One more menopause myth debunked - sleep disturbances and hot flashes

[eskee]

Obstet Gynecol Surv. 2005 Feb;60(2):106-7.

Lack of sleep disturbance from menopausal hot flashes.

Freedman RR, Roehrs TA.

Wayne State School of Medicine, C. S. Mott Center, Detroit, Michigan.

It is widely believed that hot flashes arouse and waken women from
sleep, possibly leading to fatigue and impaired performance.

In this prospective survey, healthy women 46 to 51 years of age were
sent a questionnaire and interviewed to rule out those having sleep
disorders or physical or mental illness and those using drugs.

The electroencephalogram, electrooculogram, and chin electromyogram
were recorded during 3 consecutive nights in a sleep laboratory.

Hot flashes were measured by the sternal skin conductance technique.
Performance was assessed using a divided attention task, the
Psychomotor Vigilance Test, and the Multiple Sleep Latency Test.

The Profile of Mood States also was administered.The 11 premenopausal
cycling women in the study were significantly younger than the 8
postmenopausal women who lacked symptoms. They had significantly higher
estradiol levels than did the 12 postmenopausal women who were
symptomatic.

Symptomatic women had an average of 5.2 hot flashes per night, whereas
none occurred in the other 2 groups.

Hot flashes occurred during stage 2 sleep in 40% of cases and during
the waking state in 34%.

No sleep variables distinguished significantly between the 3 groups.

More than half (55%) of awakenings that occurred within 2 minutes of a
hot flash took place before the flash, 40% afterward, and 5%
simultaneously.

There were no significant differences between the 3 groups in
self-reported fatigue.

There also were no significant group differences in any of the
performance measures.

These findings fail to support the idea that hot flashes disturb sleep
in postmenopausal women. Past reports of sleep disturbance at the time
of menopause may reflect sleep disorders that, in the present study,
were screened out.

[Chris Malcolm]

Post by eskee
Obstet Gynecol Surv. 2005 Feb;60(2):106-7.
Lack of sleep disturbance from menopausal hot flashes.
Freedman RR, Roehrs TA.
Wayne State School of Medicine, C. S. Mott Center, Detroit, Michigan.
It is widely believed that hot flashes arouse and waken women from
sleep, possibly leading to fatigue and impaired performance.
In this prospective survey, healthy women 46 to 51 years of age were
sent a questionnaire and interviewed to rule out those having sleep
disorders or physical or mental illness and those using drugs.
The electroencephalogram, electrooculogram, and chin electromyogram
were recorded during 3 consecutive nights in a sleep laboratory.
Hot flashes were measured by the sternal skin conductance technique.
Performance was assessed using a divided attention task, the
Psychomotor Vigilance Test, and the Multiple Sleep Latency Test.
The Profile of Mood States also was administered.The 11 premenopausal
cycling women in the study were significantly younger than the 8
postmenopausal women who lacked symptoms. They had significantly higher
estradiol levels than did the 12 postmenopausal women who were
symptomatic.
Symptomatic women had an average of 5.2 hot flashes per night, whereas
none occurred in the other 2 groups.
Hot flashes occurred during stage 2 sleep in 40% of cases and during
the waking state in 34%.
No sleep variables distinguished significantly between the 3 groups.
More than half (55%) of awakenings that occurred within 2 minutes of a
hot flash took place before the flash, 40% afterward, and 5%
simultaneously.
There were no significant differences between the 3 groups in
self-reported fatigue.
There also were no significant group differences in any of the
performance measures.
These findings fail to support the idea that hot flashes disturb sleep
in postmenopausal women. Past reports of sleep disturbance at the time
of menopause may reflect sleep disorders that, in the present study,
were screened out.

A confused conclusion. The author sets out to find out if hot flashes
cause disturbed sleep which in turn leads to impaired performance
during the day due to fatigue, lack of sleep, etc.. First of all it is
found that hot flashes do often wake the women up, but no impairment
of performance due to the sleep disturbance is found. The author seems
sometimes to be conflating sleep disturbance with sleep disturbance
which causes impaired performance, and sometimes not.

The point is, as the author seems to have discovered, that it is
possible to have one's sleep disturbed in the night without this
necessarily meaning you don't in the end get enough sleep to perform
well the next day.

[eskee]

Mr. Malcom, you provide interesting responses to my purely scientific
posts. However, my growing impression is that you have an investment in
maintaining the status quo of menopause myth. Can you please explain
why this investment in menopause myth is important for you. Thank you.
eskee

[Chris Malcolm]

Post by eskee
Mr. Malcom, you provide interesting responses to my purely scientific
posts. However, my growing impression is that you have an investment in
maintaining the status quo of menopause myth. Can you please explain
why this investment in menopause myth is important for you. Thank you.

I not aware of believing in any myths about menopause, but that's
hardly suprising, since generally speaking none of us believe in
myths. It's those silly folk over there who believe in myths. We
right thinking folk over here naturally only believe in the truth :-)

If you'd like to ask a more specific question I'd be happy to answer
it.

It occurs to me that you may have been misled by a bad habit of
mine. I criticise bad science regardless of whether the researchers
agree with my views. This leads some people to suppose that since I'm
criticising the work of folk who hold certain views, that therefore I
must hold contrary views. That doesn't follow. I don't like having my
views supported by bad science :-)

[kathryn]

Post by Chris Malcolm

Post by eskee
Mr. Malcom, you provide interesting responses to my purely scientific
posts. However, my growing impression is that you have an investment in
maintaining the status quo of menopause myth. Can you please explain
why this investment in menopause myth is important for you. Thank you.

I not aware of believing in any myths about menopause, but that's
hardly suprising, since generally speaking none of us believe in
myths. It's those silly folk over there who believe in myths. We
right thinking folk over here naturally only believe in the truth :-)
If you'd like to ask a more specific question I'd be happy to answer
it.
It occurs to me that you may have been misled by a bad habit of
mine. I criticise bad science regardless of whether the researchers
agree with my views. This leads some people to suppose that since I'm
criticising the work of folk who hold certain views, that therefore I
must hold contrary views. That doesn't follow. I don't like having my
views supported by bad science :-)

It was a prospective survey, where is the bad science? Serious

Post by Chris Malcolm
To determine whether hot flashes produce disordered sleep in
symptomatic postmenopausal women.

To do this the sleep of a group of postmenopausal symptomatic women
was compared to the sleep of a group of premenopausal women and also
with a group of postmenopausal asymptomatic women in a sleep lab. The
women in all three groups were aged 46 to 51 years.

The results found that [ quote from the original abstract ]

Post by Chris Malcolm
There were no significant group differences on any sleep stage measure.

And the lab test measures were backed up with the results of the
performance tests and sleep/fatigue questionaires.

Post by Chris Malcolm
There were no significant group differences on the multiple sleep latency
test or any performance test or questionnaire measure.

[ quotes are from the original abstract:
http://www.fertstert.org/article/PIIS0015028204006144/abstract ]

Again those words "group differences", obviously there may have been
individual differences, but the point of the study was to compare the
results of the symptomatic postmenopausal group to the other two
groups. WYSIWYG. Currently HT is indicated only for symptomatic
postmenopausal women, not premenopausal women, and not
asymptomatic postmenopausal women, and that may be the reason
behind the study design.

btw I believe estee is promoting her sources, but that's ok, at least
in my opinion, her contributions to the ng discussion make it
worthwhile. The abstract of the article she posted and the one that
generated your original response, can be found below

http://makeashorterlink.com/?Y67C21B5A

Any further thoughts? Dana wants more posts.

Kathryn

[Chris Malcolm]

Post by kathryn

Post by Chris Malcolm

Post by eskee
Mr. Malcom, you provide interesting responses to my purely scientific
posts. However, my growing impression is that you have an investment in
maintaining the status quo of menopause myth. Can you please explain
why this investment in menopause myth is important for you. Thank you.

I not aware of believing in any myths about menopause, but that's
hardly suprising, since generally speaking none of us believe in
myths. It's those silly folk over there who believe in myths. We
right thinking folk over here naturally only believe in the truth :-)
If you'd like to ask a more specific question I'd be happy to answer
it.
It occurs to me that you may have been misled by a bad habit of
mine. I criticise bad science regardless of whether the researchers
agree with my views. This leads some people to suppose that since I'm
criticising the work of folk who hold certain views, that therefore I
must hold contrary views. That doesn't follow. I don't like having my
views supported by bad science :-)

It was a prospective survey, where is the bad science? Serious
question.

I was trying to give a general answer to a vague question without
writing a long essay :-) In my comment on that particular study I
criticised a carelessness of expression in the conclusion as quoted
which appeared to be conflating the ideas of "sleep disturbance" in
the sense of something which wakes you up, and "sleep disturbance" in
the sense of something which stops you getting enough sleep. The study
itself may well have been perfectly good science, but I was including
in my notion of "bad science" those cases where conclusions are
carelessly expressed.

That may seem a bit picky, but the whole point of science is to
*communicate* what you have learned, and if, for example, you tell the
world that having discovered a correlation between eating X and
suffering Y, you have concluded that people should stop eating X in
order to avoid suffering Y, then I would call that bad science even if
the correlation was discovered by flawlessly exemplary science.

In the case of my comment on the hot flash sleep disturbance study I
was only making a mild comment about the expression of the conclusion,
and it was one which some other posters commented on too.

Post by kathryn

Post by Chris Malcolm
To determine whether hot flashes produce disordered sleep in
symptomatic postmenopausal women.

To do this the sleep of a group of postmenopausal symptomatic women
was compared to the sleep of a group of premenopausal women and also
with a group of postmenopausal asymptomatic women in a sleep lab. The
women in all three groups were aged 46 to 51 years.
The results found that [ quote from the original abstract ]

Post by Chris Malcolm
There were no significant group differences on any sleep stage measure.

And the lab test measures were backed up with the results of the
performance tests and sleep/fatigue questionaires.

Post by Chris Malcolm
There were no significant group differences on the multiple sleep latency
test or any performance test or questionnaire measure.

http://www.fertstert.org/article/PIIS0015028204006144/abstract ]
Again those words "group differences", obviously there may have been
individual differences, but the point of the study was to compare the
results of the symptomatic postmenopausal group to the other two
groups. WYSIWYG. Currently HT is indicated only for symptomatic
postmenopausal women, not premenopausal women, and not
asymptomatic postmenopausal women, and that may be the reason
behind the study design.

I find nothing to complain about in the abstract. I may well have been
complaining about what someone was quoted as saying to a reporter
about the study, I can't remember. So to be fair I should have
explained that I'm well aware that reporters often report comments
inaccurately and often summarise carelessly. In my original posting I
did make my obections about the wording immediately below a quotation
of the words I was criticising.

I made the general remarks about people sometimes being misled about
my opinions by assuming that I would only criticise something if I
disagreed with the conclusion because I've sometimes ended up here in
asm after a long and rather baffling argument to discover that my
opponent had been assuming all along that I believed certain things
because they assumed that I wouldn't criticise something where I
actually agreed with the conclusion that was being drawn just because
I didn't like the way it was being drawn.

And I certainly didn't mean to give the impression that I was making
any serious criticism of the study that happened to have been being
discussed when eskee made her query about my general stance with
respect to the menopause myth.

Post by kathryn
btw I believe estee is promoting her sources, but that's ok, at least
in my opinion, her contributions to the ng discussion make it
worthwhile. The abstract of the article she posted and the one that
generated your original response, can be found below
http://makeashorterlink.com/?Y67C21B5A
Any further thoughts? Dana wants more posts.

I'll try to remember to be less po-faced when I comment or criticise
:-) It does mislead people.

And while I'm at it, I should point out that of course all these
remarks about how I sometimes have misled people were made because it
occurred to me that eskee *might* have been mistaken in what she
thought my views were. That's not a criticism of her, and in any case
I by no means assume that she is mistaken about my views. She may be
perfectly correct.

I'm certainly not trying to discourage eskee or anyone else from
posting things we can argue about :-)

[kathryn]

Post by Chris Malcolm

Post by kathryn

Post by Chris Malcolm

Post by eskee
Mr. Malcom, you provide interesting responses to my purely scientific
posts. However, my growing impression is that you have an investment in
maintaining the status quo of menopause myth. Can you please explain
why this investment in menopause myth is important for you. Thank you.

I not aware of believing in any myths about menopause, but that's
hardly suprising, since generally speaking none of us believe in
myths. It's those silly folk over there who believe in myths. We
right thinking folk over here naturally only believe in the truth :-)
If you'd like to ask a more specific question I'd be happy to answer
it.
It occurs to me that you may have been misled by a bad habit of
mine. I criticise bad science regardless of whether the researchers
agree with my views. This leads some people to suppose that since I'm
criticising the work of folk who hold certain views, that therefore I
must hold contrary views. That doesn't follow. I don't like having my
views supported by bad science :-)

It was a prospective survey, where is the bad science? Serious
question.

I was trying to give a general answer to a vague question without
writing a long essay :-) In my comment on that particular study I
criticised a carelessness of expression in the conclusion as quoted
which appeared to be conflating the ideas of "sleep disturbance" in
the sense of something which wakes you up, and "sleep disturbance" in
the sense of something which stops you getting enough sleep. The study
itself may well have been perfectly good science, but I was including
in my notion of "bad science" those cases where conclusions are
carelessly expressed.
That may seem a bit picky,

Hey I like picky, that's why I responded to your comments and missed
my favourite TV show, [ As Time Goes By ] in doing so. I was aware
your comments were based on the abstract of the study as presented in
the journal first posted.

Post by Chris Malcolm
Lack of Sleep Disturbance From Menopausal Hot Flashes.
Obstetrical & Gynecological Survey. 60(2):106-107, February 2005.
Freedman, Robert R.; Roehrs, Timothy A.
These findings fail to support the idea that hot flashes disturb sleep in
postmenopausal women.....

I was being picky too by bringing up the abstract of the original
study published in Fertility and Sterility. the conclusion here is
worded slightly differently. is the meaning also different? I think
so, but can't quite put my finger on the reason why. Perhaps the word
'data' rather than 'findings'.

Post by Chris Malcolm
Volume 82, Issue 1, Pages 138-144 (July 2004)
Lack of sleep disturbance from menopausal hot flashes
Robert R. Freedman and Timothy A. Roehrs
Received 15 September 2003;revised 9 December 2003;accepted 9 December 2003.
These data provide no evidence that hot flashes produce sleep disturbance in
symptomatic postmenopausal women. .....

[ quoted message cont'd]

Post by Chris Malcolm
but the whole point of science is to
*communicate* what you have learned, and if, for example, you tell the
world that having discovered a correlation between eating X and
suffering Y, you have concluded that people should stop eating X in
order to avoid suffering Y, then I would call that bad science even if
the correlation was discovered by flawlessly exemplary science.
In the case of my comment on the hot flash sleep disturbance study I
was only making a mild comment about the expression of the conclusion,
and it was one which some other posters commented on too.

Didn't one poster mention that there is more to disturbed sleep than
hot flashes? I rather thought that supported the study conclusions.
There is something about 'cycling' hormones and sleep disturbance that
needs studying for sure.

<snip>

Post by Chris Malcolm
I find nothing to complain about in the abstract. I may well have been
complaining about what someone was quoted as saying to a reporter
about the study, I can't remember. So to be fair I should have
explained that I'm well aware that reporters often report comments
inaccurately and often summarise carelessly. In my original posting I
did make my obections about the wording immediately below a quotation
of the words I was criticising.

This was the second abstract, published in a med journal, Obstetrical
& Gynecological Survey, and available thru PubMed. eskee has posted
the abstracts for several other of these 'condenced studies' published
in this same journal, the last one, about postmenopausal women and Soy
Isoflvavones led to the latest flame war on the ng.

We needed that wakeup --- IMO.

Post by Chris Malcolm
I made the general remarks about people sometimes being misled about
my opinions by assuming that I would only criticise something if I
disagreed with the conclusion because I've sometimes ended up here in
asm after a long and rather baffling argument to discover that my
opponent had been assuming all along that I believed certain things
because they assumed that I wouldn't criticise something where I
actually agreed with the conclusion that was being drawn just because
I didn't like the way it was being drawn.
And I certainly didn't mean to give the impression that I was making
any serious criticism of the study that happened to have been being
discussed when eskee made her query about my general stance with
respect to the menopause myth.

Post by kathryn
btw I believe estee is promoting her sources, but that's ok, at least
in my opinion, her contributions to the ng discussion make it
worthwhile. The abstract of the article she posted and the one that
generated your original response, can be found below
http://makeashorterlink.com/?Y67C21B5A
Any further thoughts? Dana wants more posts.

I'll try to remember to be less po-faced when I comment or criticise
:-) It does mislead people.
And while I'm at it, I should point out that of course all these
remarks about how I sometimes have misled people were made because it
occurred to me that eskee *might* have been mistaken in what she
thought my views were. That's not a criticism of her, and in any case
I by no means assume that she is mistaken about my views. She may be
perfectly correct.
I'm certainly not trying to discourage eskee or anyone else from
posting things we can argue about :-)

Same here, I do appreciate the fact that eskee posts her discoveries
here, and hope she does not take any resulting discussion as directed
to her personally.

But I do find this Journal where she is reading, rather weird. JMO

http://www.obgynsurvey.com/

Kathryn

[Marilee]

Post by kathryn
This was the second abstract, published in a med journal, Obstetrical
& Gynecological Survey, and available thru PubMed. eskee has posted
the abstracts for several other of these 'condenced studies' published
in this same journal, the last one, about postmenopausal women and Soy
Isoflvavones led to the latest flame war on the ng.
We needed that wakeup --- IMO.

Would you expand upon this last comment? Did you mean we needed the wakeup
flame war, or what? I hope this doesn't start the flames again, but I
really would like to know what you're referring to.

Marilee

[kathryn]

On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"

Post by Marilee

Post by kathryn
This was the second abstract, published in a med journal, Obstetrical
& Gynecological Survey, and available thru PubMed. eskee has posted
the abstracts for several other of these 'condenced studies' published
in this same journal, the last one, about postmenopausal women and Soy
Isoflvavones led to the latest flame war on the ng.

checking back there were only two studies posted from this Journal
recently, the other studies eskee posted were from other sources. My
mistake.

Post by Marilee

Post by kathryn
We needed that wakeup --- IMO.

Would you expand upon this last comment? Did you mean we needed the wakeup
flame war, or what? I hope this doesn't start the flames again, but I
really would like to know what you're referring to.
Marilee

I was referring to the basic questioning of ideas, that ultimately led
to a flame war, as it often does in such cases, but even so, makes the
exchange worthwhile imo, if it leads to a rethinking of some of the
older ideas.

Is menopause an estrogen deficiency conditon/disease or not? The study
posted showed that postmenopausal women [ note POSTmenopausal women,
this is important in answering the question ] who took Soy (
Isoflavone ) supplements did NOT benefit, in whatever it was,
cognition I think, so that's one score that it is not.

Then the discussion led on to the ability to store estrogen in fat,
and whether this was a benefit in alleviating menopause symptoms -- or
not -- or even of harm. If SO then that is one score for menopause as
an estrogen deficiency condition /disease. The discussion then led to
symptoms...and whether dry itchy ears could be considered 'menopausal'
or not -- according to one doctor they were -- if so then that would
be one score for menopause as an estrogen deficiency
condition/disease. Up to this point the discussion was getting testy,
to be sure, It would help in such discussions if the cheerleaders on
the sidelines with little to contribute held back a little. Not that
I was not without blame.

Want to start all over again? On the basics I mean, the subject is
still menopause myths -- Is menopause a deficiency condition?

have fun...I really couldn't figure this one out.. only 343
women...never took statistics, but isn't the CI spread in this one
kind of big? And they didn't provide the OR for the women still taking
HT, only said 'similiar', why not? Also how many of the 343 /82 were
taking ERT? Remember when we always remembered to ask that question?
That' s important when looking at whether menopause is an estrogen
deficiency condition/disease or not when reading these studies.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15668595

Post by Marilee
Menopause. 2005 Jan-Feb;12(1):12-7.
Early postmenopausal hormone therapy may prevent cognitive impairment later in life.
Bagger YZ, Tanko LB, Alexandersen P, Qin G, Christiansen C; for the PERF Study Group.

<small quote>

Post by Marilee
was decreased by 64% (odds ratio [OR]: 0.36, 95% CI: 0.15-0.90; P = 0.03).

And if it is proposed that HT be considered a therapy to prevent
cognitive impairment, aside from the question of estrogen
'deficiency', then of course men would benefit too, wouldn't they?

While I am at it, here is another study, in this one the women are
ahead of the game answering the question.

http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15672962

Post by Marilee
Effect of the WHI study on the attitude of Israeli gynecologists to hormonal therapy during menopause.
Clin Exp Obstet Gynecol. 2004;31(4):267-8.
PMID: 15672962 [PubMed - in process]

<small quote>

Post by Marilee
RESULTS: Ninety-five percent of the physicians believed that HT is still a legitimate treatment modality during
menopause, although almost 40% would now limit it to the management of climacteric symptoms. As a result
of the WHI study, 65% of the physicians recommended cessation of HT use in up to 30% of their treated
postmenopausal patients. The responders estimated that about 40% of their patients using HT ceased
treatment on their own initiative following publication of the WHI study.

Kathryn

[Marilee]

Post by kathryn
On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"

Post by Marilee

Post by kathryn
This was the second abstract, published in a med journal, Obstetrical
& Gynecological Survey, and available thru PubMed. eskee has posted
the abstracts for several other of these 'condenced studies' published
in this same journal, the last one, about postmenopausal women and Soy
Isoflvavones led to the latest flame war on the ng.

checking back there were only two studies posted from this Journal
recently, the other studies eskee posted were from other sources. My
mistake.

Post by Marilee

Post by kathryn
We needed that wakeup --- IMO.

Would you expand upon this last comment? Did you mean we needed the wakeup
flame war, or what? I hope this doesn't start the flames again, but I
really would like to know what you're referring to.
Marilee

I was referring to the basic questioning of ideas, that ultimately led
to a flame war, as it often does in such cases, but even so, makes the
exchange worthwhile imo, if it leads to a rethinking of some of the
older ideas.
Is menopause an estrogen deficiency conditon/disease or not? The study
posted showed that postmenopausal women [ note POSTmenopausal women,
this is important in answering the question ] who took Soy (
Isoflavone ) supplements did NOT benefit, in whatever it was,
cognition I think, so that's one score that it is not.
Then the discussion led on to the ability to store estrogen in fat,
and whether this was a benefit in alleviating menopause symptoms -- or
not -- or even of harm. If SO then that is one score for menopause as
an estrogen deficiency condition /disease. The discussion then led to
symptoms...and whether dry itchy ears could be considered 'menopausal'
or not -- according to one doctor they were -- if so then that would
be one score for menopause as an estrogen deficiency
condition/disease. Up to this point the discussion was getting testy,
to be sure, It would help in such discussions if the cheerleaders on
the sidelines with little to contribute held back a little. Not that
I was not without blame.
Want to start all over again? On the basics I mean, the subject is
still menopause myths -- Is menopause a deficiency condition?

No, it's not, in my opinion--but I believe that's not a surprise to anyone
here.

What are your thoughts on this?

Marilee

Post by kathryn
have fun...I really couldn't figure this one out.. only 343
women...never took statistics, but isn't the CI spread in this one
kind of big? And they didn't provide the OR for the women still taking
HT, only said 'similiar', why not? Also how many of the 343 /82 were
taking ERT? Remember when we always remembered to ask that question?
That' s important when looking at whether menopause is an estrogen
deficiency condition/disease or not when reading these studies.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15668595

Post by Marilee
Menopause. 2005 Jan-Feb;12(1):12-7.
Early postmenopausal hormone therapy may prevent cognitive impairment later in life.
Bagger YZ, Tanko LB, Alexandersen P, Qin G, Christiansen C; for the PERF Study Group.

<small quote>

Post by Marilee
was decreased by 64% (odds ratio [OR]: 0.36, 95% CI: 0.15-0.90; P = 0.03).

And if it is proposed that HT be considered a therapy to prevent
cognitive impairment, aside from the question of estrogen
'deficiency', then of course men would benefit too, wouldn't they?
While I am at it, here is another study, in this one the women are
ahead of the game answering the question.
http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=pubmed&dopt=Abstract&list_uids=15672962

Post by Marilee
Effect of the WHI study on the attitude of Israeli gynecologists to
hormonal therapy during menopause.
Clin Exp Obstet Gynecol. 2004;31(4):267-8.
PMID: 15672962 [PubMed - in process]

<small quote>

Post by Marilee
RESULTS: Ninety-five percent of the physicians believed that HT is still a
legitimate treatment modality during
menopause, although almost 40% would now limit it to the management of
climacteric symptoms. As a result
of the WHI study, 65% of the physicians recommended cessation of HT use in
up to 30% of their treated
postmenopausal patients. The responders estimated that about 40% of their
patients using HT ceased
treatment on their own initiative following publication of the WHI study.

Kathryn

[kathryn]

On Sun, 30 Jan 2005 17:53:23 -0600, "Marilee"

Post by Marilee

Post by kathryn
On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"
Want to start all over again? On the basics I mean, the subject is
still menopause myths -- Is menopause a deficiency condition?

No, it's not, in my opinion--but I believe that's not a surprise to anyone
here.
What are your thoughts on this?

The lower estrogen levels we had as children were not considered
deficient, so why would lower levels after menopause be considered so.

The lower estrogen levels we had each time when we were pregnant,
and/or lactating the same. It is only when we were [ past tense in my
case] cycling that the large doses of estrogen were needed for
ovulation and cyclical breast changes.

Imagine the estrogen levels that would be required if we didn't have
menstrual cycles and our bodies had to be primed and ready for
pregnancy at any time. Sheesh. Evolution was kind, we have periods,
too much estrogen is not a good thing.

Post by Marilee
Marilee

Kathryn

[t***@gmail.com]

Post by kathryn
On Sun, 30 Jan 2005 17:53:23 -0600, "Marilee"

Post by Marilee

Post by kathryn
On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"
Want to start all over again? On the basics I mean, the subject is
still menopause myths -- Is menopause a deficiency condition?

No, it's not, in my opinion--but I believe that's not a surprise to anyone
here.
What are your thoughts on this?

The lower estrogen levels we had as children were not considered
deficient, so why would lower levels after menopause be considered so.

I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever come
across that claim.

Post by kathryn
The lower estrogen levels we had each time when we were pregnant,
and/or lactating the same. It is only when we were [ past tense in my
case] cycling that the large doses of estrogen were needed for
ovulation and cyclical breast changes.
Imagine the estrogen levels that would be required if we didn't have
menstrual cycles and our bodies had to be primed and ready for
pregnancy at any time. Sheesh. Evolution was kind, we have periods,
too much estrogen is not a good thing.

Post by Marilee
Marilee

Kathryn

[CG]

Post by t***@gmail.com

Post by kathryn
The lower estrogen levels we had as children were not considered
deficient, so why would lower levels after menopause be considered

so.
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever come
across that claim.

They just can't refrain from medicalizing everything about the human
existence, can they? [rhetorical question]

Cathering


This being a woman thing isn't at all like they made it out to be
in the brochure. -(our own jfred)

To reply, please remove Spam Free from the email address above.

[t***@gmail.com]

Post by CG

Post by t***@gmail.com

Post by kathryn
The lower estrogen levels we had as children were not considered
deficient, so why would lower levels after menopause be considered

so.
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever come
across that claim.

They just can't refrain from medicalizing everything about the human
existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as a
disease condition.

Post by CG
This being a woman thing isn't at all like they made it out to be
in the brochure. -(our own jfred)
To reply, please remove Spam Free from the email address above.

[Marilee]

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com

Post by kathryn
The lower estrogen levels we had as children were not considered
deficient, so why would lower levels after menopause be considered

so.
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever come
across that claim.

They just can't refrain from medicalizing everything about the human
existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as a
disease condition.

I think you're right.

Someone (irl) tried to tell me the other day (and I can't for the life of me
remember who it was) that "so many" things are caught by the "yearly
physical". Ha. It is my opinion that the vast majority of "things" caught
at that time is because [the woman] noticed something not quite normal--for
her--and decided it was time to "get checked out". That's not the same
thing.

I'm also still a bit disgruntled about "easy menopause". When I look at the
magical "35 Possible Symptoms" ( http://www.minniepauz.com/35symptoms.html )
(which, by the way, includes the "If you have two or more of the following"
phrase--bleah), I have, or have had, no fewer than 18 of them at one time or
another. (I realize some have experienced many more.)

The fact that I consider at least 9 of those 18 to be midlife related rather
than perimenopause doesn't change the amount of, um, [suffering?
discomfort?] I've had. There are also at least 3 items on the list that Jim
has experienced in recent years that I haven't had, and 9 of my 18 that
he -has- experienced or is experiencing.

So if I complain here about all of the 18 whether I think they're truly
perimenopausal symptoms or not, will I be instantly transferred to the
"difficult menopause" column? It seems an odd way to gauge things. The
amount of pain or discomfort I experience will not have changed one iota,
but the ~cause~ will have changed dramatically.

Marilee

[Chakolate]

Post by Marilee
Someone (irl) tried to tell me the other day (and I can't for the life
of me remember who it was) that "so many" things are caught by the
"yearly physical". Ha. It is my opinion that the vast majority of
"things" caught at that time is because [the woman] noticed something
not quite normal--for her--and decided it was time to "get checked
out". That's not the same thing.

And what about the people who get regular physicals and decide if something
seems wrong that they can just wait, since they'll be seeing the doctor in
a few months anyway.

Chakolate

[t***@gmail.com]

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com

Post by kathryn
The lower estrogen levels we had as children were not

considered

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com

Post by kathryn
deficient, so why would lower levels after menopause be

considered

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com
so.
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever come
across that claim.

They just can't refrain from medicalizing everything about the human
existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as a
disease condition.

I think you're right.
Someone (irl) tried to tell me the other day (and I can't for the life of me
remember who it was) that "so many" things are caught by the "yearly
physical". Ha. It is my opinion that the vast majority of "things" caught
at that time is because [the woman] noticed something not quite normal--for
her--and decided it was time to "get checked out". That's not the same
thing.

Did you ask this person exactly what? I've never heard of anything
significant picked up on a scheduled physical or pelvic exam.

Post by Marilee
I'm also still a bit disgruntled about "easy menopause". When I look at the
magical "35 Possible Symptoms" (

http://www.minniepauz.com/35symptoms.html )

Post by Marilee
(which, by the way, includes the "If you have two or more of the following"
phrase--bleah), I have, or have had, no fewer than 18 of them at one time or
another. (I realize some have experienced many more.)
The fact that I consider at least 9 of those 18 to be midlife related rather
than perimenopause doesn't change the amount of, um, [suffering?
discomfort?] I've had. There are also at least 3 items on the list that Jim
has experienced in recent years that I haven't had, and 9 of my 18 that
he -has- experienced or is experiencing.
So if I complain here about all of the 18 whether I think they're truly
perimenopausal symptoms or not, will I be instantly transferred to the
"difficult menopause" column? It seems an odd way to gauge things.

The

Post by Marilee
amount of pain or discomfort I experience will not have changed one iota,
but the ~cause~ will have changed dramatically.
Marilee

[Marilee]

Post by kathryn

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com

Post by kathryn
The lower estrogen levels we had as children were not

considered

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com

Post by kathryn
deficient, so why would lower levels after menopause be

considered

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com
so.
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever

come

Post by Marilee

Post by t***@gmail.com

Post by CG

Post by t***@gmail.com
across that claim.

They just can't refrain from medicalizing everything about the

human

Post by Marilee

Post by t***@gmail.com

Post by CG
existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as

a

Post by Marilee

Post by t***@gmail.com
disease condition.

I think you're right.
Someone (irl) tried to tell me the other day (and I can't for the

life of me

Post by Marilee
remember who it was) that "so many" things are caught by the "yearly
physical". Ha. It is my opinion that the vast majority of "things"

caught

Post by Marilee
at that time is because [the woman] noticed something not quite

normal--for

Post by Marilee
her--and decided it was time to "get checked out". That's not the

same

Post by Marilee
thing.

Did you ask this person exactly what? I've never heard of anything
significant picked up on a scheduled physical or pelvic exam.

Yes. She (I think it was a female) couldn't think of anything, either. I
think she was thinking of slightly abnormal paps, then realized that the
couple of times she'd had them herself it was all worry with nothing to show
for it.

Marilee

[kathryn]

On Mon, 31 Jan 2005 15:07:48 -0600, "Marilee"

Post by Marilee

Post by Marilee

Post by Marilee

Post by t***@gmail.com

Post by t***@gmail.com
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever

come across that claim.
They just can't refrain from medicalizing everything about the

human

Post by Marilee

Post by t***@gmail.com

existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as

a

Post by Marilee

Post by t***@gmail.com
disease condition.

I think you're right.
Someone (irl) tried to tell me the other day (and I can't for the

life of me

Post by Marilee
remember who it was) that "so many" things are caught by the "yearly
physical". Ha. It is my opinion that the vast majority of "things"

caught

Post by Marilee
at that time is because [the woman] noticed something not quite

normal--for

Post by Marilee
her--and decided it was time to "get checked out". That's not the

same

Post by Marilee
thing.

Did you ask this person exactly what? I've never heard of anything
significant picked up on a scheduled physical or pelvic exam.

Yes. She (I think it was a female) couldn't think of anything, either. I
think she was thinking of slightly abnormal paps, then realized that the
couple of times she'd had them herself it was all worry with nothing to show
for it.
Marilee

Along the same lines of discussion, I was reading yesterday about the
new recommendations for diabetes screening in Canada, even here
there are adverse screening effects to consider, so screening testing
is not suggested for everyone 'as part of a general physical.'

If you have hypertension, which I do, then yes, screening is
considered worthwhile. If you have symptoms or other indications then
the testing is not 'screening' but diagnostic and that's another topic
completely.,

http://www.cmaj.ca/cgi/content/full/172/2/177

Post by Marilee
Screening for type 2 diabetes mellitus to prevent vascular complications: updated
recommendations from the Canadian Task Force on Preventive Health Care
Denice S. Feig [et al]
CMAJ January 18, 2005; 172 (2).

[small quote]

Post by Marilee
Potential harms of screening
There has been little direct assessment of the potential harmful effects of screening
for diabetes, and no decrease in quality of life has been associated with screening.37
The potential but unresearched harms of screening may include labelling, anxiety and
altered self-perception, and loss of insurability. It has been estimated that in at least
30% of people who have positive impaired glucose tolerance or impaired fasting glucose
test results, glucose levels revert to normal and diabetes never develops.38,39,40,41,42,43,44

Kathryn

[t***@gmail.com]

Post by kathryn
On Mon, 31 Jan 2005 15:07:48 -0600, "Marilee"

Post by Marilee

Post by Marilee

Post by Marilee

Post by t***@gmail.com

Post by t***@gmail.com
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever

come across that claim.
They just can't refrain from medicalizing everything about the

human

Post by Marilee

Post by t***@gmail.com

existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as

a

Post by Marilee

Post by t***@gmail.com
disease condition.

I think you're right.
Someone (irl) tried to tell me the other day (and I can't for the

life of me

Post by Marilee
remember who it was) that "so many" things are caught by the "yearly
physical". Ha. It is my opinion that the vast majority of "things"

caught

Post by Marilee
at that time is because [the woman] noticed something not quite

normal--for

Post by Marilee
her--and decided it was time to "get checked out". That's not the

same

Post by Marilee
thing.

Did you ask this person exactly what? I've never heard of anything
significant picked up on a scheduled physical or pelvic exam.

Yes. She (I think it was a female) couldn't think of anything, either. I
think she was thinking of slightly abnormal paps, then realized that the
couple of times she'd had them herself it was all worry with nothing to show
for it.
Marilee

Along the same lines of discussion, I was reading yesterday about the
new recommendations for diabetes screening in Canada, even here
there are adverse screening effects to consider, so screening testing
is not suggested for everyone 'as part of a general physical.'
If you have hypertension, which I do, then yes, screening is
considered worthwhile. If you have symptoms or other indications then
the testing is not 'screening' but diagnostic and that's another topic
completely.,
http://www.cmaj.ca/cgi/content/full/172/2/177

Post by Marilee
Screening for type 2 diabetes mellitus to prevent vascular

complications: updated

Post by kathryn

Post by Marilee
recommendations from the Canadian Task Force on Preventive Health Care
Denice S. Feig [et al]
CMAJ January 18, 2005; 172 (2).

[small quote]

Post by Marilee
Potential harms of screening
There has been little direct assessment of the potential harmful effects of screening
for diabetes, and no decrease in quality of life has been associated with screening.37
The potential but unresearched harms of screening may include

labelling, anxiety and

Post by kathryn

Post by Marilee
altered self-perception, and loss of insurability. It has been estimated that in at least
30% of people who have positive impaired glucose tolerance or

impaired fasting glucose

Post by kathryn

Post by Marilee
test results, glucose levels revert to normal and diabetes never

develops.38,39,40,41,42,43,44

Which is why this current mania for frequent self-testing is so bloody
stupid. No one knows what normal blood sugar levels are when they're
being checked every 15 minutes for several hours. People are diagnosing
themselvesas diabetics when they're perfectly healthy and aren't really
diabetic at all. When treatment guidelines to prevent diabetic
complications include using high doses of statins to lower cholesterol
to unheard of levels - IIRC diabetics are now supposed to aim for LDL
levels of 60 or below along with restrictive dangerous low carb diets
- I can see a lot of harm being done by this kind of overdiagnosis.

Post by kathryn
Kathryn

[Chris Malcolm]

Post by Marilee

Post by kathryn
Along the same lines of discussion, I was reading yesterday about the
new recommendations for diabetes screening in Canada, even here
there are adverse screening effects to consider, so screening testing
is not suggested for everyone 'as part of a general physical.'
If you have hypertension, which I do, then yes, screening is
considered worthwhile. If you have symptoms or other indications then
the testing is not 'screening' but diagnostic and that's another

topic

Post by kathryn
completely.,
http://www.cmaj.ca/cgi/content/full/172/2/177

Post by Marilee
Screening for type 2 diabetes mellitus to prevent vascular

complications: updated

Post by kathryn

Post by Marilee
recommendations from the Canadian Task Force on Preventive Health

Care

Post by kathryn

Post by Marilee
Denice S. Feig [et al]
CMAJ January 18, 2005; 172 (2).

[small quote]

Post by Marilee
Potential harms of screening
There has been little direct assessment of the potential harmful

effects of screening

Post by kathryn

Post by Marilee
for diabetes, and no decrease in quality of life has been associated

with screening.37

Post by kathryn

Post by Marilee
The potential but unresearched harms of screening may include

labelling, anxiety and

Post by kathryn

Post by Marilee
altered self-perception, and loss of insurability. It has been

estimated that in at least

Post by kathryn

Post by Marilee
30% of people who have positive impaired glucose tolerance or

impaired fasting glucose

Post by kathryn

Post by Marilee
test results, glucose levels revert to normal and diabetes never

develops.38,39,40,41,42,43,44
Which is why this current mania for frequent self-testing is so bloody
stupid. No one knows what normal blood sugar levels are when they're
being checked every 15 minutes for several hours.

So what? All that it is required to know is what is abnormal and
problematic, and that is fairly clearly defined, e.g., in the
diagnostic criteria for diabetes.

Post by Marilee
People are diagnosing
themselvesas diabetics when they're perfectly healthy and aren't really
diabetic at all.

People are diagnosing themselves with all sorts of daft problems. They
always have and always will. Reducing the amount of publicly available
information and advice because idiots will over react is an attitude
which logically ends up with deciding that we should avoid teaching
the lower classes to read because they'll just read nonsense and get
confused and do stupid things. We get back to the nanny state where
authorities take all your important decisions because you're too
stupid to be trusted with the management of your own life.

Post by Marilee
When treatment guidelines to prevent diabetic
complications include using high doses of statins to lower cholesterol
to unheard of levels - IIRC diabetics are now supposed to aim for LDL
levels of 60 or below along with restrictive dangerous low carb diets
- I can see a lot of harm being done by this kind of overdiagnosis.

But statins etc. are *prescription* drugs. You can't get them
prescribed unless a *doctor* diagnoses you. And the problems of
dangerous low carb diets are overwhelmingly the problems of people
trying to lose weight, e.g. the popularity of
"what-folk-think-is-an-Atkins-diet" with film stars. I put in the ""
because almost all of the people I've met who think they're following
the "Atkins diet" aren't, they're following some ridiculously
over-the-top carb-forbidding version of it they found in a
magazine. They think it means meaty fry-ups with no bread, potatoes,
or pasta. I've met lots of folk who've got the Atkins book and claim
to be following the Atkins diet, but only one of them, the one who had
actually read the book carefully from beginning to end, was actually
following it. The rest were simply carb-cutting, and had rather weird
ideas about what foods contained carbohydrates.

In the specific case of diabetes, the problems of self-overdiagnosis
would have to be very much worse than Terri suggests if they were to
get anywhere near the serious problems that it is well known are
caused by the current underdiagnosis. Hence the new diabetic screening
programmes which many national health bodies are now setting up.

Of course lots of folk who display impaired glucose tolerance or
glucose fasting levels revert to normal and don't develop diabetes!
The whole point is that in susceptible pre-diabetic people you can
move into or out of the danger area by simple changes of diet or
lifestyle. In some cases all that's required is a switch from a fast
food diet to a healthier one, and that's what some folk will do anyway
for other reasons.

The point is that persistently occurring high blood glucose levels
over many years are bad for you, but in the early stages of diabetes
rather simple changes of diet (and perhaps exercise) can remove you
from the danger area.

Few people test their blood sugar levels frequently without being a
diagnosed diabetic, because otherwise the costs of the test strips is
horrendous. Those who do test frequently are trying to identify kinds
and quantities of foods which produce high blood sugar spikes. All
they have to do is to reduce those spikes. This does not involve
absurdly restrictive low carb diets unless you're a serious case who
is trying to do without the necessary drugs which the doctor has
prescribed. In some cases all you have to is add components to the
diet, e.g. oils and some curry spices reduce the effective glycemic
index of some carbohydrates.

Should health authorities stop warning people about the problems of
being overweight because some idiots will make themselves ill
following stupid diets?

In my own personal case I'm a diabetic who is "eating to the meter",
i.e., testing blood glucose and avoiding what spikes me. All I need to
do to drop keep my blood glucose levels out of the diabetic damaging
ranges is to follow a "paleolithic" diet, which is far from
carb-restrictive. In practice I find I can use a few tricks, such as
adding oil, cheese, or certain spices, to avoid having to be so strict
in what I avoid. I couldn't have discovered those tricks -- which
don't work for everyone -- without doing a lot of testing.

I don't do much testing now, I don't need to. But in order to discover
a reasonable diet for me, including those helpful tricks about what to
include as well as avoid, it was necessary for me to do a number of
comprehensive tests such as every fifteen minutes for a few hours, in
order to establish my own behaviour.

How it compared to normal was completely irrelevant, and as Terri
points out, there aren't any well established normal curves for
comparison. That completely misses the point, which is to establish a
baseline reference of how your *own* system behaves. That's the
necessary prerequisite to devising effective monitoring regimes which
will enable effective changes to be detected, not in some hypothetical
"normal" blood sugar response, but your own particular idiosyncratic
response.

My doctor agrees. That's why he prescribed the necessary test
strips. By using them I've been able to make only those changes to my
diet which were necessary. Without so much testing I'd have had to be
much more restrictive, because I would have had to restrict many
things which are often bad for many diabetics just in case. In other
words, I would have had to follow general advice derived from
population research, which would have been both more restrictive and
less effective.

[Chakolate]

Post by t***@gmail.com
Which is why this current mania for frequent self-testing is so bloody
stupid. No one knows what normal blood sugar levels are when they're
being checked every 15 minutes for several hours. People are diagnosing
themselvesas diabetics when they're perfectly healthy and aren't really
diabetic at all. When treatment guidelines to prevent diabetic
complications include using high doses of statins to lower cholesterol
to unheard of levels - IIRC diabetics are now supposed to aim for LDL
levels of 60 or below along with restrictive dangerous low carb diets
- I can see a lot of harm being done by this kind of overdiagnosis.

In the first place, people are much less likely to self-diagnose diabetes
than almost any other disease/condition, because it involves sticking
yourself repeatedly, something most people would rather not do. (Imagine
that!) Second, the most common reaction to a diagnosis of diabetes is
denial; very few people push to get this diagnosis.

As for not knowing what 'normal' is, that's pretty irrelevant. If your
post-prandial test is over 200, you're in trouble. Everybody needs to test
for themselves to define 'normal' for themselves. My dad is pretty happy
if his fasting glucose is under 130 (he's 83) but I'd be appalled for
myself.

I think diabetes is one disease where early detection really is extremely
beneficial. When the study said that 30% of people with hyperglycemia
never became diabetic, doesn't that imply that 70% eventually do? And
perhaps that 30% is comprised of people who were scared into changing their
lifestyles to prevent diabetes. The lifestyle changes to prevent diabetes,
weight loss and exercise, are almost always beneficial, whether diabetes is
in your future or not.

I'm not being terribly clear here about my point, I think, but you get what
I'm saying anyway, right? It may not be useful to worry patients about
whether their cholesterol is too high, but introducing concern over blood
sugar levels, especially when the treatment is diet and exercise, can only
help.

Or am I missing something?

Chakolate

[t***@gmail.com]

Post by Chakolate

Post by t***@gmail.com
Which is why this current mania for frequent self-testing is so bloody
stupid. No one knows what normal blood sugar levels are when

they're

Post by Chakolate

Post by t***@gmail.com
being checked every 15 minutes for several hours. People are

diagnosing

Post by Chakolate

Post by t***@gmail.com
themselvesas diabetics when they're perfectly healthy and aren't really
diabetic at all. When treatment guidelines to prevent diabetic
complications include using high doses of statins to lower

cholesterol

Post by Chakolate

Post by t***@gmail.com
to unheard of levels - IIRC diabetics are now supposed to aim for LDL
levels of 60 or below along with restrictive dangerous low carb diets
- I can see a lot of harm being done by this kind of overdiagnosis.

In the first place, people are much less likely to self-diagnose diabetes
than almost any other disease/condition, because it involves sticking
yourself repeatedly, something most people would rather not do.

(Imagine

Post by Chakolate
that!)

One would think that's the case, but I know a lot of what I call
"recreational diabetics" - people who have tried to convince their
doctors to diagnose diabetes but who can't quite convince them - who
are using "painless" meters and sticking themselves and recording their
results as many as 8 times a day.

Post by Chakolate
Second, the most common reaction to a diagnosis of diabetes is
denial; very few people push to get this diagnosis.

I'm not sure that's true.

Post by Chakolate
As for not knowing what 'normal' is, that's pretty irrelevant. If your
post-prandial test is over 200, you're in trouble. Everybody needs to test
for themselves to define 'normal' for themselves. My dad is pretty happy
if his fasting glucose is under 130 (he's 83) but I'd be appalled for
myself.
I think diabetes is one disease where early detection really is extremely
beneficial. When the study said that 30% of people with

hyperglycemia

Post by Chakolate
never became diabetic, doesn't that imply that 70% eventually do?

And

Post by Chakolate
perhaps that 30% is comprised of people who were scared into changing their
lifestyles to prevent diabetes. The lifestyle changes to prevent diabetes,
weight loss and exercise, are almost always beneficial, whether diabetes is
in your future or not.

Exactly. Because of my horrendous family history for type II diabetes
I'm very aware of the possibility and do a random sugar on myself (and
my husband because he's somewhat overweight) about every 3 months. If I
find something abnormal there I'll do fasting sugars and if those are
outside of normal limits I'd definitely see a doctor for a fasting
sugar and a GTT if necessary. OTOH my weight is under good control and
I've been exercising daily for more than 20 years - walking - so I'm
already doing what I need to do to prevent or delay diabetes.

Post by Chakolate
I'm not being terribly clear here about my point, I think, but you get what
I'm saying anyway, right? It may not be useful to worry patients about
whether their cholesterol is too high, but introducing concern over blood
sugar levels, especially when the treatment is diet and exercise, can only
help.
Or am I missing something?

I think you're missing the doctor's self-interest in diagnosing
diabetes which translates to more office visits, more lab work and more
prescriptions. Plus the increasing emphasis on statins for cholesterol
control in diabetics. The FDA rejected the first attempt at making
statins otc, but they are already approved for otc sale in the UK.

Post by Chakolate
Chakolate
--
Time and trouble will tame an advanced young woman, but an advanced old
woman is uncontrollable by any earthly force.
--Dorothy L. Sayers

[t***@gmail.com]

Post by kathryn
On Mon, 31 Jan 2005 15:07:48 -0600, "Marilee"

Post by Marilee

Post by Marilee

Post by Marilee

Post by t***@gmail.com

Post by t***@gmail.com
I came across an article the other day that called little girls
"hypoestrogenic." I was stunned. It was the first time I'd ever

come across that claim.
They just can't refrain from medicalizing everything about the

human

Post by Marilee

Post by t***@gmail.com

existence, can they? [rhetorical question]
Cathering

I think the medical industry views the condition of being female as

a

Post by Marilee

Post by t***@gmail.com
disease condition.

I think you're right.
Someone (irl) tried to tell me the other day (and I can't for the

life of me

Post by Marilee
remember who it was) that "so many" things are caught by the "yearly
physical". Ha. It is my opinion that the vast majority of "things"

caught

Post by Marilee
at that time is because [the woman] noticed something not quite

normal--for

Post by Marilee
her--and decided it was time to "get checked out". That's not the

same

Post by Marilee
thing.

Did you ask this person exactly what? I've never heard of anything
significant picked up on a scheduled physical or pelvic exam.

Yes. She (I think it was a female) couldn't think of anything, either. I
think she was thinking of slightly abnormal paps, then realized that the
couple of times she'd had them herself it was all worry with nothing to show
for it.
Marilee

Along the same lines of discussion, I was reading yesterday about the
new recommendations for diabetes screening in Canada, even here
there are adverse screening effects to consider, so screening testing
is not suggested for everyone 'as part of a general physical.'
If you have hypertension, which I do, then yes, screening is
considered worthwhile. If you have symptoms or other indications then
the testing is not 'screening' but diagnostic and that's another topic
completely.,
http://www.cmaj.ca/cgi/content/full/172/2/177

Thank you for posting this article, kathryn.

I found the following quote very interesting:

"There is no direct evidence that screening for diabetes in the
preclinical phase leads to benefit. Although there is good (level I)
evidence that treatment with tight glycemic control in patients who
have a clinical diagnosis of diabetes decreases the progression of
microvascular complications after 10 years of treatment, benefits were
seen only in intermediate outcomes (i.e., decreased progression of
retinopathy and nephropathy), with a nonsignificant trend toward
decreased rates of myocardial infarction.15 Health outcomes such as
death, cardiovascular events, blindness, end-stage renal disease and
amputations were not reduced.
Therefore, early detection of diabetes through screening 5-6
years before clinical symptoms emerge in order to treat with tight
glycemic control may not have a substantial incremental benefit over
clinical diagnosis. With screened patients, presumably the gain during
the first 15 years would be similar to or even less than that seen in
diagnosed patients, given that their level of hyperglycemia would be
milder in most cases. One could expect that the benefit might be
translated into improved health outcomes in trials of longer duration.
Improved health outcomes might also be demonstrated if treatment were
started sooner; however, there is no evidence indicating this
currently."

Still more evidence that 'early detection' of still another disease is
of little or no clinical benefit.

Post by kathryn

Post by Marilee
Screening for type 2 diabetes mellitus to prevent vascular

complications: updated

Post by kathryn

Post by Marilee
recommendations from the Canadian Task Force on Preventive Health Care
Denice S. Feig [et al]
CMAJ January 18, 2005; 172 (2).

[small quote]

Post by Marilee
Potential harms of screening
There has been little direct assessment of the potential harmful effects of screening
for diabetes, and no decrease in quality of life has been associated with screening.37
The potential but unresearched harms of screening may include

labelling, anxiety and

Post by kathryn

Post by Marilee
altered self-perception, and loss of insurability. It has been estimated that in at least
30% of people who have positive impaired glucose tolerance or

impaired fasting glucose

Post by kathryn

Post by Marilee
test results, glucose levels revert to normal and diabetes never

develops.38,39,40,41,42,43,44

Post by kathryn
Kathryn

[Eva]

Post by t***@gmail.com

Post by kathryn
On Mon, 31 Jan 2005 15:07:48 -0600, "Marilee"
http://www.cmaj.ca/cgi/content/full/172/2/177

Thank you for posting this article, kathryn.
"There is no direct evidence that screening for diabetes in the
preclinical phase leads to benefit. Although there is good (level I)
evidence that treatment with tight glycemic control in patients who
have a clinical diagnosis of diabetes decreases the progression of
microvascular complications after 10 years of treatment, benefits were
seen only in intermediate outcomes (i.e., decreased progression of
retinopathy and nephropathy), with a nonsignificant trend toward
decreased rates of myocardial infarction.15 Health outcomes such as
death, cardiovascular events, blindness, end-stage renal disease and
amputations were not reduced.
Therefore, early detection of diabetes through screening 5-6
years before clinical symptoms emerge in order to treat with tight
glycemic control may not have a substantial incremental benefit over
clinical diagnosis.......

-------------
How can it be that "progression of retinopathy" is decreased, but
"blindness" is not? This doesn't make sense.
Eva

[t***@gmail.com]

Post by Eva

Post by t***@gmail.com

Post by kathryn
On Mon, 31 Jan 2005 15:07:48 -0600, "Marilee"
http://www.cmaj.ca/cgi/content/full/172/2/177

Thank you for posting this article, kathryn.
"There is no direct evidence that screening for diabetes in the
preclinical phase leads to benefit. Although there is good (level I)
evidence that treatment with tight glycemic control in patients who
have a clinical diagnosis of diabetes decreases the progression of
microvascular complications after 10 years of treatment, benefits were
seen only in intermediate outcomes (i.e., decreased progression of
retinopathy and nephropathy), with a nonsignificant trend toward
decreased rates of myocardial infarction.15 Health outcomes such as
death, cardiovascular events, blindness, end-stage renal disease and
amputations were not reduced.
Therefore, early detection of diabetes through screening 5-6
years before clinical symptoms emerge in order to treat with tight
glycemic control may not have a substantial incremental benefit over
clinical diagnosis.......

-------------
How can it be that "progression of retinopathy" is decreased, but
"blindness" is not? This doesn't make sense.
Eva

Because the blindness that diabetes causes apparently originates with
something other than retinopathy or in addition to it. End stage renal
disease also continues to occur at the same rate even though
nephropathy is also slowed. Microvascular benefits don't seem to
translate into any true clinical benefit...

[Chris Malcolm]

Post by Eva

Post by t***@gmail.com

Post by kathryn
On Mon, 31 Jan 2005 15:07:48 -0600, "Marilee"
http://www.cmaj.ca/cgi/content/full/172/2/177

Thank you for posting this article, kathryn.
"There is no direct evidence that screening for diabetes in the
preclinical phase leads to benefit. Although there is good (level I)
evidence that treatment with tight glycemic control in patients who
have a clinical diagnosis of diabetes decreases the progression of
microvascular complications after 10 years of treatment, benefits were
seen only in intermediate outcomes (i.e., decreased progression of
retinopathy and nephropathy), with a nonsignificant trend toward
decreased rates of myocardial infarction.15 Health outcomes such as
death, cardiovascular events, blindness, end-stage renal disease and
amputations were not reduced.
Therefore, early detection of diabetes through screening 5-6
years before clinical symptoms emerge in order to treat with tight
glycemic control may not have a substantial incremental benefit over
clinical diagnosis.......

How can it be that "progression of retinopathy" is decreased, but
"blindness" is not? This doesn't make sense.

Exactly. We haven't yet had enough time to develop the figures for
blindness, only for progression of retinopathy. So there is "no
evidence". Yet.

As I keep pointing out, absence of evidence is *not* evidence of
absence"!

[Chris Malcolm]

Post by t***@gmail.com

Post by kathryn
http://www.cmaj.ca/cgi/content/full/172/2/177

Thank you for posting this article, kathryn.
"There is no direct evidence that screening for diabetes in the
preclinical phase leads to benefit. Although there is good (level I)
evidence that treatment with tight glycemic control in patients who
have a clinical diagnosis of diabetes decreases the progression of
microvascular complications after 10 years of treatment, benefits were
seen only in intermediate outcomes (i.e., decreased progression of
retinopathy and nephropathy), with a nonsignificant trend toward
decreased rates of myocardial infarction.15 Health outcomes such as
death, cardiovascular events, blindness, end-stage renal disease and
amputations were not reduced.
Therefore, early detection of diabetes through screening 5-6
years before clinical symptoms emerge in order to treat with tight
glycemic control may not have a substantial incremental benefit over
clinical diagnosis. With screened patients, presumably the gain during
the first 15 years would be similar to or even less than that seen in
diagnosed patients, given that their level of hyperglycemia would be
milder in most cases. One could expect that the benefit might be
translated into improved health outcomes in trials of longer duration.
Improved health outcomes might also be demonstrated if treatment were
started sooner; however, there is no evidence indicating this
currently."
Still more evidence that 'early detection' of still another disease is
of little or no clinical benefit.

No, it's *not* evidence! It's *absence* of evidence!

Specifically, the kind of tight control which is currently being
advocated by some has not been possible for long enough for enough
diabetics for there to be any evidence with respect to final outcomes
like blindness and amputations.

If you read the above quote carefully you can see the medical politics
at work: he is very careful not to make the specific claim that there
is no benefit, but given that what he is writing will affect national
health policies, and in this particular case decisions which will cost
a great deal of money, he is writing it in such a way that a careless
reader will over-interpret it.

[t***@gmail.com]

I know a woman who thinks she was lucky to go for a routine pelvic when
she got an abnormal pap smear report. She went back in 3 months for a
repeat one - it was negative, went back 6 months later for another
which was also negative, and has pap smears every 6 months now "just in
case.' She says she'd never have known that she had cancer and would
never have known that she needed very frequent screening if she hadn't
had that routine pap smear. Getting it through her head that an
"abnormal pap smear' doesn't mean cancer is impossible so I've given
up.

[Cathy Friedmann]

Post by kathryn
On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"

Post by Marilee

Post by kathryn
This was the second abstract, published in a med journal, Obstetrical
& Gynecological Survey, and available thru PubMed. eskee has posted
the abstracts for several other of these 'condenced studies' published
in this same journal, the last one, about postmenopausal women and Soy
Isoflvavones led to the latest flame war on the ng.

checking back there were only two studies posted from this Journal
recently, the other studies eskee posted were from other sources. My
mistake.

Post by Marilee

Post by kathryn
We needed that wakeup --- IMO.

Would you expand upon this last comment? Did you mean we needed the wakeup
flame war, or what? I hope this doesn't start the flames again, but I
really would like to know what you're referring to.
Marilee

I was referring to the basic questioning of ideas, that ultimately led
to a flame war, as it often does in such cases, but even so, makes the
exchange worthwhile imo, if it leads to a rethinking of some of the
older ideas.
Is menopause an estrogen deficiency conditon/disease or not?

Well, maybe a condition, but not a disease!

The study

Post by kathryn
posted showed that postmenopausal women [ note POSTmenopausal women,
this is important in answering the question ] who took Soy (
Isoflavone ) supplements did NOT benefit, in whatever it was,
cognition I think, so that's one score that it is not.
Then the discussion led on to the ability to store estrogen in fat,
and whether this was a benefit in alleviating menopause symptoms -- or
not -- or even of harm. If SO then that is one score for menopause as
an estrogen deficiency condition /disease. The discussion then led to
symptoms...and whether dry itchy ears could be considered 'menopausal'
or not -- according to one doctor they were --

I want to clarify - reiterate this point: he said that it was his own
theory - his hunch - based on what he's seen in his own practice; linking it
up w/ the other drying effects less estrogen can have on one's body. He
didn't tell me that it was a for-sure thing, even in his own opinion. It's
a slight discrepancy, but also an important one, IMO. Esp. considering the
incredible amount of brou-ha-ha the whole thing (innocently, I might add! -
I simply thought it was interesting & on-topic!) started.

And, btw - after a month+ of using the med that was prescribed, my ears are
no longer itchy or flaky or on their way to painfulness, & my follow-up ENT
visit showed that they are looking much more normal again. I will probably
need to continue to use the med on a semi-continual (as in: every other ->
third day instead of every day) basis, though. Maybe later on a less often,
as-needed, basis. Time will tell.

if so then that would

Post by kathryn
be one score for menopause as an estrogen deficiency
condition/disease. Up to this point the discussion was getting testy,
to be sure, It would help in such discussions if the cheerleaders on
the sidelines with little to contribute held back a little. Not that
I was not without blame.
Want to start all over again?

Not so sure! Besides the possibility of more nasty confrontations, I am
very short on time these days!

On the basics I mean, the subject is

Post by kathryn
still menopause myths -- Is menopause a deficiency condition?

I'll semi-bite: It's all relative... Relative to what one's body
experienced before menopause - yes, IMO. The body (well, mine anyway - I
know there are plenty of women who experience an easy menopause) seems to
act like it's in 'shock' & having withdrawal symptoms - as in... "Whoa -
hey, what *happened*?! I don't have what I used to have for years on end,
and here I was, all nice & comfortable & _used_ to that!" Otoh, does the
body _need_ that former amount of estrogen anymore? Well, in some
circumstances it'd be nice to still have the former levels (comfort-wise),
but are there reasons - beyond now being in a non-reproductive state - that
the body is now, post-meno, better off with lesser levels??

It's all relative, IMO.

Cathy

[Priscilla Ballou]

Post by Cathy Friedmann

Post by kathryn
Is menopause an estrogen deficiency conditon/disease or not?

Well, maybe a condition, but not a disease!

I disagree on the use of either term: estrogen deficiency condition or
estrogen deficiency disease. Menopause is a transitional period, marked
by changing levels of various hormones. "Deficiency" implies there is a
desired level which the current level has fallen below. This does not
compute when the body is going through a transition from one set of
levels to another. There is plenty of change and decreasing levels, but
no deficiency. IMO.

Priscilla

[Cathy Friedmann]

Post by Priscilla Ballou

Post by Cathy Friedmann

Post by kathryn
Is menopause an estrogen deficiency conditon/disease or not?

Well, maybe a condition, but not a disease!

I disagree on the use of either term: estrogen deficiency condition or
estrogen deficiency disease. Menopause is a transitional period, marked
by changing levels of various hormones. "Deficiency" implies there is a
desired level which the current level has fallen below. This does not
compute when the body is going through a transition from one set of
levels to another. There is plenty of change and decreasing levels, but
no deficiency. IMO.

Well, 1) I *did* say "maybe", 2) see my continued reply much further down in
that same post; re: it's all relative, IMO. Relative to what one once had,
& to what one now needs.

Cathy

[Priscilla Ballou]

Post by Cathy Friedmann

Post by Priscilla Ballou

Post by Cathy Friedmann

Post by kathryn
Is menopause an estrogen deficiency conditon/disease or not?

Well, maybe a condition, but not a disease!

I disagree on the use of either term: estrogen deficiency condition or
estrogen deficiency disease. Menopause is a transitional period, marked
by changing levels of various hormones. "Deficiency" implies there is a
desired level which the current level has fallen below. This does not
compute when the body is going through a transition from one set of
levels to another. There is plenty of change and decreasing levels, but
no deficiency. IMO.

Well, 1) I *did* say "maybe", 2) see my continued reply much further down in
that same post; re: it's all relative, IMO. Relative to what one once had,
& to what one now needs.

Yes, but "deficiency" implies that it's a problem that the levels are
different. I think it's not a bug but a feature! ;-)

Priscilla

[Cathy Friedmann]

Post by Priscilla Ballou

Post by Cathy Friedmann

Post by Priscilla Ballou

Post by Cathy Friedmann

Post by kathryn
Is menopause an estrogen deficiency conditon/disease or not?

Well, maybe a condition, but not a disease!

I disagree on the use of either term: estrogen deficiency condition or
estrogen deficiency disease. Menopause is a transitional period, marked
by changing levels of various hormones. "Deficiency" implies there is a
desired level which the current level has fallen below. This does not
compute when the body is going through a transition from one set of
levels to another. There is plenty of change and decreasing levels, but
no deficiency. IMO.

Well, 1) I *did* say "maybe", 2) see my continued reply much further down in
that same post; re: it's all relative, IMO. Relative to what one once had,
& to what one now needs.

Yes, but "deficiency" implies that it's a problem that the levels are
different.

Right - that's why I said that it's all relative. Might seem like a
deficiency at first - relative to where one used to be, but otoh, re: post
meno - may also be regarded as not a deficiency, since the height of the bar
changes - due to what the body apparently requires at that point.

Cathy

I think it's not a bug but a feature! ;-)

Post by Priscilla Ballou
Priscilla
--
"It is very, very dangerous to treat any human, lowest
of the low even, with contempt and arrogant whatever.
The Lord takes this kind of treatment very, very personal."
- QBaal in newsgroup alt.religion.christian.episcopal

[Chris Malcolm]

Post by kathryn
On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"
Is menopause an estrogen deficiency conditon/disease or not? The study
posted showed that postmenopausal women [ note POSTmenopausal women,
this is important in answering the question ] who took Soy (
Isoflavone ) supplements did NOT benefit, in whatever it was,
cognition I think, so that's one score that it is not.
Then the discussion led on to the ability to store estrogen in fat,
and whether this was a benefit in alleviating menopause symptoms -- or
not -- or even of harm. If SO then that is one score for menopause as
an estrogen deficiency condition /disease. The discussion then led to
symptoms...and whether dry itchy ears could be considered 'menopausal'
or not -- according to one doctor they were -- if so then that would
be one score for menopause as an estrogen deficiency
condition/disease. Up to this point the discussion was getting testy,
to be sure, It would help in such discussions if the cheerleaders on
the sidelines with little to contribute held back a little. Not that
I was not without blame.
Want to start all over again? On the basics I mean, the subject is
still menopause myths -- Is menopause a deficiency condition?

You can't necessarily do the kind of scoring points for and against
that you've suggested above. For example, let us suppose for the sake
of argument that menopause is a time when one of the body's hormones
shifts down in level, and that it takes (say) some years for the
body's regulatory systems which involved that hormone to adjust. There
will therefore (in this hypothetical case) be a period of some years
when some of the body's regulatory systems are maladjusted. During
this period maladjustment symptoms will be suffered which will be
ameliorated by adding a supplement of the missing hormone. But you
can't count that as a point in favour of menopause being a deficiency
disease.

The point is that if there is a lengthy period of adjustment to the
new levels then that period will show the signs you have suggested
would mark it as a deficiency. Howwever. treating it as a deficiency
might well hinder the adjustment process and cause other later
problems.

Someone mentioned that puberty is a transition period between
different hormonal regimes. The process of adjustment during puberty
takes a few years, during which it can be quite hard to live with the
sufferer, is it not? And is it not likely that if there was a drug
which would restore teenage hormone levels to pre-pubertal levels,
wouldn't the teenager (and her parents) feel a lot better, do better
in sports and in exams, etc.?

The problem with so may studies which produce results suggesting
benefits of HRT or other palliative treatments is that they don't have
a long enough perspective or an understanding of the machinery that
they're tinkering with. Things which make you feel better now are not
necessarily good for you in the long term.

Suppose you had an old car whose engine was losing power. What would
you think of a garage mechanic who tried to sell you a supercharger on
the grounds that research showed that all old cars which had a
supercharger fitted had immediate significant improvements in engine
power?

[Chakolate]

Post by Chris Malcolm
The problem with so may studies which produce results suggesting
benefits of HRT or other palliative treatments is that they don't have
a long enough perspective or an understanding of the machinery that
they're tinkering with. Things which make you feel better now are not
necessarily good for you in the long term.

Perfectly stated, IMO.

Chakolate

[Cathy Friedmann]

Post by Chris Malcolm

Post by kathryn
On Sun, 30 Jan 2005 14:43:05 -0600, "Marilee"
Is menopause an estrogen deficiency conditon/disease or not? The study
posted showed that postmenopausal women [ note POSTmenopausal women,
this is important in answering the question ] who took Soy (
Isoflavone ) supplements did NOT benefit, in whatever it was,
cognition I think, so that's one score that it is not.
Then the discussion led on to the ability to store estrogen in fat,
and whether this was a benefit in alleviating menopause symptoms -- or
not -- or even of harm. If SO then that is one score for menopause as
an estrogen deficiency condition /disease. The discussion then led to
symptoms...and whether dry itchy ears could be considered 'menopausal'
or not -- according to one doctor they were -- if so then that would
be one score for menopause as an estrogen deficiency
condition/disease. Up to this point the discussion was getting testy,
to be sure, It would help in such discussions if the cheerleaders on
the sidelines with little to contribute held back a little. Not that
I was not without blame.
Want to start all over again? On the basics I mean, the subject is
still menopause myths -- Is menopause a deficiency condition?

You can't necessarily do the kind of scoring points for and against
that you've suggested above. For example, let us suppose for the sake
of argument that menopause is a time when one of the body's hormones
shifts down in level, and that it takes (say) some years for the
body's regulatory systems which involved that hormone to adjust. There
will therefore (in this hypothetical case) be a period of some years
when some of the body's regulatory systems are maladjusted. During
this period maladjustment symptoms will be suffered which will be
ameliorated by adding a supplement of the missing hormone. But you
can't count that as a point in favour of menopause being a deficiency
disease.
The point is that if there is a lengthy period of adjustment to the
new levels then that period will show the signs you have suggested
would mark it as a deficiency. Howwever. treating it as a deficiency
might well hinder the adjustment process and cause other later
problems.
Someone mentioned that puberty is a transition period between
different hormonal regimes. The process of adjustment during puberty
takes a few years, during which it can be quite hard to live with the
sufferer, is it not? And is it not likely that if there was a drug
which would restore teenage hormone levels to pre-pubertal levels,
wouldn't the teenager (and her parents) feel a lot better, do better
in sports and in exams, etc.?
The problem with so may studies which produce results suggesting
benefits of HRT or other palliative treatments is that they don't have
a long enough perspective or an understanding of the machinery that
they're tinkering with. Things which make you feel better now are not
necessarily good for you in the long term.
Suppose you had an old car whose engine was losing power. What would
you think of a garage mechanic who tried to sell you a supercharger on
the grounds that research showed that all old cars which had a
supercharger fitted had immediate significant improvements in engine
power?

This (the above) exactly what I meant, re: "It's all relative" in my other
posts. But you explained it a lot better, & in more detail.

Cathy

[Susan]

x-no-archive: yes

Post by Chris Malcolm
The point is, as the author seems to have discovered, that it is
possible to have one's sleep disturbed in the night without this
necessarily meaning you don't in the end get enough sleep to perform
well the next day.
--
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Well, yeah, plus the author seems to assume that any menopause related
sleep problems would be due to hot flashes. That hasn't been my
experience.

Susan

[Louise Bremner]

Susan <***@aol.com> wrote:

x-no-archive: yes

Post by Susan

Post by Chris Malcolm
The point is, as the author seems to have discovered, that it is
possible to have one's sleep disturbed in the night without this
necessarily meaning you don't in the end get enough sleep to perform
well the next day.
--
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Well, yeah, plus the author seems to assume that any menopause related
sleep problems would be due to hot flashes. That hasn't been my
experience.

Glad someone else thinks that. I was beginning to wonder whether I was
odd in having definite hot flashes but not night sweats (yet--touch
wood), but also having sleep disturbances.

________________________________________________________________________
Louise Bremner (log at gol dot com)
If you want a reply by e-mail, don't write to my Yahoo address!

[Jette Goldie]

Post by Susan
x-no-archive: yes

Post by Susan

Post by Chris Malcolm
The point is, as the author seems to have discovered, that it is
possible to have one's sleep disturbed in the night without this
necessarily meaning you don't in the end get enough sleep to perform
well the next day.
--
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Well, yeah, plus the author seems to assume that any menopause related
sleep problems would be due to hot flashes. That hasn't been my
experience.

Glad someone else thinks that. I was beginning to wonder whether I was
odd in having definite hot flashes but not night sweats (yet--touch
wood), but also having sleep disturbances.

I think I've spotted a trend in my night sweats - they happen
at a certain point in my cycle and when I have *certain kind*
of dreams ....... the kind that would have you saying "is it hot
in here, or is it just me?" ;-)

[kathryn]

Post by Susan
x-no-archive: yes

Post by Chris Malcolm
The point is, as the author seems to have discovered, that it is
possible to have one's sleep disturbed in the night without this
necessarily meaning you don't in the end get enough sleep to perform
well the next day.
--
IPAB, Informatics, JCMB, King's Buildings, Edinburgh, EH9 3JZ, UK
[http://www.dai.ed.ac.uk/homes/cam/]

Well, yeah, plus the author seems to assume that any menopause related
sleep problems would be due to hot flashes. That hasn't been my
experience.
Susan

The study excluded any women with sleep problems, that is what is so
different about this study -- Freedman wanted to study menopausal hot
flashes, that's what he does -- he's done at least a dozen studies --
on hot flashes.

I found it interesting that the majority of women who did wake up with
hot flashes, woke up a few minutes before the commencement of the the
flash, though nearly as many woke up after, no doubt cold and sweaty,
very few women woke up during a hot flash.

I used to have a hot flash a few moments after waking up every morning
-- still do sometimes. I used to have a hot flash just as I was
settling down to sleep each night too.

Anyway remember, the Obstetrical & Gynecological Survey, the source of
this abstract is a 'readers' digest' of medical articles for doctors
who do not have time to keep up with the literature. The original
study was published in July 2004, in the Journal Fertility and
Sterility.

http://www.fertstert.org/article/PIIS0015028204006144/abstract

Different details are highlighted in the two abstracts, most
interesting, were they written for two different audiences? Another
reason to always get the full text of any study before making any
personal treatment decisions.

Kathryn

[Cathy Friedmann]

Post by kathryn
I found it interesting that the majority of women who did wake up with
hot flashes, woke up a few minutes before the commencement of the the
flash,

Maybe that 'aura' one sometimes gets before a flash was responsible?
Although I think my own "here comes a hot flash" aura sort of deals always
occur less than a minute before the actual flash. At least that's when I
consciously perceive them. (Maybe something's quietly going on before I
actually notice it??)

though nearly as many woke up after, no doubt cold and sweaty,

Post by kathryn
very few women woke up during a hot flash.
I used to have a hot flash a few moments after waking up every morning
-- still do sometimes. I used to have a hot flash just as I was
settling down to sleep each night too.

I often experience these - after going to bed but before drifting off, &
upon waking, but not during the night. Only while awake.

Cathy

Post by kathryn
Anyway remember, the Obstetrical & Gynecological Survey, the source of
this abstract is a 'readers' digest' of medical articles for doctors
who do not have time to keep up with the literature. The original
study was published in July 2004, in the Journal Fertility and
Sterility.
http://www.fertstert.org/article/PIIS0015028204006144/abstract
Different details are highlighted in the two abstracts, most
interesting, were they written for two different audiences? Another
reason to always get the full text of any study before making any
personal treatment decisions.
Kathryn

[l***@gmail.com]

Hot Flash-caused lack of sleep has serious health consequences, such as a lowered immune system. If you are suffering from hot flushes that rob you of sleep, do not ignore the problem! The longer you let it slide, the more difficult it becomes to regain your health. Every woman is different when it comes to getting through these "power surges," but an AMA study has shown that for some women the process can take up to 14 years. All the more reason to prepare yourself. NightBliss (www.hotflashes.co) is a air-cooling system that blows cool air over your body, under the covers, and provide instant relief to hot flashes. They guarantee it will work for you and offer a 100% satisfaction guarantee. If for any reason you wish to return the product, they will refund your money and transportation cost. A mechanical solution is safer than a hormonal.

The idea that being awakened many times a night by anything doesn't affect your "performance" the next day is counter-intuitive, I think.