What Causes Hot Flashes, Anyway?

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- Millions of middle-aged women experience it: that sudden onset of intense heat, sweating and flushing known as a hot flash.

Though it's long been believed that the drop in hormone levels that accompanies menopause contributes to hot flashes, experts say relatively little is known about what actually causes them, or what's occurring when women have one.

"About 70 percent of women experience hot flashes, but their underlying physiology isn't well understood," said Rebecca Thurston, an assistant professor of psychiatry, psychology and epidemiology at University of Pittsburgh.

A new study by Thurston and her colleagues attempts to get at the underlying physiology. Researchers had 21 perimenopausal and postmenopausal women aged 40 to 60 who reported having daily hot flashes wear a heart monitor over a 24-hour period. Perimenopause is the time leading up to menopause when the ovaries produce less estrogen but a woman still gets her period.

The heart monitor showed that during a hot flash, heart-rate variability -- a measure of beat-to-beat changes in heart rate -- decreased significantly, a sign that the parasympathetic nervous system isn't working as well as it normally does.

The parasympathetic nervous system is one aspect of the autonomic nervous system, which regulates unconscious bodily functions such as heart and respiration rates. While the sympathetic nervous system governs the fight-or-flight response, the parasympathetic nervous system is involved with "rest and restore," or regulating the body at rest, Thurston explained.

Other research has found an association between cardiovascular disease and decreased parasympathetic nervous system control of the heart. While researchers say it's too soon to conclude that hot flashes have a connection to heart disease, it's worth continuing to study them, Thurston said.

"There were transient decreases during the hot flash, but the good news is it does come back up," Thurston said.

The research is in the April issue of Menopause.

For something that's so common, experts say it's surprising how little is understood about hot flashes. What's known is that they can vary in severity, frequency and duration. Some women may get just a few hot flashes; others suffer from multiple hot flashes a day for years.

Hot flashes are also one of the most common complaints sending women to see their doctors, experts said. Hot flashes can impair quality of life, sleep and lead to feelings of depression, according to background information in the study. Still other studies have hinted that hot flashes are associated with ill health effects, including low bone density and heart disease.

Specifically, studies have found that women who experience hot flashes are more likely to have signs of early atherosclerosis (sometimes called hardening of the arteries), such as calcified plaques in the aorta of the heart, Thurston said.

But women don't have to simply suffer with them, said Dr. Margery Gass, executive director of the North American Menopause Society.

The most effective treatment for hot flashes is hormone therapy, typically estrogen and progestin, Gass said. However, because hormone therapy carries some risks -- including boosting the risk of certain cancers, including endometrial cancer -- women should only turn to hormones if they're really bothered by hot flashes, and then they should stay on hormones only as long as they need to, Gass said.

Another treatment option: selective serotonin reuptake inhibitors, or SSRIs -- a class of drugs commonly used to treat depression or anxiety. But the medications don't work as well as the hormones for most women, Thurston said.

Lifestyle changes can also help, Gass said. As people age, their "thermoneutral zone" -- the temperature at which they feel not too hot and not too cold -- shrinks.

A very minor increase in core body temperature can trigger hot flashes in some women. So, avoid becoming overheated, Gass said. Bring a fan to work and switch it on if you feel you're getting warm. Wear layered clothing so that you can peel off layers as needed. At night, sleep with a loosely woven blanket and sleep with one leg uncovered, and avoid down comforters.

Over time, hot flashes diminish, and usually totally disappear, Gass said.

"The natural course of hot flashes is they get milder and less frequent over time, and for the majority of women, they disappear altogether," Gass said. "A few women may have occasional ones forever, but usually they're manageable."

More information

WomensHealth.gov has more on menopause.

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More Unmarried Couples Having Babies: CDC

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- More unmarried women who live with their partners are having babies than ever before, a new government report shows.

Twenty-seven percent of births between 2003 and 2010 were to such couples -- a threefold increase from 1985, researchers from the U.S. Centers for Disease Control and Prevention found.

"It's thought that in births outside of marriage, one parent isn't present. But our data is showing that a large proportion do have two parents, even though

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Herbal Remedy Ingredient Tied to Cancer, Kidney Failure

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- A toxic component of a plant used in certain types of herbal remedies can cause kidney failure and upper urinary tract cancer, researchers warn.

Aristolochic acid is found in Aristolochia herbal remedies, which have been used for centuries and still are used in many countries.

This study of 151 patients with upper urinary tract cancer in Taiwan concluded that aristolochic acid is a primary contributor to the incidence of this cancer in Taiwan, where the incidence is the highest reported anywhere in the world and where Aristolochia herbal remedies are widely used.

The researchers found that 83 percent of the patients had evidence in their kidneys of DNA changes that are related to the plant toxin and associated with the development of cancer.

"We believe our latest research highlights the importance of a long-overlooked disease that affects many individuals in Taiwan, and, by extension, in China and other countries worldwide, where Aristolochia herbal remedies traditionally have been used for medicinal purposes," Dr. Arthur Grollman, a professor of pharmacological sciences at Stony Brook University School of Medicine, in New York, said in a university news release.

In previous research, Grollman and his colleagues linked the ingestion of Aristolochia clematitis (commonly known as birthwort) to widespread kidney disease in the Balkans.

The findings of the studies show that public health officials need to take action to stop kidney damage and upper urinary tract cancer related to aristolochic acid, Grollman said.

The study was published online April 9 in the journal Proceedings of the National Academy of Sciences.

More information

The U.S. National Kidney Disease Education Program explains how to keep your kidneys healthy.

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Over-the-Counter Bug Bite Remedies Don't Work: Report

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Vitamin D Doesn't Help Kids Do Better in School, Study Finds

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Baldness Drug May Cause Sexual Side Effects: FDA

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- Two Merck & Co. drugs -- one to treat hair loss in men, the other to treat an enlarged prostate gland -- will get revised labels warning of potential sexual side effects that can last even after patients stop taking the drugs, the U.S. Food and Drug Administration said Thursday.

The two drugs -- Propecia to combat male pattern baldness, and Proscar, to treat enlarged prostates -- share the same chemical compound, called finasteride. One dose of Propecia contains 1 milligram of finasteride; one dose of Proscar contains 5 milligrams.

The new Propecia label will include a warning of "libido disorders, ejaculation disorders, and orgasm disorders that continued after discontinuation of the drug," the FDA said in a news release.

The Proscar label will include a warning about "decreased libido that continued after discontinuation of the drug," the agency said.

The labels of both drugs will also carry about a description of reports of male infertility and/or poor semen quality that clears up or improves after the drugs are stopped.

Although a cause-and-effect relationship between the drugs and these side effects hasn't been established, case reports suggest there's a potential problem, the FDA said.

The agency added, however, that only a small percentage of men using these drugs have experienced an adverse sexual event.

The FDA said it believes the drugs are safe to take for their approved uses. It recommends that patients and their doctors consider the new information on the revised labels when weighing a best treatment option.

Last year, both drugs' labels were changed to warn of the possibility of erectile dysfunction even after discontinuing the drug, according to the FDA.

Dr. Anthony D'Amico, chief of genitourinary radiation oncology at Brigham and Women's Hospital in Boston, said Thursday that the revised labels contain "an important message that people need to hear."

"Particularly because Propecia is used by 20- and 30-year-olds for hair loss and these are people of childbearing age, so if they are getting issues with fertility that a big issue," he said.

In a statement released Thursday afternoon, Merck said:

"Merck believes that Propecia and Proscar are generally well tolerated and effective for their respective intended uses in accordance with their approved product labeling. In addition, please note that a causal relationship between the use of Propecia or Proscar and continued sexual dysfunction after discontinuation of treatment has not been established."

D'Amico said Thursday's announcement from the FDA "points up the usefulness of post-marketing studies on drugs that have been studied, but not for long enough periods to know what can happen when large numbers of people use them and what happens when they are discontinued."

More information

For more on the label changes, visit the U.S. Food and Drug Administration.

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Common Plastics Chemical Might Boost Diabetes Risk

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- High blood levels of chemicals called phthalates, which are found in soaps, lotions, plastics and toys, may double the risk for type 2 diabetes among older adults, Swedish researchers say.

"Our study supports the hypothesis that certain environmental chemicals can contribute to the development of diabetes," said lead researcher Monica Lind, an associate professor of environmental medicine in the section for occupational and environmental medicine at Uppsala University.

"Most people come into daily contact with phthalates as they are used as softening agents in everyday plastics and as carriers of perfumes in cosmetics and self-care products," she added.

The study's implications "must be to cut down on plastics and choose self-care products without perfumes," Lind said.

But the research does not prove cause and effect. To find out whether phthalates (pronounced THAL ates) truly are risk factors for diabetes, further studies are needed that show similar associations, she said.

"Experimental studies are also needed regarding what biological mechanisms might underlie these connections," Lind stressed.

The report was published online April 12 and in the June print edition of Diabetes Care.

For the study, Lind's team collected data on more than 1,000 Swedish men and women, age 70, who took part in the Prospective Investigation of the Vasculature in Uppsala Seniors Study.

The researchers measured the participants' blood sugar, insulin levels and levels of toxins from the breakdown of phthalates.

As expected, they found diabetes was more common among those who were overweight and had high cholesterol.

And they also found an association between blood levels of some phthalates and diabetes. That association remained even after taking into account obesity, cholesterol, smoking and exercise.

For people with high phthalate levels, the risk of developing diabetes was about double compared to those with lower levels, the investigators found.

Some phthalates were also linked to disrupted insulin production, the researchers said. Insulin is a hormone that helps deliver blood sugar into the body's cells for energy. Without insulin, or with too little of the hormone, too much sugar stays in the blood, setting the stage for diabetes.

"Even at relatively low levels of phthalate in the blood, the risk of getting diabetes begins to rise," Lind added.

Other studies have linked these chemicals with breast growth in boys and reproductive problems in men, possibly caused by estrogen disruption.

Phthalates are used in hundreds of products, such as toys, vinyl flooring and wall coverings, detergents, lubricating oils, food packaging, pharmaceuticals, blood bags and tubing, according to information from the U.S. Food and Drug Administration. Personal care products, such as nail polish, hair sprays and shampoos, also contain phthalates.

At present, "the FDA does not have compelling evidence that phthalates, as used in cosmetics, pose a safety risk," according to the FDA website.

In the United States, companies are not required to test the long-term health effects of chemicals before using them in consumer products. Lind said this means the dangers of hazardous chemicals aren't known until they are already widely used.

Lind said the health effects of chemicals should be tested before they reach the consumer market similar to the way drugs get tested before being approved.

"We are looking at a tip of an iceberg," she said in terms of a possible health crisis. "We are just scratching the very top of the iceberg."

The way the system is designed, if phthalates were banned, they would be replaced by other chemicals about which even less is known, Lind said.

According to the Environmental Working Group, a group trying to rid hazardous chemicals from consumer products, there is no practical way to choose phthalate-free products. Sometimes the print on ingredient labels is too small to read, and different names are often used for the same plasticizing chemicals. And some products lack ingredient labels even though they're required by federal regulations.

That said, some of the names to look for in cosmetics, self-care products, solid air fresheners, and scented candles are: mono-methyl phthalate (MMP), mono-ethyl phthalate (MEP) and mono-isobutyl phthalate (MiBP), which are types of the chemicals dimethylphthalate (DMP), diethyl phthalate (DEP) and di-isobutyl phthalate (DiBP). DMP is also used in ink and as a softening agent in plastics.

More information

For more information on phthalates in cosmetics, visit the U.S. Food and Drug Administration.

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Head, Body Lice Are Genetically Very Similar

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- Genetic evidence suggests that head and body lice are the same species, a new study says.

The finding is significant because body lice transmit deadly bacterial diseases while head lice do not, the researchers explained.

The researchers compared the number and sequences of all the protein-coding genes expressed at each life-cycle stage of head and body lice and found that the two organisms were very similar.

"The differences in their sequences were so minor that if we didn't know they were separate groups, we would have considered them the same species," study leader Barry Pittendrigh, an entomology professor at the University of Illinois in Urbana-Champaign, said in a university news release.

"As body lice transmit diseases and head lice don't, this system provides a unique opportunity to understand subtle changes that allow body lice to transmit human diseases," study co-author and University of Illinois graduate student Brett Olds said in the release.

The study appears online and in the April issue of the journal Insect Molecular Biology.

Previous research has shown that even when they are both present on the same person, head and body lice don't go into each other's territories, the release noted. There is little connection between human hygiene and head lice, but body lice are quick to appear when there's a decline in hygiene, such as during times of war or economic hardship.

More information

The U.S. Centers for Disease Control and Prevention has more about body lice.

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DNA Testing Finds Allergens, Toxins in Traditional Chinese Medicines

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Mouse Study Hints at New Path for Diabetes Treatment

HealthDay – 43 mins ago THURSDAY, April 12 (HealthDay News) -- A potential new treatment for type 2 diabetes targets the hormone glucagon instead of insulin, according to a new study in mice.

Although the research hasn't yet progressed past animal models of the disease, initial results suggest that the novel therapy can lower blood sugar, decrease insulin resistance, lower cholesterol and help keep fatty deposits from settling in the liver.

What's more, the researchers didn't see any adverse effects from the treatment.

"A new target for the adverse effects of glucagon on diabetes has been identified, and with treatment we got rid of all the bad stuff, but didn't cause side effects," said the study's lead author, Dr. Ira Tabas, a distinguished professor of medicine at Columbia University Medical Center, in New York City.

Results of the study are published in the April 12 online edition of Cell Metabolism.

Glucagon is a hormone whose main role is to protect the body and brain from low blood-sugar levels during periods of fasting, such as overnight. It is produced by the alpha cells in the pancreas, Tabas said. When the alpha cells in the pancreas sense dropping blood sugar and insulin levels, they secrete glucagon, which in turn, causes the liver to produce glucose to feed the brain and body.

Normally, glucagon only kicks in when you're starving, because it senses low insulin levels. But, in type 2 diabetes, the body becomes resistant to insulin, so even though insulin is present, the liver thinks the body has no glucose because the insulin isn't helping get glucose into the body's cells the way it should, Tabas explained. That causes the liver to send out a signal for glucagon, and then the liver releases more sugar. "It just turns into a horrible feedback cycle," he said.

Commenting on the study, Dr. Vivian Fonseca, president of medicine and science at the American Diabetes Association, explained that "when you eat a meal and your sugar goes up, glucagon and glucose should switch off, but that doesn't happen in type 2 diabetes."

Currently, type 2 diabetes treatments focus on replacing insulin or making insulin work more effectively (known as improving insulin sensitivity). But, finding a way to block some of the action of glucagon might also help control type 2 diabetes.

The problem is that because glucagon serves a vital function in keeping the brain and body nourished with glucose in times of fasting, scientists can't make a drug that completely suppresses the action of glucagon.

In addition to the brain not getting enough sugar, early research that just partially blocked glucagon caused weight gain, fatty liver deposits and increased cholesterol. Tabas said it's still not entirely clear why partially blocking glucagon caused these effects.

Clearly, a different approach was needed. So, rather than trying to block glucagon, Tabas and his colleagues followed glucagon's pathways.

"Imagine if you have five pathways: A, B, C, D and E. Blocking pathways A and B can stop diabetes. But, if you block C, D, and E, you cause bad effects. So, you have to move further downstream to find the molecules that are responsible for pathways A and B so you can block those without blocking C, D, and E," Tabas explained.

"The more specific you can get, the less likely you'll have adverse effects," he added.

The pathway they found is an enzyme called CaMKII, and Tabas said this particular pathway is also being studied in inflammatory diseases, such as arthritis and asthma, because inhibiting this enzyme seems to lower inflammation as well.

When the researchers blocked CaMKII in obese mice bred to have diabetes, their blood sugar went down, insulin sensitivity improved, cholesterol decreased and fatty liver improved. And, there was no evidence of adverse effects from blocking CaMKII.

"There's always a concern whenever you inhibit any molecule in the body. We need to know why it's there naturally and what could be the possible effects of inhibiting it. Our study showed no specific concerns though," Tabas said.

While the findings of the new study are promising, scientists note that research involving animals often fails to produce similar results in humans.

For her part, Fonseca said, "This is an interesting and exciting scientific finding on how glucagon works, and it provides a new treatment target. But, it's in the very early stages of research."

More information

Learn more about currently available treatments for type 2 diabetes from the American Diabetes Association.

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Passengers on 'Bat' Plane Cleared of Rabies Risk

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Politics May Get in the Way of Empathy, Research Shows

THURSDAY, April 12 (HealthDay News) -- A new study finds that empathy -- the ability to understand and share someone else's feelings -- vanishes when people have different political views.

U.S. researchers asked the study participants to read a short story about a person -- either a Democrat or a Republican -- who went hiking in winter and got lost with no food, water or extra clothes. People who had the same politics as the fictional hiker felt empathy for the hiker, while those with opposing political views did not.

The study appears in the March issue of the journal Psychological Science.

"Political values are emotionally charged. People get really fired up," study co-author Ed O'Brien, of the University of Michigan, said in a news release from the Association for Psychological Science.

The findings suggest that people are less likely to feel empathy for others they regard as very different from themselves, the researchers said.

For example, people may be less opposed to torture if it's used on people who are nothing like them, O'Brien said. Or people may have little sympathy for the homeless because they can't relate to their situation.

"Even if you're feeling shared pain, you may not let that connection affect your opinions of people who are very, very different from you," O'Brien added.

More information

Utah State University has more about teaching empathy.

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