It’s time for my curated women’s health updates, and there’s plenty to share this March. Let’s go!
Menopause and neuroscience.
70% of women experience neurological symptoms during the menopausal transition, and while historically menopause was associated only with the ovaries, it’s now understood that symptoms such as hot flashes, forgetfulness, mood changes, and insomnia are all neurological symptoms, writes The Guardian.
While very few brain studies look at menopause, interest in the topic has been surging lately.
The 2021 study led by Lisa Mosconi, the largest examination of the menopausal brain to date, showed substantial differences in brain structure across the menopause stages. Critically, many of these changes are temporary, and the brain tries to compensate for these changes through increased blood flow and energy production.
Other studies found an association between frequent hot flashes and an increased likelihood of having Alzheimer’s disease biomarkers and that the first signs of the brain disorder can appear at about the same time women start menopause, suggesting the hormonal event might have implications for disease risk.
There was a bunch of news around menopause, so I’m listing them right here as well:
- On February 28th, researchers from University College London pooled the data from 22 studies and concluded that talking therapies such as CBT and mindfulness-based interventions (MBI) could help with physical menopause symptoms, like hot flashes.
- March 5th, It’s time to stop treating menopause like a disease, according to Lancet: The article calls for a reframing of menopause and a management approach that is not simply focused on medical interventions that relieve symptoms.
- On March 22nd, the recent Nature study on whales may show the evolutionary nature of menopause (which presents itself in very few biological species). Just as in humans, menopause in toothed whales evolved by selection to increase their total lifespan without also extending their reproductive lifespan. This could provide insights for our understanding of the evolution of menopause in general.
While the studies have their limitations, it’s important to see the surge of research interest around the topic.
PMS
On March 5th, Flo Health Inc. shared the results of their RCT demonstrating the effectiveness of the Flo app in improving PMS symptom management. In 3 months, the use of Flo significantly reduced symptom burden and decreased the number of absent days from work (the study results were accepted for publication at JMIR).
Addressing PMS has the potential to contribute $115 billion to the global economy. But, as of 2015, the number of scientific studies about erectile dysfunction exceeded that of premenstrual syndrome by 5x.
A reminder: in January 2024, Flo published their research in Nature NPJ Mental Health, exploring the effects of acute stress on pain perception among women during the Russia-Ukraine conflict (based on de-identified data from over 88k Flo users in Ukraine). Higher stress levels were linked to lower pain sensitivity. See here for more.
IUD for fertility
This month, I was fortunate to visit the Montpellier regional development agency, AD’OCC Invest in Occitanie, thanks to Angélique CACHEUX, and read and learn more about the local startup scene, including its digital health potential. In a local magazine (practicing my French), I noticed an article about Womed, a startup developing the first fertility-oriented IUD (intrauterine device). The device is CE-marked and, in 2021, has already demonstrated its safety and efficiency in a trial of 23 patients.
Apparently, on March 7, 2023, Womed announced that the results of the PREG2 clinical trial demonstrated Womed Leaf® is effective in the management of severe and moderate intrauterine adhesions (IUAs), the primary mechanical cause of female infertility. At the 6-week follow-up visit, women who received Womed Leaf were 2.4 times more likely to have no adhesion than those in the control group.
Depression and cardiovascular disease
On March 12th, women with depression might face a higher cardiovascular disease risk than men:the study published in JACC: Asia tracked and reviewed medical claims between 2005 and 2022, analyzing more than 4 million patients. The results suggest that the hazard ratio of a depression diagnosis leading to CVD was 1.39 in men and 1.64 in women. While the study has some limitations, it raises the important point of treating patients as the whole person in the world of sub-specialties and considering connections between mental and physical health.
Latest research in endometriosis
Oxford University scientists conducted the largest genetic study of endometriosis to date, published in Nature Genetics (using the data of over 60,000 individuals diagnosed with endometriosis and more than 700,000 control subjects). The study revealed 42 genetic regions that are significantly associated with the disease, many of which are related to pain perception.
In 2023, researchers from Cedars Sinai used single-cell genomics technology to map out the molecular profile of endometriosis, providing detail on the condition’s complex cellular makeup (published in Nature Genetics), using nearly 400,000 cells from a total of 21 affected or healthy individuals. The study can be a game changer for identifying potential therapeutic targets at a cellular level; it could enhance treatment outcomes and reduce disease recurrence.
Other studies investigated connections between endometriosis, IBS, and the gut microbiome, as well as its association with mental health conditions. While past research suggested these mental health issues were merely byproducts of chronic pain, the study reveals their distinct genetic underpinnings, expanding our understanding of endometriosis beyond its reproductive implications.
A reminder: in February 2024, we saw the first promising results from the clinical trial of the first non-hormonal, non-surgical treatment for endometriosis (dichloroacetate) in Scotland. If the trial is successful, the drug (the first in 40 years!) could be on the market within 5-7 years.
March 19th, In the US, Biden signs an executive order to expand and improve how the US federal government funds health research about women, calling for an investment of $12 billion in new funding for women’s health research.
On March 19th, Bloomer Tech from Cambridge is launching a clinical trial for their smart bra that tracks heart health. The bra, which originated a decade ago at MIT, collects data about women’s cardiovascular system, hormones, and metabolism, showing the results on an app. The device underwent a feasibility study in 2018 and other tests with humans before Bloomer Tech prepared for the latest clinical trial.
Smart bras might be a great twist in the medical device industry; check out IcosaMed from Switzerland, a smart bra for breast cancer monitoring. IcosaMed’s technology emits ultrasound waves to perform echography scans for potentially cancerous cells.
March 21st, An AI breast screening solution called Mia (CE Mark IIa) helped doctors find an additional 12% more cancers than in routine practice during the collaboration between Kheiron Medical Technologies, NHS Grampian, and the University of Aberdeen (as part of a study with 10,889 patients). The augmented AI workflow also showed a decrease in women recalled unnecessarily for further assessment and modeled a workload reduction of up to 30%.
About 20% of women with breast cancer have tumors that are missed by mammogram screening, which is why many countries mandate that two radiologists should read every mammogram.
Overall, it seems like McKinsey coined the term ‘closing the women’s health gap’ with their report on the state of women’s health, released this January. There’s been a handful of publications and interviews repeatedly referring to the report and the ‘gap term’, or citing the studies mentioned in this report. I hope that this awareness surge will greatly contribute and lead to concrete developments in the mid-term.
