Cooper City Health And Wellness Center

Aging in Cooper City is difficult enough for women without having to deal with declining hormones. Women in Cooper City often complain of a diminished sense of well being, chronic fatigue, and a loss of libido just to mention a few symptoms of hormone imbalance.

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For many women there is a tremendous void in treatment of menopausal symptoms. Hot flashes, mood swings and low or no sex drive are just the tip of the iceberg. Some earlier hormone imbalance symptoms of estrogen deficiency are frequent waking at night. Many others are present, including “mental fogginess.” A woman’s short-term memory retention may be dwindling and her concentration and focus isn’t as good as it used to be. Frequently, women may experience some loss of energy to the point that they actually slide into symptoms of chronic fatigue. In addition, women may experience some mood swings and irritability, and at the extreme may actually develop feelings of depression. With the loss of energy and chronic fatigue, females find themselves unable to exercise as much as in the past, or to recover as quickly when exercising. Women often find themselves increasing weight gain in spite of attempts at exercising. One hormone imbalance symptom that is not frequently discussed is the loss of sex drive and diminished libido. Not only is energy level and sense of well being diminished, but anticipation and enjoyment of sexual activity is waning as well.

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Theoretically,  menopause is not a disease.  Therefore, there is no cure.  Many women opt to forgo any treatment at all, and simply tolerate many of the symptoms associated with this normal transition.  However, for those women whose symptoms are so severe as to interfere with their quality of life, there are many options at their disposal.

Remedies may be implemented by the woman herself for the conditions associated with menopause.  For example,

Hot flashes: Several nonprescription treatments are available, and lifestyle choices can help.

  • Many women feel that regular aerobic exercise can help reduce hot flashes
  • Foods that may trigger hot flashes, such as spicy foods, caffeine, and alcohol, should be avoided.
Heart disease: A low-fat, low-cholesterol diet helps to reduce the risk of heart disease.

Weight gain: Regular exercise is helpful in controlling weight.

Osteoporosis: Adequate calcium intake and weight-bearing exercise are important. Strength training (lifting weights or using exercise bands in resistance training) can strengthen bones.

Certain medications are beneficial in reducing many of the signs and symptoms of menopause.

Hormone Replacement Therapy

  • estrogen or a combination of estrogen and progestin
  • treats hot flashes
  • reduce fracture risk by building bone mass
  • improve cholesterol levels
  • decrease vaginal dryness
  • estrogen and progestin combination associated with increased risk of heart attack, stroke, and breast cancer
  • estrogen alone associated with increased risk of endometrial cancer
  • increased risk of gallstones and blood clots
Selective Serotonin Reuptake Inhibitors (SSRIs)
  • normally used for depression and anxiety
  • effective in reducing hot flashes
Clonidine (Catapres)
  • used to lower blood pressure
  • effective in reducing hot flashes
Gabapentin (Neurontin)
  • primarily used for treating seizures
  • used to treat hot flashes
Megestrol (Megace)
  • short-term relief of hot flashes
  • not recommended as first-line drug
Medroxyprogesterone (Depo-Provera)
  • injectable
  • sometimes effective in treating hot flashes
  • may cause weight gain and bone loss
Several medication options are available for the treatment of osteoporosis during menopause.  They include:
  • Aldenodrate (Fosamax)
  • Raloxifene (Evista)
  • Calcitonin (Calcimar or Miacalcin)
There are natural remedies on the market which report to reduce hot flashes.  However, for many, the clinical studies are conflicting and inconclusive.  These include:

Black Cohosh

  • herbal supplement
  • German studies recommend limiting its use to six months or less
  • not regulated by the Food and Drug Administration
  • side effects include nausea, vomiting,  dizziness, visual problems, slow heart beat, and excessive sweating
Plant Estrogens (Phytoestrogens)
  • soy is an example
  • safety of soy in women with breast cancer not established
Other Herbal Preparations - avoid or take under supervision of health care provider
  • dong quai
  • red clover
  • chaste-berry
  • yam cream
  • Chinese medicinal herbs
  • evening primrose oil
There are several treatment options available to help alleviate the symptoms of menopause.  These treatments should be individualized for each patient.  As many of these methods are not without risk, they should be implemented and monitored under the guidance of a physician.

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Are You Curious About Testosterone Therapy?

The subject of testosterone therapy has caught my attention lately. I had begun to study about it when about three or four months ago my wife brought me a bottle of testosterone capsules for a 90-day trial. She wanted to see if it would help me in my battle with afternoon fatigue and general lethargy.

I thought why not, it can't hurt. I wasn't desperate or anything, I was mostly curious about "Low-T" and wanted to experience for myself all these health claims that are flying around the media lately. For example, these TV commercials about the cure for erectile dysfunction were getting on my nerves. I am particularly dismayed by the couple in two separate bathtubs. What's up with that? (Sorry no pun intended).

Then a few days ago I got a call from a telemarketer, asking how my testosterone trial was going. I told him it was working great for keeping elephants out of my flower beds. As long as I was taking the capsules, no elephants had trampled my flowers. He was not impressed by my humor, and just wanted to get me to order more. Nope, I told him. I really couldn't tell any difference on or off the capsules. When he told me I needed more time for my body to adjust to the product, I ended the conversation. I know more about Low T after my extensive research than he seemed to know

On the other hand, someone is buying this stuff. In an article by Rachael Rettner, (published on line on MyHealthNewsDaily June 3, 2013, Copyright © 2013 Ms. Rettner says, "The percentage of middle-aged men in the United States taking testosterone to treat symptoms of low testosterone, or "low T," has increased substantially in recent years, a new study suggests."

For the last ten years, prescriptions for testosterone supplements among men over age 40 has been gradually increasing until today more than 3% of men in that age bracket have received some form of testosterone therapy. That is almost three times more than in 2001.

But does the stuff work? The answer is that study results have been less than supportive that it does. In fact, I found many so-called scientific studies that made all sorts of weird claims, but none were truly conclusive. It is like my-elephant-in-the-flowerbed comment. The obvious sarcasm is that if I did nothing, the elephants wouldn't bother me because I don't have any elephants wandering around my suburb. Scientific research cannot prove a hypothesis by the absence of symptoms.

Ms Rettner presented her most shocking comment when she quoted an editorial by Dr. Lisa Schwartz and Dr. Steven Woloshin, of the Dartmouth Institute for Health Policy & Clinical Practice: "the low T campaign [is] "a mass, uncontrolled experiment that invites men to expose themselves to the harms of a treatment unlikely to fix problems that may be wholly unrelated to testosterone levels."

"Before anyone makes millions of men aware of low T, they should be required to do a large-scale randomized trial to demonstrate that testosterone therapy for healthy aging men does more good than harm," they wrote.

By Dr. Luke Aaronson, PhD

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