What You Need To Know About Low T (Testosterone) and Heart Disease

I have received dozens of calls from men who are concerned about the recent study that reports that testosterone replacement therapy increases the risk of heart attacks and strokes. This blog is intended to clarify some of the misinformation that is attracting so much media attention. The Androgen Study Group, a large group of physicians and researchers of which I am a member, is calling for the retraction of the paper that appeared in the Journal of American Medical Association linking testosterone and cardiovascular risks — data that its authors of the paper in the journal are standing firmly behind.

In a letter to Howard Bauchner, MD, editor-in-chief of the Journal of the American Medical Association, members of the group — formed in response to the paper and comprised of more than 125 doctors — said the study’s credibility was compromised by at least two corrections and should be pulled from the journal.
A close friend and colleague, Dr. Abraham Morgentalker pointed out the there’s no misconduct, no one faked any data, it’s just sloppy. The group called it “gross data mismanagement.”

The paper, published in JAMA in November by Michael Ho, MD, PhD, of the Eastern Colorado VA, and colleagues, found that testosterone therapy was associated with a greater risk of death, heart attack, and stroke in male veterans who’d had coronary angiography. (If the men were having coronary angiography, it stands to reason that they already had some heart disease or they wouldn’t have been subjected to this invasive procedure)

But two corrections have since been published. The first, in the Jan. 15 issue, was a clarification that the results were based on “estimates” and not raw data.

The second, which Morgentaler and colleagues focus on in their letter to the editor of the journal, involved reclassivication of patient who were excluded from the study. More than 1,000 excluded patients were assigned to different categories of exclusion, including 100 who were women!

The authors included almost 10% women in an all-male study, so why should we believe any of the other data? The Androgen Study Group points out that the data were so off that it’s hard to believe the data for the entire study are accurate.

However, Ho and colleagues said they “stand firmly by the results of our study,” noting that the overall number of excluded patients remains the same, as does the total number of included patients, and the main results of the study were not changed.

The study group said that these claims run contrary to 40 years’ worth of research on testosterone, which suggests that the hormone has some beneficial effects in certain heart patients.

But the testosterone therapy field has garnered much media attention for its financial relationships with industry. Several articles in the New York Times, including one on the marketing of “Low T”, another on the selling of testosterone gels, and an editorial, have questioned the potential overselling of the therapy.

It is true that several members of the Androgen Study Group, myself included, have relationships with testosterone drug makers, such as AbbVie, Watson, and Endo Pharmaceuticals.

It is my opinion that men who are symptomatic for low testosterone and have complaints such as lethargy, decreased libido, loss of muscle mass, and decrease in erections or potency AND who have a documented decrease in the blood level of testosterone, are good candidates for hormone replacement therapy. These men who are going to receive testosterone should have a normal digital rectal exam and a normal PSA test if they are less than 75 years of age.

Bottom Line: Low testosterone has effects that impact a man’s quality of life. If a man has symptoms of low T and a documented decrease in the blood testosterone level, he should speak to his physician about testosterone replacement therapy.

Really Saving Souls

My medical soul was lifted after reading an editorial, A Wedding In Intensive Care, in the Thursday, March 20 2014 New York Times by Dr. Haider Javid Warraich. The story describes a terminally ill lady in the ICU whose daughter’s wedding was to take place in a few months. The doctor informed the daughter that her mother, who was on IV opiates, would certainly not be able to attend her wedding. The crying daughter called her fiancé and told him that her mother would was very sick and would not be there for her wedding. The fiancé stepped up to the plate and suggested that they immediately arrange the wedding and to hold the ceremony in the ICU. The entire ICU staff, doctors, nurses, and administration, went into “let’s make it happen” mode and organized a beautiful wedding in the ICU.

The patient stopped her pain medication for a few hours to be able to be “in the moment”. The wedding was beautiful and one that will be remembered for a lifetime by the family, the doctors, the nurses, and the entire ICU staff. The next day the patient was transferred to hospice and all the tubes and IVs were discontinued in order to “make her comfortable.”

Dr. Warraich concluded, “Doctors often share their patients’ sorrow, but rarely their joys.” This lovely story should help all doctors focus on the wonder that we can bring to our patients and their families. We are part of an amazing profession that affords us the opportunity to not only diagnose and treat diseases, but also to make magic happen for so much of the world. Perhaps we can collect such stories and write our own “Chicken Soup For The Doctors’ Souls.”

P.S. Four months later the patient was still alive and doing well in the hospice environment.

Dr. Neil Baum is a physician in New Orleans

ED Prevention-It May Take More Than Take Two Aspirin In the Morning

Erectile dysfunction (ED) affects millions of American men. Most of the causes are do to physical reasons and many can be reversed. This article will discuss action steps every man can take prevent and perhaps reverse ED.

Most men will experience an occasional erection problem. However when ED occurs most of the time, it is an indication that action steps need to be taken and an evaluation of a doctor is in order.

Here are some steps to consider to prevent ED from rearing its ugly head.

Kick the butts in the butt. Numero uno on your ED prevention list is to stop smoking. For men under the age of 40, smoking is the biggest cause of erectile dysfunction.

That’s because maintaining an erection requires a healthy blood supply, and nicotine causes your blood vessels to constrict, and can even result in your penis shrinking in size. The longer you’re a smoker, the more difficult it is to treat or reverse erectile dysfunction.

Get off your butt and get moving. Regular exercise is a must for both your heart and circulation — and because of that, it’s also an important way to prevent ED.

Regular exercise can improve blood flow to the penis, as well as to the rest of your body. Not to mention, working out increases your energy, lowers blood pressure, reduces stress, helps you sleep better, and makes you feel (and look!) more attractive — which are all helpers in avoiding erection problems.

Deep six the alcohol bottle. Sure, kicking back with a little booze is a great way to de-stress — but in large amounts, alcohol is a depressant. That means the more you drink, the more likely the alcohol will lead to erectile dysfunction (depression is one of the biggest causes of ED). This effect increases as you get older, so older men who are at greater risk for erection problems should take steps to limit the number of alcoholic beverages they consume. Talk to your doctor to find out if you should aim for less than the two-drinks-per-day maximum that’s often advised for men.

Fruits and veggies are an ED buster. A number of studies show that obesity, high cholesterol, diabetes, heart disease, and high blood pressure are linked to erectile dysfunction. Since a healthy diet is one of the best ways to protect against these diseases, it makes sense for your sexual health to eat healthily. What foods should be a part of your ED-prevention diet? Lots of fruits and vegetables, plenty of fiber, and very little saturated fat. If you’re struggling with your weight or cholesterol, ask your doctor for help.

Floss and brush your teeth. 
Turns out, erectile dysfunction and chronic gum disease share many of the same risk factors. In one recent study, 80 percent of men who had severe erectile dysfunction (caused by poor penile blood supply) also had chronic gum disease. Keeping your mouth healthy with flossing, brushing, and regular dental visits is one more way to keep your sex life in tip-top shape.

Relax. 
Stress and anxiety are frequent contributors to erection problems. That’s because stress causes your body to release stress hormones that are good for your “fight or flight” response, but bad for your blood flow because it causes blood vessels to contract. To prevent ED, find ways to reduce stress (without resorting to drugs, cigarettes, or alcohol, of course).

Good Zzzzzzzs can be a game changer. 
Fatigue can be a detriment to your sex life — so getting plenty of rest before a romp in the hay is always a good idea. But if you’re struggling to get a good night’s sleep and feeling drained throughout the day, you could have a condition called sleep apnea (which is signaled by very noisy snoring and periods of interrupted breathing). Studies show that men with erectile dysfunction are more than twice as likely to have sleep apnea, so if your partner is sleeping in the other room because of your snoring, talk to your doctor.

Bottom Line: ED is a devastating condition that can be a harbinger of other conditions such as high blood pressure, high cholesterol, heart disease, diabetes, depression, kidney disease and stroke. Take the steps provided in this article and you will have better erections and a much healthier life.

Dr. Neil Baum is a urologist in New Orleans and can be reached at (504) 891-8454 or through his website: http://www.neilbaum.com

Overactieve Bladder-Botox May Be a Solution

Overactive bladder or urinary frequency, urgency and urge incontinence affects millions of American men and women. Most men and women can be helped with medication. However, some suffers are unable to achieve any relief with medication or suffer from the side effects so that taking the medication is not possible. Now a new FDA treatment using Botox has been tested for those patients, mostly women, who have difficult to treat overactive bladder.

Botulinum toxin, otherwise known as Botox, has been historically used by the plastic surgery community to help alleviate wrinkles on the face. Botox relaxes muscular tissue. When used in the bladder, it can relax the bladder muscle resulting in fewer visits to the bathroom. Women who use the bathroom more than 8 times during the day and may be experiencing frequent bathroom trips at night may benefit from Botox treatment. Botox has been determined to be a safe and effective treatment for overactive bladder and urinary incontinence.

The procedure of Botox injections is simple, quick, and can easily be done in the office setting. It is typically done with the help of a cystoscope under local anesthesia but can also be done in the same day surgery setting under monitored anesthesia depending on patient preference. There are no incisions. The bladder is examined carefully with the cystoscope and Botox is injected into the bladder wall through a special needle passed through the cystoscope directly into the bladder muscle. Most patients tolerate the procedure very well, maximum benefit is obtained in about 2 weeks, and the treatment lasts 4 to 9 months and then can be repeated again.

Patients usually notice a reduction in their urinary frequency and urgency about 5 days after the procedure. If leakage occurred before Botox, there should be no leakage afterwards. There are a few reported side effects such as blood in the urine after the procedure but then clearing within a few days. Bladder infection may occur as a result of the minimally invasive procedure, so antibiotics are typically given as a precaution after the procedure. About 1 in 10 to 1 in 20 patients describe difficulty emptying the bladder after the procedure and may need to pass a urinary catheter intermittently to achieve complete emptying of the bladder for a few weeks post op.

Bottom Line: Overactive bladder is a common problem that affects the quality of lives of millions of American men and women. Most of patients can be helped with medication. Now Botox is available for those who find the medication ineffective or suffer from intolerable side effects.

Tomatoes Can Punch Out Prostate Cancer

Tomatoes Can Punch Out Prostate Cancer
Prostate cancer remains one of the most common cancers in men and causes the death of nearly 30,000 men each year. The cause of prostate cancer is unknown but we do know that having a family member with prostate cancer and African American men have a higher incidence of prostate cancer which leads me to believe that there is a genetic or hereditary basis for prostate cancer.

A recent study from the Journal of National Cancer Institute has pointed out that increased consumption of lycopenes, which are found in tomatoes, tomato-based products, pink grapefruit, and watermelons appear to decrease the risk of prostate cancer.

The study suggests that increasing the consumption of a diet rick in lycopene-containing foods reduces the aggressive potential of prostate cancer. The study showed that a high in take of tomato or tomato-based products was associated with a 10%-20% decrease in prostate cancer risk and those men who had high blood levels of lycopenes had a 25% decrease risk of prostate cancer.

For those men who do not like tomatoes, you can take a supplement of lycopene, 20-25mg per day.

Bottom Line: No one knows for certain why lycopenes decreases the risk of prostate cancer. But as my wise Jewish mother would say, “It may not help, but it voidn’t hoit.”

Medical Tests That You Can Do Without

I just had my annual physical examination. I am without any symptoms; take a baby aspirin and a vitamin; have no co morbid conditions. I asked myself did I really need a chest x-ray when I am exposed to so much radiation during my work at the hospital or did I need an EKG with no symptoms and a negative family history? I found my answer in a recent AARP article about “10 Tests To Avoid”.

1. Nuclear stress tests, and other imaging tests, after heart procedures
If you have had heart bypass, stent or other heart procedure, you don’t need nuclear stress test or other tests that their hearts are beating strong and the results rarely change the plan of management. Instead, patients and doctors should focus on what does make a difference in keeping the heart healthy: managing weight, quitting smoking, controlling blood pressure and increasing exercise.

2. Yearly electrocardiogram or exercise stress test
Someone at low risk for heart disease could be 10 times more likely to get a false-positive result than to find a true problem with their heart. The stress test could lead to unnecessary heart catheterization and stents. Instead, it is important to have your blood pressure and cholesterol checked at least once a year. And if you’re at risk for diabetes, have your blood glucose level checked as well.

3. PSA to screen for prostate cancer
Cancer is always scary, but the PSA test often finds slow-growing cancers that won’t kill men. An estimated 75 percent of tests that show high PSA levels turn out to be false alarms.
The American Urological Association, of which I am a member, supports the use of PSA testing, but should be considered mainly for men ages 55 to 69. I also believe that no testing is required in the man without any symptoms if the man is more than 75 years of age. However, men with a positive family history of prostate cancer and African American men should have an annual PSA test and a digital rectal examination.

4. PET scan to diagnose Alzheimer’s disease
In the last few years, doctors have begun using PET scans with a radioactive dye to look for beta-amyloid protein that is found in the brains of people with the Alzheimer’s disease. Even if a PET scan could accurately diagnose the disease, it’s untreatable. If you’re concerned about your memory, the better course is to have a complete medical evaluation by a doctor who specializes in diagnosing and treating dementia.

5. X-ray, CT scan or MRI for lower back pain
Back pain is incredibly common — 80 percent of people will suffer from back pain some time in their lives. It can be both excruciating and debilitating. Naturally, people want to know what’s wrong. Here’s the catch: The best imaging machines in the world often can’t tell them. Many older people with no back pain can have terrible-looking scans.
Most back pain goes away in about a month and imaging tests tend to lead to expensive procedures that often don’t help or shorten recovery. If you don’t feel better in a month, talk to your doctor about other options such as physical therapy, yoga or massage. But if your legs feel weak or numb, you have a history of cancer or you have had a recent infection, see your doctor.

6. Yearly Pap tests
The yearly Pap smear is a common part of women’s health checklists, but it doesn’t need to be. Women at average risk only need them every three years, since cervical cancer generally takes 10 to 20 years to develop. If women have also had negative tests for the human papillomavirus (HPV), which is now known to cause the cancer, they only need a Pap test along with the HPV test every five years. And women older than 65 who have had several normal Pap tests in a row can stop having them altogether. Also, if you have had a total hysterectomy for a benign condition such as uterine fibroids and the entire uterus and cervix have been removed, you do not need any further Pap test. Do note, however, that a yearly visit to an ob-gyn stays on the to-do list.

7. Bone density scan for women before age 65 and men before age 70
For the estimated 10 million people — mainly women —in the United States who have osteoporosis, bone-strengthening medications can lower the chances of breaking a bone. But many experts argue that for those ages 50 to 65 who have osteopenia — mild bone loss — testing and subsequent drug prescriptions may be a waste of time and money. Not only is the risk of fracture often quite low, medications such as Fosamax (alendronate) and Boniva (ibandronate) have been linked to throat or chest pain, difficulty swallowing, heartburn, muscle pain, bone loss in the jaw and thigh-bone fractures. And there’s scant evidence that people with osteopenia get much benefit from the drugs.
To help keep your bones strong, try walking and weight-bearing exercises,. Get enough calcium, 1000mg\day, and vitamin D, 1000IU\day, in your diet. If you smoke, quit.

8. Follow-up ultrasounds for small ovarian cysts
Many women receive repeated ultrasounds to verify that ovarian cysts have not become cancerous, but current research says that these tests aren’t necessary. For one thing, premenopausal women have harmless ovarian cysts regularly. For another, about 20 percent of postmenopausal women also develop harmless cysts.
The likelihood of these small simple cysts ever becoming cancer is exceedingly low.

9. Colonoscopy after age 75
Most people should have screening for colon cancer at 50 and then every five to 10 years after that, if the first test is normal. By age 75 — if you’ve always had normal colonoscopies — you can stop taking this test altogether. That should be good news, because a colonoscopy can cause serious complications in older people.
To protect your colon, eat plenty of fruits, vegetables and whole grains for fiber. Cut down on fatty foods, red meat and processed meats. Lose weight if you’re overweight and exercise. Sound familiar? It should, because that’s the best advice for protecting the rest of your body — and mind — as well.

10. Yearly physical
There’s little evidence that having an annual checkup can keep you healthy. Now I they tell me! Many tests that doctors regularly perform — to diagnose anemia, liver disease or urinary tract infections, for example — don’t make sense unless there’s a reason to suspect a problem.
Certainly, if you have an illness that needs treatment, you should see your physician. And do talk to your doctor about how often you need to have your blood pressure and cholesterol tested.

Bottom Line: Use good judgment about your health and your visit to the doctor. Ask the doctor if the test is really necessary and if the results will change how he\she is taking care of you. My message is that patients, including myself, need to become involved in their healthcare.
This article was inspired and modified from AARP, 10 Test to Avoid, by Elizabeth Agnvall, http://www.aarp.org/health/conditions-treatments/info-2014/choosing-wisely-medical-tests-to-avoid.3.html

Healthy Eating For Middle Aged Men

Middle age men are making an effort to improve their lifestyles. They are exercising more than the previous generation and they are making an effort to practice good nutrition. This article will discuss the best foods for the baby boomer generation.

Women in middle age experience menopause, which is the abrupt cessation of the decrease in estrogen production by their ovaries. Men have their own more subtle changes as they age called andropause. With andropause come slowly decreasing testosterone levels, lower metabolism, an enlarged prostate, and an increased risk for cardiovascular problems and other diseases. These changes can affect your sex life, mood, ability to sleep, concentration, and prostate health.
Eating the right foods can help increase your energy level, lower your cholesterol and blood pressure and even improve your sex life. Eating a variety of healthful foods will strengthen your immunity and help you age better. Eating plenty of fiber is also important to keep your digestive track running regularly and decrease the risk of colon cancer.
Nuts

Nuts are some of the best foods for men over 50 for many reasons. Nuts are good for your heart health, but they also pack other benefits in a tiny space. Almonds can improve your sleep and mood. Brazil nuts are helpful for proper prostate functioning. Walnuts have anti-inflammatory properties that are good for muscles. Pistachio nuts can help lower cholesterol, protect your heart, and improve erectile function.
Cruciferous Vegetables

Cruciferous vegetables like broccoli, broccoli sprouts, Brussels sprouts, cauliflower, kale, bok choy, cabbage, radishes, and others are some of the best foods for men over 50. They help prevent bladder cancer and other types of cancer (especially when eaten raw) and they are high in fiber. Don’t believe us? Here are 10 reasons to eat broccoli and some studies on how eating vegetables can reduce prostate cancer progression.
Berries

Aging men should try to eat one cup of berries per day. All berries are good for you, but blueberries and acai berries are highest in antioxidants and are especially good for the health of your brain. Feeling forgetful? Pop some berries. Berries are high in vitamin C and fiber. Berries and other foods like apples and tea are rich in flavonoids called anthrocyanins. A study from Harvard found anthrocyanins to be especially beneficial to men in preventing Parkinson’s. Men, but not women, who ate the most of this flavonoid were 40% less likely to develop Parkinson’s than men who ate the least about.
Red and Orange Fruits and Vegetables

Red and orange fruits and vegetable are so good for you. They are high in beta-carotene, which is a precursor to vitamin A, which can help your immune system fight cancer and other diseases. Red and orange bell peppers, pomegranates, tomatoes, beets, carrots, sweet peppers, and chili peppers all top the list for the best foods for men over 50. Chili peppers can help improve your metabolism, work as blood thinners, and even increase your mood by releasing endorphins. Sweet potatoes have been shown to prevent diabetes and many other diseases such as Alzheimers, Parkinsons, cancer, heart attack, and stroke. They even help with skin health and wrinkles. Beets and other vegetables high in nitrates may improve sexual health, and carrots are good for your skin and for fighting cancer and inflammation. You can’t beat lycopene health benefits for men. Lycopene from tomatoes and watermelon help to help boost sexual health while promoting a normal prostate size and fighting against prostate cancer.
Beans and Lentils

Filled with fiber and protein, beans and lentils make a great meat substitute. Like berries, black beans contain anthrocyanins, which are especially good for brain health. People who eat beans at least three times a week experienced a 33% reduced risk of colon polyps (which often lead to colon cancer).
Green Leafy Vegetables

Dark green vegetables are good for your brain health and sexual health. Spinach is high in lutein and can even increase blood flow to the penis, helping with erectile function. Green leafy vegetables are high in folate and potassium, plus they are a great nondairy source for calcium, which is good for your bones. A study reported that that men who ate greater amounts of leafy green vegetables had a 34% reduced risk of aggressive prostate cancer.
Whole Grains

Whole grains are high in fiber and protein too. Oatmeal is one of the best cholesterol lowering foods because oatmeal is high in fiber. The fiber found in whole grains such as oatmeal, barley, brown rice, and wheat calms inflamed tissues and keep the colon and heart healthy. Consider adding quinoa, which is technically a grain-like seed that is a source of complete protein, to your diet of whole grains.
Foods Rich in Omega 3

Some of the best foods for men over 50 are foods high in omega-3 fatty acids for heart, prostate, and brain health. This includes certain fatty fish like wild salmon, tuna, and sardines, and non-fish foods like flaxseed and walnuts. Flaxseed is a high-fiber mood lifter and it improves heart health. Sprinkle flaxseed on yogurt, salad, or oatmeal. When shopping for fish, buy only wild salmon. There are other benefits to eating these fish as well. Tuna is high in niacin for your heart and selenium. It preserves elastin for tighter skin. Some foods that contain omega-3 fatty acids and also contain the mineral zinc are oysters and Alaskan king crab legs. Zinc plays a role in prostate health and sexual health.
Green Tea

Drinking several cups of green tea per day helps prevent cancers such as prostate cancer, plus it provides cardiovascular benefits by improving blood flow and it helps lower cholesterol. In addition, green tea is good for your brain.
Heart-Healthy Oils

The best foods for men over 50 include heart-healthy oils such as olive oil, seeds, nuts, and avocado. Avocados are high in monounsaturated fat and have the ability to help lower cholesterol and reduce inflammation for cells and joints. Heart-healthy oils also are good for prostate health. Some studies on heart healthy food for prostate cancer demonstrated that these foods slowed progression of cancer and increased survival.
Healthy Spices for Men over 50

There are spices for your food that are also available in supplement form. Curcumin, which is derived from turmeric, is good for fighting tumors and it has anti-inflammatory properties that are beneficial for rheumatoid arthritis, prostatitis, and other inflammatory conditions. Cinnamon has many health benefits for aging men as well, including regulating blood sugar lowering cholesterol, helping relieve arthritis pain, and boosting cognitive function and memory. Garlic is another flavoring for food that is one of the best foods for men over 50 because it can lower risk for benign enlargement of the prostate gland.

Bottom Line:
After age 50, it is imperative to your health to develop a healthy lifestyle, which includes regular exercise and paying attention to your nutrition. You will feel better, think better, and fight disease better if you give your body the nutrients and tools it needs to work its best.
This article was inspired by an article on Best Foods For Men Over Age 50.

– See more at: http://www.prostate.net/2013/nutrition/best-foods-for-men-over-50/#sthash.HTb3i2SK.dpuf

Urinary Incontinence-Non-Medication Solutions

Millions of Americans suffer from incontinence. Americans are already “polymedicated” or taking far too many drugs. Many of my patients are trying to solve problems naturally without the use of medications. This blog will discuss the treatment of urinary incontinence without prescription medications.

Incontinence is a symptom of a urinary tract problem, and there are different types of urinary incontinence. Women commonly have overactive bladder\urge incontinence or stress incontinence with the loss of urine with coughing, sneezing, or with exercise.

Men most commonly experience stress incontinence — the accidental release of urine when the bladder is under pressure — after being treated for prostate cancer.
Another type of incontinence called overflow incontinence, occurs more commonly in men. This is associated with enlarged prostate — benign prostatic hyperplasia (BPH). BPH can squeeze the urethra and keep the bladder from completely emptying.

Whether you have stress incontinence, urge or overflow incontinence, there are natural steps you can take to support your urinary health and restore continence. If an enlarged prostate is causing your symptoms, you can learn how to promote a normal prostate size.

The lifestyle choices you make and the foods you eat can help you regain control of your bladder. Following are several lifestyle changes you can make that will positively affect your bladder control, prostate and urinary health.
Manage Fluids

Drink pure water. While it is important to stay properly hydrated, you want to avoid drinking in the two to three hours before bedtime.
Supplements

There are several natural supplements that support the urinary tract, and many supplements that shrink the prostate. Many men find urinary health benefits from quercetin, saw palmetto, curcumin, green tea extract, cranberry, stinging nettle and pygeum.

Fruits And Vegetables
These foods are high in antioxidants, vitamins, minerals and fiber. These support prostate health and urinary tract health, as well as being good for the rest of you too.

Consume Healthy Fats
Healthy fats such as omega-3 fatty acids and monounsaturated fats help promote prostate health.

Avoid Food Additives And Sugar
Some foods and additives are harmful to the prostate and your urinary function. Try to avoid the worst ingredients in processed foods.

Maintain A Healthy Weight
Being overweight can worsen symptoms of urinary incontinence by putting excess pressure on the bladder. Exercise helps promote prostate health.

Kegel Exercises
Doing Kegels every day can help improve bladder control. Other alternative treatments such as physical therapy may also be of help.

Avoid Cigarettes Or Drink
Smoking is a risk factor for stress incontinence. Alcohol increases urinary frequency, so try to limit or avoid it.

Drink Green Tea
Green tea health benefits come from its strong antioxidant and anti-inflammatory properties. Whether your drink it or take it as a supplement, look for caffeine-free green tea.

Avoid Caffeine
Caffeine from coffee, tea and soda can promote urinary frequency. A study on incontinence in men and caffeine shows that men who consumed 234 mg or more of caffeine every day were 72 percent more likely to have some urinary incontinence compared to men who drink small amounts.

Avoid Foods That Irritate The Bladder
Foods and drinks that can irritate the bladder include citrus fruits, citrus juice, carbonated drinks and spicy foods.

Go When You Need to Go
Don’t hold your urine when you need to go. Holding it can irritate your urinary tract and possibly lead to a urinary tract infection.

Of course, there are medications and other treatments that can help with urinary symptoms of BPH, but they have some unwanted side effects. Before taking any medications, you should give some of the natural supplements and lifestyle changes a try. They may help and they won’t hurt.

Bottom Line: The first step is to talk to your doctor about what is causing your urinary incontinence and to develop a plan for dealing with the problem. Learn as much as you can about urinary incontinence. If you suffer from urinary incontinence, try some of these non-prescription alternatives. They just might work and will decrease your dependence on Depends!

This blog was inspired and modified by an article Treat Urinary Incontinence Naturally
Dr. Geo Espinosa
http://easyhealthoptions.com/easy-health-options-digest/treat-urinary-incontinence-naturally/

Testosterone Replacement Therapy (TRT) After Prostate Cancer Diagnosis

For nearly 50 years the medical profession has had the opinion that men with prostate cancer or at risk for prostate cancer should avoid testosterone as it was like adding gasoline to a fire. Well, that assumption has been reversed and there are certain men with prostate cancer who have symptoms of low testosterone, such as lethargy, falling asleep after meals, loss of muscle mass, and decreased libido, and who have documented low blood testosterone levels.
Testosterone replacement therapy (TRT) might be suitable for men with hypogonadism who also have a history of prostate cancer, but more research is needed, according to a group of Canadian and American scientists.

Typically, TRT is not considered for this population because exogenous testosterone is believed to stimulate the growth of prostate cancer cells. However, recent research has suggested that TRT might be safe for these men. Still, these studies have been small and the safety of TRT is still questioned.
This study took another look at this issue. Using Surveillance, Epidemiology, and End Results (SEER)-Medicare data, the researchers examined the prostate cancer-specific outcomes, disease-specific survival, and overall survival information for 149,354 men with prostate cancer. The men’s median age was 73 years. Less than one percent of the men (1,181) underwent TRT after their cancer diagnosis.

Testosterone was administered via injections or subcutaneous pellets. Men on TRT underwent a median of 8 years of follow up; for men who did not take testosterone, the follow-up median was 6 years. TRT was more common among men who had had radical prostatectomy and those who had well-differentiated tumors. TRT was less common among men on watchful waiting or active surveillance protocols.

Overall and cancer-specific mortality rates were higher among men who were not on TRT. Also, TRT was not associated with higher rates of salvage androgen deprivation therapy.
The researchers noted the following:
• TRT did not appear to raise the rates of overall or cancer-specific mortality. In fact, the men taking testosterone had fewer mortality events than those who were not on TRT. The researchers were not certain why this occurred and noted the need for more follow-up.
• The percentage of men using TRT was low and declined over time. In 1992, 1.24% of the men underwent TRT after prostate cancer diagnosis. By 2006, that rate fell to 0.40%. In contrast, the researchers pointed out that the prevalence of hypogonadism, for which TRT is often prescribed, is much higher, ranging from 2.1% to 25%, depending on the parameters used.
• Income and educational status were factors in TRT use. “Seemingly, educated young men of means are more likely to either seek out, be offered, or accept TRT than other men,” wrote the study authors.
They added, “As the effects of hypogonadism intensify with age, and as our understanding of hypogonadism and testosterone deficiency expands, improved access to testosterone replacement will be important for older, low-socioeconomic (SES) men with prostate cancer, should further studies corroborate TRT safety.”
In light of these results, the researchers concluded that TRT could be safe for men after prostate cancer diagnosis. However, they stressed the need for prospective studies to confirm their findings.

The study was published online in January in the Journal of Sexual Medicine.

Bottom Line: There are times when it is necessary to challenge old ideas and assumptions. This certainly applies to testosterone replacement therapy and men with prostate cancer. If a man has a stable PSA after treatment for localized prostate cancer, has symptoms of low testosterone, and a documented decrease in the blood testosterone levels, then hormone replacement therapy may be helpful.

Resources
The Journal of Sexual Medicine
Kaplan, Alan L., MD
“Testosterone Replacement Therapy Following the Diagnosis of Prostate Cancer: Outcomes and Utilization Trends”
(Full-text. First published online: January 21, 2014)
http://onlinelibrary.wiley.com/doi/10.1111/jsm.12429/full

Testopel for Hormone\Testosterone Replacement Therapy In Men

Millions of American men suffer from low T or decreased testosterone levels. The symptoms include a decrease in libido or sex drive, lethargy, decrease muscle mass, decrease in bone density, and even depression.

Treatment options include injections of testosterone, which can be done at the doctor’s office or by the man in his own home, testosterone gels, which are applied every day to the skin, and testosterone pellets or Testopel. Testopel is the only FDA-approved testosterone treatment on market designed to continually deliver testosterone for 4 – 6 months.
The three treatment options include injections of testosterone every two to three weeks, topical gels, and injections of pellets or Testopel under the skin which will last for 4-6 months.
The pellets are inserted under the skin using a local anesthetic. The procedure takes approximately 10-15 minutes for the insertion process. The procedure requires the creation of a small opening in the buttocks area and using a special insertion device to insert from 9-12 pellets. The number of pellets is dependent upon the testosterone level.

Testopel is contraindicated in men with an elevated PSA or who have an abnormal digital rectal exam.

Men have to discontinue the use of any blood thinners such as aspirin, Plavix, Coumadin, and even fish oil prior to the insertion of the pellets.
There is a small possibility that the pellets may exit the insertion site and that the insertion site may become inflamed and require the use of antibiotics.
There may be a small amount of pain at the injection site which can usually be controlled with Advil or Tylenol. The pain can also be reduced by applying ice to the insertion site.
It is important to understand that men receiving Testopel will need to monitor their PSA, blood counts, testosterone levels, and possibly his liver functions on a regular basis.
Men with breast cancer should not use Testopel. In patients with breast cancer, Testopel may cause elevated calcium levels in the blood.

Men who have or might have prostate cancer or have had an adverse reaction should not use Testopel .

Men treated with Testopel may be at an increased risk for developing an enlarged prostate and prostatic cancer.

Swelling of the ankles, feet, or body with or without heart failure may be a serious problem in patients treated with Testopel who have heart, kidney, or liver disease. In addition to your doctor stopping treatment with Testopel, your doctor may need you to take a medicine known as a diuretic

It is also a possibility that gynecomastia (enlarged breasts in men) frequently develops and occasionally persists in patients being treated for hypogonadism

Because Testopel pellets are placed under the skin it is more difficult for your doctor to change the dosage compared to medicines taken by mouth or medicines injected into the muscle (intramuscular injection). Surgical removal may be required if treatment with Testopel needs to be stopped.

In addition, there are times when the Testopel pellets may come out of the skin

While taking Testopel, your doctor may periodically do tests to check for liver damage. Your doctor may also check for increased red blood cells if you are receiving high doses of Testopel

Side effects of Testopel include more erections than normal or erections that last a long time, nausea, vomiting, changes in skin color, ankle swelling, changes in body hair, male pattern baldness, acne, suppression of certain clotting factors, bleeding in patients on blood thinners, increase in libido, headache, anxiety, depression, inflammation and pain at the implantation site and rarely anaphylactoid reaction (a sudden onset of allergic reaction)

Bottom Line: Androgen or testosterone deficiency is a common problem in middle age and older men. Help is available and Testopel is one solution.