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Health

When menopause should not be managed alone

Dr Ramya Raj, Specialist Obstetrician & Gynaecologist, International Modern Hospital Dubai

While many women do move through menopause without formal medical care, certain symptoms should prompt professional guidance. These include hot flushes or night sweats that disrupt sleep or daily functioning, mood changes such as persistent anxiety or low mood, brain fog affecting work or memory, vaginal dryness or pain during intimacy, recurrent urinary symptoms, unexplained weight gain, or changes in blood pressure, cholesterol, or blood sugar. Heavy or irregular bleeding, especially after periods have stopped, should always be medically assessed.Some women also assume that symptoms like mood changes, joint pain, or fatigue are unrelated to menopause and therefore not worth mentioning lets explore what are mood swings during menopause? who gets them?as this question will be haunting most of us,they are extreme abrupt fluctuations in mood common during the menopausal transition and upto 75% of women over 40 going through menopause.

Doctors can make these conversations more approachable by normalizing menopause as a life stage rather than a medical failure. Simple, open-ended questions such as “How are these changes affecting your daily life?” or “What worries you most right now?” help women feel heard rather than rushed into treatment decisions.

Supporting women emotionally and physically during menopause

Healthcare providers can play a crucial role by addressing menopause holistically, not just hormonally. Emotional support is as important as symptom control. Many women feel dismissed or embarrassed discussing sleep disruption, libido changes, or emotional volatility. Acknowledging these experiences as common and valid can significantly reduce hesitation to seek help.There are certain triggers for hot flushes during menopause like stress ,smoking, excessive caffeine intake ,alcohol consumption and having spicy food and hot weather. So Practical support includes individualized care plans that may involve lifestyle adjustments avoiding these triggers, non-hormonal therapies, hormonal treatment when appropriate, mental health screening, and referrals to nutritionists or physiotherapists. Non prescriptive  medications do have a role in alleviating symptoms like isoflavane supplements ,soy products, black cohosh and vitamin E.Regular follow-ups, even brief ones, help reinforce that menopause is an ongoing transition, not a one-time consultation.life style modifications like maintaining a healthy weight ,smoking cessation ,relaxation response techniques and acupuncture do help.

Creating women-friendly clinical environments—longer appointment slots, educational materials, and reassurance that symptoms will be taken seriously—also encourages engagement.

Misconceptions that prevent women from seeking care

Several persistent myths keep women from accessing support. One is the belief that menopause symptoms are something to “just endure.” Another is that treatment, particularly hormone therapy, is universally unsafe—despite strong evidence that it can be safe and effective for many women when appropriately prescribed.systemic estrogen therapy  is the most effective treatment for vasomotor symptoms and only therapy currently approved by US FDA.It has other benefits like preventing alzheimers  disease in the presence of normal brain tissue, increases good cholesterol and reduces atherosclerosis and coronary heart disease, improves bone health and helps in maintaining quality of life in menopausal lady if appropriately prescribed by medical expert ruling out contraindications .Harmone replacement therapy is versatile and can be administered in various forms including transdermal patch,topical preparation, vaginal suppositories and oral medications.This way , its clear and informative that there are multiple options to tailor the treatment to each individuals need.

Doctors can counter these misconceptions by offering clear, balanced information and emphasizing that seeking help does not mean over-medicalizing a natural process. Practical advice includes encouraging women to track symptoms, prioritize sleep and bone health, maintain cardiovascular screening, and understand that early conversations allow for simpler, more effective interventions.

Bottom line: Menopause is a normal life event and not a disease! Menopause does not require medical intervention for every woman, but no woman should feel she has to suffer in silence. Open dialogue, reassurance, and personalized care can transform menopause from an isolating experience into a manageable and well-supported life transition.Maximal Benefit with Harmonal replacement therapy requires early onset of treatment with right dose for the appropriate duration according to an individual patient’s need

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Health

Novartis: Rare muscle disease drug shows early promise

 Novartis (NOVN.S), opens new tab said on Thursday an experimental drug, which it acquired ​as part of its $12 billion takeover of ‌Avidity, showed promise in an early-to-mid-stage study in patients with a type ​of genetic muscle disorder characterized ​by slowly progressive muscle weakness.

  • The Swiss ⁠drugmaker said the drug, known as ​del-brax, lowered two blood markers linked ​to the disease and showed reduced signs of muscle damage in patients with facioscapulohumeral ​muscular dystrophy.
  • Novartis said the drug ​shows potential to become the first disease-modifying ‌treatment ⁠for FSHD, which can cause weakness in the face, shoulders, arms and other muscles.
  • The company estimates it affects ​about ​45,000 to ⁠87,000 people in the U.S. and EU.
  • The drug’s safety ​profile was consistent with ​previous ⁠results, the company said.
  • Novartis plans to discuss the data with health regulators ⁠around ​the world, while a ​late-stage study of the drug is currently enrolling ​patients.

 The Thomson Reuters

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Health

Obesity drug shows promise in reducing belly and liver fat

Boehringer Ingelheim said on Sunday ​its experimental obesity drug cut visceral and liver fat while minimizing loss of lean mass in ‌a late-stage study, data showed, bolstering its case for benefits beyond weight loss as competition in obesity drugs intensifies.

The drug, survodutide, was licensed from Denmark’s Zealand Pharma (ZELA.CO), opens new tab. An injectable that mimics the proteins GLP-1 and glucagon to create a feeling of fullness, its weight-loss trial results were ​announced in April, showing patients lost an average of 16.6% over 76 weeks.

Analysis of a group of ​patients who had MRI measurements at the start and end of a 76-week trial showed that survodutide reduced harmful ⁠abdominal fat by up to 34% and liver fat by up to 63.1% from the baseline, Boehringer said.

Analysts have ​said the weight-loss numbers were broadly comparable to existing GLP-1 injections from Novo Nordisk (NOVOb.CO), opens new tab and Eli Lilly (LLY.N), opens new tab and below newer ​rivals in development, and that the company needed to differentiate the drug’s benefits.

Lean mass accounted for no more than 10.8% of the change in body composition at the highest dose of 6 milligrams, suggesting the weight loss was driven mainly by fat reduction.

The drug’s effect ​on liver-fat reduction and preservation of lean mass are central to whether it will be able to stand out ​commercially, alongside tolerability and how long patients stay on the drug. Detailed data from the study could help Boehringer make a ‌stronger case ⁠that survodutide should be judged not only by pounds lost but by where weight is lost.

“We believe survodutide will become an important new option at the intersection of obesity and liver disease, two conditions that are deeply connected but rarely addressed together,” said Boehringer executive Shashank Deshpande, who leads the company’s human medicines business.

Boehringer acquired the rights in ​2011 to solely develop and ​commercialise survodutide from Zealand, which is ⁠entitled to royalty payments on global revenue.

PATIENTS WITH LIVER DISEASE BENEFIT

In a separate late-stage study of overweight or obese patients with a fatty liver disease called MASLD, survodutide ​met both its main goals.

After 48 weeks, up to 84.2% of patients on the ​drug showed ⁠a liver fat reduction of at least 30%, compared with 24.3% for those on placebo. Patients on survodutide also lost up to 12.2% of their body weight, versus 1% for placebo.

In 61% of the patients the drug helped achieve liver fat ⁠normalization, or ​a liver fat content below 5%, compared with 5.7% on placebo.

U.S. ​biotech Altimmune (ALT.O), opens new tab is also developing a drug that targets both the appetite-suppressing gut hormone, GLP-1, and glucagon.

Survodutide is also being tested in other late-stage ​studies, including for patients with fatty liver disease and fibrosis.

 REUTERS

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Health

Millions with breast cancer could safely skip chemotherapy

Millions of people with breast cancer could safely avoid chemotherapy as scientists have developed a DNA test that can distinguish between patients who are likely to benefit from the treatment and those who are not, according to trial results.

The international study found that more than two-thirds of its participants could be spared the side of effects of chemotherapy and treated with hormone therapy alone.

Chemotherapy can cause fatigue, nausea, hair loss, a weakened immune system and fertility issues.

The study, led by University College London (UCL), involved more than 4,000 newly diagnosed patients over the age of 40 in the UK, Norway, Sweden, Australia, New Zealand and Thailand.

Scientists used a gene test called Prosigna to measure the activity of 50 genes involved in breast cancer growth and calculate a patient’s risk of the disease returning.

Those who received a low score – two-thirds of the group – were not treated through chemotherapy. The five-year survival rate of their group was 93.7%, compared with a 94.9% rate among patients who received chemotherapy as part of their care.

The primary treatment for breast cancer is usually surgery to remove tumours. Chemotherapy is often recommended afterwards to diminish the risk of return.

It is also regularly offered to people with early-stage breast cancer that has spread to the nearby lymph nodes.

Clinicians are concerned the treatment provides little benefit to those with the most common type of breast cancer, UCL said.

The university said more than 5,000 NHS patients a year could avoid chemotherapy as a result of the trial.

Karen Bonham, from Cardiff, took part in the trial and said the results are an “immense relief” and feel “like Christmas”.

The 64-year-old avoided chemotherapy thanks to the Prosigna test and has instead received radiotherapy and hormone therapy over eight years.

“Cancer diagnosis and treatment can be shocking,” she said.

“It certainly propels you into a world of uncertainty. Life priorities realign – you simply want to survive.”

The findings of the study will be presented at the world’s largest cancer conference, the American Society of Clinical Oncology’s annual meeting, in Chicago, United States, on Saturday.

Professor David Miles, a leading cancer specialist, described the findings as “practice-changing”.

“We can now confidently predict many patients will get no benefit at all, and therefore there’s no need for them to have the chemotherapy,” he told BBC’s Newshour.

He added that the test would allow doctors to “confidently define a large population of women who simply aren’t going to benefit and don’t need to go through all that unpleasantness for no benefit at all.”

“We used to give chemotherapy to 100 women to benefit 10, knowing that 90 didn’t need it,” he said.

Tanya Hutson, who was diagnosed with breast cancer in 2022 and had chemotherapy as part of her treatment, called the new DNA test “absolutely amazing”.

“It just proves what happens when money is put into research,” she said, adding that chemotherapy had been “brutal”.

“For all these people out there who don’t need it but are still getting it – it’s an absolute game changer.”

It is not known whether the findings apply to people under the age of 40, with a result still several years away, according to UCL.

BBC

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