Latest news with #hormones
Yahoo
4 days ago
- Health
- Yahoo
Are You Self-Sabotaging Your Hormone Therapy?
If you've been navigating the ups and downs of estrogen in midlife, you've probably heard the names: estradiol, estrone and estriol—the three main types of estrogen in the body. But new research is turning the spotlight onto another form of estrogen that may play a bigger role than previously thought—2-hydroxyestrone, sometimes referred to as a 'protective' estrogen. In a recent study published in Menopause: The Journal of The North American Menopause Society, researchers looked at how a naturally derived supplement called 3,3′-diindolylmethane (DIM), a compound found in vegetables like broccoli and Brussels sprouts, may help shift estrogen metabolism in a beneficial direction. Specifically, they found that DIM supplementation increased levels of 2-hydroxyestrone while reducing levels of 16α-hydroxyestrone, a form of estrogen some studies have linked to increased breast cancer risk. More from Flow Space Why Midlife Women Are More Likely to Experience This Painful GI Condition So what does this mean for your hormones, your health and your hot flashes? Here's what experts say you should know about DIM, 'good' estrogens and the future of hormone support in midlife and beyond. That 'Natural' Supplement Might Be Messing With Your Hormones DIM is a compound your body produces when you digest cruciferous vegetables like broccoli, kale and cabbage. It's been turned into a supplement and heavily promoted online as a way to 'detox' estrogen, clear hormonal acne or 'balance' hormones during perimenopause and menopause. But in supplement form, you're often getting much higher doses than you'd ever get from eating vegetables, and that can affect how your body processes hormones like estrogen. 'I like to say estrogen is a 'use it and lose it' hormone meaning you want to get the benefit of the estrogen, but you don't want it lingering in the body longer than it needs to because then it starts to accumulate and cause issues,' Dr. Stephanie Wallman, medical director at The Lanby, tells Flow Space. 'For menopausal women, who don't have much naturally cycling estrogen, there is not as much estrogen around and therefore do not require DIM to help move estrogen out of the body.' In other words, if you're using DIM during menopause, it may disrupt hormone balance rather than restore it, especially in women already dealing with fluctuating or low estrogen levels. And for women using hormone therapy, you may be undermining your own treatment without realizing it. That could explain sudden changes in how you feel—like hot flashes returning, mood dips or other symptoms flaring up again. Some experts also caution that while altering estrogen metabolism may reduce certain risks (like estrogen-sensitive cancer), the long-term effects of sustained DIM use—especially in high doses—haven't been well studied. 'Each woman is programmed through their genes and environmental factors to process (detoxify) estrogen differently,' says Wallman. 'If a woman is predisposed to hold on to estrogen more or to process it through a less desirable pathway, this will still happen during menopause.' Other Side Effects of DIM You've probably seen the promises: DIM will 'balance your hormones,' 'detox estrogen' and 'support healthy metabolism.' But what's actually happening under the surface is far more nuanced, and for women in midlife, it's worth a closer look. For starters, DIM doesn't remove toxins. 'Detoxify sounds appealing, but it's not a scientific term here,' Dr. Neha Pathak, chief physician editor at WebMD, tells Flow Space. 'DIM doesn't remove anything from the body, it just changes how estrogen is broken down.' That might be helpful in some cases, but it's not inherently good or bad; it depends on your body, your symptoms and your overall hormonal profile. When estrogen is metabolized, it can take different 'routes' in the body. Some metabolites—like 2-hydroxyestrone—are considered gentler and possibly protective, while others—like 16α-hydroxyestrone—may be more active or linked to cancer risk. DIM pushes metabolism toward the former. But experts caution that we don't fully understand what those changes mean in the long run. 'It's more complex than just 'good' or 'bad' estrogen,' says Pathak. 'We still have a lot to learn about what these changes really mean for long-term health.' Another gray area? Cancer prevention. While some studies suggest that certain estrogen breakdown patterns are associated with a lower risk of breast cancer, there's no strong evidence that taking DIM as a supplement will actually reduce your risk. 'That's still a big question mark,' says Pathak. 'We don't know if trying to manipulate estrogen metabolism in this way leads to better outcomes.' Talk to Your Doctor Before Mixing Supplements with Hormone Therapy Many women start taking DIM often without realizing it could impact their hormones in significant ways. And many never bring it up with their doctor. But that silence can be risky, even if you're not on hormone therapy. 'DIM works very well and has become very popular among supplements that women try on their own,' says Wallman. 'But it can also cause side effects that are not so obviously tied to taking DIM, so I certainly recommend that doctors understand what DIM is—and what you can expect to happen when someone starts using it.' The issue is that DIM doesn't behave like a harmless vitamin. It influences how your body breaks down estrogen, sometimes shifting the balance of estrogen metabolites in unpredictable ways. That might be helpful in some situations, but it could also affect mood, sleep or energy levels, and even change how other medications or hormone therapies work. 'In my practice, no one walks out without me knowing everything about their hormones, so I'm certainly asking about DIM,' says Wallman. 'But many practitioners are not—and they should be.' Before adding anything new to your wellness regimen, talk to your healthcare provider, ideally someone who's experienced with menopause, perimenopause or hormone health. The goal isn't just to get a green light, it's to make sure the supplement actually makes sense for your body, your symptoms and your treatment plan. Pathak, suggests bringing a few key questions to your appointment: Do I really need this? Could it affect other medications or supplements I'm taking? Can I get similar benefits from diet instead? How will we track if it's helping—or doing more harm than good? Because while DIM may support healthy hormone metabolism in certain situations, it's not a one-size-fits-all solution. Your needs in midlife are unique—and so is your hormonal landscape.
Yahoo
4 days ago
- Health
- Yahoo
My Neck Was Aging Faster Than My Face. Here's What I Did to Slow the Process Down
Who doesn't want to hear the words, 'You have beautiful skin'? I'd certainly longed to think that way about myself since my pre-teens when my hormones went haywire and my face paid the price. I can remember the first confidence-busting blemish. Sometime between when I headed to middle school one morning and departed that afternoon, a microscopic zit had groundswelled into a bump the size of a pencil eraser. With a dance just hours away, I did what any other teen might do; descended into my friends' basement bathroom and gouged at the eyesore. That moment would begin my obsession with my skin, with no pimple surviving my close inspection under a magnifying mirror. As I evolved from college student to beauty reporter/writer/editor, I even had one on my office desk (and believe me, I extracted a few things while sitting at it after hours writing about celebrity skincare routines) until the pandemic forced me to work from my couch. Then, like many people, I actually found comfort in a consistent routine. But let's be real, I also grew older, and I presume I won the battle with my hormones. However, age has brought forth new unflattering issues. Yes, from my forehead to my neck, my skin is pristine: even and smooth, and glows like no other, I'm told. But, when I began to notice lines along my neck, that teenage panic set in again. Like any beauty editor would, I assessed my regimen, and raided my medicine cabinet. I'd already been in the habit of drawing my skincare down to my neck, but now I reached for neck-specific products, hoping something would soften the look of these newfound lines. Nothing worked. Next: I called my dermatologist, Dr. Anna Karp, who I like to think of as part doctor, part therapist. (She reminds me that even babies have other smile lines among other helpful things.) In spring 2025, I sat in her chair to discuss my new area of concern, and it turns out my timing was impeccable. In October 2024, Allergan Aesthetics scored a major FDA approval milestone when the company's Botox Cosmetic injectable became the first and only one approved for the use in the jaw and neck to temporarily improve the look of platysma muscle (otherwise known as the vertical lines that run from the jaw to the neck) in adults. When Dr. Karp explained the development to me, I felt so seen. I am not alone. Dr. Karp says there's an uptick in curiosity, noting that more patients 'are interested in this 'Nefertiti lift,' which uses Botox Cosmetic along the lower jaw and platysma muscle to soften the vertical bands.' She posits this is likely the result of factors such as tech neck. That struck a chord with me. Though I have covered beauty, and as a result slathered lotions and potions all over my face, ahem, more than 15 years, the end result of testing was writing endless reviews while hunched over a laptop much like I am now. Another factor was something I have labeled 'Zoom scrutiny,' ie: the effect of watching, nay, analyzing your own face on screen during meetings. Never miss a story — sign up for to stay up-to-date on the best of what PEOPLE has to offer, from celebrity news to compelling human interest stories. Dr. Karp made me make an 'eek' face. It reminded me of when a general practitioner makes you say, 'ahh.' This way, she said, she could get a closer look at how my neck contracts. She then explained I'd be a good candidate for Botox Cosmetic in the platysma because I showed early signs of skin laxity and some dynamic movement of the platysma muscle contributing to lower face heaviness. While my bands had not entered moderate territory (those with moderate to severe bands are ideal candidates, she says), Dr. Karp added I'd still be a good candidate to try the cosmetic treatment because in addition to helping soften neck bands, treating the platysma with Botox Cosmetic can also help improve the contour of the jawline, and create a more lifted, youthful appearance in the lower face. 'The goal is a smoother, more elegant neck and enhanced definition along the jaw,' she affirmed. Like any fabulous doctor would (visit to find a trained provider; prices vary by provider), Dr. Karp also explained what the treatment would not do. For instance, I also have horizontal lines, which this would not improve. Additionally, it would not tighten skin. I live my life by a tight schedule, so I asked about a timeline. She said it was possible I could see results in as little as a couple of days, with full results visible at about the two week mark. Results from the temporary treatment could last for up to four months. Dr. Karp then presented the bottle of Botox Cosmetic for my treatment. Like all new bottles, it contained 100 units (a standardized measurement) of the neurotoxin. She injected 16 units in my jawline and 20 units in my neck, a typical amount for treating platysma bands, she explained. is now available in the Apple App Store! Download it now for the most binge-worthy celeb content, exclusive video clips, astrology updates and more! I promise, it didn't hurt. It felt more like a quick pinch than anything else. And it was over in what felt like a minute. Now I had to wait — and see. A few days passed. And a few more. And at first I wasn't sure if I could notice a difference, and then I kind of forgot I'd done anything at all. It was different than when you get a facial and have that instantly gratifying sculpted silhouette (which only lasts a few hours, I might add). At times, I'd spot myself talking and think my neck appeared smoother, but, was it really? Then, exactly three weeks to the day that I had the treatment, I sat with two very discerning friends at dinner and one said, 'Your skin always looks this great, but what did you do to your…' As her finger drew a virtual circle around my neck, I exclaimed, 'I got Botox!' and told them both about the experience. Then, I asked what specifically they noticed, to which one replied, 'the area just looks more…snatched.' And with that I called Dr. Karp's office and booked my next appointment. Read the original article on People
Yahoo
7 days ago
- Health
- Yahoo
A Guide to the Newest Innovations in Midlife Hair Thinning Treatments, From Red Light Therapy to PRP
I've never had an abundance of hair, so seeing it get thinner in the past 10 years has been fairly depressing. I attributed breakage to weekly blowouts, but post-Covid and post-office life, I'm no longer paying for those high-heat, hair-pulling salon sessions. My hair still isn't getting any thicker or healthier. Talking to girlfriends my age, I have come to accept that hair shedding is a common hair condition to develop in menopause. I've also decided to take some action. I'm fortunate that I don't have Androgenetic Alopecia, which is severe hair loss, so I don't need anything drastic (yet). But like many of us, I am not sitting on a pile of money, so I can't throw thousands of dollars at my thin hair, either. I'm going easy first—but there are lots of interesting innovations in hair restoration to explore. Why Does Hair Thin in Midlife? When talking about what causes menopausal hair loss, the simple answer is fluctuating hormones. It's the same thing that everyone tells postpartum women: Your hormones are going crazy, so your hair is going to fall out more rapidly. In menopause and perimenopause, it's the natural dip in progesterone that can especially mess with your tresses. Other factors might also hit hard in midlife. 'Individuals face hair loss due to medical treatments, stress or illness in addition to hormonal shifts,' says Jennifer Donovan, owner of Le Shag salon in Kingston, NY, which has a dedicated program for hair restoration. 'Post-COVID, many clients have reported unexpected hair concerns—from thinning to changes in texture—often linked to heightened stress or long-term effects of illness.' Experts also point to diet, so critical to hair growth. We could eat chips and drink cocktails in our youth without beauty consequences, but not anymore. Jay Smalls, a Los Angeles-based trichologist (a healthcare professional who specializes in hair and scalp health), has his clients cut down or give up on processed food, alcohol and smoking as the first step to combating hair loss. 'Our bodies don't need hair as a core biological component. We just want hair!' says Smalls, whose company, sells products for aging hair, and he sees clients individually as well. If our diets lack diversity by the time we hit middle age, Smalls says, our bodies de-prioritize hair growth. Why is Hair Loss Treatment Having Such a Moment? 'People are taking better care of themselves now with so much information being made available. You also have celebrities who are willing to talk about their hair loss issues,' says Ashley Person, a hair stylist in New York City who works with many women (and celebs) over 40. 'I believe women are more comfortable because fewer people are keeping it a secret.' (See: Ashley Tisdale and her alopecia, for example.) There are a ton of remedies available, so to keep this simple, I'll go from the easiest and least-expensive options to the most invasive, expensive — and innovative — medical procedures. This isn't even an exhaustive list of all you can do, just an overview! Step One: Reduce Stress Why it works: Stress can push hair growth into a resting phase, and if stress continues, hair might fall out, as described by the National Institutes of Health. Cost: You can tackle stress for free. 'If you have no money, . Your cortisol levels are the biggest culprit of future hair loss,' says Smalls. Pro: Banishing stress helps you sleep and eat better, too. Con: Easier said than done, right? No one can magically change the outside stressors in life. But you can be in charge of how you react to them. Step Two: Eat Better and Consider Supplements Why it works: Your body needs a rich array of nutrients and protein to make hair. A Mediterranean diet, as described in our authoritative guide to thinning hair, is among the best for midlife. Experts also point to supplements to give hair added nutrients. And then: 'Water water water!' says Donovan. 'Hydration is key.' Cost: Your food costs might change as you buy lean meat, fruit and vegetables, but eating better doesn't need to break your budget. What might add to your monthly outlay are supplements. I'm currently on Nutrafol (winner of 'best supplement for healthy hair' in our annual Flow Space Wellness Awards) and that's costing about $75 a month through three-month deliveries. Pro: We all know that most people look better when they eat better. Con: Theoretically, eating clean should be easy. But it's hard to be disciplined when others are having burgers and fries. It's also tough to make switches when you really like sugar (like me) or your life regularly includes alcohol. Neither of those are great for hair. Step Three: Protect and Nurture Your Scalp—And Reconsider Hair Dying Why it works: We obsess about the skin on our face, yet the skin on our scalp is right there too, and takes more of a beating because it directly faces the sun and harmful UV rays. It also takes the brunt of salon treatments, like hair dye. The scalp can not proliferate hair, Smalls says, if it's always working hard to repair itself. 'The scalp ages six times faster than the skin on our face,' Smalls says. 'We scratch our scalp. We don't use sun protection. And if you start dying your hair at 30, in 10 years, at age 40, you'll start to see the results of all of that chemical exposure. Whatever you did five years ago is still showing in your hair now.' (Gulp.) Cost: It doesn't cost much to wear a hat or other hair covering when you're in the sun. And you save money if you stop highlights and hair dye, though those are hard beauty habits to give up. (Talk to your stylist. I have a friend who embraced her natural gray and it looks stunningly beautiful! But I have yet to give up my highlights so I'm not one to talk.) Topical scalp medications, like Minoxidil, are another way to go and have been around for years. You can buy an Amazon Minozidil Treatment for $25; the online reviews are mixed but mostly positive. can help and good ones cost in the ballpark of $50 a month. In our Wellness Awards, many experts recommended Davines Naturaltech Energizing Superactive Treatment, and I am trying it now (it tingles in a good way). Smalls sells a serum called To the Root that aims to neutralize free radicals from sun exposure and deliver antioxidants to encourage growth. There are also scalp spas. Person turned me on to RejuvaScalp which targets dermatitis, psoriasis, and other scalp conditions through deep-cleaning and massage stimulation. Pro: Protecting our scalp is smart, and serums are cheaper than hair coloring treatments. Con: Many of us, myself included, are addicted to our highlights. Growing them out is a commitment. Step Four: Try Hormone Replacement Therapy Why it works: The loss of estrogen and progesterone as we age has a profound effect on hair. Talk to your primary-care doctor or your ob/gyn about whether hormone replacement therapy (HRT) or menopause hormone therapy (MHT) might be right for you. 'If you can start low-level HRT earlier rather than later, you'll notice changes,' Smalls says. I have found it to be true; my hair has gotten noticeably better one year into HRT. Cost: It depends on what your doctor prescribes and what insurance covers. I'm on an estrogen patch and progesterone pills, and even with my insurance, I probably pay $100 a month. But I have friends whose insurance covers everything. Pro: Replacing lost hormones through medicine can have benefits beyond helping your hair. I have more energy and sleep better on HRT, and the skin on my face looks healthier. Con: Not everyone likes the idea of ingesting hormones. And while my ob/gyn is a huge proponent, my primary care doctor wants me to only stay on HRT for five years. Step Five: Consider a Hair Topper or Extensions Why it works: Anything mentioned up until now will show positive results over time. But clipping in a hair topper or something like a fake ponytail can provide immediate gratification. There are also elaborate ways to weave in extensions. 'As part of my salon's advanced offerings we have a stylist trained in the InvisaBlend system,' Donovan says. 'With that, we feed individual human hairs into existing thinning areas. This allows the client's own hair to grow while adding density. It's a breathable system that allows all serums and topical treatments to fully reach the scalp for better hair growth.' Cost: Adding fake hair or human-hair extensions can cost a little or a heck of a lot, depending on what you're looking at. I went down a rabbit hole of trying to price the ones that look super natural and the services are a minimum of a thousand dollars, and often more, plus you need maintenance. Pro: I can't get enough of the Cinderella stories behind these. Check out @thelaurenashtyncollection (out of South Carolina) or @hairdreaming (out of LA). The before and afters are both compelling and demystifying! Step Six: Red Light Therapy or Medical Treatments Why it works: With low-level red light therapy, or a medical treatment like platelet-rich plasma therapy (PRP — and also nicknamed the 'vampire facial'), you're taking bigger steps to stimulate blood circulation and hair growth. Low-level red-light therapy is the less drastic measure. We've reviewed plenty of red-light panels for your face and also a red light therapy hat for hair growth. The good tools get expensive, and results take time — the hat is to be used for 10 minutes a day for 16 weeks, and then three or four times a week forever after that. PRP is more intense. It involves a blood draw, a centrifuge, and injecting active stem cells into your scalp. Johns Hopkins describes how it can be used for things like injuries and wound healing in addition to male-patterned baldness. But women try it, too, including, apparently, Gwyneth Paltrow. Cost: According to Smalls, red-light therapy devices can cost anywhere from $30 to $500, but the cheap stuff might not be legit or useful. PRP or any medical treatment can — or certainly should — run you thousands of dollars. If someone is offering it on the cheap, beware, says Smalls. 'You need to do it with a trusted provider. I compare it to Botox. It's something you'd only want to get from a really trusted medical professional,' Smalls says. More from Flow Space FDA Experts Call for Rethink on Menopause Hormone Therapy Warnings
Medscape
18-07-2025
- Health
- Medscape
Androgen Excess? New Guidelines Shift Focus Beyond Just PCOS
The Society for Endocrinology, a UK-based organization representing a global community of scientists and clinicians working with hormones, has published updated guidelines for diagnosing and managing androgen excess in women. The new recommendations provide a practical, evidence-based framework, emphasizing early identification and treatment tailored to the underlying etiology. Unlike some national protocols that focus primarily on polycystic ovary syndrome (PCOS) — the most common cause of hyperandrogenism — these guidelines cover a broader spectrum of causes, offering a more comprehensive clinical approach. Early detection remains crucial, as certain effects of androgen excess — such as voice deepening, clitoromegaly, and androgenic alopecia — may be irreversible if left untreated. The guidelines define total testosterone levels above 86 ng/dL or free testosterone levels above 3.2 ng/dL as suggestive of hyperandrogenism. They also highlighted the importance of using accurate and standardized testing methods, cautioning that both under- and overdiagnosis can result from laboratory variability. To improve diagnostic reliability, the Society for Endocrinology recommends liquid chromatography-tandem mass spectrometry (LC-MS/MS) over immunoassays, citing its superior specificity and sensitivity, particularly at the low hormone concentrations typically observed in women. Proper sample preparation is also critical. Recommendations include fasting for at least 8 hours, collecting blood samples in the early morning between days 3 and 5 of the menstrual cycle, and discontinuing hormonal contraceptives for 6 to 8 weeks prior to testing. Given the high variability between labs, Karen de Marca Seidel, MD, director of the Brazilian Society of Endocrinology and Metabolism, highlighted the importance of this preparation in an interview with Medscape's Portuguese edition. Speaking to Medscape's Portuguese edition , Elaine Frade, PhD, head of the Department of Female Endocrinology, Andrology, and Transgender Health at the Brazilian Society of Endocrinology and Metabolism, noted that while LC-MS/MS is the gold standard, its availability is still limited in many countries, including Brazil, due to high costs and limited insurance coverage. As a result, many laboratories only offer LC-MS/MS testing after a preliminary abnormal result on conventional immunoassays. Causes and Treatment 'The etiological investigation should be prompt and accurate, as treatment depends on the underlying cause. Symptoms can also have a significant psychosocial impact and may, in some cases, leave permanent effects,' Frade said. Androgen excess in women may stem from a range of causes — most commonly ovarian or adrenal in origin, but also from exogenous androgen use or, more rarely, disorders of sexual development. Ovarian causes include PCOS, ovarian hyperthecosis, and androgen-secreting tumors. Adrenal causes include congenital adrenal hyperplasia and adrenal tumors. Given its high global prevalence, PCOS should be the initial diagnostic consideration. According to the widely accepted Rotterdam criteria, diagnosis requires at least two of the following: oligo- or anovulation, clinical or biochemical signs of hyperandrogenism, and polycystic ovarian morphology on ultrasound. Frade noted that many women with PCOS also present with overweight or obesity and varying degrees of insulin resistance. Treatment for PCOS generally involves both pharmacologic and lifestyle interventions. These may include combined oral contraceptives, weight reduction, and regular physical activity. In cases where symptoms persist, antiandrogens may be introduced. 'The choice of contraceptive depends on the predominant symptoms and the patient's individual response. A progestin can be selected based on its targeted effect,' Frade explained. Seidel noted that in Brazil, commonly used therapeutic agents include spironolactone, metformin, and cyproterone acetate. The latter, a synthetic progestin with antiandrogenic properties, is not widely available in all countries but remains an option in selected cases. Ovarian hyperthecosis, characterized by diffuse hyperplasia of the theca cells leading to sustained androgen production, is more frequently diagnosed in postmenopausal women. In such cases, bilateral oophorectomy is often the preferred management. For younger patients, conservative treatment using oral contraceptives and antiandrogens may be a viable option. Androgen-secreting ovarian tumors should be considered in cases with abrupt symptom onset, rapid progression, and pronounced signs of virilization, such as increased muscle mass and voice deepening. In these patients, serum testosterone levels often exceed 5 nmol/L, and transvaginal ultrasound is warranted for further evaluation. Among adrenal causes, nonclassic congenital adrenal hyperplasia is particularly noteworthy. Estimated to affect approximately 1% of women, this genetic condition can present with subtle symptoms and minimal virilization. A thorough family history should be taken. Screening includes measuring 17-hydroxyprogesterone during the follicular phase, with adrenocorticotropic hormone stimulation testing in ambiguous cases. Low-dose glucocorticoid therapy is typically reserved for symptomatic women seeking pregnancy or those who do not respond adequately to hormonal contraceptives. Adrenal tumors that produce androgens usually lead to elevated dehydroepiandrosterone sulfate levels. Diagnostic workup should include imaging studies such as abdominal CT or MRI. Treatment is surgical, with mitotane or chemotherapy considered in malignant cases. Seidel acknowledged that diagnosis is not always straightforward. 'In major hospitals or referral centers, comprehensive investigations are feasible. But in the private sector, the quality of the workup often depends on the physician's expertise and the patient's ability to access additional testing,' she said. When clinical findings do not align with classic etiologies of hyperandrogenism, exogenous androgen use must be considered — even if patients do not readily disclose it. According to Seidel, this may now be one of the most common, yet underrecognized, causes of androgen excess in women in Brazil. Potential sources include hormone implants containing testosterone or gestrinone, anabolic steroids used for aesthetic purposes, or off-label hormone replacement therapies during menopause. Due to limited regulation and scarce reliable information about these products, many patients are unaware they are being exposed to androgens. Seidel noted that many present with clinical signs of androgen excess without realizing they are taking androgens. In this context, Frade emphasized a critical point: 'There is no minimum testosterone threshold below which hormone replacement is indicated in women.' She stressed that the concept of 'female androgen deficiency' lacks strong scientific validation and should not be used to justify hormone supplementation. Frade also highlighted that managing hyperandrogenism can be complex. Treatment typically requires long-term follow-up, and patients may have unrealistic expectations regarding the reversal of physical signs. 'It's essential to establish a clear and realistic treatment plan from the start. Even with effective management of the underlying cause, some clinical manifestations may be permanent or show only limited improvement,' she said.
Reuters
09-07-2025
- Health
- Reuters
Health Rounds: Experimental Bayer drug eases menopause-like symptoms from breast cancer therapy
July 9 (Reuters) - (This is an excerpt of the Health Rounds newsletter, where we present latest medical studies on Tuesdays and Thursdays. To receive the full newsletter in your inbox for free sign up here.) The hot flashes and night sweats that plague breast cancer survivors during years-long hormone-suppressing therapy are eased by an experimental non-hormonal drug being developed by Bayer ( opens new tab, according to results from a late-stage trial. The participants in the trial – similar to two-thirds of breast cancer patients overall - had tumors that use the hormones estrogen and progesterone to grow. The goal of so-called endocrine therapy is to block those hormones, which reproduces the uncomfortable menopause symptoms. The most effective way to relieve these symptoms in healthy women is to replace the hormones, which is not feasible when tumors use the hormones to grow. In a year-long trial involving 474 breast cancer patients experiencing daily hot flashes due to hormone-suppressing therapy, 316 received Bayer's elinzanetant and 158 received a placebo. Within three months, more than 70% of those on elinzanetant reported at least a 50% reduction in moderate-to-severe hot flashes, compared to about 36% of the placebo group, the researchers reported at a recent meeting of cancer doctors and in The New England Journal of Medicine, opens new tab. The Bayer drug also significantly improved sleep quality and menopausal quality of life by week 12. 'It is important to treat vasomotor symptoms because they can negatively impact quality of life and lead to women prematurely stopping their breast cancer treatment,' said study leader Dr. Fatima Cardoso of the Champalimaud Clinical Center in Lisbon. Elinzanetant belongs to a new class of drugs called neurokinin receptor antagonists that target the neurobiological mechanisms in the brain involved in hot flashes and night sweats. The U.S. Food and Drug Administration recently approved an Astellas Pharma (4503.T), opens new tab drug from the class under the brand name Vezoah for easing symptoms of menopause. It is not approved for treating breast cancer patients, so that use would be off-label, the study authors noted. Doctors can prescribe any approved medicine as they see fit, but companies can only promote them for approved uses. An editorial, opens new tab published with the study notes that up to 90% of women with early breast cancer treated with endocrine therapy experience hot flashes and other vasomotor symptoms, which may impact their survival if the symptoms lead them to quit taking the medications. In one large study of breast cancer survivors, half the participants reported non-adherence to endocrine therapy, the editorial says. Bayer is awaiting approval of elinzanetant from the FDA and the European Medicines Agency. Cases of type 1 diabetes caused by cancer immunotherapy drugs can be controlled – and even reversed – by treatment with already approved medicines for autoimmune conditions like psoriasis and rheumatoid arthritis, laboratory studies suggest. Type 1 diabetes, in which the body mistakenly attacks and destroys insulin-producing cells in the pancreas, occurs in 1% to 2% of patients receiving immunotherapies known as checkpoint inhibitors, such as Merck's (MRK.N), opens new tab Keytruda and Bristol Myers Squibb's (BMY.N), opens new tab Opdivo. The condition is often permanent, requiring insulin therapy for life. With the increased use of the blockbuster cancer drugs, 'preventing long-term autoimmune damage is becoming a critical part of survivorship care,' study leader Dr. Melissa Lechner of the David Geffen School of Medicine at UCLA said in a statement. 'This is one of the first times we've found a way to intervene in these toxicities in a meaningful way,' she added. Her team identified a new group of immune cells called CD4+ T follicular helper cells, or Tfh cells, which produce signaling molecules called IL-21 and IFN-gamma that fuel the immune attack on the pancreas. In experiments in mice, the researchers found that a class of drugs known as JAK inhibitors, which block the IL-21 and IFN-gamma pathways, not only blocked the effects of the two signaling molecules but also reduced the number of Tfh cells and, in some cases, restored normal blood sugar levels. The results were reported in JCI Insight, opens new tab. Available JAK inhibitors include Pfizer's (PFE.N), opens new tab Xeljanz, Rinvoq from AbbVie (ABBV.N), opens new tab and Eli Lilly's (LLY.N), opens new tab Olumiant. 'This is the first study to identify Tfh cells and the IL-21/IFN-gamma pathway as key drivers of checkpoint inhibitor–induced type 1 diabetes,' said Lechner. 'Importantly, we show that this pathway can be therapeutically targeted with a drug that is already FDA-approved and widely available without weakening the immune system's ability to fight cancer.' (To receive the full newsletter in your inbox for free sign up here)
