Hormone replacement therapy for preventing cardiovascular disease in post-menopausal women

Platelet Function in Aging

Aging is associated with an increased incidence of cardiovascular disease and thrombosis. Platelets play a major role in maintaining hemostasis and in thrombus formation, making them a key player in thrombotic disorders. Whereas it is well-known that platelet aggregability is increased in vascular diseases, the contribution of age-related changes in platelet biology to cardiovascular risk is not well-understood. Several lines of evidence support that platelets from older subjects differ in their function and structure, making platelets more prone to activation and less sensitive to inhibition. These age-related changes could lead to platelet hyperactivity and to the development of a prothrombotic state in advanced age. This review will focus on platelet biochemical modifications during aging and on the mechanisms by which these alterations could lead to thrombotic disease.

Cognitive Behaviour Therapy for Menopausal Hot Flushes and Night Sweats: A Qualitative Analysis of Women's Experiences of Group and Self-Help CBT

Background: There is a growing need for non-medical treatments for women experiencing problematic menopausal symptoms such as hot flushes and night sweats (HF/NS). A recent randomized control trial (RCT) (MENOS2) provides evidence of the effectiveness of Group CBT and Self-Help CBT for HF/NS. Aims: This study examines MENOS 2 participants’ experience of the CBT treatments. Method: Twenty women who had experienced CBT for HF/NS (10 Group CBT and 10 Self-Help CBT) were interviewed at the end of the trial to explore how they experienced the treatment and its effects. The interviews were analysed using interpretative phenomenological analysis. Results: Women experienced both treatment formats as positive and helpful, increasing their ability to cope and their sense of control over HF/NS. Four super-ordinate themes were identified: making sense of symptom change, new ways of coping and regaining control, acknowledging and challenging the menopause taboo, and social interaction and support versus individual learning. Conclusions: These qualitative results are consistent with those of the main trial in that women found both CBT formats helpful in reducing the impact of HF/NS. However, the results also suggest possible mechanisms of change and provide useful information on women's responses to the different treatment components and formats.