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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

You should not receive testosterone therapy if you have:

Possible risks of testosterone treatment include:

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

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

Continue reading here:
Hypogonadism in Men | Endocrine Society

Recommendation and review posted by Bethany Smith

Background

Clinical hyposmia and anosmia are commonly seen, most frequently with either post-inflammatory, age-related, or idiopathic causes being most frequent. Actual anatomical abnormalities of the olfactory groove or olfactory bulb are far less common. A recent case report showing a possible link between congenital olfactory bulb agenesis and Wolff-Parkinson-White syndrome suggested that there may be a relationship between cardiac arrhythmia and olfactory bulb development. While Kallmann syndrome (KS) is the classic syndrome involving olfactory bulb agenesis and hypogonadotropic hypogonadism, this case report and a prior report noting isolated hypogonadotropic hypogonadism and the Wolff-Parkinson-White syndrome suggest there may be more rare associations between cardiac arrhythmia and olfactory groove abnormalities.

A retrospective study was conducted to attempt to elucidate whether there may be a link between cardiac arrhythmias and olfactory anatomical abnormalities. The olfactory bulb volume (OBV) and olfactory sulcus depth (OSD) of 44 patients with cardiac arrhythmias were compared to 43 healthy control patients. Additionally, 11 patients with acute COVID-19 were also compared in those groups. Patients were seen between September and December 2020. Available MRI images were utilized.

The average right and left olfactory bulb volume was 29.4218.17 mm3 and 25.6715.29 mm3 for patients with cardiac arrhythmia, 40.7930.65 mm3 and 38.9521.87mm3 for healthy controls, and 21.3015.23 mm3 and 17.759.63 mm3 for COVID-19 patients. The average right and left olfactory sulcus depth was 7.681.31 mm and 7.471.56 mm for patients with cardiac arrhythmia, 10.671.53 mm and 10.621.67 mm for controls, and 7.910.99 mm and 8.020.88 mm for COVID-19 patients. The right and left olfactory bulb volume difference versus controls was significant for cardiac arrhythmia patients (p=0.028 and p=0.0038) and for COVID-19 patients (p=0.047 and p=0.0029), and the right and left olfactory sulcus depth difference versus controls was significant for cardiac arrhythmia patients (p<0.0001 and p<0.0001) and for COVID-19 patients (p<0.0001 and p<0.0001). Both COVID-19 and cardiac arrhythmia patients were, on average, significantly older than controls. On multivariate analysis, cardiac arrhythmia or COVID-19 diagnosis did not significantly correlate with smaller olfactory bulb volume, but older age, cardiac arrhythmia diagnosis, and COVID-19 diagnosis did significantly correlate with smaller olfactory sulcus depth. On multivariate analysis, older age was significantly correlated with cardiac arrhythmia diagnosis and COVID-19 diagnosis.

Olfactory bulb volume and olfactory sulcus depth in both cardiac arrhythmia and COVID-19 patients appeared significantly smaller than in controls. Cardiac arrhythmia and COVID-19 patients were significantly older than controls. Age, as well as genetic predisposition, may contribute to a difference in the radiographic olfactory anatomical findings in patients with cardiac arrhythmias and COVID-19.

A recent case report [1] noted an adult patient with previously undiagnosed congenital anosmia as well as the radiographic absence of the olfactory groove/bulbs as well as Wolff-Parkinson-White syndrome. Further investigation revealed a prior case report [2] involving a patient with isolated hypogonadotropic hypogonadism, pronounced hypodontia, and the Wolff-Parkinson-White syndrome. The classic Kallmann syndrome (KS) involves hypogonadotropic hypogonadism and olfactory bulb aplasia. The presence of one of the two classic signs of Kallmann syndrome in the aforementioned case reports but not both, while both involved Wolff-Parkinson-White syndrome, prompted an investigation into whether there may be an association between cardiac arrhythmia in general and olfactory nerve abnormalities [3-7]. The gonadotropinreleasing hormone1 (GnRH) system is involved in the development of both the reproductive and olfactory systems, which may contribute to the concomitant reproductive and olfactory dysfunction seen in Kallmann syndrome patients [4,5]. Human cardiac tissue and cardiac-associated immune cells have been shown to contain GnRH receptors, and studies in cephalopods have suggested that GnRH may have receptor targets in the cardiovascular system, which may explain the possible link between cardiac arrhythmias and olfactory nerve abnormalities. Additionally, a recent study [8] on MRI and CT findings in patients with COVID-19-related anosmia noted that radiographic olfactory changes included olfactory cleft opacification, decreased olfactory bulb volumes (OBVs), and olfactory bulb signal abnormalities such as increased signal intensity, hyperintense foci, and microhemorrhages. Olfactory bulb volume and olfactory sulcus depth (OSD) have been shown to be altered in myriad conditions, from septo-optic dysplasia to depression, post-infectious anosmia/hyposmia, and many others [9-17]. This retrospective study aimed to determine whether patients with cardiac arrhythmias and patients with acute COVID-19 had decreased olfactory bulb volume and olfactory sulcus depth relative to healthy controls.

The patient data were collected through a retrospective review of the records of patients who presented to a university hospital between September 2020 and December 2020, underwent head/brain MRI, and fit the study inclusion and exclusion criteria. Between September and December 2020, the head/brain or maxillofacial MRI of 44 patients with cardiac arrhythmias, 43 healthy control patients, and 11 patients with acute COVID-19 were analyzed. Patients aged 18 years or older were included in the three groups. Cardiac arrhythmia patients were analyzed if they had a current diagnosis of any cardiac arrhythmia and had an available head/brain or maxillofacial MRI completed between September and December 2020. COVID-19 patients were analyzed if they had a current diagnosis of acute COVID-19 and had an available head/brain or maxillofacial MRI completed between September and December 2020. Healthy control patients were analyzed if they had an available head/brain or maxillofacial MRI completed between September and December 2020 and did not carry a current diagnosis of any cardiac arrhythmia, COVID-19, disorders of smell/taste, anosmia, hyposmia, or head trauma. Patient medications were analyzed to exclude patients taking medications that could cause anosmia/hyposmia such as intranasal zinc medications, topical decongestant intranasal sprays, and oral medications such as phenothiazines or nifedipine. Figure 1 shows a coronal MRI image illustrating the olfactory bulb and the olfactory sulcus. OBVs were calculated using volumetric analysis of the olfactory bulb on T2 MRI sequences as previously described [12] using the 3D Slicer software ver. 4.10.2 (http://www.slicer.org/). The 3D slicer software is a free, open-source software package for the analysis of medical imaging developed by Harvard University and facilitated volumetric analysis of the olfactory bulb data. The olfactory bulbs were segmented by tracing their outlines manually, and the software ran a quantification process that rendered the volume of the olfactory bulb. OSD was measured as described previously [8] on coronal T2 images by measuring the depth to the deepest point of the olfactory sulcus along a line tangent to the inferior borders of the gyrus rectus. In addition to patient diagnosis and olfactory bulb volume and sulcus depth, data on patient age and gender were compared. Patient data were de-identified and retrospective, and this study was approved by the SUNY-Upstate Institutional Review Board (1427574-1).

Patient data were compiled in Microsoft Excel (Microsoft Corporation, Redmond, Washington, USA) and the data were analyzed using XLSTAT (Addinsoft, Paris, France). Continuous variables were analyzed using the Students t-test and one-way analysis of variance (ANOVA) for comparison between groups. The Pearson Correlation/Association test was also utilized to determine the correlation between the observed data variables. Multivariate analysis was conducted via logistical regression using XLSTAT, utilizing a Newton-Raphson algorithm. The level of statistical significance was set at p < 0.05.

Table 1 shows the patient characteristics for each group. Of the 44 cardiac arrhythmia patients, 38 had atrial fibrillation only, one had atrial fibrillation and supraventricular tachycardia, three had atrial flutter, one had sick sinus syndrome, and one had prolonged Q-T syndrome. Table 2 shows the olfactory bulb volume and olfactory sulcus depth, patient age, and patient sex data and univariate analysis data for the three patient groups. The average right and left olfactory bulb volume was 29.4218.17 mm3 and 25.6715.29 mm3 for patients with cardiac arrhythmia, 40.7930.65 mm3 and 38.9521.87mm3 for healthy controls, and 21.3015.23 mm3 and 17.759.63 mm3 for COVID-19 patients. The average right and left olfactory sulcus depth was 7.681.31 mm and 7.471.56 mm for patients with cardiac arrhythmia, 10.671.53 mm and 10.621.67 mm for healthy controls, and 7.910.99 mm and 8.020.88 mm for COVID-19 patients. The right and left olfactory bulb volume difference versus controls was significant for cardiac arrhythmia patients (p=0.028 and p=0.0038) and for COVID-19 patients (p=0.047 and p=0.0029), and the right and left olfactory sulcus depth difference versus controls was significant for cardiac arrhythmia patients (p<0.0001 and p<0.0001) and for COVID-19 patients (p<0.0001 and p<0.0001). Multivariate analysis via XLSTAT utilizing logistical regression of the data using an iterative algorithm using the Newton-Raphson algorithm was performed. The multivariate analysis data are shown in Table 3. On multivariate analysis, age (p=0.001) and cardiac arrhythmia diagnosis (p=0.0001) or COVID-19 diagnosis (p=0.0001) remained significant predictors of smaller olfactory sulcus depth but not of smaller olfactory bulb volume. Patient sex was not a significant predictor of olfactory sulcus depth or olfactory bulb volume on multivariate analysis. The average age for the cardiac arrhythmia group was 76.1113.13 years (p<0.0001 vs control group), 51.8617.66 years for the control group, and 69.2717.64 years for the COVID-19 group (p=0.0005 vs. control group). Of the 44 cardiac arrhythmia patients, 28 were male and 16 were female. Of the 43 control patients, 21 were male and 22 were female. Of the 11 COVID-19 patients, six were male and five were female.

The volume of the olfactory bulbs and the depth of the olfactory sulcus are readily obtained from MRI imaging and can be used as a neuroanatomical comparative tool to assess the structure of the olfactory system in patients [18,19]. Olfactory bulb volumes and olfactory sulcus depth values [8,20] vary by patient population, MRI protocol, and measurement/calculation method but are typically on the order of 30-90 mm3 for olfactory bulb volumes and 5-10 mm for olfactory sulcus depth, similar to the average values noted in the patient population in this study. Isolated olfactory nerve agenesis is rare, as in a case report in a 12-year-old girl by Carswell et al. [21], noting a patient with congenital complete absence of the olfactory nerves. Coimbra et al. [3] also reported a similarly rare case of isolated olfactory bulb agenesis. The human olfactory apparatus develops during the fetal stage, and the developing fetus can detect odors as early as 28 weeks, and the developing olfactory bulbs can be seen on MRI at this point. Olfactory axons project from the nasal epithelium prior to the formation of the olfactory bulbs and lack a peripheral ganglion, but the synaptic structures of the future olfactory bulb have this functionality. The olfactory bulb begins to laminate at 14 weeks, but complete myelination occurs postnatally. The olfactory system does not contain direct thalamic projections, but the olfactory bulb and anterior olfactory nucleus essentially serve as thalamic surrogates. Olfactory abnormalities can be seen in children with brain malformations, endocrine disorders, chromosome anomalies, and craniofacial abnormalities [4-6]. Kallmann syndrome is a classically described syndrome presenting with congenital olfactory bulb agenesis. Kallmann syndrome is a subtype of the broader group of isolated gonadotropin-releasing hormone (GnRH) deficiency (IGD) syndromes [7]. KSconsists of hypogonadotropic hypogonadism with anosmia and a congenital absence of the olfactory bulbs. There are also less severe and somewhat more common pathologies seen in IGD, including hypothalamic amenorrhea (HA), constitutional delay of puberty (CDP), and adult-onset hypogonadotropic hypogonadism (AHH). The association between hypothalamic hypogonadism and olfactory bulb agenesis in Kallmann syndrome is thought to be related to the association between the GnRH neurons and the olfactory placode. IGD can also be related to non-reproductive features such as midline facial defects, renal agenesis, limb abnormalities, hearing loss, and eye movement and balance disorders.

Acquired olfactory dysfunction can be commonly seen in post-upper respiratory infection (URI) anosmia or hyposmia [10]. Studies have shown that olfactory bulb volume and olfactory sulcus depth decreased in patients with olfactory loss after URI compared to normal controls. Studies have also shown that there may be significant gray matter volume loss in the right orbitofrontal cortex (OFC) in patients with post-infectious olfactory disfunction and that there may be a significant negative correlation between the volume of gray matter in the right OFC as well as olfactory bulb volume with the duration of olfactory loss in these post-infectious olfactory loss patients versus normal controls. Kandemirli et al. [8] examined olfactory function and CT and MRI findings in patients with persistent COVID-19 olfactory dysfunction. They evaluated olfactory function with the Sniffin' Sticks test and collected quantitative measurements of olfactory bulb volumes, olfactory sulcus depths, and olfactory radiographic characteristics. They noted frequent olfactory cleft opacification (~73.9% of cases), subnormal olfactory bulb volumes in ~43.5% of cases, and shallow olfactory sulci in ~60.9% of cases. They also noted frequent abnormalities in olfactory bulb shape, olfactory bulb signal intensity, and frequent microhemorrhages and abnormalities in the clumping of or scarcity of olfactory filia. Studies have also shown that olfactory bulb volume can be decreased in patients with depression, after transsphenoidal pituitary surgery, in patients with Parkinsons disease, and that olfactory bulb volume can be decreased in women and with increasing age [11-17].

In this study, olfactory bulb volume and olfactory sulcus depth in patients with cardiac arrhythmia, acute COVID-19, and healthy controls were measured. Patients with cardiac arrhythmia and COVID-19 had significantly smaller right and left olfactory bulb volumes and olfactory sulcus depths than controls on univariate analysis and were significantly older than controls. On multivariate analysis, olfactory bulb volume did not correlate significantly with cardiac arrhythmia diagnosis or COVID-19 diagnosis. On multivariate analysis, smaller right and left olfactory sulcus depth did significantly correlate with cardiac arrhythmia and COVID-19 diagnosis. On multivariate analysis, older age was also significantly correlated with cardiac arrhythmia and COVID-19 diagnosis. This may indicate that there may be a correlation between the propensity to develop cardiac arrhythmia and the propensity for olfactory dysfunction or atrophy of the olfactory bulb and/or olfactory sulcus over time. This study's limitations include its retrospective nature, which introduces the possibility of recall and selection bias. Given the retrospective nature of this study, there was some heterogeneity in the MRI studies/sequences available for patients in this study. A prospective study in which all patients had a uniform fine-cut MRI protocol standardized for the study protocol and specifically targeted at the olfactory anatomy would be helpful. Additionally, the relatively low patient numbers are a limitationand may limit power in the statistical analysis. Patient medication lists were screened to exclude patients on intranasal or oral medications that may affect olfaction, but the use of medications not reported by patients and not present in the medical record or use of other patient medications that might unknowingly affect olfaction is another possible limitation. The mild diversity in the arrhythmia types in the cardiac arrhythmia group (although the vast majority were atrial fibrillation patients) and the mild heterogeneity in the diagnoses of the control group may also limit the statistical analysis. Future prospective studies with larger patient numbers and a greater diversity of other cardiac arrhythmia types with distinct statistical analyses for each arrhythmia type (e.g., a large number of purely Wolff-Parkinson-White patients) would be of use. The significantly older age of the cardiac arrhythmia and COVID-19 patients may also act as a confounder, and indeed, on multivariate analysis, older age did significantly correlate with smaller olfactory sulcus depth, as did cardiac arrhythmia diagnosis and COVID-19 diagnosis. This may indicate that cardiac arrhythmia, COVID-19 diagnosis or susceptibility, and older age may all correlate significantly with small olfactory sulcus depth, and that older age is also independently correlated with a propensity for cardiac arrhythmia. Additionally, the collection and availability of a formal, standardized olfactory function measurement in all patients, such as Sniffin sticks or the Pittsburgh Smell Identification test, would also allow useful correlation between functional/clinical olfactory data (quantitative olfactory measurements) and radiographic olfactory bulb volume and olfactory sulcus depth data.

This retrospective radiographic study demonstrated smaller olfactory bulb volumes and olfactory sulcus depths on MRI in patients with a history of cardiac arrhythmia and patients with COVID-19 compared to healthy control patients. Cardiac arrhythmia and COVID-19 patients were significantly older than controls. Multivariate analysis demonstrated that cardiac arrhythmia diagnosis and COVID-19 diagnosis, as well as older age, were all significantly associated with smaller olfactory sulcus depth but not with smaller olfactory bulb volume. Future prospective studies with standardized MRI protocols and larger groups of patients with cardiac arrhythmias and larger numbers of healthy controls may help elucidate whether there is a correlation between a predisposition to cardiac arrhythmia and radiographic abnormalities in the olfactory bulb/olfactory sulcus.

See original here:
Olfactory Radioanatomical Findings in Patients With Cardiac Arrhythmias, COVID-19, and Healthy Controls - Cureus

Recommendation and review posted by Bethany Smith

The GlobalHormone Replacement Therapy Market Size was estimated at USD 16227.83 million in 2021 and is projected to reach USD 18029.01 million by 2028, exhibiting a CAGR of 1.51% during the forecast period.

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This Hormone Replacement Therapy Market report offers detailed analysis supported by reliable statistics on sale and revenue by players for the period 2017-2022. The report also includes company description, major business, Hormone Replacement Therapy product introduction, recent developments and Hormone Replacement Therapy sales by region, type, application and by sales channel.

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Eli Lilly

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The Global Hormone Replacement Therapy market is anticipated to rise at a considerable rate during the forecast period, between 2022 and 2028. In 2021, the market is growing at a steady rate and with the rising adoption of strategies by key players, the market is expected to rise over the projected horizon.

Report Overview

Hormone replacement therapy refers to the treatment of the patients with hormone deficiency due to conditions such as dwarfism or women nearing menopause, which requires replacement of hormones in the body whose levels have become low.

Market competition is intense. Eli Lilly, Pfizer, AbbVie, Novo Nordisk, etc. are the leaders of the industry, and they hold key technologies and patents, with high-end customers. Top 5 players combined 45.13% market share in all.

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Hormone Replacement Therapy Market Regional Analysis:

Geographically, this report is segmented into several key regions, with sales, revenue, market share and growth Rate of Hormone Replacement Therapy in these regions, from 2015 to 2027, covering

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1 Hormone Replacement Therapy Market Overview

1.1 Product Overview and Scope of Hormone Replacement Therapy1.2 Hormone Replacement Therapy Segment by Type1.2.1 Global Hormone Replacement Therapy Market Size Growth Rate Analysis by Type 2022 VS 20281.3 Hormone Replacement Therapy Segment by Application1.3.1 Global Hormone Replacement Therapy Consumption Comparison by Application: 2022 VS 20281.4 Global Market Growth Prospects1.4.1 Global Hormone Replacement Therapy Revenue Estimates and Forecasts (2017-2028)1.4.2 Global Hormone Replacement Therapy Production Capacity Estimates and Forecasts (2017-2028)1.4.3 Global Hormone Replacement Therapy Production Estimates and Forecasts (2017-2028)1.5 Global Market Size by Region1.5.1 Global Hormone Replacement Therapy Market Size Estimates and Forecasts by Region: 2017 VS 2021 VS 20281.5.2 North America Hormone Replacement Therapy Estimates and Forecasts (2017-2028)1.5.3 Europe Hormone Replacement Therapy Estimates and Forecasts (2017-2028)1.5.4 China Hormone Replacement Therapy Estimates and Forecasts (2017-2028)1.5.5 Japan Hormone Replacement Therapy Estimates and Forecasts (2017-2028)

2 Market Competition by Manufacturers2.1 Global Hormone Replacement Therapy Production Capacity Market Share by Manufacturers (2017-2022)2.2 Global Hormone Replacement Therapy Revenue Market Share by Manufacturers (2017-2022)2.3 Hormone Replacement Therapy Market Share by Company Type (Tier 1, Tier 2 and Tier 3)2.4 Global Hormone Replacement Therapy Average Price by Manufacturers (2017-2022)2.5 Manufacturers Hormone Replacement Therapy Production Sites, Area Served, Product Types2.6 Hormone Replacement Therapy Market Competitive Situation and Trends2.6.1 Hormone Replacement Therapy Market Concentration Rate2.6.2 Global 5 and 10 Largest Hormone Replacement Therapy Players Market Share by Revenue2.6.3 Mergers and Acquisitions, Expansion

3 Production Capacity by Region3.1 Global Production Capacity of Hormone Replacement Therapy Market Share by Region (2017-2022)3.2 Global Hormone Replacement Therapy Revenue Market Share by Region (2017-2022)3.3 Global Hormone Replacement Therapy Production Capacity, Revenue, Price and Gross Margin (2017-2022)3.4 North America Hormone Replacement Therapy Production3.4.1 North America Hormone Replacement Therapy Production Growth Rate (2017-2022)3.4.2 North America Hormone Replacement Therapy Production Capacity, Revenue, Price and Gross Margin (2017-2022)3.5 Europe Hormone Replacement Therapy Production3.5.1 Europe Hormone Replacement Therapy Production Growth Rate (2017-2022)3.5.2 Europe Hormone Replacement Therapy Production Capacity, Revenue, Price and Gross Margin (2017-2022)3.6 China Hormone Replacement Therapy Production3.6.1 China Hormone Replacement Therapy Production Growth Rate (2017-2022)3.6.2 China Hormone Replacement Therapy Production Capacity, Revenue, Price and Gross Margin (2017-2022)3.7 Japan Hormone Replacement Therapy Production3.7.1 Japan Hormone Replacement Therapy Production Growth Rate (2017-2022)3.7.2 Japan Hormone Replacement Therapy Production Capacity, Revenue, Price and Gross Margin (2017-2022)

4 Global Hormone Replacement Therapy Consumption by Region4.1 Global Hormone Replacement Therapy Consumption by Region4.1.1 Global Hormone Replacement Therapy Consumption by Region4.1.2 Global Hormone Replacement Therapy Consumption Market Share by Region4.2 North America4.2.1 North America Hormone Replacement Therapy Consumption by Country4.2.2 United States4.2.3 Canada4.3 Europe4.3.1 Europe Hormone Replacement Therapy Consumption by Country4.3.2 Germany4.3.3 France4.3.4 U.K.4.3.5 Italy4.3.6 Russia4.4 Asia Pacific4.4.1 Asia Pacific Hormone Replacement Therapy Consumption by Region4.4.2 China4.4.3 Japan4.4.4 South Korea4.4.5 China Taiwan4.4.6 Southeast Asia4.4.7 India4.4.8 Australia4.5 Latin America4.5.1 Latin America Hormone Replacement Therapy Consumption by Country4.5.2 Mexico4.5.3 Brazil

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5 Segment by Type5.1 Global Hormone Replacement Therapy Production Market Share by Type (2017-2022)5.2 Global Hormone Replacement Therapy Revenue Market Share by Type (2017-2022)5.3 Global Hormone Replacement Therapy Price by Type (2017-2022)6 Segment by Application6.1 Global Hormone Replacement Therapy Production Market Share by Application (2017-2022)6.2 Global Hormone Replacement Therapy Revenue Market Share by Application (2017-2022)6.3 Global Hormone Replacement Therapy Price by Application (2017-2022)

7 Key Companies Profiled7.1 Company7.1.1 Hormone Replacement Therapy Corporation Information7.1.2 Hormone Replacement Therapy Product Portfolio7.1. CHormone Replacement Therapy Production Capacity, Revenue, Price and Gross Margin (2017-2022)7.1.4 Companys Main Business and Markets Served7.1.5 Companys Recent Developments/Updates

8 Hormone Replacement Therapy Manufacturing Cost Analysis8.1 Hormone Replacement Therapy Key Raw Materials Analysis8.1.1 Key Raw Materials8.1.2 Key Suppliers of Raw Materials8.2 Proportion of Manufacturing Cost Structure8.3 Manufacturing Process Analysis of Hormone Replacement Therapy8.4 Hormone Replacement Therapy Industrial Chain Analysis

9 Marketing Channel, Distributors and Customers9.1 Marketing Channel9.2 Hormone Replacement Therapy Distributors List9.3 Hormone Replacement Therapy Customers

10 Market Dynamics10.1 Hormone Replacement Therapy Industry Trends10.2 Hormone Replacement Therapy Market Drivers10.3 Hormone Replacement Therapy Market Challenges10.4 Hormone Replacement Therapy Market Restraints

11 Production and Supply Forecast11.1 Global Forecasted Production of Hormone Replacement Therapy by Region (2022-2028)11.2 North America Hormone Replacement Therapy Production, Revenue Forecast (2022-2028)11.3 Europe Hormone Replacement Therapy Production, Revenue Forecast (2022-2028)11.4 China Hormone Replacement Therapy Production, Revenue Forecast (2022-2028)11.5 Japan Hormone Replacement Therapy Production, Revenue Forecast (2022-2028)

12 Consumption and Demand Forecast12.1 Global Forecasted Demand Analysis of Hormone Replacement Therapy12.2 North America Forecasted Consumption of Hormone Replacement Therapy by Country12.3 Europe Market Forecasted Consumption of Hormone Replacement Therapy by Country12.4 Asia Pacific Market Forecasted Consumption of Hormone Replacement Therapy by Region12.5 Latin America Forecasted Consumption of Hormone Replacement Therapy by Country

13 Forecast by Type and by Application (2022-2028)13.1 Global Production, Revenue and Price Forecast by Type (2022-2028)13.1.1 Global Forecasted Production of Hormone Replacement Therapy by Type (2022-2028)13.1.2 Global Forecasted Revenue of Hormone Replacement Therapy by Type (2022-2028)13.1.3 Global Forecasted Price of Hormone Replacement Therapy by Type (2022-2028)13.2 Global Forecasted Consumption of Hormone Replacement Therapy by Application (2022-2028)13.2.1 Global Forecasted Production of Hormone Replacement Therapy by Application (2022-2028)13.2.2 Global Forecasted Revenue of Hormone Replacement Therapy by Application (2022-2028)13.2.3 Global Forecasted Price of Hormone Replacement Therapy by Application (2022-2028)

14 Research Finding and Conclusion

15 Methodology and Data Source15.1 Methodology/Research Approach15.1.1 Research Programs/Design15.1.2 Market Size Estimation15.1.3 Market Breakdown and Data Triangulation15.2 Data Source15.2.1 Secondary Sources15.2.2 Primary Sources15.3 Author List15.4 Disclaimer

Continued.

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Global Hormone Replacement Therapy Market Is Projected To Thriving At A CAGR of 1.51% During 2022-2028 | 120 Report Pages - Digital Journal

Recommendation and review posted by Bethany Smith

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

Read this article:
Hormone therapy for breast cancer - Mayo Clinic

Recommendation and review posted by Bethany Smith

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

Recommendation and review posted by Bethany Smith

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

Recommendation and review posted by Bethany Smith

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.

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

Recommendation and review posted by Bethany Smith

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.

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

More:
Hot Flashes From Hormone Therapy, Poorer Outcomes in Breast Cancer - Medscape

Recommendation and review posted by Bethany Smith

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.

Comments will be moderated. Keep comments relevant to the article. Remarks containing abusive and obscene language, personal attacks of any kind or promotion will be removed and the user banned. Final decision will be at the discretion of the Taipei Times.

Excerpt from:
Smartphone use increases urination at night: nutritionist -

Recommendation and review posted by Bethany Smith

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

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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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Anti-Abortion Centers Find Pregnant Teens Online, Then Save Their Data - Bloomberg

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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.

Story continues

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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The most common birth control methods and how effective they are at preventing pregnancy - Yahoo Life

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Scientists have developed a new technique that can repair and even regenerate heart muscle cells after a heart attack (or myocardial infarction).

While it has only been tested on mice so far, if it works the same in humans it could potentially be a life-saving treatment for people who have suffered a heart attack.

The technique uses a synthetic messenger ribonucleic acid (mRNA).mRNA creates a 'blueprint' of DNA sequences that the body then uses to build the proteins that form and regulate our cells.By tweaking the mRNA, scientists can deliver different instructions for different biological processes.

Here, the edited instructions promote the replication of heart muscle cells (cardiomyocytes) via two so-called mutated transcription factors, Stemin and YAP5SA.

Essentially, the idea is to make heart muscle cells, which have very little ability to regenerate, act more like stem cells, which can be turned into various other types of specialized cells by the body.

The difference made by the mRNA treatment after four weeks. (The Journal of Cardiovascular Aging)

"No one has been able to do this to this extent and we think it could become a possible treatment for humans," says biologist Robert Schwartz, from the University of Houston in Texas.

Less than 1 percent of adult cardiac muscle cells can regenerate the cardiomyocytes we have when we die are mostly the same ones we've had since the first month of life and that means heart attacks and heart disease can leave the heart in a permanently fragile state.

In experiments in both tissue culture dishes and in living mice, Stemin was shown to turn on stem cell-like properties in the cardiomyocytes, while YAP5SA promoted organ growth and replication. The process has been described as a "game-changer" by the team.

The in vivostudy involving living mice affected by damaged hearts showed myocyte nuclei replicating by at least 15-fold in the 24 hours after the injections of the mutated transcription factors, Stemin and YAP5SA.

"When both transcription factors were injected into infarcted adult mouse hearts, the results were stunning," says Schwartz.

"The lab found cardiac myocytes multiplied quickly within a day, while hearts over the next month were repaired to near normal cardiac pumping function with little scarring."

The synthetic mRNA added to the cells disappeared in a few days, just as the mRNA produced in our bodies does, the researchers report. This gives the new technique an advantage over gene therapy processes that cannot be easily stopped or removed once they're underway.

It still remains to be seen whether the approach can be translated successfully into humans and many more years of research will be required to get this into a working treatment but the team behind the research is confident.

Work continues to understand more about heart disease and heart injury, andhow the body respondsin its aftermath. Studying cardiovascular health remains a priority for scientists, with heart disease currentlythe leading cause of deathin the US (accounting for around a quarter of all deaths).

"This is a huge study in heart regeneration especially given the smart strategy of using mRNA to deliver Stemin and YAP5SA,"says biologist Siyu Xiao, from the University of Houston.

The research has been published in hereandherein the Journal of Cardiovascular Aging.

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Scientists Have 'Healed' a Heart Attack in Mice by Regenerating Muscle Cells - ScienceAlert

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MarketsandResearch.biz studies Global Autologous Stem Cell Based Therapies Market from 2022 to 2028 give a comprehensive market research and projections that provide complete strategy-based analysis solutions to confirm the most fantastic productivity in all segments and geographies, with correct values and forecasts. The study looks at Autologous Stem Cell Based Therapies market intensity, main market extension factors, merchandise exports sectors, and current general market changes.

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Global Autologous Stem Cell Based Therapies Market 2022 Scope of the Report Regeneus, Mesoblast, Pluristem Therapeutics Inc, US STEM CELL Inc. ...

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Global Surgical Mesh Market Is Estimated To Be Valued At US$ 1.29 Bn In 2022, And Is Forecast To Surpass US$ 2.2 Bn Valuation By The End Of 2032

Sales of surgical meshes are expected to account for more than 21 Mn units by 2032-end, owing to their increasing application in untapped markets, says a Fact.MR analyst.

Fact.MR A Market Research and Competitive Intelligence Provider: The global surgical mesh market is estimated to exceed a valuation of US$ 1.29 Bn in 2022, and expand at a significant CAGR of 5.5% by value over the assessment period (2022-2032).

The availability of surgical meshes in absorbable and non-absorbable forms has expanded their application for temporary as well as permanent reinforcement. In recent years, demand for surgical meshes has escalated in aiding breast reconstruction as they reduce the exposure risk of the implant. Increasing health literacy in North America and Europe will create ample opportunities for surgical mesh manufacturers over the coming years.

Sedentary lifestyle and increasing obesity among the population have resulted in several chronic health issues. The consequent weakening of the muscles extends space for organ prolapse and hernia. Putting these organs back in place by stitching the muscles together can result in muscle tearing and the recurrence of prolapse. However, reinforcing the weakened muscles with the help of a surgical mesh has shown to decrease recurrence and increase the longevity of the repair.

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To attract new customers, market players are focusing on portfolio enhancement. Robust investments in R&D are driving product innovation for key market players. Meshes inhibiting the growth of bacterial films and preventing tissue adhesions are luring new consumers. Collaboration of manufacturers with scientific personnel and operating surgeons have enabled bespoke designing of meshes to best fit patients needs.

Manufacturers are also aiming for portfolio expansion through acquisition and partnerships. Partnering with companies that offer a well-aligned portfolio has significantly increased consumer penetration for key manufacturers. However, augmenting relations with local players and operating surgeons will be a key determinant of the products commercial success.

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Scientific collaborations and robust R&D investments have also guided product innovation and became a common strategic approach adopted by leading surgical mesh manufacturing companies to upscale their market presence.

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Newborn Screening Market -Newborn Screening Market by Product (Newborn Screening Instruments, Consumables), by Test Type (Dry Blood Spot Tests, Hearing Tests, Critical Congenital Heart Disease (CCHD) Screening Tests), by Technology (Immunoassays & Enzymatic Screening Tests, Tandem Mass Spectrometry, Molecular Assays, Hearing Screening Technologies, Pulse Oximetry, Others), by End User (Clinical Laboratories, Hospitals) and by Region- 2022 to 2032

Doxorubicin Market - Doxorubicin Market Analysis, By Formulation (Lyophilized Doxorubicin Powder, Doxorubicin Solution), By Cancer Type (Breast Cancer, Prostate Cancer, Ovarian Cancer, Lung Cancer, Bladder Cancer, Stomach Cancer, Leukemia), By Distribution Channel (Hospital Pharmacies, Retail Pharmacies, e-Commerce) - Global Market Insights 2022 to 2026

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It happens more often than you might think: A middle-aged woman schedules an annual physical with her primary care physician, dutifully answers all of her doctors questions, and completes the appropriate bloodwork. Then, a few months later, shes struggling with a recurring issue that never came up in a routine exam. As a result, she may have to undergo more extensive medical treatment that could have been avoided if addressed earlier.

Its important for all women and especially those who are in their middle years (50-70) to establish a relationship with their primary care provider, says Melanie Santos, MD, FACOG, FPMRS, medical director of pelvic health for St. Jude Medical Center in Fullerton, California. Santos is a urogynecologist who specializes in treating women with incontinence and other pelvic floor disorders. I see most patients more often than an annual exam, so sometimes they feel more comfortable with me than they do with their primary care doctor, she said. I often find myself recommending that they see their primary care doctor about certain medical conditions that they have been keeping private.

In some cases, women are too embarrassed to bring up personal concerns with their doctor, such as urine leakage or other pelvic issues. For others, they simply dont feel they have the time to seek treatment. Women tend to take care of everyone else in their lives before they manage their own health, Dr. Santos said. They wait until the dust settles with everything else, when in reality, their problem may have a simple and quick solution.

For women who are past their childbearing years, it is especially important to be honest with their primary care doctor, because they may be experiencing treatable conditions related to menopause, heart health, bone health, or pelvic health.

During menopause (when a womans sex hormone levels decrease, which results in her menstrual cycle stopping) and perimenopause (the time leading up to that point), the body undergoes several hormonal changes that can cause a variety of unpleasant symptoms. While some women believe its just a part of aging and something they have to go through, there are plenty of ways in which a primary care doctor can help.

Hormone replacement therapy is considered a safe and effective choice for women whose hot flashes and night sweats are intolerable. However, its not the only option. Other medications that treat hot flashes and night sweats include gabapentin, an anti-seizure medication, and antidepressants. Doctors also recommend that women avoid hot-flash triggers, including alcohol, caffeine, stress, tobacco, and spicy foods. Additionally, there are other natural ways to manage symptoms that doctors can help recommend and manage.

The key is for a woman to talk about it in detail and describe what is happening so that the doctor can determine the best way to help her. So many people suffer when they dont need to, said Dr. Santos. That, in turn, can affect mental health, and create a cascade of other problems.

Heart disease is the leading cause of death for women in America, and it leads to almost as many deaths in women as it does in men. Symptoms of heart disease in women are different than in men and can include (but are not limited to):

Dr. Santos said women shouldnt feel shy about reporting any new or unusual symptoms to their doctor. Even if a patient suspects her symptoms are probably just acid reflux, she should still talk to her primary care provider. Telemedicine has become a big part of what some providers offer, Dr. Santos said. It is very easy to have a quick virtual appointment with your doctor to discuss your concerns.

The Centers for Disease Control and Prevention recommends that women ages 65 and older should undergo a bone density test to learn if they suffer from osteoporosis. If a woman has a parent who has broken a hip or other risk factors for osteoporosis, however, she should undergo her first bone density test between the ages 50 and 64.

Brittle bones can be especially risky for women as they grow older because they are at a high risk of experiencing a debilitating fracture. Early symptoms can include:

There are three main types of pelvic floor disorders: urinary dysfunction or incontinence, or lack of bladder control; bowel dysfunction or fecal incontinence, or lack of bowel control; and pelvic organ prolapse, a condition in which the uterus, bladder, and bowel may drop within the vagina. According to Dr. Santos, women who have these issues, such as urinary incontinence, often wait an average of seven years before seeking treatment. Thats living with discomfort for a long time!!

Incontinence can be a difficult topic to broach with a primary care doctor, but its an important one. Some women think that leaking urine or fecal matter is just a part of aging they will have to live with, but thats not true. There are many treatment options, and some are very easy fixes. If a problem causes you concern, it doesnt matter if its a part of aging, Dr. Santos said. You shouldnt have to just live with it.

Dr. Santos suggests compiling a list of questions before an appointment to avoid forgetting anything. When you go to the grocery store, you dont just wing it, she said. You make a list and use that to guide your shopping trip. Its the same with a doctor appointment.

A strong relationship with a primary care doctor can lead to overall better health and better quality of life. There is nothing that they havent already heard and no issue is cause for embarrassment. Communication is key to treatment.

If you are looking for a primary care doctor, you can search for one whos right for you in our provider directory.

Were with you, wherever you are. Make Providences app your personalized connection to your health. Schedule appointments, conduct virtual visits, message your doctor, view your health records, and more. Learn more and download the app.

Womens health resources

How heart disease affects women

Pelvic floor therapy

This information is not intended as a substitute for professional medical care. Always follow your health care professional's instruction

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Women's healthcare from top to bottom - Providence

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ACTIVE HEALTH FOODS, INC. ANNOUNCES ADDITIONAL INDUSTRY LEADERS TO ITS BOARD OF DIRECTORS - El Paso Inc.

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LGBTQ patients are at higher risk for sexually transmitted infections, HIV and certain cancers. Community Health Network primary care physician Dr. Mike Giffen said LGBTQ friendly health providers are crucial in reducing these health disparities.

LGBTQ patients are at higher risk for sexually transmitted infections, HIV and certain cancers. Community Health Network primary care physician Dr. Mike Giffen said LGBTQ-friendly health providers are crucial in reducing these health disparities.

If the provider is not open, if the patient's not comfortable and not open, we kind of gloss over a lot of stuff, Giffen said. And that's where a lot of this stuff is missed.

Giffen said trust is key in developing patient-provider relationships that are open and honest, especially if the patient is a member of the LGBTQ community. He said if trust is not built, health disparities in the community will continue.

So that's why this is super important, is to try to kind of break down those disparities and kind of actually level the playing field and get patients the care they deserve, he said.

Giffen said the LGBTQ community also faces higher rates of anxiety, depression and other mental health disparities. As a primary care physician, he helps those in need of hormone replacement therapy, surgery or other gender-affirming medical care. He said he has created a tight-knit community with other LGBTQ-friendly providers across the state.

I've built a nice network of connections of different surgeons and differenttherapists and counselors kind of across the board, Giffen said. Anything of a person who really needs their care.

Giffen said he understands many people are hesitant to get medical care. He said he wants to make sure patients feel comfortable.

People always think they come to a doctor and they need to have a lot of issues and a lot of stuff has to be up front, he said. Meeting with a patient can be literally just a conversation. Hey, it's good to meet you. Let's make sure this is a good, you know, interaction. And if you feel comfortable, we can move forward.

Contact reporter Darian Benson at dbenson@wfyi.org. Follow on Twitter: @helloimdarian.

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Open, honest conversations key in reducing LGBTQ health disparities - WFYI

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Trans kids seek safety and freedom on Transgender Day of Visibility

States are passing anti-LGBTQ laws across the country, but that can't erase the past, present or future of the transgender community.

Scott L. Hall and Cody Godwin, USA TODAY

After starting hormone replacement therapy, Elliot Wade noticed a difference in his body.

It wasn't that he hated his body before he started to transition. But there was something comforting about being in a body that looked like he felt a man.

"Immediately, when I started to see the effects of testosterone, then I was much more happy with myself," he said. "I can say that my overall mental health just improved significantly."

When Wade sought hormone replacement therapy about four years ago, he was seen quickly and could start with informed consent, meaning he wouldn't have to go through months of therapy and other counseling before receiving treatment.

But others in Lafayette and Acadiana aren't always as lucky, often being told an office isn't taking new patients or being placed on a waitlist for about six months before being seen by a medical provider for hormone replacement therapy, said Louisiana Trans Advocates Board Secretary Peyton Rose Michelle.

Outside of finding providers who offer hormone replacement therapy, Michelle said it can be difficult and frustrating to find physicians and medical providers in the area who offer gender-affirming care, which treats individuals in a way that aligns their outward traits with their gender identity.

Wade socially transitioned, coming out to loved ones and telling them about his preferred pronouns and new name when he was 17. It wasn't until he was 20 that he sought hormone replacement therapy.

At first he thought he would have to move outside Louisiana to seek the care he wanted without having to jump through hoops like being diagnosed with gender dysphoria. But he found treatment at a clinic in Lafayette.

"I didn't hate myself. It didn't hurt to look at myself," the 24-year-old Black man said. "I've heard of experiences where it's horrific for (people) to look in the mirror or get out of bed in the morning.

"While I was able to go two years, that two years for somebody else? It could be torturous."

Pride in Acadiana: From Drag Queen Storytime to a celebration with a parade

But even finding basic medical care can be challenging.

"I still haven't found a general practitioner that I feel is receptive or understands or takes me seriously," Wade said. "It's also really frustrating to have to go in and educate somebody about your body or to feel like they aren't believing you."

"There aren't enough doctors that are trained to help trans people," he added. There are a lot of doctors, nurses, medical professionals that are sympathetic and want to help, but they don't really know where to start."

A 2015 U.S. Transgender Survey, the most recent survey, found about 23% of more than 27,000 respondents reported they didn't seek needed health care for fear of being mistreated as a transgender person.

Even after a trans person finds a health care provider who isn't outright transphobic, they can still be misgendered or have a provider who doesn't know the best treatment.

"There's so many barriers to access," Michelle said. "Some doctors are less educated on working with trans people. It's very common for trans people to have to educate their own providers about how to even treat them."

"Even doctor's offices that provide affirming care sometimes slip in their affirming care," she added.

Gender-affirming care involves a range of social, psychological, behavioral and medical interventions that affirm a persons gender identity when it conflicts with the gender they were assigned at birth, according to the World Health Organization.

It can include everything from hormone replacement therapy, counseling, voice coaching to physically altering surgery or any combination of care. There are no one-size-fits-all treatments for trans men, trans women, non-binary and gender-fluid people.

LGBTQ discrimination: Most LGBTQ Americans face discrimination amid wave of anti-LGBTQ bills, study says

For subscribers: Gender-affirming care helps save lives, cuts depression risk in transgender and nonbinary youth, study finds

And while Wade has found providers who offer gender-affirming care, it isnt always seamless. Wade wanted an intrauterine device, which is used as a long-term contraceptive. His gynecologist, who Wade said is receptive, wasnt sure whether the IUD would work for Wade because of his hormone treatment.

The treatment was successful but his doctor never informed him that muscle spasms that mimic contractions could be a side effect. It was something theyd never seen before.

Everything was fine except that I was suffering, Wade said. Just having that nuance in that background makes a lot of difference.

Gender-affirming health care improves mental health and the overall well-being of gender-diverse people, according to the U.S. Department of Health and Human Services.

"It can make it or break it for a lot of my clients," said Monet David, a licensed professional counselor in Lafayette.

It's important to David as someone who treats mental health that clients felt like they weren't being judged or like she was going to make assumptions about them.

"People don't want to have to justify who they are in a session," David said. "I don't want you to have to explain what it means to be trans. As a mental health professional, I should know about that.

"There's too many texts, too many podcasts, too many books, all this content out there that people are willingly writing. You shouldn't have to perform additional emotional labor to catch me up to speed."

Health and wellness: How doctors' assumptions about LGBTQ patients can be harmful to their health

When she first started practicing, she didn't have as much autonomy to offer affirming care. Now she does that through her paperwork, asking for pronouns and allowing people to not indicate their gender.

She advertises herself as a practitioner who offers gender-affirming care and as someone who's trained in serving the LGBTQ+ community, she said.

"In Lafayette, there's still a pretty big make up of people who are uncomfortable by that," she said. "So by choosing to be affirming, I think I'm excluding myself from a big population that is turned off by that, but it's worth it.

"That's what matters the most."

Wade has sought out health care providers who offer gender-affirming care and said it makes a difference.

"For me, it's made accessing medical care not as scary," he said.

Until that care is widespread, Wade, who also sits on the Louisiana Tras Advocates board,said people will need to advocate for themselves and do the best they can with the resources they have.

Michelle has a wishlist of things she would change about health care for gender-diverse people.

It includes intake forms that separately ask about gender and sex assigned at birth. It asks about a preferred name, pronouns and honorifics. She wants people to be able to go to their longtime primary care physicians and receive treatment and be referred to other specialties without hesitation.

"In a perfect world, you just tell your doctor what you want. and they say, 'OK, here's what you can do about it' instead of being like, 'I have no clue what that is,'" she said.

"I could go on a very long list about other things that I wish doctor's offices did to make trans people more comfortable and provide services. But they first have to provide services."

For resources about finding gender-affirming care in Louisiana, visit http://www.latransadvocates.org.

Contact Ashley White at adwhite@theadvertiser.com or on Twitter @AshleyyDi.

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Trans health care options in Louisiana exist, but are hard to come by - Daily Advertiser

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Breast cancer affects millions of women around the world. In the United States alone, it is estimated that one in eight women will develop breast cancer in their lifetime. While there are many factors that can contribute to the development of this disease, some lifestyle choices and habits can play a significant role. Read on to find out moreand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

One of the best ways to catch breast cancer early is to perform regular self-examinations. This allows you to become familiar with how your breasts look and feel so that you can more easily spot any changes.

Screening mammograms are an important tool in the early detection of breast cancer. These tests can often find tumors that are too small to be felt by hand.

Women who don't get regular mammograms are at a higher risk of developing this disease. If you're over the age of 50, it's important to get a mammogram every two years. You may need to get them more frequently if you have a family history of breast cancer.

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One of the most important things you can do to reduce your risk of breast cancer is to avoid smoking. Tobacco use is linked to a variety of health problems, including cancer. Smoking cigarettes or using other tobacco products increases your risk of developing breast cancer. In fact, studies have shown that women who smoke have a 20 to 30 percent higher risk of developing this disease.

If you currently smoke, quitting is one of the best things you can do for your health.

Another bad habit that can lead to breast cancer is excessive drinking. Alcohol consumption can increase your risk of developing this disease. If you drink alcohol, it's important to do so in moderation. Women who drink more than three alcoholic beverages per week have a higher risk of developing breast cancer than those who don't drink.

A poor diet can also contribute to the development of breast cancer. Eating a diet high in processed and red meats has been linked to an increased risk of this disease. Conversely, eating a diet rich in fruits and vegetables may reduce your risk. It's also important to maintain a healthy weight and avoid excessive weight gain. Being overweight or obese is a major risk factor for breast cancer since excess fat tissue can produce hormones that can promote the growth of cancer cells.

Getting regular exercise is another important way to reduce your risk of breast cancer. Studies have shown that women who are physically active have a lower risk of developing this disease. Women who exercise for at least 30 minutes per day have a significantly lower risk than those who don't get any exercise.

Certain birth control methods have also been linked to an increased risk of breast cancer. Oral contraceptives that contain estrogen and progestin can slightly increase your risk. This is especially true if you use them for 10 or more years. If you're concerned about the risks associated with birth control, talk to your doctor about other options.

Hormone replacement therapy (HRT) is another factor that can contribute to the development of breast cancer. HRT is often used to relieve symptoms of menopause, such as hot flashes and night sweats. This treatment can also help prevent osteoporosis. However, HRT has been linked to an increased risk of breast cancer. If you're considering HRT, talk to your doctor about the risks and benefits.

While there are many factors that can contribute to the development of breast cancer, some lifestyle choices and habits can play a significant role. Smoking, drinking alcohol, and eating a poor diet are all bad habits that can increase your risk. Getting regular exercise and maintaining a healthy weight are good ways to reduce your risk. Certain birth control methods and hormone replacement therapies can also contribute to the development of this disease. If you have any of these risk factors, it's important to talk to your doctor about them. And to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

Gethin Williams MD Ph.D. is the Medical Director of Imaging & Interventional Specialists.

Gethin Williams, MD, Ph.D

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8 Bad Habits Leading to Breast Cancer Eat This Not That - Eat This, Not That

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In recent years, transgender people and particularly, transgender kids have become pawns in a broader political struggle.

Florida officials in June proposed a rule preventing the states Medicaid program from reimbursing providers for a series of therapies meant to treat gender dysphoria. Florida joined other red states that have moved to restrict access to those medical treatments.

Gender dysphoria is defined as strong, persistent feelings of identification with another gender coupled with significant discomfort and distress with ones own assigned gender and sex.

Floridas efforts follow years of litigation and lawmaking driven by conservatives about whether transgender girls can compete in womens sports, how the existence of transgender people is explained in schools and which bathroom is appropriate for them to use.

Essentially, those in favor of treating the condition with hormonal therapy care and those against the practice are accusing each other of the same thing: distorting the scientific evidence in order to politicize the well-being of children.

Lets delve into some of the most important questions on the subject.

Want to suggest more questions that could appear in a future story? Email kwilson@tampabay.com or codonnell@tampabay.com.

An estimated 16,200 Florida teenagers roughly 1.32% of children aged 13 through 17 identify as transgender, according to a June report by The Williams Institute, a think tank at UCLAs School of Law. The report uses data from Floridas 2019 Youth Risk Behavior Survey. Across the U.S., as many as 300,000 teens identify as transgender, the report found.

That does not mean they meet the psychological criteria to be diagnosed with gender dysphoria. Based on the number of people who seek treatment, up to 0.014% of those assigned male at birth and 0.003% of those assigned female at birth are later diagnosed with gender dysphoria, according to the American Psychiatric Association.

To be diagnosed, the condition must persist for six months, and children must be able to verbalize their discomfort, according to the definition of gender dysphoria offered by the American Psychiatric Association.

Its not clear. However, the number of children needing services to treat gender dysphoria or related mental health issues is on the rise in some western countries such as the United Kingdom. Some attribute this to decreasing social stigma to being transgender, or the increased availability of services. Others, including conservative policymakers, have hypothesized the condition is socially influenced.

For Nikole Parker, gender identity was a matter of life and death.

I would not be alive if I did not transition, said Parker, whos now the director of transgender equality at the LGBTQ advocacy group Equality Florida.

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Many transgender people experience gender dysphoria so acutely it has negative consequences for their mental health. Parker says when she began her transition journey at 19, she wanted to align her body with her gender identity so much that she acquired hormones off the black market.

At least one in four kids diagnosed with gender dysphoria report having attempted suicide, according to three studies cited by a peer-reviewed case report.

The medical therapies, which experts say should be administered gradually along with extensive consultation from mental health professionals, fall under three categories.

First, if a child has not already gone through adolescence, they can be put on puberty blockers. This can alleviate distress from body changes that dont align with identity. Puberty blockers can also buy children time to figure out how or whether they want to proceed with their transition.

Next, they can be prescribed hormones: typically estrogen for transgender girls and testosterone for transgender boys. Like puberty blockers, these hormones treat a number of other medical conditions. The Endocrine Society, which advises doctors on hormone science, notes that for most kids, 16 is the youngest age that they can consent to treatment.

Finally, people can pursue gender confirmation surgeries that involve reconstructing reproductive organs. However, medical societies do not generally recommend these irreversible surgeries for children.

In a recent report, Floridas Agency for Health Care Administration explored whether insurance should cover these therapies and whether they fall under the states professional medical standards, or whether they were experimental or investigational.

The state decided the scientific community had not demonstrated enough evidence to show whether the treatments were safe or effective in easing the mental health burden associated with gender dysphoria. More traditional mental health counseling is appropriate for transgender kids, but not hormonal therapies, Florida officials have said.

Major medical societies such as the Endocrine Society and American Academy of Pediatrics and the World Professional Association for Transgender Health disagree with the states assessment. They recommend the treatments be available for kids and adults.

A team of Yale researchers wrote a policy paper in April criticizing conservative-run states for restricting access to puberty-blocking drugs, arguing that the therapies are safe, effective, and fully reversible.

The drugs have been prescribed by doctors since the 1980s to treat kids suffering from a phenomenon called precocious puberty, in which some children begin the process of puberty at an inappropriately early age. Once a child is of the proper age to go through puberty, they are taken off the drugs.

Some other academics, including many cited by Florida officials, argue the effects of puberty blockers arent fully reversible. They say theres not enough evidence to demonstrate whether puberty blockers alleviate the mental health symptoms of gender dysphoria nor is there enough evidence on the long-term effects of the drugs prescribed to kids to treat gender dysphoria.

Hormonal therapies present more significant long-term effects for children, some of which can be irreversible, such as a reduction in fertility.

Michael Haller, the chief of pediatric endocrinology at the University of Florida, works at a clinic in Florida that treats children with gender dysphoria. He says his patients benefit from hormonal therapies, and that the families know the potential downsides.

The majority of the bodies that have looked at the available data and who take care of these patients have argued in favor of these treatments, Haller said.

Some who have undergone hormonal therapies say they regret the process. Experts on both sides of the debate around hormonal therapies agree more study is needed. Haller said in his experience, the number of children who regret transitioning is exceedingly low.

State officials are questioning the authority of three medical societies: the Endocrine Society, the American Academy of Pediatrics and the World Professional Association for Transgender Health.

Those three groups have endorsed hormonal therapies care based on studies that rely on survey results; doctors shouldnt heed their advice, Florida officials say.

Physicians who recommend sex reassignment treatment are not adhering to an evidence-based medicine approach and are following an eminence-based model, the June report from the state reads. Florida officials argued the guidance recommending puberty blockers to treat childhood gender dysphoria is based on studies that involved small sample sizes and subjective methods.

In response, the World Professional Association for Transgender Health, a nonprofit dedicated to advancing the health of transgender people, called the states report misleading and dangerous. The Endocrine Society stands by its guidance, which was primarily crafted by nine experts according to the groups standards for evidence-based guidelines. The American Academy of Pediatrics also backs its guidance, which was created with the help of more than a dozen expert members.

Paul Hruz, an associate professor of pediatrics at the Washington University School of Medicine in St. Louis, was one researcher cited in the Florida report. He said Florida officials did a good job highlighting what he describes as gaps in the science that call into question the efficacy of hormonal treatments for kids.

I think it would be erroneous to say we know the answer and that were going to limit our investigation, Hruz said.

Haller said the bulk of the scientific evidence, along with the clinical benefits hes seen, justify prescribing hormonal therapies.

The benefits far outweigh the risk, Haller said.

Another researcher cited by the Florida Agency for Health Care Administration, James Cantor, testified in favor of a law that blocks the use of puberty blockers and hormone therapies for children during a recent federal court case in Alabama.

The judge wrote that he gave Cantors testimony very little weight as it emerged in cross-examination that Cantor had never treated a transgender child under the age of 16 or diagnosed a child with gender dysphoria.

The Florida Department of Health issued guidance in April recommending against gender-affirming care for kids. It also recommended against social transitioning, in which a child takes on a different outward presentation. That can include assuming a new name or wearing new clothes.

Critics of the states guidance, including DeSantis former surgeon general, signed a letter in April noting that Floridas stance on social transitioning is not in line with the countries cited by the state that are skeptical of hormonal therapies.

Surgeon General Joseph Ladapo, who leads the state health department, asked a few weeks later that the Florida Board of Medicine create rules that could restrict access to certain gender dysphoria treatments.

The Agency for Health Care Administration has now proposed a rule that would block Medicaid from covering procedures that alter primary or secondary sexual characteristics.

A hearing is set for July 8 on that rule, which LGBTQ advocates have harshly criticized. They argue the DeSantis administration is interfering with a personal medical choice for political gain.

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As DeSantis focuses on Florida transgender kids, heres what you need to know - Tampa Bay Times

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The days of safe and legal abortion are limited in Tennessee.

Our state has a trigger ban on abortion, scheduled to go into effect when the Supreme Court ruling on Dobbs v. Jackson becomes final and Roe v. Wade is overturned. When this happens, it means that emgergency physicians like me will no longer be able to refer my patients who need an abortion to a facility where they can obtain one safely within our state.

The only exception for the new abortion ban in Tennessee would be for the life of the mother, a term deliberately vague enough to give many doctors and healthcare workers pause. What does the life of the mother exception really mean? How threatened must someones life be before we can intervene and help them medically?

Take ectopic pregnancies. In an ectopic pregnancy, a fertilized egg implants itself outside the uterus, typically in the fallopian tubes or an ovary, but occasionally into other sites in the abdominal cavity. Ive seen a case report of an ectopic pregnancy in someones liver.

These pregnancies are not viable. Contrary to the belief of some politicians, there is no medical way to salvage them or reimplant them into the uterus. Eventually, an ectopic pregnancy will grow large enough to rupture the organ in which it is growing and cause the patient to hemorrhage.

In current practice, if I diagnose an ectopic pregnancy in my emergency department, I call my obstetric/gynecology colleague and we discuss the case. If the patient is not too far along in the pregnancy and there are no signs of rupture, we treat the patient with a medical abortion. The patient takes a pill called methotrexate and follows up in the clinic for a repeat ultrasound and check of her hormone levels. If there is cardiac activity on ultrasound, hormone levels are high, the ectopic pregnancy is large or there are any signs of rupture, the Ob/Gyn physician takes the patient for an operation to remove the ectopic pregnancy, thus aborting the nonviable fetus.

In countries with laws preventing abortions for any reason, patients with non-viable fetuses have become septic from uterine infections and died. Is that what lies in store for patients in a post-Roe v. Wade Tennessee?

In a post-Roe state where abortion is illegal from the moment of conception with only life of the mother exceptions, a physician may hesitate to act until the patient is hemorrhaging and their life is at risk. But we know from years of scientific study that treating ectopic pregnancies prior to rupture leads to better outcomes and fewer deaths. I worry that the vaguely-worded abortion laws about to take effect in Tennessee will cause women to suffer and die as a result.

Another case would be that of a pregnant patient who goes into labor before the fetus is viable, or before 24 weeks.The first step is an ultrasound, done in the emergency department, before the patient is admitted to the labor and delivery ward and my OB colleague takes over treatment. The treatment involves trying to stop the labor with medications. If that is unsuccessful and the patients water breaks, then an abortion is necessary to save the mothers life.

There have been several cases around the world where patients have not been given abortions when theyve gone into preterm labor with nonviable fetuses because of anti-abortion laws. These patients have become septic from severe infections allowed to fester in their wombs and spread throughout their bodies until they go into multi-system organ failure and die.

I know other emergency and OB/Gyn physicians who are incredibly concerned about these two scenarios and countless others. What will the OB physicians who specialize in high risk pregnancies do when their high risk patients suffer? How will in-vitro fertilization be affected by the new laws?

And where is that line where a patients life is so at risk that doctors are allowed to do their jobs?

If I, an emergency physician, dont know the answer to these questions, you can bet most other doctors in our state dont either. What I do know is our patients will suffer and some will die.

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A post-Roe Tennessee threatens patients and hamstrings physicians Tennessee Lookout - Tennessee Lookout

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DAVINA McCALL could not believe it when two US neuroscientists told her hormone replacement therapy might reduce the risk of dementia and she was not the only one.

In the presenters Channel 4 documentary Sex, Mind And The Menopause, Dr Lisa Mosconi and Dr Roberta Diaz Brinton from Arizona University said oestrogen could have huge potential in lowering womens chances of developing Alzheimers.

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Speaking exclusively to Sun Health, Dr Brinton revealed that women are twice as likely to get dementia because of the way their brain changes during menopause, when oestrogen levels drop and affect brain function.

She said: On average, women live four and a half years longer than men, but that doesnt account for a two-fold greater lifetime risk of developing Alzheimers disease.

Our research shows its not because women live longer than men. Its because they begin the disease earlier, in mid-life.

Due to oestrogen loss during menopause, the brain can suffer a 20 to 25 per cent drop in glucose metabolism, the process that provides the brain with fuel.

That drop can trigger a starvation response in the brain.

It can lead to a decline in white brain matter (which helps different parts of your brain communicate) and an increase in a sticky plaque, called amyloid beta deposition, which, according to Dr Brinton, is found in greater quantities in people with dementia.

In theory, prescribing oestrogen to women who are in perimenopause which starts several years before menopause could reduce their risk of these problems and dementia.

But HRT is not suitable if, for instance, you have had breast, ovarian or womb cancer.

Most read in Womens Health

And oestrogen treatment is no good post-menopause, either. Dr Brinton said: Using oestrogen as a treatment doesnt work, as the brain has already changed. Its needed when women have symptoms.

She adds there is no data on whether intervening before symptoms would work, and little research has been carried out on HRT and the brain in the UK.

That is not good enough, says Dr Louise Newson, who supports our Fabulous Menopause Matters campaign, especially when 600,000 British women have dementia and it is the leading cause of death in UK women.

The HRT shortages have also forced some women to take drastic action and buy the drugs they need on the black market.

Sam Youngz, 49, a wellness adviser from Telford, Shrops, said: My nan had dementia and my mum suffers. Ive been diagnosed with Ehlers-Danlos syndrome, a connective tissue disorder that affects the whole body including the brain. My risk is high.

Sam went through early menopause at 37 and was shocked by the revelations in Davinas show. She said: I was finally diagnosed as menopausal at 44, so the news is too late for me. I dont know if it would have helped, but I wish Id had the chance to try.

Fabulous Menopause Matters

An estimated one in five of the UKs population are currently experiencing it.

Yet the menopause is still whispered in hush tones like its something to be embarrassed about.

The stigma attached to the transition means women have been suffering in silence for centuries.

The Sun are determined to change that, launching the Fabulous Menopause Matters campaign to give the taboo a long-awaited kick, and get women the support they need.

The campaign has three aims:

The campaign has been backed by a host of influential figures including Baroness Karren Brady CBE, celebrities Lisa Snowdon, Jane Moore, Michelle Heaton, Zoe Hardman, Saira Khan, Trisha Goddard, as well as Dr Louise Newson, Carolyn Harris MP, Jess Phillips MP, Caroline Nokes MP and Rachel Maclean MP.

Exclusive research commissioned by Fabulous, which surveyed 2,000 British women aged 45-65 who are going through or have been through the menopause, found that 49% of women suffered feelings of depression, while 7% felt suicidal while going through the menopause.

50% of respondents said there is not enough support out there for menopausal women, which is simply not good enough. Its time to change that.

Dr Newson said research looking at both women who do and women who do not take HRT could be a game-changer.

She added: Is it because men have more testosterone in the brain that they are less likely to develop dementia?

We need answers. We know if women have their ovaries removed, their cognitive function declines faster than women who havent had them removed.

Women who go through early menopause are also more likely to experience dementia. But does giving these hormones back to women help reduce the risk?

Its logical to assume putting something back in the brain that helps it function would help. The logic is there. Nothing is proved.

After four years of low mood, brain fog and insomnia, Katie Taylor, 53, is reaping the benefits of HRT.

The Latte Lounge founder a website that supports women in mid-life lives in London with her husband and children, and at 47 was diagnosed as perimenopausal.

She began using oestrogen and progesterone patches and said: In a few weeks, all my symptoms disappeared. I had energy again.

She was sleeping better and her brain clarity returned. Katie added: I can see the difference HRT has made.

Dr Newson, who had brain fog before starting HRT, said: Many women think they have dementia. We know brain fog improves with HRT. If it helps reduce dementia risk too, then thats incredible.

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Im a GP heres the truth behind Davina McCalls claims about HRT and dementia... - The Irish Sun

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Want To Stay Asleep Through The Night? Stop Taking This Supplement - mindbodygreen.com

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The grant is being used to fund a first-of-its-kind clinical trial that will recruit healthy individuals through a genome-first approach and perform deep metabolic phenotyping to understand the underlying mechanisms responsible for the regulation of the human bodys metabolism through natriuretic peptide hormones.

The grant is being used to fund a first-of-its-kind clinical trial that will recruit healthy individuals through a genome-first approach and perform deep metabolic phenotyping to understand the underlying mechanisms responsible for the regulation of the human bodys metabolism through natriuretic peptide hormones.Researchers from the University of Alabama at Birmingham Division of Cardiovascular Disease have been awarded a $3.7 million grant from the National Heart Lung and Blood Institute to study how genetically determined differences in natriuretic peptide levels (heart hormones) regulate the handling of glucose metabolism and use of energy while resting and while exercising.

The grant is being used to fund a first-of-its-kind clinical trial that will recruit healthy individuals through a genome-first approach and perform deep metabolic phenotyping to understand the underlying mechanisms responsible for the regulation of the bodys metabolism through NPs.

NPs are hormones produced by the heart that regulate cardiometabolic health. These hormones are released in response to changes in pressure inside the heart. These hormones are also responsible for regulating how the body responds to glucose and how it utilizes energy at rest and while working out.

Pankaj Arora, M.D., associate professor of medicine and the director of the $11 million NIH-funded Cardiovascular Clinical and Translational Research Program and the UAB Cardiogenomics Clinic, received the grant.

An estimated 37 million adults in the United States have diabetes, and an additional 96 million adults have pre-diabetes, which predisposes them to a higher risk of potentially fatal cardiovascular events such as heart attack, stroke and heart failure.

Researchers believe that genetically determined low NP levels may contribute to some individuals having a poor glucose metabolism and a low amount of any exercise. Individuals with lower circulating NP levels are predisposed to a higher risk of cardiometabolic diseases such as diabetes, high blood pressure, heart attacks, stroke and heart failure.

Pankaj Arora, M.D., associate professor of medicine and the director of the $11 million NIH-funded Cardiovascular Clinical and Translational Research Program and the UAB Cardiogenomics Clinic, received the grant.The study is employing an innovative genome-first strategy to assess the role of NPs in regulating the cardiovascular and metabolic health of an individual, Arora said. We will be enrolling individuals with and without a common genetic variant that predisposes them to have low NP levels. The study participants will then undergo a comprehensive metabolic assessment to understand the influence of genetically determined low NP levels.

The study is the result of decades of interdisciplinary research conducted by UAB scientists in collaboration with investigators across the country. Through past research, Arora and colleagues have shown that certain RNA-based regulators control the production of NPs and serve as potential therapeutic targets. Arora and his colleagues are studying how these regulators can be targeted for a precision medicine approach to the treatment of common cardiometabolic diseases.

There are certain RNA-based regulators that control the production of these good heart hormones that were discovered by our group of researchers, Arora said. These regulators reduce the production of NPs in individuals with a low NP genotype and may serve as potential therapeutic targets for the treatment of high blood pressure, diabetes, pre-diabetes and heart failure.

In addition to an innovative genome-first approach, the study by Arora and colleagues may also unravel a potentially new line of personalized therapeutics that follow the same genome-first precision medicine approach.

Arora believes that innovative studies like these build upon the advances in genomic medicine and bring the knowledge of decades of research back to the benefit of the patients at their bedside. UAB has been supporting such bench-to-bedside initiatives that translate scientific evidence accumulated from large-scale population genomic studies and bench research to the patient bedside. UAB physician-scientists are leading several such initiatives to enhance clinical and translational research in the domains of cardiometabolic disease.

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Arora receives $3.7 million grant to assess a genome-first approach to improving cardiometabolic health through heart hormo - University of Alabama at...

Recommendation and review posted by Bethany Smith