New Method May Help Pinpoint Woman's Final Menstrual Period

Title: New Method May Help Pinpoint Woman's Final Menstrual Period
Category: Health News
Created: 3/26/2013 10:35:00 AM
Last Editorial Review: 3/26/2013 12:00:00 AM

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New Method May Help Pinpoint Woman's Final Menstrual Period

Doctors could use information to start preventive treatment for bone loss, researcher says

By Robert Preidt

HealthDay Reporter

TUESDAY, March 26 (HealthDay News) -- A new formula to predict a woman's final menstrual period could help menopausal women fight bone loss and reduce their heart disease risk, a new study reports.

The formula is based on the changing levels of two hormones: estradiol, which is found in the ovaries; and follicle-stimulating hormone, which is present in the brain and gives instructions to the ovaries.

Estradiol levels fall and follicle-stimulating hormone levels rise as women go through menopause, the University of California, Los Angeles, researchers explained in a news release from the Endocrine Society.

Currently, doctors monitor women's menstrual bleeding patterns to determine the menopause transition phase. However, this phase is an imprecise indicator of when the final menstrual period will occur, according to the authors of the study published in the April issue of the Journal of Clinical Endocrinology & Metabolism.

"We need a better way to answer women's questions about when to expect the final menstrual period," lead author Dr. Gail Greendale, of UCLA's David Geffen School of Medicine, said in the news release.

"If further research bears out our approach, it could be the first step to developing web-based calculators and other tools women can use to estimate where they are in the menopause transition and how far away their final period is," she added.

The ability to predict a woman's final menstrual period could prove important for their health, the researchers suggest. In the year before the final menstrual period, women experience accelerated bone loss and increased heart disease risk, the study authors said.

"For example, some researchers have proposed that an intervention begun one or two years before the final menstrual period would greatly decrease future fracture risk by preventing the very rapid bone loss that occurs in the few years before and few years after the final menses," Greendale said. "But before ideas such as this can be tested, we need to accurately predict where a woman is in her timeline to menopause."

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IUD May Be Best for Heavy Menstrual Bleeding

Jan. 9, 2013 -- Heavy menstrual bleeding is a rarely discussed but remarkably common condition that affects about 1 in 4 women.

For many, monthly periods are much more than a minor annoyance. They stop life in its tracks for days each month.

Oral contraceptives and progestin hormone pills are commonly prescribed medical treatments for heavy periods in the U.S., but they aren’t always effective for many women.

Now a landmark study from Europe, published in the New England Journal of Medicine, concludes that an IUD that releases progestin may be a more effective therapy.  

The Mirena IUD implantable contraceptive was found to be superior to oral contraceptives and non-hormonal drugs approved for the treatment of heavy menstrual bleeding in reducing the condition's effect on quality of life.

The IUD is widely used in Europe to treat heavy menstrual bleeding, but it is not used as much in the U.S.

OBGYN professor Eve Espey, MD, of the University of New Mexico, says this is partly due to a bias toward surgical treatments in the U.S. and partly due to what she calls a “hangover” from negative feelings about IUDs dating back to the early 1970s.

That was when as many as 300,000 women who used an IUD known as the Dalkon Shield filed lawsuits claiming to have been injured by the device. The most common complaint was pelvic infection.

“The Dalkon Shield has given all IUDs a bad name for almost 40 years, but modern IUDs are really very safe,” she says.

The study included 571 women with heavy periods followed for two years during treatment with either the Mirena IUD, oral hormone therapy, or the non-hormonal anti-bleeding drugs tranexamic acid and mefenamic acid.

Women who used the Mirena IUD reported greater improvement in quality of life, including their social routines, work-day routines, family life, and sex.

After two years, 64% of the women in the IUD group were still using the treatment vs. 38% of the women in the group using other treatments.

Researcher Janesh Gupta, MD, of the University of Birmingham in the U.K., says the study shows that the Mirena IUD is the clear treatment for women who want to preserve their fertility.

“Around 25% of women have very heavy periods at some point in their reproductive lives,” Gupta says. “This is a massive problem and this treatment is a safe and very effective option for a large percentage of women.”

He says pelvic infection is not a major concern, as long as the woman is screened for infection before the IUD is fitted.

Cleveland Clinic gynecologic surgeon Linda Bradley, MD, has been using the Mirena IUD to treat patients with heavy periods for many years.

She says the study has the potential to be a game changer if it brings the treatment to the attention of more women with heavy menstrual bleeding and their doctors.

Bradley is vice chair of the Obstetrics, Gynecology, and Women’s Health Institute at the Cleveland Clinic as well as the director of The Fibroid and Menstrual Disorders Center and Hysteroscopic Services.

“Women with this condition will embrace this treatment if they know about it,” she says. “I have used it for years, and my patients love it.”

Espey agrees. She says a majority of patients that she treats with the IUD have significant improvement in their heavy bleeding.

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