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.

Weight Loss for Women - Free Tips

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For many women, the prospect of facing menopause brings great fear and apprehension. It is a time in life where reproduction ends, and for some women, leaves them with no way of identifying what their future life's purpose will be. Many women recall with not so fond memories the experiences of their mothers and grandmothers as they faced menopause with few of the hormone replacement help methods, which are available to females today. We have all heard the horror stories of hormone imbalance: night sweats, mood swings, etc. and are certainly not looking forward to the time when we too will be facing these unpleasant hormone deficiency side effects that often go hand in hand with perimenopause and menopause.

However, countless women today are seeking new ways to cope with the unpleasant hormonal changes, which so often accompany the onset of menopause. In the past, women have relied upon synthetic hormone replacement treatments which have been rather hit or miss in terms of their effectiveness. With the release of the Women's Health Initiative study, proving some synthetic hormones to be more harmful than good, women feared hormone replacement therapy all together. What most women didn't realize was that the WHI study neglected to disclose that their researchers did not use bio-identical hormones but only synthetic hormones. Although initial confusion about HRT was created, women are now searching for alternatives to hormone replacement and discovering a new safer solution which is bio-identical hormone replacement therapy or BHRT.

Although BHRT is an age old remedy, countless doctors and their patients are just learning of this option. If you are wondering why doctors are just learning of BHRT, there is a simple answer. Bio-identical hormones aren't patentable because they are in their natural form, thus pharmaceutical companies don't do studies on them. However, BHRT is in the forefront of anti-aging treatment and for many doctors the newest method for helping cure much that ails the menopausal woman. Different from conventional methods of hormone replacement therapy, which seeks to have women ingest synthetic or chemically altered versions of naturally occurring hormones, BHRT offers a more natural fit for the body. BHRT offers women plant based hormones that have the exact chemical and molecular structure as hormones that are produced in the human body. Unlike synthetic hormones, BHRT isn't alien to our body thus BHRT is received well with virtually no side effects.

BHRT is allowing many women to address the multiple concerns and health issues which rapidly face women who are actively going through the stages of menopause. The doses of BHRT are designed for each individual patient and are not a one-size fits all recipe. With bio-identical hormone replacement therapy, there is the recognition that each woman is different, therefore, her hormone treatment must be individualized to meet her very specific needs. Physicians who are advancing the use of bio-idientical hormone replacement therapies for their patients will first work with a woman to discover if she is actively in the perimenopause / menopause stage. Not only will the doctor need a complete physical history, but he or she will also need a patient's most up-to-date medical information which will in turn aid her in determining the specifics of each individual woman's case. At this point physicians who use bio-identical hormone replacement therapy will take blood, and from the blood results, can determine in which hormonal areas the female patient may be struggling.

Bio-identical hormone replacement therapy then calls for each hormone supplement to be compounded and dispensed in a manner which will be most effective in treating the specific hormone levels of the female patient involved. This type of customization of medicine ensures that an individual's specific concerns are addressed and that the menopause symptoms, the ones that are most bothersome to the patient, will be actively treated and brought under control.

There are many who are vocally singing the praises of BHRT. Numerous followers in the healthcare profession, particularly those who deal with women's health and their concerns, are ecstatic over these remarkable developments in the treatment of menopause. Many are finding their patients happier and healthier than they have seen them in years; furthermore, they like that bio-identical hormone replacement therapy has virtually no known side effects unlike synthetic hormones. BHRT seems to reduce the risks of blood clots and strokes, which can be so prevalent with the use of traditional hormone replacement therapy, and there are fewer concerns over cancer rates. Actually, in well known medical journals, researchers have reported that the bio-identical hormones, estrogen and testosterone, are not only safe but also have a positive impact on some diseases like osteoporosis and prostate cancer.

While many healthcare providers are still citing the lack of FDA approval, BHRT seems to be making quite a mark in the world of women's healthcare. For too long, women have been subjected to the toils and troubles that menopause can bring. With the advent of bio-identical hormone replacement therapy, the many concerns of patients and doctors are disappearing, as the hormone treatment continues to produce positive results and prove itself effective with even more patients. Numerous women are now able to approach this new stage of their lives feeling healthy and happy, ready to conquer the many unique and rewarding challenges and dreams that will come in the remainder of their adult life.

Treatment for Menopause

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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.

Testosterone Replacement Therapy or a Testosterone Booster?

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What is Testosterone?

Testosterone is a very important hormone, primarily produced in males via their testicles, and in smaller quantities from their adrenal glands. Females produce much smaller amounts of this hormone than men do, via the ovaries as well as adrenal glands. The importance of testosterone in the male body lies in how it controls the expression of sexual characteristics at different stages in the body's development, regulates sexual functions later in life, and assists in the generation of bone and muscle mass, among other functions it governs.

In healthy human males, testosterone levels peak in young adulthood, and naturally decrease over time, happening gradually and without sharp drop offs. However, some men's testosterone levels drop off suddenly, with significant and noticeable effects to their physical and mental well-being. This condition is known as "Andropause" (male menopause) or Low T. Judging by reports, it certainly seems to be on the increase.

Effects of Low Testosterone

Among the more severe and disturbing effects that low testosterone levels have on the male body, we find a decreased interest in sexual activity, erectile dysfunction, decreased muscle mass, osteoporosis (weak bones) and a diminished sense of well-being. One or more of the above can easily threaten a man's sense of identity, opening the door to even more issues. Several at once can be devastating. These symptoms develop over time, so there won't necessarily be a clear before and after to refer to.

What Should I Do?

If you suspect that you are suffering from a decrease in testosterone levels, the first thing you should do is get a check up by a medical professional. There are several reliable lab tests that your physician can run to verify that you are suffering from low testosterone levels, as well as rule out other conditions that may present with similar symptoms.

You need to be candid with your doctor! We realize this can be an embarrassing subject, but your doctor will only be able to help if you give them a full picture of what's going on. The sooner you check up on this, and the more straightforward you are, the higher the chances of being helped.

Testosterone Replacement Therapy

One of the ways to treat low testosterone levels is to introduce more testosterone into the body. Testosterone can now be manufactured commercially, and is available in different forms that, once applied in the proper manner, will go into the body increasing levels temporarily. Some of the more common forms that commercially produced testosterone comes in are gels, patches and injections.

The key part of this therapy is that it is temporary. Your body will not begin to produce testosterone in greater quantity on its own, but will instead now rely on obtaining it from the outside world. There are also some side effects involved (which are beyond the scope of this article), depending on the treatment and the dose, which should be discussed with your physician prior to selecting a product.

Testosterone Boosters

A better alternative, and one well worth trying, is to use a testosterone booster. Unlike testosterone replacement therapy, testosterone boosters do not introduce testosterone into the body. What they do is increase the body's ability to produce this hormone at higher levels, sometimes even at levels similar to before the condition started. Additionally, many of these boosters are made of all natural ingredients with proven ability to naturally raise testosterone production, and without many of the side effects that come with replacement therapies.

Since they work to recover the body's ability to produce testosterone, they also do not shock the body by introducing large amounts at any given time, as happens with an injection. There are many products on the market, though, and you will want to look at online reviews and other information to separate the wheat from the chaff.

More importantly, this does not relieve you of the need to talk to your physician. Remember there are other conditions which can cause similar, or identical, symptoms. You definitely do not want to be treating the wrong condition. A doctor's professional opinion, along with good lab work, is essential.


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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.

Information About Breast Cancer Treatment

bioidentical hormone replacement therapy weight loss

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

Does Testosterone Replacement Therapy Help Improve Sperm Production?

hormone replacement therapy cost

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

Information About Breast Cancer Treatment

bioidentical hormone replacement doctors

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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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