S28: Integrative Medicine for Women: State of the Science

Margaret Chesney1, Noel Bairey-Merz2, Julienne Bower3, Judith Balk4

1University of California, San Francisco, USA; 2Cedars-Sinai Medical Center, USA; 3University of California, Los Angeles, USA; 4Department of Obstetrics, Gynecology and Reproductive Sciences, University of Pittsburgh, USA

 

This symposium will present the state of the science for integrative medicine in the treatment of three leading health challenges for adult women.     The first presentation will focus on cardiovascular disease (CVD), the leading cause of death among women in the United States (U.S.).  This presentation will review the evidence on CVD risk factors and outcomes, including integrative approaches to primary and secondary prevention targeting nutrition and diet, weight management strategies, psychosocial stress and inactivity. Specific mechanistic pathways including microvascular coronary dysfunction, endothelial dysfunction and cardiac autonomic nervous system imbalance will be discussed as they relate to integrative medicine. Clinical trials of mind-body interventions including stress reduction, meditation, and acupuncture to reduce risk of death for patients with heart disease will be reviewed.    Breast cancer is the most common cancer in women in the U.S. It is estimated that 80% of breast cancer survivors use CAM, including vitamins and herbs, special diets, and mind-body approaches. This usage is driven by the psychosocial and physical effects of diagnosis and treatment, including long-term side effects such as fatigue, depression, and sleep disturbance, which afflict approximately 30% of breast cancer survivors.   Findings from recent trials in breast cancer populations will be highlighted, including of mindfulness meditation, yoga, and other mind-body therapies. Growing evidence suggests beneficial effects of these therapies on health and well-being. In addition, effects on biological outcomes such as cortisol and immune function will be presented.      Adult women experience symptoms during perimenopause that have a detrimental effect on quality of life.  While not life-threatening, the symptom prevalence makes perimenopause a concern. Up to 75% of perimenopausal women have hot flushes, 45% report sleep disruption, and 23% of perimenopausal and postmenopausal women report mood changes.  Integrative approaches such as nutrition, supplements, mind-body medicine, and acupuncture are often considered helpful, although evidence from clinical trials for many of these strategies is lacking. The state of the science regarding the theoretical bases for the integrative approaches will be reviewed. The current state of the science regarding an evidence-based approach to treating the symptoms of perimenopause and menopause will be presented.    In closing, data will be presented indicating that women are major consumers of health care, more likely to use CAM than men, and often the decision-makers for their families. Thus, as the body of evidence regarding integrative women's health grows, women may become an important constituency group for the field of integrative medicine.