Monthly Archives: January 2014

Estrogens and the intervertebral disc

Estrogens and the intervertebral disc

  1. J Calleja-Agius
  2. Y Muscat-Baron
  3. M P Brincat

  1. Department of Obstetrics and Gynaecology, Mater Dei Hospital, Malta
  1. Correspondence: Dr J Calleja-Agius MRCOG MRCPI, 12 ‘Mon Nid’, Gianni Faure Street, Tarxien TXN2421, Malta. Email:


Intervertebral discs are an integral part of the vertebral column. It has been shown that menopause has a negative effect on bone and on intervertebral discs.Estrogen has a beneficial effect of preserving the health of collagen-containing tissues, including the intervertebral disc.The intervertebral disc allows for mobility of the spine, and maintains a uniform stress distribution of the area of the vertebral endplates. Also, the disc influences spinal height. The disc tissue is adapted for this biomechanical function. The function of the spine is impaired if there is a loss of disc tissue. Narrowing of the disc space due to degeneration of intervertebral discs is associated with a significantly increased risk of vertebral fractures. Estrogen should be seen as the first-choice therapy for bones and other collagen-rich tissues, such as intervertebral discs, because it maintains homeostasis of the bone-remodelling unit. Unlike bisphosphonates, estrogen is unique in its ability to regenerate bone collagen after its disintegration, apart from suppressing osteoclastic activity. Besides, there is insufficient data on deterioration in bone qualities and micro-cracks in patients on long-term bisphosphonates

Vitamins ‘blocking cancer treatment’

Nick Collins, London

LATE-stage cancer patients could be thwarting their own treatment by taking multi-vitamin pills containing antioxidants, the Nobel Prize-winning scientist James Watson has warned.

The benefits of supplements containing antioxidants such as vitamins A, C and E are the subject of fierce debate.

While some studies suggest that they could offer moderate protection against cancer, Professor Watson, who with Francis Crick discovered the ‘‘double helix’’ structure of DNA in 1953, argues that the pills could be doing more harm than good.

In a new paper, he claims that the reason late-stage cancers often become untreatable is that they produce high levels of antioxidants which stop treatments such as chemotherapy and radiotherapy from working.

In healthy people, antioxidants can be helpful because they attack molecules known as ‘‘free radicals’’ which can damage DNA. But many cancer treatments use free radicals to kill tumour cells, meaning antioxidants could prevent them doing their job.

Professor Watson said studies should be carried out to test his theory, which he described as ‘‘among my most important work since the double helix’’.

Writing in the Royal Society’s Open Biology journal, he said: ‘‘For as long as I have been focused on the understanding and curing [of] cancer, well-intentioned individuals have been consuming antioxidative nutritional supplements as cancer preventatives if not actual therapies.

‘‘In light of the recent data strongly hinting that much of late-stage cancer’s untreatability may arise from its possession of too many antioxidants, the time has come to seriously ask whether antioxidant use much more likely causes, than prevents, cancer.

‘‘Blueberries [which are high in antioxidants] had best be eaten because they taste good, not because their consumption will lead to less cancer.’’

Professor Nic Jones, Cancer Research UK’s chief scientist, said: ‘‘We know from many large studies that, far from being potent cancer-fighters, antioxidant supplements seem to be ineffective for cancer prevention in healthy people, and some can even slightly increase the risk of cancer. This should give people good reason to think twice about relying on them.’’

Steve Williamson, cancer spokesman for Britain’s Royal Pharmaceutical Society, added: ‘‘I always advise patients not to take antioxidants while they are having chemotherapy in case it counteracts it.’’

Read more:

Designer Vaginas.

12 June 2013, 6.32am EST

Who really pays for designer vaginas?

Increasing numbers of Australian women are asking their doctors for a designer vagina. So many, in fact, that the government is reviewing whether such surgery should be publicly-funded via Medicare. Over the last ten years, claims through the medical benefit scheme (MBS) for labioplasty have increased…

More and more women are going under the knife in search of the ‘perfect’ vagina. Flickr/Hey Paul Studios

Increasing numbers of Australian women are asking their doctors for a designer vagina. So many, in fact, that the government is reviewing whether such surgery should be publicly-funded via Medicare.

Over the last ten years, claims through the medical benefit scheme (MBS) for labioplasty have increased from 200 to over 1,500 per year. The resulting cost, rising from $40,000 to $740,000 annually, has led to a government review questioning the procedure.

The Royal Australian and New Zealand College of Obstetricians and Gynaecologists strongly discourage labioplasty, unless there are compelling medical reasons. They cite a range of potential complications, including scarring, permanent disfigurement, infection, pain, and altered sexual sensations.

So why are so many Australian women demanding labioplasty, a surgical operation that involves reduction of protruding labial tissue surrounding the vagina? The main reason given is dissatisfaction with the appearance of the genitals.

This dissatisfaction is not unusual in the general population. One study found over 50% of women felt unhappy with the size or appearance of their labia. In another, over 40% of women had considered genital surgery.

The dramatic increase in genital dissatisfaction over the last decade is not due to changes in women’s anatomy. It’s due to changing social views on what is a “normal” vulva and vagina. A prepubescent, hairless, Barbie doll appearance now stands as the ideal.

Pornography is partly to blame, depicting women’s genitals as a slit, with no visible labia at all. But the Australian censorship board enshrines such practices in law by allowing only “discrete genital detail” to be shown.

The airbrushing of photographs of women’s genitals is the inevitable consequence. The fact that women requesting labioplasty bring such images to their doctors as a model for surgery shows the insidious nature of pornography’s influence.

But how else can heterosexual women find out what “normal” female genitals look like? Outside of pornography, women’s genitals are culturally invisible. The days of self-examination in feminist consciousness-raising groups, when women used a mirror and speculum to explore their vaginas, are long gone.

This is a shame. If we dared to look, we would find that the majority of adult women look very different from the photographs depicted in pornographic magazines. A recent study of genital size in 50 women found huge variation, with most women having protruding labia, not a simple slit.

The reality of the female body has been airbrushed for centuries, the vagina is no exception. Shutterstock/Jochen Schoenfeld

Medical textbooks ignore this fact, depicting women’s genitalia with smaller proportions than even those shown in pornography. Labia that protrude in a normal way are described as “hypertropic” (abnormal enlargement), but there’s no clear guidance on what level of protrusion merits such diagnosis.

With all this in mind, it’s not surprising that many women are referred for labioplasty without a physical examination, as the woman’s complaint of “abnormal” labial shape or size is simply accepted. When an examination is conducted, women are still referred for treatment, even if their labia are in the normal range.

The medical profession may simply be guilty of believing that they can make women happy by acquiescing to their requests for genital surgery. Yet many women are sexually dissatisfied or anxious about their genitals after surgery and, for some women, labioplasty is just one of many cosmetic surgery procedures undertaken.

This is not to criticise women who seek such surgery. It’s difficult to resist the idealised images of female sexuality that surround us. The reality of the female body has been airbrushed for centuries, with artists depicting the nude with a vaginal slit and no hair. All notions of seepage – flesh or fluid – are completely removed from the frame.

The current popularity of Brazilian waxing (removing all pubic hair) has made prepubescent genital the new norm. It also draws attention to labial skin that would otherwise be concealed, a further explanation for the increased numbers of women seeking labioplasty.

Rather than subjecting women who are dissatisfied with their genitals to the surgeon’s knife, we need to inform them, and their partners, about what is normal. Some surgeons show women images of the wide range of female genitals to try to dissuade them from labioplasty.

Artists, photographers, women’s blogs, and feminist action groups have also joined the quest to normalise and celebrate the diversity of women’s genitals.

The real issue here is women’s dissatisfaction with their bodies. We should be challenging the unrealistic images and expectations that perpetuate this unhappiness, not cutting into women’s flesh.

Estrogen: A master regulator of bioenergetic systems in the brain and body.

Front Neuroendocrinol. 2013 Aug 29. pii: S0091-3022(13)00043-5. doi: 10.1016/j.yfrne.2013.08.001. [Epub ahead of print]

Estrogen: A master regulator of bioenergetic systems in the brain and body.


Neuroscience Department, University of Southern California, Los Angeles, CA 90033, United States.


Estrogen is a fundamental regulator of the metabolic system of the female brain and body. Within the brain, estrogen regulates glucose transport, aerobic glycolysis, and mitochondrial function to generate ATP. In the body, estrogen protects against adiposity, insulin resistance, and type II diabetes, and regulates energy intake and expenditure. During menopause, decline in circulating estrogen is coincident with decline in brain bioenergetics and shift towards a metabolically compromised phenotype. Compensatory bioenergetic adaptations, or lack thereof, to estrogen loss could determine risk of late-onset Alzheimer’s disease. Estrogen coordinates brain and body metabolism, such that peripheral metabolic state can indicate bioenergetic status of the brain. By generating biomarker profiles that encompass peripheral metabolic changes occurring with menopause, individual risk profiles for decreased brain bioenergetics and cognitive decline can be created. Biomarker profiles could identify women at risk while also serving as indicators of efficacy of hormone therapy or other preventative interventions.

Copyright © 2013 Elsevier Inc. All rights reserved.

Menopause is uniquely human

This is my first post of the new year, as I have returned to work  :((. Oh well….I hope everything went well for all of you, and you have a hormonally healthy 2014. Most women find going through menopause a shock, as it is hard to understand why this is happening. We really don’t know.

20 August 2013, 1.31pm AEST

Menopause is uniquely human

Human women are the only animals who go through menopause, with most other primates remaining fertile until death.

The reason of menopause as an evolutionary trait is not known but research suggests the female reproductive system hasn’t adjusted to increasing human lifespan.

Researchers hope to examine the role of grandparents in primate development to see if this may have caused the evolutionary anomaly.

Reproductive aging patterns in primates reveal that humans are distinct


Women rarely give birth after ∼45 y of age, and they experience the cessation of reproductive cycles, menopause, at ∼50 y of age after a fertility decline lasting almost two decades. Such reproductive senescence in mid-lifespan is an evolutionary puzzle of enduring interest because it should be inherently disadvantageous. Furthermore, comparative data on reproductive senescence from other primates, or indeed other mammals, remains relatively rare. Here we carried out a unique detailed comparative study of reproductive senescence in seven species of nonhuman primates in natural populations, using long-term, individual-based data, and compared them to a population of humans experiencing natural fertility and mortality. In four of seven primate species we found that reproductive senescence occurred before death only in a small minority of individuals. In three primate species we found evidence of reproductive senescence that accelerated throughout adulthood; however, its initial rate was much lower than mortality, so that relatively few individuals experienced reproductive senescence before death. In contrast, the human population showed the predicted and well-known pattern in which reproductive senescence occurred before death for many women and its rate accelerated throughout adulthood. These results provide strong support for the hypothesis that reproductive senescence in midlife, although apparent in natural-fertility, natural-mortality populations of humans, is generally absent in other primates living in such populations.


  • Author contributions: K.B.S. and S.C.A. organized the Working Group that performed this research; S.C.A., J.A., D.K.B., M.C., L.M.F., A.P., T.S.S., K.B.S., W.F.M., and A.M.B. designed research; S.C.A., J.A., D.K.B., M.C., L.M.F., A.P., T.S.S., and K.B.S. performed research; S.C.A. and A.M.B. analyzed data; and S.C.A., J.A., D.K.B., M.C., L.M.F., A.P., T.S.S., K.B.S., W.F.M., and A.M.B. wrote the paper.

  • The authors declare no conflict of interest.

  • Data deposition: Data underlying these analyses have been deposited in the Dryad Data Repository,, (10.5061/dryad.m327n).

  • This article contains supporting information online at

Freely available online through the PNAS open access option.