 2014, Medical News Today reported on another study associating marijuana use with sleep problems. Led by researchers from the University of Pennsylvania, that study found that the earlier people start using marijuana, the more likely they are to develop sleep problems later in life.
Written by Honor Whiteman

Healthy diet, exercise 'not enough to treat obesity,' say experts

Last updated: 13 February 2015 at 1am PST

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People who are obese are often told to eat healthier and exercise more in order to lose weight. But in an article recently published in The Lancet Diabetes & Endocrinology, obesity experts claim the condition is a chronic disease that can be caused by biological factors, meaning many cases may not be cured with a healthy diet and physical activity alone.

While a healthy diet and exercise may help obese individuals lose weight in the short term, the experts say around 80-95% eventually gain back that weight.

In the US, around 35% of adults and 17% of children and adolescents are obese. Both the Centers for Disease Control and Prevention (CDC) and the National Institutes of Health (NIH) cite a healthy diet and exercise as a primary factor in combatting obesity. But is it really that simple?
Not according to lead author Dr. Christopher Ochner, assistant professor of pediatrics and psychiatry at the Icahn School of Medicine at Mount Sinai in New York, NY, and colleagues.
In their article, the experts state that while a healthy diet and exercise may help obese individuals lose weight in the short term, around 80-95% eventually gain back that weight.
They explain that this is partly because a reduced intake of calories can activate a type of biological "fat-loss defense" that encourages the body to stay at a higher weight.
According to the authors, this defense mechanism once protected humans when food was scarce. In these modern times, however, humans tend to have higher body weights for longer periods. As such, the defense mechanism drives calorie consumption and fat storage so a higher body weight can be maintained.

Most obese people 'unable to override fat-loss defense' with diet and exercise

The authors say that in a 21st century environment where high-calorie, high-fat foods are the norm, alongside low levels of physical activity, the majority of people who are obese are unable to override the defense mechanism simply through lifestyle changes.
Dr. Ochner adds:

"Although lifestyle modifications may result in lasting weight loss in individuals who are overweight, in those with chronic obesity, body weight seems to become biologically 'stamped in' and defended.
Therefore, the current advice to eat less and exercise more may be no more effective for most individuals with obesity than a recommendation to avoid sharp objects for someone bleeding profusely."

What is more, Dr. Ochner says that even individuals who were obese and have achieved significant weight loss through dieting may not be able to escape the fat-loss defense mechanism.
"Few individuals ever truly recover from obesity; rather they suffer from 'obesity in remission,'" he adds. "They are biologically very different from individuals of the same age, sex, and body weight who never had obesity."
If this is the case, what can obese individuals do to sustain long-term weight loss?

Obesity should be recognized as a 'chronic and often treatment-resistant disease'

The authors believe the biological mechanisms preventing long-term weight loss need to be addressed going forward.
They note that one form of gastric bypass surgery - known as Roux-en-Y - has been shown to be effective in reversing changes in appetite-related hormones caused by obesity, which affects how the brain responds to food. They say this may be why bariatric surgery appears to be the only obesity treatment that works long term.
In order to tackle obesity, Dr. Ochner says the condition needs to be recognized as a "chronic and often treatment-resistant disease with both biological and behavioral causes," and it should be treated with biological interventions as well as lifestyle changes.
"Ignoring these biological factors and continuing to rely on behavioral modification will surely result in the continued inability to treat obesity effectively and the premature death of millions of individuals each year," he adds.
Medical News Today recently learned how a woman became obese after receiving a fecal transplantation from an overweight donor.
Written by Honor Whiteman

Going red: raising awareness of heart disease in women

Last updated: 6 February 2015 at 8am PST

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Only 1 in 5 American women believe that heart disease is their greatest health threat. However, while another major killer - breast cancer - is responsible for 1 in 31 women dying, heart disease and stroke are attributed to the deaths of 1 in 3 American women.

February 6th is National Wear Red Day.

Heart disease is the leading cause of death among women in the US today. This spotlight will examine why awareness of heart disease among women is so low and what is being done to change things.
Historically, heart disease and heart attacks have typically been associated with men. Consequently, most research in this area has focused on men, and as a result, a distorted picture of heart disease and risk has formed, with women's needs being ignored and awareness of their risk suffering.
In an interview with abc2, Dr. Suzanne Steinbaum, cardiologist and spokesperson for the American Heart Association (AHA), described how women's perceptions of heart disease are slowly changing:
"When I go out and say heart disease is your number one killer more than all cancers combined, I remember 10 years ago, I remember 5 years ago everyone saying 'Really? Are you sure?' Isn't it breast cancer?' And I see now they're saying, 'yeah, we've heard of that.'"
One factor in this shift in attitudes is Go Red For Women. Set up in 2004 by the AHA, Go Red For Women is an initiative designed to raise awareness of heart disease among women, dispelling myths and empowering women to take control of their health.

Heart disease: the facts

According to the Centers for Disease Control and Prevention (CDC), around 600,000 people die of heart disease in the US every year, a total representing 1 in 4 deaths. The most common form of heart disease is coronary heart disease, responsible for around 380,000 deaths each year and costing the US $108.9 billion annually.
Coronary heart disease occurs when a substance called plaque, made up of cholesterol deposits, builds up in the arteries, restricting the flow of blood and narrowing the arteries. Narrow arteries are more susceptible to being blocked by blood clots. A common symptom of coronary heart disease is angina.
Heart attacks are another aspect of heart disease. Also referred to as a myocardial infarction, a heart attack occurs when part of the heart muscle either dies or is damaged due to a reduction in blood supply. Around 720,000 Americans have heart attacks each year, with 515,000 of these people experiencing them for the first time.
While heart disease is typically seen as a male health problem, it kills similar amounts of men and women. The Mayo Clinic state that more women than men die of heart disease each year.
Women experience different challenges to men when it comes to heart disease, and this could be where part of the misconception stems from. While similar numbers of men and women die of heart disease, heart attack diagnosis is much more common in men than women. Are enough people aware of the different ways in which women experience heart disease?

Unique problems faced by women

The most well-known symptom of a heart attack is chest pain or discomfort, but women are more likely than men to experience heart attacks differently. Dr. Nieca Goldberg, a volunteer with the AHA, explains:

"Although men and women can experience chest pressure that feels like an elephant sitting across the chest, women can experience a heart attack without chest pressure. Instead, they may experience shortness of breath, pressure or pain in the lower chest or upper abdomen, dizziness, lightheadedness or fainting, upper back pressure or extreme fatigue."

The symptoms listed by Dr. Goldberg are common to many other conditions and are not typically associated with a heart attack. This can lead to some women downplaying the severity of these symptoms when they occur.
Some of these symptoms can also be associated with conditions that only affect women - pregnancy and menopause. In fact, both pregnancy and menopause can increase the risk of heart disease in women; reduced levels of estrogen are a risk factor for cardiovascular disease in small blood vessels, and there is an increased risk of both high blood pressure and diabetes when pregnant.

"We are just at the beginning of understanding the differences between the sexes when it comes to heart disease," says Dr. C. Noel Bairey Merz, director of the Women's Heart Center at the Cedars-Sinai Heart Institute.
She believes that the heart disease experienced by each gender should have its own name.
"The more we find out, the more it becomes clear that men and women can experience different diseases and the medical names for those diseases should reflect the differences. There is enough research to conclude that women and men can experience different types of heart disease," she explains.
Dr. Bairey Merz suggests that women's heart disease should be referred to as ischemic heart disease, indicating its primary cause being a lack of blood flow and oxygen to the heart. The form of heart disease that typically affects men should still be referred to as coronary heart disease, as men are more likely to have plaque build-up in the large arteries surrounding the heart.

'Medicine favoring men'

It is not just different symptoms that affect rates of heart disease diagnosis between men and women. The methods employed to make diagnoses are also a factor.

As heart disease has traditionally been associated with men, research has tended to focus on them, reducing awareness of women's risks.

A recent study has suggested that while similar numbers of men and women report to emergency rooms with chest pains, women are less likely to be diagnosed with a heart attack.
The authors suggest that using different criteria for men and women in a diagnostic blood test could improve diagnosis rates. In heart attack diagnosis, blood tests are commonly used to measure levels of troponin, a protein released by the heart during an attack.
Traditionally, a single diagnostic threshold for both men and women is used. However, previous research has identified that troponin levels can be twice as high in men than in women. Using gender-specific diagnostic thresholds led to improved heart diagnosis rates in the study.

"If these results are confirmed in the much larger clinical trial we're funding, these results suggest that using a high sensitivity troponin test, with a threshold specific to each gender, could save many more women's lives by identifying them earlier to take steps to prevent them dying or having another, bigger heart attack," stated Prof. Peter Weissberg, medical director of the British Heart Foundation in the UK.
There are many examples of ongoing research where the goal is to improve the way in which heart disease in women is diagnosed and treated. But while doctors, scientists and researchers are working toward this, what can the general public do? This is where Go Red For Women come in.

National Wear Red Day

Heart disease is a deadly health condition, but a great many of deaths caused by it are considered to be avoidable. A CDC report in 2010 stated that an estimated 200,070 avoidable deaths from heart disease, stroke and hypertensive disease occurred in the US.
This fact emphasizes the importance of raising awareness of heart disease, because a real difference can be made and lives can be saved. Go Red For Women report 80% of heart disease and stroke cases in women are preventable.
Through education and lifestyle changes, the risk of heart disease can be reduced, and this is the focus of the Go Red For Women campaign. Go Red For Women explain what it means to "Go Red" with the following acronym:

• Get your numbers - check your blood pressure, cholesterol and glucose levels with a doctor
• Own your lifestyle - live healthily by regularly exercising, eating a balanced diet and quitting smoking
• Raise your voice - support the call for more research and education focusing on women
• Educate your family - promote healthy living among those closest to you
• Donate - support the cause by donating your own time or money.

Funds raised by Go Red For Women activities are used to increase heart disease awareness and to support research, community and education programs that benefit women's health. Over 200,000 health care providers have been given educational tools for the patients thanks to the efforts of the campaign.
Across the US on February 6th, thousands of people will be donning red clothing in order to show support and to raise awareness. Many will also use this moment as a springboard for making lifestyle changes to reduce their personal risk. The Mayo Clinic recommend the following changes to help people "own their lifestyle:"

• Maintain a healthy weight
• Exercise 30-60 minutes most days of the week, or 60-90 minutes if weight loss is needed
• Follow a diet that is low in salt, saturated fat and cholesterol
• Do not smoke
• Follow the advice of doctors and take medications precisely as prescribed.

One thing that is especially important to realize is that heart disease can affect all women, regardless of age, race or ethnicity. Women with a family history of heart disease in particular should be aware of their risk factors.
Amanda Gonzalez was only 18 when she was given an implanted cardioverter defibrillator to treat an irregular heart rhythm. She told Go Red For Women she wants women to know that heart disease is not limited to those over 65:

"People would always tell me, 'You're too young to have heart disease,' but it can affect you at any age, especially if it's in your family history. One year prior to my cardiac event, my grandfather died of a heart attack in my home. Heart disease snuck up on me during the best time of my life. It's never too early to check your heart health, so don't wait until it's too late!"

Go Red For Women has made a difference. More than 900,000 women have joined Go Red For Women. This group have been found to live healthily, talk about heart health with others and are more likely to visit their doctors - 91% visited their doctor in the past 12 months, compared with 73% of all US women.
Lifestyle changes and education are the simplest ways that heart disease rates will fall. As we put on our red t-shirts today, we hope that Go Red For Women and the AHA continue to have success in the future.
Written by James McIntosh

The power of love: how relationships benefit body and mind

Last updated: 12 February 2015 at 8am PST

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"All you need is love," sang the Beatles. When one considers the widely documented health benefits of being in a happy relationship, they might have been on to something. In this spotlight, we take a look at the health reasons for celebrating being with someone.

Research has demonstrated a myriad of health benefits - physical, mental and emotional - associated with being in an affectionate relationship.

With Valentine's Day approaching, many people fortunate enough to find themselves in relationships will be preparing for a day of celebration. The health conscious may look at boxes of chocolates and meals in restaurants warily, but it is worth remembering that outside of these indulgences, a wealth of health benefits have been identified for people in relationships.
Many will be aware that sex is a form of exercise, increasing the heart rate and reaching an average peak at orgasm comparable to forms of light exercise, such as walking upstairs. It is also fine for people with heart disease to have sex, so long as they can still do equivalent activities (such as walking up two flights of stairs) without experiencing chest pain.
Outside of this, though, several other health benefits arise from being in a relationship. And being in a loving relationship is not simply a bed of roses; different types of relationship have their own effects. We investigate.

Put a little love in your heart

The heart is one of the most conspicuous symbols of love, and perhaps it is unsurprising that love is associated both literally and figuratively with one the most important organs in the human body. With February being American Heart Month, it seems prudent to examine the less obvious benefits to the heart first.
Research has indicated that being in a satisfying relationship can lead to improved survival rates after coronary bypass surgery - an aggressive treatment for heart disease. The effects of satisfaction were reported to be just as important to survival as traditional risk factors, such as obesity and tobacco use.
This finding may have been due to happy relationships encouraging healthful behavior, such as quitting smoking and keeping fit.
Less active displays of intimacy than sex can also be beneficial to cardiovascular health. One study found that couples holding hands for 10 minutes followed by a 20-second hug had healthier reactions to a public speaking task than participants who merely rested quietly.
The couples that had brief warm social and physical contact exhibited lower heart rates, lower blood pressure and smaller increases in heart rate, with results comparable for men and women.
"These findings suggest that affectionate relationships with a supportive partner may contribute to lower reactivity to stressful life events," write the authors. The implication from the study is that affectionate relationships could be related to better cardiovascular health.
Hypertension can be dangerous, leading to serious conditions including heart failure, stroke and heart attack. Research has also found that it can increase the risk of cognitive decline later in life. However, lowering blood pressure is not the only aspect of being in a relationship that benefits cognitive functioning.

Always on your mind

Sex has also been found by researchers to improve mental health. A small study of 46 men and women suggested that like other forms of physical activity, sex reduces levels of stress.
Researchers conducted stress tests involving acts such as doing mental arithmetic out loud, finding that people who had sex coped better with stress than participants that had no sex at all.
A person's sense of well-being can also be improved by sex. A much larger study of 3,000 people aged 57-85 demonstrated that those who were having sex rated their health much more favorably than those who were not.
In this study, it was not just sex that led to improved well-being, but being in a satisfying relationship overall. The researchers found that participants in close relationships were more likely to report they were in "excellent" or "very good" health, rather than merely "good" or "poor."
According to the Mayo Clinic, thinking positively in this manner could lead to further health benefits, including reductions in the risk of the following:

• Common cold
• Depression
• Distress
• Overall mortality.

Dr. Larry J. Young, of Emory University in Atlanta, GA, told Medical News Today that the benefits to health and well-being that come from being in a relationship are best understood from seeing what happens when a relationship is lost, either by death or splitting up:
"Loss of a loved one (e.g. spouse or romantic partner) leads to an increase in mortality, immune suppression, cardiovascular disease and depression."

Love is not the same for everyone

It should be pointed out that no one seems to experience love in precisely the same way as everyone else. We are all drawn to different kinds of people and expect many different things from a relationship. It should not be surprising, for this reason, that the health implications of love also vary.

Could levels of affection and attachment style determine the health benefits couples receive from their relationship?

Recently, MNT reported on a study investigating the effects of attachment style on pain relief. Adult attachment style refers to patterns exhibited by individuals in relationships related to how they seek or avoid closeness.
Typically, the presence of a partner in a painful situation would be considered comforting and a relief, yet this was not the case for every participant in the research.
In a small study of 39 women, "moderately painful" laser pulses were administered to the participants' fingers while their romantic partner was present and then absent. The authors found that the more women were avoidant of closeness in their relationships, the more pain they experienced when their partner was present.
The authors concluded that "partner presence may not have beneficial effects on the experience of pain when the individual in pain is characterized by higher attachment avoidance." The presence of others may disrupt the preferred method of coping with "the threat value of pain" for such individuals.
For the women reporting high closeness with their partner, it may be oxytocin - a hormone sometimes referred to as "the love hormone" - that could be responsible for their experiencing reduced levels of pain.
Lead author Dr. Charlotte Krahé told MNT they believed that oxytocin might be part of a neurobiological mechanism involved in shaping the effects of interacting with close others on the pain experience.
Oxytocin has been associated by researchers with parts of the brain that are involved in emotional, cognitive and social behaviors. Acts of intimacy, such as sexual intercourse, holding hands and looking into another person's eyes, stimulate the release of oxytocin in men and women. The hormone is produced in larger amounts in mothers when they are giving birth or nursing.
In an article published in Nature, Dr. Young suggests that long-term bonding between mates may be regulated by the same mechanisms as those involved in maternal bonding.
Oxytocin "interacts with the reward and reinforcement system driven by the neurotransmitter dopamine - the same circuitry that drugs such as nicotine, cocaine and heroin act on in humans to produce euphoria and addiction," he writes.
"I think this is the only reason that we do hug and touch each other all the time. I think this is the mechanism that keeps oxytocin levels high in relationships," says Dr. Rene Hurlemann, a professor of psychiatry at the University of Bonn in Germany.

Addicted to love, and then withdrawal

"We have evidence that it is the withdrawal from oxytocin after social loss that leads to the depressive side effects, at least based on our studies in monogamous prairie voles," Dr. Young told MNT.

A study of nuns has demonstrated that romantic relationships and sex are not required for good health and long life.

In a paper published in Psychopharmacology in 2012, Dr. Young and James P. Burkett reviewed research on drug addiction alongside research on social attachments. "The psychology of human love and drug addiction share powerful overlaps at virtually every level of the addictive process, from initial encounters to withdrawal," the authors conclude.
Oxytocin was found to play a modulatory role in many aspects of drug addiction, along with additional roles in the processing of memories and information involved in social attachment.
The association between oxytocin and addiction was explored further last year in research conducted by the University of Adelaide in Australia. The study suggested that poor development of oxytocin during early childhood could explain why some individuals succumb to addictive behavior.
Dr. Young and Burkett state that the overlaps in the psychology of human love and drug addiction suggest that forms of treatment for one domain may be effective in another. "[For] instance, treatments used to reduce drug cravings may be effective in treating grief from the loss of a loved one or a bad breakup," they write.
These findings suggest that further research into the neurobiological mechanisms of love could reveal ways in which its positive healthful effects could be brought to people that find themselves without it.

Not all doom and gloom for single people

Single people can feel quite downhearted around Valentine's Day, being surrounded by people experiencing a joy that, at that moment in time, eludes them. Reading about these examples of health benefits for happy and affectionate couples may well contribute toward to this.
It is not all doom and gloom for single people, however. Research has found that having a good network of friends can have many of the same positive effects as being in a relationship.
One study of 1,500 people aged over 70 found that participants who reported having strong friendship groups tended to live longer than people with fewer friends. The authors suggested that this finding could be due to friends having a positive influence on lifestyle choices.
Despite all the health benefits that sex provides, research has also demonstrated that a life of celibacy can also be one that is long and healthy. A longitudinal study of 678 nuns aged 75-107 found many participants maintaining an active lifestyle and demonstrating strong cognitive function well into old age.
So, while there is much to celebrate about being in a relationship around Valentine's Day, it is by no means the be-all-end-all, especially when looking from a health perspective. Good health and long life can be enjoyed by anyone, no matter what their relationship status is.
Written by James McIntosh

Alligator blood may provide basis of wartime anti-infectives

Last updated: 13 February 2015 at 7am PST

The Defense Threat Reduction Agency has funded a study into "sophisticated germ fighters" that may protect soldiers in the field from infection. However, these germ busters do not originate from a petri dish or test tube, but somewhere altogether more dangerous. The source? Alligator blood.

George Mason University professor Barney Bishop poses with "Fluffy," an American alligator.
Image credit: St. Augustine Alligator Farm Zoological Park

The Agency's project is in its fourth year and, if fully funded over 5 years, will be worth $7.57 million. A 17-member multidisciplinary research team at George Mason University in Fairfax, VA, is conducting the research, the latest results of which are published in the journal PLOS ONE.
Although the team is looking at ways to protect wounded soldiers on the battlefield from infections or biological weapons, the researchers believe their work will also benefit civilians.
Study co-author Monique van Hoek, a professor in the School of Systems Biology and the National Center for Biodefense and Infectious Diseases at Mason, says: "We hope that these could be the basis to develop new treatments."
The Mason team turned their attention to alligators from the observation that, despite living in bacteria-laden environments and feasting on carrion, these creatures rarely fall ill. The researchers suspected that antimicrobial peptides - small proteins that are part of the innate immunity of all higher organisms - may be behind alligators' enhanced immunity.
Unlike antibodies, which are produced to fight specific bacteria or viruses, peptides offer more general protection.

"Innate immunity may work less well than antibodies, but it works well enough," van Hoek says. "The reason why we're so interested in them: they are part of nature's way of dealing with the onslaught of bacteria and viruses that we face every day. Every breath that you take, every thing that you eat, you're constantly exposed to bacteria and your body needs to fend them off in some way."

Researchers surprised to find alligator peptides are fragments of larger proteins

The Mason team analyzed blood samples provided by Kent Vliet of the University of Florida and the St. Augustine Alligator Farm Zoological Park in St. Augustine, FL. They were surprised by the "sophistication and diversity" of the peptides in the alligator blood.

Fast facts about alligators

• The American alligator can grow up to 11.2 ft long and weighs nearly half a ton
• Alligators have been known to use tools to snare prey, including using small sticks to attract nesting birds. They also eat fruit in addition to prey and carrion
• One of the earliest relatives of the alligator was the 40 ft Deinosuchus, which stalked North America 70 million years ago.


Alligators are one of the most ancient animals on Earth. Over the course of 37 million years, these reptiles have evolved what the Mason team describes as a "formidable defense against bacterial infections."
Using custom-made nanoparticles, the Mason researchers were able to capture peptides from the complex soup of proteins and peptides in alligator plasma.
However, the team was surprised to discover that these unusually potent peptides were fragments of larger "parent" proteins.
Next, the team will compare their findings on the alligator peptides with samples taken from Siamese crocodiles, Nile crocodiles and gharials - the crocodiles native to the Indian Subcontinent.
In 2014, Medical News Today examined a study published in the Proceedings of the National Academy of Sciences that suggested a new generation of antibiotics may be found in small peptides.
Written by David McNamee

Cancer care 'rated more highly' if patients can share decisions

Last updated: 14 February 2015 at 12am PST

Decision-making controlled by doctors leads to poorer ratings from cancer patients on the quality of their care and physician communication, a survey reveals. It shows that reaching decisions in a shared way with patients is important even for those patients who prefer their doctors to take the control.

Doctors do not always know best, the study suggests, and - especially for cancer - need to involve patients in decisions.

Dr. Nancy Keating, from Harvard Medical School in Boston, MA, worked with her co-authors on survey results from patients diagnosed with lung or colorectal cancer. The study analyzed responses from 5,315 patients about the decision-making roles behind 10,817 treatment decisions.
All the patients' answers were drawn from a large study known as CanCORS, and Dr. Keating's analysis was designed to assess the relationship between how patients play a role in decisions and how they report the quality of their care and rate their physician's communication.
Most patients, 58%, expressed a preference for a shared approach between themselves and their doctor when it came to decisions about treatments. The patients reported, however, that less than half, 44%, of decisions were shared, and that 17% were controlled by physicians.
The quality of care was rated as "excellent" by:

• Just under 70% of the patients who said they shared the decision-making
• Less than 60% of the patients who said they had treatment decisions made for them.

In contrast to responses varying by styles of decision-making actually received, the proportion giving the highest rating did not vary by the style that patients preferred.
The excellent rating hovered around the 67-68% mark regardless of whether patients preferred to lead decisions, share them, or have them controlled by their doctors.
So even if patients preferred their doctors to control decisions, they reported less satisfaction with the quality of care if decisions were in fact controlled in this way.
A similar relationship was seen for ratings of communication given for physicians by patients. The highest rating was given by just under 60% of patients overall, but patients were less likely to give it if they experienced physician-controlled rather than shared decisions:

• 58% described physician communication as excellent when decisions were shared
• 44% said it was excellent when physicians controlled the decision-making.

The study authors conclude that even patients' expressed preferences should not lead to decision-making processes being controlled by physicians, and that a shared approach is important for patients' experiences of quality care. The paper's conclusion reads:

"Given the increasing emphasis on patient experiences and ratings in health care, these results highlight the benefits of promoting shared decision-making among all patients with cancer, even those who express preferences for less active roles."

'Not all cancer care' fits one style of decision-making

The data for this analysis led by Dr. Keating came from the CanCORS (Cancer Care Outcomes Research and Surveillance Consortium) study, a large population-based survey of lung or colorectal cancer patients between 2003 and 2005. The results on the effect of decision-making have been published online by JAMA Oncology.
The survey responses about cancer care decision-making regarded surgery (42%), chemotherapy (36%) and radiation therapy (22%).
A commentary article about the study in the same journal issue says it adds "critical evidence" toward "individualizing the approach to decision-making in an evidence-based fashion." But the commentary does not accept the value of shared decision-making, or SDM, outright.
Written by bioethicist Sarah Hawley, PhD, and radiation oncologist Dr. Reshma Jagsi - both experts in cancer patient preferences and decision-making - the commentary says "shared decision-making is a key element of high-quality care, but this does not mean that 'one size fits all.'"
Drs. Hawley and Jagsi conclude:

"While the important study [...] confirms that most patients want a voice in their care, we believe that there remains much need to improve our understanding so that physicians may tailor treatment discussions to the different types of patients they encounter."

Shared decision-making has been identified, particularly within the field of oncology, as a "key element in patient-centered care," says the commentary, adding that SDM has been associated with better patient knowledge about treatment options and improved satisfaction with care.
Questions remain though, it says, about how this approach impacts on patients who vary by:

• Type of cancer diagnosis
• Socio-demographic characteristics, and
• Preferences for involvement in decision-making.

Using evidence such as revealed in the survey will improve doctors' ability to "individualize" decision-making approaches and "allow us to maximize the respect we accord to the patients in our care."
Written by Markus MacGill

New, aggressive form of HIV identified in Cuba

Last updated: Today at 1am PST

In Cuba, a variant of HIV that is much more aggressive than other known forms of the virus has been documented. Patients infected with this new variant progress to AIDS so rapidly that they may not even know they are infected, with AIDS symptoms occurring within 3 years of infection.

HIV anchors itself to proteins on the membranes of cells before it is able to penetrate the cell.

If a person contracts multiple strains of HIV - typically by engaging in unprotected sex with multiple infected partners - then these strains can recombine into a new variant of HIV within the host. The new Cuban variant of HIV is one such recombinant version of the virus.
HIV anchors itself to co-receptors - proteins on the membranes of cells - before the virus is able to penetrate the cell. The first co-receptor that HIV anchors to is known as CCR5. Then, after a number of years of normal health, the virus switches to the anchor point CXCR4, which results in a faster progression to AIDS.
In the recombinant form of HIV identified in Cuba, HIV makes the transition to CXCR4 shortly after infection, reducing the healthy phase and initiating the progression to AIDS.
An international team of researchers compared the blood of 73 recently-infected patients with this recombinant form of HIV - of whom 52 had been diagnosed with AIDS - with blood from 22 patients who had progressed to AIDS after the normal "healthy" period of infection with HIV.
The patients with the recombinant HIV were found to have abnormally high doses of the virus and defensive molecules called RANTES.
RANTES is part of the human immune response and binds to CCR5 - the co-receptor that HIV initially anchors onto after infection.
Because RANTES is present at higher concentrations in these patients than normal, it suggests that most of the CCR5 proteins were unavailable as anchor points for HIV. Therefore, the recombinant HIV would have to bypass its usual anchor point, heading straight to CXCR4 instead.

Protease in recombinant variant boosts virus replication

One of the HIV subtypes implicated in the recombinant variant was also found to contain a protease - an enzyme that cleaves proteins in new viruses - that enables the virus to replicate in greater numbers. The researchers suggest that this protease makes it easier for the transition to CXCR4 to occur.
Normally, say the authors of the study - which is published in the journal EBioMedicine - the transition from CCR5 to CXCR4 is "very difficult."
Recently, Medical News Today reported on a study published in the journal Cell that explored the theory that pools of dormant HIV lurking in DNA may hold a potential cure for the infection.
We also looked at a new smartphone accessory purportedly capable of diagnosing HIV and syphilis from one finger prick of blood within 15 minutes. This accessory - or "dongle" - has been piloted among health care workers in Rwanda, with 97% of patients recommending the device. With a manufacturing cost of just $34, the dongle is much more affordable than the standard forms of diagnostic testing, which typically cost $18,450.
Written by David McNamee

Menopausal hormone therapy associated with ovarian cancer risk

A new study has found that use of hormone replacement therapy for the menopause is associated with an increased risk of developing the two most common forms of ovarian cancer, even if it is used for just a few years.

Ovarian cancer is the 8th most common cancer among women in the US, excluding non-melanoma skin cancers.

The results of the meta-analysis published in The Lancet suggest that the increase in risk associated with hormone replacement therapy (HRT) is a significant one.
"For women who take HRT for 5 years from around age 50, there will be about one extra ovarian cancer for every 1,000 users and one extra ovarian cancer death for every 1,700 users," states study author Prof. Sir Richard Peto from the University of Oxford in the UK.
HRT for the menopause was increasingly used during the 1990s before use rates were abruptly halved the following decade after a large randomized trial. However, HRT use stabilized during the 2010s, with an estimated 6 million women taking HRT in the US and the UK combined.
The menopause can cause some women's estrogen and progesterone levels to drop significantly. In such cases, HRT boosts hormone levels in order to reduce certain menopausal symptoms, such as hot flushes, urinary problems and vaginal discomfort.
In 2002, the Women's Health Initiative (WHI) randomized trial called the therapy into question, suggesting that there was a slight increased risk of breast cancer after 5 years of HRT use. Some experts have argued that the WHI study has flaws making it harder to establish a causal link.
At present, HRT guidelines vary with regards to ovarian cancer. The US Food and Drug Administration's (FDA) statement does not mention the disease and is based solely on the WHI findings, which recorded few incidences of ovarian cancer.
For the study, the University of Oxford in the UK organized the Collaborative Group on Epidemiological Studies of Ovarian Cancer, involving over 100 researchers from across the world working together to assess individual participant data from previous studies.
Researchers reviewed 52 epidemiological studies, both published and non-published, representing virtually all the existing evidence collected on ovarian cancer and HRT use. A total of 21,488 women with ovarian cancer - predominantly from North America, Europe and Australia - featured in the studies.

Risk increase 'directly relevant to today's patterns of use'

The group found a significantly increased risk of developing ovarian cancer for women who were current or recent users of HRT - those who had used the treatment within the previous 5 years. Despite the risk of ovarian cancer falling over time after stopping HRT, women who had taken HRT for at least 5 years were still at an increased risk of ovarian cancer 10 years later.
An increased risk of ovarian cancer was found with both the two main forms of HRT - estrogen-only preparations and preparations containing estrogen and a progestogen. Several other factors, including the age at which HRT began, tobacco use, hysterectomy and family history of cancer, did not affect the proportional increase in risk.
However, the increase in risk was only found for serous and endometrioid ovarian cancers - the two main types of ovarian cancer. The risks for the two less common forms, mutinous and clear cell ovarian cancers, were not found to increase with HRT.
More than half of the statistical information utilized in the analysis came from prospective studies. An important strength of these studies was that participants were recruited before they knew they would develop ovarian cancer, making the results robust and protected from certain forms of bias.
Distinctly similar relative risks observed across the various studies lead the authors to state that their findings strongly suggest a causal relationship between HRT and an increased overall risk of ovarian cancer.
"The definite risk of ovarian cancer even with less than 5 years of HRT is directly relevant to today's patterns of use - with most women now taking HRT for only a few years - and has implications for current efforts to revise UK and worldwide guidelines," concludes study author Prof. Dame Valerie Beral.
Last month, Medical News Today reported on a new mouse model of ovarian cancer that had enabled researchers to identify two genes behind one of the most severe forms of the disease.
Written by James McIntosh