Almost two-thirds of postmenopausal women experience hot flushes; 10–20% of these find it very distressing [1]. Symptoms may last for up to 5 years after natural menopause, and, in at least 20% of women, flushes may persist for up to 15 years. Hormone replacement therapy (HRT) is the most efficacious treatment. However, alternatives are needed… Read More
Type of exercise and bone protection
The cumulative risk of fracture for a postmenopausal woman over the age of 50 years can reach up to 60%. Exercise has the potential to modify fracture risk in postmenopausal women through its effects on bone mass and geometry [1]. To determine the magnitude of these effects in postmenopausal women, Hamilton and colleagues have performed… Read More
Vegetarianism and the risk of cancer
Vegetarianism is regarded by many as one of the best ‘eat healthy’ strategies. Epidemiological studies have shown that consuming a vegetarian diet is associated with lower levels of low density lipoprotein cholesterol and a smaller incidence of overweight, hypertension and type 2 diabetes mellitus compared to consuming a diet with meat [1]. Some studies have… Read More
High weight or body mass index increases the risk of vertebral fracture
In the general population, low body weight and body mass index (BMI) are known and significant risk factors for any fracture, but the specific association between body weight, BMI, and prevalence of vertebral fractures in osteoporotic women is not fully recognized. In a paper recently published in Journal of Bone and Mineral Metabolism, Pirroand colleagues… Read More
Overdiagnosis of breast cancer due to screening?
A recently published paper has received considerable publicity in the lay press and is worthy of reflection [1]. It addresses the question of the number of cases of breast cancer which would not have been diagnosed without organized screening (overdiagnosis is the detection of asymptomatic cancers that will not cause death or symptoms). The introduction… Read More
Hormone therapy and ovarian cancer
In a nationwide prospective cohort study of Danish women who turned 50 years old between 1995 and 2002 [1], 909,946 women were eventually included in the analysis; 575,883 were never-users of HRT and 334,063 were ever-users. During an average follow-up of 8 years, there were 3068 ovarian cancers of which 2681 were epithelial tumors. Ever-use… Read More
Prevention of non-vertebral fractures with vitamin D
Antifracture efficacy with supplemental vitamin D has been questioned by several trials published in the last 4 years, leading to uncertainty among patients and physicians regarding recommendations for vitamin D supplementation. A recent meta-analysis confirms the efficacy of oral supplemental vitamin D in preventing non-vertebral and hip fractures among older individuals (≥ 65 years) [1].… Read More
Randomized, controlled trials vs. observational studies on bisphosphonate therapy to reduce fracture risk in osteoporotic postmenopausal women
Among the methodological questions raised following the Women’s Health Initiative trial was the alleged disparity between the results of randomized, controlled trials (RCTs) and observational studies on hormone replacement therapy. A similar argument could be posed in regard to treatment of postmenopausal osteoporosis by bisphosphonates: are the results of RCTs in line with ‘real world’… Read More
Colorectal Cancer Screening – 2009
Colorectal cancer is one of the most prevalent malignancies in women. Similar to breast cancer, there are efficient strategies for its early detection that are associated with significantly improved prognosis. When I was a student, the combination of barium enema and fecal occult blood test (FOBT) was the mainstay of colorectal screening. Years later, colonoscopy… Read More
Short-term suspension of hormone therapy and mammography recall
In a paper recently published in Annals of Internal Medicine, Buist and colleagues [1] reported the results of a randomized, controlled trial to test whether 1 or 2 months’ suspension of hormone replacement therapy (HRT) before screening mammography would decrease additional mammographic imaging recalls in women aged 45–80 years. A total of 1704 women aged… Read More