Menopause symptoms and Bioidentical HRT

Symptoms of Menopause/Perimenopause

Menopause (the cessation of menstrual periods for 12 months) and Perimenopause, the stage of gradually falling hormone levels prior to menopause affect about 70% of women, some more severely than others. Symptoms begin to occur when a woman's ovaries decrease and eventually stop producing the hormones necessary to maintain the normal monthly cycle. The fluctuating and eventual marked decrease of estrogen and progesterone lead to symptoms which include hot flashes, mood swings, night sweats, irregular periods, loss of libido and vaginal dryness just to name the most common ones. Other symptoms include fatigue, hair loss, sleep disorders, memory lapses, weight gain, bloating, depression, anxiety, irritability, headaches, osteoporosis, joint pain and itchy skin.

Besides alleviating some or all of these symptoms, hormone replacement can have long lasting benefits for a woman's health.

How is Testosterone Administered

What is the best way to administer T? That all depends on what your priorities are. There are three basic routes, listed below with their positives and negatives.The choice really is up to you

Daily cream
-easy to apply
-raises T quickly, easy to control and adjust dose
-may lead to more DHT DiHydroTestosterone) production and it's effects on hair and benign prostatic hypertrophy
-can get on significant others in the first hour

Weekly injections
-easily done with small needle injection into fat
-less daily hassle
-can adjust dose as needed
-does require taking tuberculin syringes and medicine if on an extended trip

Sub-Cutaneous Pellets
-good steady state delivery for 3-4 mos
-no need to remember to use
-does require a small in office procedure to place
-dosage cannot be adjusted once placed
-can (rarely) become infected

Liposuction in the wrong hands ; Cosmetic surgery can be deadly!

USA today posted a front page article on Sept 14, 2011 about deaths occurring after liposuction by doctors who are not plastic surgeons. The article emphasizes the necessity for proper training and how many doctors who have not had that training are trying to do cosmetic procedures to inflate their incomes during these tough economic times. Most states permit any physician do procedures in their offices that do not require general anesthesia regardless of their specialty training. Problems often arise after the procedure when the patient is at home recovering. Be vigilant and check your doctor's credentials before booking that procedure. A good place to start is at the American Board of Plastic Surgery which maintains a list of the doctors that are Board Certified to practice the specialty. It is also prudent to remember that there are "boards" that certify doctors that aren't recognized by the American Board of Medical Specialties. Don't fall for a fake board certification. Many doctors would like to do plastic surgery but they don't want to spend the 7 plus years of training after medical school that is necessary. Don't be fooled, play it safe.

Dr. J

Possible Testosterone side effects

The side effects of increased testosterone are easily managed. The major effect is an increase in red blood cells. This leads to an increased oxygen carrying capacity, although if too high it is not healthy. This is more often seen when T injections are used. The treatment is to donate blood twice a year. There have been no testosterone associated thromboembolic (clotting) events reported to date.

Gynecomastia (swelling of the breast tissue) can be seen if testosterone is converted to Estrogen (female hormone). Estrogen levels are checked while on T and can be controlled by blocking the enzyme (aromatase) that converts T to Estrogen. This decreases the swelling. As your body fat decreases while on T, and aromatase is made in fat, estrogen will naturally decrease. Interestingly men need some estrogen to maintain libido and a sense of well being.

Fluid retention is rare and self limiting.

Decrease in testicular size and sperm count. Other drugs must be taken with T if you and your partner are trying to become pregnant.

Does T increase male pattern baldness? It is unknown at this time. Men that are susceptible to hair loss from Testosterone typically have exhibited this trait earlier in their lives. The culprit is DHT (dihydro T) that is made from T. This can be blocked using Avodart.

Patient notes

I just received this from a patient. It is so nice to hear from happy patients.

Thank you so much for the wonderful New Look!

The apparent care and enthusiasm you displayed while answering my questions and my husband's questions put me at ease.

I had been contemplating the surgery for years but after the first visit to your office my decision was easy.

I absolutely love my new figure and have already referred you to a number of people who are looking to have various work done including my physician!

Thank you so much from a truly satisfied customer!

Lots of well wishes,

R.B.

Testosterone and "Roid Rage"

Some of my patients and frankly their spouses, worry that replacing T will lead to easy excitability and "roid rage". Remember our goal is to replace your T to its healthiest levels, not something that is abnormal. We are using Testosterone and not a synthetic that was designed to skirt sports bans and has serious side effects. Just the opposite is seen in men who had low T. They are more calm and less "grumpy" when their T is normalized. They lose the "grumpy old man" syndrome that may have developed. They have more energy and are calmer. In general, they are happier.