WellFemme At The AMS Congress: Latest Menopause Updates

Our WellFemme Doctors present their highlights from the Australasian Menopause Society’s Congress in Adelaide, 24-26th November 2021.

The fact that many ended up writing full-length articles demonstrates just how passionate they are about these subjects! We’ll publish these in dedicated Blog posts over the coming months, but for now here are our “take-home messages” about menopausal health:

Dr Kelly latched onto a grab-bag of menopause-related facts:

• Menopause increases the speed of ageing by 6%
• The optimal BMI for healthy ageing is 28
• Dementia risk doubles every 5 years after menopause, reaching 41% by age 90
• Vaginal laser therapy was no more effective than “sham” treatment in recent trials
• Hydro-distention is effective treatment for painful bladder and urinary frequency
• Testosterone naturally increases in women after age 70 up to the level of 20-30 year-olds
• Women with surgical menopause may respond better to testosterone treatment
• Bariatric surgery increases women’s lives by 3 years on average
• Women are twice as likely to die after a heart attack than men
• Gestational diabetes and pre-eclampsia significantly increase cardiovascular risk, even after just 10 years

Dr Anna has qualifications in sports medicine and physical education, so it’s no surprise that she was excited by the latest evidence on the power of exercise as we age:

“Why is it so important and what can cardio and strength training do for you? Studies have shown:

• Higher aerobic fitness at midlife was associated with living longer: the fitter you are, the longer you live!
• Higher levels of aerobic fitness were associated with an 88% decreased risk of dementia compared to a medium level fitness
• Improving muscle strength and muscle mass reduces:
  • mortality (all causes of death) by 20-25%
  • cardiovascular disease by 20-25%
  • type 2 diabetes by 30%, and
  • cancer deaths by 15-20%
• Combined aerobic and muscle strengthening programmes are associated with significantly less cardiovascular disease, cancer and chronic lung disease.
• Comparisons of low, medium and high amounts of aerobic training show that those doing higher levels of aerobic training (300 mins/week) consistently lose more total weight and fat mass, and have a higher level of fitness.
• A slower gait (walking speed) is actually associated with a smaller brain!

Exercise is not optional. It is even more critically important at mid-life. We know that peri- and post menopause are associated with weight gain, body fat and composition changes and skeletal muscle loss. Aerobic and muscle strengthening exercise programmes help your overall health, longevity, and brain as well as your appearance. It is NEVER too late to start!” [The full version of Dr Anna’s post will be published in our Blog over the coming month]

Along a similar theme, Dr Lynda’s take-home message is about how diet and exercise affect your epigenetic age:

“I am passionate about a healthy diet and regular exercise as the foundation of health. Menopause is a time of change for women, a time when they can improve health and slow the ageing process. A healthy diet and exercise are the cornerstones of good health in anybody, but most especially menopausal women.

Yippee, all the things I carry on about were in the Epigenetic Age lecture. Epigenetic age is your physiological or “health age,” NOT your age in years. Your epigenetic age is DECREASED by a diet rich in fruit, vegetables and fish, moderate alcohol and doing plenty of exercise. So a healthy diet and exercise keeps you young – something I have always thought

Your epigenetic age is INCREASED by insulin resistance (ie. pre-diabetes), being overweight, having high blood pressure and increased fats in your blood.”

Dr Katie was forced to reflect on how we manage our time:

“We generally know what we need to do to improve our health, but one of the biggest barriers is finding the TIME to focus on your wellbeing. One talk was about Steven Corey’s time management matrix (it’s worth a google).

It was suggested that we write down what we do with our hours in each day. Be honest… I have now limited my time on social media (big time). I realised I was focussing on non-urgent, non-important tasks in my ‘free time’ and avoiding the looming big (and sometimes boring) important tasks, putting them off until they became URGENT and then feeling under pressure to complete them.”

[Dr Katie’s thoughts on this subject will be more fully explored shortly in a longer Blog post]

Our WellFemme dementia expert, Dr Marita Long paid close attention to the presentation on cognition:

We suspect that oestrogen has a protective role for the brain- just like it does for the heart and bones – because women who experience premature menopause are at higher risk of developing dementia when they aren’t treated with hormone therapy. However currently hormone therapy is not recommended specifically for primary prevention of dementia.

While the evidence evolves we need to work on all the other modifiable risk factors- eat well, exercise daily, don’t smoke and limit your alcohol intake, keep socially engaged and ensure that you get good quality sleep. The disease process for dementia starts 20-30 years before it is evident so the key message is – make the changes now! Take time to prioritise your health and enjoy the benefits for now and in the future. [More of Dr Marita’s insights about dementia and cognition also in a near-future Blog post]

Finally, Dr Ruth has a few words about the magic “window of opportunity” for HRT:

“At the AMS Congress last week there was an update on data from the Women’s Health Initiative (WHI) Study.  This was a massive study done in the US a number of years ago, and when the initial results came out in 2002 it lead to confusion and fear around HRT in women, especially in regards to higher breast cancer risk.  Subsequent studies from the WHI data have clearly showed that in younger women and those close to menopause there are more benefits than risks for HRT.

There is a “window of opportunity” for starting HRT, which reduces the risk of developing cardiovascular disease and has minimal risk for breast cancer.  This opportunity window is for women under 60 years old or women that are still within 10 years of going through menopause. HRT for the vast majority of these women is extremely safe and effective for menopausal symptoms, whilst reducing risk of heart disease, colon cancer, diabetes and osteoporosis  : )

OUR FAVOURITE RESOURCES FROM THE CONGRESS:

Infographic “Understanding the risks of Breast cancer” from the Bristish Menopause Society

AMS pre-appointment guide for discussing menopause with health professionals

Revised Global  Consensus Statement on Menopausal Hormone Therapy

Book: “Managing Hot Flushes and Night Sweats: A cognitive behavioural self-help guide to the menopause” by Myra Hunter.

Guide: “Considering Surgery to Reduce Your Risk of Ovarian Cancer?” Royal Melbourne Women’s Hospital.

The Decreased Sexual Desire Screener

Online strength training course for healthy ageing from Project Three Six Twelve

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