Category Archives: Testosterone Replacement Therapy

Cork woman Jess N Mhaolin was just 27 years old when she went into menopause.

Jess had always had trouble with her periods as a teenager, she would miss days of school because of the debilitating pain.

The first time I remember being in hospital because of my periods, I was about 15, she told RSVP.

The doctors thought it was my appendix. Then they found ovarian cysts on the ultrasound. There was very much the attitude that Id grow out of it.

Read more: Limerick mum says hormone replacement therapy has changed her life after menopause

In her 20s, Jesss symptoms got worse, but she still felt like she wasnt taken seriously by doctors.

I had a consultant tell me to go away and have a baby and that would sort it out, she said. I changed consultants I dont know how many times. A few people said it might be IBS so I tried a low FODMAP diet. That didnt work. I tried natural remedies, I tried yoga, I tried different painkillers. None of it worked.

Around 2017, Jess was finally diagnosed with endometriosis, a condition that causes cells similar to the lining of the uterus to grow outside the uterus. She was put on a treatment that put her system to sleep.

In theory, that sounded great, because I wasnt getting periods anymore so I wasnt in pain, admitted Jess.

In reality, it was shutting down my hormone centre. I couldnt regulate my temperature. I was nauseous all the time. I was severely bloated. I was having terrible mood swings.

The next step for Jess was to go through surgical treatment and during this stage, doctors discovered problems with her ovaries. She had to have emergency surgery to have her right ovary removed because there was a growth on it, and her left ovary had stopped working because it was covered in adhesions.

She went to a specialist surgeon in the UK to have treatment on the left ovary but when she was there, she was given some devastating news.

During my scan, the consultant basically stopped what he was doing, sat me down and explained that my left ovary had practically shut down, Jess added.

He asked me if I had suffered menopausal symptoms. I had been experiencing them but Id been through so many operations that I thought it was part of the recovery process.

An hour later, Jesss surgeon gave her her options: but the most practical one was a full hysterectomy.

He gave me some time to think and I remember standing in the middle of Harley Street in London, just crying, she recalled. I had this whole future mapped out in front of me in my head. I thought Id be settled at 30, be buying a house and probably having a baby with someone.

All of a sudden Im 27, in a country that isnt home, being given this devastating news. It was like someone had taken a piece out of my heart that I was never going to get back.

Jess went through with the hysterectomy, but her road hasnt been easy.

Most of my friends are at the age now where they are having their first or second child, or theyre pregnant, she continued.

Im not in a relationship. Part of that is by choice, because I'm married to my job. But part of it is: How do you approach the subject of not being able to have kids with someone? Do you tell them straight away? Do you tell them a few dates in?

Now 30 years old, Jess struggles with the side effects of menopause, but hormone replacement therapy has really helped.

Im on oestrogen and testosterone gel, and it makes such a difference. If I forget to use it or I dont use enough, I would feel towards the end of the day that I would start to get anxious, the brain fog would begin and I would get hot flushes.

My mum is actually going through menopause at the same time as me, so I can talk to her about it which is comforting but also sad.

The Government policy advisor said she is happy to share her story because she wants to help other women.

I thought menopause was something that happened to you when you were maybe 55, when youd had your kids, she said. If I had known that I was having menopausal symptoms before that last scan, maybe I would have had enough time to freeze my eggs. Its hard to know, and I could drive myself mad thinking about it.

Women can get menopause in their 30s for various reasons, so its important to know the symptoms and always advocate for yourself.

Visit The Menopause Hub's website here for more information.

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Cork woman felt like she lost part of herself after going into menopause aged 27 - RSVP Live

New York, Sept. 13, 2022 (GLOBE NEWSWIRE) -- Reportlinker.com announces the release of the report "Global Testosterone Replacement Therapy Market 2022-2026" - https://www.reportlinker.com/p04046949/?utm_source=GNW 1% during the forecast period. Our report on the testosterone replacement therapy market provides a holistic analysis, market size and forecast, trends, growth drivers, and challenges, as well as vendor analysis covering around 25 vendors.The report offers an up-to-date analysis of the current global market scenario, the latest trends and drivers, and the overall market environment. The market is driven by initiatives to increase awareness about hypogonadism among population, rise in chronic diseases, and untapped potential in developing countries.The testosterone replacement therapy market analysis includes the product segment and geographic landscape.

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The analyst presents a detailed picture of the market by the way of study, synthesis, and summation of data from multiple sources by an analysis of key parameters such as profit, pricing, competition, and promotions. It presents various market facets by identifying the key industry influencers. The data presented is comprehensive, reliable, and a result of extensive research - both primary and secondary. Technavios market research reports provide a complete competitive landscape and an in-depth vendor selection methodology and analysis using qualitative and quantitative research to forecast accurate market growth.Read the full report: https://www.reportlinker.com/p04046949/?utm_source=GNW

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The Global Testosterone Replacement Therapy Market is

Hypogonadism is a common condition in the male population, with a higher prevalence in older men, obese men, and men with type 2 diabetes. It is estimated that approximately 35% of men older than 45 years of age and 30-50% of men with obesity or type 2 diabetes have hypogonadism.

Testosterone is an important sex hormone in men. It is secreted by the testes and is responsible for the typical male characteristics, such as facial, pubic, and body hair as well as muscle. This hormone also helps maintain sex drive, sperm production, and bone health. The brain and pituitary gland (a small gland at the base of the brain) control the production of testosterone by the testes.

Be open with your doctor about your medical history, all prescription and nonprescription drugs you are now taking, sexual problems, and any major changes in your life. Your doctor will take a thorough history of your symptoms and then complete a physical exam, including your body hair, breast tissue, and the size and consistency of the testes and scrotum.

Your doctor will also use blood tests to see if your total testosterone level is low. The normal range depends on the lab that conducts the test. To get a diagnosis of hypogonadism, you need at least two early morning (710 AM) blood tests that reveal low testosterone in addition to signs and symptoms typical of low testosterone. The cause of hypogonadism can be investigated further by your doctor. This might include additional blood tests, and sometimes imaging such as a pituitary MRI.

Male hypogonadism is a combination of low testosterone levels and the presence of any of these symptoms:

Over time, low testosterone may cause a man to lose body hair, muscle bulk, cause weak bones (osteoporosis), low red blood cells and smaller testes. Signs and symptoms (what you see and feel) vary from person to person.

There are many causes of hypogonadism. They may involve a problem with the testes or with the signal from the brain that controls testosterone secretion. Low testosterone can result from:

Improvement of testosterone levels can improve sexual concerns, bone health, muscle and anemia (low red cells in the blood). Hypogonadism can be treated with the use of doctor-prescribed testosterone replacement therapy. This treatment is safe and can be effective for men who are diagnosed with consistently abnormal low testosterone production and symptoms that are associated with this type of androgen (hormone) deficiency.

Although testosterone replacement therapy is the primary treatment option, some conditions that cause hypogonadism, such as obesity, can be reversible without testosterone therapy. These should be addressed before testosterone therapy is contemplated. If testosterone therapy is needed, goals of treatment are to improve symptoms associated with testosterone deficiency and maintain sex characteristics.

There are many different types of testosterone therapy. Method of treatment depends on the cause of low testosterone, the patients preferences, cost, tolerance, and concern about fertility. You should discuss the different options with your physician "your partner in care" to find out which therapy is right for you.

Injections: Self or doctor administered in a muscle every 12 weeks; administered at a clinic every 10 weeks for longer-acting. Side effects: uncomfortable, fluctuating symptoms.

Gels/Solutions: Applied to upper arm, shoulder, inner thigh, armpit. Side effects: may transfer to others via skin contact must wait to absorb completely into skin.

Patches: Adhere to skin every day to back, abdomen, upper arm, thigh; rotate locations to lessen skin reaction. Side effects: skin redness and rashes.

Buccal Tablets: Sticky pill applied to gums twice a day, absorbs quickly into bloodstream through gums. Side effects: gum irritation.

Pellets: Implanted under skin surgically every 36 months for consistent and long-term dosages. Side effects: pellet coming out through skin, site infection/ bleeding (rare), dose decreasing over time and hypogonadism symptoms possibly returning towards the end of dose period.

Nasal Gel: Applied by pump into each nostril 3x a day. Side effects: nasal irritation or congestion.

Sometimes a medication called clomiphene citrate is used to treat hypogonadism, but this is not FDA approved for this indication. A thorough discussion is needed with your doctor.

You should discuss with your physician how to monitor for prostate cancer and other risks to your prostate. Men with known or suspected prostate or breast cancer should not receive testosterone therapy. You should also talk to your doctor about the risks of testosterone therapy if you have, or are at risk for, heart disease or stroke. In addition, if you are planning fertility, you should not use testosterone therapy.

You should not receive testosterone therapy if you have:

Possible risks of testosterone treatment include:

If you are treated with testosterone, your doctor will need to see you regularly, along with blood tests.Testosterone therapy is only recommended for hypogonadism patients. Boosting testosterone is NOT approved by the US Food and Drug Administration (FDA) to help improve your strength, athletic performance, physical appearance, or to treat or prevent problems associated with aging. Using testosterone for these purposes may be harmful to your health.

There is no firm scientific evidence that long-term testosterone replacement is associated with either prostate cancer or cardiovascular events. The FDA requires that you are made aware that the possibility of cardiovascular events may exist during treatment. Prostate cells are stimulated by testosterone, so be extra vigilant about cancer screenings. African American men over age 45 especially those with family history of cancer are already at risk for prostate cancer.

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Hypogonadism in Men | Endocrine Society

Hormone changes affect everyone, yet 73 percent of women in the U.S. do not seek medical help for menopause, according to the 2021 State of Menopause Study by Bonafide. These changes are one of the top reasons women come to see me. As a functional medicine doctor, Ive helped women manage this stage of their lives for more than 20 years. Its the visible symptoms that bring them in: night sweats or loss of hair. However, there are silent results of changing hormones that are equally as important to address. Before I explain a solution, I want to walk you through why women experience those symptoms, the different types of symptoms, and finally, what you can do to combat some of the issues.

In typical cases, hormones start to change in your early forties. Most women will feel like they have estrogen dominance symptoms. This is not because they make too much estrogen, but rather their ability to make enough progesterone which counters the effects of estrogen slows down. The symptoms may be heavy, irregular, and painful periods, breast tenderness and moodiness, insomnia, painful sex, vaginal dryness, and loss of libido. Symptoms tend to be worse, especially just before they start their period.

Several years later, usually between 48-52 years old, woman transition to menopause. This is a particularly difficult time as women may start having heavy periods off and on, worsening mood swings, highs and lows with irritability, insomnia, hot flashes, night sweats, weight gain, painful intercourse, vaginal dryness, urinary frequency, loss of libido, hair thinning and loss. Then, when a woman hasnt had a period for a year, she has officially entered menopause.

When it comes to hormone changes, women see me for two specific reasons: feelable and invisible symptoms. Feelable symptoms are the ones you can physically feel. These affect your daily life. They can range from hot flashes to night sweats, insomnia to mood swings, irritability to memory loss, and even weight gain and hair loss.

These are symptoms you cannot feel but greatly impact your life. Hormone changes can wreak havoc on your bones and muscles in the form of osteoporosis or osteopenia, leading to hip fractures which can be life-changing. Your cognitive health can decline as well as increasing fears of memory loss and Alzheimers dementia. You may experience heart disease in the forms of high blood pressure and high cholesterol which are leading causes of strokes and heart attacks. Another silent symptom is an increase in insulin resistance leading to belly fat weight gain and diabetes.

Many women feel they just have to deal with all of these changes. That could not be further from the truth. The information Im about to provide can be an absolute game changer in your life.

Bioidentical hormone replacement, as opposed to synthetic hormone replacement, is using hormones like estradiol, that your body recognizes as biologically identical to the hormones that you naturally make. Synthetic hormones, like the ones found in Premarin, come from a horses urine and are not identical to what your body naturally makes.

The old thoughts that hormones are dangerous for you are based on studies done on synthetic hormones that are bad for you. However, Ive found that bioidentical hormones are recognized by your body and it reacts accordingly.

I use specialized testing to look at how a woman is breaking down estrogen. The goal is to make sure her body can process the hormones properly. The next step is to balance hormones using bio-identical estrogen, progesterone, and testosterone. Once a balance is established, there is lab testing before and during to make sure the dosage is correct. Of course, I have follow-up visits to make sure symptoms have improved. When you combine all this together, not only do you not have to live with these menopause symptoms, but you can safely navigate this period of your life and improve longevity and vitality for years to come.

If hormone replacement therapy is done properly, it can reduce the risk of heart attacks, strokes, Alzheimers dementia, and broken hip bones. Not to mention improving quality of life, improving libido, vaginal dryness complaints, insomnia, hot flashes/night sweats, mood stabilization and decreasing risk of depression.

Clinical trials, including Heart and Estrogen/Progestin Replacement Study I and the Womens Health Initiative, have shown that conventional hormone replacement results in increased thrombotic events, an increased risk of breast cancer, and dementia. However, biodentical hormone therapy used by functional medicine doctors do not carry these increased risks.

Using transdermal creams or patches or bioidentical estrogen hormones and progesterone, not progestin, does not afford the same risks. This is why current and more advanced hormone replacement therapy is safer.

I have found additional ways to help my patients navigate their changing hormones. However, you would want to consult your doctor if you have any questions about trying these yourself.

In addition to bioidentical hormone replacement therapy, there are things you can do to limit your symptoms and yes, it does start with your diet. I recommend limiting your processed foods. Essentially, this is anything that comes out of a box or a bag. Try to eat about 3 to 4 cups of vegetables, 1 to 2 servings of fruit, healthy fats, and proteins every day.

Get a good nights sleep, exercise, and make sure you incorporate self-care, like a bath, sauna, or massage to alleviate stress. I also recommend taking magnesium, taurine, NAC, and B complex vitamins to help mitigate some symptoms.

You can help your bone density by doing weight-bearing exercises or joining a club called OsteoStrong. There are some supplements I recommend like Ossopan MD. Its a highly absorbable form of calcium plus essential minerals that you can get from a functional medicine doctor along with Vitamin K2 and D3.

If youre concerned about heart disease, you should limit simple sugars, basically anything white like bread, pasta, candy, and ice cream. The foods I recommend are whole food oils like avocado and olives, proteins, and foods found in the Mediterranean diet. I will also recommend Omega-3 fatty acids, magnesium, CoQ10, niacin, bergamot, berberine, alpha lipoic acid, and taurine based on a specialized lipid study. HITT workouts and intermittent fasting can also help lower your risk for heart disease. Always consult with your doctor first.

The final invisible symptom I would like to address is cognitive decline. In addition to exercise and sleep, I highly recommend Grain Brain by Dr. David Permutter. You can also find other suggestions in my previous article about improving cognitive function.

Hormone changes are inevitable. I strongly recommend arming yourself with information and asking lots of questions. You may have to live with changing hormones, but that does not have to adversely change your life.

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The One Thing This Doctor Says Is A Game Changer When It Comes To Hormones And Aging - TravelAwaits

Strictly Come Dancings Head Judge Shirley Ballas has forged a glittering career to date and is gracing our screens once more, as the latest celebrities take to the dance floor for a new Strictly series.

But, as Shirley explains in her own words, its not all baubles, bangles and beads. Behind the scenes, Shirley has been managing her ongoing menopause journey, and she describes the early part of her experience as one of the darkest periods of her life.

Following her own difficulties, Shirley decided to speak out to help other women and has now joined the new Menopause Your Way campaign with QVC.

According to research commissioned by the campaign, only one in 10 women feel prepared for the landmark change. Of those who believed they knew what symptoms to expect, two in five still felt they did not have a clear understanding of how to manage them.

Here, Shirley opens up to Good Housekeeping about her experience with menopause, how she found support and where she is on her journey today.

I didnt know what was wrong to begin with, I didnt put the menopause tag on it. It started with all those sweats and the bad skin and generally feeling low all the time. It was overwhelming.

I can only say it feels like a volcano in your tummy, and it goes all the way up and starts erupting. You start sweating, you're uncomfortable, you're agitated. I didn't want to go out anymore, I was struggling to go to work. Doctors gave me anti-anxiety medication and then they gave depression medicine, nobody understood it.

Your body starts to change during menopause, it gets a little more rounded because it starts to protect itself and thats absolutely fine. But at the time, I didnt know why I was gaining weight when Id always been physically fit.

My skin was drying out, my nails were chipping, I felt dehydrated all the time and I had no libido.

It was my son, Mark, who first sat me down and said, Okay, lets talk about it. He was willing to take a whole afternoon to listen to me. He introduced me to his doctor in the United States, where we were living at the time. From there, I started taking bio-identical hormones (an alternative to HRT, hormone replacement therapy) which was life changing.

Allen Berezovsky

Other than my brother taking his own life [Shirleys brother, David, died in 2003 after battling depression], I would say it was one of the other darkest periods of my life. Some women, like my mother, they sail through the menopause, but that certainly wasn't the case for me. I just wanted to get up in the morning and feel better.

Not everyone can take hormones, but I found hormone replacement life changing and I regularly check my oestrogen and testosterone levels with a doctor. Its all about understanding your own body and using a combination of approaches.

Ive always had a healthy way of eating, Ive always exercised. I love yoga and going for a walk in the park. I try to find time for myself, even just half an hour is better than no time at all.

I want women to know that its not all baubles, bangles and beads just because Im seen dressed up in glad rags on a Saturday.

Being on Strictly has given me a platform. I feel like I have a responsibility to try to help women understand what their bodies are going through when they hit menopause at 45 or 50 or whenever they go through it, because early menopause can happen even in your 20s.

I do a lot of work around other causes like cancer and suicide and I feel that menopause is just as a strong conversation that needs to be happening. Thats why I joined the campaign with QVC, to help educate people and move conversations forward.

The key for me is education. This message is not just for women, it's also for men, for workplaces, for families and younger generations. We learn about puberty when were younger, but we dont know about how our bodies will change after that. I think its just as key to understand the whole biological process all the way up until menopause is complete.

If you notice a sudden change in your body, particularly around the age of menopause, then you have to find help. Go and see a doctor because if you start early enough when it comes to taking hormones or accessing support, then it can be a non-frightening experience.

You can also find information to read up on and links for support through the QVC campaign.

We want to help put the message out to help women of all ages and educate the whole family. The people around you need to understand the high and the low moods, the night sweats and whats going on in your body. Dont suffer in silence. Thats the key message, no more suffering.

I would say its ongoing with my hormones but generally, Im in a much better period now than 10 years ago which was horrific. Id say when I was around 57 my body started to balance out.

Of course, Ive been looking forward to the new Strictly series so it's a very exciting period, but Ill still be going to get my hormone levels checked during the Strictly run. Its an ongoing journey.

Shirley Ballas is partnering with QVC UK's Menopause Your Way campaign, to offer reassurance, insight and inspiration to empower women experiencing the menopause.

You can get tickets to join Shirley Ballas for fizz and cake at Good Housekeeping Live in partnership with Dyson on Friday 14 October.

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Shirley Ballas on her difficult experience with menopause - Good Housekeeping

Testosterone is essential for your reproductive and general health. Certain foods and lifestyle changes may encourage your body to produce more of this hormone.As you age, your bodys testosterone production naturally decreases, according to 2022 research. Some medications and health conditions can also cause low levels of testosterone.

Low testosterone, also known as hypogonadism, can affect your bone health, sex drive, and mood.

Regardless of what causes the decrease, it is important to work with a medical professional to return your levels to a healthy range for you. In some cases, you may need testosterone replacement therapy, but you can also try to increase this hormone naturally.

Keep reading to learn which foods to eat and which to avoid to increase your bodys testosterone production.

Research suggests that honey enhances serum testosterone levels in males. Serum testosterone refers to testosterone found in the blood.

In a peer review of studies from 2019, researchers found that honey may enhance the bodys luteinizing hormone production. The luteinizing hormone stimulates testosterone production.

Other factors, like honeys antioxidant properties, may enhance the performance of Leydig cells. These cells are responsible for testosterone production.

Consuming eggs may increase your testosterone levels, but make sure you consume the yolk. The yolk of one medium egg contains about 225 milligrams (mg) of cholesterol. Your body uses cholesterol to make testosterone.

One 2021 study examined the effect of consuming just egg whites versus whole eggs. In the study, the group who consumed whole eggs experienced an increase in testosterone levels.

A 2021 study indicates that diets low in beans and legumes may have links to low testosterone levels.

Researchers in 2020 also linked low zinc levels to hypogonadism in males. Separately, researchers in 2018 linked low protein intake to hypogonadism in a study on rats.

Beans and legumes are high in protein and zinc.

In fact, 100 grams (g) of dried black beans contain 24.4 g of protein and 3.37 mg of zinc. For reference, the National Institutes of Health (NIH) recommends 11 mg of zinc for males and 8 mg for females daily.

The amount of protein you need varies based on your activity level and body weight, per 2016 research.

Research suggests that magnesium increases free and total testosterone values in males. Free testosterone refers to testosterone that, unlike most of your testosterone, is not bound to a protein in your blood.

One particular 2014 study demonstrated an increase in magnesium consumption leads to an increase in testosterone in men. The increase occurred in both athletes and people who live a sedentary lifestyle.

Dark leafy greens and vegetables contain high magnesium levels. In fact, 100 g of spinach contains 93 mg of magnesium.

The NIH recommends 400420 mg of magnesium daily for males and 310320 mg for females.

Avocados are another good source of magnesium. The U.S. Department of Agriculture reports that 100 grams of avocado contain 29 mg of magnesium.

There is also another reason why avocados may increase testosterone. A 2015 research review states that this fruit contains boron, a chemical element linked with increased testosterone.

Increased boron intake may relate to higher levels and better use of testosterone in the body, according to the same review.

However, a 2018 study suggests that supplementing with boron supplementation is likely ineffective for increasing testosterone levels specifically for athletic performance purposes.

One 2020 study found a correlation between fish oil supplementation and higher free testosterone in males. Other research from 2020 also suggests a positive relationship between DHA-enriched fish oil and increased testosterone in males.

You do not need to take a supplement to get fish oil into your diet. Fatty fish contain high levels of fish oil.

Types of fatty fish include:

A 2018 study by researchers at Taipei Medical University suggests that following a diet high in Western-style foods may decrease serum testosterone levels. These Western-style foods include bread, pastries, dairy products, and desserts.

The study participants who ate diets high in these foods and ate out often had lower serum testosterone levels.These diets were also low in homemade meals and leafy greens.

Learn more about low testosterone levels.

Exercising is good for your overall health, including your hormone health, 2020 research suggests. Avoiding testosterone-affecting behaviors can also help increase levels naturally.

One peer review of studies in 2016 examined the effects of smoking cigarettes and testosterone levels. The results suggest that smoking cigarettes may actually increase testosterone levels in males. This is because nicotine prevents your body from disposing of testosterone.

Yet other researchers in an older 2007 study noted that this correlation might mask borderline hypogonadism.

Read our tips for quitting smoking.

BPA exposure can also decrease testosterone in males, a 2019 research review suggests. Avoiding plastics with this chemical may help with low levels.

Learn more about BPA plastics.

Fish oil, zinc, and magnesium supplements may increase testosterone. You should always consult with your doctor before starting a new supplement. Additionally, taking certain testosterone-boosting supplements may pose a health risk, according to a 2018 case report.

The Food and Drug Administration (FDA) does not extensively regulate dietary supplements. Contact your doctor before starting use.

Here are some frequently asked questions about testosterone.

How can I raise my testosterone levels fast?

Eating a nutrient-rich diet, exercising, and avoiding activities that lower your testosterone levels may help raise your testosterone levels quickly.

Hormone replacement therapy may be the fastest option for aging males experiencing symptoms of low testosterone, per 2021 research.

Does milk increase testosterone?

There is conflicting information on whether milk increases testosterone. Researchers at the National Taipei University of Nursing and Health Sciences hypothesized in 2021 that low fat dairy products may have a positive effect on male fertility, whereas full fat dairy products may have a negative effect.

Yet they note that more research is necessary to draw a conclusion.

Nutrient- and antioxidant-rich foods may boost your bodys ability to produce testosterone. Eating a diet high in fatty fish, avocados, and leafy greens can have a positive effect on your overall health.

Other natural methods for increasing your testosterone include exercising. While some supplements may improve your testosterone levels, you should talk with your doctor before taking any of these.

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Foods That Boost Testosterone: 7 Options and How They Work - Healthgrades

Dear Dr. Roach: My 75-year-old husband was frustrated with not being able to retain an erection. He talked to his doctor about it, and she prescribed 200 mg of testosterone cypionate, which he would inject into his bottom once a week. He did this for four months, and then had a severe bilateral stroke (as in, he does not know where he is, what happened to him, cannot read or write, cannot walk, etc.).

After spending two weeks in the ICU, he went to a rehabilitation hospital for three weeks. The hematologist there told me his hemoglobin level was up to 20, and there was no reason a 75-year-old should have been prescribed testosterone when it can elevate his hemoglobin so much.

What are the normal protocols for testosterone with older men? Could his testosterone injections have led to his stroke?

D.H.

Dear D.H.: Testosterone replacement therapy is commonly prescribed to men in their 70s and 80s. Elevations of the hemoglobin levels are certainly well-described, but levels above normal only happen about 1% of the time. Experts recommend checking a blood count to look for these elevations three to six months after starting treatment. Testosterone should be stopped if the hemoglobin level is above normal.

Sometimes, there are other causes for the hemoglobin to go up, but a rise that high, when he had never had it before, makes it seem very likely to me that the testosterone was the cause. A hemoglobin level that high, from any cause, is a risk for stroke and heart attack. It is very possible the testosterone prescription led directly to the stroke.

I am publishing this in the column so that men who are taking testosterone know they should be periodically tested for this unusual complication.

Dear Dr. Roach: I had carpal tunnel surgery two years ago. I now have trigger fingers in my index and ring fingers. I had cortisone injections but that didnt cure it. I, at one point, was not able to open my fingers. Now, my fingers are really stiff, and I cant bend them. Surgery was suggested. Im hesitant, because Im wondering if this will get better on its own with exercises.

J.T.

Dear J.T.: Trigger finger is caused by the tendon getting stuck inside one of the pulleys of the hand. To the best of my knowledge, carpal tunnel surgery doesnt predispose to trigger finger, but there are some conditions that put people at risk for both conditions. Initial treatment of trigger finger is conservative, with splinting and anti-inflammatory drugs.

If that doesnt work, injection of cortisone by a hand surgeon is usually successful.

Most of the hand surgeons I know will try injection three times before recommending surgery. Unfortunately, postponing surgery too long can lead to the finger getting a contracture, where it will not straighten at all.

Readers may email questions to ToYourGoodHealth@med.cornell.edu.

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Dr. Roach: Testosterone injections most likely led to severe stroke - Detroit News

A few months ago, a friend of mine in her early 40s said she was having hot flashes, mood swings, and a lower sex drive. She wondered if she could be experiencing symptoms of menopause. Youre too young, I thought. But, as it turns out, shes not. After speaking to her OB/GYN, my friend realized she is experiencing perimenopause symptoms of menopause without actual menopause (which is marked by a year without a menstrual cycle). She learned it can start as early as your mid-30s (though mid-40s is more common).

It turned out my friend wasnt alone in her surprise and lack of knowledge of this hormonal phase. Earlier this year, Bonafide, a wellness company that makes non-prescription products to help alleviate common health issues in women, came out with their Second Annual State of Menopause Survey. The goal was is to shed light on the need to destigmatize talking about menopause and perimenopause for that matter. The company surveyed more than 2,000 women ages 40 to 65 about various menopausal-related things, from their knowledge about the process to their general feelings and sentiments surrounding it.

Twenty-five percent were not aware of when perimenopause typically starts while 31% did not know their treatment options. In addition, just 28% knew how to care for themselves during perimenopause before it started.

Ahead, womens health experts weigh in and unpack what, exactly, perimenopause is and how you can best be prepared for it.

Perimenopause begins years before actual menopause, OB/GYN Kecia Gaither, tells TZR in an email. It reflects a period of time when the ovaries begin to gradually make less estrogen and when no more eggs are released by the ovaries. Perimenopause ends when women have gone a year without having a menstrual cycle. She also says its important to note that each woman is different and, as such, perimenopause will occur at different ages. However, in general, perimenopause typically begins for a woman in her 40s. Again, this transition period varies from woman to woman from months in some to a decade or so in others.

Dr. Sherry Ross, womens sexual health expert, and author of she-ology and she-ology the she-quel, agrees. This hormonal change typically happens within a couple years of menopause, which usually happens around age 51, she tells TZR in an email. But for some, it can happen much earlier. Every decade brings about some emotional and physical change, but for women, the decade of ones 40s may pack the biggest punches of all.

Echoing Gaither, Ross says that every woman will experience perimenopause differently, including when the hormonal storm begins. There is also evidence that women who smoke, have a family history of early menopause, undergo treatment for cancer with chemotherapy or radiation, or have a hysterectomy (without removing the ovaries) may experience perimenopause earlier than other women, she explains.

Symptoms of perimenopause are similar to menopause, so you may wonder what the difference is. Perimenopause is a transitional period before and after a woman is still menstruating, but beginning to experience symptoms, Dr. Tamika K. Cross, OB/GYN and pH-D Feminine Health advisor, tells TZR in an email. While menopause is defined as 12 months without a menstrual cycle.

Ross says symptoms may include:

And not every woman will have symptoms, Cross says. This just varies with genetics, but more often than not, there are at least a few of the symptoms experienced, although the severity may vary.

Gaither says diagnosis of perimenopause is made clinically by presenting symptoms and getting your hormonal levels (FSH) checked. Although there is no treatment, per se, she says there are many options to help alleviate symptoms.

It depends on each womans specific situation and medical history, Cross explains. Its important to talk with your doctor to see what options are best for you. Ross also points out that different symptoms will require different treatments.

That said, there are some avenues to explore for specific concerns. For instance, for heavy and irregular periods, The best treatment for this tends to be with hormones, such as low-dose oral contraception (as a way to control erratic periods), says Ross. Experiment with different pills in order to find the one with the least side effects. Other options include cyclic progesterone, IUDs with progesterone, hormone replacement therapy (HRT), and non-hormonal alternatives, such as acupressure and herbal therapy. Ross says your healthcare provider can explain the ins and outs of these, and what may work best for you.

For the dreaded hot flashes, Dressing in layers and staying in cool temperatures are the first steps in dealing with hot flashes, explains Ross. Air conditioning is your friend! Plan ahead. Bring a cooler with ice for your hands or feet. If you know that hot beverages, spicy foods, red wine, and hot climates bring on hot flashes, avoid them (if possible). And she says herbal remedies (more on those below) may include black cohosh and other traditional Chinese medicine. Acupressure may help with mild hot flashes, as well, she adds.

For mood swings, Antidepressants are effective in controlling depression, anxiety, and panic attacks, and a therapist may also give added support, says Ross. And, of course, exercise, the elixir to all. When you exercise, theres a natural release of mood-boosting endorphins and serotonin, the feel-good hormones that your body can naturally produce.

For those experiencing low sex drive, low libido, and/or vaginal dryness, Testosterone therapy may be helpful for a low libido, says Ross. For help with vaginal dryness, lubricants (such as KY and extra virgin coconut oil) are a good and affordable investment. Sometimes, once you gain control of the annoying hot flashes, irregular bleeding, and emotional distress of perimenopause, sexual interest is regained and your libido is rescued. She also points out that there is an FDA-approved medication called Addyi, known as the pink pill for women. It works on neurotransmitters in the brain, including serotonin, dopamine, and norepinephrine, all found to be involved with sexual desire.

When it comes to trying to combat perimenopause or at least manage its effects better a great initial plan of attack against symptoms is with a thoughtful and healthy lifestyle. A well-balanced, and colorful, diet of fruit, vegetables, whole grains, and nuts and a limited amount of saturated fats, oils, sugar, and dairy will help, says Ross. Drinking water, warm or hot, helps relax the uterine muscles, too. In fact, drink as much water as possible, 2-3 liters a day, to help minimize water retention and bloating. She adds that you can also try consuming water-based foods, including berries (strawberries, blueberries), celery, cucumber, lettuce, and watermelon. Adding ginger to hot water is another useful remedy, she says. And find an exercise routine that will keep you interested well beyond this perimenopausal period, too.

If diet and lifestyle changes dont curb the symptoms of perimenopause, Ross says there are some safe alternatives to help you get through your day. There are many scientifically studied herbs and vitamins that can help manage the symptoms, so you can avoid prescription medications given to you by your healthcare provider, she explains. Passion flower extract, chasteberry, royal jelly, ashwagandha, and maca root are some of the more researched herbs that can actually improve your symptoms and life. She notes that herbs are not FDA-approved like pharmaceutical medications, but that using a well-regulated manufactured herbal supplement can achieve the same effects as prescription medication. And they will safely treat hormonal unrest caused by perimenopause, she adds. Vitamins are important, too. Ross suggests taking calcium, vitamins E and D, thiamine, magnesium, and omega 3-fish oil to help relieve the period bloat and swelling.

Getting a good nights sleep is imperative, too. Hot flashes can mess with ones sleep patterns, Ross explains. First and foremost, avoid excessive caffeine and alcohol (if you dont care to give it up entirely). Seriously, consume your favored vices in moderation. Theyre not bad, per se its just better to have less. She recommends one large cup of coffee in the morning and not more than three to four alcoholic beverages a week (if at all). Set a regular bedtime, limit your liquids after dinner (so you need not take a midnight bathroom break), and try a warm bath before bed, she adds. And is your mattress comfortable and supportive? If not, make it so. Lastly, put your electronic devices (phone included) far from your night table. You dont need the lure (or the light) of them at bedtime.

And acupuncture is another way to manage perimenopauses symptoms. This ancient Chinese treatment for maintaining health and vitality by balancing energy flow works for many medical conditions, says Ross. For women especially, headaches, lower back pain, and menstrual cramps are helped through acupuncture. Even though the studies are not conclusive, hot flashes and heart palpitations may improve with acupuncture treatment, too.

But in addition to the above, getting psychological support and reassurance from others is also key. Sometimes, what we need most is a thorough understanding of exactly what is happening physiologically, if only to realize that what were going through is completely normal, says Ross. Therapy and support groups are often helpful in navigating this hormonal obstacle course.

Lastly, Ross says that women in their 40s (give or take) who are experiencing unusual hormonal symptoms need to find a healthcare provider to help them navigate the changes caused by perimenopause. There are simple treatment remedies, along with reassurance, that these are natural symptoms that need to be taken seriously not just by the patient, but also by the healthcare provider.

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RALEIGH, N.C., Sept. 21, 2022 (GLOBE NEWSWIRE) -- In a release issued under the same headline on August 2, 2022 by Marius Pharmaceuticals, please note that the correct number for reporting side effects ofKYZATREX to Marius is 1-833-949-5040. The corrected release follows:

Marius Pharmaceuticals, a patient-centric healthcare company, today announced the approval of KYZATREX (testosterone undecanoate) by the U.S. Food and Drug Administration (FDA). KYZATREX is an oral testosterone replacement therapy ("TRT") indicated in adult males for conditions associated with a deficiency or absence of endogenous testosterone, also known as hypogonadism. The approval of KYZATREX provides an important option in treating hypogonadism or more commonly known as, Testosterone Deficiency, which affects approximately 40% of men older than 45 years of age and 30-50% of men with obesity or type 2 diabetes have hypogonadism1. KYZATREX has been approved in three dosage strengths, 100mg, 150mg, and 200mg.

I would like to congratulate our scientific team on this major milestone, and now it is up to our commercial team to make KYZATREX a leading therapy and a go-to brand for millions of hypogonadal men in the U.S. Low Testosterone affects numerous metabolic factors as well as often overlooked, true quality of life, hence annual testosterone testing should be mandatory for men over age 40, remarked Himanshu H. Shah, Chairman of Marius.

KYZATREX is a proprietary oral softgel capsule that is absorbed primarily via the lymphatic system, avoiding liver toxicity. The oral delivery method eliminates the risk of application site reactions common with intramuscular testosterone injections as well as potential transference to women or children that can occur with topical testosterone gels and creams. With daily dosing in the morning and evening (with food), KYZATREX more closely mimics the daily rhythm of natural testosterone production compared to long-acting therapies.

With so many men suffering daily effects of Testosterone Deficiency and often abandoning or not electing to get treatment, we see FDA-approved KYZATREX as a newly viable oral option that has demonstrated safety and effectiveness. Further, Testosterone Deficiency is a big blind spot in medicine today and our research will continue to explore the importance of testosterone in both male and female health, commented Shalin Shah, CEO of Marius.

KYZATREX has the potential to become the new gold standard of care for treating patients with hypogonadism. There are at least six million symptomatic men suffering from hypogonadism in the U.S., and over 100 million men globally.

Please see additional Important Safety Information for KYZATREX below.

1 Endocrine Society

About Testosterone and Hypogonadism

Hypogonadism, often referred to as Testosterone Deficiency, is a condition that occurs when the body does not produce adequate levels of testosterone. Primary hypogonadism (testicular failure due to certain conditions) and hypogonadotropic hypogonadism both result in low serum testosterone concentrations. In addition to testosterones widely accepted role in sexual and reproductive function, it also has important roles in numerous other metabolic and inflammatory process and is one of the most common causes of secondary osteoporosis in men. Patients with hypogonadism may experience fatigue, low energy, decreased muscle mass, weight gain, low libido, poor cognition, difficulty sleeping, and other mood disorders, such as depression and anxiety. Because low levels of testosterone can also increase the risk of developing type 2 diabetes and obesity, hypogonadism is a common comorbidity in a broader set of conditions, including type 2 diabetes and Non-Alcoholic Steatohepatitis (NASH).

About KYZATREX

KYZATREX is a proprietary softgel oral formulation absorbed primarily via the lymphatic system (meaning it is not toxic to the liver) indicated in adult males for conditions associated with a deficiency or absence of endogenous testosterone. The safety and efficacy of KYZATREX was demonstrated in a phase 3, multi-center, open-label, six-month study in 155 hypogonadal males between 18 and 65 years of age with documented hypogonadism, as defined by a below normal serum testosterone level (281 ng/dL) and at least one sign or symptom of testosterone deficiency. In the efficacy population (n=139), 88 percent of hypogonadal men treated with KYZATREX achieved a mean plasma total testosterone concentration (Cavg) over 24 hours within the normal range (222-800 ng/dL) on the final pharmacokinetic (PK) visit of the study at Day 90 (primary endpoint). Based on exploratory endpoints, patients who received KYZATREX reported improvements in quality of life, energy/fatigue, erectile function, intercourse satisfaction, and positive mood. The most common side effect reported in 2 percent of KYZATREX patients was increased blood pressure (2.6%). The safety and efficacy of KYZATREX in males less than 18 years old have not been established.

Please see additional Important Safety Information below, including Boxed Warning for potential increased blood pressure, for KYZATREX.

About Marius Pharmaceuticals

Marius Pharmaceuticals is a patient-centric healthcare company focusing on therapies designed for hypogonadism or Testosterone Deficiency. The companys mission is to improve the functional lives of patients by reducing the downstream effects of Testosterone Deficiency, which include multiple comorbidities, such as type 2 diabetes and obesity. For more information, please visit http://www.mariuspharma.com

Important Safety Information for KYZATREX (testosterone undecanoate)

Use

KYZATREX (testosterone undecanoate) is a prescription drug that is used to treat adult men who have low or no testosterone levels due to certain medical conditions. KYZATREX is a controlled substance (CIII) because it contains testosterone. It is not known if KYZATREX is safe or effective in males younger than 18 years old. Improper use may affect bone growth in children. KYZATREX is not meant for use by women.

Important Safety Information for KYZATREX

KYZATREX can increase blood pressure, which can increase the risk of having a heart attack or stroke and can increase risk of death due to a heart attack or stroke. Your risk may be greater if you have already had a heart attack or stroke or if you have other risk factors for heart attack or stroke.

Do not take KYZATREX if you: have breast cancer; have or might have prostate cancer; are a woman who is pregnant (KYZATREX may harm your unborn baby); are allergic to KYZATREX or any of its ingredients; or have low testosterone without certain medical conditions (e.g., do not take KYZATREX if you have low testosterone due to age).

Before you take KYZATREX, tell your healthcare provider about all of your medical conditions, including if you: have high blood pressure or are treated for high blood pressure; have a history of diabetes; have heart problems; have high red blood cell count (hematocrit) or high hemoglobin laboratory value; have urinary problems due to an enlarged prostate; have liver or kidney problems; or have problems breathing while you sleep (sleep apnea).

Tell your healthcare provider about all the medicines you take, including prescription and over-the-counter medicines, vitamins, and herbal supplements. Taking KYZATREX with certain other medicines can affect each other. Especially, tell your healthcare provider if you take: insulin; medicines that decrease blood clotting (blood thinners); corticosteroids; or medicines that increase blood pressure, such as some cold medicine and pain medicines.

KYZATREX may cause other serious side effects including:

Call your healthcare provider right away if you have any of the serious side effects listed above.

The most common side effect of KYZATREX is high blood pressure. Other side effects may include headache, joint or back pain, diarrhea, increased red blood cell count, anxiety, constipation, swelling of the legs, and increased prostate specific antigen (PSA) levels.

These are not all the possible side effects of KYZATREX. For more information, ask your healthcare provider or pharmacist.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit http://www.fda.gov/medwatch or call 1-800-FDA-1088. You may also report side effects to Marius by calling 1-833-949-5040.

Keep KYZATREX and all medicines out of the reach of children.See Full Prescribing Information and Medication Guide for KYZATREX.

Media Contact:Lilly Washburn lilly@mariuspharma.com

Photos accompanying this announcement are available at:

https://www.globenewswire.com/NewsRoom/AttachmentNg/ba2569ca-0922-4b49-8d68-49424b5e44d4

https://www.globenewswire.com/NewsRoom/AttachmentNg/f825d70b-874a-4cef-9160-429f83bbfc66

Read the original here:
CORRECTION -- Marius Pharmaceuticals Receives FDA Approval of KYZATREX, an Oral Testosterone Replacement Therapy - GlobeNewswire

Background: The aim of testosterone replacement therapy (TRT) is to improve symptoms and signs of testosterone deficiency including decreased libido, erectile dysfunction, depressed mood, anaemia, loss of muscle and bone mass, by increasing serum testosterone levels to physiologic range. TRT has been used in the last 70 years, and overtime, numerous preparations and formulations have been developed to improve pharmacokinetics (PKs) and patient compliance. The routes of delivery approved for use in the Western world include buccal, nasal, subdermal, transdermal and intramuscular (IM).

Objectives: The aim of this narrative review was to describe and compare all available and approved testosterone preparations according to pharmacology, PKs and adverse effects.

Materials and methods: We have performed an extensive PubMed review of the literature on TRT in clinical practice. Contraindications and monitoring of TRT were analyzed by comparing available guidelines released in the last five years. We provide a review of advantages and disadvantages of different modalities of TRT and how to monitor treatment to minimize the risks.

Results: TRT is associated with multiple benefits highly relevant to the patient. However, the recommendations given in different guidelines on TRT are based on data from a limited number of randomized controlled trials (RCTs), as well as non-randomized clinical studies and observational studies. This is the case for the safety of a long-term TRT in late-onset hypogonadism (LOH). No evidence is provided indeed on the effects of TRT on endpoints such as deterioration of heart failure suggesting a cautious approach to T replacement in older men with a history of heart failure.

Conclusion: Clinicians must consider the unique characteristics of each patient and make the necessary adjustments in the management of LOH in order to provide the safest and most beneficial results.

Keywords: androgen deficiency; hormonal therapy; late-onset hypogonadism; testosterone.

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Testosterone replacement therapy - PubMed