Research from around the world

Experts from the Jean Hailes Foundation for Women’s Health comment on recent world  research  on exercise and inactivity, relationships and sexual satisfaction.

Reverse ill-effects of inactivity

Couch potatoes can lower their risk of developing heart disease, diabetes and other health conditions if they start spending as much time exercising as they previously spent being inactive, a recent study shows.

Mildly overweight, but otherwise healthy, people whose health and fitness deteriorated when they volunteered to be physically inactive for six months had a complete reversal of deterioration in health measures when they increased their activity level over six months. This is good news for people who’ve recently gained weight, according to Foundation research director Professor Teede. “In this study these people fared the worst during the sedentary period and also made the greatest improvement when they increased their level of physical activity,” she said. “Even small increases will make a difference.”

Working mothers healthier

Who would have thought that being a working mum in a steady relationship would keep you healthy and in good shape? Recent research tracking long-term health of British men and women born in 1946 throughout their life showed that by age 54, women who had been partners, parents and employees were significantly less likely to report ill-health than  women who did not fulfil these roles.

Foundation psychologist Dr Mandy Deeks believes that a woman’s roles and how much importance she places on them will have an effect on her health. “Having roles in your life that are important to you and that you feel good about will impact on your self-esteem, stress levels and make you less vulnerable to illness.”

Sexual satisfaction

It’s official. Sexual satisfaction is good for your mental health! A study of 2000 US women aged 40  to 69 showed that three quarters of middle-aged and older women are sexually active and two-thirds are at least somewhat satisfied. Also noted in this study was that better mental health was associated with greater sexual satisfaction.

Medical director Dr Sue Reddish reports that sexual satisfaction and libido are huge issues for many women. “Sexual satisfaction is an individual experience between a couple and can relate to many things other than ‘orgasm’. Better mental health, associated with greater sexual satisfaction, reflects the relationship between mood and libido and many factors can impact on both. These may include quality of relationships, stress, tiredness, hormones, past experiences and expectations, current medication and health, self-esteem and body image,   among many  other things.”

'Bio-identical' hormones: what you need to know

Many women have ridden an emotional rollercoaster regarding hormone treatments for menopause symptoms – particularly after the findings of a major American study a few years ago. Approved hormone therapy has received much negative media attention and many women have stopped using approved pharmaceutical treatments, searching instead for alternative ways to manage symptoms. 'Bio-identical' hormones – or ‘natural’ hormones – have been growing in popularity.

About 'bio-identical' hormones

'Bio-identical' hormones are sometimes called ‘natural’ hormone replacement therapy, made up as lozenges and absorbed through the lining of the cheek, or as creams, absorbed through the skin, or as tablets. Dosages are made up individually, based often on hormone levels in the saliva or blood.

‘Natural’

These hormone preparations are described as ‘natural’ 'bio-identical' hormones, which may be misleading as it implies they are not manufactured or synthesised but are found in this form in nature. They are actually manufactured synthetically from a  substance extracted from either soy or yam – as are  most hormones, including the pill. Compounding

Compounded 'bio-identical' hormones preparations require a doctor’s prescription and are made up by ‘compounding pharmacists’ rather than pharmaceutical companies. Compounding pharmacists may have exactly the same training as your family pharmacist.

Quality control

Individual pharmacists are not required to adhere to the codes of conduct of the professional pharmaceutical body, Medicines Australia, when making 'bio-identical' preparation. These codes apply only to pharmaceutical companies. This means there is limited formal quality control on compounding pharmacists’ formulations.

Regulation

The Australian government department responsible for the approval of medicines, the Therapeutic Goods Administration (TGA), requires vigorous safety and effectiveness information before approving any medications. As they are compounded by individual pharmacists and not made by pharmaceutical companies, 'bio-identical' hormone formulations are not subject to TGA rules and are therefore not  approved medicines.

Dosage

Doctors prescribing 'bio-identical' hormone therapy take saliva or blood samples to detect hormone levels; however, there is little connection between blood levels and menopausal symptom relief and this practice is not proven. There has also been no formal research into dosage levels – doses prescribed are the responsibility of the prescribing doctor.

About oestrogen

The oestrogen that’s in many oral and all non-oral approved hormone therapies is exactly the oestrogen that occurs naturally in the human body – oestradiol. It is misleading to suggest that bioidentical lozenges and creams are more ‘natural’ or have advantages over TGA-approved pharmaceutical oestrogen therapies. The hormone preparations made in a pharmacy may contain a unique mix of the three major classes of oestrogen in the female body: oestradiol, oestrone and oestriol. Oestrogen mixes are sometimes combined with progesterone, testosterone or DHEA (a hormone made by the adrenal glands in the body) or each one prescribed alone. DHEA is not approved for use in Australia by the TGA.

Safety and effectiveness

There is no research evidence that recommended doses of hormone preparations made by compounding pharmacists are safe or even effective. Currently there is no proven, published data for these products, yet recommendations for specific doses and supposedly equivalent doses to TGA-approved hormone therapies have been provided. No studies have been conducted to show the lowest dose of compounded oestrogen needed to treat symptoms. Similarly, no adequate data exists to show the dose of compounded progesterone necessary to protect the lining of the uterus from uterine cancer and whether using lozenges or creams is safe.

Side effects

It has been claimed this compounded form of hormone therapy does not cause side effects. This is unproven and unlikely. Side effects have been documented, including complications of approved oestrogen and testosterone therapy while on 'bio-identical' hormone preparations. Blood levels of hormones can also be very elevated on bioidentical therapy. The advice for women is that until further research is done, they need to be cautious about considering what is essentially untested therapy.

Weighing up the evidence

Women and health professionals are constantly being given information about ‘hormone imbalance’ and how to deal with menopause ‘naturally’. All this information should be carefully evaluated, giving consideration to its accuracy, the reputation of the information provider and the vested financial interests of the group promoting the information.

See our Fact Sheet:  'Bio-identical' hormones (55.48 KB) 

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Note: This article is an archive. Whilst the Jean Hailes Foundation for Women’s Health has made every effort to ensure this information was accurate at the time of publication, the article content has not been updated since the date listed below.

Content updated April 18, 2007