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Having less sex linked to earlier menopause

Women who reported engaging in sexual activity weekly were 28% less likely to have experienced menopause at any given age than women who engaged in sexual activity less than monthly.

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Women who engage in sexual activity weekly or monthly have a lower risk of entering menopause early relative to those who report having some form of sex less than monthly, according to a new UCL study.

The researchers observed that women, who reported engaging in sexual activity weekly, were 28% less likely to have experienced menopause at any given age than women who engaged in sexual activity less than monthly. Sexual activity includes sexual intercourse, oral sex, sexual touching and caressing or self-stimulation.

The research, published in Royal Society Open Science, is based on data from the USA’s Study of Women’s Health Across the Nation (SWAN). It’s the largest, most diverse and most representative longitudinal cohort study available to research aspects of the menopause transition.

First author on the study, PhD candidate Megan Arnot (UCL Anthropology), said: “The findings of our study suggest that if a woman is not having sex, and there is no chance of pregnancy, then the body ‘chooses’ not to invest in ovulation, as it would be pointless. There may be a biological energetic trade-off between investing energy into ovulation and investing elsewhere, such as keeping active by looking after grandchildren.

“The idea that women cease fertility in order to invest more time in their family is known as the Grandmother Hypothesis, which predicts that the menopause originally evolved in humans to reduce reproductive conflict between different generations of females, and allow women to increase their inclusive fitness through investing in their grandchildren.”

During ovulation, the woman’s immune function is impaired, making the body more susceptible to disease. Given a pregnancy is unlikely due to a lack of sexual activity, then it would not be beneficial to allocate energy to a costly process, especially if there is the option to invest resources into existing kin.

The research is based on data collected from 2,936 women, recruited as the baseline cohort for the SWAN study in 1996/1997.

The mean age at first interview was 45 years old. Non-Hispanic Caucasian women were most represented in the sample (48%), and the majority of women were educated to above a high school level. On average they had two children, were mostly married or in a relationship (78%), and living with their partner (68%).

The women were asked to respond to several questions, including whether they had engaged in sex with their partner in the past six months, the frequency of sex including whether they engaged in sexual intercourse, oral sex, sexual touching or caressing in the last six months and whether they had engaged in self-stimulation in the past six months. The most frequent pattern of sexual activity was weekly (64%).

None of the women had yet entered menopause, but 46% were in early peri-menopause (starting to experience menopause symptoms, such as changes in period cycle and hot flashes) and 54% were pre-menopausal (having regular cycles and showing no symptoms of peri-menopause or menopause).

Interviews were carried out over a ten-year follow-up period, during which 1,324 (45%) of the 2,936 women experienced a natural menopause at an average age of 52.

By modelling the relationship between sexual frequency and the age of natural menopause, women of any age who had sex weekly had a hazard ratio of 0.72, whereas women of any age who had sex monthly had a hazard ratio of 0.81.

This provided a likelihood whereby women of any age who had sex weekly were 28% less likely to experience the menopause compared to those who had sex less than monthly. Likewise, those who had sex monthly were 19% less likely to experience menopause at any given age compared to those who had sex less than monthly.

The researchers controlled for characteristics including oestrogen level, education, BMI, race, smoking habits, age at first occurrence of menstruation, age at first interview and overall health.

The study also tested whether living with a male partner affected menopause as a proxy to test whether exposure to male pheromones delayed menopause. The researchers found no correlation, regardless of whether the male was present in the household or not. Last author, Professor Ruth Mace (UCL Anthropology), added: “The menopause is, of course, an inevitability for women, and there is no behavioural intervention that will prevent reproductive cessation. Nonetheless, these results are an initial indication that menopause timing may be adaptive in response to the likelihood of becoming pregnant.”

Health & Wellness

Osteoporosis risk may be greater in gay men – study

As it is, sexual minorities already have greater risks of several adverse health outcomes. This may be due to a greater prevalence of unhealthy lifestyle factors, including smoking; as well as the significant stresses they experience related to the stigma associated with their sexuality.

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Non-heterosexual minority men have a greater risk of poor bone health than heterosexual men. This is according to a study published in the American Journal of Human Biology, which also noted that this risk appears to be independent of lifestyle and psychosocial factors.

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Surprisingly, the study – “Sexual orientation‐based disparities in bone health: Evidence of reduced bone mineral density and mineral content among sexual minority men but not women in multiple NHANES waves” by James K. Gobb and Eric C. Shattuck – did not find that non-heterosexual minority women were more likely to experience poor bone health.

As it is, sexual minorities already have greater risks of several adverse health outcomes. This may be due to a greater prevalence of unhealthy lifestyle factors, including smoking; as well as the significant stresses they experience related to the stigma associated with their sexuality.

But according to the people behind this study, there has been little research looking at whether sexuality has any impact on bone health using assessments of bone mineral density measures or fracture risk.

To examine the association between bone health and sexuality, these researchers combined data on 3,243 adults from the 2007 to 2008, 2009 to 2010, and 2013 to 2014 cycles of US National Health and Nutrition Examination Survey. The data included dual-energy X-ray absorptiometry (DXA) assessments. With an average age of 36 years, the participants included 253 sexual minority people (53 lesbian/gay, 97 bisexual, and 103 same-sex experienced) and 2,990 heterosexuals.

Sexual orientation-based comparisons were made for a number of bone health indicators, including z-scored bone mineral density in the lumbar spine (L1-4 vertebrae) and proximal femur (femoral head, greater trochanter, and intertrochanteric line), bone mineral content in the femur and spine, and osteoporosis risk.

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The study reported sexual orientation‐based disparities in bone mass across all anatomical sites. This effect was due to differences between heterosexual and gay men and persisted in linear regressions after adjusting for risk factors.

Differences were also found in femoral and femoral neck BMC in heterosexual and gay men (P = .02) and in femoral, femoral neck and spinal BMC between heterosexual and bisexual women (P = .05). Sexual orientation remained significant in BMC regressions.

“Our findings suggest that sexual minority men but not women are at greater risk for poor bone health relative to heterosexuals and this disparity is independent of the lifestyle and psychosocial risks included in our models,” the researchers stressed.

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Health & Wellness

Trans women can safely maintain estrogen treatments during gender affirming surgery

The practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

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There was no difference in blood clots when estrogen hormone therapy was maintained during gender affirming surgery.

This is according to a study (titled, “No Venous Thromboembolism Increase Among Transgender Female Patients Remaining on Estrogen for Gender Affirming Surgery”) helmed by John Henry Pang with Aki Kozato from Mount Sinai, and was published in the Journal of Clinical Endocrinology & Metabolism.

Historically, the lack of published data contributed to heterogeneity in the practice of whether doctors and surgeons advised transgender women to withhold their estrogen therapy before surgery. The sudden loss of estrogen in the blood was sometimes very uncomfortable with symptoms that amounted to a sudden, severe menopause.

So the researchers tapped 919 transgender patients who underwent gender affirming surgery at Mount Sinai’s Center for Transgender Medicine and Surgery between November 2015 and August 2019. Notably, including 407 cases of transgender women who underwent primary vaginoplasty surgery.

This study found that the practice of withholding estrogen prior to gender affirming surgery was not necessary. Most transgender women can now safely remain on their estrogen therapy throughout surgery.

The bottom line: This study found that most transgender women can  safely maintain their estrogen hormone treatments during gender affirming surgery.

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Health & Wellness

Facebook posts help facilitate belief that HPV vaccine is dangerous to health

Nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

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The human papillomavirus infection, or HPV, is one of the most common sexually transmitted infections, according to the Centers for Disease Control and Prevention (CDC). HPV is associated with health problems including genital warts and cancers, but a vaccine has been available since 2006 to help stop the virus. The CDC reports more than 12 years of data supports the HPV vaccine is safe and effective, yet HPV vaccination rates still remain low.

Social media has a history of being a popular place for sexual health discussions, and the HPV vaccine is one of the most discussed vaccines on the internet. Monique Luisi, an assistant professor in the University of Missouri School of Journalism, has studied more than 6,500 public HPV vaccine-related posts on Facebook from 2006 to 2016. In a previous study, Luisi used these Facebook posts to identify a negative trend on Facebook related to how people perceive the HPV vaccine.

Now, she suggests this negative trend on Facebook may also cause people to develop a false perception of the health risk of the vaccine. After looking at the percentage of posts that made the vaccine seem more dangerous, less dangerous or neither, Luisi found nearly 40% of Facebook posts about the HPV vaccine amplified a perceived risk, and the data suggests these posts had momentum over time.

“We should not assume that only the disease is perceived as a risk, but when research supports it, that medical treatments and interventions might unfortunately also be perceived as risks,” she said. “It’s more likely that people are going to see things on social media, particularly on Facebook, that are not only negative about the HPV vaccine, but will also suggest the HPV vaccine could be harmful. It amplifies the fear that people may have about the vaccine, and we see that posts that amplify fear are more likely to trend than those that don’t.”

Luisi suggests the spread of this negative information may lead people to have a false perception of the vaccine, so people should consult their doctor or health care provider before making an informed decision.

“Facebook remains a very popular social media platform for adult audiences, which necessitates action to address HPV vaccine risk messages,” she said. “People are going to see what they are going to see on social media, so it’s important to not only take what you see on social media, but also talk to a doctor or health care provider. Just because it’s trending doesn’t mean it’s true.”

Luisi notes research must continue to address the perception of vaccine safety where the vaccine is perceived as a greater health threat than the virus or disease it prevents, and her study could also inform officials for the ongoing COVID-19 vaccine roll out and distribution.

“As the COVID-19 vaccine is being rolled out, people are likely going to see a lot of negative information, and that negative information will be what trends on social media,” she said. “But, if the public can anticipate this negative information, it will be interesting to see if that will that make them less sensitive to the perceived risk of the vaccine.”

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Health & Wellness

Depression and stress could dampen efficacy of COVID-19 vaccines

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

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Decades of research show that depression, stress, loneliness, and poor health behaviors can weaken the body’s immune system and lower the effectiveness of certain vaccines.

A new report accepted for publication in Perspectives on Psychological Science suggests that the same may be true for the new COVID-19 vaccines that are in development and the early stages of global distribution. Fortunately, it may be possible to reduce these negative effects with simple steps like exercise and sleep.

Vaccines are among the safest and most effective advances in medical history, protecting society from a wide range of otherwise devastating diseases, including smallpox and polio. The key to their success, however, is ensuring that a critical percentage of the population is effectively vaccinated to achieve so-called herd immunity.

Even though rigorous testing has shown that the COVID-19 vaccines approved for distribution are highly effective at producing a robust immune response, not everyone will immediately gain their full benefit. Environmental factors, as well as an individual’s genetics and physical and mental health, can weaken the body’s immune system, slowing the response to a vaccine.

This is particularly troubling as the novel coronavirus continues to rage across the world, trigging a concurrent mental health crisis as people deal with isolation, economic stressors, and uncertainty about the future. These challenges are the same factors that have been previously shown to weaken vaccine efficacy, particularly among the elderly.

“In addition to the physical toll of COVID-19, the pandemic has an equally troubling mental health component, causing anxiety and depression, among many other related problems. Emotional stressors like these can affect a person’s immune system, impairing their ability to ward off infections,” said Annelise Madison, a researcher at The Ohio State University and lead author on the paper. “Our new study sheds light on vaccine efficacy and how health behaviors and emotional stressors can alter the body’s ability to develop an immune response. The trouble is that the pandemic in and of itself could be amplifying these risk factors.”

Vaccines work by challenging the immune system. Within hours of a vaccination, there is an innate, general immune response on the cellular level as the body begins to recognize a potential biological threat. This frontline response by the immune system is eventually aided by the production of antibodies, which target specific pathogens. It is the continued production of antibodies that helps to determine how effective a vaccine is at conferring long-term protection.

The good news, according to the researchers, is that the COVID-19 vaccines already in circulation are approximately 95% effective. Even so, these psychological and behavioral factors can lengthen the amount of time it takes to develop immunity and can shorten the duration of immunity.

“The thing that excites me is that some of these factors are modifiable,” said Janice Kiecolt-Glaser, director of the Institute for Behavioral Medicine Research at The Ohio State University and senior author on the paper. “It’s possible to do some simple things to maximize the vaccine’s initial effectiveness.”

Based on prior research, one strategy the researchers suggest is to engage in vigorous exercise and get a good night’s sleep in the 24 hours before vaccination so that your immune system is operating at peak performance. This may help ensure that the best and strongest immune response happens as quickly as possible.

“Prior research suggests that psychological and behavioral interventions can improve vaccine responsiveness. Even shorter-term interventions can be effective,” said Madison. “Therefore, now is the time to identify those at risk for a poor immune response and intervene on these risk factors.”

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Health & Wellness

Bisexual men more prone to eating disorders than gay or straight men – study

80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

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Bisexual men are more likely to experience eating disorders than either heterosexual or gay men. This is according to a report from the University of California San Francisco, published in the journal Eating and Weight Disorders.

A handful of studies have actually indicated that gay men are at increased risk for disordered eating, including fasting, excessive exercise and preoccupation with weight and body shape. This newer study, however, suggests that bisexual men are even more susceptible to some unhealthy habits.

For this study, the researchers surveyed over 4,500 LGBTQ adults, and a quarter of the bisexual male participants reported having fasted for more than eight hours to influence their weight or appearance. This is higher when compared to 20% for gay men.

The research also found that 80% of bisexual men reported that they “felt fat”, and 77% had a strong desire to lose weight, both figures higher than the 79% and 75% for gay men, respectively.

Now this is worth stressing: According to study co-author Dr. Jason Nagata, not everyone who diets or feels fat has an eating disorder. “It’s a spectrum — from some amount of concern to a tipping point where it becomes a pathological obsession about body weight and appearance,”Nagata was quoted as saying by NBC News.

For Nagata, several factors may be at play here, including “minority stress” (the concept that the heightened anxiety faced by marginalized groups can manifest as poor mental and physical health outcomes).

“LGBTQ people experience stigma and discrimination, and stressors can definitely lead to disordered eating,” Nagata was also quoted as saying. “For bi men, they’re not just facing stigma from the straight community but from the gay community, as well.”

Of all the respondents, 3.2% of bisexual males were clinically diagnosed with eating disorders (compared to 2.9% of gay men). For heterosexual men, it’s only 0.6%.

For the researchers, there is a need to conduct eating disorder research on various sexual identities independently. This is also to raise awareness on this issue (and how it affects different people of various SOGIESCs).

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Health & Wellness

Timing and intensity of oral sex may affect risk of oropharyngeal cancer

Love giving head? Consider this: Having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer.

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Human papillomavirus (HPV) can infect the mouth and throat to cause cancers of the oropharynx.

This is according to a study published in CANCER, a peer-reviewed journal of the American Cancer Society, which has found that having more than 10 prior oral sex partners was associated with a 4.3-times greater likelihood of having HPV-related oropharyngeal cancer. The study also shows that having oral sex at a younger age and more partners in a shorter time period (oral sex intensity) were associated with higher likelihoods of having HPV-related cancer of the mouth and throat.

Previous studies have shown that performing oral sex is a strong risk factor for HPV-related oropharyngeal cancer. To examine how behavior related to oral sex may affect risk, Virginia Drake, MD, of Johns Hopkins University, and her colleagues asked 163 individuals with and 345 without HPV-related oropharyngeal cancer to complete a behavioral survey.

In addition to timing and intensity of oral sex, individuals who had older sexual partners when they were young, and those with partners who had extramarital sex were more likely to have HPV-related oropharyngeal cancer.

“Our study builds on previous research to demonstrate that it is not only the number of oral sexual partners, but also other factors not previously appreciated that contribute to the risk of exposure to HPV orally and subsequent HPV-related oropharyngeal cancer,” said Dr. Drake. “As the incidence of HPV-related oropharyngeal cancer continues to rise… our study offers a contemporary evaluation of risk factors for this disease. We have uncovered additional nuances of how and why some people may develop this cancer, which may help identify those at greater risk.”

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