Monthly Archives: July 2021

Hormone replacement therapy (HRT) is a treatment to relieve symptoms of themenopause. It replaces hormones that are at a lower level as you approach themenopause.

The main benefit of HRT is that it can help relieve most of the menopausal symptoms, such as:

Many of these symptoms pass after a few years, but they canbe unpleasant and taking HRT can offer relief for many women.

Itcan also help prevent weakening of the bones (osteoporosis), which is more common after the menopause.

Some types of HRT can increase your risk of breast cancer.

The benefits of HRT are generally believed to outweigh the risks. But speak to a GP if you have any concerns about taking HRT.

Read more abouttherisks of HRT.

Speak to a GP if you're interested in starting HRT.

You can usually begin HRT as soon asyou start experiencing menopausal symptoms and will not usually need to have any tests first.

A GP can explain thedifferent types of HRTavailable and help you choose one that's suitable for you.

You'll usually start with a low dose, which may be increased at a later stage. It may take a few weeks to feel the effects of treatment and there may be someside effects at first.

A GP will usually recommend trying treatment for 3 months to see if it helps. If it does not, they may suggest changing your dose, or changing the type of HRT you're taking.

Most women can have HRT if they're having symptoms associated with the menopause.

ButHRT may not be suitable if you:

Inthese circumstances,alternatives to HRTmay be recommended instead.

There are many different types of HRT and finding the right 1 for you can be difficult.

There are different:

A GP can give you advice to help you choose which type is best for you.You may need to try more than 1 type before you find 1 that works best.

Find out more about the different types ofHRT.

There's no limit on how long you can take HRT, but talk to a GP about how long they recommend you take the treatment.

Most womenstop takingitonce their menopausal symptoms pass, which is usually after a few years.

Women who take HRT for more than 1 year have a higher risk of breast cancer than women who never use HRT. The risk is linked to all types of HRT except vaginal oestrogen.

The increased risk of breast cancer falls after you stop taking HRT, but some increased risk remains for more than 10 years compared to women who have never used HRT.

When you decide to stop, you can choose to do so suddenly or gradually.

Gradually decreasing your HRT dose is usually recommended because it's less likely to cause your symptoms to come back in the short term.

Contact a GP if you have symptoms that persist for several months after you stop HRT, or if you have particularly severe symptoms. You may need to start HRT again.

As with any medicine, HRT can cause side effects. But these will usually pass within 3 months of starting treatment.

Common side effects include:

If you're unable totake HRT or decide not to,you may want to consider alternativeways of controlling your menopausal symptoms.

Alternatives to HRT include:

Several remedies (such as bioidenticalhormones) are claimed to help withmenopausal symptoms, but these are not recommended because it's not clear how safe and effective they are.

Bioidentical hormones are not the same as body identical hormones. Body identical hormones, or micronised progesterone, can be prescribed to treat menopausal symptoms.

Read more about alternatives to HRT.

Page last reviewed: 09 September 2019Next review due: 09 September 2022

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Hormone replacement therapy (HRT) - NHS

Transgender hormone therapy, also sometimes called cross-sex hormone therapy, is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is feminization or masculinization:

Some intersex people may also undergo hormone therapy, either starting in childhood to confirm the sex they were assigned at birth, or later in order to align their sex with their gender identity. Non-binary people may also undergo hormone therapy in order to achieve a desired balance of sex hormones or to pass as a desired gender. [1]

The formal requirements for hormone therapy vary widely.

Historically, many health centers required a psychiatric evaluation and/or a letter from a therapist before beginning therapy. Many centers now use an informed consent model that does not require any routine formal psychiatric evaluation but instead focuses on reducing barriers to care by ensuring a person can understand the risks, benefits, alternatives, unknowns, limitations, and risks of no treatment.[2] Some LGBT health organizations (notably Chicago's Howard Brown Health Center[3] and Planned Parenthood[4]) advocate for this type of informed consent model.

The Standards of Care for the Health of Transsexual, Transgender, and Gender Nonconforming People (SOC) require that the patient be referred by a mental health professional who has diagnosed the patient with persistent gender dysphoria. The Standards also require that the patient give informed consent, in other words, that they consent to the treatment after being fully informed of the risks involved.[5]

The World Professional Association for Transgender Health (WPATH) Standards of Care, 7th edition, note that both of these approaches to care are appropriate.[6]

The World Professional Association for Transgender Health (WPATH) and the Endocrine Society formulated guidelines that created a foundation for health care providers to care for transgender patients.[7] UCSF guidelines are also used.[8][citation needed] There is no generally agreed-upon set of guidelines, however.[citation needed]

Feminizing hormone therapy usually includes medication to suppress testosterone production and induce feminization. Types of medications include estrogens, antiandrogens (testosterone blockers), and progestogens.[9] Most commonly, an estrogen is combined with an antiandrogen to suppress and block testosterone. This allows for demasculinization and promotion of feminization and breast development.

Masculinizing hormone therapy usually includes testosterone to produce masculinization and suppress the production of estrogen.[10] Treatment options include oral, parenteral, subcutaneous implant, and transdermal (patches, gels). Dosing is patient-specific and is discussed with the physician.[11] The most commonly prescribed methods are intramuscular and subcutaneous injections. This dosing can be weekly or biweekly depending on the individual patient.[citation needed]

Hormone therapy for transgender individuals has been shown in medical literature to be generally safe, when supervised by a qualified medical professional.[12] There are potential risks with hormone treatment that will be monitored through screenings and lab tests such as blood count (hemoglobin), kidney and liver function, blood sugar, potassium, and cholesterol.[11][9] Taking more medication than directed may lead to health problems such as increased risk of cancer, heart attack from thickening of the blood, blood clots, and elevated cholesterol.[11][13]

Transgender hormone therapy may limit fertility potential.[14] Should a transgender individual choose to undergo sex reassignment surgery, their fertility potential is lost completely.[15] Before starting any treatment, individuals may consider fertility issues and fertility preservation. Options include semen cryopreservation, oocyte cryopreservation, and ovarian tissue cryopreservation.[14][15]

A study due to be presented at ENDO 2019 (the Endocrine Society's conference) reportedly shows that even after one year of treatment with testosterone, a transgender man can preserve his fertility potential.[16]

Many providers use informed consent, whereby someone seeking hormone therapy can sign a statement of informed consent and begin treatment without much gatekeeping. For other providers, eligibility is determined using major diagnostic tools such as ICD-10 or the Diagnostic and Statistical Manual of Mental Disorders (DSM). Psychiatric conditions can commonly accompany or present similar to gender incongruence and gender dysphoria. For this reason, patients are assessed using DSM-5 criteria or ICD-10 criteria in addition to screening for psychiatric disorders. The Endocrine Society requires physicians that diagnose gender dysphoria and gender incongruence to be trained in psychiatric disorders with competency in ICD-10 and DSM-5. The healthcare provider should also obtain a thorough assessment of the patient's mental health and identify potential psychosocial factors that can affect therapy.[17]

The ICD-10 system requires that patients have a diagnosis of either transsexualism or gender identity disorder of childhood. The criteria for transsexualism include:[18]

Individuals cannot be diagnosed with transsexualism if their symptoms are believed to be a result of another mental disorder, or of a genetic or chromosomal abnormality.[citation needed]

For a child to be diagnosed with gender identity disorder of childhood under ICD-10 criteria, they must be pre-pubescent and have intense and persistent distress about being the opposite sex. The distress must be present for at least six months. The child must either:

The DSM-5 states that at least two of the following criteria must be experienced for at least six months' duration for a diagnosis of gender dysphoria:[19]

In addition, the condition must be associated with clinically significant distress or impairment.[19]

Some organizations but fewer than in the past require that patients spend a certain period of time living in their desired gender role before starting hormone therapy. This period is sometimes called real-life experience (RLE). The Endocrine Society stated in 2009 that individuals should either have a documented three months of RLE or undergo psychotherapy for a period of time specified by their mental health provider, usually a minimum of three months.[20]

Transgender and gender non-conforming activists, such as Kate Bornstein, have asserted that RLE is psychologically harmful and is a form of "gatekeeping", effectively barring individuals from transitioning for as long as possible, if not permanently.[21]

Gender-affirming care is health care that affirms people to live authentically in their genders, no matter the gender they were assigned at birth or the path their gender affirmation (or transition) takes. It allows each person to seek only the changes or medical interventions they desire to affirm their own gender identity, and hormone therapy (HRT or gender-affirming hormone therapy) may be a part of that. [22]

Some transgender people choose to self-administer hormone replacement medications, often because doctors have too little experience in this area, or because no doctor is available. Others self-administer because their doctor will not prescribe hormones without a letter from a psychotherapist stating that the patient meets the diagnostic criteria and is making an informed decision to transition. Many therapists require at least three months of continuous psychotherapy and/or real-life experience before they will write such a letter. Because many individuals must pay for evaluation and care out-of-pocket, costs can be prohibitive.

Access to medication can be poor even where health care is provided free. In a patient survey conducted by the United Kingdom's National Health Service in 2008, 5% of respondents acknowledged resorting to self-medication, and 46% were dissatisfied with the amount of time it took to receive hormone therapy. The report concluded in part: "The NHS must provide a service that is easy to access so that vulnerable patients do not feel forced to turn to DIY remedies such as buying drugs online with all the risks that entails. Patients must be able to access professional help and advice so that they can make informed decisions about their care, whether they wish to take the NHS or private route without putting their health and indeed their lives in danger."[23] Self-administration of hormone replacement medications may have untoward health effects and risks.[24]

A number of private companies have attempted to increase accessibility for hormone replacement medications and help transgender people navigate the complexities of access to treatment. Plume is building a healthcare service specifically for the transgender community.[25] In September of 2020, Plume partnered[26] with Solace to expand accessibility and awareness of Gender-Affirming Hormone Therapy (GAHT). Solace is a mobile application focused on providing access to credible, relevant transition information and allowing users to create a custom transition roadmaps and goals.[27]

Read the original here:
Transgender hormone therapy - Wikipedia

Menopause is a natural biological process that all women experience at some point in their lives. During this time, your body goes through numerous changes as it adjusts to fluctuating hormone levels. The hormones that once existed in such vast amounts begin to dwindle as you pass childbearing years, and theyll continue to decrease throughout the rest of your life. These changes can cause symptoms, such as hot flashes, mood swings, and even depression.

Hormone replacement therapy (HRT) can make a big difference in counteracting these symptoms by replacing the diminished hormones in a natural way. However, HRT isnt without risks. In fact, it has been linked to an increased risk of breast cancer, heart disease, and stroke. You should carefully consider these risks before deciding if HRT is the best treatment option for your symptoms.

In the early years of HRT, doctors most often prescribed it in the form of synthetic prescription medications. These drugs are made from a blend of hormones isolated from a pregnant horses urine. Premarin is the synthetic form of estrogen, while Provera is the synthetic version of progesterone. Though synthetic drugs used to be the preferred HRT theyve become less popular in recent years. Some risks were identified in clinical trials that led many women to seek out an alternative form of HRT called bioidentical HRT.

In bioidentical HRT, a pharmacist mixes a special blend of hormones intended to replace the depleted hormones in your body. Bioidentical hormones are generally extracted from elements found in nature. Its believed that your body is unable to differentiate between these hormones and the natural hormones your body creates. This way of tricking your body into its former state has been shown to be successful in many women. However, medical researchers dont yet know exactly how much of each hormone is needed. As a result, bioidentical HRT may involve multiple doctor visits and frequent tests to find the level of HRT dosing thats right for you.

Since each dose varies from person-to-person, bioidentical hormones are difficult to test for safety and effectiveness on an overall basis. The lack of information on the risks of bioidentical hormones causes many women to assume that these natural hormones are better or safer than synthetic hormones.

However, the word natural is open to interpretation. Bioidentical hormones arent found in this form in nature. Rather, theyre made, or synthesized, from a plant chemical extracted from yams and soy. This same chemical is used in soy supplements, so bioidentical hormones are technically categorized as natural supplements. As a result, the U.S. Food and Drug Administration regulates them under a different set of rules than those covering prescription and over-the-counter drugs. This means that bioidentical hormones dont need to be rigorously tested in humans, making it hard to know whether theyre safe or effective. Though theres no definitive answer, most experts believe bioidentical HRT involves the same risks as synthetic HRT. Neither type of HRT is considered to be safer than the other.

In your childbearing years, your ovaries produce estrogen and progesterone. These hormones regulate your reproductive cycle and promote the bodys use of calcium. The ovaries decrease their production of these hormones as you age, which often results in:

HRT replenishes estrogen and progesterone levels in the body, helping to reduce these effects. This type of treatment comes with other benefits as well. In addition to easing the symptoms of menopause, HRT may also reduce your risk for diabetes, tooth loss, and cataracts. Many women are able to live a more productive and comfortable life after successful HRT treatments.

While some health benefits are linked to HRT, several risks are associated with it as well.

HRT has been connected to an increased risk for certain types of cancers, especially breast cancer. The studies that discovered a link between HRT and breast cancer refer to women being treated with synthetic HRT, not bioidentical HRT. However, there are no studies that show that bioidentical HRT is any safer than synthetic HRT. The risk of breast cancer increases the longer a woman engages in any type of HRT, and the risk decreases once HRT is stopped.

A higher risk for uterine cancer also exists when menopausal women with a uterus use estrogen HRT only. This is why doctors will generally prescribe progesterone along with estrogen. If youve had a hysterectomy, you can forego progesterone and simply take estrogen.

Other risks for women undergoing HRT include osteoporosis and stroke. Osteoporosis is particularly prevalent among postmenopausal women, which is why synthetic HRT is now mostly used for short-term relief of menopause symptoms. However, its important to note that the risks of osteoporosis exist in menopause without HRT.

Though there are risks involved with HRT, its still the best way to treat severe menopause symptoms and improve quality of life. You and your doctor can discuss the risks and benefits for you specifically and evaluate other treatment options. Its critical to work closely with your doctor so you can decide whats right for you.

Read this article:
Estrogen and Hormone Replacement Therapy: Is it Right for You?

ExploreMenopause affects both gray and white brain matter, study finds

By 2025, more than 1 billion women around the globe will be postmenopausal, according to the North American Menopause Society, and yet, while most women generally know what menopause is, the modern characterization of this transition as negative or mysterious has left them without a deeper understanding.

In some ways, that seems to be changing as conversation about menopause becomes more normalized. New products, books and communities are cropping up daily providing women with information and support through menopause. Dr. Jen Gunter, author of The Menopause Manifesto (Kensington, $18.95), said in an essay for The New York Times the time has come for a feminist menopause that rejects the patriarchal notion that a womans worth is tied to her ovarian function and that the end of her reproductive life represents the end of her productive life.

The femtech industry which refers to software and technology designed to address the health care needs of women is expected to reach almost $50 billion by 2025 and menopause management has high market potential as indicated by the explosion in startup companies focusing on the area.

Its hard to miss all the advertisements for products that claim to alleviate symptoms of menopause from the inside out. Supplements claiming to relieve hot flashes, sleep disturbances and mood swings are widely available but have little supporting evidence on their efficacy. Other products take a more general focus, such as skin creams or shampoos, specifically advertised to address the skin and hair concerns of women in perimenopause.

In the 1960s, estrogen replacement became the dominant regimen for treating menopause, but estrogen is not the wonder drug everyone thought it was, writes Susan Mattern, distinguished research professor of history at the University of Georgia and author of The Slow Moon Climbs (Princeton, $19.95), and while hormone replacement therapy may help with hot flashes, studies have revealed that it also comes with elevated risk of stroke, breast cancer, heart disease and more.

Most doctors advise short-term hormone replacement and only for severe symptoms, Mattern said, but when women are hyper-focused on physical symptoms that we attribute to menopause, they could be missing the bigger point.

Usually it is hard for me to listen to conversations about menopause because most of what people say about it is wrong, she said. We think of it as a medical condition and something you need to go to the doctor for. There has been an enormous amount of profit made off of menopause, selling drugs to women who think they are sick.

Because menopause can impact so many different systems in the body, addressing any concerns requires a multidisciplinary approach, one that doesnt place outsized importance on menopause as a physical transformation. I wish doctors would become more educated about what other disciplines are saying about menopause, said Mattern.

Menopause only became a subject of medical interest in Europe in the 18th century, said Mattern in her book, and our understanding of it rests on that most recent and somewhat faulty foundation. For most of human history, menopause has been seen as a developmental transition to an important stage of life something we should consider a solution rather than a problem, Mattern writes.

Why would animals outlive a time when they can reproduce copies of themselves? (Menopause) is something that has been important to the success of our species, said Mattern. Because women have a long post-reproductive life stage, humans across time have been able to rapidly populate while also controlling population size and managing resources.

So why do so many women seem to be in the dark about the changes to their bodies?

We dont talk about it because it is a mortifying subject, Mattern said. There is no reason to fear menopause and there is no reason to be embarrassed about it.

Part of changing the narrative means creating a space for women to talk about menopause in a more revolutionary manner than what has existed in the past.

About five years ago, Licia Freeman, a marriage and family therapist in Atlanta, created a 12-week menopause therapy group when she began attracting clients that mirrored what was happening in her own life.

It was not a group to just complain, Freeman said. It was about menopause but it merged into more existential topics what is going on in their lives outside of their bodies.

The women discuss careers and retirement, relationships, travel and how to manage it all during a perimenopausal and postmenopausal period that they are learning to reframe as a time and space for living life more passionately and freely. Freeman helps the women find skills to manage depression, anxiety and irrational thinking that may be exacerbated by the traditional messaging surrounding menopause.

There are so many necessary losses in life. We are constantly grieving something, said Freeman. The aim is to reach acceptance. (Menopause) is a stage of life with no limitation really.

Read more on the Real Life blog (www.ajc.com/opinion/real-life-blog/) and find Nedra on Facebook (www.facebook.com/AJCRealLifeColumn) and Twitter (@nrhoneajc) or email her at nedra.rhone@ajc.com

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OPINION: Changing the myths, mystery and mortification around menopause - Atlanta Journal Constitution

The Department of Health and Human Services (DHHS) is the U.S. federal government agency responsible for protecting the health of the American public.

The DHHS HIV guidelines help inform healthcare professionals of the best ways to treat HIV based on the latest clinical evidence and expert opinions.

In this article, we break down some of the key points of the DHHS guidelines and what to know about the most recent changes.

The main goal of the DHHS guidelines is to offer recommendations to healthcare professionals on the best treatment options for people with HIV. The guidelines are written and updated based on the most recent scientific evidence.

Doctors can consult these guidelines to determine the right treatment at various stages of HIV. For example, the guidelines provide recommendations on when to start antiretroviral therapy (ART), which drugs should be used, and what to do if initial treatment isnt working.

The full guidelines provide a long list of recommendations you can read here. Weve summarized some key points below so you can get an idea of the type of information these guidelines include.

Initial HIV treatment generally consists of two medications called nucleoside reverse transcriptase inhibitors in combination with a third active antiretroviral (ARV) drug from one of three drug classes:

The following drug regimens are classified as recommended initial regimens for most people with HIV. A slash (/) between medications means theyre available as a combination drug within the same pill:

When ART isnt working, several factors should be considered, including:

At the time this article was written, the DHHS guidelines were most recently updated on June 3, 2021.

Researchers are continuing to improve their understanding of how to best treat and manage HIV. The guidelines are updated periodically to include the latest research and expert opinions.

Heres an overview of the most recent changes included in the 2021 update.

New evidence from the Botswana Tsepamo Study, an ongoing observational study that started in 2014, suggests that the rate of neural tube defects (a type of structural change in a developing fetus) is lower than expected in women taking dolutegravir at the time of conception.

Dolutegravir is now recommended as an initial treatment option for people who may get pregnant.

The medication raltegravir was moved from recommended initial regimens for most people with HIV to recommended initial regimen in certain clinical situations.

The change was partially made due to the results of the Botswana Tsepamo Study. Since dolutegravir is now a viable treatment for people who can get pregnant, its no longer necessary to choose raltegravir over dolutegravir.

It was initially recommended that if ART treatment doesnt work, it should be followed by two and preferably three fully active ARV drugs.

Its now recommended that the new treatment can include two fully active drugs if at least one has a high resistance barrier. Examples of such drugs include boosted darunavir or dolutegravir. The change was made based on the results of ongoing clinical trials.

Updates include the mechanism behind declining CD4 counts despite suppressive ART.

CD4 cells are a type of white blood that fights infections. Knowing a persons CD4 count helps determine their risk of developing opportunistic infections.

The new guidelines also include updated strategies to reduce persistent inflammation.

Updates include the role of long-acting injectable regimens cabotegravir plus rilpivirine. Long-acting injectables are a new form of ART that involve infrequent injections instead of daily oral medication.

The Food and Drug Administration (FDA) approved the first long-acting injectable for treating HIV in January 2021.

The adolescent and young adults section has been updated to include current data on the rate of HIV among youth in the United States.

The guidelines now also have more details on the unique challenges that youth with HIV face compared to adults.

This section now includes data from a 2020 review of eight studies that found that women are more likely to gain weight than men after starting ART.

Theres also now more information regarding the effects of menopause and hormone replacement therapy while on HIV treatment.

This section now includes information about when to consider the long-acting injectable cabotegravir plus rilpivirine in people with a substance use disorder.

Current research is limited to people with good medication adherence.

Newly discovered drug interactions have been included in the guidelines, including interactions between the drugs cabotegravir plus rilpivirine and fostemsavir.

A section was added discussing the cost effectiveness of new drugs, such as ibalizumab, in HIV thats resistant to multiple ARV drugs.

Monthly prices of commonly prescribed ARV drugs have been updated with 2021 prices.

Updates describe current recommendations for ARV drugs that can be used if 3 months of isoniazid and rifapentine are prescribed for tuberculosis.

There are many free or low-cost programs available to help people with HIV. Here are some resources that may be helpful:

The DDHS HIV guidelines were developed to help healthcare professionals stay up to date with the latest HIV research so they can provide the best possible treatment. The guidelines are updated regularly as new research or evidence becomes available.

The guidelines are available online for free to anybody who wants to read them.

Original post:
Overview of the Latest DHHS HIV Treatment Guidelines - Healthline

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Global Hormone Replacement Therapy Market Technology Prospectus to 2027 Pfizer, BioSante Pharmaceuticals and Amgen, Noven Pharmaceuticals, Bayer AG ...

Living with ADHD while going through menopause can be challenging, but there are ways to manage both.

What do ADHD and menopause have in common other than mood changes and inattention?

Though some symptoms are observable on the outside, folks around you may not understand even half of what youre handling internally, let alone that youre managing both at the same time.

Living with attention deficit hyperactivity disorder (ADHD) comes with its own challenges. And if youre going through perimenopause or menopause, you may face more difficulties.

ADHD is a neurocognitive disorder that has three presentations:

People can receive a diagnosis early in childhood as well as late in life.

Dr. Ellen Littman, a clinical psychologist in New York state, explains that estrogen has powerful effects on brain chemistry throughout your lifetime.

Menopause is among the top biggest events to change estrogen in your body, among starting your period and becoming pregnant.

Estrogen is considered neuroprotective, in that high levels increase the availability of neurotransmitters (brain messengers) like dopamine and serotonin, which enhance cognition, mood, sleep, verbal memory, and even ADHD symptoms, Littman says, who is publishing an upcoming review article about the female hormonal effects on ADHD.

However, your levels of estrogen decline beginning in perimenopause and are spent during menopause.

While people face some symptoms off and on during menopause, Littman says those who also have ADHD experience intensified symptoms.

By understanding the relationship between menopause and increased ADHD symptoms, they are less likely to be ambushed by the amplified difficulties they experience, she says.

Both ADHD and menopause are known for patternless shifts in brain activity and hormone changes.

So, you might begin to see how overlapping symptoms happening concurrently or one after the other can worsen the experience of both conditions and make them difficult to manage.

A 2016 study even looks at the effectiveness of using ADHD medication to treat people experiencing executive function issues during menopause.

While going through menopause when you have ADHD can feel overwhelming, there are ways you can manage both conditions.

Finding a psychiatrist whos well versed and experienced in treating ADHD in people going through menopause can help you get the care you deserve.

While it might not be easy to find a psychiatrist with experience in this area, start by asking your current mental health professional or gynecologist for recommendations.

If you cant find a psychiatrist whos familiar with research demonstrating hormone involvement in ADHD symptoms, Littman suggests sharing information or articles (like this one) with them.

If you feel that your credibility is being questioned, its important to feel entitled to finding the clinician who best fits your needs, she says.

Littman suggests finding a gynecologist whos experienced in treating people going through menopause, and who will also work with the doctor who treats your ADHD.

Since women now spend about a third of their lives in menopause, it is critical to find a treatment regimen tailored to your specific needs, she says.

According to a 2019 survey of postgraduate resident trainees in family medicine, internal medicine, and obstetrics and gynecology in U.S. residency programs, only 6.8% of them reported feeling just adequately prepared to manage women experiencing menopause.

No one clinician is knowledgeable about all aspects of each individual experience, but Littman says finding doctors who will collaborate and communicate with your gynecologist can help tailor treatment.

For instance, if your ADHD medications need adjusting, as well as your decreasing estrogen levels, having both your gynecologist and doctor who treats your ADHD collaborate could help.

While pharmacologists often adjust the dosage to meet the new challenges, increased estrogen could address both menopausal and ADHD symptoms. Bioidentical hormone replacement therapy (HRT) is one route to increased estrogen for many women, Littman says.

Although your doctors may be hesitant to communicate with each other, being assertive and informing them of your conditions, as well as bringing information from each doctor to your appointments, can help ensure theyre in tune with whats going on with your body.

While theres a wide range of menopausal symptoms that occur on a continuum, Littman points out that ADHD can worsen symptoms like impaired cognition and mood.

In fact, a 2019 research paper suggests that ADHD symptoms, and even concurrent symptoms from other conditions, are also vulnerable to the hormonal changes experienced during menopause, says Littman.

Both conditions can muddle with your executive functions, a clinical term for your:

If you find that these areas of your life are becoming more difficult to manage, coming up with a plan to help navigate them can make your days easier.

For instance, if keeping and organizing appointments and commitments is difficult, setting an email calendar reminder so you get notifications on your phone, tablet, and desktop can help you stay on track.

If self-monitoring is a blind spot as of late, you could try leaning on your inner circle to gently give you a signal if agitation or strong emotions are coming off more than intended.

You might also look into present moment awareness to reconnect with mindfulness and strengthen your self-awareness.

In addition to seeing a professional, Littman suggests pursuing your own psychoeducation. Consider bookmarking the following resources:

The more you can understand about the relationship between your [brains response to ADHD] and your body in menopause, the more you can be an active participant in your treatment. And the more your support network understands about your challenges, the more supportive and compassionate they can be, Littman says.

While managing your ADHD while going through menopause can be challenging at times, there are ways to make the process easier.

Littman says that on the clinical front, new research brings hope for better treatments ahead.

Were on the brink of an exciting new understanding of the experience of women with ADHD, she says. As new studies continue to implicate the powerful role of hormones in womens experience of ADHD, the potential for more comprehensive and successful treatments may be on the horizon.

You can stay tuned for Littman and teams upcoming study on ADHD and estrogen, titled: ADHD in Females Across the Lifespan and the Role of Estrogen. It publishes August 2021 in The ADHD Report.

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Tips to Manage when You're in Menopause with ADHD - PsychCentral.com

The desire to look younger is natural

Like many other living organisms, humans are born, survive, compete for resources, reach maturity, reproduce, take care of their young, sometimes the young of their young, continuously decline, and die. Evolution needs us for just two purposes adapt and reproduce. But, unlike other species, humans are very conscious of their fate. Humans are very much aware that after reaching peak performance they will eventually grow old and die. We arevery conscious of our fate after reaching peak performance loss off function, frailty, and eventual loss of everything we worked so hard to earn.

We observe our parents, and other elderly around them, attend funerals, and understand that eventually we will get into this state. We are also very contempt with that fate as evolution made sure that. The more ambitious of us are trying to advance science, the rest seek refuge in religion, some in philosophy, some in accumulation of wealth, and some see the continuation of ourselves in our children. But despite the many technological advances transpiring in the laboratories all over the world, there is nothing we can do at this point to escape aging. There are diets, exercises, sleep, and supplements, but these provide very marginal benefits. We do not see 120+ old yoga and diet practitioners or marathon runners around. But these simple habits do help look younger longer. And many people that have very harmful habits like smoking but still diet and exercise to look younger.

Nature is also very unfair and sexist. The females lose reproductive capacity much faster then males. Most females enter menopause between 40 and 60. The average age of menopause in the US is 51. And it is very common to see the couples where the males are significantly older. And for this reason nature found its way to signal the reproductively active people that the older person is not someone they would like to copulate with. And there are many signals: graying hair, wrinkles, body composition, etc. There are few beauty contests for people over 25, and most fashion models become popular in their teenage years. Males can reproduce longer and often remain more attractive to younger females but the level of attractiveness is usually lower and often augmented by social and economic status. It also does seem like the younger women prefer older men more often then the other way around.

So looking younger is a natural desire just like it is natural to seek a younger spouse after a certain age. It is a desire to maintain reproductive viability.

And even though there are not that many aging processes that we can have any control of, the desire to look younger spurred a giant industry. Now it is technologically possible to shave a decade or even two off the way we look via cosmetic interventions, makeup, and surgery.

But whenever we see media images of older celebrities, particularly those who seem much younger than their actual age, the inevitable questions concerning whether "he/she had work done"" or snide remarks about too much botox/liposuction" are rarely far behind.

But why is there such a stigma about wanting to look younger?Despite all these often vicious remarks about cosmetic surgery and other attempts at looking young and attractive, it's not just celebrities who are doing this.While cosmetic surgery used to be reserved solely for the very rich, it is becoming much more affordable, and, not surprisingly, more people than ever are taking advantage.According to the 2019 Plastic Surgery Statistics report released by the American Society of Plastic Surgeons, more than eleven million surgical and nearly fourteen million non-surgical procedures took place worldwide last year, almost four million of those procedures in the United States alone.

Healthcare and medicine

While most cosmetic surgery patients are women,male patients are also becoming more common, and the demand for such services has steadily risen over the past decade.The primary market for women is routine procedures such as breast augmentation, rhinoplasty (nose reshaping), "tummy tucks," and dermabrasion.On the other hand,male patients are getting hair transplantation, breast reductions (or augmentation), calf and pectoral implants,penile extensions (where available), and various other improvements to make them look more masculine as well as attractive.Older clients are also getting procedures specifically intended to make them look younger and thinner, including facelifts, eyelid surgery, botox, and liposuction, to name a few highly demanded anti-aging procedures.

Cosmetic surgery has become such a growth industry that even a cursory Google search can direct would-be users to local clinics.Suppose the desired service is not available locally or cheaply. In that case, would-be customers can look into "medical tourism" involving other countries where they can get surgery and enjoy other travel perks, often in the form of all-expense-paid travel packages. Such medical tourism junkets have become a significant economic boost to otherwise economically disadvantaged countries, and the demand will undoubtedly rise as baby boomers grow older.

In many ways, though,this demand for cosmetic surgery is just the tip of the iceberg.While not everyone can afford (or are interested in) cosmetic surgery,the desire to look younger and healthier has sparked a vast anti-aging industry worldwide.Along with an astonishing number of books, videos, and courses available online offering advice on fighting the signs of age, more people than ever are seeking out various services offering the promise of looking younger and more desirable.That includes weight loss clinics, nutrition counselors, personal trainers, yoga instructors, and a host of other purveyors of youth and beauty.Many older adults seeking out these services seem to be driven by their fears about aging, not to mention unrealistic media representations about the human body (particularly the female body).

But other fears seem to be driving this need to look younger.Though laws banning age discrimination continue to pass in countries worldwide, many older adults feel compelled to hide visible signs of aging to avoid being thought of as "old." The need to look younger has sparked an entire movement surrounding the concept of "agelessness," particularly for women who are far more likely than men to be judged for their appearance.Not surprisingly, many celebrities, male and female alike, have lent their name to various anti-aging products of doubtful validity, all of which promise users the same "agelessness" they enjoy themselves (actress Suzanne Somers and her endorsement of bioidentical hormone replacement therapy, for example).

However, almost inevitably, we are now facing a backlash in the form of a "body positive" movement encouraging men, especially women, to reject what feminist researchers describe as the objectifying of physical appearance favoring a more "genuine" look.It also highlights the double standard that exists between older men and women. While older men can be considered competent regardless of their gray hair and wrinkles, recent research suggests that many women find themselves required to look younger to be accepted.Even those women who refrain from dying their hair to appear more authentic often use other beauty practices to look more youthful. Ironically, for women who choose to make themselves look younger, the most likely backlash they experience usually comes from other women rather than men, a finding recently supported by evolutionary psychology research.

But is there anything wrong with wanting to look younger and more desirable?Numerous studies show the link between perceived attractiveness, self-esteem, and subjective wellbeing.According to one study recently published in the Journal of Women and Aging, the same body dissatisfaction often seen in adolescent girls can also occur in many women as they grow older.An online survey of over three hundred women between the ages of forty-five and sixty-five found that women who were dissatisfied with their appearance and were afraid of growing older were especially prone to depression.They were also far more likely to resort to anti-aging regimens to make themselves look younger.

In another study published last year, researchers found a strong link between perceived self-attractiveness and life satisfaction in women from different age groups (825, 3045, and over 60).The study showed similar results for both overall perceived attractiveness and attractiveness of specific body parts.And people who look younger also feel younger, something that has enormous health benefits, particularly in helping people handle stress (including financial stress), cope with depression and loneliness, and greater sexual satisfaction.

Our recent work on psychological and subjective aging clocks developed using AI also provided a clue that looking younger and thinking more positively about the future correlated with lower mortality. So by looking younger you may actually live longer.

Despite the ongoing political battle over body positivity and "authenticity," wanting to look younger is very natural and certainly no cause for being stigmatized.Ultimately though, simply looking younger is not enough.we still need to invest more efforts into aging and longevity biotechnology.Helping people to live longer and more productive lives remains one of the most significant medical challenges imaginable.Also, eliminating the risk of deadly age-related conditions such as Alzheimer's disease makes research into aging an investment that will repay itself many times over.

Cosmetic procedures coupled with aging clocks may help improve the outlook on life, provide more ... [+] optimistic view on the future, extend reproductive age, and decrease mortality.

To learn more about the exciting and complex field of anti-aging research, consider attending the largest conference on aging research and drug discovery organized every year by the University of Copenhagen and Columbia University 8th Aging Research and Drug Discovery.

Link:
No Shame In Wanting To Look Younger - It Is Natural And You Might As Well Live Longer - Forbes

Linda Robson said the menopause turned her into a madwoman (Picture: ITV)

Linda Robson spoke honestly about her experiences with the menopause admitting it made her unbearable to live with.

The actress, 63, said on Thursdays Loose Women that she ended up with a low libido and began to shout at her children.

The menopause is when a woman stops having periods and is no longer able to get pregnant naturally. Symptoms can include hot flushes, vaginal dryness, difficulty sleeping or low mood.

According to the NHS, the severity of the symptoms people going through menopause will experience will vary, and symptoms often begin months or years before the menstruation stops altogether. This is known as perimenopause.

Lindas life was transformed for the better when she was on hormone replacement therapy (HRT) to help relieve the symptoms, but stopped when her sister was battling cancer, which led to her feeling even worse.

She told panelists Charlene White, Brenda Edwards and Nadia Sawalha: I knew I was going through the menopause because my sister went through it at 38 and I started getting all the symptoms, hot sweats, and no one can understand what a hot sweat is until youve had one.

You think its like a flash but its not. It actually goes through your whole body. It goes up through your back, over your head, all your make-ups gone.

She went on: Ive always had quite a high libido and all of a sudden I had no libido and I turned into a mad woman. I was shouting at the kids all the time, at my husband and everything.

So I decided to try the HRT and it just changed my life. But then my sister got breast cancer so me and my other sister came off of HRT. Its the worst Ive ever been.

Nadia interjected: I think that was the beginning of you going downhill.

Linda agreed: I was always quite happy, breezy, and all of a sudden I was a monster. The kids were going to me, Mum youve gotta go back on HRT and as soon as I went back on it my life changed again. My libidos through the roof!

Typically menopause comes on between the ages of 45 and 55, with the average age being 51.

Nadia urged people to speak to someone if any of their discussion resonated with them.

Loose Women airs weekdays from 12.30pm on ITV.

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Linda Robson says struggle with menopause turned her into a monster - Metro

Navan plans to focus on enhancing diversity and inclusion within the AAJ.

ATLANTA (July 14, 2021) Beasley Allens Navan Ward was installed as the 75th president of the American Association for Justice today during the groups annual meeting. He is the second minority to hold the position, with the first being more than two decades ago. It is this area of representation that Ward and other AAJ leaders are working to improve on in the future and is central to Wards goals for his administration.

I am thankful for my experience at Beasley Allen, where our leadership fosters a culture of inclusion and values the unique backgrounds, experiences and personal achievements of minority lawyers, Ward said. The firm has been recognized for its focus on diversity among its lawyers, including by Law360 as one of the 10 Best Law Firms for Black Attorneys in the U.S and previously recognized as the #1 law firm with African American partners. It is an approach we want to nurture in firms nationwide, Ward said.

The AAJ leadership understands that leaders from diverse backgrounds can strengthen and empower each other and those they lead. Navan has worked with AAJ leadership to recruit, train, and encourage members from different backgrounds (including race, gender, age, geography, and level of career) to become active leaders.

On many different levels and across various landscapes, our country is rebuilding, so it is the perfect time to do the same within the American Association for Justice. The AAJ is an organization that advocates for access to justice and works to preserve the rights given by the 7th Amendment of the U.S. Constitution. It is important that the organization genuinely reflects the diversity that makes it great. I look forward to implementing strategies that will build on the work of the past presidents and strengthen our leadership moving forward, Ward said.

Ward launched what has become the cornerstone of these efforts in 2012 called the American Association for Justice Diversity and Inclusion Leadership Academy. The Leadership Academy trains highly qualified and talented AAJ members, particularly those underrepresented within the association, to help them become more effective leaders. Graduates are encouraged to participate in leadership opportunities throughout AAJ, including the six-to-seven-year national officer track. The Leadership Academy provides leadership and benefits from continued training and leadership development. It is one way the organization guarantees the retention of minority leaders who can ensure underrepresented member groups have a voice in the future of the AAJ.

Ward is the firms lead attorney on the metal-on-metal hip implant litigation and proton pump inhibitor (PPI) litigation and practices from the Atlanta office. Currently, he serves on the Plaintiffs Steering Committee (PSC) for the DePuy ASR Hip Implant Recall Multi-District Litigation (MDL), DePuy Pinnacle Hip Implant MDL and was appointed as co-lead counsel for the Plaintiffs Executive Committee (PEC) in the Biomet M2a Magnum Hip Implant Products Liability MDL. Ward has been instrumental in assisting with the verdicts and global settlements against major hip implant manufacturers, including Johnson & Johnson / DePuy for $4.057 billion, Howmedica Osteonics Corporation / Stryker for over $1 billion, and Biomet Corporation for more than $250 million, and additional confidential settlements involving other metal-on-metal or modular-neck hip components. Ward has also been appointed to the PEC for the PPI MDL.

Before his work on PPI and hip implant litigation, Ward was heavily involved with the hormone replacement therapy litigation, representing hundreds of women diagnosed with breast cancer due to ingesting these combination hormone medications. His trial team was responsible for obtaining a $72.6 million verdict for three hormone therapy clients that went to trial. Ward was also responsible for overseeing the Meridia pharmaceutical drug litigation. This medication caused heart attacks and strokes and was heavily involved with the Cox-2 (Vioxx, Celebrex and Bextra) pharmaceutical drug litigation. His practice has also handled personal injury and wrongful death cases, including those involving nursing home abuse and neglect and trucking crashes. Overall, Ward has obtained more than $360 million for the specific clients that he has represented in the various areas he has practiced.

For his efforts in representing clients, Beasley Allen awarded him as the firms Litigator of the Year in 2013 and Mass Torts Litigator of the Year in 2011 and 2014.

In 2017, Ward received the AAJ Minority Caucus Stalwart Award for his dedicated years of service to the Minority Caucus and the organization overall. It also awarded him the AAJ Distinguished Service Award in 2012 and 2015 and its Wiedemann & Wysocki Award in 2014. Ward has been regularly selected to the Best Lawyers in America list, the Super Lawyers list, and named to the LawDragon 500 Leading Plaintiff Consumer Lawyers, the 500 best attorneys across the nation in this category.

Ward previously served in other AAJ leadership positions, including a past chairman of the Minority Caucus, past chairman of the Diversity Committee, and a member of the Board of Governors. He is a former Alabama State Bar delegate for the American Bar Association, past president of the Alabama Lawyers Association, the Alabama State Bars Young Lawyers Section, and the Montgomery County Association for Justice. Ward was a member of Leadership Montgomerys Class XXI, a former chairman of the Father Walters Charity Golf Tournament, and a member of the Alabama Law Foundation Grant Committee.

About Beasley Allen Law Firm

Founded in 1979, Beasley Allen Law Firm is a leader in complex plaintiff litigation nationwide. We work with attorneys and clients nationwide and have offices located in Atlanta, Georgia, Montgomery, Alabama, and Mobile, Alabama.Our award-winning attorneys live by our creed of helping those who need it most. For more information about our firm, please visit us online at http://www.beasleyallen.com.

Originally posted here:
Beasley Allen's Navan Ward Installed as the American Association of Justice 75th President - Montgomery Independent