Testosterone Replacement Therapy in West Palm Beach

Are you one of the many people in West 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 West 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.

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

bioidentical hormone replacement therapy weight loss

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

Ten Common Myths About Testosterone Treatment For Women

hormone replacement therapy cost

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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Convincing Your Husband to Check His Testosterone Level

From the time they are little boys playing cowboys and Indians in the backyard, men are taught that they should be "manly." The macho image saturates the media in movies, television, and books. Even the romance novels aimed at women feature manly men with unbuttoned shirts on the cover.

It has become almost an unspoken rule that for a man to be respected, he should be strong, unemotional, and independent. With this in mind, think about what you may be doing to your husband if you question his manhood?

As the concerned wife, you may not think apprehension about testosterone levels have anything to do with questioning his manhood, but to your husband, you are doing just that. The very word testosterone has become synonymous with manliness. There are many jokes made about the "testosterone in the room" when men try to show up each other.

It is no wonder that the phrase "Honey, maybe you have low testosterone" is almost guaranteed to evoke an unsavory response. If the hormone is a concern, you cannot put your husband on the defensive by seemingly implying that he is not enough of a man.

Before even bringing up the subject, consider the symptoms of low t. He may not be even suffering from the problem, so do not put undue stress on him unless he is exhibiting the symptoms.

Generally, when men suffer low testosterone levels, he will show some of the following symptoms: decreased energy and strength, lower libido or sex drive, weakness of the bones, depression or anger, erectile dysfunction, an increase in fat on the body, and decrease in muscle mass.

Generally, 'low t' is caused by a signal mix-up between the brain and the testicles. For some reason, the brain may be signaling to lower testosterone creation or to halt production completely. Testosterone levels are low if they are under 300.

Although these symptoms are not definitively low testosterone, if a man is suffering from more than one, there is definitely a cause for concern. If you believe that your husband may be suffering from the hormone deficiency, then tread lightly.

It really does not matter how long you have been married, how close you are to your husband, or how well you know him. You could face a negative response if you blatantly tell him you are not happy with his sex drive or his energy level.

Remember, the problem is in no way about you. Do not make the situation about you, because if you do, he will see that as self-centeredness since he is the one suffering. His decreased sex drive does not mean he is no longer attracted to you. He is going through a difficult time, and implying that it is hard on you will only create bad feelings.

The low testosterone test is simply a blood test. No invasive procedures are required, and no embarrassing exams have to happen. Since finding out is fairly simple, you can make sure your husband knows this.

If you feel that your husband is exhibiting the symptoms of low testosterone levels, then you definitely need to broach the subject. Even if the condition is not low testosterone, there could be other underlying medical problems. Any time someone is exhibiting symptoms, it is best that they see a doctor.

However, in this case, a man may very well feel that his manhood is being called into question. There are three keys to talking with your husband about the problem: honesty, selflessness, and patience.

The first thing you need to remember is that you have to be honest, while being tactful at the same time. Instead of jumping at the big subject, like intimacy, choose something a little less inflammatory.

Begin with a phrase, like "You have been kind of tired lately, haven't you?" This way, you are opening the door to a discussion without even bringing up the idea of a testosterone problem.

Once he begins to talk and confirm his problem with fatigue, then you can delve deeper. Remember to go at his pace, not yours. Suggest that you read an article and found it interesting, or that you were concerned since he did not seem to be getting enough sleep.

When you feel ready, bring up testosterone. Make sure he knows you are bringing it up because of the many negative effects it can have on him and you are simply concerned with his health.

This is when selflessness comes in. At no point should you imply that it is a hardship for you at all. Do not bring up that you are under any stress or that you feel you are missing out on anything. Doing so is almost a guarantee of anger or defensiveness on his part.

Remember that if he is suffering low-t, it is nothing he can repair on his own, and it is unfair of you to blame him for a medical condition.

Finally, you must practice patience. If you bring up the subject and he gets angry, then put it on a back burner for a while. Give him some time to calm down and think more clearly. You may even want to email him an article on the subject so that he can think about it without feeling under pressure by talking face to face.

Thankfully, low testosterone levels in men can easily be treated with testosterone replacement therapy. There are a number of treatment options, including gels that are applied to the skin daily, patches similar to nicotine patches, injections, and tablets.

Not all treatments are right for each person, so a physician will have to evaluate your husband's overall health to determine the right course of action. Generally, with treatment, a man's quality of life immediately increases.

In order to successfully speak with your husband about the possibility of low testosterone, remember to be patient, to make it about him, not you, and be honest. Odds are, your husband has already noticed the problem, but he does not know how to bring it up himself.

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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