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Dr. Justin Houman Medical Director and Board-certified Urologist

FARMINGTON, Conn. (PRWEB) August 10, 2022

Renowned Male Reproductive Medicine and Surgery Specialist Will Provide Clinical Oversight For All of Bastion Healths Initiatives

Farmington, CT, August 10, 2022 - Bastion Health, the first-ever comprehensive virtual clinic for mens health specializing in reproductive and prostate health, announces the appointment of Dr. Justin Houman as Medical Director. As Medical Director, Dr. Houman will provide clinical expertise and oversight for all of Bastion Healths initiatives.

Dr. Houman is a urologist and fellowship-trained Male Reproductive Medicine and Surgery specialist. His practice is focused on mens health, including male hormone management, sexual health, and male fertility. As a minimally-invasive microscopic surgeon, he specializes in microsurgical varicocelectomy, vasectomy reversals, and sperm retrievals.

Dr. Houman has published multiple manuscripts on mens health, male fertility, and the health effects of wearable technology. Dr. Houmans studies have been published in peer-reviewed journals such as the Journal of the American Medical Association and the Journal of Sexual Medicine.

We are honored to have Dr. Houman join Bastion Health. With his leadership and expertise, he will help us build the future of mens health, said Reza Amin, founder, and CEO of Bastion Health.

For more information on Bastion Health, visit http://www.getbastion.com.

About Bastion Health

Bastion Health is the first-ever comprehensive digital mens health clinic specializing in reproductive and prostate health, offering quick and convenient access to urologists and mens health specialists. Bastion aims to normalize the conversation surrounding mens health and offers a way for men to proactively take control of their health from the comfort of their own home with convenient consultations, diagnostic testing, assessments, clinical treatment plans, and on-demand educational content, available through the Bastion Health AI-powered app. Bastion Health was founded by Reza Amin and is based in Farmington, CT.

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Bastion Health Announces the addition of Dr. Justin Houman as Medical Director - PR Web

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In states that have banned abortion, some women with unwanted pregnancies are pursuing an unconventional workaround: They are self-managing their abortions, seeking out the necessary know-how online and obtaining the medications without the supervision of a clinic or a doctor.

At first glance, the practice may recall the days before Roe v. Wade, when women too often were forced to take risky measures to end an unwanted pregnancy. But the advent of medication abortion accomplished with drugs, rather than in-office procedures has transformed reproductive care, posing a significant challenge to anti-abortion legislation.

Even before the Supreme Court's decision to overturn Roe v. Wade, medication abortions accounted for more than half of abortions in the United States. Federal regulators made access to the pills even easier during the pandemic by dropping the requirement for an in-person visit and allowing the drugs to be mailed to patients after a virtual appointment.

But many states never allowed telehealth abortion, and new laws prohibiting abortion apply to all forms of the procedure, including medications. So women in increasingly restrictive parts of the country are procuring the pills any way they can, often online, despite state prohibitions.

There are no reliable estimates of the number of women who undertake their own medication abortions, according to the Guttmacher Institute, which researches and supports abortion access.

With the overturning of Roe v. Wade, abortion is now banned in at least 10 states, according to a database maintained by The New York Times. Voters in Kansas on Tuesday rejected a ballot measure that would have removed abortion rights protections from the state constitution.

Limits of one sort or another are nonetheless expected in at least half of U.S. states, and so both sides of the divide are bracing for an increase in self-managed abortions.

Critics of abortion in any form insist that medication abortions are riskier than claimed, and even more so without medical supervision. The procedure should not be undertaken beyond 10 weeks gestation, they note, or performed without a doctors visit, because dating a pregnancy accurately is not always possible.

Other medical complications can be missed, they say including ectopic pregnancy, in which the fertilized egg implants outside the uterus.

Claims that medication abortion is safe are based on flawed and incomplete data, which prioritize convenience and cost over the health and safety of patients, said Dr. Christina Francis, chair of the American Association of Pro-Life Obstetricians and Gynecologists, which opposes all abortions except to prevent permanent harm or death to the mother.

Physicians who support abortion tell a different story: There is plentiful evidence that medication abortion is safe, and women already carry out the procedure almost entirely alone at home, even if they do see a doctor to obtain the drugs. Self-management is not so different, supporters argue.

Its quite safe and effective based on studies weve done, national data provided by the states and the Guttmacher Institute, and the experience of other countries, said Dr. Beverly Winikoff, the founder of Gynuity Health Projects, who performed much of the research on medication abortion that led to its approval in the United States more than 20 years ago.

The procedure typically involves taking two drugs: mifepristone, which stops the pregnancy by blocking a hormone called progesterone, followed a day or two later by misoprostol, which causes the uterus to contract.

More than half a million women had medication abortions in 2020 in the United States, and fewer than half of 1 percent experience serious complications, studies show. Medical interventions like hospitalizations or blood transfusions were needed by fewer than 0.4 percent of patients, according to a 2013 review of dozens of studies involving tens of thousands of patients.

Medication abortion is noninvasive, doesnt cause sepsis and doesnt cause ruptures of internal organs, like the illegal abortions of the pre-Roe era, Dr. Winikoff said.

It doesnt mean people cant have excessive bleeding and need to get care occasionally, but those are not the dire circumstances of people from 50 years ago, she added.

The drugs are regulated by the Food and Drug Administration, however, and are intended to be taken under a doctors supervision. The agency discourages internet purchases of mifepristone because patients will be bypassing important safeguards, officials said in a statement.

But the F.D.A. does not advise against online purchases of misoprostol (brand name Cytotec), which is used to treat a number of medical conditions. Misoprostol can terminate pregnancies by itself, recent studies have shown.

While no treatment is 100 percent safe, taking the pills on your own at home does not affect your risk of complications, said Dr. Carolyn Westhoff, an obstetrician gynecologist and professor at Columbia University and the editor in chief of the journal Contraception.

But self-management also means a woman does not have a familiar health care professional nearby to call in case of an emergency or complications. Dr. Westhoff and other experts fear that women performing their own abortions may be reluctant to seek medical help in states that have criminalized abortion.

Cassie, 20, who uses the pronouns they and them and asked that only a first name be used because they reside in Texas, where most abortions are banned after about six weeks of pregnancy, managed their own abortion in January.

Cassie, who already had a child and was struggling financially, filled out an online request form for abortion pills from Aid Access, which is based in Europe. The drugs took longer to arrive than expected, and when they did, Cassies pregnancy was already 12 weeks along.

I just took them and prayed for the best, Cassie said. They experienced heavy bleeding, nausea and the worst cramps Ive had in my entire life.

I was crying, curled up in a ball of pain in the middle of my bed, they said.

When the bleeding did not subside, Cassies partner drove them to the hospital, where the remaining tissue was removed.

That was its own horrifying experience of praying that they wouldnt know or suspect Id caused it myself, Cassie said.

Both the know-how and the tools to perform an abortion are increasingly easy to access.

Women who live in states where abortion is legal can turn to U.S.-based telehealth providers like Abortion on Demand and Hey Jane, which offer detailed information to women seeking abortions and provide pills by mail after a video visit in states where these services are legal.

MYA Network provides physicians who answer questions about self-managed abortion, and Abortion Pill Info offers tips on keeping online research private.

For women in states with abortion bans, Plan C offers a number of workarounds, including a list of online pharmacies selling abortion drugs that the organization has tested and tutorials on setting up mail forwarding in another state to receive the drugs.

The site also refers people to Aid Access, which screens women online and orders abortion pills from overseas pharmacies that are sent in envelopes without return addresses, even to states where abortion is illegal. The group charges $150 or less, depending on income.

Hannah, a 26-year-old in Oklahoma, said she managed her own abortion with pills from Aid Access late last year, when local clinics, overwhelmed with patients from Texas, could not accommodate her.

Hannah, who asked to not be identified because abortion is now banned in her state, said she suffered from depression at times before she became pregnant, but had plummeted to a new low and was suicidal.

I couldnt afford a pregnancy and was not well enough, physically or mentally, to carry a pregnancy, she said. Her self-managed abortion was no worse than a normal period for me.

A medication abortion cannot be distinguished from a miscarriage, and traces of the pills cannot be discovered if they are taken orally, said Dr. Rebecca Gomperts, a Dutch physician who founded Aid Access.

If a woman needs care after taking the pills, we always tell people to say they had a miscarriage, she said. Its exactly the same symptoms, and the treatment is exactly the same.

A study of thousands of women in the United States who received abortion pills from a provider without an in-person visit during the pandemic found that the practice was safe.

Complications are the rare exception. Another recent study looked at self-managed abortions in Nigeria, where abortion is banned except to save the life of the mother, and in Argentina (which legalized abortion up to 14 weeks in late 2020).

Twenty percent of the nearly 1,000 women who participated in the study sought care at hospitals after the procedure, but most only wanted to confirm the abortion was complete. About 4 percent reported ongoing pain, fever or bleeding. Seventeen required procedures to complete the abortion, 12 stayed in the hospital overnight, and six needed blood transfusions, according to the study, which was published in The Lancet Global Health in late 2021.

The surprise finding was that while some of the women took the mifepristone-misoprostol combination, the success rate for those taking misoprostol alone a widely used drug that can be purchased in countries like Mexico without a prescription and is fairly inexpensive was higher than that of the two-drug combination.

Most state laws that restrict abortion make performing an abortion a crime for doctors, not patients. Only three states South Carolina, Oklahoma and Nevada have laws that explicitly make it a crime to end ones own pregnancy.

Other states, however, have wielded child endangerment statutes or other laws against women suspected of terminating their pregnancies.

In Indiana, Purvi Patel was sentenced to 20 years in prison in 2015 for inducing a self-managed abortion; her conviction was overturned in 2016. In Texas, murder charges were brought against Lizelle Herrera earlier this year in relation to a self-managed abortion, but prosecutors said they would not pursue the case.

At least 11 states have laws with broad personhood language that applies to fetuses, said Dana Sussman, deputy executive director of National Advocates for Pregnant Women. At least six Kentucky, Louisiana, Ohio, South Dakota, Texas and Wyoming define a fetus as a person throughout the criminal code, making it easier to prosecute women who terminate their own pregnancies.

Both the American Medical Association and the American College of Obstetricians and Gynecologists, which support abortion as an essential component of health care, oppose criminalizing self-managed abortion, as they say doing so will deter women from seeking medical attention.

At the moment, health care providers are not legally required by any state to report patients they suspect of self-managing an abortion, according to If/When/How, an abortion-rights advocacy group. But laws are in flux.

Were operating in an area of complete uncertainty, Ms. Sussman said.

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Some Women Turn to Self-Managed Abortion as Access Recedes - The New York Times

For more information about your reproductive health rights and related federal resources, you can visit the US government's Reproductive Rights site.

The US Supreme Court overturned Roe v. Wadeon June 24, effectively ending the constitutional right to an abortion, which had been in place since 1973. The majority opinion in Dobbs v. Jackson Women's Health Organization doesn't criminalize abortion on a federal level, but it leaves the decision ofallowing access to abortion up to individual states.

The Supreme Court ruling targetedin-clinic abortions. However, it's still possible and legal to obtain what's commonly known as the abortion pill -- actually two medications, mifepristone and misoprostol, which are taken one after the other and which can be used at home.

"Both methods of abortion are safe and effective, and it's important that my patients be able to choose the method that is right for them," Dr. Nisha Verma, Darney-Landy Fellow at the American College of Obstetricians and Gynecologists, said in a statement. "Some of my patients prefer the abortion procedure, knowing that when they leave my care, they are no longer pregnant. Others prefer to be able to take the pills needed for medication abortion in the comfort and privacy of their own home. Both choices are great choices, and both methods should be equally available to all of my patients."

On June 24, Attorney General Merrick Garland said that states can't ban the medications based on disagreement with the Food and Drug Administration's judgment on their safety and efficacy. President Joe Biden also said that his administration would protect access to the FDA-approved oral abortifacient medications, as well as to contraceptives.

Despite that, many states have banned or placed heavy restrictions on medication abortion. For example, Louisiana Gov. John Bel Edwards signed a bill into law that prohibits pregnant people getting the abortion pill through the mail. According to the bill, anyone who mails the abortion pill risks a $1,000 fine and up to six months in prison.

The abortion pill can safely terminate a pregnancy.

"Women in states that ban abortion will still be able to end unwanted pregnancies with abortion pills ordered online from overseas, though the legal situation is murky and carries potential risks,"CNBC reported in June.

Since the overturning of Roe, Biden has signed an executive orderaimed at making the abortion pill "as widely accessible as possible." On July 13, Politico reported that the Biden's administration has reminded thousands of US pharmacies that they risk breaking federal laws if they refuse to fill orders for contraception or abortion medication or discriminate based on a person's pregnancy status.

Here's what you need to know about medication abortion.

The abortion pill actually consists of two medicines, taken one after the other, that are used to terminate a pregnancy: mifepristone and misoprostol. According to Planned Parenthood, the pill is recommended for up to 11 weeks of pregnancy. After 11 weeks, the side effects of the pill, like cramping, nausea and chills, may be more intense.

"Data indicates that medication abortion can be used for abortions after 70 days gestational age," said Verma. "A different medication regimen may be used to increase the effectiveness of the process after nine weeks from the last menstrual period."

Once people obtain the medication, they take mifepristone first. This pill blocks the body's production of progesterone, a hormone required for a pregnancy to develop normally. Next, they take the second pill, misoprostol, up to 48 hours later. Misoprostol essentially induces the cervix and uterus to relax and expel the contents of the uterus.

After taking misoprostol, people may experience heavy cramping and bleeding, similar to a miscarriage. According to Planned Parenthood, if there's no bleeding within 24 hours of taking the second pill, people should call their nurse or doctor.

The abortion pill is actually two pills: mifepristone and misoprostol.

To ensure the medication worked, take a pregnancy test, or follow up with your doctor. According to the National Library of Medicine, the abortion pill is 99.6% effective at nine weeks of gestation or less.

"The current evidence shows that most people are able to safely and effectively manage their abortions using mifepristone and misoprostol when they acquire these medications from reliable sources," said Verma. "Medication abortion is an extremely safe medical intervention."

There are a number of ways to get the abortion pill. In states where abortion has been banned, it's possible to get the medication by using mail forwarding. Here are a few resources:

Planned ParenthoodYou can obtain the abortion pill at your nearest Planned Parenthood health center. Use the Find a Health Center locator on Planned Parenthood's website. Once you find a nearby clinic, you can call 1-800-230-PLAN or book an appointment online. The locator will let you know what services the clinic offers, what the hours are and information about insurance and payments.

Plan CPlan C is an information campaign with the goal of normalizing the self-directed option of the abortion pill by mail. Visit the website, click Find Abortion Pills and choose your state. Plan C will let you know if abortion is banned in your area, inform you of available services for accessing the pill by mail with clinician support, and give you information on prices, delivery time frames and more.

Many organizations can help you get the abortion pill discreetly and fast through the mail.

Abortion FinderYou can also find a nearby abortion provider through abortionfinder.org. As with Planned Parenthood, you'll need to input some information (which the site says is kept private and confidential), like your location, age range and the first day of your last period (it'll still work if you're unsure). Click Find a Provider to view a directory of verified providers in the US, as well as articles about abortion and a guide to abortion laws by state.

Abortion on DemandAbortion on Demand is an organization dedicated to delivering the abortion pill to people in need, quickly, easily and safely. Visit the website and click Schedule Visit. You'll be guided through a short questionnaire and set up a telehealth appointment with a doctor. If you meet Abortion on Demand's requirements, the service can overnight the abortion pills to you in discreet packaging along with medications to help with cramping and nausea. After you've taken the pills, the organization will check on you and offer follow-up doctor support.

According to Planned Parenthood, the medication costs about $750, but price varies based on your state, health center or applicable health insurance. You can find it several hundred dollars cheaper through some providers, like Aid Access, Abortion Telemedicine and Forward Midwifery.

According to Planned Parenthood, the abortion pill may be free or cheaper with health insurance, but some plans don't cover it. To find out for sure, you'll need to call your insurance provider.

If your insurance doesn't cover the pill, or you need more assistance, you can look into abortion fund organizations like the National Network of Abortion Funds. On NNAF's site, you can search your state to find a fund and see if it offers financial assistance. These funds can also help with child care, contraception, lodging, translators and more.

Plan B isn't the abortion pill.

Yes. Plan B, or the "morning after pill" is an emergency contraceptive designed to prevent pregnancy before it begins. Abortion pills are used to terminate an existing pregnancy. Plan B is most often used by people who forgot a dose of their daily birth control, for example, and recently had unprotected sex.

Plan B, or levonorgestrel, temporarily delays ovulation and prevents sperm from fertilizing an egg. The abortion pill blocks the progesterone hormone, which is produced when someone's already pregnant.

For more information, check out which states are banning abortion and what to know about the Supreme Court ruling.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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Can I Still Get the Abortion Pill? Everything to Know - CNET

The blue light wavelength mostly comes from sunlight, but it is also produced by artificiallight sourceslike those found on smartphones, as noted by WebMD. Past tests show that exposure to blue light, particularly later in the day when it's time to go to bed, can affect the quality of your sleep. According to the Sleep Foundation, blue light disrupts the release of melatonin, the hormone responsible for making you feel sleepy. While this is beneficial during the day when we are active, it's not a good thing when night falls and you need to get quality shut-eye.

After the sun goes down, blue light messes up the body's natural circadian rhythm, which can lead to health problems such as obesity, cancer, heart disease, and diabetes (via Harvard). Additionally, blue lights may put your eyesight at risk. Studies have found that out of all the lights in the spectrum, blue light carries the most energy and can cause eye damage if you are overexposed to it (via Nature).

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Why You Need To Stop Using Your Android Phone Before Going To Sleep - SlashGear

The debateabout treatments for transgender young people has been reignited by the closure of a controversial NHS clinic that prescribedpuberty blockers to children.

TheTavistock clinic, in north London, has beenaccused of rushing teenagers into life-altering treatment on hormone-blocking drugs, The Timesreported. An independent review led by senior paediatrician Dr Hilary Cass was also highly critical of the Tavistocks Gender Identity Development Service, which is to be wound down by next spring.

The closure means the UK will no longer have a dedicated gender identity clinic for under-18s, but new regional centres will be set up to ensure the holistic needsof vulnerable young patients are fully met, according to the NHS England.

The clinic is being shut down after review chief Cass, a former president of the Royal College of Paediatrics and Child Health,concluded in a recently published report that the Gender Identity Development Service (GIDS) wasnot a safe or viable long-term option.

NHS England commissioned the reviewin September 2020 in response to a complex and diverse range of issues including a significant and sharp rise in referrals. In the decade from 2011, referrals to the Tavistock rose from 250 to 5,000.

Other issues included scarce and inconclusive evidence to support clinical decision; concerns about a significant number of childrenpresenting with neurodiversity and other mental health needs and risky behaviours;long waiting times for assessments; and significant external scrutiny of the service, said NHS England.

Cassfoundthat the current model of care was leaving young peopleat considerable risk of poor mental health and distress.According to her review, therewere critically important unanswered questions over the clinics use of puberty blockers, which have been prescribed to children as young as ten, anduncertainties about the long-term outcome of medical intervention.

The damning extent of the Tavistocks failingshad already beenmade clear inthe Interim Cass reportin February, said Nikki Da Costa in The Telegraph.

These failings included lack of open discussion among clinicians; pressure to adopt an unquestioning approach; failure to consider whether medical transition really is the best option; overlooking childrens complex needs; limited mental health assessments; failure to identify children who may be vulnerable and at risk; and failure to follow up after treatment, Da Costa continued. This would matter if it affected only a handful of children let alone thousands. It is horrific.

Legal experts are now warning that the Tavistock and Portman NHSTrust could besued by patients who felt they did not receive the right treatment.

The Tavistock clinic led the way in prescribing puberty-blocking drugs to children and young people, said The Times. In 2011, the clinic began a trial of puberty blockers including Lupron, a drug used off label to reducethe production of sex hormones.

According to the paper, there has been barely any research into the drugs, including long-term side effects such as infertility.

In her review, Cass said there was a lack of clarity over whether the drugssimply pause puberty or act as an initial part of a transition pathway. She also warned that brain development may be temporarily or permanently disrupted by puberty-blockers.

The closure of the clinic representsa victory for those who say self-proclaimed gender identity should not trump biological sex, saidThe Economist.

The tide in Britain appears to be turning against groups who espouse the belief that gender identity trumps all else, and towards maintaining support for sex-based rights and evidence-based medicine, the paper continued. Critics argue that the next step is tounderstand why so many children with mental health problems are identifying as trans.

With the Cass review,the tide turned on an ideology that has ruined lives, saidThe TelegraphsDa Costa, who served as director of legislative affairs for both Boris Johnson and Theresa May. Coupled with warnings about the use of puberty blockers, it should slow the rush to medicalise young people.

However, tthe BBCs social affairs editor Alison Holtwarned that the Tavistock closure would be a source of worry for other young people wanting support with gender dysphoria.

The hope is the services that replace it will be more helpful, useful and efficient, said Holt.

NHS England has acceptedrecommendations by Cassto establish two new clinics for children with gender dysphoria by spring of next year. One of these clinics will be at Great Ormond Street Hospital in London, and the other will be a partnership between Alder Hey Childrens NHS Foundation Trust in Liverpool and the Royal Manchester Childrens Hospital.

Children being considered for hormone treatment will enter into formal clinical trials and followed until adulthood to assess long-term outcomes, The Times reported. And afurther six or seven similar services could be opened in other parts of the country.

But that may come as little comfort to thethousands of young people and their families currentlyawaiting treatment, saidThe Guardian.Many report having to go private in order to access timely treatment, according to the paper.

And with waiting lists remaining painfully long, it is unlikely the impact of the new hubs will be felt for some time.

Continued here:
What the Tavistock clinics closure means for the trans debate - The Week UK

The aviation regulator Directorate General of Civil Aviation (DGCA) is working on a poliy for transgender pilots, according to a report.

The Indian Express on Monday reported that the policy the DGCA is working on would be in line with norms and regulations laid down by the US Federal Aviation Administration (FAA).

The report comes after DGCA declined Adam Harry, a transgender pilot, his flying licence on grounds of gender dysphoria and hormone replacement therapy. Harry, enrolled in a flying school, would have been the first Indian trans pilot.

Here we explain Harry's case, what the DGCA and Civil Aviation Ministry said on the subject, and what we know about the policy DGCA is working on.

Adam Harry was certified female at birth. He underwent surgery in 2021 and began his hormonal therapy in 2018.

The Economic Times reported that he underwent extensive medical examination and was also asked "several uncomfortable transphobic questions". Eventually, as stated above, he was declared unfit to fly because of gender dysphoria and hormone replacement therapy.

Gender dysphoria is the feeling of discomfort or distress that might occur in people whose gender identity differs from their sex assigned at birth or sex-related physical characteristics, according to Mayo Clinic. The DGCA declared Haryy unfit citing this condition as such a condition "could lead to depression and anxiety that can further disrupt the persons life and have negative impact on their daily life", reported The Economic Times.

Moreover, the paper cited DGCA telling Harry to undergo tests once the therapy is complete. But that's not possible as trans people need hormone therapy throughout their life.

Harry told The New Indian Express that he would be certified to fly anywhere outside India.

He further said, "The only difference is that I take additional supplements for testosterone which a male body produces naturally by birth. The DGCA must study the guidelines in other foreign countries which offer flying licences to the third gender and revise the criteria to certify pilots in India."

Harry has filed a writ petition in the Kerala High Court against DGCA.

Members of Parliament Priyanka Chaturvedi and AA Rahim raised the case of trans pilots in Rajya Sabha.

In a question to Ministry of Civil Aviation, available on Rajya Sabha website, Chaturvedi and Rahim asked:

Whether the DGCA as a policy does not provide pilot license to transpersons;

(b) if so, the reasons for the same;(c) whether the medical tests for issuing license do not recognise transpersons;(d) if so, the reasons for the same;(e) whether transpersons undergoing hormone therapy are denied medicalclearance; and(f) if so, the scientific and medical basis on which this is done?

In the answer their questions, MoS Aviation General (Retired) VK Singh replied that "there are no restrictions for a transpersons to obtain a pilot license from DGCA". The answer further stated that hormone therapy is not criteria to disallow anyone from flying.

Singh's reply stated, "Use of hormonal replacement therapy is not a disqualifying criteria if the applicant has no adverse symptoms or reactions."

However, there is one condition. The minister's reply stated, "However, flying duties are not permitted while the dose of hormonal treatment is being stabilized or until an adequate physiological response has been achieved and the dose no longer needs to be changed."

It added that the norms stated in the reply are in line with Federal Aviation Administration (FAA) and European Union Aviation Safety Agency (EASA).

The policy that the DGCA is working on is in very early stage at the moment.

The Indian Express quoted a senior government official as saying, "Currently, there are no restrictions for any trans person to get a pilot licence as long as they comply with the various provisions that include age, medical fitness, knowledge, experience, etc. However, there is no stated policy and that is something the DGCA is working on."

As stated above, the DGCA policy in the making is based on US FAA's norms and regulations. The FAA amended its rules in 2016, allowing a smoother certification process of trans pilots.

The US-based National LGBTQ Task Force highlighted the difference between pre-2016 and post-2016 rules in the United States.

"Transgender pilots were previously required to take an extraordinary battery of psychological tests including memory, personality, projective and intelligence tests among others. Transgender pilots were frequently grounded or lost their jobs due to the burdensome process," noted the Task Force.

It explained the changes: "Trans pilots must still receive medical certification like other pilots but will only be required to submit current clinical records with an evaluation from a psychiatrist or psychologist and reports on any surgery."

See the original post:
India's First Trans Trainee Pilot Adam Harry's Case That Led DGCA To Work On Policy For Trans Pilots - Outlook India

Most of the time, weight gain is the result of diet and lifestyle. However, there are medical condition that can cause you to gain weight.

When youre struggling to lose weight, the reasons are usually clear: youre eating too much, choosing the wrong foods, and/or not exercising enough. But what if you feel like youre doing everything right and the pounds still wont budge? What if, in fact, youre continuing to gain weight?

It may be time to look beyond diet and exercise for the root cause of your problem. Many medical conditions can make weight loss nearly impossible, some of them quite serious. If youre experiencing unexplained weight gain, make an appointment with your doctor to take a closer look at whats going on.

According to the Cleveland Clinic, leptin is an appetite-suppressing hormone that helps regulate hunger and weight. Its directly related to how much body fat you have; the more fat youre storing, the more leptin is in your bloodstream, sending signals to modify your appetite so your caloric expenditure and intake match up. People who have leptin resistance arent getting those helpful signals and thus still feel the need to overeat even as the pounds creep up.

Medical News Today reports that problems with your kidneys can also cause you to gain weight, even though they also cause loss of appetite. Kidneys that arent functioning properly arent able to rid your body of fluid and waste, which then build up in the bodys tissues. If this is happening to you, youll notice swelling primarily in your legs, ankles, and feet. You may also be urinating less frequently and when you do, your urine might appear frothy.

People suffering from polycystic ovarian syndrome may notice unexplained weight gain around their middle region. This condition is believed to be caused by an excess of the male hormone androgen and low-grade inflammation, according to the Mayo Clinic, and can also result in acne, unusual hair growth on the back, chest, and face, male pattern baldness, and cysts on the ovaries. Although there isnt a cure for this condition, it can be managed with lifestyle changes and hormone therapy.

Depression can cause a cascade of symptoms that directly impact your weight. Depression is linked with the stress hormone cortisol, says WebMD, which can make excess weight gather around your stomach. People with depression frequently suffer from sleep problems and low energy and may turn to food or substances for relief, all of which can cause weight gain. Even medication to alleviate depression can cause weight gain, although some options dont have that side effect.

The thyroid is an endocrine gland in the neck that regulates many of the bodys automatic functions, including metabolism, body temperature, and heart rhythm. Hypothyroidism occurs when the activities of the thyroid slow down, causing weight gain, fatigue, dry skin, and the sensation of being cold. According to the American Thyroid Association (thyroid.org), hypothyroidism can be diagnosed with blood tests and, if detected, successfully managed through medication.

According to the American Heart Association, rapid weight gain is one of the leading signs of heart failure. While everyone experiences mild weight fluctuations on a daily basis, a sudden weight gain of over 2 pounds in a day or 5 pounds in a week could be a sign that your heart is in trouble. Heart failure occurs when your heart cant pump blood efficiently. Other symptoms include dizziness, chest pains, irregular heartbeat, difficulty breathing, and swelling in your ankles, legs, and feet. Get medical help immediately if youre experiencing these symptoms.

Getting your weight under control is a good goal. But when you arent seeing any progress, its time to talk to your doctor to rule out underlying causes.

Read this article:
6 Medical Conditions That Can Cause You to Gain Weight - SciTechDaily

Robyn Edie/Stuff

Dr David Sar Shalom, of the Invercargill Medical Centre, says new guidelines for accessing gender-affirming healthcare will remove the demeaning barrier for transgender patients to see a psychologist before starting hormones. [file photo]

Gender diverse people will no longer have to see a psychologist before being able to access hormone treatment in Southland.

Invercargill Medical Centre Dr David Sar Shalom said the first southern-specific pathway to accessing gender-affirming hormones went live in April.

Prior to the introduction of the pathway, Sar Shalom said patients were facing waits of up to two years to access gender-affirming hormone treatment.

The delay was because adults seeking access to hormone therapy in the Southern DHB were required to be assessed by a psychiatrist or psychologist before being seen by an endocrinologist, despite the fact being gender diverse is not a recognised mental illness.

READ MORE:* Pop-up Wellington vaccination clinic takes steps to not misgender or deadname rainbow patients* Call for more research into use of puberty blockers* Coronavirus: Trans New Zealanders unable to get gender-affirming healthcare* Kiwi transgender and non-binary people at higher risk of suicide - survey* Rainbow Youth welcome Government funding for gender affirming surgery

This meant there was often a six to eight month wait to see a psychologist to provide a referral, and then a further six to eight months wait for endocrinology, he said.

Gender-affirming hormone treatment is the process of using hormones to alter a persons physical appearance to more closely align with their gender identity, and includes the prescription of estrogens, testosterone blockers and testosterone.

In its study of gender-affirming healthcare in Aotearoa New Zealand last year, the Professional Association for Transgender Health Aeotoroa (PATHA) found marked differences between each DHBs pathway to accessing hormones.

In some DHBs, including Southern, there were requirements for psychologist referrals to access endocrinologists whereas in other areas, such as Canterbury, gender-affirming hormone treatment was led by GPs, with studies showed this reduced stress amongst patients.

It was this Canterbury model which had been loosely adapted for Southland, Sar Shalom said.

The change in requirements for psychological assessment only impacts adults looking to receive gender-affirming hormones, and does not cover gender-affirming surgery or children looking to access hormones.

He pointed out that psychological assessment before hormone prescription was not common in other areas, such as when the contraceptive pill is prescribed, with the change reducing stigma for the gender diverse community.

Now we have these very clear guidelines that you dont need to have a psychologist assessment to access these gender-affirming hormones ... being gender diverse is not a mental illness, so to require psychological assessment is quite demeaning.

Kavinda Herath/Stuff

Number 10 director Jude Crump says her North Island colleagues were shocked to hear of the wait times required in the Southern DHB to access gender-affirming hormones. [File photo]

Number 10 director Jude Crump said wait times to see psychologists in order to access gender-affirming hormone therapy had been one of the biggest issues being seen by the centre.

According to the New Zealand College of Clinical Psychologists website, there are three psychologists specialising in transgender, sex and gender diverse services in Dunedin, and none in Invercargill.

As a result, patients had been spending long periods on wait lists, with many younger patients struggling with fuel costs and time spent travelling to Dunedin.

I dont know how much longer it is but colleagues in the North Island that hear how long our wait times are, were shocked, she said.

There had been an increase in the amount of gender diverse people seeking to access to hormones, she said, which was likely due to more information and acceptance around the rainbow community.

Sar Shalom encouraged patients to be aware of the guideline changes in order to advocate for their rights.

Its a work in progress ... but theres a clear pathway now, for any GP practise to follow.

See the article here:
Guideline change removes 'demeaning' barrier to hormone therapy - Stuff

MONTREAL Long-acting, injectable cabotegravir (CAB LA) continues to show superiority over oral daily tenofovir diphosphate plus emtricitabine (TDF-FTC) as preexposure prophylaxis (PrEP) for HIV, according to new data from two HIV Prevention Trials Network (HPTN) studies reported here at the International AIDS Society (IAS) Conference 2022.

Follow-up data from the HPTN 084 trial, which compared the two regimens in 3224 sub-Saharan persons who were assigned female sex at birth, show that three new HIV infections occurred in the CAB LA group in the 12 months since the study was unblinded, vs 20 new infections among the TDF-FTC group. That translates to an 89% lower risk of infection in the CAB LA arm across both the blinded and unblinded phases of the trial, said lead investigator Sinead Delany-Moretlwe, MD, PhD, director of research, Wits Reproductive Health and HIV Institute, the University of the Witwatersrand, in Johannesburg, South Africa, during a press conference.

"The trial was designed with the assumption that both drugs were highly effective in preventing HIV infection but that, given the challenges with taking a pill a day, that injectable cabotegravir may offer an adherence advantage," she told Medscape Medical News. "Our data appear to confirm this, as most of the participants in the TDF-FTC arm who became infected with HIV had evidence of poor or inconsistent use of PrEP."

The study also found that pregnancy incidence increased "two- to threefold" between the blinded and the unblinded period, "and this emphasizes to us the desire of women to conceive safely, without the threat of HIV, and the importance of us continuing to evaluate the safety and pharmacology of cabotegravir in pregnant and breastfeeding women during open-label extension phase of HPTN 084, so that [they] are not excluded from access to this highly effective PrEP agent," she said. To date, no congenital anomalies have been reported in babies born during the study.

In an update report from HPTN 083, which also showed superiority of CAB LA over TDF-FTC in cisgender men and transgender women (TGW), researchers reported the safety and efficacy of CAB LA use in TGW using gender-affirming hormone therapy (GAHT).

Among the 4566 participants in HPTN 083, 570 were TGW, and of those, 58% used GAHT at baseline, reported Beatriz Grinsztejn, MD, PhD, head of the STD/AIDS Clinical Research Laboratory at the Instituto Nacional de Infectologicia/Fundao Oswaldo Cruz.

CAB LA drug concentrations measured in a subset of 53 TGW who received on-time CAB injections were comparable between those taking (n = 30) and those not taking GAHT (n = 23), "suggesting the lack of a gender-affirming hormone effect on CAB pharmacokinetics," she said. "These are very promising results, as we all know that the use of gender-affirming hormone therapy is a major priority for our transgender women community, and so the lack of drug-drug interaction is really a very important result."

"Cabotegravir long-acting PrEP is now approved for all at-risk populations, including men who have sex with men, transgender women, and cisgender women, after the results of HPTN 083 and 084," commented Monica Gandhi, MD, MPH, an infectious disease doctor, professor of medicine, and associate chief in the Division of HIV, Infectious Diseases, and Global Medicine at the University of California, San Francisco (UCSF).

Gandhi, who was not involved in either study, is also director of the UCSF Center for AIDS Research and medical director of the HIV Clinic ("Ward 86") at San Francisco General Hospital. "The incredible efficacy of long-acting PrEP for cisgender women shown by HPTN 084 is game-changing for our practice, and we have already instituted CAB LA across a range of populations at Ward 86," she told Medscape. "The durability of the 89% additional efficacy of CAB LA over oral TDF/FTC is thrilling and will lead to a greater use of long-acting options."

She acknowledged that information on potential interactions of GAHT was needed from the HPTN 083 trial. "That cabotegravir levels did not change with the use of estradiol or spironolactone for gender-affirming therapy is important news for our practice and to reassure our TGW that they can safely and effectively use CAB LA for HIV prevention."

The HPTN 084 and 083 trials were funded by the National Institutes for Allergy and Infectious Diseases. Delany-Moretlwe, Grinsztejn, and Gandhi have disclosed no relevant financial relationships.

International AIDS Society (IAS) Conference 2022: Abstracts 13063 and 12707. Presented July 28, 2022 (to the press).

Kate Johnson is a Montreal-based freelance medical journalist who has been writing for more than 30 years about all areas of medicine.

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube.

More:
Injectable HIV Prevention Better Than Pills in Two Trials - Medscape

Have you ever had a moment that made you think, hmm... maybe my body is trying to tell me something? Maybe it was a headache telling you to drink more water, or maybe it was your low energy level after a workout telling you to grab a carb-heavy snack. For me, it was when my normally mild periods suddenly became unbearably painful.

What was my body trying to tell me? At the time, I had no idea. It was a few months into the pandemic, and despite the onslaught of bad news making headlines, I felt like I was handling everything surprisingly well (spoiler: I actually wasn't).

I knew my period symptoms meant something was probably off with my hormones, so I decided to take a hormone test to give me a better idea of what was going on in my body. All that stress I thought I was taking in stride? I was actually internalizing it, and it was skyrocketing my cortisol and DHEA levels, two of the body's major stress hormones.

"Having both cortisol and DHEA high is the perfect storm to throw both progesterone and estrogen out of whack," says Amanda Frick, ND, executive director of medical affairs at Thorne. "Your body needs progesterone to create cortisol. If your cortisol level is high, then...essentially your body is 'stealing' progesterone to keep up with the high cortisol output. A low level of progesterone...can cause common premenstrual mood fluctuations, breast tenderness, and irritability, as well as making your periods heavier, longer, and more painful."

Mystery, solved. But here's where the story gets interesting: The dietitian I was working with recommended I start taking a lineup of supplements to support my stress levels (in addition to a few lifestyle changes to help me decompress), and it all actually worked. Among her recs were Thorne's Basic Prenatal as my baseline multivitamin, plus vitamin B6, magnesium, ashwagandha, and several other nutrients.

How did I know it worked? Because less than a year after starting my supplement regimen, I checked in on my levels with Thorne's at-home Stress Test, and both my DHEA and cortisol were back in normal range. And those period cramps that had left me curled up in bed? Reduced to mild discomfort, only for the first few hours of my period.

I've always been a huge proponent of listening to your body and advocating for yourself (and your health) until you find solutions that make you feel more like you. And after my experience with using home testing to find the answers I was searching for, I love that Thorne is making that process more accessible to more people with its lineup of 13 different health testsall of them designed to provide a personalized, science-backed approach to health and wellness.

Want to try one out yourself, or just curious how it works? Keep reading for all the details on how an at-home health test might be able to help you achieve your wellness goals.

Depending on which test you take (Thorne has options ranging from gut health to sleep to fertility), you'll collect your samples in a variety of ways. For the stress test, all I had to do was spit into the provided collection tubes four times throughout the day, package them up in the pre-addressed mailer, and drop them off at the post office.

In about a week, my results were posted to my account. They came with easy-to-understand explanations of the science-y stuff, and an extensive list of recommendations (which is part of what makes Thorne unique from other at-home health test options) for managing my stress through my diet, daily activities, and of course, supplements. "You get the information you want about your health status without being left saying, now what?" Dr. Frick says.

Although the main benefit of testing is collecting data and finding answers to your health questions, Thorne's method offers some major benefits. First, Thorne provides tests that might not be offered at a traditional doctor's office, and many of them allow you to skip the physical trip to the doc altogether with convenient at-home health test options.

Second, while $150+ is certainly an investment, it's much more affordable than many other testing options. (For me, it was a worthwhile exchange when I considered how much I'd be willing to spend to put an end to the intensity of my period cramps.)

Finally, the supplement recs are legit. Thorne has staked its reputation on quality (supplements are tested four times for purity and potency), and Thorne is the only supplement manufacturer that collaborates with Mayo Clinic on wellness research. And when you get individualized recommendations for supplements that really work based on your actual health data, as Dr. Frick says, "that can make a huge difference in your path forward." A path with more self empowerment and less period problems, in my case? That's one worth following.

*These statements have not been evaluated by the Food and Drug Administration. This product is not intended to diagnose, treat, cure, or prevent any disease.

Excerpt from:
I Tested My Stress and It Was Through the RoofHeres the Expert-Backed Plan Thats Getting Me Through It - Well+Good

Crows feet, also known as wrinkles and fine lines, are a part of the gradual changes that your skin experiences as you become older. Being carefree about skincare becomes a thing of the past, and learning how to get rid of wrinkles and get our glow back can become important.

The lack of antioxidants and elasticity is the main reason why crows feet appear on the face. The good news is that you can get these nutrients with several home remedies.

Health Shots got in touch with Dr Nivedita Dadu, renowned dermatologist, founder, and chairman of Dr Nivedita Dadus Dermatology Clinic, who listed some of the best home remedies that can help you treat wrinkles and fine lines.

Dr Dadu says, Crows feet are known as laugh lines, which are a common sign of ageing. As we age, our skin loses elasticity, resulting in crows feet, lines, and wrinkles. To prevent crows feet, you need to take proper care of your skin and make sure its getting the essential vitamins and nutrients to stay healthy, hydrated, and firm.

Milk can be used to reduce the appearance of wrinkles around the eyes. It contains glycolic acid that helps exfoliate dead skin cells while promoting the production of collagen in the skin. But always make sure to use organic, hormone-free milk.

This healing plant hydrates skin, which will soften the appearance of fine lines around the eyes. It is loaded with antioxidants and increases collagen production when taken in dietary form. Aloe vera helps in the improvement of facial wrinkles. It has a photo-protective effect on the skin. It can help to reduce the appearance of crows feet and wrinkles.

Also, read: Troubled by fine lines and wrinkles on your face? Try these 5 Ayurveda tips for a youthful glow

When the skin ages, it loses its elasticity and thus becomes saggy. Applying egg whites on the face helps in tightening the skin. It also helps to treat crows feet over time. The protein present in egg whites aids skin cells and tissue repair. It also stimulates new skin cell growth to enhance beauty. It helps in tightening the skin pores and reduces the appearance of wrinkles and crows feet. Its antioxidant activity also helps to fight free radical damage.

The topical application of coconut oil helps to boost collagen production in the skin. It can also keep the skin moisturized. It delays the appearance of wrinkles and crows feet. This moisturizes the skin and can also aid crows feet.

Avocados are rich in monounsaturated fatty acids that help to revitalize dry skin. The high vitamin D and E content in avocados also stimulate the production of collagen, which reduces the appearance of crows feet. It contains healthy fats that allow skin revitalization. Avocados make the skin look youthful and flawless.

Also, read: Combat lines and wrinkles in your 30s with this 6-step nighttime skincare routine

Lemon juice is rich in citric acid, which helps get rid of the crows feet by acting as an exfoliant. The natural astringent properties of lemon juice can also help reduce blemishes and make skin softer. Lemon is a powerhouse of vitamin C and antioxidants. If you have sensitive skin, avoid applying lemon juice directly to the skin. Instead, mix it with papaya or avocado and mask the face.

Cucumbers contain thiamine, riboflavin, and niacin, along with vitamins B5 and B6, which help nourish the skin. The soothing properties of cucumbers can also help reduce the appearance of wrinkles around the eyes. This comes to the rescue in cases of heat waves and rashes, cooling down the skin.

1. Eat and drink right: Try to include healthy foods and fruit into your daily diet such as vitamin C rich foods, and green vegetables. Try to avoid foods rich in fat and carbohydrates.

2. Oil massage: Contrary to popular belief, massaging your face with oil is actually beneficial. On a regular basis, try to give a face massage for 5 to 10 minutes with almond or castor oil.

3. Dont forget to exfoliate: Exfoliation is essential for your skin. So, exfoliate twice a week with a mild scrub.

4. Wear sunscreen: Not applying sunscreen can increase wrinkles and fine lines on your face. So, apply sunscreen with SPF 30 on a daily basis.

5. Stay hydrated: It is important that you stay hydrated if you want to prevent premature ageing. So, drink 7-8 glasses of water every day.

View original post here:
7 home remedies for crows feet to keep wrinkles and fine lines at bay - Health shots

The World Health Organization recommends two regimens for medication abortion: misoprostol alone or combined with another medication, mifepristone. (Robyn Beck / AFP via Getty Images)

The Supreme Courts overturning of Roe v. Wade has paved the way for more than half of U.S. states to outlaw abortion. As we look to the future of abortion in the U.S., we can learn from the experiences of people in countries with restrictive abortion laws who have managed to find safe, effective ways to have abortions by using the original abortion pill: misoprostol.

In the 1980s, Brazilians discovered that an ulcer medication, misoprostol, could induce a miscarriage by causing contractions of the uterus to expel a pregnancy. Across Latin America, women and other people who can become pregnant began to use misoprostol to manage their own abortions. Infection, hemorrhaging and death from unsafe abortion declined precipitously.

The World Health Organization recommends two regimens for medication abortion: misoprostol alone or combined with another medication, mifepristone, which blocks the hormone progesterone to end a pregnancy. Today, in countries where abortion is legally available, misoprostol is most commonly used together with mifepristone. But where abortion is legally restricted, misoprostol is often used alone for self-managed abortion because it is inexpensive and widely available, often over the counter (unlike mifepristone).

Around the globe, grassroots feminists have organized abortion support such as safe-abortion hotlines for those who are self-managing abortions, often with misoprostol alone. Study after study has found that self-managed abortion with misoprostol is more than 90 percent effective.

Why, then, are most clinic-based abortions performed using misoprostol in combination with mifepristone? For one, early clinical trials showed that misoprostol was less effective alone than in combination with mifepristonebut recent evidence on self-managed use of misoprostol alone suggests otherwise.

Differences in patients experiences using the two regimens may also be a contributing factor. The side effects from misoprostol can include nausea, fever, chills, vomiting and diarrhea. Because the misoprostol-alone regimen calls for multiple doses of misoprostol (as opposed to one if combined with mifepristone), those who use this regimen may experience these side effects more frequently and/or with more severity.

Women and other people who can become pregnant should have access to the method of abortion care that works best for them, but in many settings, including here in the U.S., barriers to abortion may mean that clinic-based medication abortion with mifepristone is not accessible or even preferable. Studies have shown that regardless of the regimen, patients can have positive abortion experiences when they have access to the information they need, feel prepared for what they will experience and are supported through the process.

So what does this mean for the future of abortion in the U.S.? While mifepristone is expensive and unnecessarily restricted by the U.S. Food and Drug Administration, misoprostol is inexpensive and widely available by prescription for different indications in pharmacies across the country.

Plan C, SASS (Self-Managed Abortion; Safe and Supported) and Reprocare provide information about where and how to get abortion pills in the U.S. The Miscarriage and Abortion Hotline offers free, compassionate and confidential medical support for anyone who would like to speak to a trained medical professional when self-managing an abortion. Organizations such as Las Libres, which has supported self-managed abortion in Mexico, are now providing misoprostol pills, information and support to those in the U.S.

Under abortion bans and restrictions, police and prosecutors are most likely to target people who are already criminalized and surveilled, including those who are low income, Black/Indigenous/of color, immigrant and undocumented. For information and support with legal questions about self-managed abortion, contact the Repro Legal Helpline, or access bail and legal counsel through the Repro Legal Defense Fund. The Digital Defense Fund offers detailed information about how to protect ones identity when searching for abortion pill information and purchasing medications online.

For decades, women living in countries where abortion is restricted have self-managed their abortions in a safe, affordable way using misoprostol alone. In light of Dobbs, many in the U.S. will no doubt follow their lead. And feminists will be there to support them when they do.

This article originally appears in the Summer 2022 issue ofMs.Become a member today to read more reporting like this in print and through our app.

Up next:

See the original post here:
Lets Talk About Misoprostolthe Original Abortion Pill - Ms. Magazine

Pets are good for your heart metaphorically and literally. When feeling stressed, people with pets have lower blood pressure than those without them. According to data collected from astudy(via Psychosomatic Medicine), not only did pet people have a lower blood pressure, but they also had a decreased base heart rate, in addition to a faster recovery time after a stressful situation. In fact, a different study found that people with hypertension had remarkably lower blood pressure within just five months of adopting a dog (via HelpGuide).

Chronically high blood pressure can lead to blood vessel damage, which results in clogged arteries, making your circulatory system work harder and become less effective. Over time, this leaves you more vulnerable to life-altering and life-threatening health concerns (especially if left untreated), including heart attacks, stroke, heart failure, kidney disease, vision loss, sexual dysfunction, angina, and peripheral artery disease (PAD). According to the American Heart Association, "your best protection is knowledge, management, and prevention" and getting a pet could help, too.

The rest is here:
The Real Effects Owning A Pet Has On Your Body - Health Digest

For more information about your reproductive health rights and related federal resources, you can visit the US government's Reproductive Rights site.

In response to the US Supreme Court overturning Roe v. Wade, many people have taken to social media to encourage users to delete their period-tracking apps, citingdigital privacy risks.

Period-tracking apps are a helpful way for people who menstruate to track their cycles. And they might do that for a number of reasons. Folks monitor their cycle in order to get pregnant, to avoid getting pregnant, to keep tabs on symptoms of medical conditions like polycystic ovarian syndrome or endometriosis, or just to be able to tell their doctor the first day of their last period when asked.

The downside of these apps is that they hold on to a lot of personal health information that could be used against the folks using the software. Data privacy concerns about period-tracking apps aren't anything new, but now the consequences of a leak of your private period data are higher, in an already highly surveilled post-Roe world.

If you still want to track your period but want to avoid apps, what are your options? If you don't want to ditch apps altogether, there are more privacy-friendly period tracking apps, like Euki. The sexual health app says it doesn't collect or store any of your data in a cloud.

The other option is to track your menstrual cycle with pen and paper. It might feel old-fashioned, but it's the most secure method. Here's how to monitor your cycle by hand:

Any type of calendar will do. You can even buy a blank notebook and draw out your own calendar. I prefer a full-size notebook planner that's blank, so I can manually fill in the days and months. A larger planner also gives you more space to write extra notes like symptoms and birth control information.

Once you have a calendar, you can log your current cycle or add previous cycle information for a more detailed record.

If you want to use your phone, your device's default calendar app offers the most privacy versus a third-party calendar app. On the other hand, depending on how much you use your phone's calendar app, adding cycle tracking information might make things a bit cluttered.

Before I deleted my period-tracking app, I took screenshots of as much past data as I could, like cycle trend overviews and past months I'd logged. This gave me a more stable place to start when I began tracking by hand.

If you don't have that information available, don't worry, you can simply start logging when your upcoming period begins.

You can keep your calendar as basic or as detailed as you like, but more information can be helpful to learn more about your personal health, as well as provide talking points for you and your doctor at wellness checkups.

Here are a few things that are useful to note:

BleedingOf course, you'll want to mark the first day of your period, but you'll also want to mark each day that you bleed. In addition, try to note how heavy your flow is each day, what color the blood is and if you notice any clots.

According to the Mayo Clinic, average menstrual bleeding lasts between two to seven days, so tracking how many days you typically bleed is important. This extra detail can help you understand what to expect every month, as well as detect abnormalities that you can share with your physician. From the first day of one period to the first day of your next period is one menstrual cycle. Cycles can vary from person to person, but on averagea cycle can last between 21 and 40 days.

Emotional symptomsA lot happens to your hormones every cycle, which can have an impact on your moods. According to the UNC School of Medicine, a person can experience irritability, depression, anxiety and mood swings. These emotional shifts can also happen before your period, which can be used as an indicator that the new cycle is about to begin. This is most commonly referred to as Premenstrual Syndrome, or PMS. Some people experience more severe emotional disturbances known as Premenstrual Dysphoric Disorder, or PMDD.

It can be helpful to rank your feelings on a scale of 1-10 to more easily spot patterns, as well as inconsistencies.

If you experience premenstrual syndrome, or PMS, make a note of what you feel and the severity in your calendar.

Physical symptomsYour cycle also affects your physical well-being in addition to your mood. These happenings are also important to write down. According to WebMD, hormone changes can cause physical symptoms like cramping, breast tenderness, acne breakouts, bloating, lower back pain, constipation or diarrhea, and more.

Again, keeping track of your physical symptoms and ranking the severity on a scale can help you better understand what's normal for you and what's not.

MedicationWhether it's prescribed, over-the-counter or birth control, it's useful to note in your log any medication you take. Medication (or missing a dose of medication) can impact your cycle, as well as your physical and emotional state.

If you take a birth control regimen designed to prevent your period for a time, it's still important to watch for bleeding and spotting. If you miss a dose of birth control, it's also worth writing down. In addition, using medications like Plan B or the abortion pill would also be important to include in your log.

Whether you're trying to get pregnant or not, keeping track of when you ovulate can make a big difference. Most drug stores sell ovulation tests to help you find out.

OvulationIn a menstrual cycle, ovulation is when an egg is released from the ovary, travels down the fallopian tube and remains for up to 24 hours for potential fertilization. According to the Mayo Clinic, in an average 28-day cycle, ovulation can occur 14 days before your next period, or six to seven days after your current period ends. This can vary, however.

Ovulation can be marked by a slight rise in the basal body temperature, changes to cervical mucus or vaginal discharge, as well as breast tenderness, bloating, light cramping and more. If you're unsure, you can also purchase at-home ovulation kits from the store. These kits are designed to detect hormone surges. If you get a positive test, ovulation should occur about 36 hours after. Your ovulation window is generally your highest chance of conception.

Sexual activityIn addition to monitoring your ovulation, tracking your sexual activity can help you plan for a pregnancy, or better avoid one. In addition, you can note whether sex was protected, as well as your last screening results for sexually transmitted diseases. Knowing when you're ovulating can also help with planning sexual activity.

Your calendar or log will be unique to you -- your lifestyle, eating habits, stress levels, cycle length, medication and more. Remember, it's about what works best for you.

Here's an example calendar based on an average 28-day cycle:

This is an example of cycling tracking based on a 28-day cycle.

The information contained in this article is for educational and informational purposes only and is not intended as health or medical advice. Always consult a physician or other qualified health provider regarding any questions you may have about a medical condition or health objectives.

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This Period-Tracking Method Will Protect Your Privacy Better Than an App - CNET

This exploratory, cross-sectional, analytical casecontrol study was approved by the Ethics Committee of the Cancer Institute of the State of So Paulo (project number 1035/2016) and by the Ethics Committee for Analysis of Research Projects at the Hospital das Clnicas of the USP Medical School (CAPPesq). Potential subjects were informed about the study at the time of a scheduled appointment, and if they agreed to participate and satisfied the inclusion and exclusion criteria, they provided written informed consent. All methods were performed in accordance with the relevant guidelines and regulations and were consistent with the Declaration of Helsinki.

Patient selection occurred between September 2017 and December 2018. During this period, all patients diagnosed with breast cancer who were seen at the First Consultation Clinic of the Cancer Institute of the State of So Paulo and who satisfied the inclusion criteria were invited to participate. Patients initially referred to the General Didactic Outpatient Clinic at the Mastology section at the Hospital das Clnicas of the USP Medical School because of abnormalities observed on a mammogram performed elsewhere, and who subsequently underwent a second mammogram with negative results at our center, and who met the inclusion criteria, were recruited for the control group.

The inclusion criteria of the breast cancer group were a histological diagnosis of breast cancer, no previous treatment for breast cancer, age between 25 and 75years, the absence of signs or symptoms of other neoplasias and no previous history of other neoplasms. The exclusion criteria of the breast cancer group were the presence of noncarcinoma breast neoplasia, such as sarcoma or phyllodes tumor, and the presence of other comorbidities, such as nephropathies, liver disease, heart disease, hematopathologies, immunological diseases or other neoplasms. The inclusion criteria for the control group were women between 25 and 75years of age, the absence of current signs or symptoms of other neoplasms and no previous history of neoplasms. The exclusion criteria for the control group were the presence of any neoplasia and the presence of other comorbidities, such as kidney disease, liver disease, heart disease, hematopathologies, immunological diseases or other neoplasms. Race was self-identified by each subject.

During the initial consultation, 10ml of blood was collected in nonheparinized tubes and transported to the Structural and Molecular Research Laboratory in Gynecology at the Faculty of Medicine of the University of So Paulo within 30min of collection. After clot formation, the serum fraction was collected by centrifugation and stored in aliquots at 80C. Thawed serum was diluted 1:200 in phosphate-buffered saline-Tween 20 and tested for the concentration of HSPA1A using a commercial ELISA kit validated for human sera and specific for HSPA1A (R&D Systems, Minneapolis, MN). Each sample was tested in duplicate, and the average values were obtained. Values were converted to pg/ml by reference to a standard curve that was generated for each assay. The lower limit of sensitivity was 156pg/ml. The demographic and clinical data of the patients participating in the study were obtained through consultation of electronic medical records.

Based on histopathological characteristics according to the WHO criteria20, breast cancer was classified as ductal carcinoma in situ, invasive carcinoma of no special type (invasive ductal carcinoma), invasive lobular carcinoma, and invasive mucinous carcinoma. The tumors were also classified into subtypes according to standard immunohistochemistry (IHC) findings. IHC was used to determine the expression of estrogen and progesterone receptors, HER2 expression and the level of Ki6721,22. Ki67 is a marker of cell proliferation and is expressed exclusively during active phases of the cell cycle. Therefore, higher Ki67 values indicate an elevated rate of cell proliferation. Additional characteristics were used to classify the tumors based on histological grade and nuclear grade according to the 8th edition of the TNM classification system23.

In all patients the HSPA1A levels are described using the median value and interquartile range. Values between categories were compared using the MannWhitney test for variables with 2 categories or the Kruskal-Walli tests for variables with more than 2 categories. The Spearman rank correlation test was used to evaluate associations between the HSPA1A level and clinical and demographic characteristics. The generalized linear model (MLG) was used for the variables that presented descriptive levels below 0.2 in the unadjusted analyses (p<0.2) and that had biological plausibility to influence the marker24,25. The present study was designated as exploratory due to the limited number of participants and, thus, was underpowered to assess differences in HSPA1A among subtypes of breast cancer lesions. The analyses were performed using IBM-SPSS for Windows version 22.0 software and tabulated using Microsoft-Excel 2010 software, and all tests were performed with a 5% significance level.

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The circulating 70 kDa heat shock protein (HSPA1A) level is a potential biomarker for breast carcinoma and its progression | Scientific Reports -...

Overview

Hormone therapy for breast cancer is a treatment for breast cancers that are sensitive to hormones. The most common forms of hormone therapy for breast cancer work by blocking hormones from attaching to receptors on cancer cells or by decreasing the body's production of hormones.

Hormone therapy is only used for breast cancers that are found to have receptors for the naturally occurring hormones estrogen or progesterone.

Hormone therapy for breast cancer is often used after surgery to reduce the risk that the cancer will return. Hormone therapy for breast cancer may also be used to shrink a tumor before surgery, making it more likely the cancer will be removed completely.

If your cancer has spread to other parts of your body, hormone therapy for breast cancer may help control it.

Hormone therapy for breast cancer is only used to treat cancers that are hormone sensitive (hormone receptor positive breast cancers).

Doctors refer to these cancers as estrogen receptor positive (ER positive) or progesterone receptor positive (PR positive). This means that these breast cancers are fueled by the natural hormones estrogen or progesterone.

A doctor who specializes in analyzing blood and body tissue (pathologist) determines if your cancer is ER positive or PR positive by analyzing a sample of your cancer cells to see if they have receptors for estrogen or progesterone.

Hormone therapy for breast cancer can help to:

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Side effects of hormone therapy for breast cancer include:

Less common, more-serious side effects of hormone therapy may include:

There are several approaches to hormone therapy.

One approach to hormone therapy is to stop the hormones from attaching to the receptors on the cancer cells. When the hormones can't access the cancer cells, the tumor growth may slow and the cells may die.

Breast cancer medications that have this action include:

Tamoxifen. Tamoxifen is usually taken daily in pill form. It's often used to reduce the risk of cancer recurrence in women who have been treated for early-stage breast cancer. In this situation, it's typically taken for five to 10 years.

Tamoxifen may also be used to treat advanced cancer. Tamoxifen is appropriate for both premenopausal women and postmenopausal women.

Aromatase inhibitors are a class of medicines that reduce the amount of estrogen in your body, depriving breast cancer cells of the hormones they need to grow.

Aromatase inhibitors are only used in women who have undergone menopause. They cannot be used unless your body is in natural menopause or in menopause induced by medications or removal of the ovaries.

Aromatase inhibitors used to treat breast cancer include:

Aromatase inhibitors are given as pills you take once a day. All three aromatase inhibitors work the same and reduce the production of estrogen in your body.

How long you continue aromatase inhibitors depends on your specific situation. Current research suggests that the standard approach would be to take these medications for up to 10 years, but every person is different and you and your doctor should carefully assess how long you should take them.

Women who haven't undergone menopause either naturally or as a result of cancer treatment may opt to undergo treatment to stop their ovaries from producing hormones.

Options may include:

Treatments to stop ovarian function may allow premenopausal women to take medications only available to postmenopausal women.

Hormone therapy for cancer that spreads to other parts of the body (metastatic breast cancer) sometimes combines hormone therapies with targeted therapy. Targeted therapy drugs attack specific weaknesses in cancer cells. The combination can make hormone therapy more effective.

Medications used in this way include:

You'll meet with your cancer doctor (oncologist) regularly for follow-up visits while you're taking hormone therapy for breast cancer. Your oncologist will ask about any side effects you're experiencing. Many side effects can be controlled.

Hormone therapy following surgery, radiation or chemotherapy has been shown to reduce the risk of breast cancer recurrence in people with early-stage hormone-sensitive breast cancers. It can also effectively reduce the risk of metastatic breast cancer growth and progression in people with hormone-sensitive tumors.

Depending on your circumstances, you may undergo tests to monitor your medical situation and watch for cancer recurrence or progression while you're taking hormone therapy. Results of these tests can give your doctor an idea of how you're responding to hormone therapy, and your therapy may be adjusted accordingly.

Explore Mayo Clinic studies of tests and procedures to help prevent, detect, treat or manage conditions.

Dec. 29, 2020

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Hormone therapy for breast cancer - Mayo Clinic

OverviewWhat are estrogen and progesterone?

Estrogen and progesterone are hormones that are produced by a womans ovaries.

Estrogen plays a role in many body functions, including:

Progesterone plays a role in many body functions, including:

As you begin to transition into menopause, your ovaries no longer produce high levels of estrogen and progesterone. Changes in these hormone levels can cause uncomfortable symptoms. Common menopause symptoms include:

Hormone therapy (HT) is used to boost your hormone levels and relieve some of the symptoms of menopause. Whether or not you should consider taking HT therapy is a discussion to have with your healthcare provider. There are many health benefits and risks associated with taking HT.

There are two main types of hormone therapy (HT):

Yes, it does.

If you still have your uterus:

Progesterone is used along with estrogen. Taking estrogen without progesterone increases your risk for cancer of the endometrium (the lining of the uterus). During your reproductive years, cells from your endometrium are shed during menstruation. When the endometrium is no longer shed, estrogen can cause an overgrowth of cells in your uterus, a condition that can lead to cancer.

Progesterone reduces the risk of endometrial (uterine) cancer by making the endometrium thin. If you take progesterone, you may have monthly bleeding, or no bleeding at all, depending on how the hormone therapy is taken. Monthly bleeding can be lessened and, in some cases, eliminated by taking progesterone and estrogen together continuously.

If you no longer have your uterus (youve had a hysterectomy):

You typically won't need to take progesterone. This is an important point because estrogen taken alone has fewer long-term risks than HT that uses a combination of estrogen and progesterone.

The following list provides the names of some, but not all, postmenopausal hormones.

Estrogen

Combination EPT

Vaginal dehydroepiandrosterone (DHEA)

Hormone therapy (HT) is prescribed to relieve menopausal symptoms including:

Other health benefits of taking HT include:

While hormone therapy (HT) helps many women get through menopause, the treatment (like any prescription or even non-prescription medicines) is not risk-free. Known health risks include:

Scientists continue to learn about the effects of HT on the heart and blood vessels. Many large clinical trials have attempted to answer questions about HT and heart disease. Some have shown positive effects in women who started HT within 10 years of menopause; some have shown negative effects when started greater than 10 years of menopause. Some studies have raised more questions about the potential benefits of HT.

Based on the data, the American Heart Association issued a statement for use of HT. They say:

Taking combined hormone therapy can increase your risk of developing breast cancer. Here are some important findings:

Hormone therapy (HT) is not usually recommended if you:

Like almost all medications, hormone therapy has side effects. The most common side effects are:

Less common side effects of hormone therapy include:

In most cases, these side effects are mild and dont require you to stop your HT. If your symptoms bother you, ask your healthcare provider about adjusting either the dosage or the form of the HT to reduce the side effects. Never make changes in your medication or stop taking it without first consulting your provider.

In general, there is no time limit to how long you can take hormone therapy. You should take the lowest dose of hormone therapy that works for you, and continue routine monitoring with your healthcare provider to reevaluate your treatment plan each year. If you develop a new medical condition while taking HT, see your provider to discuss if its still safe to continue taking HT.

The decision to take hormone therapy needs to be a very personalized one. Hormone therapy is not for everyone. Discuss the risks and benefits of hormone therapy with your healthcare provider at an office visit specifically dedicated for this conversation. Youll need the time to address all the issues and answer questions in order to arrive at a decision that is best for you. Factors considered should be your age, family history, personal medical history and the severity of your menopausal symptoms.

Be sure to talk about the pros and cons of the different types and forms of HT as well as non-hormonal options such as dietary changes, exercise and weight management, meditation and alternative options.

Read more here:
Hormone Therapy for Menopause Symptoms - Cleveland Clinic

OverviewWhat is gonadotropin-releasing hormone (GnRH)?

Everyone makes gonadotropin-releasing hormone (GnRH). When youre an adolescent starting puberty, increasing levels of this hormone stimulate the production of follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

FSH and LH are gonadotropins (goh-NA-doh-TROH-pinz). Gonadotropins are essential to your reproductive health. They help your sex glands (gonads) mature and function. Gonads in people designated female at birth (DFAB) are ovaries and in people designated male at birth (DMAB), theyre testicles.

Your healthcare provider may also use these terms to refer to gonadotropin-releasing hormone:

In the female reproductive system, GnRH indirectly stimulates your bodys production of estrogen and progesterone. These are the predominant female sex hormones that play a key role in ovulation and conception (your ability to get pregnant).

In the middle of your menstrual cycle:

In the male reproductive system, GnRH stimulates the production of:

Your endocrine system is responsible for producing GnRH. Nerve cells (neurons) in your brains hypothalamus gland make and release GnRH into your blood vessels. The hormone then travels to your pituitary gland at the base of your brain. GnRH stimulates your pituitary gland to make and release follicle-stimulating hormone and luteinizing hormone.

GnRH levels are naturally low in children and rise during puberty. Afterward, testosterone, estrogen and progesterone control GnRH levels. Your body makes less GnRH when your sex hormone levels are high. It makes more GnRH when sex hormones are low. The one exception is during ovulation when a females body makes more GnRH and estradiol.

An overproduction of GnRH is rare. Elevated levels may increase your risk of pituitary adenomas. These noncancerous (benign) tumors can cause your body to make too much follicle-stimulating hormone and luteinizing hormone. As a result, your body may make too much estrogen or testosterone. In children, high GnRH levels may cause precocious (early) puberty.

Conditions associated with low GnRH levels in females include:

Conditions associated with low GnRH levels in males include:

A blood test can measure levels of follicle-stimulating hormone and luteinizing hormone. This requires a simple blood draw. You dont have to fast (not drink or eat) before getting this blood test. However, people who are menstruating may need to get a blood test during a certain time in their menstrual cycle (period).

A GnRH stimulation test can help determine high or low production of GnRH. During this test:

Results above the normal range suggest early puberty.

These actions can keep your endocrine system healthy and functioning:

GnRH medications can stop your pituitary gland from making the hormones that stimulate the production of sex hormones.

These medicines include:

Healthcare providers use GnRH medications to treat prostate cancer in people designated male at birth, as well as these conditions in people designated female at birth:

A note from Cleveland Clinic

Your bodys production of gonadotropin-releasing hormone (GnRH) affects your sex hormone levels, libido and fertility. In children, too much GnRH can bring on early puberty, while too little hormone can delay puberty. You need GnRH to make follicle-stimulating hormone and luteinizing hormone. These hormones (gonadotropins) stimulate the production of testosterone, estrogen and progesterone. Healthcare providers also use GnRH medications to treat certain cancers and other conditions.

View post:
Gonadotropin-Releasing Hormone (GnRH): Purpose & Testing

By Katie DohmanPhotography by Ackerman + GruberProduced in partnership with Greenspring Media

About a decade ago, Nathalie Crowley drove 150 miles each way every two weeks from Duluth to the Twin Cities to get access to gender-affirming hormone care, therapy, hair removal, and other wellness services she needed, but couldnt get anywhere closer to home.

At the time, very few providers offered hormone care, and transgender people living outside the Twin Cities metro area had to travel major distances to get it. Five years later, the number of providers had grown only slightly.

Crowley eventually moved to the Twin Cities, and when a position opened on the board of Family Tree Clinic a community clinic focused on providing comprehensive sexual and reproductive healthcare she jumped. Finding a mix of her professional skills and lived experience a match, she joined the staff in 2018 as a patient coordinator helping patients with financial aid, insurance and other services they desperately needed to access better healthcare.

Now, Crowley is the director of people and culture at Family Tree, focused on fulfilling the organizations mission. Family Tree wants to end health disparities, and we need to start with that in our own backyard, with our own staff, she says. But its also making sure we have a culture steeped in acceptance of peoples gender and sexual identities, racial identities, and make sure that its a safe place for everyone to be. What we want is for the people who are providing care and staffing the clinic to really represent the people we are serving.

Thats a big job, especially for a small-but-mighty nonprofit.

Theres been a complete transformation in Family Trees patient population, especially over the last decade, and primarily in the context of LGBTQ patients. In 2009, just 9% identified as LGBTQ. Today, its about 60%.

Additionally, Family Trees patients are about 50% Black, Indigenous, and people of color (BIPOC). About a quarter are uninsured. Another 30% rely on medical assistance programs, and nearly three-quarters meet low-income guidelines.

There are a lot of factors that account for the stratospheric jump in LGBTQ patients, but at the heart of it is the willingness to change with, and prioritize, patient needs.

You can come as you are here, Family Tree Clinic Medical Director and Certified Professional Midwife Jennifer Demma says. However you feel on that day, youre still seen and heard and valued and respected. We dont need you to be someone else.

That includes a trauma-informed approach, with consent at the heart of every interaction. It means taking every chance to make sure patients feel seen, heard and understood in their gender. It feels revolutionary, but to Family Tree, its just how healthcare should be delivered.

As care has improved, demand has skyrocketed including for gender-affirming hormone care for trans people. This program, piloted in 2015 (in part thanks to grants from the Bush Foundation and PFUND Foundation, a regional LGBTQ grantmaker) is now getting ready to spread its wings across the region.

The Bush Foundation deepened its investment to $757,000 in 2021 to help Family Tree scale its gender-affirming care, expand service offerings and train more providers across greater Minnesota, North Dakota and South Dakota. In doing this, Family Trees successes can be decentralized and shared with other providers, helping to bring this approach to care closer to more people. From there: driving systems change.

Were not doing anything at Family Tree thats not possible at any other healthcare places, but its about shifting what is valued, Demma says. We have to dismantle the systems were a part of to be in alignment with those values, and support changing whos doing the work.

To understand the work, and the people doing it, a quick rewind: Since 1971, Family Tree has been a communitybased sexual and reproductive healthcare clinic providing services such as birth control and sexually transmitted infection testing to all on a sliding scale.

The clinics reputation grew as a comprehensive, affordable, nonjudgmental place to get healthcare. The patient load, and eventually the waitlist, grew accordingly. Until 2020, providers and staff were stuffed into a converted school in St. Paul, tending to an increasingly diverse patient population with a wider range of needs for healthcare resources and services.

Dylan Flunker, research and policy manager at Rainbow Health, a clinic and advocacy center for equitable healthcare access, centers his work on research around LGBTQ people and their access to and experience with healthcare. He says the organization has used Family Tree Clinic as a case study in how to be an inclusive care provider. They iterate in a way that I dont see a lot of other organizations are willing to, he says. They have the willingness to try something, keep what works, and they dont just take one step onto the path. They continue to identify the next step to make sure everyone is getting the care they need.

In November 2021, Family Tree expanded into a federally designated medically underserved neighborhood on Nicollet Avenue in Minneapolis. The two-story building is a bright, airy space that has come to function as much a community center as a clinic; one that will allow for 10,000 more patients who may be otherwise falling through the cracks on top of the 22,000 it already sees annually.

Family Tree has grown from a St. Paul family planning clinic to a regional leader in LGBTQ health, science-based sex education and culturally responsive care.

The transformation didnt happen overnight. In 2009, Family Tree launched its LGBTQ Health Access Initiative, and in 2015, launched the Transgender Hormone Care Program pilot. The plan was to serve 30 people with gender-affirming hormone care in the first year. It served more than 100. Within three years, it had served 500 patients, and worked to train, consult with, and expand the number of providers who perform gender-affirming hormone care to create a broader network of providers.

Although gender-affirming hormone care is more widespread than ever, trans patients are still falling into big geographic and philosophical gaps, not to mention discrimination both legislatively and personally. In 2021, about 52 percent of Family Tree patients identified as trans, nonbinary or gender noncomforming up from just 1 percent in 2009. Patients still regularly travel to Family Tree for care from seven states, Indigenous lands and Canada.

That shows how pervasive the need is, Demma says. Its not just hormone care. People are traveling from other states to get a physical and pap smear because they will be affirmed in their gender, and they cant find that in the community they live in. They cant find anywhere that doesnt continue to harm, oppress, and marginalize a person who is just trying to get healthcare.

Dr. Kelsey Leonardsmith has been a family medicine physician at Family Tree since 2017 and the director of the child and adolescent transgender hormone care program since 2019. Their studies at Harvard gave them a peek into the first gender-affirming pediatric program in the country at Boston Childrens. They were blown away by the power of interventions, even though at the time they didnt know pediatric hormone care would play a starring role in their practice. But after witnessing systems rife with medical discrimination and hearing traumatizing stories from LGBTQ community members, they knew they had a role to play in improving care.

Trans folks have dramatically high rates of medical discrimination they have almost universally experienced at least some form of prejudice in a medical environment, they say.

Leonardsmith cites a 2020 survey in an adolescent medical journal that studied mental health outcomes between those who wanted hormone care and got it versus those who wanted hormone care and didnt get it. For the first group, there was a huge reduction in risk of suicide. Thats really striking, they say. But even more alarming to them was that the number of people in the second group those who wanted care but didnt receive it was 10 times larger than the first group.

Leonardsmith has been creating and supporting networks of providers who want to offer gender-affirming hormone care regionally, often through informal consultation. They point out that it doesnt take many providers joining to dramatically increase access.

For Leonardsmith, its not just hormones that are considered gender-affirming care. I always say to young people: Theres no wrong way to have a gender and theres no one path through your life. This your journey, not my journey, and Im here to walk with you and help you match yourself to the tools I have to offer to help you live your best life.

Still, Family Tree needs more people trained and offering care.

Part of the Bush Foundation grant can support the efforts we already have: partnerships with educational programs and to strengthen gender-inclusive content in their programs, whether thats medical school, residency, nurse practitioner or midwifery programs, Demma explains. The ability to then reach and support providers in surrounding areas that maybe dont have access to resources, or sometimes just need to have a trusting relationship where they can be vulnerable enough to ask questions and admit they dont know something to do it in a safe, responsible way.

Rainbow Healths Flunker adds that Family Tree staff could have approached this work with a scarcity mindset, focusing on keeping patients all to themselves. But they didnt. What I especially love is that they are looking at it from an abundance mindset: We have this knowledge, and we want everyone to be thriving in their home communities. That is one thing I think is amazing and revolutionary about the program. Theyre not falling into the trap of seeking perfection over progress.

At Family Tree, Crowley says lots of work has been done to make sure that the provider and staff roster reflects their patients, but theres still work to do. And externally, theres also a lot of hope: [We can continue] to do that work on a larger scale, all over Minnesota and the upper Midwest, helping people get access to the wonderful care we provide. People are so, so hungry for it, and there is real desire from lots of providers who just dont have the support system, so were excited to offer that.

Were not in an ER, and were not EMTs, but we really are saving peoples lives, Crowley continues. Its a world she couldnt have imagined when she was regularly traversing the state, seeking her own gender-affirming care just a decade ago. Giving them a safe place to receive healthcare is so incredibly important. And its true for all the work we do LGBTQ, trans, cis people all the work we do is lifesaving in one way or another. We are making a really big difference.

Katie Dohman is an award-winning freelance writer based in West St. Paul covering health, wellness, parenting, and other lifestyle topics. She lives with her husband, three kids, and four pets while they slowly renovate a century-old home.

Jenn Ackerman and Tim Gruber are a husband and wife photo team living in Minneapolis, MN. Despite their work taking them around the globe they love documenting life around the Midwest. Theyve been fortunate to work regularly for clients like National Geographic and The New York Times. While the camera is a simple tool they love that it has been a catalyst for experiencing so many new things in life. When you dont find them behind a camera you can find them going on neighborhood walks or bike rides soaking up the best nature Minneapolis and Minnesota has to offer.

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Family Tree Clinic has broadened its scope of services and its regional impact by helping transgender people get the hormone care they need - Sahan...

Patients with estrogen receptorpositive breast cancer are usually given adjuvant hormone therapy (AHT) to block estrogen. A common side effect of this therapy is hot flashes, but these are often so uncomfortable that they in turn require treatment.

New findings from a large real-world study suggest that this may result in worse outcomes. The study followed more than 7000 women who had been treated for breast cancer from 2006 to 2019 and found that those who had been treated for hot flashes after beginning AHT had significantly shorter disease-free survival (DFS).

They also had a 14.2% higher 5-year discontinuation rate, which may account for the poorer outcomes.

This finding is in direct contrast with previous results from a clinical trial that found that hot flashes during AHT were predictive of better outcomes.

"Results from clinical trials might not translate to the real world because the therapy discontinuation rates differ between these two settings," said study author Wei He, PhD, School of Public Health, Zhejiang University, China, and Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden.

In routine clinical practice, AHT discontinuation rates of 31%-73% have been reported in real-world settings, which is much higher than the 8%-28% that have been reported in clinical trials.

"Cancer care providers need to be aware that prescribing symptom-relieving drugs to patients with treatment-related side effects may not be enough to prevent treatment discontinuation," He added in a statement.

The study was published in the June 2022 issue of the Journal of the National Comprehensive Cancer Network.

In this study, He and colleagues evaluated the association of hot flashes that begin soon after AHT initiation with outcomes in a real-world setting. Using several Swedish registries (National Quality Registry for Breast Cancer, Prescribed Drug Register, and Cause-of-Death Register), the team identified 7152 patients with breast cancer who were not using chemotherapy and had initiated AHT in Stockholm from 2006 through 2019. They were followed through to 2020.

At a median follow-up of 6.8 years, the 5-year and 10-year DFS was 95.8% and 91.0%, respectively. Patients who began using drugs to treat hot flashes shortly after beginning AHT had a significantly shorter DFS (adjusted hazard ratio [HR], 1.67). When different AHT therapeutics were examined, similar associations were observed for aromatase inhibitor (AI) and tamoxifen users, although the association with DFS among the AI users did not reach statistical significance.

The median follow-up for discontinuation of AHT was 3.5 years and the 5-year discontinuation rate for AHT was 48.9%. Women who initiated treatment for hot flashes shortly after AHT initiation were more likely to discontinue their treatment (adjusted HR, 1.47) These associations were similar for both AI and tamoxifen.

An additional analysis showed that discontinuation of AHT was more likely to be associated with a shorter DFS (adjusted HR, 1.46).

Jame Abraham, MD, FACP, chairman of the Department of Hematology and Medical Oncology, Cleveland Clinic Taussig Cancer Institute, who was not involved in the study, noted that these data show that approximately 20% of patients with breast cancer discontinue anti-estrogen therapy prematurely,

"There can be multiple reasons for this, including side effects," said Abraham in a statement. "It is interesting to see that this real-world data shows worse outcomes in patients with hot flashes, likely leading to more early discontinuation of endocrine therapy. It is important for the clinicians to continue to pay attention to the management of side effects and adherence to therapy."

J Natl Compr Canc Netw. 2022 Apr 6;1-7. Full text

Roxanne Nelson is a registered nurse and an award-winning medical writer who has written for many major news outlets and is a regular contributor to Medscape.

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By Liu Tzu-hsuan / Staff writer

People should not use their smartphone within one hour of going to bed to prevent frequent urination, a doctor has said.

Captain Clinic president Liu Po-jen (), an expert in functional nutrition, wrote on Facebook that blue light emitted by smartphones stimulates the central nervous system and disrupts sleep at night.

Blue light keeps the sympathetic nervous system from winding down, Liu quoted urologist Wang Hung-jen () as saying.

Photo: Tsai Shu-yuan, Taipei Times

Blue light not only inhibits the production of melatonin, a hormone that regulates sleep cycles, but might also inhibit the production of antidiuretic hormones, which lower the kidneys production of urine, Liu said.

If the antidiuretic hormone level remains high at night, people would have to urinate more often, he added.

Middle-aged men who usually urinate more than twice per night, with a volume of at least one-third of the amount of urine during the day, should adjust their lifestyle and seek a doctors advice, he quoted Wang as saying.

Liu advised people who urinate often during the night to stop using their phone an hour before going to bed, as this would help balance their nervous system.

So as not to be tempted, people could put their phone outside their bedroom, he added.

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If youre looking to get pregnant, you may have heard at some point that tracking ovulation is a valuable tool. But, given that Sex Ed is kind of an awkward blur, you probably have some questions on exactly how to go about tracking ovulation.

Lets back up a sec: Ovulation is what happens when your ovaries release an egg. Ovulation usually happens in the middle of your menstrual cycle, which would be 14 days before the start of your period if you have an average 28-day cycle, according to the Mayo Clinic.

That said, not everyone has a 28-day cycle, so your ovulation point may be very different from your besties and even your sisters. In fact, its possible to ovulate anywhere from day 11 through day 21 of your cycle, according to the American Pregnancy Association.

Why does this matter? In order to make a baby, your egg has to meet up with your partners sperm. So, you want to time things so that theres actually an egg waiting to be fertilized when you have sex.

Tracking your ovulation can help you find the time when you are most likely to be successful conceiving, says Iris Insogna, MD, of Columbia University Fertility Center. Otherwise, it can be difficult to know when might be the most effective timing for your efforts. That can put added stress and strain on what may already be anxiety-inducing situation.

This can be most helpful for heterosexual couples trying to conceive, Dr. Insogna says. For single women or those in same-sex relationships, this can also be important for timing home inseminations with donor sperm, she adds.

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Not everyone has symptoms during ovulation, but you might have some, says Jessica Walter, MD, a reproductive endocrinologist and infertility specialist at Northwestern Medicine. During ovulation a folliclefluid-filled sacin the ovary breaks open to release the egg inside, she explains. This process can lead to some bleeding and release of inflammatory fluid into the belly from the rupturing follicle.

When this happens, you might have mild bloating, cramping, pelvic pain, breast tenderness, or changes in your discharge. Cervical mucus around the time of ovulation is often characterized as like egg whites, as it becomes slippery and stretchy in consistency and clear in color, Dr. Walter says.

Need more info? Read on

Again, ovulation usually happens on day 14 of your cycle but everyones cycle different. Because of this, when you should start tracking your ovulation really depends on the length of your cycle, Dr. Insogna says.

If you have a typical 28-day cycle, then starting to track ovulation around day 10 is a good idea, she says. Just to make sure you dont miss it. If your cycle length is shorter than that, you may want to start tracking earlier, like day six or seven, to make sure you dont miss your fertile window, she says.

You have a surprisingly large number of options for tracking ovulation. Here are the biggies:

Ovulation predictor kits are the most reliable method for women with regular cyclesand I strongly recommend them, Dr. Insogna says. They generally work by detecting a surge in luteinizing hormone (LH), which triggers ovulation, in your pee. When that surge happens, ovulation will follow soon after. Ovulation generally occurs 14 to 26 hours after detection of the LH surge and almost always within 48 hours, says Alexa Sassin, MD, assistant professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine/Texas Childrens.

Ovulation predictor kits are the most reliable method for women with regular cycles.

But, she notes, they dont work for *all* women, especially those who have a high baseline level of LH, which can happen in women with polycystic ovary syndrome (PCOS) or in women with diminished ovarian reserve.

The calendar method is pretty simple: You just figure out your average cycle length and assume youre ovulating at the midway point. While its cheaper than testing your pee every month, its not necessarily the most reliable. This method may not be accurate, however, as many women have cycle variabilities that are not accounted for with calendar calculations, says Kjersti Aagaard, MD, PhD, professor in the Division of Maternal-Fetal Medicine in in the Department of Obstetrics & Gynecology at Baylor College of Medicine/Texas Childrens.

3. Try an ovulation- and period-tracking app.

Ovulation tracking apps use the same concepts to help track ovulation and period cycle length as the calendar methodthey just remove the whole doing math thing for you. Some of the applications may apply an algorithm to help predict ovulation based on personalized information inputted into the app, Dr. Sassin says. However, the accuracy of such predictions remains unclear, she adds. Noted!

If you are hesitant to put your health data in an app due to uncertainty surrounding privacy practices, you can use the paper calendar method to track your cycle instead.

Your basal body temperature (or BBT) is your bodys temperature when you are fully at rest, says Lauren Demosthenes, MD, senior medical director with Babyscripts. In most women, the bodys normal temperature increases slightly during ovulation (0.51F) and remains high until the end of the menstrual cycle, she explains. The most fertile days are the two to three days before this increase in temperature.

This requires some legwork on your end, though: Youll need to take your temperature every morning after you wake up, before you do anything (including get out of bed or sip water). Then, record your daily temperature and, when you have an increase, youre likely ovulating, Dr. Demosthenes says.

This is a little tricky. This method cannot be used to predict ovulation. Rather, BBT can only predict that ovulation has likely occurred, Dr. Sassin says. Got it.

Some women have an increase in cervical mucus or vaginal discharge in the five to seven days before ovulation, Dr. Aagaard says. This increase in cervical mucus is due to fluctuations in ovarian hormones, she explains. During this time, the cervical mucus is noted to be more abundant, thin, slippery, and stretchy.

When you get that egg-white consistency, youre likely to be ovulating. Before ovulation, the mucus is more watery and slippery, which indicates a good time to try to conceive, Dr. Demosthenes says. After ovulation the mucus becomes more thick and sticky due to progesterone. This makes conceiving more difficult."

Foolproof? No. But "some women are attuned to their cervical mucus and can use this to help with timing intercourse," Dr. Demosthenes says.

Saliva ferning predicts ovulation by looking at the patterns formed by the saliva in your mouth. When the hormone estrogen increases near ovulation, dried saliva may form a fern-shaped pattern, Dr. Aagaard says.

This method can be performed at home with a microscope but may not work for all women, she notes. Some medications can change your saliva, making this especially tricky, she says. Also, do you really want to get a microscope? You may be better off using some of the other methods here.

Experts agree this is a really tough one to answer, given that factors like your age, reproductive health, and your partners reproductive health all play a role in your ability to conceive.

Approximately 80 percent of families or people will conceive in the first six to nine months of attempting pregnancy, with the probability of pregnancy greatest in the first three months, Dr. Sassin says. Family planning studies have shown that the likelihood of pregnancy is greatest when intercourse or insemination occurs the day before ovulation.

But, again, this is all variable and individual. If youve been trying to conceive for a year with regular sex and youre under 35, Dr. Demosthenes recommends talking to your doctor. And, if youre over 35, its recommended that you check in soonerat six months.

Meet the experts:

Iris Insogna, MD, specializes in obstetrics and gynecology, reproductive endocrinology/infertility at Columbia University Fertility Center.

Jessica Walter, MD, is a reproductive endocrinologist and infertility specialist at Northwestern Medicine. Lauren Demosthenes, MD, is an ob-gyn at the University of South Carolina, School of Medicine Greenville, as well as the senior medical director at Babyscripts, a virtual maternity care platform.Alexa Sassin, MD, is an assistant professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine/Texas Childrens.Kjersti Aagaard, MD, PhD, is a professor in the Division of Maternal-Fetal Medicine in in the Department of Obstetrics & Gynecology at Baylor College of Medicine/Texas Childrens.

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How To Track Your Ovulation Most Accurately, According To Ob-Gyns - Women's Health

When Lisa suspected she was pregnant, she did what other teenagers might: She Googled her options to terminate. One of the first links that popped up in the search engine was a clinic in Volusia, Florida, where the 19-year-old lived. The offer of a free pregnancy test tempted Lisa into booking an appointment and she drove there with her boyfriend, parking across the street. It was a small town, and she did not want to be recognized.

The consultation room was filled with posters depicting fetuses with speech bubbles, as if they were asking to be born. Lisa sobbed as one of the women running the clinic confirmed she was pregnant; they had refused to let her take a test home. Lisa needed to return for an ultrasound in four weeks to be certain, and then they could discuss options. But until then, they told her, she absolutely should not go to an abortion clinic. Maybe youll miscarry and then you wont have any problems, the woman suggested.

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There are many different birth control options out there and what works for one person may not be ideal for the next. (Getty Images)

The Supreme Court overturned Roe v. Wade. Follow along with Yahoo's coverage.

Now that Roe v. Wade has been overturned, leaving states to decide whether or not to allow abortion within their borders, it's understandable that some people have been thinking about their birth control methods or are considering going on one and how effective they are at preventing pregnancy. But there are many different birth control options out there and what works for one person may not be ideal for the next.

"Certain birth control options work better for some people, while others may prefer a different option," women's health expert Dr. Jennifer Wider, tells Yahoo Life. "Some people are more susceptible to side effects than others, too. So while the birth control pill, for example, will work well with minimal side effects for one person, someone else may experience side effects that they wouldn't experience with a different option therefore dictating their choice."

With that in mind, here's a breakdown of the most common birth control methods plus how they work.

Sterilization is an option for both men and women, but the procedure is different depending on your anatomy.

How does it work?

Female sterilization is the chosen birth control method for nearly 19% of women in the U.S. who are currently using contraception, according to the Centers for Disease Control and Prevention (CDC). Female sterilization, which typically means a tubal ligation, is when the fallopian tubes are removed or cut and tied with special thread, or closed shut with bands or clips, or sealed with an electric current, according to the American College of Obstetricians and Gynecologists (ACOG). A tubal ligation, also known as a tubal sterilization, works by preventing sperm from reaching the egg.

Male sterilization comes in the form of a vasectomy, which is a surgical procedure that cuts the vas deferens, tubes that carry sperm from the testicles to the urethra, per the U.S. National Library of Medicine. After a vasectomy, sperm can't move out of the testicles. Because of this, a person who has had a successful vasectomy cannot make a woman pregnant, the U.S. National Library of Medicine explains.

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How effective is it?

Both male and female sterilizations are more than 99% effective at preventing a pregnancy, according to ACOG. However, the organization says, a vasectomy is slightly more effective.

How do you get it?

Both require surgery, so you'll need to consult your doctor about next steps, Dr. Christine Greves, an ob-gyn at the Winnie Palmer Hospital for Women and Babies, tells Yahoo Life.

Other key facts

Sterilization is permanent, and it's not a decision to be taken lightly. "A tubal ligation is only for folks who are 100% convinced they never want to be pregnant again [or ever pregnant]," Dr. Mary Jane Minkin, a clinical professor of obstetrics and gynecology and reproductive sciences at Yale Medical School, tells Yahoo Life. "For anyone else who has any hesitation at all, a long-acting reversible contraceptive is better."

If couples are considering sterilization, Minkin recommends a vasectomy over tubal ligation. "It's a lot easier their plumbing is outdoors; ours is indoors," she says.

IUDs are one of the most effective forms of reversible birth control available. (Getty Images)

LARC is a class of birth control used by about 10% of women who use contraception. This category includes intrauterine devices (IUDs) and the implant.

How does it work?

LARC is designed to be a "set it and forget it" method of birth control, Greves says. This means that you need to replace them only after a period of time. IUDs are typically replaced anywhere from three to 10 years, depending on which one you choose, ACOG says. The implant lasts for up to three years, according to ACOG.

There are two major forms of IUDs: hormonal and nonhormonal. Both forms work to create an inhospitable environment for sperm and implantation, Wider says. "Hormonal IUDs release a type of hormone progestin that acts to thicken the cervical mucus to make it difficult for the sperm to meet the egg, suppress ovulation and thin the lining of the uterus, thus preventing a pregnancy," she says. The copper IUD, which is nonhormonal, interferes with the sperm's ability to move, ACOG explains, and to reach an egg to fertilize it.

The implant is a flexible, plastic rod about the size of a matchstick that's inserted just under the skin in the upper arm, where it releases progestin into the body, per ACOG.

How effective is it?

IUDs and the implant are the most effective forms of reversible birth control available, ACOG says, noting that they're 20 times more effective than birth control pills, the patch or the ring. During the first year of use, less than 1% of women who have an IUD or implant will get pregnant.

How do you get it?

You'll need to meet with a health care provider to get an IUD or the implant, Greves says.

Other key facts

"A LARC is for someone who doesn't want to think about contraception and have it acting all the time," Minkin says. This can also be helpful for "someone who either has a hard time remembering to take a pill every day or knows they don't want kids right now but aren't sure if they are permanently done or not," Greves says.

The hormones progestin and estrogen are combined in birth control pills to prevent ovulation. (Getty Images)

There are different forms of oral contraceptives, but this is collectively referred to as "the Pill."

How does it work?

The Pill uses the hormones progestin and estrogen to prevent ovulation, Minkin explains, so no egg is released. "You don't get pregnant without an egg out there," she says. However, there is also something called the "mini Pill" that is progestin-only, which is an option for women who are breastfeeding or unable to take contraceptives with estrogen.

How effective is it?

With typical use (i.e., it may not be used perfectly), 9% of women will become pregnant during the first year of using a combined hormonal birth control method, ACOG says. With perfect use, less than 1% of women will become pregnant during the first year on the Pill. The mini Pill is estimated to be 87% effective at preventing pregnancy, according to the Mayo Clinic.

How do you get it?

The Pill is available only via prescription, so you'll need to consult your doctor first, Greves says.

Other key facts

Oral contraceptives are the second most common form of birth control in the U.S., with nearly 13% of women on birth control using it. The Pill may also help lessen period cramps and heavy bleeding. "If you have crummy periods and need contraception, birth control pills are very nice," Minkin says.

Unlike many other forms of birth control, condoms can also protect against many sexually transmitted infections. (Getty Images)

Condoms are available for men and women. However, male condoms are much more popular than female condoms they're used by about 9% of women who use contraception.

How does it work?

Male condoms are a barrier method of birth control that fits over a penis. A condom prevents pregnancy because it "stops the sperm from entering the vaginal canal," Wider explains.

How effective is it?

When used perfectly, condoms are 98% effective at preventing pregnancy, according to Planned Parenthood. In real life, though, they're about 85% effective, the organization says.

How do you get it?

Condoms can be easily purchased online and in select stores, such as pharmacies and grocery stores.

Other key facts

Unlike many other forms of birth control, condoms can also protect against many sexually transmitted infections (STIs), Greves points out. "Condoms can be helpful for someone who doesn't want to have hormones or is worried about their body being sensitive to medication and wants to try other options," she says.

The ring is placed in the vagina and releases estrogen and progestin to prevent pregnancy. (Getty Images)

While the above are the main forms of birth control used in the U.S., there are other options. Those include:

The patch, a combined hormonal birth control method that delivers estrogen and progestin via a patch worn on the skin.

The ring, a flexible, plastic ring that's placed in the vagina that releases estrogen and progestin.

The shot, an injection that contains the hormone depot medroxyprogesterone acetate (DMPA, or Depo-Provera), which protects against pregnancy for 13 weeks.

If you're interested in using birth control or are considering switching methods, Greves recommends talking to your doctor about your options. They should be able to offer personalized guidance.

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