Category Archives: Hormone Replacement Therapy

I was extremely fortunate to be able to afford to transition in my own time (Picture: Alex Woolhouse)

There have been so many amazing firsts since transitioning.

The first time my sister called me her sister, the first time my parents called me their daughter. The first time I looked in the mirror and saw the femininity in my face. The relief and happiness I have felt has made it all worth it.

However, transitioning in the UK is expensive.

When I started doing it in 2018, it was by far the biggest drain on my finances Ive spentaround 7,000 so far.

But transpeople shouldnt be forced to choose between waiting on the NHSfor yearsor spending thousands of pounds to access private healthcare.

I was extremely fortunate to be able to afford to transition in my own time, doing what I wanted, privately; but not everyone has this luxury. Transitioning to relieve symptoms of medically-diagnosed gender dysphoria isnt a luxury it can be a necessity.

Coming outat 22,my friends and family wereunperturbed. I had always been a girl in their eyes and this for me and them seemed like the logical answer to the question of who Alex was. I was always Alex.

From cominghome from school and ripping off my boys school uniformto dress up as a princess from age four,to starring as Tanya in my university production of Mamma Miaat 20.It wasnt about being happier as a girl than I was a boy, it was just an undeniable truth that I was and am a girl.

At first, I wasnt going to do anything in termsof physically transitioningaside from growing my hair and getting my nails done.I thought that was enough for me and that the mental toll of medically transitioning would be too much with my corporate job at the time.

Sure, I got my first pair of work-appropriate heels and a lovely suit from Massimo Dutti, which I felt amazing in, but I really didnt think about what I would want and need in terms of the medical side.

But as I began making changes like these to how I lived my life, I became stronger in my convictions and knew that I wanted to live my life as a woman, whatever that meant to me. I wanted to be a mummy, to wear a white dress at my wedding, be a big sister. All of this meant medical intervention to ensure my face and body matched who I am.

I decided to start hormone replacement therapy (which is getting testosterone blockers and taking oestrogen pills) in 2018at the age of 22.I knew I wantedit nowbecause I knew who I was.

ButI had heard horror stories of NHS waiting times NHS Guidelines say 18 weeks is the limit from referral to treatment, but in reality the average waiting time for a first appointment with a gender identity clinic is 18 months, according to the LGBT Foundation.

SoI went about accessing trans healthcareprivately. Even still, this took around six monthsto get the ball rolling.

I got referred by my private work GP to go to a private psychologist, who would end up diagnosing me with gender dysphoria and refer me on to private hormone therapy.

Eachstepcost upwards of 200; thankfully I had the money.

A new passport, blood tests before hormones, the medication itself: it all added up.This cost around 1,000 in total to access hormone therapy.

And none of this actually helped with gender dysphoria. I would still constantly obsess with how masculine or feminine I was looking, walking or talking. I felt physically sick when I saw a hair on my chin and simply didnt look like how I felt on the inside.

Dealing with this was another major cost that I was extremely lucky to be able to cover. I went to a lovely Harley Street doctor, who gave me the face of my dreams using temporary fillers and botox (for around 2,000 a year every year until I have permanent surgery,which would incur another huge cost if I decide to do it one day) and a beautician who would laser my entire body from below the eyelashes (for around 1,000 for nine months or so of not having to shave every day).

I started to look more like the woman I was and this had by far had the biggest impact on my life. It meant I could walk down the street without fear of having some awful slur thrown at me.

I wasnt stared at on the Tube anymore. A waiter would call me madam. A nightclub bouncer wouldnt baulk at my ID. I could even date (pretty) normally and live my life normally. Fabulously, but normally.

But all of this isnt fair. I was only able to transition in the way that I wanted to in the time that worked for me because I could afford to do so. And I could only afford to do so because I was earning a lot.

According to TransUnite, the average cost of privately transitioning is approximately 20,000 a figure that includes aftercare. This is more money than most people earn in a year and is, for some, a completely out-of-reach cost in terms of saving.

Transitioning isnt just cosmetic things or procedures to look and feel more beautiful, but the way to relieve a medically-diagnosed condition that thousands of people throughout the UK, the world and history have experienced.

People should not have to be able to afford to experience life in the same way that non-transgender people do.

The provision of transition-related healthcare in the UK is insufficient. I work in the legal team at Mermaids, a charity that supports transgender, non-binary and gender diverse young people who are blighted by horrendous waiting times for medical care. The demand is not equal to the supply.

Patients are waiting years on NHS lists, suffering through irreversible puberties that dont match who they are and not getting the help they need.

As more trans people feel able to come out, we need to have healthcare provision to match it. The current system certainly contributes to the mental health crisis that we see in transgender people.

Just Like Uss School Report this year found that young LGBT+ people are three times more likely to self-harm and twice as likely to have depression than their peers.

The emotional cost of experiencing gender dysphoria is high. It is easy to take for granted living in a body that matches who you are. Everyone worries about what they look like, but when how you look, sound and develop is completely incompatible with how you experience your gender, this isnt just a worry, this can be debilitating.

Everyones story should be able to be like mine: accessing the healthcare they need in a timely manner so they can alleviate the symptoms they experience.

My healthcare journey has been thankfully smooth and I am glad that I have been able to make it work for me as I have developed as a woman. But no one should have to be able to afford thousands of pounds to live freely as themselves.

Mermaids is a charity supporting trans and gender diverse kids, young people, and their families. If you or someone you know needs support, you can get in touch via their website here.

Do you have a story youd like to share? Get in touch by emailing James.Besanvalle@metro.co.uk.

Share your views in the comments below.

MORE : NHS waiting lists for trans people are too long, I had to use my student loan to go privately

MORE : I waited over five years to access hormone therapy on the NHS

MORE : Im bored with MPs arguing over who does and who doesnt have a cervix

See the article here:
It's cost me over 7,000 to transition so far - I'll have to spend more - Metro.co.uk

Prostate Cancer Therapeutics Market Product Differentiation to Create Fructuous Opportunities

According to a recent report published by Transparency Market Research (TMR), the prostate cancer therapeutics market was valued at ~US$ 10 Bn in 2019, and is projected to arrive at a value tantamount to ~US$ 19.6 Bn by 2027, expanding at a CAGR of ~8% during the period of 2019-2027. The rise of prostate cancer at an alarming rate ~1.6 Mn new diagnosed cases of prostate cancer were registered in 2017 as found by the American Cancer Society, is a crucial factor influencing patients into availing prostate cancer therapeutics. However, the key success factor propelling notable cancer therapeutics uptake is attributable to advancements in oncology, leading to the early diagnosis of prostate cancer.

The movement of the prostate cancer therapeutics market, however, could be hampered, in light of the reluctance evinced by patients towards premium cancer therapies and drugs. However, private and public sector investments made for underpinning the research and development activities of market players will catapult the growth trajectory of the market.

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Biotechnology A Novel Technology Driving Effectiveness of Therapeutics

Recent developments in prostate cancer therapeutics encompass various bioinformatics programs to achieve optimal cancer treatment. Market players approach prostate cancer therapeutics with an innovative approach, including proteome profiling, exome sequencing, and whole-genome, to develop a pathway for an effective cure and treatment.

An example of this can be taken from Biopep Solutions, Inc. The company is centering its efforts towards the development of BPS-001, which is a complex and multivalent biologic drug that possesses anti-tumor attributes. The drug is said to inhibit the progression of tumor cells, thereby curbing the future progression of prostate cancer.

Emerging trends have also identified the rapid growth in oral drugs intake. Surgeons recommend the intake of oral drugs on a regular basis for chemotherapy, in light of their long-time-to-effectiveness. In addition, drugs administered through intravenous therapies are highly likely to cause side effects to the hair, bone marrow, and intestines, which further upkeeps the popularity of oral therapeutics.

Hospital Pharmacies to Drive Significant Prostate Cancer Therapeutics

Despite the growing number of ambulatory surgical centers and clinics centered at offering therapies for the treatment of prostate cancer, hospitals remain the preferred medium of care. This leads to the high sales of prostate cancer therapeutics through hospital pharmacies, which is likely to account for half of the market share in 2027, by recording an above-average CAGR of ~9% during 2019-2027.

The technological lead of North America, centered at the development of novel technologies to improve the effectiveness of prostate cancer therapeutics, and the advent of vaccines such as Sipuleucel-T, are projected to remain intact during the forecast period. In 2019, North America will account for ~41% market share, followed by Europe and Asia Pacific.

The growth of the European prostate cancer therapeutics market will remain influenced by the high incidence of prostate cancer reported in France and Norway, which has led to the rise in the development of early detection and treatment therapies. That being said, Asia Pacific will demonstrate an exponential improvement in market performance, given the spurt in the number of medical tourists seeking cost-effective treatment in developing countries.

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Global Prostate Cancer Therapeutics Market: Segment Analysis

The global prostate cancer therapeutics market has been segmented based on therapy, distribution channel, and region

In terms of therapy, the global market has been classified into hormone therapy (luteinizing hormone-releasing hormone analogs, luteinizing hormone-releasing hormone antagonists, and antiandrogens), chemotherapy (systemic chemotherapy and regional chemotherapy), biologic therapy, and targeted therapy.

The hormone therapy segment dominated the global prostate cancer therapeutics market in 2018, and the trend is projected to continue during the forecast period.

Based on distribution channel, the global market has been divided into hospital pharmacies, retail pharmacies, online sales, and others.

The hospital pharmacies segment dominated the global market in 2018, due to an increase in admissions of geriatric patients in hospitals and laboratories for the diagnosis of old age-related diseases.

Global Prostate Cancer Therapeutics Market: Regional Segmentation

In terms of region, the global prostate cancer therapeutics market has been segmented into North America, Europe, Asia Pacific, Latin America, and the Middle East & Africa.

North America

North America was a major market for prostate cancer therapeutics in 2018. The demand for prostate cancer therapeutic products is high in the region due to a rise in the disease prevalence. However, growth of the market in North America is attributed to the launch of promising emerging therapies in the biologic and hormone therapy segments. The expected launch of some pipeline products is likely to drive the market in the region during the forecast period.

Europe

Manufacturers are anticipated to focus on hormone therapy segments such as antiandrogens in the prostate cancer therapeutics market in Europe. The hormone therapy segment is expected to continue to be a potentially viable segment for investment during the forecast period. The expected launch of pipeline products late in the forecast period is likely to boost market growth. However, restrictions on the use of few drugs by the European Medicines Agency for the treatment of prostate cancer are anticipated to hamper the market in the region 2019 and 2027.

Asia Pacific

Manufacturers in the prostate cancer therapeutics market in Asia Pacific are anticipated to focus on therapies such as antiandrogens and luteinizing hormone-releasing hormone antagonists. The hormone therapies segment is expected to continue to be a potentially-viable segment for investment during the forecast period. Rise in awareness programs by associations and companies is a major factor likely to boost the growth of the market in the region in the near future.

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Global Prostate Cancer Therapeutics Market: Major Players

Key players operating in the global prostate cancer therapeutics market include

These players are adopting strategies such as new product development, partnerships, and acquisitions to remain competitive in the global market.

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Read the original post:
Prostate Cancer Therapeutics Market Size to Gain Traction of ~US$ 19.6 Billion, Growth Opportunities by 2027 - Digital Journal

Diet culture is the water we're all swimming in. Its a system that upholds thinness and says the smaller your body, the greater your moral superiority. But theres no body shape thats intrinsically good or bad.

Host Anita Rao unpacks the science that props up diet culture with anti-diet registered dietician Christy Harrison and certified internal medicine physician Dr. Louise Metz. She also hears from Mirna Valerio, ultrarunner and author of A Beautiful Work in Progress, about how shes pushing back against the ways diet culture manifests in the doctor's office and on the trails.

Also joining the conversation are Ilya Parker, owner of Decolonizing Fitness, and Natalia Petrzela, associate professor of history at The New School, to talk about the history of fitness culture and its intersections with diet culture.

10 important lessons to take away about diet culture

1. Diet culture is rooted in racism and misogyny.

Early evolutionary biologists who were working around [the 1800s] started to point to fatness as a mark of evolutionary inferiority, says Christy Harrison, registered dietician and author of "Anti-Diet: Reclaim Your Time, Money, Well-Being, and Happiness Through Intuitive Eating."

This thinking has been used to justify the oppression of people considered to have excess body fat, including women and people of color.

2. Body Mass Index (BMI) wasnt meant to be used as an indicator of health.

In fact, this method of determining ones body mass wasnt even invented by a medical professional.

It was actually originally created by a Belgian astronomer in the 1830s, says Dr. Louise Metz, an internal medicine physician based in Chapel Hill, North Carolina. It was designed for populations not for individuals and was not designed to define health in any way.

3. Its impossible to determine someones health or fitness based on the way they look.

Just ask Mirna Valerio, creator of the blog Fat Girl Running, who frequently fields concerns about her larger size despite the fact that she trains for marathons on a near-daily basis.

The questions are always there on people's faces, Valerio says of the weight stigma she encounters on the trail. The questions about whether I really do the things that I say that I do because I'm still fat, despite the fact that I've done 14 ultramarathons and 10 marathons.

4. Medical fatphobia prevents people of all sizes from receiving adequate healthcare.

For those in larger bodies, the prevalence of medical fatphobia means doctors can be quick to attribute their symptoms to their weight a phenomenon that causes them to rule out other and often more insidious explanations.

The same goes for someone in a smaller body, says Metz. If we assume they are healthy based on their body, we will misdiagnose a high number of people who have metabolic conditions.

5. Medical fatphobia means you can also be denied treatment based on your size.

Ilya Parker, physical therapist assistant and founder of Decolonizing Fitness, describes the experience of being denied gender-affirming treatment as a result of weight stigma: I experienced a lot of medical gatekeeping from my primary care physicians, who were literally refusing to initiate gender-affirming care or refer me to an endocrinologist, which is who I needed to see to receive hormone replacement therapy.

6. Diet culture has always been about money, not health.

At the turn of the century, many doctors took their cues from the burgeoning life insurance industry when deciding which bodies posed the highest financial risk. According to Harrison, doctors at the time began encouraging patients to lose weight as a way of supposedly reducing health risks, but really, it was about reducing monetary risks from the insurance industry.

7. Intentional weight loss is rarely permanent

We see in the research that up to 98% of the time when people embark on weight loss efforts, they end up regaining all the weight they lost within five years, says Harrison. In fact, up to two-thirds of people who embark on weight loss efforts may regain more weight than they lost.

8. Language used in fitness spaces perpetuates transphobia.

Based on his own experiences of being a transmasculine participant in group exercise classes, Parker urges fellow fitness instructors and trainers to reconsider their gendered language.

It's countless group classes that I've been in where language was so important, especially when you're like: Hey, guys can only do this exercise, ladies can only do this exercise. And then also making the assumption that you know who's in the room.

9. Diet culture claims that fatness is un-American.

Historian Natalia Petrzela traces this connection back to the 1950s, when physical fitness began to be touted as a key component of American citizenship. [Politicians] spoke of this in unapologetically fat-shaming ways, Petrzela says. I mean, JFK gives this big talk about the soft American and how an American who is physically soft is a national liability.

10. You can decline to be weighed at the doctors office.

Let your provider know that you would like medical care from a Health at Every Size perspective, says Metz. And if you do not want to discuss weight or weight management at your visit, then you have the right to ask for that.

Read more from the original source:
Deconstructing diet culture: Lessons unlearned from a thin-obsessed society - WUNC

Sara IbrahimandAnna Lancyconsider the importance of menopause in the workplace and the ramifications it will have for employers in this article for theInternational Employment Lawyer

With menopausal women now the fastest-growing workforce demographic, menopause is no longer an issue employers can ignore. The average age of menopause for women in the UK is 51 and, according to the Office for National Statistics, in May 2021, 72% of women aged 16-64 years old were in work in the UK, while between April and June 2021, 4,459,000 were in the 50-64 age group.

Worryingly, a 2019 survey conducted by BUPA and the Chartered Institute for Personnel and Development (CIPD) found that three-in-five menopausal women usually between 45 and 55 years old were negatively affected at work, and that almost 900,000 women in the UK lost their jobs because of menopausal symptoms.

These figures demonstrate how much work is still to be done in the UK to raise awareness and provide better support to menopausal workers. However, globally, menopause presents an even bigger issue. There are 657 million women between 45 and 59 years old worldwide, of whom 50% are employed and potentially impacted by issues of menopause at work.

In the UK, menopause is not specifically protected under the Equality Act 2010. However, conduct that puts an employee at a disadvantage or subjects the employee to less favourable treatment because of their menopause symptoms may amount to discrimination on the grounds of one or more protected characteristic(s), such as disability (section 6), sex (section 11) or age (section 5).

Of the cases that come before the employment tribunal, menopause-related discrimination claims are most commonly brought under the protected characteristic of disability. Depending on the circumstances, a menopausal worker may also have a claim of unfair dismissal, constructive unfair dismissal, harassment, and victimisation.

It should also be borne in mind that trans men may be affected by menopause and, therefore, have the right to bring the above claims and may additionally be able to rely on the protected characteristic of gender reassignment (section 7) if they are treated less favourably than women affected by the menopause.

In this article we will do three things: provide an overview of the proposed legislative changes to support menopausal workers; analyse the case law concerning menopause-related discrimination claims; and outline what steps employers can take to ensure they support menopausal workers.

Legislative proposals

On 23 July 2021, the Women and Equalities Committee launched a new inquiry aimed at scrutinising the existing legislation and business practices regarding menopause and the workplace. Given the committees concern about the knock-on effects of the menopause on workplace productivity, the gender pay gap, and the gender pension gap, it should be anticipated that legislative change will be proposed.

In the committees first evidence session on 17 November 2021, there were some notable proposed legislative changes. Professor Joanna Brewis from the Open University Business School advocated in favour of enacting section 14 (combined discrimination) of the Equality Act and highlighted that, for most people, menopause involves a combination of sex and age.

Under the present law, it is not possible to claim direct discrimination based on more than one characteristic. The vast majority of cases that have either been through or are going through the tribunal are about direct discrimination. Given menopause clearly impacts workers of a certain age and the fact that combined discrimination claims would significantly strengthen tribunal cases, it would not be surprising if this proposal was adopted.

Also of note, Adam Pavey, a solicitor at Pannone Corporate, advocated for making menopause a protected characteristic as a way of removing the stigma of talking about menopause. He argued the fact that menopause is not a protected characteristic can cause claimants difficulty in the tribunal process. For example, often the employer will put the claimant to strict proof as to their symptoms amounting to a disability.

Assuming menopause did become a protected characteristic, an increased number of tribunal claims is likely. It would be difficult, however, for the legislature to justify making menopause a protected characteristic when other medical conditions are treated as disabilities under the Equality Act. A more consistent approach may be categorising menopause as a deemed disability, such as how cancer is treated.

In light of the fact that menopause affects all women, it is prudent for employers to adopt a clear menopause policy. Evidence submitted by 4Women highlighted that, without support for menopausal symptoms, the UK could lose a staggering 14 million workdays a year.

In October, there was a second reading debate of the Menopause (Support and Services) Bill, in which the government set out its proposals to support those experiencing the menopause. One of the main changes in the Bill would be to exempt hormone replacement therapy (HRT) from NHS prescription charges a vital step to making treatment available to those suffering menopausal symptoms.

Menopause case law

Analysis of figures from HM Courts and Tribunals Service showed that there were five tribunal cases in the UK in 2018 that referred to the claimants menopause. However, there have been 10 in the first six months of 2021 alone. The rise in cases does suggest menopausal workers are feeling increasingly confident to challenge employers. Below we touch upon some of the most significant menopause-related claims.

Disability discrimination

In Donnachie v Telent Technology Services Ltd, the tribunal considered whether an employees menopause symptoms amounted to a disability. Ms Donnachie experienced hot flushes seven or eight times a day, which were regularly accompanied by palpitations and feelings of anxiety. She also experienced night sweats, fatigue, and memory and concentration difficulties. Ms Donnachie was prescribed HRT patches by her GP, which improved her symptoms, but they persisted, particularly when she was under pressure.

Ms Donnachies employer argued that she merely suffered from typical menopausal symptoms and therefore the impact on her was not substantial. However, the employment judge, held that Ms Donnachie was disabled by reason of menopause or symptoms of menopause, stating: I see no reason why, in principle, typical menopausal symptoms cannot have the relevant disabling effect on an individual.

The difficulties experienced by menopausal workers in establishing that their symptoms amount to a disability is illustrated by the recent case of Rooney v Leicester City Council. Despite setting out Ms Rooneys comprehensive list of symptoms and the adverse effects on her day-to-day activities, the tribunal concluded that the effects were only minor or trivial.

Rooney appealed this decision and the Employment Appeal Tribunal (EAT) held that the tribunal had erred in law in holding that [Rooney] was not a disabled person at the relevant time. The EAT found it difficult to understand how the tribunal had concluded that Rooney was not disabled, when the tribunal had not expressly contested the evidence about Rooneys symptoms.

Sex discrimination

In Merchant v BT Plc, Ms Merchant was dismissed following a final warning for poor performance. She had previously given her manager a letter from her doctor explaining that she was going through the menopause, which can affect her level of concentration at times.

In dismissing her, the manager chose not to carry out any further medical investigations of her symptoms, in breach of BTs performance-management policy. The tribunal upheld her claims of direct sex discrimination and unfair dismissal and held that the manager would never have adopted this bizarre and irrational approach with other non-female-related conditions.

Age discrimination

There are very few cases argued as age discrimination claims. The most notable case is A v Bonmarche Ltd (In administration), which was also a sex discrimination case. Ms A had worked in retail for 37 years and was a high achiever. Her situation at work changed around May 2017 when she began to go through the menopause. Ms As male manager would demean her and humiliate her in front of other staff who were younger than Ms A and would laugh at the managers remarks. The manager also called Ms A a dinosaur in front of customers and continually criticised her unreasonably.

Ms A contacted higher management regarding her managers treatment of her, but no action was taken. She suffered a breakdown in November 2018 and her manager was threatening towards her when she returned to work leading to her resignation. She made a claim to the employment tribunal on the basis that she had suffered harassment and bullying in relation to both age and sex discrimination, and she was awarded 28,000.

It is evident that tribunals are treating menopause symptoms seriously and employers may want to do the same to avoid litigation and a negative impact on workplace relations.

Best practice support

The duty to make reasonable adjustments under section 20 of the Equality Act arises where a disabled person is placed at a substantial disadvantage by a provision, criterion or practice; a physical feature of the employers premises; or an employers failure to provide an auxiliary aid, compared with persons who are not disabled. It requires an employer to take such steps as it is reasonable to have to take to avoid any such substantial disadvantage.

When considering the situation of a woman with menopausal symptoms, possible reasonable adjustments might include amending absence management triggers; working from home, moving the employee closer to a window or ventilation system to increase their exposure to fresh air, or providing an electric fan; allowing the employee to adapt a uniform; allowing more rest breaks; moving the employee closer to toilet facilities and where a menopausal worker works night shifts, a move to daytime hours could be a reasonable adjustment.

Employers should also consider introducing a menopause policy that encourages menopausal workers to have open conversations with managers about any symptoms they are experiencing and the specific steps that could be taken to alleviate those symptoms. The written document should be circulated throughout the workplace and outline typical menopause symptoms while also recognising that the symptoms of individuals can differ greatly.

The policy should include the support available to menopausal workers and a sickness absence policy which accommodates workers experiencing menopause transition (ie, similar to a maternity leave policy). Channel 4 launched its menopause policy on World Menopause Day 2019 the policy is freely available on its website.

Finally, employers should train and upskill the entire workplace but specifically line managers with knowledge about menopause so that they are better equipped to provide support to menopausal workers. This could include organising training and events so that employees can develop an understanding of the symptoms and effects of menopause.

Read the rest here:
Why employers can no longer ignore menopause in the workplace - Lexology

Hormonal IUDs like Mirena and Jaydress can have full-body effects noticeable in breast imaging scans even though they work by releasing hormones directly into the uterus, a not-yet-published study out of Germany suggests.

The finding counters the popular understanding that IUDs work purely locally,lead author Dr. Luisa Huck of RWTH Aachen University's department of diagnostic and interventional radiology, said in a Q&A document for reporters. "Our study results suggest that this is not true."

In fact, the researchers found the IUDs' full-body hormonal effects were similar to those of hormone replacement therapy, a press release says. They say their findings show it's "plausible that IUDs can have side effects similar to that of other hormonal treatments," as women have long reported.

Dr. Amy Roskin, an OB-GYN and Chief Medical Officer of The Pill Club who was not involved in the study, told Insider she's not surprised by the findings, which were presented last monthat the Radiological Society of North America's annual meeting.

"We already know that although the primary effect of the levonorgestrel IUD hormone is on the uterus, some of the hormone is absorbed and will impact other tissue and areas," she said, adding that the level absorbed systemically should still be lower than with other birth control methods like the pill.

While manufacturers like Bayer don't claim IUDs completely spare the rest of the body from hormones or their side effects, they say their devices have "mainly local progestogenic effects."

The study authors say their work is important to validate women's reports of full-body side effects from IUDs, and to help patients and clinicians make informed decisions about contraception.

Co-author Dr. Christiane Kuhl, chief of the Department of Radiology at RWTH Aachen University, wanted to look at IUDs' effects on breast tissue after noticing that women who used them tended to have a higherbackground parenchymal enhancement (BPE) on contrast-enhanced breast MRI.

BPE is a sensitive marker of hormone levels.

To conduct the study, she and colleagues identified 48 premenopauseal women in a hospital database who had no history of breast cancer or hormone or antihormone intake, and who had undergone a contrast-enhanced breast MRI at least twice.

Half of the women underwent the first breast MRI exam before they got their IUDs and the second once the IUDs were inserted. The other half had their first MRI with an IUD and the second after it was taken out.

This method allowed them to see how IUDs affected each women's BPE levels andavoid any age-related hormonal changes that could have muddied the results.

The researchers found that BPE levels went up significantly in 23 of 48 patients.

Not only does that suggest IUDs' effects can be detected far from the uterus, but it also means IUD use should be considered when interpreting the results of breast MRI, the study authors say.

"IUDs appear to be a very safe means of contraception, and are generally well tolerated," Huck wrote to reporters. "However, in case you experience so-far unexplainable side effects, talk to your doctor, and consider using other types of contraception."

For example, Roskin saidthe copper IUD is hormone-free.

Read more here:
IUDs may have an effect on the whole body, not just uterus - Insider

"I wouldn't be without it," Lisa Snowdon said of hormone replacement therapy. "It's been a game-changer, I feel like myself again." The 49-year-old added: "I'm not screaming at my partner all the time, I don't have these rages. I feel like I recognise myself again." In a candid interview on ITV's Lorraine, Lisa recalled her troubling experience of the peri-menopause the transition where periods have not yet stopped.

"When I look back, it definitely did creep up on me," she said. "I first started experiencing symptoms of low mood, depression, anxiety."

The former Britain's Next Top Model host reduced her symptoms to perhaps feeling "a bit unhappy".

Lisa continued: "And then, slowly but surely, the symptoms sort of started changing and evolving."

The presenter experienced "painful periods" and "awful cycles" that were "really irregular".

READ MORE:Cancer: New shocking report finds up to 740,000 cancer cases could have been missed

"All these other different symptoms that started coming up," she remembered.

At the time, Lisa found it difficult to leave the house and "didn't know what to do".

She "didn't have the energy" she used to have, brain fog was a reality, and feelings of anxiety persisted.

Lisa described it as "feeling really lonely and out of sorts, and not recognising [her own] body".

DON'T MISS

Once Lisa found out she was going through the peri-menopause, she began hormone replacement therapy.

GP and menopause specialist, Dr Louise Newson also appeared on the daytime chat show Lorraine to discuss the benefits of hormone replacement therapy.

Dr Newson mentioned that there are "different types" and dosages of hormone replacement therapy to suit each woman.

"It's derived from the yam plants," Dr Newson said of hormone replacement therapy. "It's one of the most natural, safest things I prescribe as a doctor."

The NHS says hormone replacement therapy helps to "relieve symptoms of the menopause", such as:

"The benefits of hormone replacement therapy are generally believed to outweigh the risks," stated the national health body.

"But speak to a GP if you have any concerns about taking hormone replacement therapy."

If you are interested in trying hormone replacement therapy, you must first book an appointment with your doctor.

"You can usually begin HRT as soon as you start experiencing menopausal symptoms and will not usually need to have any tests first," the NHS noted.

"A GP can explain the different types of HRT available 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."

Lisa Snowdon will be on ITV's Celebrity Catchphrase on Saturday, December 5 at 7.15pm.

Continued here:
Lisa Snowdon health: 'I wouldn't be without it' hormone replacement therapy - Daily Express

Erectile dysfunction (ED) is the most common sexual health problem in men that causes a substantial negative impact on intimate relationships, quality of life, emotional and psychological well-being and self-esteem.

The incidence increases with age and affects up to one-third of men throughout their lives. Male sexuality, a complex physiological process, is an important part of the quality of life. The maintenance of normal sexual function depends on the coordination of the human multi-system, involving the coordination of the nervous system, the cardiovascular system, the endocrine system and the reproductive system. When these systems or psychosocial aspects are changed, it will affect the quality of normal sexual life for any individual.

In men, sexual function declines over time, beginning during the fifth decade and affecting all domains of sexual health including desire, arousal, erectile function, and ejaculation/orgasm. Here I try to highlight the risk factors, types and major treatment protocols for ED that can be useful for patients.

Risk factors for erectile dysfunction

Erectile dysfunction is the persistent inability to achieve or maintain a penile erection satisfactorily for sexual performance and is the most common male sexual disorder. 44% of men in the age group 60-69 years and up to 70% of men above 69 years endorse erectile difficulties; in men below 40 years of age 5 % endorse ED.

Types of erectile dysfunction

Theare two major subtypes of ED which includes Lifelong ED and Acquired ED.

Lifelong ED:in which erection cannot be achieved from the outset of sexual desire.

Acquired ED:in which ED begins after a period of normal erectile and sexual activity.

Each of these subtypes can have either psychogenic or organic contributors.

Treatment of erectile dysfunction

The treatment of ED comprises psychosexual therapy, lifestyle modifications, and medical and surgical interventions.

Psychotherapy:Psychotherapy is considered as a first-line ED therapy. It is both noninvasive and effective, and can be combined with other therapies.

Lifestyle modification in men with ED:It is believed that lifestyle adjustments in men with ED not only reduce cardiovascular risk but also improve ED symptoms. Lifestyle alterations such as smoking cessation reduce cardiovascular mortality by 36%, physical activity results in 30-50% reductions in diabetes mellitus and coronary artery disease incidence, and diet reduces death from CAD by up to 36%.

Based on these findings, recommended lifestyle alterations include regular exercise, smoking cessation, dietary intervention with emphasis on the Mediterranean like diet, as well as moderate alcohol consumption.

Hypogonadism and ED:Testosterone supplementation is often recommended in hypogonadal men with ED, which may ameliorate both ED symptoms as well as cardiovascular risk. Studies have shown a 57% overall response rate to testosterone monotherapy in men with ED, with an improvement in erectile function in 39% of men, as well as improvements in sexual performance, desire, and motivation. Testosterone supplementation should begin prior to treatment with ED-specific medications.

Oral therapies:Phosphodiesterase 5 inhibitors are first-line medical therapy for ED and encompass numerous drugs including the first-generation drugs. These include: Sildenafil (Viagra), Vardenafil (Levitra) and Tadalafil (Cialis).

Sildenafil, tadalafil, and vardenafil are the most popular ED drugs in current use. Sildenafil was the first PDE5i approved for ED treatment, has a time of onset of 30 minutes and an 8-hour duration of clinical efficacy. Both sildenafil and vardenafil have a delayed onset of action after fatty food ingestion. In contrast, tadalafil has a longer time of onset of 2 hours, with a 36-hour duration of efficacy and with no interaction with food.

Transurethral therapies:While limited in its utility, transurethral alprostadil (prostaglandin E1(PGE1) is a reasonable first-line or combination ED therapy. First brought to market in 1994 and marketed as Medicated Urethral System for Erection (MUSE), transurethral alprostadil has shown limited efficacy, with response rates of 27% to 53%."However, combination therapy with sildenafil has been shown to salvage the effects of MUSE. The system is also beneficial in men whose penile nerves have been compromised as it bypasses the need for intact neurological pathways for erection".

Intracavernosal therapies:Intracavernosal injection therapies constitute a second-line ED treatment and are often used when oral therapies fail. Like MUSE, injectable therapies bypass the need for intact neurological pathways for erection. These include various combinations of PGE1, phentolamine, papaverine, and vasoactive intestinal peptide (VIP).

When used alone, PGE1 results in high rates of erections usable for sexual intercourse. A combination of papaverine and phentolamine, marketed as Androskat but commonly referred to as Bimix, is also available. Bimix has an efficacy rate of 94% with a side effect incidence of 0.9% to 2.6% for prolonged erection, pain, or hematoma.

Surgical therapy in men with ED

The spectrum of ED treatment is incomplete without mention of some invasive therapies such as penile prosthesis and penile revascularization procedures.

Penile prosthesis:"Insertion of a penile prosthesis is considered as the third-line therapy for ED, used after patients fail medical therapies''. Penile prosthesis is available in semi rigid and inflatable forms, with the inflatable form being the most popular.

The semirigid prosthesis is easier to implant and maybe a better option for men with poor manual dexterity and difficulty using the pump of the inflatable prosthesis. Penile prosthesis requires replacement every 8 to 15 years, and the most common complication after implantation is infection.

Penile revascularization surgery:Approaches to penile revascularization include repair of arterial stenosis and penile venous ligation, depending on the ED aetiology. This therapy can be offered to nonsmoking, non-diabetic men who are less than 55 years of age, with isolated arterial stenoses without generalized vascular disease.

"The principles guiding penile revascularization include anastomosis of the inferior epigastric artery to the dorsal penile arteries and/or the deep dorsal vein".

Conclusion:

Erectile dysfunction significantly limits the quality of life of a growing number of men. Given the rise in the number of predisposing factors due to sedentary lifestyle and dietary choices, ED has been affecting a larger population in every upcoming year. The spectrum of treatment ranges from minor lifestyle changes to major surgical interventions.

Continued research into the molecular mechanisms of ED and the development of improved medications will further expand the significant armamentarium of treatments currently available, improving not only the quality of life of affected men but also their life span.

Unusual sexual disorders everyone should know about

Many patients didn't consult doctor about some sexual disorders but instead prefer self-medication like Viagra without having erectile dysfunction therefore leaving some less common sexual disorders to remain undiagnosed and hence untreated. In an attempt to shed light on these, here are five uncommon sexual disorders that deserve greater attention.

Sexosomia:This condition is a specialized non-REM parasomnia, in which affected patients vocalize, masturbate, fondle, or attempt intercourse while sleeping. When these people wake up, they dont remember anything.

According to limited research, this condition preferentially affects men (67%-81% male predominance) and begins between 26 and 33 years on average. Unsurprisingly, this condition may lead to interpersonal, clinical, and criminal repercussions. Sexsomnia likely exists on a continuum starting with sleepwalking. Interestingly, obstructive sleep apnoea is a recognized precipitant of sex-arousal disorders. In a handful of those treated for sleep apnoea, these disorders abated. Other possible treatments include maintaining sleep hygiene, antidepressants, and refraining from drugs and alcohol.

Post orgasmic illness syndrome:Post orgasmic illness syndrome (POIS) is an illness that causes a patient to experience flu-like and allergy symptoms post-orgasm. It mostly affects men but women can also experience POIS. Symptoms develop soon after orgasm. These include fatigue, weakness, fever, mood changes, memory problems, concentration problems, sore throat, and itchy eyes, and commonly last between 2 and 7 days.

The aetiology of POIS remains unknown, but some experts think that in men it could be an autoimmune or allergic reaction to semen. Other experts hypothesize that it could be due to a chemical imbalance in the brain.

Although no definitive treatment for this condition exists, some men have tried SSRI antidepressants, benzodiazepines, or antihistamines. When all else fails, abstinence is an option. Alternatively, sex can be scheduled for when a person has enough time to cope and recover.

Persistent genital arousal disorder:Persistent genital arousal disorder (PGAD), a syndrome marked by spontaneous sexual arousal or orgasm primarily affects women. These orgasms are unpleasant, and some women found relief via masturbation. Most of these patients are sent for psychiatric treatment, although there appears to be a neurological underpinning. We hypothesize that many cases of PGAD are caused by unprovoked firing of C-fibers in the regional special sensory neurons that subserve sexual arousal, the authors wrote. Some PGAD symptoms may share pathophysiologic mechanisms with neuropathic pain and itch. Bolstering the position that PGAD is more neurological in nature. Neurological treatment following neurological evaluation has helped some. Interventions that have shown efficacy in individual patients include surgery to remove sacral nerve cysts and administration of IV immune globulin, as well as tapering doses of antidepressants.

Retrograde ejaculation:When a man has an orgasm,a sphincter muscle shuts off access to the bladder so that semen can propel through the urethra. With retrograde ejaculation, a disorder of this muscle causes semen to divert into the bladder. Common causes include complications from prostate surgery, adverse effects of drugs such as SSRIs or medications used to treat enlarged prostate, and nerve damage caused by multiple sclerosis or uncontrolled diabetes.

For most men, the symptoms of retrograde ejaculation are benign. Treatment can consist of medication discontinuance if drugs are the cause. If due to nerve or muscle damage of the bladder, pseudoephedrine or imipramine could ameliorate muscle tone at the bladder entrance. Finally, in vitro fertilization may be an option for those interested in having children.

Sexual desire disorders:The sexual response cycle is impacted by biopsychosocial factors and comprises four phases including desire, arousal, orgasm, and resolution. Desire, in turn, consists of three parts: sexual drive, sexual motivation, and sexual wish.

Sexual drive results from psycho neuroendocrine mechanisms. Hypoactive sexual desire disorder (HSDD) and sexual aversion disorder (SAD) are two types of sexual desire disorders. These conditions likely exist on a spectrum, with SAD being more severe. HSDD is defined as a persistent deficiency or lack of sexual fantasy or desire for sex. SAD involves aversion and avoidance of sexual contact with a partner. Subtypes include generalized, acquired, lifelong, situational, secondary to psychological factors, and secondary to combined factors.

Treatment for sexual desire disorders includes analytically-oriented sex therapy and psychotherapy, such as cognitive-behavioral therapy. Of note, SAD is often progressive and refractory to treatment. Additionally, various hormone replacement treatments, as well as bupropion, herbal remedies, and even amphetamine and methylphenidate have been tried, with mixed success. Addressing patients sexual problems Sexual desire disorders are underrecognized, under-treated disorders leading to a great deal of morbidity in relationships.

Conclusion:

By becoming more familiar with prevalence, etiology, and treatment of sexual desire disorders, people hopefully will become more aware and comfortable with this topic so that they can consult doctor at right time to get appropriate diagnosis and treatment.

See the article here:
Erectile dysfunction: Risk factors and treatment - Rising Kashmir

Choosing the best supplement to take to slow down aging depends on how you define aging. If looking in the mirror and seeing wrinkles makes you feel old, then your top supplement choices would be three antioxidants, vitamins E and C, and the trace mineral selenium, all of which have been shown to prevent sun damage to the skin that results in that leathery, saggy outward sign of getting on in years.

But aging is also defined by what you don't see in the mirror, the underlying biology that manifests in lower quality of life, cognitive decline, and increased susceptibility to illness. While those skin-saving antioxidants help the inside of you, too, experts say the number one best supplement to slow aging for you is likely the one nutrient (or more likely, several nutrients) in which you are deficient. (A blood test will tell you, although many doctors and dietitians agree that most Americans are deficient in these important nutrients: vitamin B12, omega-3 fats, and vitamin D.) Read on, and for more on how to eat healthy, don't miss 7 Healthiest Foods to Eat Right Now.

You need these two nutrients to produce neurotransmitters that allow communication between brain cells. Being deficient in them and having low levels of neurotransmitters results in depression, anxiety, fatigue, decreased concentration, cognitive decline, and poor sleep, says nutritional psychiatrist Sheldon Zablow, MD, author of Your Vitamins Are Obsolete.

Zablow says nearly all multivitamins and most individual B12 supplements contain artificial forms that are difficult for people to absorb. He recommends choosing the bioactive, natural forms of B12 methylcobalamin and adenosylcobalamin and for folic acid L-methylfolate. Deficiencies in these key B vitamins are so prevalent because Americans are eating less red meat (a good source of B12) and taking more prescribed medications that block the body's ability to use B12 and folate, drugs like the diabetes medication metformin, birth control pills, hormone replacement therapy, GERD medications, and nonsteroidal anti-inflammatory drugs.

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Omega-3 fatty acids are an integral building block for the brain and studies have shown that omega-3s may reduce the risk of cognitive decline in older people, says Isa Kujawski, MPH, RDN, a functional registered dietitian nutritionist and the founder of Mea Nutrition. "High levels of omega-6 fatty acids rampant in the standard American diet (mostly from the corn oil and vegetable oils used in our food) may also compromise omega-3 levels," she says.

Fish and seafood are the best food sources of DHA and EPA, but most people don't eat the suggested 8 ounces of fish weekly to help prevent heart disease and will likely benefit from omega-3 supplements with DHA and EPA.

Three-quarters of teens and adults in the United States are deficient in vitamin D, according to JAMA Internal Medicine. Getting older puts us at even more risk for deficiency due to age-related metabolic changes, says Kujawski. Called the "sunshine vitamin" because it is produced in the skin by exposure to sunlight, "vitamin D plays a central role in immune health, muscle health, and heart health, which are all concerns among the elderly population," says Kujawski. It's also important for bone strength because it helps your body absorb and use calcium.

Taking a good multivitamin daily is solid insurance that you're getting essential nutrients every day, including those especially important as you age, suggests registered dietitian nutritionist Elizabeth Ward, MS, RDN, co-author of The Menopause Diet Plan, A Natural Guide to Managing Hormones, Health, and Happiness. One essential nutrient that you won't find in multis, however, is choline. "It's the raw material for producing a neurotransmitter that allows cells in the nervous system to communicate with each other, which is why choline is associated with better memory retention," Ward says. "Research suggests that postmenopausal women need more choline than they did in their premenopausal years."

Another way to slow the aging process is by eating the right meals. Check out these 26 Best Anti-Aging Foods and cook yourself younger!

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The #1 Best Supplement to Slow Aging, Say Experts Eat This Not That - Eat This, Not That

Thyroid nodules are not usually cancerous, but can cause pain and discomfort, as well as thyroid complications.

Thyroid nodules are not usually cancerous, but can cause pain and discomfort, as well as thyroid complications.Surgeons in theHeersink School of Medicineat theUniversity of Alabama at Birminghamare the first in Alabama to offer a new therapy to treat benign nodules from the thyroid by means of ablation, or heat. The process, called radiofrequency ablation, reduces nodules in the thyroid by introducing heat energy to the nodule, causing it to shrink.

Thyroid nodules are an abnormal growth of tissue in the thyroid gland. The thyroid gland produces important hormones needed by the body. The thyroid is located in the neck, and while nodules are usually not cancerous, they can cause swelling of the neck, difficulty swallowing, pain/discomfort, and sometimes even difficulty breathing. They can also lead to the production of excess hormones.

Surgery to remove the nodules is an option; but as does any surgery, this results in a scar, is associated with risks and may require patients to be on lifelong thyroid hormone replacement.

Radiofrequency ablation is a non-invasive procedure using an ultrasound-guided probe to the targeted area, saidJessica Fazendin, M.D., assistant professor in theDivision of Breast and Endocrine Surgery,Department of Surgery.The probe, a small electrode, supplies heat energy to the nodule, diminishing it in size until the body can flush it away naturally over several months.

Fazendin says the ideal candidate is someone with a benign nodule that has been biopsied to be sure it is not cancerous and is also causing cosmetic defects, difficulty swallowing, discomfort or disruption of normal hormone production. The procedure takes between 30 and 60 minutes and does not require a hospital stay.

There are a number of benefits of ablation over surgery, saidErin Buczek, M.D., assistant professor in theDepartment of Otolaryngology.This is a scarless procedure with a very low complication rate, is performed under local anesthesia and allows for normal thyroid hormone production.

Thyroid RFA was developed over 15 years ago and is in use worldwide. UAB surgeons Fazendin and Buczek are the first in Alabama to offer this procedure.

Patients can self-refer by calling the Division of Breast and Endocrine Surgery at 205-934-1211 or the Department of Otolaryngology at 205-801-7801 or via theUAB Medicine website.

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UAB Medicine first in Alabama to offer scarless ablation for thyroid nodules - UAB News

Investing

December 6, 2021 10:32 am

After years of a low interest rate environment, many investors have turned to equities not only for the growth potential but also for solid and dependable dividends, which help to provide an income stream. What this equates to is total return, which is one of the most powerful investment strategies going.

We like to remind our readers about the impact that total return has on portfolios, because it is one of the best ways to help improve the chances for overall investing success. Again, total return is the combined increase in a stocks value plus dividends. For instance, if you buy a stock at $20 that pays a 3% dividend, and it goes up to $22 in a year, your total return is 13%: a 10% for the increase in stock price and 3% for the dividends paid.Five top large cap companies that are Wall Street favorites are expected to raise their dividends this week, so we screened our 24/7 Wall St. research universe and found that all are rated Buy by some top analysts. While it is always possible that not all of them do indeed raise their dividends, analysts expect them to, and the data is based generally on past increases in the firms dividend payouts.

It is important to remember, though, that no single analyst report should be used in making a buying or selling decision.

This top pharmaceutical and med-tech stock has very solid growth potential. Abbott Laboratories (NYSE: ABT) manufactures and sells health care products worldwide.

Its Established Pharmaceutical Products segment offers branded generic pharmaceuticals to treat pancreatic exocrine insufficiency; irritable bowel syndrome or biliary spasm; intrahepatic cholestasis or depressive symptoms; gynecological disorders; hormone replacement therapy; dyslipidemia; hypertension; hypothyroidism; Mnires disease and vestibular vertigo; pain, fever and inflammation; migraines; anti-infective clarithromycin; cardiovascular and metabolic products; and influenza vaccines, as well as to regulate physiological rhythm of the colon.

The Diagnostic Products segment provides immunoassay and clinical chemistry systems; assays used to screen or diagnose cancer, cardiac, drugs of abuse, fertility, infectious diseases, and therapeutic drug monitoring; hematology systems and reagents; diagnostic systems and cartridges; instruments to automate the extraction, purification and preparation of DNA and RNA from samples, and detect and measure infectious agents; genomic-based tests; informatics and automation solutions; and a suite of informatics tools and professional services.

Shareholders currently receive a 1.38% yield. The company is expected to raise the dividend to $0.54 per share from $0.45.

Morgan Stanley has a $146 price target on Abbott Laboratories stock. The consensus target is $115.53, and shares traded early Monday at $132.40.

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5 Strong Buy Blue Chip Stocks With Dividend Hikes Expected This Week - 24/7 Wall St.