Testosterone Replacement Therapy in Palm Beach

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

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.

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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 wellbeing diminished, but anticipation and enjoyment of sexual activity is waning as well.

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Marijuana attacks your precious testosterone in almost every negative way possible. One study after another has shown that cannabis lowers testosterone. For example one research team found that "a reanalysis of existing data established that testosterone levels are depressed both after smoking one marijuana cigarette and after intravenous infusion of delta-9-tetrahydrocannabinol, a pharmacologically active component of marijuana". The same study concluded that it would take at least 24 hours for testosterone levels to normalize after marijuana use. (NOTE: It's not just the smoke - an IV will do it.)

Another study found that not only was testosterone decreased after short term marijuana use, but leutenizing and follicle stimulating hormone were lowered as well. And just to add to the endocrinological misery, the arch-villain and stress hormone cortisol was raised as well. There are also studies in animals and humans that strongly indicate that marijuana blunts growth hormone response as well. And so it is no wonder that animal studies show that marijuana use shrinks the testes. So, if you're not happy with lowered testosterone, infertility and elevated cortisol, you can sit around enjoying the fact that you've got a little more air flow through your boxers.

You should also know that there are many reports that chronic marijuana use leads to gynecomastia, i.e. "enlarged male breasts", due to its abundant amounts of phytoestrogens. One journal writer pointed out that "given the effects of marijuana on the HPG axis in males and the possibility that noncannabinoid components of marijuana smoke have affinity to the estrogen receptor, an association with gynecomastia is plausible but has not been convincingly demonstrated". Remember that estrogen fights against testeosterone in the body as well.

Marijuana has also recently been flagged as particularly dangerous for young people because it decreases seratonin and increases norepineprine. While these are not sex hormones like testosterone, these can alter mood negatively and, through prolonged use, may permanently alter anxiety levels and reaction to stress. Again, the researchers are suggesting this may have long term, possibly lifetime anxiety and mood repercussions. I would also add that any increase in stress will also likely lower testosterone as well.

So we ask the question, "Could someone please explain again why anyone in their right mind would smoke marijuana?" The only thing we can think of is the extra hydrogen cyanide. That's right - marijuana tobaco is much higher in hydrogen cyanide - probably five times higher - than cigarette tobacco. Maybe that partially explains why habitual pot smoking is so hard on the lungs and why cannabis use has also now been linked to the most aggressive form of testicular cancer.

Not to make the bad news even worse, but there is also considerable reported evidence of erectile dysfunction among chronic marijuana users. This is undoubtedly partially due to the lowered testosterone. However, the other reason was discovered by one study that showed marijauna effected Nitric Oxide and summarized by saying, "We conclude that early endothelial damage may be induced by chronic cannabis use (and endocannabinoid system activation". Let me translate that: it may take your sex life with it. If so, decreased sexual activity is also associated with lowered testosterone levels as well.

The tragedy with marijuana is that many cultures and youth are embracing marijuana as more "natural", but this is far from being the case. One recent study found that marijuana induces just as much cell toxicity and DNA damage as cigarette smoke. The researchers were very clear that marijuana displayed just as much cancer causing power as the cigarette smoke: "In addition, when corrected for total particulate matter yield, little difference was observed in the mutagenic activity of samples smoked under the extreme vs the standard regime for both tobacco and marijuana condensates".

In summary, there is significant evidence that marijuana lowers testosterone, nitric oxide, leutinizing hormone, growth hormone and raises cortisol at the same time. Hormonally, there is no justifiable reason for cannabis use.

Treatment for Menopause

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Testosterone replacement can offer great assistance to the male reproductive cycle, from boosting the sex drive to help treating erectile dysfunction, but one of the most common misconceptions about it is that it can boost sperm production. Introducing testosterone into the body by artificial means causes the body to stop producing its own, and there is a possibility that infertility can result, especially if the treatment is not done professionally. A lot of men are able to treat other testosterone-related problems with hormone replacement therapy and have great success, and only find out later that the process may have caused infertility. Being aware of the side effects and ensuring you understand what the long term consequences for your body are, is essential for you to have a positive testosterone replacement experience. What it really comes down to is why you need testosterone replacement therapy. Do you need it because your T levels are low and have a negative effective on your body's ability to produce sperm, or is it solely due to other reasons?

One of the biggest reasons that testosterone replacement is so popular with older men is that most of them have already had children, and they do not have plans to conceive again. In younger men who need help boosting their testosterone levels, they need to weigh up the benefits or relief from low testosterone side effects against the chances of them not being able to have a family.

One of the most obvious areas we see the effects of long term anabolic steroid use is in the bodybuilding world. Men who have been supplementing testosterone, and often in cases where they have been supplementing it without the right kind of medical assistance, for an extended period of time, experience fertility problems. The problems may only show up a few years later, or they may be immediate. In some cases, infertility may be temporary and stop when the person stops taking the supplements, and in other cases the effects may be permanent and irreversible.

When you start bringing testosterone into the body, you send a message to your body that it does not need to make its own, or it should be making substantially less of its own. Your body is hardwired to maintain homeostasis, or constant levels throughout each system and cell, and to conserve energy and supplementing with testosterone sends it the message that the body does not need as much. Artificial testosterone signals the pituitary gland to stop producing the hormones that stimulate the testicles to generate sperm. In some people, it can reduce sperm production substantially, while in others it can stop it completely. In some cases the testes actually shrink in size, because of their reduced functionality in the body.

In older men who experience hypogonadism as a natural response to ageing, this is not cause for concern, but in younger men whose conditions may be hereditary or caused by a trauma to the body, this is not always the best option. If you are thinking of having a family and need to have testosterone replacement, you should approach it in an informed manner and find out as much as possible about the treatment procedure and what it means for you.

Some men can take reverse hormones and other forms of treatment to encourage sperm production later on, but the process is not always successful for all men. Other men may decide to wait a little longer before having testosterone supplements and have their family first.

While testosterone therapy can improve your quality of life and relieve uncomfortable symptoms, it is a powerful process that will have effects on your body, which need to be discussed with your doctor. It can help your sex life in terms of boosting your libido and even helping with premature ejaculation, but if you want to conceive a child, you might need to investigate it further before making a decision.

Hormone Imbalance in Women

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Are you one of those guys who are burning the candle at both ends and maybe only getting 4 or 5 hours of sleep a night? Are you also one of those guys having problems with his sex drive and feeling out of sorts? Well, recent studies done in the last 3 years show that these symptoms could all be due to the effect of sleep on testosterone - just how, though, may be a chicken and egg question!

While it's true that lower testosterone levels can be the cause of a sluggish sex drive and irritability it seems to be a matter of research opinion whether low sleep levels cause low testosterone or low testosterone causes lack of sleep.

Here's what we know about sleep, and testosterone to date as it relates to men:

After age 30, men's testosterone levels drop between 1 and 2% a year! By the time they reach 40 they start experiencing trouble sleeping. They complain of less deep sleep time, the period of sleep where the body repairs itself.

In fact, as a man gets older, the most recent studies assert, he can lose deep sleep time altogether! That means the older a man gets, the more his testosterone levels continue to decline, the less deep sleep he gets, the more his body's repair mechanisms decline and the higher his risk climbs for disease!

The reason for this decline in deep sleep time is thought to be due to a loss of neuron activity, which synchronizes brain activity. These neurons are responsible for about 20% of achieving deep sleep. They are intact in young men and get further scrambled as a man ages.

To further complicate things, low testosterone levels are thought to contribute to this loss of neuron activity in the brain. The take away of these studies, then, whichever perspective you come from, seem to say that restoring testosterone to healthy, youthful levels would likely help a man not only achieve deep, restorative sleep again, but also keep him healthier, re-invigorate his sluggish sex drive and keep him in a happier frame of mind.

Do You Have Symptoms of Low Testosterone?

One of the most frequent complaints I hear from my over-40 patients is that their sex drive has diminished significantly from when they were younger. One of the first things I do is to check a testosterone level and most often find that it is decreased. Interestingly, as well, is that they also often complain of not sleeping very much and are depressed!

Now whether their lack of sleep is from a too hectic lifestyle, stress, or from their decreased testosterone level, is not clear. However, when I recommend that they try to get between 6-8 hours of sleep a night their testosterone levels seem to naturally increase and their mood is brighter!

But decreased testosterone levels don't just affect men over 50, it can start as young as the 30-40's! Many men don't seek treatment because they think it's just a part of getting older and they're embarrassed to talk about it! Like menopause in women, low testosterone is not something men have to suffer through just because it's associated with getting older. Here are some other symptoms you may not associate with low testosterone levels:

•Fatigue
•Emotional changes, like depression, irritability, "grumpy old man" syndrome
•Decreased muscle strength
•Loss of height
•Weight gain, especially belly fat

What Does Cause Low Testosterone?

Low testosterone levels can be caused or aggravated by a number of things both nutritional and environmental. For my patients who have lower than optimal testosterone levels, here are some other things I tell them to pay attention to in their diet and lifestyle:

Xenoestrogens - in food and water supplies. These are "environmental estrogens" from soy products and plastics that get into our food and can decrease testosterone levels. Stay away from foods containing soy, most notably protein bars and soymilk. If you buy frozen foods, transfer them from their plastic container into a glass dish before heating.
Lack of Protein - men need between 0.5 to 1 gram of high quality protein per pound of body weight per day to both build muscle strength and testosterone. Sources include pork, beef, and chicken, which also have higher levels of zinc, which is testosterone friendly.
Lack of Cholesterol - many men over 40 are watching cholesterol intake for the sake of their arteries, but too little cholesterol will stop testosterone production. Aim for about 30% fat, mostly monounsaturated (nuts, olive oil) and some saturated (red meat, eggs) to build testosterone. Go very light, or leave out, polyunsaturated fats (fish, vegetable oils) as studies have shown they can decrease testosterone perhaps because they may contain xenoestrogens.
Lack of Nutrition - zinc is a major building mineral for testosterone. The B vitamins, especially B1, B6, and B12 are helpful in keeping testosterone levels healthy. Be sure that your vitamin/mineral supplement includes these.
Too Much Alcohol - alcohol increases blood sugar levels, which decreases testosterone. Limit to a few drinks per week.
Lack of Sleep - as mentioned earlier, less than 6 hours of sleep a night can seriously rob your body of its repairing mechanisms and this includes the re-manufacturing of hormones like testosterone. See that you get at least 6-8 hours of sleep at night, more if you have been ill or under a lot of stress. Try some natural sleep aids like Valerian, calcium/magnesium supplements with some warm milk before bed. Cut back caffeine to not past 4 pm, and limit heavy meals to 2-3 hours before bedtime.

Researchers may finally decide which comes first; low testosterone then poor sleep, or poor sleep then low testosterone. In the meantime, I'm going to continue to counsel my patients that adequate sleep is at least a significant factor in low testosterone levels. However, before you start thinking dangerous steroids or prescription testosterone replacements, try the natural suggestions offered here. I believe your T-levels will be up to optimal levels and your sex drive and pleasant mood back on track in no time!

Mark Rosenberg, M.D.
Institute For Healthy Aging


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Bioidentical Hormone Replacement Therapy in Palm Beach

Are you one of the many people in Palm Beach who are burning the candle at both ends and maybe only getting 4 or 5 hours of sleep a night? Are you also one of those guys having problems with his sex drive and feeling out of sorts? Well, recent studies done in Palm Beach in the last 3 years show that these symptoms could all be due to the effect of sleep on testosterone – just how, though, may be a chicken and egg question!

While it’s true that lower testosterone levels can be the cause of a sluggish sex drive and irritability it seems to be a matter of research opinion whether low sleep levels cause low testosterone or low testosterone causes lack of sleep.

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High prolactin levels in men are a guaranteed killer of your sex life. The normal range for prolactin in men is 2-14 ng/ml, but yours should be under 8 and preferably between 2-3 if you want optimal sexual function. The symptoms in males of high prolactin levels are low/no libido, weak erections, premature ejaculation, long refractory period, listlessness, and low energy.

So how can you lower your prolactin? There are some over-the-counter supplements that will help if you are in the 8-14 range and you want to get down closer to 2 or 3, but if your levels are above 14, you need to talk with your doctor or endocrinologist about getting on a prescription-strength supplement.

The over-the-counter supplements that can lower prolactin levels in men are P-5-P, which is the bioavailable form of Vitamin B6. 100mg daily is the recommended dose. Another option is 400mg daily of an herb called Vitex Agnus Castus, also purported to have mild prolactin lowering effects in males. Finally, you can take mucuna pruriens standardized for l-dopa. Your dose will vary based on how much l-dopa is in the formulation.

If these don't work for you, I would strongly recommend talking to your doctor about a prescription drug called Cabergoline, which will obliterate your prolactin and turn you into a "marathon man" sex machine.

My prolactin varied between 15-21 ng/ml, so I used a combination of P-5-P and penis hand exercises to deal with my problem. The P-5-P lowered my prolactin below 8, and the hand exercises improved my erection quality as well as my penis size, which gave me greatly increased confidence which also improved my libido. I went from 5.5 puny inches to very well endowed.

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It might be tempting to get a quick fix for hot flashes, but consider a different perimenopause treatment besides hormone replacement therapy (HRT). HRT may be inexpensive and easy, but its long-term risks outweigh the benefits - not to mention that it will likely further aggravate the symptoms of menopause! This outcome occurs because HRT causes estrogen dominance, a condition where there is far more estrogen than progesterone in the body. On the other hand, products that are natural for menopause-related symptoms will provide relief from your symptoms without causing estrogen dominance.

How is estrogen dominance related to traditional perimenopause treatments?
Estrogen dominance was a term coined by Dr. John Lee, the first doctor who published shocking findings on the dangers of HRT. His research was premised on the fact that a woman can experience serious health problems if she has normal or excessive estrogen, but little or no progesterone to balance out estrogen's effects on the body. Progesterone inhibits estrogen's effects on the body, e.g. when estrogen increases fat accumulation and weight gain, progesterone burns fat for energy. For these reasons, Dr. Lee suggested that giving progesterone supplements would benefit menopausal women more than estrogen-only HRT. However, his work was shunned by the medical community despite mounting evidence against HRT and the damage it causes. It's easy to see why - when Dr. Lee's research first came out in the 1980s, everyone was still caught up in the hype of estrogen HRT pushed by pharmaceutical companies.

Despite what you might be led to believe, HRT promotes unopposed estrogen. Women these days are very susceptible to becoming estrogen dominant, even when they are menopausal. The beauty products and cosmetics we use are laden with xenoestrogenic preservatives - manmade chemicals that behave like estrogen when they enter the body. Cows and chickens are also fed estrogen so they can grow and fatten up faster. On the other hand, we aren't exposed to the same levels of progesterone. Taking HRT will only skew the balance of estrogen and progesterone, causing estrogen dominance and increasing the risks of various health problems.

Risks of estrogen dominance caused by medications for perimenopause
Below are just some of the risks faced by menopausal women when they take HRT.

Increased menopause symptoms
While restoring your estrogen levels might reduce hot flashes initially, it may also cause increased weight gain, poor sleep patterns, headache, anxiety, and depression if left unopposed.

Fibrocystic breasts and breast cancer
Researchers from Harvard University discovered that the longer your exposure to estrogens, the greater your risk of fibrocystic breasts (breast cysts) and breast cancer. In their Nurses' Health Study, a study that tracked the health of 70,000 women for almost 20 years, they discovered that menopausal women who used estrogen had a 30% increased risk for breast cancer than women who didn't take HRT. The risk for breast cancer was 40% more among women who took estrogen and progestin (a manmade progesterone). Those who were taking HRT for over five years had an elevated risk that increased with their age. The Nurses' Health Study supports early evidence that HRT plays a significant role in the onset of breast cancer, even if progestin is added to balance out the estrogen.

Blood clots
Studies show that an increased risk of blood clots among menopausal women is triggered by two things: cigarette smoking and the use of synthetic estrogens.

Gallstones and liver problems
If you have a liver disorder, then you should definitely avoid HRT; estrogen affects the function of the liver enzymes. Research shows that women taking HRT have twice the risk of developing gallstones that require surgical removal.

Uterine cancer
Four to eight out of every one thousand menopausal women will develop uterine cancer because of HRT. Although the risk of uterine cancer is decreased when progestin is added, research shows that progestin will place you at risk for breast cancer. Other risk factors like cigarette smoking, a family history of uterine cancer, and abnormal uterine bleeding will also increase the likelihood of HRT-related uterine cancer despite the presence of progestin.
Unlike the symptoms of menopause, which are temporary, the side effects of HRT may last a lifetime. Avoid these risks and consider making lifestyle changes or using natural progesterone or phytoestrogens (plant estrogens) for perimenopause and menopause relief.

How Bio-Identical Hormone Replacement Therapy Is Used To Treat Menopause

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There's a growing interest in testosterone hormone replacement for treating symptoms related to aging. You've probably seen advertisements of virile, muscle bound men in their 60's and 70's.

Along with the growing interest there's also a growing amount of information. But much of it is anecdotal stories, misleading data and flat out, unproven myths. Especially as it relates to testosterone replacement therapy for women.

The fact is that medically administered, testosterone therapy is also used to successfully treat symptoms of hormone deficiency in pre and postmenopausal women. And two physicians-Dr. Rebecca Glaser and Dr. Constantine Dimitrakakis-are dispelling the misinformation about it through scientific research.

Dr. Glaser and Dr. Dimitrakakis focus on subcutaneously implanted, bio-identical hormones (human identical molecule) and not oral, synthetic androgens or anabolic steroids.

With that in mind, here are the 10 myths of testosterone replacement therapy for women.

Myth #1: Testosterone is a "male" hormone

Although men have a higher circulating level of testosterone than women, from a biological perspective, men and women are genetically similar. Both sexes include functional estrogen and androgen (testosterone) receptors. And while estrogen is popularly considered the primary female hormone, throughout a woman's lifespan, testosterone is actually the most abundant, biologically active hormone with significantly higher levels than estradiol. And as early as 1937, testosterone therapy was reported to effectively treat symptoms of the menopause.

Myth #2: Its only role in women is sex drive and libido

There's a lot of hype about testosterone's role in sexual function. But in reality, it's a fraction of the overall physiologic effect testosterone plays in women. That's because testosterone governs the health of almost all tissues including the breast, heart, blood vessels, gastrointestinal tract, lung, brain, spinal cord, peripheral nerves, bladder, uterus, ovaries, endocrine glands, vaginal tissue, skin, bone, bone marrow, synovium, muscle and adipose tissue.

The function of these tissues declines as testosterone declines. The result of this deficiency in both men and women includes dysphoric mood (anxiety, irritability, depression), lack of well-being, physical fatigue, bone loss, muscle loss, changes in cognition, memory loss, insomnia, hot flashes, rheumatoid complaints, pain, breast pain, urinary complaints, incontinence as well as sexual dysfunction. And just like for men, these symptoms are successfully treated in women through testosterone therapy.

Myth #3: It masculinizes females

Testosterone therapy has been safely and successfully administered in women for over 76 years. Rather than decrease a woman's femininity it increases it. Testosterone stimulates ovulation, increases fertility and safely treats the nausea of early pregnancy without adverse effects.

Sure, large doses of supra-pharmacological synthetic testosterone are used to treat female to male transgender patients to increase male traits like body hair. But this requires high doses over an extended period of time. Even then, true masculinization is still not possible. And these effects are reversible by simply lowering the dosage.

Myth #4: It causes hoarseness and voice changes

Hoarseness is most commonly caused by inflammation due to allergies, infectious or chemical laryngitis, reflux esophagitis, voice over-use, mucosal tears, medications and vocal cord polyps. Testosterone possesses anti-inflammatory properties. There is no evidence that testosterone causes hoarseness and there is no physiological mechanism that allows testosterone to do so.

Although a few anecdotal case reports and small questionnaire studies have reported an association between 400 and 800 mg/d of danazol and self-reported, subjective voice 'changes' an objective study demonstrated the opposite.

Twenty-four patients received 600 mg of danazol (synthetic testosterone) therapy daily and were studied for 3 and 6 months. There were no vocal changes that could be attributed to the androgenic properties of danazol. These conclusions are consistent with a one year study examining voice changes on pharmaco-logic doses of subcutaneous testosterone implant therapy in women by Glaser and Dimitrakakis.

Myth #5: It causes hair loss

Hair loss is a complicated, genetically determined process and there is no evidence that either testosterone or testosterone therapy cause it. In fact, from a medical perspective, dihy-drotestosterone (DHT), not testosterone, is considered the active androgen in male pattern balding.

There are many factors associated with hair loss. For example, it's common in both women and men with insulin resistance. Insulin resistance increases 5-alpha reductase, which increases conversion of testosterone to dihy-drotestosterone in the hair follicle.

In addition, obesity, age, alcohol, medications and sedentary lifestyle increase aromatase activity, which lowers testosterone and raises estradiol. Increased DHT, lowered testosterone, and elevated estradiol levels can contribute to hair loss in genetically predisposed men and women. But so can medications, stress and nutritional deficiencies.

In studies conducted by Glaser and Dimitrakakis, two thirds of women treated with subcutaneous testosterone implants have scalp hair re-growth on therapy. Women who did not re-grow hair were more likely to be hypo or hyperthyroid, iron deficient or have elevated body mass index. And none of the 285 patients treated for up to 56 months with subcutaneous T therapy complained of hair loss.

Myth #6: It has adverse effects on the heart

On the contrary, there is overwhelming biological and clinical evidence that testosterone promotes a healthy heart. Testosterone has a beneficial effect on lean body mass, glucose metabolism and lipid profiles in men and women. It is successfully used to treat and prevent cardiovascular disease and diabetes.

Testosterone also widens blood vessels in both sexes, has immune-modulating properties that inhibit plaque and strengthens the cardiac muscle. It improves functional capacity, insulin resistance and muscle strength in both men and women with congestive heart failure.

Myth #7: It causes liver damage

High doses of oral, synthetic androgens (e.g., methyl-testosterone) pass through the digestive system, are absorbed into the entero-hepatic circulation and can adversely affect the liver. But subcutaneous implants and topical patches avoid the entero-hepatic circulation and bypass the liver. So there is no adverse effect on the liver, liver enzymes or clotting factors.

Furthermore, non-oral testosterone does not increase the risk of deep venous thrombosis or pulmonary embolism like oral estrogens, androgens and synthetic progestins. And despite the concern over liver toxicities with anabolic steroids and oral synthetic androgens, there are only 3 reports of hepa-tocellular carcinoma in men treated with high doses of oral synthetic methyl testosterone. Even the report of benign tumors (adenomas) with oral androgen therapy is exceedingly rare.

Myth #8: It causes aggression

Although anabolic steroids can increase aggression and rage, this does not occur with testosterone therapy. Even supra-pharmacologic doses of intramuscular testosterone undecanoate do not increase aggressive behavior. But as stated before, testosterone can aromatize to estradiol. And there is considerable evidence among species, that estrogens, not testosterone, play a major role in aggression and hostility.

However, in studies conducted by Glaser and Dimitrakakis, over 90% of women treated with subcutaneous testosterone therapy have documented decreased aggression, irritability and anxiety. And this is not a new finding. Androgen therapy has been used to treat PMS for over 60 years.

Myth #9: It may increase the risk of breast cancer

It was recognized as early as 1937 that breast cancer was an estrogen sensitive cancer and that testosterone acted as a counter balance to estrogen. Clinical trials in primates and humans have confirmed that testosterone has a beneficial effect on breast tissue by decreasing breast proliferation and preventing stimulation from estradiol.

However, some epidemiological studies have reported an association between elevated androgens and breast cancer. But these studies suffer from methodological limitations, and more importantly, do not account for associated elevated estradiol levels and increased body mass index. And the cause and effect interpretation of these studies conflicts with the known biological effect of testosterone.

Although testosterone is breast protective, it can aromatize to estradiol and have a secondary, stimulatory effect on the estrogen receptor. But when testosterone is combined with an aromatase inhibitor in a subcutaneous implant, it blocks testosterone from aromatizing.

This form of treatment has been shown to effectively treat androgen deficiency symptoms in breast cancer survivors and is currently being evaluated in a U.S. national cancer study. In addition, Dimitrakakis and Glaser see a reduced incidence of breast cancer in women treated with testosterone or testosterone with anastrozole implants.

Myth #10: The safety of testosterone use in women has not been established

Testosterone implants have been used safely in women since 1938. Any real concerns would be well established by now.

Long-term data exists on the successful and safe use of testosterone in doses of up to 225 mg in up to 40 years of therapy. In addition, long term follow up studies on supra-pharmacologic doses used to 'female to male' transgender patients report no increase in mortality, breast cancer, vascular disease or other major health problems.

Many of the side effects and safety concerns attributed to testosterone are from oral formulations, or are secondary to increased aromatase activity due to elevated estradiol. This effect increases with age, obesity, alcohol intake, insulin resistance, breast cancer, medications, drugs, processed diet and sedentary lifestyle. Although often overlooked or not addressed in clinical studies, monitoring aromatase activity and symptoms of elevated estradiol is critical to the safe use of testosterone in both sexes.

Adequate testosterone is essential for physical, mental and emotional health in both sexes. Abandoning myths, misconceptions and unfounded concerns about testosterone and testosterone therapy in women allows physicians to provide evidence based recommendations and appropriate therapy

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West Palm Beach, Florida

West Palm Beach is a city in and the county seat of Palm Beach County, Florida, United States.[6] It is located immediately to the west of the adjacent Palm Beach, and is one of the three main cities in South Florida. The population was 100,343 (revised) at the 2010 census. The University of Florida Bureau of Economic and Business Research (BEBR) estimates a 2016 population of 108,896, a 7.9% increase from 2010. It is the oldest municipality in the Miami metropolitan area, having been incorporated as a city two years before Miami in November 1894. Although West Palm Beach is located approximately 68 miles (109 km) north of Downtown Miami, it is still considered a principal city within the Miami metropolitan area, due to the solid urbanization between both cities. The estimated population of the Miami metropolitan area, which includes all of Palm Beach County, was 6,012,331 people at the 2015 census.

The beginning of the historic period in south Florida is marked by Juan Ponce de León's first contact with native people in 1513. Europeans found a thriving native population, which they categorized into separate tribes: the Mayaimi in the Lake Okeechobee Basin and the Jaega and Ais people in the East Okeechobee area and on the east coast north of the Tequesta. When the Spanish arrived, there were perhaps about 20,000 Native Americans in south Florida. By 1763, when the English gained control of Florida, the native peoples had all but been wiped out through war, enslavement, or European diseases.[7]

Other native peoples from Alabama and Georgia moved into Florida in the early 18th century. They were of varied ancestry, but Europeans called them all "Creeks." In Florida, they were known as the Seminole and Miccosukee Indians. The Seminoles clashed with American settlers over land and over escaped slaves who found refuge among them. They resisted the government's efforts to move them to the Indian Territory west of the Mississippi. Between 1818 and 1858, three wars were fought between Seminoles and the United States government. By 1858, there were very few Seminoles remaining in Florida.[8]


Testosterone Replacement Therapy in Palm Beach