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• Researchers say that a drug used as an emergency contraceptive or to treat fibroids may help lower breast cancer risk.
• Ulipristal acetate, the “morning after pill,” was found to reduce the activity of breast cells where cancers start.
• The drug also altered the structure and stiffness of breast tissue.
• The authors say this discovery could potentially help prevent aggressive breast cancers in younger females.

A medication used as an emergency contraceptive or to treat fibroids may also help lower the risk of some of the most aggressive breast cancers. 

In a new study, women who were more likely to develop breast cancer because of their family history took the drug ulipristal acetate, also known as the “morning after pill,” for 12 weeks. 

Afterward, the researchers found a reduction in certain features linked to cancer risk, including the activity of certain breast cells believed to be the starting point for hard‑to‑treat cancers. The drug also changed the structure and “stiffness” of breast tissue.

The researchers speculate that this could open up a new way to prevent breast cancer in younger, premenopausal women. The findings were published on November 5 in Nature.

Blocking progesterone to lower breast cancer risk

The research team conducted the Breast Cancer–Anti-Progestin Prevention Study 1 (BC-APPS1) at a single center in Manchester, United Kingdom. 

Their goal was to see if blocking the hormone progesterone could reduce the risk of biological signs of breast cancer.

All participants were women ages 25 to 45, still having regular periods, and with a moderately to highly increased chance of getting breast cancer due to their family history. On average, their lifetime risk was about 1 in 4.

Thirty‑two women joined between 2016 and 2019. After screening, 26 began treatment and 24 finished the study. 

Each took a 5-milligram tablet of ulipristal acetate every day for 12 weeks, starting on the first day of their period. This drug blocks progesterone’s effects.

Before starting and after finishing the 12‑week course, doctors collected small samples of breast tissue using a needle biopsy, with the beginning and ending samples being taken from a different breast. 

The first biopsy was timed for the part of the cycle when progesterone is normally highest, so the team could see the maximum impact of the drug.

They then examined the tissue in a lab to:

• count different types of breast cells
• test how active certain cell types were
• examine changes in genes and proteins, especially those involved in tissue framework (the “extracellular matrix”)
• measure how fibers, such as collagen, were arranged and the stiffness of the tissue

They also reviewed MRI scans and mammograms for changes in breast density, a known risk factor.

Ulipristal acetate targeted markers of breast cancer

The primary result was a significant decrease in breast cell growth. On average, 8.2% of cells were growing before treatment, compared with only 2.9% afterward.

One particular cell group, called luminal progenitor cells, decreased from 43% of breast cells to 30% after the drug was administered. These cells are thought to be the starting point for triple‑negative breast cancers, which are more aggressive and difficult to treat. Other cell types remained relatively unchanged.

Tests of cell activity showed similar results. The number of “mixed” colonies (cells that can develop into different types) dropped from 70% to 55%, and the ability to form mammospheres (small cell clusters grown in lab dishes) fell by about half.

Gene and protein studies showed that the drug altered the behavior of hormone-sensing cells — the ones that respond to progesterone — and reduced the production of key collagen proteins that help give breast tissue its structure, especially collagen VI. 

This matters because the way collagen is organized affects tissue stiffness and breast density, both of which are linked to cancer risk.

The team also found fewer “collagen signals” being sent to other cells like fibroblasts and basal cells, probably because the hormone‑sensing cells were making fewer signalling molecules (such as WNT5A). In turn, fibroblasts made less collagen.

Physical measurements confirmed the tissue changes: collagen fibers were less tightly aligned, and the breast tissue was softer after treatment.

The drop in high‑risk progenitor cell activity was greatest in women who had denser breasts to start with, suggesting they may benefit most from this approach.

Lab experiments supported these findings. When human breast cells were grown in stiff environments, progesterone’s effects on progenitor cells were stronger. 

Both ulipristal acetate and another anti‑progesterone drug reversed this, breaking the cycle between stiffness, progesterone activity, and progenitor cell growth.

Overall, taking ulipristal acetate for 12 weeks reduced cell growth, decreased the number of high-risk breast cells, and altered tissue structure in ways associated with a lower cancer risk, without serious side effects.

What to know about breast cancer prevention

While she said more data is needed before uliprital acetate can be recommended as a preventive measure, Sagun Shrestha, MD, Chief of Medical Oncology at City of Hope Cancer Center in Phoenix, AZ, noted the importance of visiting your primary care doctor and gynecologist for regular exams and following mammogram guidelines. Shrestha wasn’t involved in the study.

“Be aware of your body and if there is anything abnormal to report and get checked at the earliest for early diagnosis of breast cancer,” she told Healthline.

Shrestha said that at-risk individuals should consider minimizing hormone replacement therapy.

It’s also essential to get regular exercise, maintain a healthy weight, and limit or avoid alcohol and smoking, she said.

“Eat fruits, whole grains, fiber, and vegetables, and try to avoid processed food,” said added.

Metin Çakmakçi, a general and breast surgical oncologist at Acıbadem Health Group Ataşehir Hospital in Istanbul, Turkey, who was not involved in the study, added that nursing can help lower the risk of breast cancer for those who become pregnant.

“If you have children, breastfeeding for several months can slightly reduce your breast cancer risk,” he told Healthline.

According to Çakmakçi, females with BRCA gene mutations or a strong family history of breast cancer may consider preventive medications like tamoxifen (for premenopausal women) or raloxifene and aromatase inhibitors (for postmenopausal women). These help reduce the risk of developing breast cancer by blocking or lowering estrogen in the body.

“These medications serve as risk-reduction options for high risk patients, but they come with their own set of side effects, which need discussion with a specialist,” he said.

Çakmakçi added that women who are at very high risk, such as those who are carriers of the BRCA1 or BRCA2 mutation, might choose to have prophylactic surgery.

“This might involve mastectomy (removal of healthy breasts to prevent cancer), and/or removal of the ovaries (which produce most of the body’s estrogen),” he said.

While this choice can be life-altering, it also comes with significant risk reduction, as high as 90%, with a mastectomy.

“People need to evaluate their own needs before getting the surgery since it involves assessing both the benefits and the potential dangers and emotional consequences,” said Çakmakçi.

Finally, a tailored screening plan combined with these preventive measures is ideal for breast cancer prevention.

“Every woman’s situation is unique,” Çakmakçi said, “so I encourage discussing your individual risk and prevention plan with your doctor — but these general measures are beneficial for virtually everyone.”

• A new study suggests your body shape may reveal heart disease risk more accurately than BMI.
• Researchers found people with larger waists relative to their height were more likely to develop calcium buildup in their heart arteries — even if their BMI was in a healthy range.
• The findings could change how doctors screen for heart risk and provide patients with a simple at-home way to monitor their health.

Your body shape might better predict your risk of heart disease than your body mass index (BMI), according to a new study.

If you want a simple way to check your heart health, measure your waist and divide that number by your height. A waist-to-height ratio (WHtR) of 0.5 or higher could signal an increased risk of heart disease.

New research, recently published in The Lancet Regional Health, found that WHtR was more closely linked to heart disease risk than both BMI and waist circumference alone. 

“I think we’ve been shifting away from BMI being the only idea that matters to waist-to-height ratio being better when it comes to cardiovascular outcomes, especially related to metabolic and atherosclerotic conditions,” said Marcio Sommer Bittencourt, MD, PhD, associate professor of cardiology at University of Pittsburgh and senior author of the research

Notably, the findings held true even among people with a BMI below 30, the threshold for clinical obesity.

In other words: people who were in the normal or overweight BMI range were still identified as having a risk for future heart disease based on their WHtR.

“For those with a BMI between 25 to 29.9 but also for those with normal BMI, waist-to-height ratio was a very important marker. Waist-to-height ratio identified individuals at higher risk for actual sclerosis development after five years even after adjustment for all classic cardiovascular risk factors,” said Thiago Bosco Mendes, MD, instructor of medicine at University of Pittsburgh and first author of the research.

Although the measurement is simple, it’s not yet a routine part of standard health screenings. WHtR could become a valuable tool for physicians to spot people at higher risk of heart disease — especially those whose BMI doesn’t reflect their true risk.

It’s also easy to do at home for anyone who wants to keep tabs on their health without stepping on a scale.

Higher waist-to-height ratio raises heart disease risk

The researchers followed 2,721 adults in São Paulo, Brazil, to examine how body measurements predicted heart disease risk in comparison to BMI.

Participants were about 48 years old on average, and nearly two-thirds were female. The sample was racially diverse, but predominantly white (57%), and included participants of mixed race, Black, and Asian backgrounds.

To be included in the study, participants had to have no coronary artery calcium (CAC) buildup, as confirmed by a heart scan. CAC is a risk indicator for heart disease, with higher values indicating a more severe condition.

Alongside this initial heart scan, researchers performed three body measurements at baseline: BMI, waist circumference, and WHtR. 

After a five-year follow-up, researchers once again measured CAC. Approximately 15% of participants exhibited signs of CAC buildup, and it was found to be more prevalent among those with larger waists.

Although all three measures — BMI, waist circumference, and WHtR — were associated with heart disease risk in an unadjusted analysis, only WHtR remained an independent predictor after accounting for traditional risk factors, such as high blood pressure, elevated cholesterol levels, and diabetes.

In patients with a WHtR of 0.5 or greater, about 18% had CAC buildup, compared to only 10% those with a WHtR of less than 0.5. For every moderate increase in waist size compared to height, the risk of developing calcium in the heart arteries went up by about 18%.

“This study helps us to see what we have always suspected, which is that those people who have greater metabolic dysfunction, in this case marked by a waist-to-height ratio, are more likely to develop cholesterol plaque,” said Yu-Ming Ni, MD, board certified cardiologist and lipidologist at MemorialCare Heart and Vascular Institute at Orange Coast Medical Center in California. Ni wasn’t involved in the research.

The risk posed by a larger WHtR wasn’t fully explained by other common metabolic issues, such as high blood pressure and blood sugar, suggesting that abdominal fat may be harmful to heart health in other ways.

That’s likely because WHtR shows the presence of visceral fat, which is stored in the abdominal cavity and is associated with an increased risk of cancer, heart disease, and diabetes.

“We know that those who have more visceral fat have more inflammation, and that’s a risk factor for atherosclerosis as well,” Mendes said.

What body measurements say about your health

Doctors have long relied on BMI, an estimate of body fat based on height and weight, to diagnose obesity, and as an indicator of risk for everything from heart disease to cancer.

It’s a straightforward calculation that has played a disproportionately significant role in healthcare and medical research. However, the question of whether BMI is an accurate predictor of health has been increasingly raised by patients and doctors alike.

Other measurements, such as waist circumference, waist-to-hip ratio, and WHtR, may be better predictors of certain health outcomes than BMI alone; however, they are not used nearly as frequently.

 “Waist circumference measurement can be a little bit harder to do uniformly across clinic settings,” Ni said, “but it is something that I think the average person could use as a gauge of their personal health.”

Bittencourt emphasized that for some people — particularly those in the healthy or overweight BMI range — body measurements may offer a more accurate picture and better predict risk, especially among people who might otherwise be considered healthy.

Understanding your WHtR measurement may offer additional insight into your health in ways that BMI and weight alone do not. Still, for general wellness, BMI is generally a reliable indicator.

“Recommendations in terms of diet, exercise, reducing caloric intake, and preference for non-ultra-processed food are not changed by our findings,” Bittencourt said. “Whatever you can do to reduce your abdominal size, your WHtR, or your weight are still recommended.”

How to measure your waist-to-height ratio

If you want to check your WHtR at home. Here’s a simple step-by-step guide on how to do it.

1. Grab a tape measure — It should be long enough to measure your height.
2. Measure your height — Stand tall without shoes and note it in inches or centimeters.
3. Measure your waist —  Wrap a tape measure around your bare belly at the level of your belly button, between your ribcage and hips. Breathe out naturally before reading the number.
4. Do the math — Divide your waist measurement by your height (use the same units for both).
5. Example — If your waist is 34 inches and your height is 68 inches: 34 ÷ 68 = 0.5.
6. A simple rule of thumb — Your waist measurement should remain less than half your height.

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• Researchers report that intermittent fasting of less than 24 hours does not appear to diminish a person’s mental performance during the periods where they are not eating.
• They say the human body has adapted to fasting intervals by burning fat as an energy source.
• Past research has shown that short-term fasting can help individuals lose weight, improve insulin sensitivity, and reduce inflammation.

Intermittent fasting does not appear to diminish a person’s mental sharpness during periods when they are not eating, according to a new study.

Researchers report in their online-first paper, published in Psychological Bulletin, that short-term fasting of less than 24 hours does not affect the mental performance of adults.

“People often worry that if they fast they won’t be able to concentrate at work or study effectively,” said David Moreau, PhD, a neuroscientist at the University of Auckland in New Zealand and the senior author of the paper, in a statement.

“Our results show that, for most adults, short-term fasting is unlikely to have a major impact on mental sharpness,” he added.

Researchers noted that children and adolescents did show some erosion of mental capabilities while fasting. That reinforced the importance of having a proper breakfast before school.

In addition, the researchers noted that adults who fast tend to perform worse in tests later in the day. They suggested the lack of food may amplify natural dips in circadian rhythm.  

“Humans evolved with periods of food scarcity, so it makes sense our cognitive systems can function well without constant refueling,” Moreau said. “That said, children and teenagers appear more vulnerable, which fits with what we know about their high energy demands.”

Short-term fasting unlikely to impact mental performance

Experts who weren’t involved in the study say the research re-emphasizes the benefits of intermittent fasting.

“The important message is fasting is not going to cause a problem with your mental performance,” said Mir Ali, MD, a general surgeon, bariatric surgeon, and medical director of MemorialCare Surgical Weight Loss Center at Orange Coast Medical Center in California.

“This may reassure a lot of people,” he added.

However, Debra Safer, MD, a professor of psychiatry and behavioral sciences at Stanford University in California, pointed out that the study only dealt with short-term fasting of less than 24 hours.

“The study included research investigations primarily examining short term effects of fasting (average 12 hours fasts on cognitive performance),” Safer told Healthline. “Assurance for people who want to fast would require having research available under conditions more similar to those who want to fast as a regular practice.”

“This would include testing the effects of fasting for longer durations of time, research that included participants who were not necessarily in a healthy weight range, testing with participants who may also have co-occurring medical and psychological disorders, particularly including those with eating disorders (or at risk for eating disorders),” Safer continued.

Human body draws from other energy sources during fasting

The meta-analysis comprised 63 studies from around the world, involving more than 3,400 individuals.

Most participants regularly fasted for between 8 hours and 24 hours, with a median fasting period of 12 hours.

The researchers concluded that fasting “neither enhances nor impairs mental performance.” They did note three factors that can influence mental acuity.

• fasting duration
• context of the cognitive test
• individual characteristics (i.e., age and body composition)

In particular, researchers noted that people tend to score lower on mental tests near the end of their fasting period.

“These findings suggest that although most adults need not worry about temporary fasting affecting their mental sharpness, implementation across specific populations and situations may require more careful consideration,” the researchers wrote.

Researchers said that glycogen, the primary stored form of glucose, serves as the main energy source for individuals who eat regularly throughout the day.

They said glycogen levels may decrease while a person is fasting, but the body finds other energy sources, such as ketone bodies, that are produced from fat tissue.

“This metabolic flexibility likely supported survival during periods of food scarcity, particularly before the advent of effective food preservation methods,” the researchers wrote.

The researchers stated that this prehistoric adaptation in the body continues to serve humans well.

“Comparative biological evidence and evolutionary theories suggest that humans developed enhanced fat storage capacity as an adaptive response to resource fluctuations,” the researchers explained.

“This energy reserve not only supported daily metabolic demands but also enabled the prolonged development and expansion of the human brain, which requires substantial energy input,” they added.

“[The study] does seem to provide reassurance that the human body is very adaptable and people – in general — can maintain cognitive performance for periods of fasting similar to what is usually observed when people have short-term perturbations in their sleep,” Safer said.

“However, some factors are important to watch out for, like how long the fasting interval is, the context one within which one is performing a cognitive task, and individual characteristics such as younger age,” she added.

Benefits of intermittent fasting

Intermittent fasting is described as a dietary pattern that switches between periods of eating and periods of fasting.

Most intermittent fasting plans don’t focus on what a person eats. The emphasis is on when they eat.

There are several popular fasting methods. They include:

• 16/8: This involves an 8-hour eating period and a 16-hour fasting period. Some people do this by skipping breakfast, while others reverse the approach by skipping dinner or eating it early.
• 5:2: This method involves eating only 500 to 600 calories on two nonconsecutive days of the week and then eating as usual the other 5 days.
• Eat Stop Eat: This plan involves fasting for 24 hours once or twice a week.

Fasting can work because of how the body reacts to an extended period of time without food. For example:

• Fasting causes an increase in human growth hormones, which in turn induces fat loss and muscle growth.
• Fasting can also improve insulin sensitivity and decrease insulin levels, making stored fat more accessible.
• In addition, fasting can initiate the process of cellular repair. This repair can include autophagy, in which cells digest and remove old and dysfunctional proteins that build up inside them.

“Fasting basically switches the body into the mode of fat burning,” Ali explained to Healthline.

Intermittent fasting can help with weight loss. One of the main reasons is that fasting results in fewer calories being consumed per day.

Research has shown that improvements in insulin sensitivity during fasting can help prevent and manage type 2 diabetes.

Some studies have indicated that fasting can reduce inflammation in the body, a key driver of chronic disease.

“Fasting is effective for a lot of people for a lot of reasons,” Ali said.

How to practice intermittent fasting

There are some side effects to intermittent fasting.

The most obvious is hunger. There are others, however. They include:

• blood sugar regulation
• low blood pressure
• interference with daily medication schedules
• loss of muscle mass

Additionally, intermittent fasting may not be the best choice for a person with a history of eating disorders or someone who is pregnant or nursing.

On the plus side, there is some flexibility with intermittent fasting schedules.

You can drink water, coffee, tea, and other liquids while fasting. You can also adhere to a daily exercise schedule.

It’s important to consume nutrient-dense foods while following an intermittent fasting plan, as well as to engage in regular exercise and ensure you get adequate sleep.

Ali recommends that people start slowly when implementing a fasting regimen. He says initially fasting for 6 to 8 hours is a good place to start. Then, a person can graduate to 8- to 10-hour fasts and eventually to the more optimal 12- to 14-hour fasts.

Ali recommended that the final meal of the day, such as dinner, contain a high amount of protein and vegetables. He suggested a lower amount of carbohydrates because those substances can burn off more quickly and induce hunger pangs.

• Researchers say people with insomnia who use melatonin supplements for more than a year have a higher cardiovascular disease risk than people with insomnia who don’t use the sleep aid.
• Experts say the research raises some important questions, but they note that the study does not directly link melatonin to the cause of the heart disease risks.
• They add that melatonin is intended for short-term use, and there are ways for a person to obtain good quality sleep without taking medication.

Researchers are reporting that long-term use of melatonin supplements may increase the risk of heart failure.

In their study, the researchers said that people who used melatonin for more than a year were more likely to be diagnosed with heart failure, require hospitalization for that condition, or die from any cause.

Their research is being presented later this week at the American Heart Association’s Scientific Sessions 2025 meeting in New Orleans.

The preliminary study has not yet been published in a peer-reviewed scientific journal.

Researchers acknowledged their study doesn’t establish a cause-and-effect relationship between melatonin supplements and heart failure risks.

However, they noted that the results raise safety concerns about the long-term use of melatonin and, therefore, may warrant further research on these supplements to assess their cardiovascular safety.

Researchers also noted that many melatonin supplements are sold over-the-counter without a prescription. They said these products are not regulated, and people can use them without the guidance of a healthcare professional.

“Melatonin supplements may not be as harmless as commonly assumed. If our study is confirmed, this could affect how doctors counsel patients about sleep aids,” Ekenedilichukwu Nnadi, MD, the lead author of the study and the chief resident in internal medicine at SUNY Downstate/Kings County Primary Care in Brooklyn, NY, said in a news release.

Experts who weren’t involved in the study said the research raises some serious questions, although they add it’s important to note the study does not directly link melatonin to cardiovascular disease risk.

“The study raises some important and unexpected concerns,” said Rigved Tadwalkar, MD, a consultative cardiologist and director of the Digital Transformation Pacific Heart Institute in Santa Monica, CA. “It’s interesting because melatonin has been thought of as being heart-protective.”

“The results are quite striking,” added Cheng-Han Chen, MD, an interventional cardiologist and medical director of the Structural Heart Program at MemorialCare Saddleback Medical Center in Laguna Hills, CA. “That being said, an association (with risks) is different than a causation.”

Melatonin and heart health risks

Melatonin is a hormone produced in the body by the pineal gland. It helps regulate the body’s sleep-wake cycle. Melatonin levels increase during darkness and decrease during daylight hours.

Melatonin supplements are chemically identical synthetic versions of the hormone. They are often used to treat insomnia, a condition characterized by difficulty falling asleep, staying asleep, or waking up too early.

It’s estimated that about one-third of people in the United States don’t get the recommended 7 hours of sleep per night. About 10% of Americans have chronic insomnia, in which they have sleep difficulties at least three times a week over a 3-month period.

Past research has indicated that melatonin can be beneficial in helping people sleep as well as assist in correcting jet lag, improving eye health, and offering pain relief to individuals with migraine.

However, researchers in the new study said data have been lacking on melatonin’s long-term cardiovascular safety. That prompted them to examine whether melatonin use might increase the risk of heart failure, specifically in chronic insomnia patients.

Their study was done over the course of 5 years. The researchers utilized the TriNetX Global Research Network, a large international database established in 2013.

The researchers looked at the electronic health records in the database of more than 130,000 people. The average age of the subjects was 55 years. More than 60% were women.

They divided participants into two groups: People with insomnia who had used melatonin supplements for at least a year and participants with insomnia who had no record of utilizing these supplements.

There were about 65,000 people in each of the groups.

None of the people studied had been previously diagnosed with heart failure or had been prescribed sleep medications other than melatonin.

The researchers reported that the subjects who used melatonin for more than a year had a 90% higher chance of incident heart failure over 5 years compared to people who didn’t use the sleep aid.

Participants taking melatonin were also nearly 3.5 times as likely to be hospitalized for heart failure when compared to those who didn’t use melatonin supplements.

In addition, people in the melatonin group were nearly twice as likely to die from any cause when compared to the non-melatonin group.

Tadwalkar noted that one reason for these figures may be that people with chronic sleep issues may face health risks associated with that condition, regardless of whether they take melatonin.

“This might be a guilt-by-association type of situation,” he told Healthline.

Chen said melatonin was designed as a short-term treatment. He said people who need to take the sleep aid for more than a year could have other serious underlying issues.

“They probably should go see a sleep specialist and try to figure out what’s going on,” he told Healthline.

Benefits of quality sleep

Experts say that getting the recommended 7 or more hours of sleep per night offers numerous health benefits.

Sleep is listed as one of the key components of the American Heart Association (AHA)’s Life’s Essential 8 healthy habits.

According to the Centers for Disease Control and Prevention (CDC), quality sleep can enhance overall health in several ways. These include:

• stronger immune system
• healthy weight maintenance
• improved heart health and metabolism
• reduced risk of chronic conditions (i.e., type 2 diabetes)
• improved memory and cognition
• reduced stress and improved mood

On the other hand, a lack of consistent quality sleep can lead to health risks, including high blood pressure, stroke, heart attack, and heart disease.

Chen and Tadwalkar both said the health risks from poor sleep probably outweigh the potential risks from melatonin use.

“Poor sleep can put a lot of stress on the heart,” noted Chen.

“Inadequate sleep is a major cardiovascular risk,” added Tadwalkar. “Chronic insomnia is a huge red flag.”

Tips to help you sleep better

There are several things you can do to achieve quality sleep without medication. Among them:

• getting bright light exposure during the day
• reducing blue light exposure at night
• avoiding caffeine late in the day
• avoiding alcohol late in the day
• avoiding late meals
• exercising during the day but not at night
• having a comfortable bed and pillow
• going to bed and waking up at the same time every day

Tadwalkar added that cognitive behavioral therapy (CBT) has also been shown to be beneficial by addressing thoughts, behaviors, and habits associated with poor sleep.

Both experts encouraged going to bed in a dark, cool, quiet room and avoiding caffeine, alcohol, and electronic screens in the evenings.

“Sleep hygiene practices are so important,” Tadwalkar said.