Monday, December 16, 2013

Are You Waiting Up For Santa Or Is It Insomnia?

Dr. Gino Tutera 
Remember being a little kid trying to stay up to hear Santa and his sleigh on the rooftop?    Do you even remember fighting the urge to fall asleep but you always did anyways?  As you aged, the anticipation may have dwindled listening for reindeer hoots, as you find yourself unable to fall asleep. 
As men and women age, their testosterone and estrogen levels naturally decrease. This affects your body in a number of ways. Unfortunately, one of these ways is an increase in difficulty falling asleep and staying asleep. Insomnia is no longer limited to Christmas Eve. With menopause and andropause, insomnia can affect your sleep on a nightly basis. There are a number of ways that we can help you to decrease the negative effects of this sleeping disorder.
SottoPelle® Hormone Replacement Therapy
SottoPelle differs from creams by using your internal system to regulate what your body knows it needs and when. Unlike other methods, Hormone Pellet Replacement Therapy does not invite foreign synthetics into your body. This method uses pure hormone and a small percentage of human fatty acid to work with the existing hormones in your body. SottoPelle has been shown to decrease the effects of insomnia and a range of other symptoms that come with growing older.
Reduce Caffeine and Alcohol
Caffeine stimulates your brain and makes it difficult to fall asleep. By eliminating caffeine consumption after 12 pm, it can help make falling asleep a little easier. Alcohol may make you feel drowsy and help you fall asleep,  but it can leave you with a headache the next morning.  Alcohol can also cause you to reawake during the middle of the night and make it more difficult to fall back asleep. Wise not to use as a sleep aid! http://www.webmd.com/menopause/sleep-problems-menopause
Exercise
If you find yourself with a lot of energy at night, try exercising to tire you out. Sleep studies have shown that exercising can help insomniacs sleep better and have more energy during the day. Be sure to not to do vigorous exercising within 3 hours of going to bed as this may keep you more awake. http://www.sleepfoundation.org/article/how-does-exercise-help-those-chronic-insomnia
Put Down the Phone
The light from your phone, television, computer, or other electronic device, can stimulate your brain and prevent you from falling asleep. The blue wavelengths these devices produce have also been shown to prevent melatonin production, the hormone that makes you sleepy. By keeping your phone out of reach and turning the television off it can help you fall asleep more easily. http://www.prevention.com/health/sleep-energy/insomnia-cure-10-simple-sleep-remedies/step-away-your-phone

Thursday, December 12, 2013

How You Can Avoid Holiday Weight Gain This Season

Dr. Enrique Jacome
During menopause and andropause, your body’s cortisol levels rise dramatically. Cortisol is the hormone commonly related to stress and during the holidays stress is felt by many. Cortisol helps the body use sugar and fat for energy. As levels rise, the rate of this function slows down; as a result, metabolism also slows. As you age, your muscle mass decreases which slows the rate that your body can use calories. This loss combined with high cortisol levels make it difficult not to gain weight as you age.
The holiday season is known for its abundance of sweets and piles of food. It’s difficult to find a holiday recipe that doesn’t have a pound of butter and sugar so how are you expected to avoid the excess weight gain during this time of year?
Exercise – It’s difficult during the most wonderful time of year to get to the gym but doing just that could help you reduce some of that holiday stress. While you exercise, endorphins are released in your brain that make you feel better. Allowing yourself to focus on one task can help you release stress and feel refreshed. Research has also shown that regular exercise can help improve self-confidence and anxiety making the holiday season a more important time than ever to stick to an exercise routine or start one!
Drink Water - While you’re enjoying your meal, put down the holiday cocktail and help yourself to a glass of water. You will avoid drinking empty calories and providing your body with hydration that can help you feel full faster.
Portion Control – Instead of filling your plate up with mountains of your favorite holiday treats, limit yourself to small portions of them. If you still think you are hungry after you finish, try waiting fifteen minutes before getting seconds to allow your brain to register that you have already eaten.
Bio-Identical Hormone Pellet Therapy – The SottoPelle® Method helps the body release hormone when it is needed and decrease it when requiring less 24/7 improving a vast number of symptoms related to andropause and menopause. Some symptoms the SottoPelle® Method helps improve are anxiety, depression, fatigue, difficulty losing weight, increased body fat, and carbohydrate cravings. The holidays seem synonymous with many of these symptoms so speak to your doctor about how SottoPelle® can help you.
Enjoy Yourself – The holidays are a chance for many to reconnect with friends and family. Instead of obsessing over calories, spend your time cherishing your loved ones and counting the blessings the year has brought you. Make healthy choices but remember to enjoy yourself.
There is nothing better than giving yourself the gift of health this holiday season with SottoPelle®.

Tuesday, December 3, 2013

Study Shows HRT For Postmenopausal Women May Decrease The Risk Of Pancreatic Cancer

Dr. Gino Tutera
A recent study found that one type of hormone replacement therapy (HRT) for postmenopausal women may decrease the risk of pancreatic cancer. In the study, women from California who took estrogen-only HRT for symptoms of menopause were 41 percent less likely to develop pancreatic cancer over a 14-year period than women who never took hormone replacement therapy.
Generally, estrogen-only hormone therapy is only provided to women who have had their uterus removed, therefore, most therapies have a combination of hormones including ones like progestin. The study found associations, and cannot prove that estrogen in hormone replacement therapy actually causes an increase or decrease in pancreatic cancer risk. In addition, pancreatic cancer is rare, so the risk of any woman in the study developing the condition was small.
About the Study: The new study involved more than 118,000 female public school professionals in California who were surveyed in 1995 to 1996 about their use of hormone replacement therapy and current or past use of oral contraceptives, and were followed until 2009. At the start of the study, 60 percent of the women were postmenopausal, 25 percent of whom were current users of estrogen-only HRT, and 33 percent of whom were current users of estrogen-plus-progestin HRT. During the study period, 323 women (0.27 percent) were diagnosed with pancreatic cancer. The study, conducted by researchers at the University of Southern California, was published online Sept. 5 in the journal American Journal of Epidemiology.

Saturday, November 30, 2013

Calling All Men – Get Help With Your Hormones During The Holidays

Dr. Gino Tutera
Often, during a hectic holiday season, men will suffer in silence with baffling symptoms they don’t understand.  As men age, certain symptoms may be signs of hormone imbalance due to andropause. It’s important to remind men that they can seek help and that Bio-Identical Hormone Pellet Therapy, The SottoPelle® Method can help them.
The following are six common signs we have visited before on our Blog but a reminder is so crucial during the chaotic days and nights over the Holidays.  The below could indicate a hormonal deficiency.
1.      Thinning of Hair & Loss of Body Hair
Decreased testosterone levels leads to loss of scalp and body hair because an imbalance of testosterone to Dihydrotestosterone (DHT) exists.  DHT inhibits the growth of new hair cells and hair cells are not replaced after they fall out when DHT activity is higher than testosterone activity.
2.      Weight Gain
Weight gain is commonly reported by men during andropause. The decrease in testosterone levels leads to higher insulin and cortisol levels. When men have high cortisol levels, their bodies can increase the production of fat cells and increases appetite. High levels of insulin and cortisol also decreases metabolism and continues to decrease testosterone. The combination of these effects leads to weight gain.
3.      Decreased Libido 
As energy decreases with lower testosterone levels, men’s sex drive often follows. The libido is considered highly dependent on hormone levels and is affected by the changes in hormones as men enter andropause. The loss of energy and strength during this time in a man’s life also plays into a lowered libido, as does less stimulation of the libido center in the brain.
4.      Trouble sleeping
Low testosterone and heightened cortisol levels can lead to sleep apnea. Because human growth hormones are made during the first ninety minutes of sleep, interrupted sleep leads to the disruption of hormone production. When sleep is interrupted it can lead to worsened fatigue and insomnia, as well as, reduce insulin sensitivity.
5.      Depression
Depression is a common side effect of decreased testosterone. Decreased testosterone leads to lower serotonin levels in the brain. Often times, men are not accustomed to being vocal about their emotions, but it is important for them to share these feelings with a medical professional as it may be a symptom of low testosterone.
6.      Muscle Loss
Testosterone is a major component in the production of strong muscles in men. As the testosterone decreases in men, their muscle strength can also decrease as they lose energy and their bodies begin turning muscle fibers into fat.
Remember: Don’t try to  fight these symptoms yourself.  The great gift of the SottoPelle Therapy can have you on your way to looking and feeling young again.  You deserve to get the most out of life and enjoy your holidays. 

Wednesday, November 20, 2013

Tips For A Healthy & Happy Thanksgiving

Dr. Enrique Jacome
Thanksgiving is one of the best holidays of the year. There is no better excuse to express gratitude for those that you love the most and open your heart and your home to spread the love.  Although some people look forward to, literally, pigging out all day, there is a better and healthier way to enjoy Thanksgiving without the proverbial hangover that comes from overindulging (whether that be food, alcohol, or both). Here are five tips to make the most out of this wonderful holiday:


1. Be sure to eat a healthy and hearty breakfast. Don’t be fooled into thinking that by skipping out on breakfast you have license to eat that much more during the Thanksgiving feast. It’s never fun to feel overstuffed. Eating a healthy breakfast that includes lean protein (eggs or egg whites, salmon, protein-enhanced smoothie, Greek yogurt) and fresh fruit (apples, pears, berries) or vegetables (spinach, bell peppers, broccoli) will get the day started on the right track and help keep you satisfied and less likely to binge or “pick” throughout the day. Take it from a seasoned Thanksgiving cook, there’s nothing quite as annoying as the person who is constantly in the kitchen picking at all the food one is meticulously putting out on serving trays.
2. Get some vigorous exercise first thing in the morning. Get outdoors for a hike, brisk walk, bike ride or run. The outdoors is invigorating and you’ll take in some needed vitamin D. You’ll also set your metabolism in gear as you prepare to potentially take in a few more calories than normal.
3. Start small. If offered, always choose the smaller plate size. We are less likely to overindulge when we use smaller plates. Why? Smaller plates equals smaller portions. Go generous on the vegetables. Say yes to soup.
4. Take your time. Although it is tempting to dive right in and (pardon the pun) gobble everything down so you can be first at seconds, taking the time to chew, breathe, and put the fork and knife down between bites will actually result in less chance of overeating. It takes the brain a little bit of time to register satiety (the feeling of fullness) after the food hits the stomach and gastrointestinal tract. When you plow through your food without taking time to pause, you’ll likely be that person who ends up having to loosen that top button on his pants or leaning way back in your chair because your trying to create space for your diaphragm to expand and contract.
5. Make the best choices. There are some stellar superfoods available this time of year and they often show up on the Thanksgiving table. Sweet potatoes are fabulous on their own – they don’t need extra butter and sugar. As a superfood, they are loaded with carotenoids, fiber, antioxidants and vitamins. So definitely say yes to sweet potatoes. Cranberries are also a definite yes. Say no to ham, which is usually loaded with sodium and nitrites but yes to turkey breast. Limit the amount of gravy you use, especially if it has been prepared with excess fat drippings or tons of butter. Pescatarians (vegetarians who also eat fish) may chose poached salmon for their main dish. Vegans may chose Tofurkey, a tofu-based dish with imitation turkey flavor. Say yes to winter green salad made with spinach, beats, pears and slivered almonds. I suggest skipping the stuffing altogether (you have enough starch from the sweet potatoes). Try alternatives to stuffing, such as wild rice or quinoa pilaf. For dessert, say yes to pumpkin pie but pass on the pecan pie. Although we love pecans, pecan pie is typically loaded with excess fat and sugar.
More than anything this Thanksgiving, be grateful for the table set before you! Give thanks for all who came together to make the feast possible. And if you’re looking for extra credit or at least a good excuse to burn a few extra calories, put on some great music after your meal and dance the Thanksgiving night away.

Monday, November 18, 2013

What Is The Thyroid Gland?

Dr. Gino Tutera
The thyroid gland is a small organ within the endocrine system.  It weighs a merely 20 grams, or less than an ounce, and it is found in the neck beneath the Adam’s Apple.  Despite its small size, it is one of the most important hormone-secreting organs in the body.  Your thyroid provides a vital hormone to maintain and function the entire body.  When this vital hormone is deficient, even in small amounts, it often results in a multitude of symptoms and conditions affecting every organ in your body.
One of the important organs in the body that often undergoes changes before, during and after menopause is the thyroid gland.  In fact, studies show that hypothyroidism is far more common in women, especially women of menopausal age or who has a family history of hypothyroidism.  The following are a few basic facts about hypothyroidism:

·         Hypothyroidism affects 20 million Americans, or 1 in every 10 people.
·         Hypothyroidism runs in families, specifically among other females
·         Hypothyroidism is up to 8x more common in women than men.
·         By the age 50, 1 out of 12 women has some level of hypothyroidism

The following list of symptoms is consistent with hypothyroidism.  If you are suffering from any of these, please speak with your family physician regarding treatment.  (These are only a few of the most common symptoms).
·         Weakness
·         Fatigue
·         Constipation
·         Weight gain
·         Depression
·         Paleness
·         Dry flaky skin
·         Hoarseness
·         Abnormal menstrual periods
·         Muscle pain
·         Thin brittle hair and fingernails

There are several blood tests that can be performed to accurately assess thyroid function.  If your physician is attempting to determine your thyroid status, the blood test panel should consist of the following:
·         TSH – Thyroid Stimulating Hormone
·         Total T 4 or T4
·         Total T3
·         Free T4
·         Free T3
·         Anti-TPO and Anti-Tg Antibodies

If your healthcare provider has determined that you present clinically with hypothyroidism, a likely course of action will be to offer thyroid hormone replacement therapy.

www.sottopelletherapy.com/doctors/enrique-jacome-md

Wednesday, November 13, 2013

Hormone Pellet Therapy – Give Yourself This Gift Before The Holiday Rush Starts

Bio-Identical Hormone Pellet Therapy, The SottoPelle® Method is the superior choice for hormone issues.  Last week we reviewed the signs of a Hormone Imbalance and the below outlines why the Pellet is superior than creams, gels or shots.

Benefits of Hormone Pellets:
  • The only method that allows the body to control the release of hormone—raising levels when more hormone is needed and decreasing it when requiring less
  • Delivers a low dose of hormones continuously, 24/7
  • Release of hormones directly into the bloodstream, thereby bypassing the gastrointestinal system and liver
  • Consistently proven more effective than oral, injected, or topical methods with regard to sexual function, mood and cognitive function, metabolic function, bone density, urinary and vaginal problems, lipid profiles, breast health and hormone ratios
  • Can last up to 6 months
  • Gels or Creams can rub on others/clothes/skin
Gift yourself an early gift this holiday season with The SottoPelle Method.

Thursday, October 24, 2013

Neural Origins Of Hot Flashes In Menopausal Women Identified By Study

Dr. Enrique Jacome
A study from neuroscientists at the Wayne State University School of Medicine provides the first novel insights into the neural origins of hot flashes in menopausal women in years. The study may inform and eventually lead to new treatments for those who experience the sudden but temporary episodes of body warmth, flushing and sweating.
The paper, "Temporal Sequencing of Brain Activations During Naturally Occurring Thermoregulatory Events," by Robert Freedman, Ph.D., professor of psychiatry and behavioral neurosciences, founder of the Behavioral Medicine Laboratory and a member at the C.S. Mott Center for Human Growth and Development, and his collaborator, Vaibhav Diwadkar, Ph.D., associate professor of psychiatry and behavioral neurosciences, appears in the journal Cerebral Cortex, an Oxford University Press journal.
"The idea of understanding brain responses during thermoregulatory events has spawned many studies where thermal stimuli were applied to the skin. But hot flashes are unique because they are internally generated, so studying them presents unique challenges," said Freedman, the study's principal investigator. "Our participants had to lie in the MRI scanner while being heated between two body-size heating pads for up to two hours while we waited for the onset of a hot flash. They were heroic in this regard and the study could not have been conducted without their incredible level of cooperation."
"Menopause and hot flashes are a significant women's health issue of widespread general interest," Diwadkar added. "However, understanding of the neural origins of hot flashes has remained poor. The question has rarely been assessed with in vivo functional neuroimaging. In part, this paucity of studies reflects the technical limitations of objectively identifying hot flashes while symptomatic women are being scanned with MRI. Nothing like this has been published because this is a very difficult study to do."
During the course of a single year, 20 healthy, symptomatic postmenopausal women ages 47 to 58 who reported six or more hot flashes a day were scanned at the School of Medicine's Vaitkevicius Imaging Center, located in Detroit's Harper University Hospital.
The researchers collected skin conductance levels to identify the onset of flashes while the women were being scanned. Skin conductance is an electrical measure of sweating. The women were connected to a simple circuit passing a very small current across their chests, Diwadkar said. Changes in levels allowed researchers to identify a hot flash onset and analyze the concurrently acquired fMRI data to investigate the neural precedents and correlates of the event.
The researchers focused on regions like the brain stem because its sub regions, such as the medullary and dorsal raphe, are implicated in thermal regulation, while forebrain regions, such as the insula, have been implicated in the personal perception of how someone feels. They showed that activity in some brain areas, such as the brain stem, begins to rise before the actual onset of the hot flash.
"Frankly, evidence of fMRI-measured rise in the activity of the brain stem even before women experience a hot flash is a stunning result. When this finding is considered along with the fact that activity in the insula only rises after the experience of the hot flash, we gain some insight on the complexity of brain mechanisms that mediate basic regulatory functions," Diwadkar said.
These results point to the plausible origins of hot flashes in specific brain regions. The researchers believe it is the first such demonstration in academic literature.
They are now evaluating the network-based interactions between the brain regions by using more complex modeling of the fMRI data. "We think that our study highlights the value of using well-designed fMRI paradigms and analyses in understanding clinically relevant questions," Diwadkar said.
The researchers also are exploring possibilities for integrating imaging with treatment to examine whether specific pharmacotherapies for menopause might alter regional brain responses.

Friday, October 18, 2013

Research Reveals New Details About The Receptor Mechanisms Of Estrogen's Role In Memory

Dr. Enrique Jacome
In a new study, Karyn Frick, professor of psychology at the University of Wisconsin-Milwaukee (UWM), uncovers details about estrogen's role in the complex cellular communication system underlying memory formation.

"The receptor mechanisms that regulate estrogen's ability to enhance memory are still poorly understood," says Frick. "With this study, we've begun to sort out several of the key players needed for estrogens to mediate memory formation."

The research, published in the the Journal of Neuroscience, focused on estrogen effects in a brain region called the hippocampus, which deteriorates with age or Alzheimer's disease. The researchers found that each of the two known estrogen receptors rapidly activate a specific cellular pathway necessary for memory formation in the hippocampus of female mice, but only if they interact with a certain glutamate receptor, called mGluR1.

The study revealed that when this glutamate receptor is blocked, the cell-signaling protein ERK cannot be activated by the potent estrogen, 17β-estradiol. Because ERK activation is necessary for memory formation, estradiol failed to enhance memory among mice in which mGluR1 was blocked.

Frick's team also found evidence that estrogen receptors and mGluR1 physically interact at the cell membrane, allowing estradiol to influence memory formation within seconds to minutes. Collectively, the data provide the first evidence that the rapid signaling initiated by such interactions is essential for estradiol to enhance memory regulated by the hippocampus.

"Our data suggesting that interactions between estrogen receptors and mGluR1 at the cell membrane are critical for estradiol to enhance memory provides important new information about how estrogens regulate memory formation," Frick says.

Wednesday, September 4, 2013

Study Shows Joint Symptoms In Postmenopausal Women Not Reduced By Calcium Plus Vitamin D Supplementation

Dr. Enrique Jacome
A team of investigators systematically analyzed the effect of calcium and vitamin D supplementation on joint symptoms in a rigorous and controlled study of postmenopausal women. They found that supplementation did not reduce the severity of joint symptoms reported by the participants. Their results are published in the Journal of the Academy of Nutrition and Dietetics.

The influence of low calcium and vitamin D deficiency on joint symptoms has been studied with mixed results. Only some observational studies have associated vitamin D with knee osteoarthritis and results from full-scale randomized trials have been sparse. "In the current study, we addressed for the first time in a full-scale, randomized clinical trial setting, the clinically relevant question of whether postmenopausal women using calcium and vitamin D supplements in currently recommended dosage would experience any favorable effect on joint pain or swelling, common symptoms in postmenopausal women," says lead investigator Rowan T. Chlebowski, MD, PhD, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center in Torrance, California.

Using data from the Women's Health Initiative (WHI) calcium plus vitamin D supplementation trial, researchers identified a subgroup of 1,911 postmenopausal women for the current study, who had been randomized to receive calcium carbonate with vitamin D3 daily or placebo and had undergone serial joint symptom assessment. Responses to a questionnaire provided qualitative information on joint pain and joint swelling before entry and two years after randomization.

Between the daily supplement use and placebo groups, joint pain and swelling at baseline entry was comparable, at more than 70 percent. After two years, analysis revealed no statistically significant difference for the frequency or severity of joint pain or swelling.

The research team also evaluated data to determine the potential for interaction with age, BMI(body mass index), physical activity, non-protocol calcium and vitamin D supplement use, race/ethnicity, and hormone therapy. Investigators found no interaction with age, BMI, race/ethnicity, or physical activity. No significant interaction was evident with non-protocol vitamin D supplement use at entry. However, participants using non-protocol calcium supplements at entry reported less joint pain compared with those in the placebo group. The influence of calcium and vitamin D supplementation individually on joint symptoms was not determined because both were provided combined in a single pill in this trial.
Dr. Chlebowski concludes, "Joint symptoms are relatively common in postmenopausal women. 

However, daily supplementation with 1,000 mg of calcium carbonate and 400 IU of vitamin D3 in a randomized, placebo-controlled clinical trial setting did not reduce the self-reported frequency or severity of joint symptoms."

Dr. Chlebowski and his team add that these findings do not speak against current recommendations for vitamin D intakes for bone health and fracture risk reduction. 

Saturday, August 24, 2013

Study Shows That Exercise Is Good For Women, But It Won't Cut Hot Flashes

Dr. Enrique Jacome
Exercise has proven health benefits, but easing hot flashes isn't one of them. After participating in a 12-week aerobic exercise program, sedentary women with frequent hot flashes had no fewer or less bothersome hot flashes than a control group. This randomized, controlled study from the MsFLASH Research Network was published in Menopause, the journal of The North American Menopause Society.

The 248 women in the trial were either approaching menopause or were postmenopausal; 142 of them continued to go about their usual activities, and 106 participated in aerobic exercise training three times a week for 12 weeks at a fitness center. All the women kept daily diaries on their hot flashes and night sweats and on how well they slept and also completed questionnaires about insomnia, depression, and anxiety.

Although exercise had small positive effects on sleep quality, insomnia, and depression, it had no significant effect on hot flashes for the women overall. Race and initial fitness did make some difference, however. White women in the exercise program did show improvement in their hot flashes compared with white women who maintained their usual activity level, but there was no similar difference among African-American women. Also, women who were more fit to begin with had greater improvement in their hot flashes with exercise.

The study helps to settle a debate about the effect of exercise on hot flashes. Previous studies have been inconsistent, but this study corroborates a recent Cochrane review on the topic, which concluded that there was no evidence to support the use of exercise as an effective treatment for hot flashes and night sweats.

"Midlife women cannot expect exercise to relieve [hot flashes and night sweats] but may reasonably expect it to improve how they feel and their overall health," said the investigators.

Tuesday, August 20, 2013

Study Shows That Estrogen May Influence Location Of Women's Fat

Dr. Enrique Jacome
Ever wondered why some women, but not all, have the "pear" shape considered by many to be desirable? Researchers might have found some answers to the mystery, after discovering that estrogen, one of the sex hormones, affects where fat is stored in a woman's body.

The study was conducted by researchers from East Carolina University and published in the American Journal of Physiology: Endocrinology and Metabolism. It involved 17 premenopausal women ages of 18 and 44 who were overweight or obese.

Researchers  asked the women to provide:
  • Weight
  • Height
  • Fat percentage
  • Lean body mass
  • VO2 max (a measure of physical fitness).
They then analyzed how estrogen affects fat accumulation in particular areas of the body.
This was done by slowly infusing estrogen into the buttocks and belly of the women overnight. The women were then given drugs that encouraged the burning of fat in the body (lipolysis). They were also asked to exercise at a level similar to a standard exercise session, both with and without the lipolysis drugs.

Fat breakdown was measured using microdialysis - a sampling technique that looks for the amount of glycerol left behind after the breakdown of fat for eventual energy production.

The researchers found that the effect of estrogen on fat deposits was dependent on the deposits' particular location and how the fat is burned.

Results of the study revealed that estrogen halted fat breakdown in the abdomen area when the hormone was infused alongside a lipolysis drug called isoproterenol. However, it did not have the same effect in the buttocks.

The researchers add that after a second drug was infused in the abdomen along with the first, no further fat was broken down.

But when both of the fat-mobilizing drugs were infused together alongside exercise, and when the participants exercised without the drugs, fat breakdown in the abdomen increased, although less in the buttocks.

The study authors say: "Our results indicate that the influence of E2 (estrogen) is dependent on the adipose tissue (loose connecting tissue) depot of interest as well as the specific regulatory mechanism targeted.

The authors add: 
"The importance of understanding estrogen action in adipose tissue is underscored by the fact that adipose tissue is an estrogen-producing organ, particularly in postmenopausal women, where adipose tissue is the major site of estrogen production."

The scientists say their findings could potentially lead to an understanding of why post-menopausal women are more likely to accumulate fat around the abdomen area.

When it comes to pre-menopausal women, the researchers say that the relationship between estrogen and the breakdown of fat is what may help maintain a woman's "pear" shape - more fat around the middle area of the body.

They conclude that further research is needed to determine the mechanisms as to why and how the effects of estrogen vary.

Saturday, August 10, 2013

Recognizing Menopausal Symptoms Is The First Step

Dr. Enrique Jacome
When I ask patients to give me a definition of menopause, I receive a variety of answers that consist of “When you get hot flashes” to “Not having a period for over a year”.  Many women go under diagnosed because of the failure of physicians to apply a scientific method for diagnosis. 

Scientifically, a diagnosis is when the level of follicle stimulation hormone (FSH) reaches a level greater than 23 miu/ml, whether she is menstruating or not. Peri-menopause typically begins when a woman is in her 40’s and can average 4 to 8 years.  Menopause occurs roughly in women their early 50’s. Every year it is estimated that 1.3 million women are expected to reach menopause.

I will take you through a series of symptoms that a woman should look for and what should she do next.  NO woman should ever have to suffer through any symptom(s) nor feel less than a woman.  Menopause is a natural part of the aging process.  Not all symptoms will show in all women.  Please use this as a guide only.
During the menopausal transition women may experience sexual dysfunction as well as depressive symptoms.  Due to the loss of estrogen, one’s symptoms can also consist of:
  • Hot flashes
  • Severe sweating – can happen both day and night
  • Insomnia
  • Vaginal dryness
  • Vaginal discomfort
  • Irritability
  • Loss of memory or fuzzy thinking
  • Cold sweats
  • Irregular periods
  • Anxiety
  • Mood swings
  • Headaches
  • Sadness
When a woman comes to me with symptoms, as previously stated, I take the time to listen to what each individual patient is telling me, never discounting any of their feelings or symptoms.  My immediate instinct as a Doctor is to help her improve her symptoms and get her on the right track to feeling like a woman again.  My first recommendation is that they have a simple blood test that will measure their pituitary hormone Follicle Stimulating Hormone (FSH) level. Depending upon the blood work I get back from their testing’s, my suggested and most successful form of hormone replacement would be via the Pellet Hormone Delivery System (PHDS). Women who have their hormones replaced via PHDS allows the body to recreate a continuous flow of hormones that the ovaries normally and previously produced within their bodies.  This method of delivery is more important than any other type of replacement therapy as it is surgically inserted and allows the body to control the release of the hormones over time.  Nothing in an oral, patch or cream can reproduce the normal hormone correction that is needed.
Always remember to go with your instinct regarding how you are feeling and if you are displaying some of the symptoms above, as each woman knows best how they should feel and seek the advice of a doctor.  Don’t ever give in or give up to the ugly face of menopause.
Remember to put your fears away, as life during and after menopause can be quite enjoyable!

Thursday, August 8, 2013

Urinary Infection During Menopause Treated With Estrogen In Mouse Study

Dr. Enrique Jacome
Estrogen levels drop dramatically in menopause, a time when the risk of urinary tract infections increases significantly. 

Researchers at Washington University School of Medicine in St. Louis have found new evidence in mice that the two phenomena are connected by more than just timing. If further research confirms these links, boosting estrogen levels may get a second look as an approach for reducing urinary infections in menopausal women. 

"Scientists tested estrogen as a treatment for post-menopausal women with urinary tract infections in the 1990s, but the results were either ambiguous or negative," says senior author Indira Mysorekar, PhD, assistant professor of obstetrics and gynecology and of pathology and immunology. "With the mouse model of menopause that we've created, we can more completely understand how estrogen levels affect infection susceptibility, bladder health and the inflammatory response to infection. That should point the way to better treatment strategies." 

The findings appear online in Infection and Immunity. 

Urinary infections are a significant cause of illness in many women throughout their lives and are particularly prevalent after menopause. The bacteria that cause these infections can spread to the kidney and bloodstream, with the potential for serious complications. 

To simulate menopause in mice, scientists surgically remove their ovaries. Like menopausal women, the mice no longer make estrogen. 

To rule out the possibility that the stress of surgery affects the risk of urinary tract infections, the researchers conducted the same surgery in other mice but put the ovaries back in, maintaining their ability to make estrogen. 

When researchers gave both groups of mice urinary tract infections, the menopausal mice had higher levels of infectious bacteria in their urine. Most of the bacteria came from barrier cells, which line the interior of the bladder. These cells are the first to be infected by the bacteria. 

"When the barrier cells are lost, they need to be replaced immediately," Mysorekar says. "In the menopausal mice, we found that this replacement process was stopping short of completion. That left cells under barrier cells exposed, and they are much more vulnerable to infection." 

The menopausal mice had more bacterial reservoirs, which are pockets of infection that may provide a place for the bacteria to hide during antibiotic treatment. After treatment stops, the reservoirs can reseed the infection. 

In earlier research, Mysorekar had identified an important regulator of the barrier cell repair process. In the new study, she showed that low estrogen levels disable this regulator. 

The bladders of the menopausal mice also had higher levels of immune inflammatory compounds known as cytokines. 

"The cytokines caused inflammation that left the bladder in bad shape," Mysorekar says. "It's possible that damage caused by inflammation increases the bacteria's ability to break into bladder tissue and create reservoirs of infection." 

In the control mice, which had normal estrogen levels, cytokine levels and inflammatory damage were both significantly lower. When researchers gave the menopausal mice estrogen, their cytokine levels and inflammatory damage also decreased significantly, as did reservoirs of infectious bacteria. 

Mysorekar notes that earlier clinical trials of estrogen's usefulness against urinary infection evaluated the treatment's success by tracking levels of bacteria in the urine. The researchers say their new results suggest that bacteria levels alone may not provide a complete picture of estrogen's effectiveness against the infections. 

"If we can find ways to look at other aspects of the infectious process in humans, we may find that estrogen is more helpful than we previously realized," Mysorekar says. "We need to look for other indicators, such as cytokines in the urine, to more fully assess estrogen's potential role in treatment." 


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