Medical Bulletin 25/ March/ 2025 - Video

Women experience a significant fall in earnings in the years following a menopause diagnosis, with more women stopping work and others working fewer hours, according to a new UCL study published by the Institute for Fiscal Studies.

Economists at UCL, University of Bergen, Stanford University and University of Delaware calculated that women experience a 4.3% reduction in their earnings, on average, in the four years following a menopause diagnosis, with losses deepening to 10% by the fourth year.

This 10% reduction in earnings is approximately half of the estimated 23% loss of earnings experienced by new mothers, also known as the ‘child penalty’.

The main sample looked at women born between 1961-1968 who had a menopause-related diagnosis between the ages of 45-55.

The fall in earnings experienced by women during menopause was primarily driven by a decrease in the likelihood of working and a reduction in contracted hours worked, the researchers found.

In the four years following a menopause diagnosis, the likelihood of claiming Disability Insurance benefits increases by 4.8%, suggesting that menopause symptoms significantly impact women’s work patterns, the team said.

The researchers are calling for better information about the menopause to be available and for women going through the menopause to have better access to menopause-related care.

“Our findings suggest that better information and improved access to menopause-related care are crucial to eliminating the menopause penalty and ensuring that workplaces can better support women during this transition.”, the researchers said.

The study found some workplaces to be more ‘menopause friendly’ than others, with women employed in smaller and private sector firms facing a greater drop in earnings than those with larger and public-sector employers.

Ref: Conti, G et al. (2025). The menopause "penalty". 25/10. London: Institute for Fiscal Studies. Available at: https://ifs.org.uk/publications/menopause-penalty-0 (accessed: 22 March 2025)

A new technique has enabled ultra-powerful magnetic resonance imaging (MRI) scanners to identify tiny differences in patients’ brains that cause treatment-resistant epilepsy. In the first study to use this approach, it has allowed doctors at Addenbrooke’s Hospital, Cambridge, to offer the patients surgery to cure their condition.

Previously, 7T MRI scanners – so called because they operate using a 7 Tesla magnetic field, more than double the strength of previous 3T scanners – have suffered from signal blackspots in crucial parts of the brain. But in research published today in Epilepsia, researchers in Cambridge and Paris have used a technique that overcomes this problem.

Around 360,000 people in the UK have a condition known as focal epilepsy, which causes seizures to spread from part of the brain. A third of these individuals have persistent seizures despite medication, and the only treatment that can cure their condition is surgery. Epileptic seizures are the sixth most common reason for hospital admission.

Ultra-high field 7T MRI scanners allow much more detailed resolution on brain scans and have been shown in other countries to be better than the NHS’s best 3T MRI scanners at detecting these lesions in patients with drug-resistant epilepsy

Chris Rodgers, Professor of Biomedical Imaging at the University of Cambridge, said: “It used to be the case that MRI scanners used a single radio transmitter, but in a similar way to how single wifi routers leave areas where you will struggle to get a signal, so these scanners would tend to leave blackspots on brain scans where it was hard to make out the relevant tissue.

“Now, by using multiple radio transmitters positioned around the patients’ head – like having a wifi mesh around your home – we can get much clearer images with fewer blackspots. This is important for the epilepsy scans because we need to see very precisely which part of the brain is misbehaving.

As a result of their findings, more than half of the patients (18 patients, or 58%) had the management of their epilepsy changed. Nine patients were offered surgery to remove the lesion, and one patient was offered laser interstitial thermal therapy (which uses heat to remove the lesion). For three patients, scans showed more complex lesions, meaning that surgery was no longer an option.

“7T scanners have shown promise over the past few years since their introduction, and now, thanks to this new technique, more epilepsy patients will be eligible for life-changing surgery

Ref: Klodowski, K et al. Parallel transmit 7T MRI for adult epilepsy pre-surgical evaluation. Epilepsia; 21 March 2025: DOI: 10.1111/epi.18353

Using a high-pressure water jet to operate on an enlarged prostate can better preserve the ability to ejaculate, compared with standard laser surgery, finds research.The technique has similar outcomes to laser surgery and can be performed with robot assistance, so could reduce waiting times for men with urinary problems caused by an enlarged prostate.

The WATER III trial involved a water-based surgical procedure, called Aquablation, currently used for small- and medium-sized prostates. The trial assessed its safety and effectiveness for use with large prostates, compared with surgery using lasers. It also investigated adverse side effects such as erectile dysfunction and urinary incontinence.

An enlarged prostate, known as Benign Prostatic Hyperplasia (BPH), is the most common prostate condition in older men. The prevalence of BPH increases with age, affecting over 50% of men aged over 50 and rising to more than 80% in those aged over 70, with global and regional variations influenced by population aging and prostate volume differences. While non-cancerous, it can cause urinary problems and significantly impact men’s health. As the prostate gland grows, BPH can squeeze the urethra leading to a frequent need to urinate, a weak urine stream, and leaking or dribbling of urine. Where lifestyle changes or medication are not effective, men can opt for surgery. Most commonly, this involves using a wire loop or laser to break up and remove the excess prostate tissue to open up the urethra.

In the trial, the researchers recruited 202 men who required surgery for their BPH. The men all had large prostates (between 80 – 180 mL). Just over half (98) of patients were assigned to undergo aquablation therapy, with the remainder (88) assigned to undergo either HoLEP or ThuLEP laser surgery.

Of the 89 men in the trial who were sexually active, retrograde ejaculation was experienced by just 15% of men in the aquablation group compared with over three-quarters of men (77%) in the laser surgery group. Urinary incontinence was reported in 9% of the men in the aquablation group compared with 20% in the standard treatment group. Short-term symptom improvement and adverse events were similar across both groups.

Hence, they concluded that the learning curve for surgeons to perform laser surgery is steep, so the ability to offer aquablation to men even with larger prostates will make treatments more accessible

Ref: WATER III trial presented at the 2025 European Association of Urology (EAU) Congress, Madrid