Bleeding irregularities common in menopause – Study
Extended and heavy menstrual bleeding during menopause is common, according to a new study.
“For most women in their 30s, menstrual periods are highly predictable. With the onset of the menopausal transition in their 40s, women’s menstrual periods can change dramatically,” study author Sioban Harlow, a University of Michigan professor of epidemiology, said in a university news release.
“These dramatic changes can be disconcerting, and often provoke questions about whether something is wrong,” she added.
The findings should reassure women who worry about what is and isn’t normal, she said.
When a woman’s ovaries stop producing the hormones estrogen and progesterone, she enters menopause. This life stage can last anywhere from two to 10 years, the researchers said. Menopause usually occurs after age 45.
“Women need more descriptive information about the bleeding changes they can expect. We need clear guidance to help women understand what changes in bleeding patterns do and do not require medical attention,” she added.
The researchers looked at 1,300 American women, aged 42 to 52. They found that 91 percent had experienced bleeding for 10 or more days, 88 percent reported spotting for six or more days, and more than three-quarters had heavy bleeding for three or more days during menopause.
More than one-third of the women had as many as three episodes of 10-plus days of bleeding over six months, according to the study published April 15 in BJOG: An International Journal of Obstetrics and Gynaecology.
The women in the study -from Michigan, Los Angeles and northern California -- were white, black, Chinese and Japanese. Previous studies have been mostly limited to white women, the investigators noted.
They said further research is required before their results could be used to change patient care.
Still, one expert welcomed the study. “We think this paper will be helpful to professionals, both clinical and investigational, as it describes in much more quantitative terms the range of bleeding patterns women may normally experience through the menopausal transition,” Dr. John Randolph Jr., a U-M professor of obstetrics and gynecology, said in the news release.
The findings might reassure some doctors that “watchful waiting is an acceptable option” when women patients report changes in bleeding patterns, Randolph added. are mostly intended for patients who already have cancer, and not preventively.”
Because each cancer type is unique and typically requires a different vaccine, “a preventive approach would require dozens of different vaccines to be given to cover all cancer types,” he explained.
The treatment under study aims to enlist so-called “dendritic” cells in the immune system, according to the study, published in the April 16 issue of Science Translational Medicine.
“Dendritic cells are the sentinels of our immune system,” said study co-author Tibor Keler, chief scientific officer at Celldex Therapeutics Inc., which funded the study. They sense invaders in the body and alert other parts of the immune system about how to fight them, Keler explained.
The new treatment works by alerting the alerters: It lets the dendritic cells know that danger is nearby. Mittendorf said the treatment acts a bit like a spark plug when it kick-starts the immune system.
The dendritic cells then essentially put up signs to let other cells know which Healthday: © 2013 HealthDay. All rights reserved. Distributed by The New York Times Syndicate. invaders to look out for and how to handle them, she said.
In the new Phase I study, researchers tested the injection treatment in 45 patients with advanced cancer who weren’t responding to medication. Studies at this stage are designed to explore side effects and dosages of medications.
“The treatment was welltolerated at all dose levels,” Keler said. The only side effects were irritation and reddening at the site of the injection.
Keler said the treatment could potentially be used with other medications that enlist the immune system to fight cancer, but only in patients whose tumors have a specific kind of protein. “It’s present in about 30 percent of melanoma cases and in a smaller percentage of various other cancer types,” Keler said. But the treatment could be expanded to treat other kinds of cancer, he said.
The cost, Overwijk said, “will be completely determined by marketing and management of whoever might manufacture this drug.” Making the drug itself won’t be unusually costly, he added.
What’s next? For now, “we are planning additional trials with our vaccine, focusing on combinations with other immunotherapy that may lead to significant clinical benefit,” Keler said. Healthday: © 2013 HealthDay. All rights reserved. Distributed by The New York Times Syndicate.