Archive for the ‘estrogen’ Category

Urinary Tract Infections (UTIs) in Women

September 4, 2016

Perhaps one of the most common infections in all women and young girls are UTIs.  Nearly 50% of all women will experience a UTI during their lifetime.

Urinary tract infections (UTIs) are very common in the U.S. In fact, UTIs are the second most common type of infection in the body and are the reason for more than 8 million visits to the doctor each year. About 50% of all women will develop at UTI during their lifetime.

Most UTIs involve the bladder (cystitis) are not serious, but some can lead to serious problems like kidney infections. The most common care or treatment for a UTI is antibiotics. Signs of a UTI involve pain or burning when you pass urine, urine that looks cloudy or smells bad, pressure in your lower abdomen, and an urge to go to the bathroom often. You can get a UTI at any age, but there are peak times in life when they are more common.

Many women report UTIs following sexual activity. Another peak time for UTIs in women is after menopause. This is because of lower vaginal estrogen levels. Lower estrogen levels make it easier for bacteria to grow. A woman’s urethra or the tube from the bladder to the outside of the body is very short, about two inches in length compared to man’s urethra which is 8-10 inches long. This short length makes it easy for bacteria to enter a woman’s bladder. The opening of a woman’s urethra is near the rectum and vagina which happen to be two common places where bacteria dwell.

Prevention of UTIs in women may be as simple as instructing women to wipe from front to back following urination and bowel movements. This helps cut the chance of spreading bacteria from the anus to the urethra.

For women who notice more UTIs after sexual activity, I will often recommend that women take a low dose antibiotic shortly before or right after sexual activity.

Bottom Line: UTIs are common in women.  Most of these infections are not serious and can be treated with a short course of antibiotics.  For women with chronic or repeated infections, low dose antibiotics may be helpful.

Advertisements

Help For An Overactive Bladder (OAB)

May 4, 2015

Nothing is more distressing than losing urine and unable to reach a toilet in a timely fashion. It is a source of embarrassment, anxiety, and even depression.

Your bladder can start to present problems at menopause as sneezing, laughing, increased urgency and frequent night calls can disturb your sleep and your peace of mind.

This is particularly true at menopause when up to 40% of women are affected by OAB. Unfairly perhaps, but women do suffer urinary incontinence four to five times as often as men.
Some of that has to do with pregnancy and childbirth, which can weaken the vagina, the pelvic floor muscles, and the ligaments that support the bladder. This can cause the bladder to be pushed out of place, making it harder for the muscles to perform. That’s why you may leak a little urine when you sneeze, cough, or laugh.

Symptoms of OAB:
* increased urinary frequency
* a sudden urge to urinate
* the need to urinate during the night
* difficulty getting to the bathroom without leaking

Types of Incontinence
There are two separate types of incontinence:
Type 1: Stress incontinence leads to leakage of urine when the pressure in the abdomen is higher than the sphincter pressure. Normally, contraction of the pelvic floor muscles compresses the urethra [bladder outlet] and prevents loss of urine and stress incontinence. Loss can happen with sneezing, coughing and during exercise such as lifting, jumping and walking.
Type 2: Urge incontinence is when an uncontrollable need to pass urine occurs due to over activity of the bladder wall muscle. Typically this occurs as you put the key in the front door or when water is running. There is generally no weakness in the pelvic floor muscles or muscles controlling the bladder outlet. This is also known as overactive bladder syndrome.

Mixed incontinence occurs when there is muscle weakness and and uncontrollable urge to go to the toilet together.

The hormone factor
For women, the bladder and urethra have hormone receptors and it is estrogen that affects the health of the pelvic muscles and the urinary tract. It is estrogen that helps to preserve the strength and flexibility of supportive pelvic and bladder tissues so low levels may be part of the reason these supportive tissues sometimes weaken as a woman ages and may also contribute to muscular pressure around the urethra.
Estrogen can improve the flow of blood and strengthen the tissue around the urethra so women who are low in body weight at menopause may not be producing sufficient for this purpose. Often prescribed are low-dose topical estrogen creams or patches but according to the Mayo Clinic, scientific evidence to support this treatment is lacking.
Low estrogen generally indicates even lower progesterone levels so a combination cream of both hormones can be effective.

When to get help
Bladder weakness can affect many areas of your life from disturbed sleep, to your sex life and embarrassment in public over urinary accidents. This can make it hard to enjoy everyday activities and so many women don’t seek help but these signs indicate you have a problem:
• urinate more than eight times in a 24-hour period
• get up in the night to urinate
• experience frequent leaking
• have changed your activities to accommodate your symptoms

How to help yourself
There are many types of surgery for stress incontinence and although this can be helpful, as time goes by a number of women will get a return of their urine leakage between 5 to 10 years after surgery. It is better to try and manage the condition by first trying pelvic floor muscle exercises which are an inexpensive and effective method of treating mild stress incontinence.

Often referred to as Kegel exercises you could follow the plan below. First you need to be able to identify your pelvic floor muscles and learn how to contract and relax them. To do this, stop urination in midstream. If you succeed, you’ve got the right muscles. Then practice this as below:
* Once you’ve identified your pelvic floor muscles, empty your bladder and lie on your back. Tighten your pelvic floor muscles, hold the contraction for five seconds, and then relax for five seconds. Try it four or five times in a row. Work up to keeping the muscles contracted for 10 seconds at a time, relaxing for 10 seconds between contractions.
* Maintain your focus. For best results, focus on tightening only your pelvic floor muscles. Be careful not to flex the muscles in your abdomen, thighs or buttocks. Avoid holding your breath. Instead, breathe freely during the exercises.
* Repeat 3 times a day. Aim for at least three sets of 10 repetitions a day.
More information:
Unfortunately at menopause women tend to put on weight, and being overweight can make bladder problems more common. Sleep at menopause is also often disturbed for this reason and for this progesterone does help aid sleep and rebalance hormones to help with any weight loss.
However for women who do need additional estrogen as well as progesterone and are not overweight a combination cream is usually more effective for the bladder.

Bottom Line: Incontinence and OAB are common maladies affecting millions of American women. You don’t have to depend on Depends! Help is available. Speak to your doctor.

Why Sex Is Good For You?

December 27, 2014

Sexual intimacy has been associated with having a heart attack, contacting a sexually transmitted disease (STD) or having an unplanned pregnancy. However there are some significant health benefits for engaging in regular sex.

Immune Boosting

Eating well, getting enough sleep, and getting vaccinated are all important in boosting your immune system. Add regular sex to these and you have a great immune system that defends your body against infective organisms. This is because research has shown that those that are sexually active had a higher blood level of certain antibodies than those that were not so active sexually and these antibodies help you fend off infections.

Bladder control for women

About 30% of women will have urinary incontinence at one time or the other in their lives. This is when a person passes urine without intending to. Studies have shown that women who had sex regularly were less likely to develop urinary incontinence as sex helps strengthen their pelvic muscles which is important for bladder control.

Lowers Blood Pressure

People who had more sex have been found to have a lower blood pressure compared to others, ensuring that they stay healthy. One study found that those who regularly had sex had a lower blood pressure compared to those who did not.

Sex is good exercise

It’s been found that on the average, you burn about five calories per minute while having sex. This can be a good source of exercise for those that hardly have time to exercise. The benefits of exercise are quite numerous and sex delivers some of those benefits. For a reference, jogging one mile burns about 100 calories.

Reduces Risk for Heart Attack

Men who had sex regularly were found to have a 50% lesser risk of developing a heart attack. This is not only because it raises your heart rate which is great; it also keeps your sex hormone, estrogen and testosterone, in balance which are important hormones and their balance can help avoid conditions such as osteoporosis and heart disease.

Better Sleep

You may have noticed that you sleep better after sex. This is because the hormone prolactin and melatonin is usually released after an orgasm. This hormone helps with relaxation and the feeling of sleepiness.

Reduces Stress

The arousal associated with sex is great in easing stress. This is because your brain releases some chemicals that help in exciting your entire body. Sex can also help stimulate happiness and boosts self-esteem.

Reduces Pain

Sex can help reduce the feeling of pain. Sex helps release a hormone, endorphins, which are much more potent than morphine, that usually raises your pain threshold. Sexual stimulation can combat chronic pain such as the pain associated with arthritis.

Bottom Line: Sexual intimacy is a healthy activity for consenting adults. This blog provides many of the reasons to engage in sexual activity.

Hot Flashes: It affects Men, Too!

August 15, 2014

We tend to associate hot flashes to women at the time of menopause. However, the condition affects men as well.

In both men and women, hormones are to blame. About 70% of women get hot flashes at the time of menopause, when estrogen levels plummet.

In men, the problem is testosterone. Normally, men don’t experience an abrupt drop in the hormone. In fact, although testosterone levels trickle down by about 1% a year after the age of 40, most men maintain levels within the normal range, and nearly all retain enough testosterone to prevent hot flashes.

The exception is men who’ve received hormonal therapy for prostate cancer that shuts down the production of testosterone. The growth of prostate cells is stimulated by testosterone, and treatments that reduce levels of the hormone or block its actions in the body can help treat the disease. Androgen deprivation can be a temporary measure to boost the effect of radiation therapy or it can be a long-term treatment for advanced prostate cancer. In the past, this was accomplished by surgically removing the testicles or by administering estrogen pills. As of mid-2005, though, treatment usually relies on injections that reduce testosterone production, such as leuprolide (Lupron) or goserelin (Zoladex), or drugs that block testosterone’s effects on tissues, such as bicalutamide (Casodex).

About 70%–80% of men who receive androgen deprivation therapy experience hot flashes.

Hot flashes feel the same to men and women: A sudden feeling of warmth or flushing that is most intense over the head and trunk, often accompanied by visible redness of the skin and by sweating, which can be profuse. Hot flashes are most common at night. They are usually brief, averaging four minutes, but often leave cold sweat behind. Flashes may be infrequent and mild or quite troublesome, sometimes occurring 6 to 10 times a day. Some people, both male and female, report anxiety, palpitations, or irritability.

Men who develop flashes during temporary androgen deprivation usually recover within three or four months of stopping treatment. However, most men don’t get over the hot flashes. In one study, over 40% of men still had flashes after more than 8 years of treatment. In another, 72% of patients said the hot flashes interfered with sleep and 59% reported they interfered with the ability to enjoy life. Fortunately, new treatments can help.
Men with prostate cancer cannot take testosterone, but they can use female hormones for hot flashes. In one study, 83% of men who tried estradiol (an estrogen) reported relief. But more than 40% experienced breast swelling or tenderness, and the trial was too brief to exclude the possibility of cardiovascular side effects. Similar studies of megestrol (Megace) and medroxyprogesterone (Provera), both members of the other group of female hormones (progesterones), have reported about 80%–90% reductions in hot flashes. But the side effects can include bloating and weight gain; in addition, the hormone appears to increase PSA levels in some patients.
Hormones can help, but newer treatments may be just as successful with fewer side effects. Two approaches have helped both men and women. One involves antidepressants. Selective serotonin reuptake inhibitors (SSRIs) such as paroxetine (Paxil) have been effective, as has a related antidepressant, venlafaxine (Effexor). Both types are well tolerated; venlafaxine can sometimes raise the blood pressure, and SSRIs can cause sexual dysfunction, but that’s not an issue for most men on androgen deprivation.

The other recent treatment uses the antiseizure medication gabapentin (Neurontin). The first reports of success were in men, but it rapidly gained wider use in women. In one study, the drug reduced the severity and frequency of hot flashes in women by 70%; dizziness is the most common side effect.

Bottom Line: Men are not immune to hot flashes. It is most common in men being treated for prostate cancer. Help is available. Let you doctor know that this is a problem and often the hot flashes can be cured or certainly can be controlled.

Do Women Have Low T? The Role Of Testosterone in Women

July 28, 2014

Testosterone is the male hormone produced in the testicles that is responsible for sex drive or libido. Women also make testosterone in their ovaries. After menopause the amount of testosterone is decreased and will affect a woman’s sex drive and libido.
Testosterone, widely and misleadingly understood to be the “male” hormone. Men produce 10 times more testosterone than women, but in their early reproductive years women have 10 times more testosterone than estrogen coursing through their bodies. And many experts now believe that it’s the loss of testosterone, and not estrogen, that causes women in midlife to tend to gain weight, feel fatigue and lose mental focus, bone density and muscle tone — as well as their libido. Testosterone is a woman’s most abundant biologically active hormone. Adequate levels of testosterone are necessary for physical and mental health in both sexes.



Benefits for Women
 
Women, before, during and past menopause, and sometimes as early as in their mid-30s, invariably have low testosterone levels. Not all women will experience its wide variety of symptoms, like low libido, hot flashes, fatigue, mental fogginess and weight gain. For those who do, and who seek to avoid taking synthetic oral hormones (shown by National Institutes of Health findings to pose an increased risk for breast cancer, heart attack, stroke, blood clots and dementia), bioidentical testosterone (whose molecular structure is the same as natural testosterone) has been shown to be safe and effective.

Some testosterone is converted by the body into estrogen — which partly explains why it is useful in treating menopausal symptoms. For those at high risk for breast cancer, or who have had it, that conversion can be prevented by combining testosterone with anastrozole — an aromatase inhibitor that prevents conversion to estrogen. Nonetheless, testosterone has been shown to beneficial for patients with breast cancer. Preliminary data presented at the American Society of Clinical Oncology have shown that, in combination with anastrozole, testosterone was effective in treating symptoms of hormone deficiency in breast cancer survivors, without an increased risk of blood clots, strokes or other side effects of the more widely used oral estrogen-receptor modulators tamoxifen and raloxifene.

Other benefits cited for testosterone therapy include:

Relieving symptoms of menopause, like hot flashes, vaginal dryness, incontinence and urinary urgency.

Enhancing mental clarity and focus. Researchers at Utrecht University in Holland recently found that testosterone appears to encourage “rational decision-making, social scrutiny and cleverness.”

Reducing anxiety, balancing mood and relieving depression combined with fatigue. Dr. Stephen Center, a family practitioner in San Diego who has treated women with testosterone for 20 years, says the regimen consistently delivers “improvement in self-confidence, initiative and drive.”

Increasing bone density, decreasing body fat and cellulite, and increasing lean muscle mass. Testosterone is the best remedy available for eliminating midlife upper-arm batwings.

Offering protection against cardiovascular events, by increasing blood flow and dilating blood vessels, and against Type 2 diabetes, by decreasing insulin resistance.

Countering the Myths

Some women believe, also incorrectly, that testosterone therapy will produce “masculinizing” traits, like hoarseness and aggression. While the hormone may cause inappropriate hair growth and acne in some women, those side effects can be remedied by lowering the dose.

Testosterone therapy has been approved for a variety of conditions in women as well as men in Britain and Australia. But while the U.S. Food and Drug Administration has approved of testosterone for use in men whose natural levels are low, the agency has not sanctioned it for women, for any reason.

How Treatment Works

Women can take testosterone as a cream, through a patch or in the form of pellet implants, which have the highest consistency of delivery. Synthesized from yams or soybeans, and compounded of pure, bioidentical testosterone, the pellets, each slightly larger than a grain of rice, are inserted just beneath the skin in the hip in a one-minute outpatient procedure. They dissolve slowly over three to four months, releasing small amounts of testosterone into the blood stream, but speeding up when needed by the body — during strenuous activities, for example — and slowing down during quiet times, a feature no other form of hormone therapy can provide.

To determine a patient’s dosage, some doctors measure testosterone levels in the blood.

Side effects of the insertion procedure, which are rare, include infection, minor bleeding and the pellet working its way out or being extruded. Some patients notice improvements within a day or two; others do not perceive benefits for a couple of weeks.

Bottom Line: Since implantation is a surgical procedure, and the pellets are manufactured by a variety of pharmaceutical compounders, who may have varying safety standards, it’s important for women to consult with an experienced, board-certified physician about treatment. Ask your doctor if you feel you are having symptoms related to low testosterone and see if testosterone replacement would be right for you

Menopause Doesn’t Mean Goodbye To Sex

June 1, 2014

The loss of estrogen and testosterone following menopause can lead to changes in a woman’s sexual drive and functioning. Menopausal and postmenopausal women may notice that they are not as easily aroused, and may be less sensitive to touching and foreplay — which can result in decreased interest in sex.
In addition, lower levels of estrogen can cause a decrease in blood supply to the vagina. This decreased blood flow can affect vaginal lubrication, causing the vagina to become dry and cause painful intercourse.
A lower estrogen level is not the only culprit behind a decreased libido; there are numerous other factors that may influence a woman’s interest in sexual activity during menopause and after. These include:
Bladder control problems (incontinence)
Sleep disturbances
Depression or anxiety
Stress
Medications
Health concerns
Some postmenopausal women report an increase in sex drive. This may be due to decreased anxiety associated with a fear of pregnancy. In addition, many postmenopausal women often have fewer child-rearing responsibilities, allowing them to relax and enjoy intimacy with their partners.

During and after menopause, vaginal dryness can be treated with water-soluble lubricants such as Astroglide or K-Y Jelly. Do not use non-water soluble lubricants such as Vaseline, because they can weaken latex (the material used to make condoms, which should continue to be used until your doctor verifies you are no longer ovulating and to prevent contracting sexually transmitted diseases). Non-water soluble lubricants can also provide a medium for bacterial growth, particularly in a person whose immune system has been weakened by chemotherapy or in women who are prone to recurrent urinary tract infections.
Vaginal moisturizers like Replens and Luvena can also be used on a more regular basis to maintain moisture in the vagina. You can also talk to your doctor about vaginal estrogen therapy.
A oral drug taken once a day, Osphena, makes vaginal tissue thicker and less fragile, resulting in less pain for women during sex. The FDA warns that Osphena can thicken the endometrium (the lining of the uterus) and raise the risk of stroke and blood clots.
Estrogen replacement may help raise the sex drive after menopause which is associated with a decrease in estrogen. Estrogen can also make intercourse less painful by treating vaginal dryness.
Doctors are also studying whether a combination of estrogen and male hormones called androgens may be helpful in increasing sex drive in women.
Bottom Line: Sexual desire and enjoyment from sexual intimacy can be preserved after menopause. It may dry the vaginal lining but it doesn’t have to dry up the desire to be sexually intimate with your partner.

Birds Do It; Bees Do It; and so Do Senior Citizens

February 17, 2014

With aging of the baby boomers, with their focus on health and wellness, and with increasing life expectancy for both men and women, it is natural and normal for our seniors to be sexually active. Many people want and need to be close to others as they grow older. This includes the desire to continue an active, satisfying sex life. But, with aging, there may be changes that can cause problems. This blog will discuss the normal changes that occur with aging and what can be done to add intimacy for both men and women.
Normal Changes With Aging
Normal aging brings physical changes in both men and women. These changes sometimes affect the ability to have and enjoy sex. A woman may notice changes in her vagina. As a woman ages, her vagina can shorten and narrow. Her vaginal walls can become thinner and also a little stiffer. Most women will have less vaginal lubrication. These changes could affect sexual function and/or pleasure. The solution to the vaginal dryness is easily resolved with the use of water soluble lubricant such as KY Jelly.
As men get older, impotence (also called erectile dysfunction–ED) becomes more common. ED is the loss of ability to have and keep an erection for sexual intercourse. ED may cause a man to take longer to have an erection. His erection may not be as firm or as large as it used to be. The loss of erection after orgasm may happen more quickly, or it may take longer before another erection is possible. ED is not a problem if it happens every now and then, but if it occurs often, a doctor can usually provide an effective solution.
What Causes Sexual Problems?
Some illnesses, disabilities, medi­cines, and surgeries can affect your ability to have and enjoy sex. Problems in your relationship can also affect your ability to enjoy sex.
Arthritis. Joint pain due to arthritis can make sexual contact uncomfortable. Exercise, drugs, and possibly joint replacement surgery may relieve this pain. Rest, warm baths, and changing the position or timing of sexual activity can be helpful.
Chronic pain. Any constant pain can interfere with intimacy between older people. Chronic pain does not have to be part of growing older and can often be treated. But, some pain medicines can interfere with sexual function. You should always talk with your doctor if you have unwanted side effects from any medication.
Dementia. Some people with dementia show increased interest in sex and physical closeness, but they may not be able to judge what is appropriate sexual behavior. Those with severe dementia may not recognize their spouse but still seek sexual contact. This can be a confusing problem for the spouse. A doctor, nurse, or social worker with training in dementia care may be helpful.
Diabetes. This is one of the illnesses that can cause ED in some men. In most cases, medical treatment can help. Less is known about how diabetes affects sexuality in older women. Women with diabetes are more likely to have vaginal yeast infections, which can cause itching and irritation and make sex uncomfort­able or undesirable. Yeast infections can be treated.
Heart disease. Narrowing and hardening of the arteries can change blood vessels so that blood does not flow freely. As a result, men and women may have problems with orgasms, and men may have trouble with erections. People who have had a heart attack, or their partners, may be afraid that having sex will cause another attack. Even though sexual activity is generally safe, always follow your doctor’s advice. If your heart problems get worse and you have chest pain or shortness of breath even while resting, talk to your doctor. He or she may want to change your treatment plan.
Incontinence. Loss of bladder control or leaking of urine is more common as we grow older, especially in women. Extra pressure on the belly during sex can cause loss of urine, which may result in some people avoiding sex. This can be helped by a change in positions. The good news is that incontinence can usually be treated.
Stroke. The ability to have sex is sometimes affected by a stroke. A change in positions or medical devices may help people with ongoing weakness or paralysis to have sex. Some people with paralysis from the waist down are still able to experience orgasm and pleasure.
Depression. Lack of interest in activities you used to enjoy, such as intimacy and sexual activity, can be a symptom of depression. It’s sometimes hard to know if you’re depressed. Talk with your doctor. Depression can be treated.
Surgery. Many of us worry about having any kind of surgery—it may be even more troubling when the breasts or genital area are involved. Most people do return to the kind of sex life they enjoyed before surgery.
Hysterectomy is surgery to remove a woman’s uterus. Often, when an older woman has a hysterectomy, the ovaries are also removed. The surgery can leave both women and men worried about their sex lives. If you’re afraid that a hysterectomy will change your sex life, talk with your gynecologist or surgeon.
Mastectomy is surgery to remove all or part of a woman’s breast. This surgery may cause some women to lose their sexual interest or their sense of being desired or feeling feminine. In addition to talking with your doctor, sometimes it is useful to talk with other women who have had this surgery. Programs like the American Cancer Society’s (ACS) “Reach to Recovery” can be helpful for both women and men. If you want your breast rebuilt (reconstruction), talk to your cancer doctor or surgeon.
Prostatectomy is surgery that removes all or part of a man’s prostate because of cancer or an enlarged prostate. It may cause urinary incontinence or ED. If removal of the prostate gland is needed, talk to your doctor before surgery about your concerns.
Medications. There are many drugs can cause sexual problems. These include some blood pressure medicines, antihistamines, antidepressants, tranquilizers, appetite suppressants, drugs for mental problems, and ulcer drugs. Some can lead to ED or make it hard for men to ejaculate. Some drugs can reduce a woman’s sexual desire or cause vaginal dryness or difficulty with arousal and orgasm. If the cause of a man or woman’s sexual problem is related to a medication, the doctor can usually reduce the dosage of the medication, change the medication that doesn’t have the side effect of sexual problems, or may even allow the patient to discontinue the medication for a short period of time, i.e., drug holiday, to allow the man or woman to enjoy intimacy without completely discontinuing the medication.
Alcohol. Too much alcohol can cause erection problems in men and delay orgasm in women.
Safe Sex Is For Seniors Too
Age does not protect you from sexually transmitted diseases. Older people who are sexually active may be at risk for diseases such as syphilis, gonorrhea, chlamydial infection, genital herpes, hepatitis B, genital warts, and trichomoniasis.
Almost anyone who is sexually active is also at risk of being infected with HIV, the virus that causes AIDS. The number of older people with HIV/AIDS is growing. You are at risk for HIV/AIDS if you or your partner has more than one sexual partner or if you are having unprotected sex. To protect yourself, always use a condom during sex. For women with vaginal dryness, lubricated condoms or a water-based lubricating jelly with condoms may be more comfortable. A man needs to have a full erection before putting on a condom.
Talk with your doctor about ways to protect yourself from all sexually transmitted diseases. Go for regular checkups and testing. Talk with your partner. You are never too old to be at risk.
What Can A Couple Do?
There are things you can do on your own for an active sexual life. Make your partner a high priority. Take time to enjoy each other and to understand the changes you both are facing. Try different positions and new times, like having sex in the morning when you both may be well-rested. Don’t hurry—you or your partner may need to spend more time touching to become fully aroused. Masturbation is a sexual activity that many older people, with and without a partner, find satisfying.
Don’t be afraid to talk with your doctor if you have a problem that affects your sex life. He or she may be able to suggest a treatment. For example, the most common sexual difficulty of older women is painful intercourse caused by vaginal dryness. Your doctor or a pharmacist can suggest over-the-counter vaginal lubricants or moisturizers to use. Water-based lubricants are helpful when needed to make sex more comfortable. Moisturizers are used on a regular basis, every 2 or 3 days. Or, your doctor might suggest a form of vaginal estrogen.
If ED is the problem, it can often be managed and perhaps even reversed. There are pills, Viagra, Levitra, Cialis, and now Stendra, that can help. They should not be used by men taking medicines containing nitrates, such as nitroglycerin. The pills do have possible side effects. Other available treatments include vacuum devices, self-injection of a drug, or penile implants.
Physical problems can change your sex life as you get older. But, you and your partner may discover you have a new closeness. Talk to your partner about your needs. You may find that affection—hugging, kissing, touching, and spending time together—can make a good beginning.
Bottom Line: Sex is good at 20-30, better at 30-40, and can be best of all after age 60. Intimacy is just as important as we age as when we were younger. Help is available; don’t be afraid to ask your doctor.

Restoring The Fountain of Youth-DHEA Just May Be The Youth Hormone For Women

January 28, 2014

American women (men too) are always looking to find a way to turn back the biologic clock. We all would like to look like the women in Cosmopolitan and Vogue Magazines. If your goal is to look younger, feel better, and improve energy level, then you might consider the benefits of DHEA.

DHEA, dehydroepiandrosterone, is a hormone produced in the adrenal gland, the small triangular structure that sits on top of the kidneys. DHEA is made by the adrenal glands and is then converted to androgens, estrogens and other hormones. These are the hormones that regulate fat and mineral metabolism, sexual and reproductive function, and energy levels. DHEA levels increase until our mid to late 20′s then gradually decline. DHEA is a very powerful precursor to all of your major sex hormones: estrogen, progesterone, and testosterone. (Its molecular structure is closely related to testosterone). DHEA is called the “mother hormone” — the source that fuels the body’s metabolic pathway.

When DHEA levels are low, your body does not have enough working material for proper endocrine function. This throws off your hormone production and you feel a general sense of malaise, along with other symptoms of hormonal imbalance — how severe depends on how many other demands are being made on your body at the same time.
There is a growing body of evidence that healthy levels of DHEA may help stave off Alzheimer’s disease, cancer, osteoporosis, depression, heart disease and obesity, but there is still no clear-cut consensus. There may be some increased risks associated with DHEA for women with a history of breast cancer — all the more reason to take DHEA under medical supervision.

Symptoms of low DHEA include extreme fatigue, decrease in muscle mass, decrease in bone density, depression, aching joints, loss of libido, and lowered immunity.
DHEA is stated to be possibly effective for these conditions:
1. Aging Skin – Taking DHEA orally seems to increase epidermal thickness, sebum production, skin hydration, and decrease facial skin pigmentation in elderly men and women
2. Osteoporosis – Taking DHEA orally 50-100 mg per day seems to improve bone mineral density (BMD) in older women and men with osteoporosis or osteopenia.
3. DHEA is also thought to contribute to a sense of well-being when used by those with adrenal and/or androgen insufficiency.
4. It may also support lean body mass in postmenopausal women.

DHEA has many potential benefits but does also have some side effects, which include hair loss, hair growth on the face (in women), aggressiveness, irritability and increased levels of estrogen. Calcium channel blockers may increase DHEA levels and those using calcium channel blockers should avoid supplementation. Anyone with a history of hormone-related cancer such as estrogen sensitive breast cancer should definitely avoid DHEA due to the probability of increased estrogen levels.

If you don’t feel DHEA is appropriate for you, it may be possible to increase the body’s natural production of DHEA with regular exercise and restricting the number of calories you consume. Calorie restriction is associated with a longer life span and the increase in DHEA production may be partially responsible. In fact, there are many studies that show you can improve your DHEA levels naturally by maintaining a body mass index of 19-25, getting adequate rest and exposure to sunlight, exercising regularly (including sexual activity), and fostering more “downtime” in your life — but more on that in a moment.

Without a medical test it’s impossible to know what your DHEA levels are. Using blood tests, your doctor can check for estradiol in the follicular phase (usually days 3–9 of a menstrual cycle); progesterone in the luteal phase (days 14–28); DHEA-S; and both free and total testosterone levels.
Treatment With DHEA Supplements

If tests indicate the need for DHEA supplementation, you may start off with as little as 1-5 mg, twice a day. The dosage can be slowly increased to 10–12 mg per day. Most doctors do not suggest any woman exceed 25 mg per day if capsule forms are used. Once balance has been restored and symptoms even out, most women produce enough DHEA on their own.

Bottom Line: Many women are suffering from hormone imbalance. Decreased DHEA can be a cause of many problems affecting middle age women and can even impact her libido and her energy levels. DHEA should never be taken casually or unsupervised, but its benefits are real for the women who need it.

Sex Drive In the Tank? Then Filler Up With DHEA

January 22, 2014

Nearly every doctor and every patient believes that their sex drive or libido comes from their testosterone level and that restoring testosterone with injections, gels, or pellets will restore a man’s virility. The answer is yes and no. Yes, testosterone is responsible for a man’s sex drive but so is the ratio of testosterone to estrogen. A testosterone/estrogen imbalance can severely inhibit sexual desire and sexual performance.

In a man’s youth, low amounts of estrogen are used to shut down the powerful cell stimulating effects of testosterone. As estrogen levels increase with age, testosterone cell stimulation may be locked in the “off” position, thus turning off sexual arousal and sensation and resulting in a loss of libido in aging men.

Another concern is that aging men sometimes convert testosterone to estrogen. The increase in estrogen is taken up by testosterone receptor sites in the cells and prevents circulating testosterone from gaining access to the cells where it can do its greatest function.

Testosterone is responsible for the sex drive in both men and women. In order for testosterone to do its job, it must be in the free form and not bound to other circulating proteins like sex hormone binding globulin (SHBG). SHBG increases with age and grabs the free testosterone making it unavailable to the cells where it is needed to initiate sex-stimulating centers in the brain. Also excess estrogen increases the production of SHBG and blocks the testosterone-receptor sites. These are the two mechanisms that impact a man’s libido associated with aging.
Therefore, it is necessary to suppress excess levels of SHBG and estrogen while increasing free testosterone to the level of a younger more youthful man. By restoring the normal ratio of testosterone to estrogen ratio a man’s libido and sexual performance often improves.

One of the easiest ways to accomplish this restoration of the normal T\E ratio is to prevent testosterone from being converted into excess estrogen. Too much estrogen plays havoc with a man’s sex life by binding to testosterone receptor sites and also the associated increase in SHBG, which decreases the freely available testosterone.
Certainly estrogen is a necessary hormone for men just as testosterone is necessary hormone for women.

The problem of an abnormal ratio of T\E can easily be diagnosed with a simple blood test for estradiol. Levels that are greater than 30pg/ml are abnormal and would benefit from treatment that lowers the estrogen level and the SHBG levels.

Treatment of elevated estradiol in men can be accomplished with a prescription medication, Armidex, which is aromatase inhibitor and blocks the conversion of testosterone to estrogen. The dosage is 50mg\day. Studies have demonstrated that this dosage decreases the estrogen level in approximately one month.

Bottom Line: Testosterone deficiency is a common problem affecting many middle age and older men. Often this is due to an imbalance of testosterone\estrogen ratio. This can be easily treated with oral aromatase inhibitors. So if you are middle age and your doctor prescribed testosterone and it isn’t working, I suggest you speak to him or her about getting an estradiol level and if it is elevated, then treatment with an aromatase inhibitor.

Dr. Neil Baum is a physician practicing at Touro Infirmary and can be reached at his office, 504 891-8454, or via his website, http://www.neilbaum.com

Saying Goodbye To Jumping Jack “Hot” Flash

July 2, 2013

Not all women will experience hot flashes, but three out of four will, with one of 10 experiencing them through their seventies. The cause of hot flashes are the dilation of the blood vessels in the face and upper chest result in increased blood flow to these areas. Some women also sweat during hot flashes. For some women, the hot flashes are not very common and are an inconvenience. For other women, they impact the woman’s quality of life and are incapacitating. The time-honored treatment for hot flashes has been estrogen replacement therapy or hormonal therapy. While hot flashes are not dangerous, they cause discomfort, embarrassment and sleep loss. During menopause some women may have more than 10 a day.

Women with uncomfortable hot flashes now have a medication option that doesn’t involve hormones. The U.S. Food and Drug Administration approved the first nonhormonal drug to treat moderate to severe hot flashes and night sweats associated with menopause. The drug, Brisdelle, contains peroxetine, a selective serotonin reuptake inhibitor (SSRI) that is also the active ingredient in the antidepressant Paxil.

Many women are reluctant to treat menopausal symptoms with hormones including estrogen and progesterone, as a 2002 study conducted by the Women’s Health Initiative implied that a combination of hormones, estrogen and progesterone, with increased cancer risk.

Side effects of the drug included headache, fatigue, nausea and vomiting. Brisdelle will be available starting in November.

Bottom Line: Every woman would like to have her hot flashes disappear like magic. Although estrogen replacement therapy has been effective in reducing hot flashes, many women do not want to take hormones. Brisdelle may just be the solution that many women have been waiting for.

Read more: http://www.nydailynews.com/life-style/health/nonhormonal-hot-flash-treatment-approved-fda-article-1.1388094#ixzz2XvmVGY89