Bone Loss, Osteoporosis, Depression, Menopause & Tai Chi
Emerging medical research indicates that an ancient health therapy may be the prescription for the future. Increasingly the menopausal problems of hormonal imbalance, often resulting in bone loss, are also affected by depression and stress. Change is stressful for all of us, even good changes, like changes of life. Maturity is a good thing, yet the stress of major life changes can result in stress and depression, which according to emerging research may further aggravate the uncomfortable symptoms of menopause. Is there any escape from this catch-22? Yes, although this may seem overwhelming in its scope, there may be great news. An ancient Chinese natural health therapy, known as Tai Chi, may help alleviate many of the aggravating symptoms of menopause in profoundly healthful ways.
Of course only your physician can help you decide what is right for your personal therapy as you enter the menopausal transition. However, you may find that you need to educate your physician regarding the benefits Tai Chi may offer you at this important time in your life. Or, perhaps if you ask around you may find a physician who has already educated himself or herself about the benefits Tai Chi may offer all women, but definitely has much to offer women entering menopause.
Emerging research indicates that Tai Chi can help reduce the incidence of depression, anxiety, and mood disturbance in regular practitioners. In a Prevention Magazine report entitled, “Tai Chi May Relieve Anxiety and Depression,” Donal P. O’Mathuna, Ph.D., a lecturer in Health Care Ethics at the School of Nursing in Dublin City University, Ireland says that, “. . . . evidence there is suggests that the benefits of tai chi extend beyond those of simply exercising. The combination of exercise, meditation, and breathing all may help relieve anxiety and depression. . .” In its article entitled, “Tai chi,” the Mayo Clinic staff at MayoClinic.com stated that preliminary research shows that practicing Tai Chi regularly may not only reduce anxiety and depression, but also increase bone mineral density after menopause. This was echoed by a report in http://www.intelihealth.com by Natural Standard and the Faculty of Harvard Medical School.
This is a very important finding, and begins to make even more sense, when you consider the National Institutes of Mental Health reports that the stress hormones found in depressed women caused bone loss that gave them bones of women nearly twice their age. Exactly why Tai Chi offers such benefit may be explained by a study from Australia’s La Trobe University that found that Tai Chi reduced levels of stress hormones more effectively than some other forms of activity. (Details at: www.seniornet.org/php/default.php?PageID=6055).
But, no matter how you slice it, research is indicating that Tai Chi may be a “very” effective multi-level beneficial therapy for women. A Chinese study reported in the December 2004 “Physician and Sportsmedicine” found that tai chi could retard bone loss among postmenopausal women significantly. Bone mineral density was measured before and after the study period. Both groups experienced general bone loss, but the rate of bone loss for the Tai Chi group was less than in the control group. In fact, the Tai Chi practicing group of women slowed bone loss by 2.6 to 3.6 times more. The study reported, “Bone loss was 2.6 to 3.6 times slower (p
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Shifting Paradigms In Hormonal Therapy Of Breast Cancer
Until recently tamoxifen occupied the central stage in adjuvant (post operative) hormonal treatment of breast cancer. Tamoxifen has been the unchallenged hormonal therapy of choice for adjuvant treatment of early stage breast cancer for over two decades.
Things have changed now. A new group of hormonal drugs that has been introduced few years ago has almost replaced tamoxifen as the treatment of choice for early stage breast cancer. This new group of drugs known as aromatase inhibitors has been shown to be more effective than tamoxifen over and over again.
This new group of drugs however is not effective in premneopausal women who have been diagnosed with breast cancer. Tamoxifen still remains the hormonal treatment of choice for women with breast cancer who have hormone receptor positive early stage breast cancer.
This new group of drugs known as aromatase inhibitors acts by inhibiting an enzyme called aromatase, which is responsible for production of small amounts of estrogen in post-menopausal women. Estrogen production from the ovaries in premneopausal women is not depended on aromatase hormone, and that is the reason why this drug is not effective in premneopausal women.
Three drugs belonging to the group of aromatase inhibitors are currently FDA approved and available for treatment of breast cancer. These drugs are anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin). All these are active drugs are generally considered to be equally effective.
Aromatase inhibitors may be useful even if a woman has already been started on tamoxifen. Aromatase inhibitors can be taken for five years after completion of five years of tamoxifen. A clinical trial (MA-17) has shown that if Femara is taken for another extra five years after completion of five years of treatment with tamoxifen, this would result in improved outcome. Other trials (ABCSG trial, ARNO trial 95, and ITA trial) have shown that it is beneficial to switch from tamoxifen to aromatase inhibitors after two to three years of treatment with tamoxifen.
Aromatase inhibitors have already shown to be superior to tamoxifen in the treatment of hormone receptor positive metastatic (cancer that has spread to distant organs) breast cancer. In this situation Femara is currently the drug of choice and tamoxifen have moved to second or third position as an option for hormonal therapy.
One thing is clear. The very foundation of tamoxifen as the hormonal treatment of choice is shaking and the aromatase inhibitors are here to stay.
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