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Pilot Project Program

Photo by Robert A. Lisak

WHRY’s Pilot Project Program has been recognized as a national model for launching new research on the health of women and uncovering sex and gender differences that affect health outcomes.

Our “seed” grants generate the data required to obtain larger external grants that focus on disorders of high morbidity and mortality in women, and conditions with meaningful clinical differences between and among women and men.

Active Pilot Projects

Studying Endometrial Cancer

Clare Flannery, MD

Associate Professor of Obstetrics, Gynecology & Reproductive Sciences

Dr. Clare Flannery (right) is examining the relationship between insulin levels and the development of endometrial cancer.

A precancerous condition that can develop in the lining of the uterus (called the endometrium) is known as atypical endometrial hyperplasia (AEH). It develops into endometrial cancer in about 30 percent of cases. In pursuit of better detection and prevention, Dr. Clare Flannery is examining how lowering levels of insulin, which promotes the growth of cells including those that may be cancerous, can help women avoid atypical endometrial hyperplasia that leads to endometrial cancer.

Their research focuses on changing the paradigm for understanding endometrial cancer development, thus allowing earlier detection as well as preventive interventions. This pilot study is providing data and direction for a subsequent large-scale clinical trial of insulin-lowering medications in women with AEH for whom current progestin therapies have not been effective. Read more about this study.

Understanding Effects of CBD on Brain Function

Sarah D. Lichenstein, PhD

Assistant Professor of Psychiatry

Dr. Sarah Lichenstein (center) is leading a study examining the sex differences in the effects of CBD on brain function.

Though not regulated by the Food and Drug Administration, cannabidiol (CBD) is increasingly used within the U.S., and the primary consumers are women. Dr. Sarah Lichenstein is leading a study targeting sex differences to determine how CBD may affect behavior and the brain in women and how that differs from the effect men experience.

The majority of research on the neurological effects of CBD in healthy adults derives from a single small study conducted entirely on men and little research has been done on optimal dosing guidelines. Understanding how the brains of women and men respond to CBD is critical to create dosing guidelines, maximize safety and efficacy in an unregulated market, and determine therapeutic potential.

Dr. Lichenstein is particularly focusing on CBD’s potential to treat anxiety disorders, the most common reason cited by CBD users for their interest in these products and a condition that is twice as prevalent among women than men. Learn more.

Mindfulness Therapy for Insomnia in Black Women

Soohyun Nam, PhD

Associate Professor of Nursing

Dr. Soohyun Nam speaks with Ann Greene, a former Yale School of Medicine research liaison, as she works to study mindfulness-based intervention for Black women experiencing insomnia.

Nearly a third of American adults suffer from some form of insomnia, but the condition affects Black women disproportionately. To address this sleep deficit, Dr. Sooyun Nam is testing — for the first time in this population — an evidence-based stress-reduction intervention for insomnia.

Known as Mindfulness Therapy, this intervention shows potential for addressing the underlying causes of insomnia in a manner that is culturally sensitive to the needs of Black women. Mindfulness focuses on how to manage stress, instead of solely trying to eliminate it. The study aims to help women achieve the sleep they need to better maintain their health and well-being and is examining benefit post-treatment and at longer term follow-up. Read more.

Resilience in COVID-19 Frontline Healthcare Providers

Sarah R. Lowe, PhD

Associate Professor of Public Health

Robert Pietrzak, PhD

Professor of Psychiatry and Public Health

Drs. Sarah Lowe (left) and Robert Pietrzak (right) are examining the resilience in Covid-19 Frontline Healthcare providers including sex differences in stress-burdens.

Health care providers working through the Covid-19 pandemic have reported anxiety, depression, and PTSD. Women providers report higher rates of these symptoms than do men providers, leading some to presume that women may be less resilient in response to stress. Drs. Lowe and Pietrzak are investigating the stressors that health care providers face while providing clinical care as well as the co-occurring stress in their lives.

Although findings indicate that women health care providers have higher rates of stress-related symptoms, results also show that women experience more co-occurring life stressors, ranging from family caregiving responsibilities to salary inequity. When the stress-burden related to these stressors is included in the analysis, the prior difference in symptom reporting between men and women is eliminated, showing the symptoms leading to the perception women are less resilient is actually due to higher levels of “background” stressors. Drs. Lowe and Pietrzak are examining stress-related burden longitudinally in this population and determining how gender-specific approaches to managing stress affect resilience for all frontline health care providers.

Learn more.

Improving Diagnostic Precision in Women with Chest Pain

Samit Shah, MD

Assistant Professor of Medicine (Cardiology)

Dr. Samit Shah tests for small vessel spasm in a patient experiencing chest pain who did not present an artery blockage.

The most common cause of a heart attack is blockage in a cardiac artery. Dr. Samit Shah is developing a new diagnostic approach for detecting reduced blood flow to the heart when a cardiac artery is not blocked. His study focuses on detection of microvascular disease as the cause of reduced blood flow to the heart. This condition, which occurs when small blood vessels constrict or spasm, affects more women than men.

Dr. Shah is studying 100 women over two years at Yale New Haven Hospital and comparing the outcomes for patients who receive the standard of care with those who undergo an additional method of screening for microvascular disease when an arterial blockage is not found. Using this method, 80 percent of women have been given the correct diagnosis and treatment plan. Dr. Shah also is tracking the health outcomes and quality of life of these patients to determine the long-term value of this new testing as a clinical standard. Read more.

Understanding the Intersection Between Pain and Opioids

Sarah Yip, PhD

Associate Professor of Psychiatry

Dr. Sarah Yip is using connectome-based predictive modeling to try and identify individuals who may be more likely to relapse into opioid addiction.

Dr. Sarah Yip is using a new technique known as connectome-based predictive modeling that relies on data and machine learning to try to predict the likelihood of relapse for those recovering from substance use disorder. Dr. Yip is determining how pathways in the brain respond to the sensation of pain and pain relief from opioids and how these connections differ between men and women. This study is one of the first to use a brain map of connections to investigate the neurobiology of pain and analgesia while investigating sex differences at the same time.

This study is designed to determine gender-specific treatments for substance misuse and with predictive modeling identify those who may be more likely to relapse into addiction so that these individuals can be provided prevention resources. Learn more.

Alternative Pain Management for Opioid Dependent Women after Cesarean Section

Audrey Merriam, MD

Assistant Professor of Obstetrics, Gynecology & Reproductive Sciences

Dr. Audrey Merriam (left) is studying for the first time if an existing steroidal medication can reduce pain, and thus the need for opioids, in women having a cesarean section.

Pregnant patients with opioid use disorder (OUD) may be prescribed drugs such as methadone or buprenorphine to optimize health outcomes before and after they give birth. However, even with these therapies women with OUD face an increased relapse risk in the postpartum period.

Dr. Audrey Merriam is determining for the first time if an existing steroidal medication can reduce pain, and thus the need for opioids in women with OUD, after a cesarean section. If proven effective, this intervention to target postoperative pain in this high-risk group would reduce opioid exposure after delivery for this population and lower the risk of relapse. It would also provide an option for all women to help reduce introduction of opioid therapies, which is the primary pathway to subsequent use and misuse of opioids. Learn more about this study.

Predicting Memory Change in Healthy Aging Women

Carolyn Fredericks, MD

Assistant Professor, Neurology

Dr. Carolyn Fredericks (right) is leading a study to understand the role genetic risk factors play in the progression of Alzheimer's Disease.

Neurologist Dr. Carolyn Fredericks is working to understand the role genetic risk factors play in the disease progression of Alzheimer’s Disease (AD) – a condition that disproportionately affects women.

Dr. Fredericks’ study focuses on a genetic variant, referred to as the APOE4 allele, which is the greatest known risk factor for AD. She seeks to understand whether healthy aging women who carry this gene have a change in brain connectivity – the way in which the brain communicates internally – that signals memory decline and subsequent AD. Her investigation aims to uncover this information that is essential to understanding the underlying causes of AD and eventual treatment.

Read more.

Sex Differences in Neuroendocrine Cancers

Pamela Kunz, MD

Associate Professor of Internal Medicine (Medical Oncology)

Dr. Pamela Kunz is studying sex differences in the side effects experienced by patients with a rare form of gastrointestinal cancer.

Dr. Pamela Kunz is conducting one of the first studies to examine sex differences in side effects when treating patients for neuroendocrine neoplasms (NENs), a rare form of cancer often found in the gastrointestinal tract. Sex differences have been found in where cancers start and in survival rates yet understanding the side effects of treatment is limited. This research focuses on analyzing clinical trial data to determine the extent of sex differences in NEN chemotherapy and radiation treatment side effects that contribute to poor quality of life, worse outcomes, and increased costs of care.

Additionally, Dr. Kunz is examining gene variations associated with these cancers that may predict how a patient will respond to a treatment. This effort is designed to tailor therapy to specific persons, and thus reduce side effects, and improve therapy outcomes and the lives of patients who are on long-term treatments. Learn more.

Examining the Effects of Hormone Therapy on the Bone Health of Adolescents

Stuart Weinzimer, MD

Professor of Pediatric Endocrinology

Stuart Weinzimer is examining the effects of hormone therapy on adolescent bone health.

The Yale Pediatric Gender Program provides psychosocial evaluations and assistance to those seeking help with regard to gender identity and gender dysphoria, which can present serious, even life-threatening risks. After comprehensive consultation, gender-affirming hormone therapy (GAHT) may also be a possible treatment option for individuals with gender dysphoria, but little is known about its effects on bone health.

Dr. Stuart Weinzimer’s study focuses on obtaining a longitudinal picture of the dynamic process of bone development in adolescents over the first year of GAHT. This study examines bone density, quality, and architecture to understand the efficacy of current treatments and the influence of exercise and diet in bone health. The data are used to assist clinicians, individuals, and families in making more informed decisions on the risks and benefits of GAHT.

Read more.