June 3, 2009 (Orlando) — The hormone replacement therapy taken by millions of women to relieve hot flashes and other  symptoms of menopause may raise the risk of dying from lung cancer, researchers say.

New findings from the landmark Women’s Health Initiative study show that women with non-small cell lung cancer are 59% more likely to die from the disease if they take combined estrogen and progestin.

The risk was particularly high for smokers: There was one avoidable death from non-small cell lung cancer for every 100 women who both smoked and took hormone therapy over eight years, the study showed.

Non-small cell lung cancer is the most common type of lung cancer and the leading cause of cancer death in women.

In light of the findings, “women almost certainly should not be using combined hormone therapy and tobacco at the same time,” says study head Rowan Chlebowski, MD, of the Harbor-UCLA Medical Center.

Combined hormone treatment did not increase the odds of developing lung cancer, the study showed.

Hormone Therapy Linked to Host of Problems

The findings represent the latest in “a series of problems that work against widespread use of combined hormone therapy,” Chlebowski says.

He’s referring to the fact that previous analyses from the Women’s Health Initiative showed that long-term use (at least five years) of hormone replacement therapy combining estrogen and progestin raises women’s risk of heart disease, stroke, blood clots, and breast cancer.

In the WHI, more than 161,000 women were randomly assigned to take combined hormone therapy or a placebo. The trial was stopped prematurely in 2002, when it became apparent that the risks of combined hormone treatment outweighed the benefits.

Although fewer women are opting for the combination in light of those findings, about 25 million prescriptions are still written every year in the U.S., Chlebowski says.

Hormone Therapy and Lung Cancer

Since the WHI was stopped, researchers have observed a significant increase in both fatal and nonfatal cancers among women who took the hormones, Chlebowski tells WebMD.

The new analysis used data from the WHI to try to answer the question of whether the increase could be explained by the influence of combined hormone therapy on lung cancer, he says.

The researchers looked at lung cancer cases and deaths for the 5 1/2 years that the women took either hormones or placebo and for nearly  2 1/2 years afterward.

Among the findings, presented at the annual meeting of the American Society of Clinical Oncology:

• There were 67 deaths from non-small cell lung cancer among the 8,052 hormone users vs. 39 among the 7,678 women who took the placebo, a significant difference.
• After a diagnosis of non-small cell lung cancer, hormone users lived a median of 9.4 months, compared with 16.1 months for women taking placebo.
• Among smokers, 3.4% of those who took hormones died from non-small cell lung cancer, compared with 2.3% of those who took placebo.
• Among never-smokers, 0.2% of hormone users died from non-small cell lung cancer, compared with 0.1% of those on placebo.
• There was no link between hormone therapy and risk of developing or dying from small-cell lung cancer.

Bruce Johnson, MD, of the Dana-Farber Cancer Institute in Boston, tells WebMD that the new study was better designed and thus “likely more accurate” than previous studies that showed no link between lung cancer and hormone therapy.

Hormone Therapy: What Should Women Do?

Smokers should definitely quit the habit if they are taking or considering taking combined hormone treatment, Chlebowski says.

Also, talk to your doctor about other options for relieving hot flashes and symptoms of menopause, he says.

If hormone treatment is needed, heed the FDA’s advice to take estrogen and progestin at the lowest doses for the shortest duration to reach treatment goals, doctors say.

©2012 An Inconvenient Woman. All Rights Reserved.

Women who take combined hormone therapy for about five years have a higher risk of abnormal mammograms and breast biopsies.

This, in turn, may decrease the effectiveness of these methods of detecting breast cancer, according to a new study published in the Feb. 25 issue of Archives of Internal Medicine.

“Women need to be aware of the risks, and it’s not just risk of increased breast cancer. It’s a risk of possibly having abnormal mammograms and really being tortured by them,” said Dr. Kristin Byrne, chief of breast imaging at Lenox Hill Hospital in New York City, who was not involved with the study. “It’s a whole slew of things they need to be aware of before making a decision to go on hormone therapy.”

Study lead author Dr. Rowan Chlebowski, a medical oncologist with the Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, said that for women with severe menopausal symptoms, the new findings “won’t be an issue.”

“It [hormone-replacement therapy] is safer than we thought maybe a year and a half ago,” he said. “Certainly, no one is going to brush off a breast biopsy. But for women trying to decide whether to start on hormone therapy or who want to see if their symptoms get better, they have to think about whether they would mind having a call back” for a mammogram.

The landmark Women’s Health Initiative (WHI) study found that combined estrogen plus progestin hormone replacement therapy (HRT) increased the risk of breast cancer. One recent study indicated that the risk was greater for lobular breast cancer than ductal carcinoma malignancy.

Since 2003, there has been a decline in breast cancer incidence that coincided with a decline in HRT use for menopausal symptoms. Nevertheless, Chlebowski pointed out, “a lot of people are still using hormone therapy.”

For the new study, the authors looked at 16,608 women who participated in the WHI from 1993 to 1998. The women were randomly assigned to receive combined hormone replacement therapy (estrogen plus progesterone) or a placebo.

Mammograms and breast exams were conducted annually and biopsies performed, if indicated.

More than one in 10 women had otherwise avoidable mammogram abnormalities (an increase of 11 percent), while one out of 25 women had otherwise avoidable breast biopsies (an increase of 4 percent), after taking the hormone therapy for five years.

Ten percent of women in the HRT group had to have a biopsy, compared to 6.1 percent in the placebo group. Yet the biopsies only detected 14.8 percent of cancers in the HRT group, compared with 19.6 percent in the placebo group.

“Your breasts become denser [with HRT], and we all know that mammography isn’t as sensitive for the detection of breast cancer in women with dense breasts,” Byrne explained.

The increase in abnormal mammograms persisted for at least 12 months even after discontinuing hormone therapy, the study found.

For the medical community, Chlebowski said, this finding “focuses attention that diagnosis is hindered. We have additional imaging modalities, and maybe we should evaluate them to see if we can get rid of this hindrance or delay in diagnosis. It hasn’t been a factor for attention before, but it probably should be.”

Chlebowski has consulted for several pharmaceutical companies.

A prepared statement from Wyeth Pharmaceuticals, which makes the hormonal product Prempro, said: “While the [study] authors report a link between an increase in abnormal mammograms and breast density among women taking combined estrogen plus progestin, this does not mean they are at an increased risk for breast cancer.

“The data used in this sub-analysis were taken from the combined estrogen plus progestin database of the WHI study and does not reflect the experience of the majority of women taking hormone therapy — those who take estrogen-alone,” the statement concluded.

Sources: Forbes.com

The Women’s Health Initiative —  U.S. National Heart, Lung, and Blood Institute.

©2012 An Inconvenient Woman. All Rights Reserved.

Increased risk for adverse cardiovascular outcomes and invasive breast cancer — and reduced risk for fractures and colorectal cancer — did not persist after women discontinued HT.

In the summer of 2002, the Women’s Health Initiative (WHI) randomized trial of estrogen plus progestin was stopped after the WHI writing group concluded that the results showed more risk than benefit: An increased risk for venous thromboembolism and modestly increased risks for stroke, cardiovascular disease (CVD), coronary heart disease (CHD), and invasive breast cancer outweighed the reduced risks for fractures and colorectal cancer. In this latest update, WHI investigators report on outcomes 3 years after study medication (estrogen-plus-progestin hormone therapy or placebo) was halted.

In contrast to findings at the time study medication was discontinued, no increased risk for thrombosis, CHD, or stroke was observed during the subsequent 3 years in women who had received HT; furthermore, neither a statistically significant increased risk for invasive breast cancer nor reduced risk for fractures or colorectal malignancies was seen. The global risk index for the entire 8 years of follow-up (hazard ratio, 1.12; 95% confidence interval, 1.03–1.21), elevated at the time the trial was stopped, was noted to be 1.11 (95% CI, 0.99–1.27) during the post-discontinuation years of observation. The all-cause death rate was higher during the post-discontinuation follow-up than during the overall follow-up, although this difference was not statistically significant (HR, 1.15; 95% CI, 0.95–1.39 and HR, 1.04; 95% CI, 0.91–1.18, respectively). Three years after randomized trial discontinuation, the risk for diagnosis of any cancer was modestly higher than during the active trial in those women who had been assigned to HT versus those who received placebo (HR, 1.24; 95% CI, 1.04–1.48). The authors noted that the increased cancer incidence in women previously assigned to HT seemed to reflect a higher risk for diagnosis of cancers other than those prespecified as outcomes (in particular, lung malignancies).

Comment: The observation that increased risks for adverse cardiovascular outcomes or invasive breast cancer and prevention of fractures and colorectal cancer all did not persist after women discontinued HT represents a notable take-home message from this follow-up analysis of WHI participants. Recent WHI reports have suggested that HT, particularly estrogen-only therapy, might be associated with a lower risk for CHD in recently menopausal women and menopausal women in their 50s (Journal Watch Women’s Health May 3 2007 and Jun 21 2007). Accordingly, we await with interest the age-specific follow-up analyses of both the estrogen-plus-progestin and the estrogen-alone WHI clinical trials focusing on cardiovascular outcomes. At the same time, the overall increase in risk for malignancies calls for continued surveillance after estrogen-plus-progestin HT is stopped.

Source:     Andrew M. Kaunitz, MD

                    Published in Journal Watch Women’s Health March 4, 2008

©2012 An Inconvenient Woman. All Rights Reserved.

JAMA. 2008;299(9):1036-1045.

Context: The Women’s Health Initiative (WHI) trial of estrogen plus progestin vs placebo was stopped early, after a mean 5.6 years of follow-up, because the overall health risks of hormone therapy exceeded its benefits.

Objective: To report health outcomes at 3 years (mean 2.4 years of follow-up) after the intervention was stopped.

Design, Setting, and Participants: The intervention phase was a double-blind, placebo-controlled, randomized trial of conjugated equine estrogens (CEE) 0.625 mg daily plus medroxyprogesterone acetate (MPA) 2.5 mg daily, in 16 608 women aged 50 through 79 years, recruited by 40 centers from 1993 to 1998. The postintervention phase commenced July 8, 2002, and included 15 730 women.

Main Outcome: Measures Semi-annual monitoring and outcomes ascertainment continued per trial protocol. The primary end points were coronary heart disease and invasive breast cancer. A global index summarizing the balance of risks and benefits included the 2 primary end points plus stroke, pulmonary embolism, endometrial cancer, colorectal cancer, hip fracture, and death due to other causes.

Results: The risk of cardiovascular events after the intervention was comparable by initial randomized assignments, 1.97% (annualized rate) in the CEE plus MPA (343 events) and 1.91% in the placebo group (323 events). A greater risk of malignancies occurred in the CEE plus MPA than in the placebo group (1.56% [n = 281] vs 1.26% [n = 218]; hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.04-1.48). More breast cancers were diagnosed in women who had been randomly assigned to receive CEE plus MPA vs placebo (0.42% [n = 79] vs 0.33% [n = 60]; HR, 1.27; 95% CI, 0.91-1.78) with a modest trend toward a lower HR during the follow-up after the intervention. All-cause mortality was somewhat higher in the CEE plus MPA than in the placebo group (1.20% [n = 233] vs 1.06% [n = 196]; HR, 1.15; 95% CI, 0.95-1.39). The global index of risks and benefits was unchanged from randomization through March 31, 2005 (HR, 1.12; 95% CI, 1.03-1.21), indicating that the risks of CEE plus MPA exceed the benefits for chronic disease prevention.

Conclusions: The increased cardiovascular risks in the women assigned to CEE plus MPA during the intervention period were not observed after the intervention. A greater risk of fatal and nonfatal malignancies occurred after the intervention in the CEE plus MPA group and the global risk index was 12% higher in women randomly assigned to receive CEE plus MPA compared with placebo.

Trial Registration clinicaltrials.gov Identifier: NCT00000611

Author Affiliations: University of North Carolina, Chapel Hill (Dr Heiss); University of Iowa, Iowa City (Dr Wallace); Fred Hutchinson Cancer Research Center, Seattle, Washington (Drs Anderson, Beresford, LaCroix, Prentice, and Mr Aragaki); University of Texas Health Science Center, San Antonio (Dr Brzyski); Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California (Dr Chlebowski); University of Cincinnati, Cincinnati, Ohio (Dr Gass); Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts (Dr Manson); National Heart, Lung, and Blood Institute, Bethesda, Maryland (Dr Rossouw); and Stanford Prevention Research Center, Stanford, California (Dr Stefanick).

AND——–

From: http://womens-health.jwatch.org/cgi/content/full/2008/304/1
WHI Estrogen-Plus-Progestin Trial: 3 Years Later

Increased risk for adverse cardiovascular outcomes and invasive breast cancer — and reduced risk for fractures and colorectal cancer — did not persist after women discontinued HT.

In the summer of 2002, the Women’s Health Initiative (WHI) randomized trial of estrogen plus progestin was stopped after the WHI writing group concluded that the results showed more risk than benefit: An increased risk for venous thromboembolism and modestly increased risks for stroke, cardiovascular disease (CVD), coronary heart disease (CHD), and invasive breast cancer outweighed the reduced risks for fractures and colorectal cancer. In this latest update, WHI investigators report on outcomes 3 years after study medication (estrogen-plus-progestin hormone therapy or placebo) was halted.

In contrast to findings at the time study medication was discontinued, no increased risk for thrombosis, CHD, or stroke was observed during the subsequent 3 years in women who had received HT; furthermore, neither a statistically significant increased risk for invasive breast cancer nor reduced risk for fractures or colorectal malignancies was seen. The global risk index for the entire 8 years of follow-up (hazard ratio, 1.12; 95% confidence interval, 1.03–1.21), elevated at the time the trial was stopped, was noted to be 1.11 (95% CI, 0.99–1.27) during the post-discontinuation years of observation. The all-cause death rate was higher during the post-discontinuation follow-up than during the overall follow-up, although this difference was not statistically significant (HR, 1.15; 95% CI, 0.95–1.39 and HR, 1.04; 95% CI, 0.91–1.18, respectively). Three years after randomized trial discontinuation, the risk for diagnosis of any cancer was modestly higher than during the active trial in those women who had been assigned to HT versus those who received placebo (HR, 1.24; 95% CI, 1.04–1.48). The authors noted that the increased cancer incidence in women previously assigned to HT seemed to reflect a higher risk for diagnosis of cancers other than those prespecified as outcomes (in particular, lung malignancies).

Comment: The observation that increased risks for adverse cardiovascular outcomes or invasive breast cancer and prevention of fractures and colorectal cancer all did not persist after women discontinued HT represents a notable take-home message from this follow-up analysis of WHI participants. Recent WHI reports have suggested that HT, particularly estrogen-only therapy, might be associated with a lower risk for CHD in recently menopausal women and menopausal women in their 50s (Journal Watch Women’s Health May 3 2007 and Jun 21 2007). Accordingly, we await with interest the age-specific follow-up analyses of both the estrogen-plus-progestin and the estrogen-alone WHI clinical trials focusing on cardiovascular outcomes. At the same time, the overall increase in risk for malignancies calls for continued surveillance after estrogen-plus-progestin HT is stopped.

— Andrew M. Kaunitz, MD

Source: From: http://jama.ama-assn.org/cgi/content/short/299/9/1036

Paper Researchers:
Gerardo Heiss, MD; Robert Wallace, MD; Garnet L. Anderson, PhD; Aaron Aragaki, MS; Shirley A. A. Beresford, PhD; Robert Brzyski, MD; Rowan T. Chlebowski, MD; Margery Gass, MD; Andrea LaCroix, PhD; JoAnn E. Manson, MD; Ross L. Prentice, PhD; Jacques Rossouw, MD; Marcia L. Stefanick, PhD; for the WHI Investigators

Published in Journal Watch Women’s Health March 4, 2008

©2012 An Inconvenient Woman. All Rights Reserved.

Gerardo Heiss, MD; Robert Wallace, MD; Garnet L. Anderson, PhD; Aaron Aragaki, MS; Shirley A. A. Beresford, PhD; Robert Brzyski, MD; Rowan T. Chlebowski, MD; Margery Gass, MD; Andrea LaCroix, PhD; JoAnn E. Manson, MD; Ross L. Prentice, PhD; Jacques Rossouw, MD; Marcia L. Stefanick, PhD; for the WHI Investigators

JAMA. 2008;299(9):1036-1045.

Context The Women’s Health Initiative (WHI) trial of estrogen plus progestin vs placebo was stopped early, after a mean 5.6 years of follow-up, because the overall health risks of hormone therapy exceeded its benefits.

Objective To report health outcomes at 3 years (mean 2.4 years of follow-up) after the intervention was stopped.

Design, Setting, and Participants The intervention phase was a double-blind, placebo-controlled, randomized trial of conjugated equine estrogens (CEE) 0.625 mg daily plus medroxyprogesterone acetate (MPA) 2.5 mg daily, in 16 608 women aged 50 through 79 years, recruited by 40 centers from 1993 to 1998. The postintervention phase commenced July 8, 2002, and included 15 730 women.

Main Outcome Measures Semi-annual monitoring and outcomes ascertainment continued per trial protocol. The primary end points were coronary heart disease and invasive breast cancer. A global index summarizing the balance of risks and benefits included the 2 primary end points plus stroke, pulmonary embolism, endometrial cancer, colorectal cancer, hip fracture, and death due to other causes.

Results The risk of cardiovascular events after the intervention was comparable by initial randomized assignments, 1.97% (annualized rate) in the CEE plus MPA (343 events) and 1.91% in the placebo group (323 events). A greater risk of malignancies occurred in the CEE plus MPA than in the placebo group (1.56% [n = 281] vs 1.26% [n = 218]; hazard ratio [HR], 1.24; 95% confidence interval [CI], 1.04-1.48). More breast cancers were diagnosed in women who had been randomly assigned to receive CEE plus MPA vs placebo (0.42% [n = 79] vs 0.33% [n = 60]; HR, 1.27; 95% CI, 0.91-1.78) with a modest trend toward a lower HR during the follow-up after the intervention. All-cause mortality was somewhat higher in the CEE plus MPA than in the placebo group (1.20% [n = 233] vs 1.06% [n = 196]; HR, 1.15; 95% CI, 0.95-1.39). The global index of risks and benefits was unchanged from randomization through March 31, 2005 (HR, 1.12; 95% CI, 1.03-1.21), indicating that the risks of CEE plus MPA exceed the benefits for chronic disease prevention.

Conclusions The increased cardiovascular risks in the women assigned to CEE plus MPA during the intervention period were not observed after the intervention. A greater risk of fatal and nonfatal malignancies occurred after the intervention in the CEE plus MPA group and the global risk index was 12% higher in women randomly assigned to receive CEE plus MPA compared with placebo.

Trial Registration clinicaltrials.gov Identifier: NCT00000611

Author Affiliations: University of North Carolina, Chapel Hill (Dr Heiss); University of Iowa, Iowa City (Dr Wallace); Fred Hutchinson Cancer Research Center, Seattle, Washington (Drs Anderson, Beresford, LaCroix, Prentice, and Mr Aragaki); University of Texas Health Science Center, San Antonio (Dr Brzyski); Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, Torrance, California (Dr Chlebowski); University of Cincinnati, Cincinnati, Ohio (Dr Gass); Brigham and Women’s Hospital, Harvard Medical School, Boston, Massachusetts (Dr Manson); National Heart, Lung, and Blood Institute, Bethesda, Maryland (Dr Rossouw); and Stanford Prevention Research Center, Stanford, California (Dr Stefanick).

Source: http://jama.ama-assn.org/cgi/content/short/299/9/1036

©2012 An Inconvenient Woman. All Rights Reserved.

”What cigarette do you smoke, Doctor?”

Hey if a Camel® is good enough Doctors, surely cigarette smoke is safe?

Right! Who would question a doctor back in the golden days of black and white TV?

Western Medicine has a long and completely unapologetic history of being wrong. The are better ways of handling symptomatic behavior than ingesting chemicals a group a guys “think” won’t cause you harm.

”What cigarette do you smoke, Doctor?”

The following is a summary of an article that appeared on www.medscape.com.

The American Association of Clinical Endocrinologists (AACE) has released a statement on hormone replacement therapy (HRT) and cardiovascular risk, emphasizing that HRT does not appear harmful in younger women in early menopause and may indeed be beneficial in this group [1]. “With this in mind, and given the powerful effects of estrogen therapy in relieving menopausal symptoms, we believe that physicians may safely counsel women to use estrogen for the relief of menopausal symptoms. Each patient should be evaluated for the severity of her symptoms, her age, and specific risk factors that might impact on her use of hormonal therapy,” the statement concludes.One of the authors of the statement, past AACE president Dr Rhoda Cobin (Mount Sinai School of Medicine, New York), told ‘Heartwire’ that a review of all the available evidence suggests that younger women who are close to menopause have less to fear from HRT than older women in terms of cardiovascular risk. “We think the data offer some reassurance to women close to the menopause, with the suggestion that estrogen supplementation may even protect against heart disease in these younger women. And even if it is not protective, it doesn’t appear to be harmful so can probably be used safely to treat menopausal symptoms. There does appear to be a window of opportunity for use of estrogen.”

She added: “After all the negative publicity from the HRT trials, physicians are now fearful of prescribing estrogen at all. But we believe there are advantages and disadvantages to such treatment and that cardiovascular risk in particular is not the same for everyone. Each woman should be considered individually, and many factors should be taken into account when thinking about prescribing HRT. These include age, time from menopause, other cardiovascular and thrombotic risks, and menopausal symptoms.

“The evidence is particularly reassuring for estrogen-only therapy, which has not been associated with increases of either cardiovascular disease or breast cancer in younger women. So for women who have had an early hysterectomy and therefore do not have to have progesterone, they should not be deprived of estrogen replacement therapy,” Cobin commented.

The AACE statement notes that in animal studies, estrogen is effective in inhibiting progression of early-stage atherosclerosis but it is much less effective in inhibiting progression of more advanced atherosclerosis in older animals. After these observations, data from the major HRT studies were reexamined to determine the effect of treatment on cardiovascular risk when stratified by age or time from menopause.

The reevaluation of the Nurses’ Health Study found that women beginning hormone therapy near menopause had a significantly reduced risk of CHD (RR=0.66 for estrogen alone; RR=0.72 for estrogen with progestin). A recent meta-analysis of 23 trials of HRT that compared results in younger women (younger than 60 or less than 10 years since menopause) vs older women showed that HRT significantly reduced CHD events in the former (OR 0.68) but not in the latter (OR 1.03). And in the Women’s Health Initiative (WHI) trial, when stratified by time since menopause, the hazard ratios for CHD were 0.76 in the women fewer than 10 years from the onset of menopause, 1.1 in those 10 to 19 years from onset of menopause, and 1.28 in those women more than 20 years from onset of menopause. By age, the hazard ratios for cardiovascular disease were 0.93 for ages 50 to 59, 0.98 for ages 60 to 69, and 1.26 for ages 70 to 79.

The AACE statement notes that further data on HRT in younger women will come from the Kronos Early Estrogen Prevention Study (KEEPS), which is evaluating five years of HRT vs placebo in 720 women aged 42 to 58 years within 36 months of final menstrual period. The end points will include prevention of progression of carotid intimal medial thickness and accrual of coronary calcium, but results will not be available for several years.

Sources: American Association of Clinical Endocrinologists, Press Release January 2, 2008, “AACE Analysis shows no excess cardiovascular risk from hormone replacement therapy for most patients”

Sue Hughes, January 7, 2008 Heartwire.

©2012 An Inconvenient Woman. All Rights Reserved.

His study consisted of 64 postmenopausal women ages 60 to 86 taking estrogen, and estrogen plus progesterone for periods of between one and 20 years. The study indicated that hearing loss is progressive. “The initial pilot data suggest that the longer a woman is on HRT, the worse the hearing loss gets.” Dr. Frisina conducted several tests and found that HRT affects both the inner ear and brain stem processing, in which a person can localize sound sources. “As we age, we lose that ability anyway.

However, it may be that HRT accelerates that loss.” Now Dr. Frisina and his colleagues are studying whether various HRT formulations are worse than others. They are also looking to see whether the hearing loss is permanent or reversible.

At the time, Dr. Frisina advised women who were planning to go on HRT to have their hearing tested beforehand and to follow up every six months; or, speak to a doctor about alternatives if they had already experienced a deterioration in hearing while on HRT.

The National Academy of Sciences (September 5, 2006) reported the results of the latest progestin linked hearing loss study. Of the124 postmenopausal women in the study, those taking hormone replacement therapy that included progestin had poorer speech understanding than women who were not taking hormones or who were using estrogen only.

Other researchers site studies that indicate subtle hearing differences during different phases of the menstrual cycle. *2/3/4/5

1) Robert D. Frisina,

Professor of Otolaryngology, Surgery, Neurobiology & Anatomy, and Biomedical Engineering

Area of Research: Neural Processing of Speech in Young and Aged, Effects of Hearing Loss and Deafness

Contact Information:

Robert_Frisina@urmc.rochester.edu

University of Rochester

School of Medicine and Dentistry

601 Elmwood Ave, Box 629

Rochester, New York 14642

Medical Center [1-5010]

Phone: (585) [275-8130]

Fax: (585) [271-8552]

2) Performance in a test demanding prefrontal functions is favored by early luteal phase progesterone: an electroencephalographic study

Solis-Ortiz S, Guevara MA, Corsi-Cabrera M Psychoneuroendocrinology; September 2004 (Vol. 29, Issue 8, Pages 1047-1057)

3) Effects of tibolone on auditory brainstem responses in postmenopausal women—a randomized, double-blind, placebo-controlled trial

Sator MO, Franz P, Egarter C, Gruber DM, Wölfl G, Nagele F

Fertility and Sterility November 1999 (Vol. 72, Issue 5, Pages 885-888)

4) Changes in Pure-Tone Thresholds and Temporary Threshold Shifts as a Function of Menstrual Cycle and Oral Contraceptives

Sara J. Swanson,Harold A. Dengerink;Washington State University

Journal of Speech and Hearing Research Vol.31 569-574 December 1988.© American Speech-Language-Hearing Association

5) Changes in Sensorimotor inhibition across the menstrual cycle: Implications for neuropsychiatric disorders

Neal R. Swerdlow, Corresponding Author, Department of Psychiatry, School of Medicine, University of California, San Diego, La Jolla, California, USA, Copyright © 1997 Published by Elsevier Inc.

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©2012 An Inconvenient Woman. All Rights Reserved.