North American Menopause Society

The following provides a brief description of the articles published in Menopause, the official peerreviewed
journal of The North American Menopause Society (NAMS). Studies published in Menopause
do not necessarily reflect the policies or opinions of NAMS.
Journalists may obtain PDFs of the articles or arrange interviews with authors by contacting Judy Cerne at
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Contents of the July-August 2007 Issue of Menopause: The
Journal of The North American Menopause Society
VOLUME 14, NUMBER 4, 2007
Editorials
Perspective on menopausal vasomotor symptoms, CAM, and the SWAN
JoAnn V. Pinkerton, MD and Lisa M. Pastore, PhD
Isoflavones and cardiovascular risk in postmenopausal women: no free lunch
Cynthia A. Stuenkel, MD
Endogenous androgens and cardiovascular risk
Robert A. Wild, MD, PhD, MPH
Directly comparing routes of administration and types of hormone therapy on risk markers for
breast cancer
James K. Pru, PhD
Articles
Cross-sectional analysis of specific complementary and alternative medicine (CAM) use by
racial/ethnic group and menopausal status: the Study of Women’s Health Across the Nation
(SWAN)
Ellen B. Gold, PhD, Yali Bair, PhD, Guili Zhang, PhD, Jessica Utts, PhD, Gail A. Greendale, MD, Dawn
Upchurch, PhD, Laura Chyu, MA, Barbara Sternfeld, PhD, and Shelley Adler, PhD
Data were analyzed from 2,118 women who completed the sixth annual visit in the Study of Women’s
Health Across the Nation (SWAN), a multisite, multiethnic, longitudinal study of midlife women. More
than half of the women used some type of complementary and alternative medicine; use of most types of
complementary and alternative medicine differed significantly by race/ethnicity, sociodemographic
factors, comorbidities, and health behaviors but was largely unrelated to menopausal status or symptom
reporting.
Effect of 6 months of exercise and isoflavone supplementation on clinical cardiovascular risk factors
in obese postmenopausal women: a randomized, double-blind study
Mylene Aubertin-Leheudre, MSc, Christine Lord, MSc, Abdelouahed Khalil, PhD, and Isabelle J.
Dionne, PhD
It is unknown whether isoflavones combined with an aerobic program could prevent cardiovascular
disease risks. This study demonstrated that 6 months of exercise combined with isoflavones improved
body composition and sex hormone-binding globulin levels to a greater extent than exercise alone.
Endogenous androgen levels and cardiovascular risk profile in women across the adult life span
Robin J. Bell, MD, PhD, Sonia L. Davison, MD, PhD, Mary-Anne Papalia, MD, Dean P. McKenzie, BA
(Hons), and Susan R. Davis, MD, PhD
In a cross-sectional study of non-healthcare-seeking adult women we found that sex-hormone-binding
globulin (SHBG) made an independent contribution to variations in serum levels of C-reactive protein,
high-density lipoprotein and triglycerides, providing support for the independent predictive value of low
SHBG for cardiovascular risk profile.
Effects of estradiol with oral or intravaginal progesterone on risk markers for breast cancer in a
postmenopausal monkey model
Charles E. Wood, DVM, PhD, Regine L. Sitruk-Ware, MD, Yun-Yen Tsong, PhD, Thomas C. Register,
PhD, Cynthia J. Lees, DVM, PhD, and J. Mark Cline, DVM, PhD
Micronized progesterone delivered by vaginal ring is readily absorbed into the systemic circulation and
produces more stable serum concentrations than oral administration. However, no significant differences
were found between standard doses of oral and intravaginal progesterone (P4) on breast epithelial
proliferation. These findings do not support the idea that intravaginal P4 has an inherently safer risk
profile than oral P4 in the postmenopausal breast.
Effects of the phytoestrogen genistein on hot flushes, endometrium, and vaginal epithelium in
postmenopausal women: a 1-year randomized, double-blind, placebo-controlled study
Rosario D’Anna, MD, Maria Letizia Cannata, MD, Marco Atteritano, MD, Francesco Cancellieri, MD,
Francesco Corrado, MD, Giovanni Baviera, PhD, Onofrio Triolo, MD, Francesco Antico, MD, Agostino
Gaudio, MD, Nicola Frisina, MD, Alessandra Bitto, MD, Francesca Polito, PhD, Letteria Minutoli, MD,
Domenica Altavilla, PhD, Herbert Marini, MD, and Francesco Squadrito, MD
In a 12-month, prospective, randomized, double-blind, placebo-controlled study, the phytoestrogen
genistein has been shown to be effective on vasomotor symptoms without adverse effects on
endometrium.
Raloxifene improves the ovariectomy-induced impairment in endothelium-dependent vasodilation
Kazuhiro Takahashi, MD, PhD, Akiko Mori-Abe, MD, PhD, Keiko Takata, MD, Tsuyoshi Ohta, MD, Jun
Kawagoe, MD, PhD, Seiji Tsutsumi, MD, PhD, Masahide Ohmichi, MD, PhD, and Hirohisa Kurachi,
MD, PhD
Raloxifene rapidly restored the flow-mediated dilatation which was impaired after surgical menopause.
Raloxifene may be effective for ameliorating and maintaining the endothelial function in premenopausal
women who undergo ovariectomy.
Articles from the Workshop on “Cross-cultural Comparisons of Midlife and Aging”
Cross-cultural comparisons: midlife, aging, and menopause
Carla Makhlouf Obermeyer, PhD and Lynnette Leidy Sievert, PhD
This summary introduces 15 papers that examine menopause, midlife, and aging from a cross-cultural
perspective, reviews the comparative method, differentiates between etic and emic data, and questions
whether there are core menopausal symptoms across research sites.
Potential use of biomarkers for analyzing interpopulation and cross-cultural variability in
reproductive aging
Gillian R. Bentley, PhD and Shanthi Muttukrishna, PhD
This article summarizes the significant variability that exists between women and populations in many
physiological aspects of reproductive aging. It also reviews a number of biomarkers that are useful for
measuring reproductive aging as well as problems associated with their use.
Conducting cross-cultural research in teams and the search for the “culture-proof” variable
Patricia Draper, PhD
This article addresses the problems researchers face when they must render information collected in
different cultural settings into coding categories that encompass all the settings.
A symptomatic approach to understanding women’s health experiences: a cross-cultural
comparison of women aged 20 to 70 years
Lorraine Dennerstein, AO, DPM, PhD, MBBS, FRANZCP, Philippe Lehert, DrEg, PhD, Patricia E.
Koochaki, PhD, BA, Alessandra Graziottin, MD, Sandra Leiblum, PhD, and Jeanne Leventhal Alexander,
MD, FABPN, FRCPC, FAPA, FACPsych
Seven symptoms were linked to indicators of ovarian hormonal depletion: hot flashes; night sweats; poor
memory; difficulty sleeping; aches in the neck, head, or shoulders; vaginal dryness; and difficulty with
sexual arousal.
Cross-cultural comparisons of health-related quality of life in Australian and Japanese midlife
women: the Australian and Japanese Midlife Women’s Health Study
Debra J. Anderson, PhD and Toyoko Yoshizawa, PhD
Research suggests that there are significant differences between Australian and Japanese midlife women
in health-related quality of life and some of the factors that contribute to these areas. It is important that
consideration be given to incorporating the same tool within the cross-cultural design of studies so that
comparisons between cultures and patterns of healthy aging can be made.
Disentangling cultural issues in quality of life data
Nancy E. Avis, PhD and Alicia Colvin, MPH
This article examines the impact of acculturation, as defined by language use, in explaining ethnic
differences in reporting health-related quality of life.
Are the effects of risk factors for timing of menopause modified by age? Results from a British
birth cohort study
Gita Mishra, PhD, Rebecca Hardy, PhD, and Diana Kuh, PhD
This study finds that the early life factors of being breast-fed and having higher cognitive ability
independently influence age at menopause, whereas the effects of weight at 2 years, parental divorce
during childhood, and mother’s age at menopause varied according to the women’s age at menopause.
The roles of biologic and nonbiologic factors in cultural differences in vasomotor symptoms
measured by surveys
Sybil L. Crawford, PhD
Cultural differences in vasomotor symptom reporting on surveys reflect both differences in the underlying
biology, which are likely to influence vasomotor symptom occurrence, and differences in nonbiologic
sociocultural factors such as attitudes toward menopause, which are likely to be related to vasomotor
symptom perception and reporting. Consequently, it is important to consider interactions of culture and
biology in studies of vasomotor symptoms.
“I take the good with the bad, and I moisturize”: defying middle age in the new millennium
Yewoubdar Beyene, PhD, Catherine Gilliss, DNSc, and Kathryn Lee, PhD
This qualitative study reports on how a premenopausal cohort of women in their forties understand
“middle age.” Menopause is understood as a natural event that is out of women’s control, whereas their
health and appearance were deemed something they can and should control.
Variation in sweating patterns: implications for studies of hot flashes through skin conductance
Lynnette Leidy Sievert, PhD
Women in Puebla, Mexico demonstrated a higher rate of concordance between subjective and objective
(sternal) measures of hot flashes and a significantly lower mean score for false negative measures
compared to women in Amherst, Massachusetts. Although women in Mexico were more likely to
describe hot flashes on the back of their neck, the addition of nuchal monitoring did not increase the rate
of concordance between subjective and objective measures within the Mexican sample.
Chilliness: a vasomotor symptom in Japan
Melissa K. Melby, PhD, CPGS, MPhil, MA
The symptom hiesho (chilliness) seems to be a more important vasomotor symptom than hot flushes and
sweats in Japanese women and may reflect differing thermoregulatory physiology, possibly influenced by
dietary soy.
Women’s midlife health across cultures: DAMES comparative analysis
Michelle A. Parsons, SM and Carla Makhlouf Obermeyer, DSc
This article explores self-reported health of middle-aged women in Lebanon, Morocco, Spain, and the
United States using the Decisions At Menopause Comparative Study (DAMES) data. Quantitative and
qualitative data illustrate that menopausal symptoms may in many cases be overshadowed by other
concerns, such as family and work responsibilities.
An application of the theory of life’s lesions to the study of the menopausal transition
Kaja Finkler, PhD
This article illuminates the experiential, existential and contextual sources influencing menopausal
manifestations. The concept of life’s lesions is proposed and suggests that women’s experiences of
physiological changes occurring during the menopausal period may be promoted by specific aspects of
their lives, described in the paper, that are embedded in society and culture.
Environmental contexts of menopause in Spain: comparative results from recent research
Cristina Bernis, PhD and David Sven Reher, PhD
The process of reproductive aging for women in the region of Madrid, Spain, living in different
environmental contexts show significant disparities in age at menopause, in the prevalence and type of the
many menopausal symptoms, and in the degree of medicalization of their own change of life. Even when
adjusting for basic confounders, the environmental context significantly influences the pace of aging as
well as the experience of hot flashes. These disparities are best understood as the result of the interaction
among biological, ecological, and behavioral factors influencing women both earlier in life and during the
change of life they are experiencing now.
Symptoms, menopause status, and country differences: a comparative analysis from DAMES
Carla Makhlouf Obermeyer, DSc, David Reher, PhD, and Matilda Saliba, MSc
Surveys on representative samples of women aged 45-55 in Massachusetts, Spain, Lebanon, and
Morocco, show differences in reported symptom frequencies across sites, but also similarities in core
symptoms including hot flashes; the article examines the determinants of these differences and
similarities.
Symptom groupings at midlife: cross-cultural variation and association with job, home, and life
change
Lynnette Leidy Sievert, PhD, Carla Makhlouf Obermeyer, PhD, and Matilda Saliba, MSc
A study of symptom clusters in Morocco, Lebanon, Spain, and the United States demonstrates crosspopulation
variation. Variables that predict symptom groupings (eg, job change, marital status,
menopause status, or level of education) also differed in country-specific ways.