New publication from Dr. Lori Brotto

Better Sex Through Mindfulness book cover

Dr. Lori Brotto has a new book! In Better Sex Through Mindfulness Dr. Brotto walks readers through the different reasons that women experience decreased sexual desire, and provides mindfulness exercises that can help restore a healthy sex life.

Follow Dr. Brotto on Twitter @DrLoriBrotto and track #BetterSexThroughMindfulness to join the conversation.  And, stay tuned for Dr. Brotto’s appearance on the Savage Lovecast podcast to discuss her book with Dan Savage.

Dr. Anna Lehman is the 2018 recipient of the WHRI Genomic Medicine Clinician Scientist Salary Award

Photo of Dr. Anna LehmanCongratulations to Dr. Anna Lehman, recipient of the WHRI Genomic Medicine Clinician Scientist Salary Award!  The award provides partial salary support for three years to enable an early- to mid-career clinical geneticist to become an independent clinician scientist leading a genomic medicine research program at BC Women’s Hospital + Health Centre.

Dr. Lehman has worked for the last seven as a clinical geneticist at Children’s & Women’s Health Centre of British Columbia and as Associate Professor of Medical Genetics at the University of British Columbia.  Through this work she has been building a translational research program geared toward improving the process of genomic diagnosis.  BC Women’s Hospital + Health Centre is currently supporting two projects developed through this program and co-led by Dr. Lehman: CAUSES (Clinical Assessment of the Utility of Sequencing and Evaluation as a Service), and RAPIDOMICS.

With the award Dr. Lehman intends to continue in her roles on the Silent Genomes, Care4Rare-Solve, and IMAGINE projects, as well as submit a grant application as principle investigator for her long-term project on the causes of Adams-Oliver syndrome.  She will also continue to research on therapeutics for rare inborn errors of metabolism as site principle investigator of an upcoming multi-site phase III randomized, blinded placebo-controlled clinical trial.  Finally, Dr. Lehman will continue to supervise and train postdoctoral fellows and PhD students in the science of genome analysis.

A special thanks to BC Women’s Hospital + Health Centre Foundation for funding this award.

International Women’s Day 2018

International Women’s Day is celebrated around the world on March 8 every year. It is a day to recognize and celebrate the achievements of women, to raise awareness of important social issues relevant to women, and to make change. Over the past few years, the Women’s Health Research Institute (WHRI) has celebrated International Women’s Day with a free public forum as an opportunity to share vital information about women’s health to a public audience. This year’s public forum, Stressed and Depressed? Depression in Women from the teenage to the golden years, explored mental health throughout a woman’s lifespan and was held at the Italian Cultural Centre.

The public was welcomed by WHRI Executive Director Dr. Lori Brotto, who gave a brief history on International Women’s Day, followed by some brief remarks from Genesa Greening, CEO and President of BC Women’s Hospital + Health Centre Foundation, on (insert).  The forum was emceed by Shirley Weir, Founder of Menopause Chicks, who gracefully guided the evening with humour, real stories, and an unparalleled ability to connect with people.

We were excited to feature three experts who highlighted the many unique mental health challenges women face throughout their lives.  Presentations kicked off with BC Children’s Hospital consulting psychiatrist Dr. Joanna McDermid, who shared insights on the use of mindfulness to combat common stressors, anxiety, and depression throughout in adolescent girls. Next, Dr. Deidre Ryan, Medical Director of the Reproductive Mental Health Program presented More than the Blues: Depression during Pregnancy & after Childbirth; and finally, Dr. Reema Jayakar, an experienced Neuropsychologist, spoke about the overlap between mood and memory and cognitive decline in elderly women.

Be sure to watch www.whri.org or follow us on twitter @womensresearch for our next public forum and keep in mind these events are always FREE!

Congratulations, Dr. Ogilvie!

Dr. Gina Ogilvie has been nominated for YWCA’s Women of Distinction Award in the category of Research and the Sciences.  This award “honours individuals and organizations whose outstanding activities and achievements contribute to the well-being and future of our community”.  Dr. Ogilvie’s work has been influential both nationally and internationally for “setting and directing health policy on reproductive health and sexually transmitted infections”.

In addition to her role as Assistant Director at WHRI, she is the Senior Advisor, Research at BC Women’s Hospital + Health Centre and leads ASPIRE (Advances in Screening and Prevention in Reproductive Cancers), a global health research program which she developed.    Dr. Ogilvie was also recently recognized for her significant contributions toward the eradication of cervical cancer as Opt’s Sexual Health Champion, and her work in Uganda was featured in the February edition of HPV World’s newsletter.

Congratulations, Dr. Ogilvie, for your outstanding work and nomination!

Endometriosis Awareness Month: An interview with Dr. Catherine Allaire

The BC Women’s Centre for Pelvic Pain & Endometriosis and BC Women’s Hospital + Health Centre  strive for better health and improved quality of life for people living with endometriosis.  The experienced interdisciplinary team provides patients with a range of care, including physiotherapy, clinical counselling, and pain education workshops alongside standard gynecologic care.  They also undertake research to advance the knowledge of and treatment options for endometriosis.

Dr. Catherine Allaire, Medical Director, spoke to WHRI about endometriosis in honour of Endometriosis Awareness Month, a global initiative which aims to shed light on a disease that affects approximately 176 million people worldwide.[1]

What is endometriosis?  

Endometriosis is a chronic condition where the cells that line the uterus are found implanted outside the uterus usually in the pelvic cavity, on the ovaries, the peritoneum (lining of the uterus), the uterus, but also on the bowel, bladder and fallopian tubes and rarely on distant sites throughout the body. These endometrial-type cells (which are why the condition is called endometriosis) respond to estrogen and create an inflammatory process that can cause pelvic pain symptoms as well as infertility. It is estimated that 1/10 women of reproductive age have endometriosis and the condition can have a tremendous impact on quality of life.

What have we learned recently about this disease and how to treat it?

There has been an exponential rise in the number of publications about endometriosis over the last decade. Finally some good research is being done on this condition and we have made some recent strides in understanding its cause. For example, Dr. Paul Yong from our centre, in collaboration with OvCare at the BC Cancer Agency, recently discovered a gene mutation called KRAS that is associated with an invasive type of endometriosis. (NEJM May 2017)[2]

We know that there is a great delay for women with endometriosis to get diagnosed and treated. Women suffer with severe menstrual cramps (the most common symptom), ovulation pain, pain with sexual activity, and possibly even painful bowel movements an average of 7 years before being diagnosed. We have to do a better job of increasing awareness among the medical community and the public to consider this diagnosis earlier and treat it appropriately to prevent possible progression to chronic pelvic pain. Though surgery is still the gold standard for diagnosis, we have changed our approach over the years to emphasize early empiric medical management and reserve surgery for the right time,  the right reason and by the right surgeon.

As the Medical Director for the Centre for Pelvic Pain and Endometriosis what is your clinical approach to treating endometriosis? 

We are a tertiary centre so many times the patients referred to us have already been diagnosed and are not doing well with standard management. There are 2 main reasons we find for this.

  • Some patients have undiagnosed or incompletely removed deeply infiltrating endometriosis. At the BCWH clinic we perform a thorough clinical exam and use bedside ultrasound to look for signs of deep endometriosis. All the gynecologists working at the clinic have advanced laparoscopic surgical skills and are able to perform complete excisional surgeries for all stages of endometriosis.
  • Some patients have developed a chronic pain syndrome or central sensitivity syndrome. They may have co-existing conditions such as irritable bowel syndrome, painful bladder syndrome, pelvic floor muscle tension, trigger points, anxiety, and catastrophizing. These patients benefit from the multi-modal interdisciplinary approach we offer at the BCWH with the help of our nurse, physiotherapist and counsellor.

You have a very active research program.  How has this research impacted your clinical practice?

The majority of our research projects and findings have been derived from our Endometriosis Data Registry. All our incoming patients are invited to participate in this data collection and most agree, so we have over 3000 patients registered at this point.  They fill out extensive questionnaires at intake, the doctors also enter their clinical findings and plan, surgical findings, pathology and we send out follow-up questionnaires at 1, 3 and 5 years.  We have been able to validate our model of care by looking at the one-year results and were pleased to find that our patients were definitely doing better, with less pain, better quality of life and less health care utilization (AJOG Jan 2018)[3]. This was tremendously affirming and gives ammunition to our colleagues across the country (and the world) to lobby their health authorities/government to financially support an interdisciplinary model of care for their patients.

You recently had an event for Endometriosis Awareness Month called the Celebration of Hope.  What was this event about?

This is the second time we have had this event and will probably do it annually going forward. All our patients with endometriosis are invited to hear a distinguished guest speaker (this year it was Dr. Suzie As-Sanie from University of Michigan), and members of our team present our most recent research findings. The talks were followed by a Mix and Mingle with delicious food and refreshments which allowed the patients to chat with us and each other, thus helping foster networks.

What inspired you to create this event and to include patients?

The main purpose was to share-back our research results with our patients. They are our partners in this ongoing research project and we could not do this without them. This is one way to thank them and keep them engaged at the same time. The other purpose is to create awareness about endometriosis through social media, and the press. We had a patient advocate who shared her story in a very compelling video. We also hope that increased awareness may lead to increased financial support for research on endometriosis.

Awareness days/weeks/months are great opportunities for knowledge translation. What would you say to other research teams considering events like the Celebration of Hope to disseminate their findings with a public audience?

Try it! Through knowledge translation events such as this, we can increase awareness for a particular condition or issue and also give back to the community. It’s a win-win.

 

 

Congratulations to WHRI member Mohamed Elgendi

Congratulations to Mohamed Elgendi (BCCHR Fellow and WHRI member), co-recipient of the 2017 Healthy Behaviour Data Challenge Phase II for the project, “On estimating sleep quality,” $25,000.

In partnership with the department of psychology (primary applicant) the project investigates the use a smartphone sensing application to predict sleep parameters solely from natural phone use and validate this approach against objectively assessed indicators of sleep quality.

New study shows that Progesterone is likely to be a safe treatment option for night sweats and hot flushes in perimenopausal women

On March 19th WHRI member Dr. Jerilynn C. Prior presented the results of her study “OR25-7: Oral Micronized Progesterone Beneficial for Perimenopausal Hot Flushes/Flashes and Night Sweats” at the Endocrine Society in Chicago, Illinois. The CIHR-funded study sought to address the gap for effective therapies to treat hot flushes and night sweats in perimenopausal women.

Perimenopause refers to the period of time during which the body begins to transition into menopause and fluctuating levels of estrogen affect the regularity of menstruation and ovulation.  Eighty percent of perimenopausal women experience hot flushes and night sweats.  In order to treat these symptoms women are often prescribed the birth control pill (an estrogen-based therapy), despite a lack of scientific evidence that this is an effective treatment option.  Furthermore, age and weight gain can contribute to an increased risk for blood clots and stroke when taking this type of birth control.

“Almost a quarter of all women today are in perimenopause,” explains Dr. Prior.  “They are often working as well as maintaining a home and caring for children and elders. About twenty percent of them will need effective treatment for hot flushes and night sweats in order to continue to be productive.”

To address this gap she looked to oral micronized progesterone (Progesterone).  When women transition from pre- to perimenopause their estradiol levels increase and  estrogenbirth control pills are no longer effective in suppressing them.  Progesterone has shown to be effective as a treatment for menopausal women experiencing hot flushes and night sweats, and does not increase the risk for blood clots or stroke.

A group of one hundred eighty-nine perimenopausal women (who had menstruated in the last year) were randomized into two groups to test the efficacy of Progesterone as a treatment option over a three-month period.  In the first group ninety-three women were given Progesterone to be taken at bedtime each day; the remaining ninety-six were given a Placebo.  The study was the first randomized controlled trial of vasomotor symptoms treatment in a group consisting solely of perimenopausal women, and also included women in early perimenopause who have never skipped a period.

The participants were trained to keep a Daily Perimenopause Calendar via online video on the CeMCOR site.  In the calendar women recorded the frequency and intensity of their hot flushes and night sweats, as well as perceived changes to their symptoms over the course of the three month trial.

While both groups reported a decrease in hot flushes and night sweats at the end of the trial, the results were not statistically different.  However, women taking Progesterone versus Placebo reported feeling that their symptoms had significantly improved.

Based on the study, a similar study in menopausal women, and existing literature, Progesterone is likely to be a safe treatment option for night sweats and hot flushes in perimenopausal women.

Dr. Prior’s full abstract will be available in the Endocrine Society’s journal, Endocrine Reviews.

The Great Hatch 2018

By Caroline Sutton


Participants at the great hatch event

The Great Hatch 2018, an annual hackathon presented by Hatching Health, took place from March 2-4 at the UBC Engineering Design Centre. Sponsored by the UBC Faculty of Engineering, the UBC faculty of Medicine, Joule Inc., and a host of other stakeholders, the annual Great Hatch ‘aims to harness the potential we have as humans to create and critically think to solve problems and improve lives’.

Caroline Sutton participated in the Great Hatch this year as a UBC Science student. She is currently working in a co-op placement with Dr. Gina Ogilvie’s team and spent 8 months working on women’s health surveillance indicators under Dr. Ann Pederson, Director of Population Health Promotion at BC Women’s Hospital.

To prepare for the event she completed a training period with entrepreneurship@UBC to work on developing her ‘pitch’ for the event. Her ‘pitch’ focused on the current lack of techniques for incorporating Intersectionality theory into population health data analysis and presentation.

The event began on March 2nd with the 100 Hatching Health participants networking and brainstorming. Participants include experts and students in product design, engineering disciplines, software and web development, and health sciences. Pitches were presented early Saturday morning, and participants organically wandered the room to create teams lead by the person who pitched.

Almost all of the participating engineers were interested in joining teams with a mechanical engineering problems such as designing biomedical devices, take-home screening tools, surgery aids, and medical implants. Wildly popular pitches were given by practicing surgeons and experienced emergency room doctors. Although Caroline was not able to find an engineer to form a complete team with her pitch, she joined a different team to work on decreasing social isolation in paediatric patients during long-term hospitalization. Her team will continue the work starting in May to advance the project as far as possible.

The rest of the event was spent working to produce a proof-of-concept prototype in time for Sunday night presentations, followed by an adjudication session and awards ceremony. The team Caroline joined received positive feedback from the judges for project integration and design, and the team was praised for designing a solution that could be feasibly implemented in current hospital settings. The award winning teams tackled issues like designing home devices to detect neuropathy, improving the shape and design of central venous access catheters, and adapting airport security technology to monitor vital signs in ED waiting rooms.

Overall, it was an amazing weekend of collaboration and intense team building, and most teams left on Sunday with future plans to improve their prototypes.

Dr. Saraswathi Vedam is in the news!

WHRI member Dr. Saraswathi Vedam has created two tools (the MADM (Mother’s Autonomy in Decision Making) Scale scale and the MORi (Mothers on Respect index) to ensure that women’s needs, respect, and autonomy are at the center of their birthing experiences.

The tools are also intended to “provide a standard way to quantify a patient’s experience”.

Read more about her work here.