I’ll be tweeting when I can from the International Menopause Society Congress.
#IMS2022
Starting with the meeting before the meeting.
The Council of Affiliated Menopause Societies.
Societies from around the world connecting and collaborating.
Welcome from IMS President Steven Goldstein.
#IMS2022 Image
New CAMS chair Dr Duru Shah pointing out that the number of women over 60 is expected to double by 2050.
UN priority is to reduce health inequities and ageism and promote healthy aging. Image
Hearing from menopause practitioners in low and medium income countries. Menopause often neglected due to lack of resources and prioritization of other issues.
Menopause care considered a luxury and patients struggling to access care and afford MHT when needed.
IMS President-elect Prof Nick Panay talking about the importance of health policies prioritizing womens’s health
#IMS2022
No speaker photos because I’m sitting in the wrong spot.
Packed auditorium. 1600 participants, 76 countries. Some online. Welcome from Prof Steven Goldstein.
First plenary lecture by Australian Prof Susan Davis.
Testosterone for women, certainties and uncertainties.
#IMS2022 Image
Testosterone recognized as a female hormone in 1943.
First used in women in 1950 for vulvovaginal atrophy.
Treatment for systemic menopausal symptoms started in 1980s. Image
A suggestion of benefit for sexual function for transdermal T in 1990s.
But is ‘female androgen deficiency’ really an appropriate term? Image
Immunoassays for T unreliable at lower levels in women.
Liquid chromatography mass spec more reliable.
Using LCMS T levels drop by 25% from 18-39 yrs.
But T levels in elderly women are similar to young women. Image
There is limited correlation of endogenous T levels and sexual function.
Cardiovascular disease. High T in post menopausal women not associated with increased CV risk.
Low T appears to be associated with higher risk.
Observational data. Subject to confounding factors. Image
What about testosterone therapy in women?
Current evidence is for use in hypoactive sexual desire disorder.
No benefit in depression. Image
Insufficient data on long term safety.
There is no biochemical diagnosis for ‘androgen deficiency syndrome’. Image
Research needed in
-premenopausal women
-POI
-osteosarcopaenia
-cognition
-CVD
-VVA (some evidence of benefit here).
#IMS2022

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More from @KarenMagraith

Oct 29
Last day of IMS.
Debate: are we over-treating with hormone therapy?
First speaker Prof Martha Hickey (Australia)
For the motion. #IMS2022 Image
Argues that the only primary indication for MHT is VMS (not mood, not sleep and not for primary prevention of disease).
Quotes US preventive task force. Image
Discusses Collaborative group on hormonal factors in breast cancer. (Lancet)
Observational study.
#IMS2022 Image
Read 12 tweets
Oct 28
Final plenary for today.
The microbiome: endocrine nexus in human health.
Prof Jack Gilbert (US). #IMS2022 Image
Our immune system regulates our microbiome.
Can be in a state of homeostasis or dysbiosis.
Dysbiosis can lead to diseases.
During menopause a reduction in microbiome diversity tends to occur.
Can affect hormones and metabolic factors eg lipids, and weight.
May affect brain chemistry and mood too.#IMS2022
Read 4 tweets
Oct 28
IMS symposium on CVD at midlife.
First speaker Prof Chrisandra Shufelt (USA).
MHT and CVD: looking back before moving forward. Image
KEEPS looked transdermal vs oral estrogen, using annual CIMT. No sigt diff.
#IMS2022 Image
ELITE looked at CIMT in groups <6 or >10 yrs post menopause. Increase in CIMT was lower in the early menopause group but not at a level to affect relative risk for CVD. #IMS2022 Image
Read 12 tweets
Oct 28
IMS Congress day 3.
Starting very early with concurrent presentations from menopause societies.
AMS presentation on Menopause and work.
Chaired by Dr Sylvia Rosevear (Aotearoa/NZ). menopause.org.au
I was the first speaker.
Case studies in menopause at work.
I began by acknowledging that some people who experience menopause don’t identify as women. Gender diverse people can also experience menopause.
#IMS2022
Whether a workplace is menopause supportive or not can make the difference between someone staying in their workplace or leaving.

This in turn can have long term impacts including on life trajectory, and retirement income. #IMS2022 Image
Read 17 tweets
Oct 27
Next session. Hormones.
First speaker Prof Alfred Mueck.
Principles to select estrogens.
Conjugated equine estrogens - contain a lot of substances, in variable amounts.
Suggests we move away from its use. #IMS2022 Image
Estradiol containing COCPs. Took a while to develop because of bleeding issues.
Now we have pills with good cycle control, because of the progestogen. Dienogest or nomegestrol. #IMS2022
Next speaker Prof Nick Panay. (UK)
Optimizing hormone therapy through choice of progestogen/progesterone.
#IMS2022 Image
Read 9 tweets
Oct 27
Next session. Debate. MHT for primary prevention. For: Prof Robert Langer. Begins by revisiting WHI #IMS2022 Image
Describes preventive effects of MHT on CHD and other conditions. Choice of progestogen important. #IMS2022
Against: Prof Mary Ann Lumsden (UK). Image
Read 8 tweets

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