OverviewWhat is hypopituitarism?

Hypopituitarism is a rare condition in which theres a lack (deficiency) of one, multiple or all of the hormones made by your pituitary gland. Hormones are chemicals that coordinate different functions in your body by carrying messages through your blood to your organs, muscles and other tissues. These signals tell your body what to do and when to do it.

The pituitary hormones are in charge of important functions in your body, such as metabolism, growth and development and reproduction. Your pituitary gland is a pea-sized gland located at the base of your brain below your hypothalamus (the part of your brain that controls your autonomic nervous system). Its a part of your endocrine system.

Your pituitary gland is connected to your hypothalamus through a stalk of blood vessels and nerves. This is called the pituitary stalk. Through the stalk, your hypothalamus communicates with your pituitary gland and tells it to release certain hormones. Your hypothalamus is the part of your brain that controls functions like blood pressure, heart rate, body temperature and digestion.

Hypopituitarism can occur from disorders of or damage to your pituitary gland or hypothalamus.

Your pituitary gland makes the following hormones:

There are three different kinds of hypopituitarism based on the number of hormones that are lacking (deficient):

There are three kinds of hypopituitarism based on the cause of it and how your pituitary gland and its hormones are affected:

Hypopituitarism can affect anyone at any age, though its a rare condition.

Hypopituitarism is a rare condition. There are approximately 10 to 40 new cases per one million people a year.

The symptoms of hypopituitarism depend on which pituitary hormone(s) are affected and deficient (lacking). The following factors also affect what kind of symptoms youll experience:

Symptoms of growth hormone deficiency in newborns include:

Symptoms of growth hormone deficiency in children include:

Symptoms of growth hormone deficiency in adults include:

Symptoms of thyroid-stimulating hormone deficiency in newborns include:

Symptoms of thyroid-stimulating hormone deficiency in children and adults are similar to symptoms of hypothyroidism, an underactive thyroid. This is because TSH stimulates your thyroid to produce its own hormones.

Symptoms of hypothyroidism include:

FSH and LH are called gonadotropins and affect your reproductive system.

Symptoms of FSH deficiency and/or LH deficiency in newborns assigned male at birth include:

Symptoms of FSH deficiency and/or LH deficiency in children include:

Symptoms of FSH deficiency and/or LH deficiency in adults assigned male at birth include:

Symptoms of FSH deficiency and/or LH deficiency in adult assigned female at birth can include:

Symptoms of ACTH deficiency in newborns include:

Symptoms of ACTH deficiency in children and adults include:

The main symptom of prolactin deficiency is a lack of breast milk production after giving birth.

Symptoms of oxytocin deficiency include:

Symptoms of ADH deficiency in newborns include:

Symptoms of ADH deficiency in children include:

Symptoms of ADH deficiency in adults can include:

Many conditions and situations can cause hypopituitarism. In some cases, healthcare providers cant determine the cause. This is called idiopathic hypopituitarism. In general, these three main factors can cause hypopituitarism:

Examples of conditions that can cause pressure on your pituitary gland or hypothalamus include:

Examples of situations that can cause pituitary or hypothalamus damage include:

Examples of rare conditions that can cause hypopituitarism include:

Your healthcare provider may order any of the following tests to diagnose hypopituitarism:

Treatment for hypopituitarism depends on which pituitary hormone(s) are deficient and the cause of the hypopituitarism. For that reason, treatment is very individualized. Your healthcare team will determine what the best treatment plan is for you. Common treatment options for hypopituitarism include:

Currently, theres no known cure for hypopituitarism, but it is treatable.

The following conditions or situations are considered risk factors for hypopituitarism:

Unfortunately, there are no known ways to prevent hypopituitarism.

The prognosis for hypopituitarism varies and depends on the following four factors:

In most cases, people with hypopituitarism require close, lifelong monitoring of their hormones and symptoms. While many people with hypopituitarism lead healthy lives, long-term pituitary damage is associated with an increased risk of mortality (death) compared to people without hypopituitarism of the same age.

Although it is not as common, a sudden and severe onset of hypopituitarism can result in a medical emergency and death if its not treated. Be sure to call your healthcare provider or go to the nearest emergency room if you are experiencing symptoms.

In most cases, hypopituitarism requires close, lifelong monitoring of the hormones affected. Be sure to see your healthcare provider regularly to make sure your treatment plan is working. If youre experiencing new or concerning symptoms, contact your healthcare provider as soon as possible.

If youve been diagnosed with hypopituitarism, you may want to ask your healthcare provider the following questions:

A note from Cleveland Clinic:

A new diagnosis can be scary, but dont be afraid to ask your healthcare provider questions about your hypopituitarism. Most cases of hypopituitarism require lifelong treatment and monitoring of your hormones, so it is important to see your provider regularly. Be sure to contact your provider if you have new or concerning symptoms. Theyre there to help.

More here:
Hypopituitarism: Symptoms, Treatment & Diagnosis

Recommendation and review posted by Bethany Smith

Thalassemia is an inherited blood disorder passed to a child by either of the parents. It causes defective red blood cell production leading to low haemoglobin and such patients require lifelong blood transfusion to cope with their lives.There are two types of thalassemia alpha and beta. Dr Ganesh Jaishetwar, consultant hematologist, hemato-oncologist and bone marrow transplant physician, Yashoda hospitals Hyderabad, told indianexpress.com, The affected children with both defective globin genes are called as thalassemia major who need regular blood transfusions and these cases can be fatal before 30 years of age, whereas the person with one defective globin gene and one normal gene are thalassemia carriers and such carriers remain asymptomatic with normal life expectancy.

One major purpose to mark this day is to debunk myths associated with thalassemia and help the patients lead a normal life. Some of the various myths and corresponding facts, as laid out by Dr Jaishetwar are:

Myth: Thalassemia is not preventable

Fact: Some communities have a higher prevalence of this gene. According to the health expert, the thalassemia trait in young couples belonging to such at risk population can be detected by haemoglobin electrophoresis by HPLC. The beta gene mutation is subjected to detection by DNA analysis.

During early pregnancy in such at-risk thalassemia carriers, the DNA mutation analysis from the chorionic villus biopsy or amniotic fluid analysis can help check if the index fetus is thalassemia major. If so, we could offer medical termination of pregnancy (depending upon cultural and religious belief of the couple) to prevent birth of a thalassemia major child. Thus, Thalassemia major is preventable, said the hematologist.

Myth: Thalassemia carriers should not get married to each other and they will always have a thalassemia major child

Fact: As long as people with thalassemia minor know of each others thalassemia status and their DNA mutation testing, they can get married to each other. To ensure a non-thalassemia major birth, one can go for the pre-implantation genetic testing, PGTM (pre-implantation embryonic genetic testing) to select the embryo that does not have the thalassemia gene.

There is only a 25 per cent chance that the foetus could be thalassemia major, but a 50 percent chance that it could be thalassemia minor like either of the parents. In the remaining 25 per cent chance, the child could be normal. Which means that 75 per cent of the time there is no fear of a thalassemia major birth, the doctor explained.

Myth- There is no treatment for thalassemia major

Fact: If a thalassemia major child is transfused with leukocyte filtered blood regularly, he or she can reach adulthood in good health.

Additionally, the expert also mentioned the importance of looking at the level of ferritin for iron overload and medicines that remove excess iron from the blood through the urine which includes the oral iron chelation agent.

He said in order to get the best results for a proper growth, proper check-ups for early organ damage by MRI of the heart, pancreas and liver should also be performed. This would ensure the thalassemia patients a good quality of life. Bone marrow transplant and gene therapy are other treatment options for thalassemia major patients, according to the health expert.

Myth Thalassemia major cannot be cured.

Fact: According to the expert, there are ways to cure thalassemia major. He said, Along with blood transfusions, allogeneic bone marrow transplantation can be a curative option for thalassemia major. Another important therapy with curative potential for thalassemia major is gene therapy which has shown promise in phase II trials. He mentioned gene therapy for curative potential for thalassemia major.

Dr Jaishetwar also mentioned novel therapies like Luspatercept that can help improve the haemoglobin of thalassemia major. He said this can contribute to making them relatively transfusion independent, however, it is expensive and needs a long-term treatment.

For more lifestyle news, follow us on Instagram | Twitter | Facebook and dont miss out on the latest updates!

Visit link:
World Thalassemia Day 2022: Doctor explains myths and facts about this blood disorder - The Indian Express

Recommendation and review posted by Bethany Smith

Astute Analytica publishes a research report on the global Gene Therapy Market. The analysis report contains in-depth data about demand, growth, opportunities, challenges, and restraints. In addition, it provides a thorough examination of the structure and possibility of global and regional industries.

The global Gene Therapy Market study includes information from key firms on R&D, new product launches, and product responses from global markets. The analysis includes a graphical presentation and a diagrammatic examination of the global market by region.

The global Gene Therapy Market size was US$ 5.8 billion in 2020 and is forecast to reach US$ XX billion by 2027, growing at a compound annual growth rate (CAGR) of 24% during the forecast period from 2021 to 2027.

Request To Download Sample of This Strategic Report:-https://www.astuteanalytica.com/request-sample/gene-therapy-market

People and economies globally rely substantially on the healthcare business. It is one of the fastest-growing industries. There is a correlation between income levels and healthcare spending in different nations, with healthcare spending accounting for more than 10% of most industrialized countries GDP.

The Centers for Medicare and Medicaid Services data calculates that the U.S. national healthcare expenditure reached US$ 4.1 trillion in 2020 and is forecast to surpass US$ 6.2 trillion by 2028. According to the Commonwealth Fund, the U.S. spent nearly 17% of gross domestic product (GDP) on healthcare in 2018. Switzerland was the second-highest-ranking country, spending 12.2%. In addition, New Zealand and Australia dedicate only 9.3%.

Regional Analysis

According to the United States, Bureau of Labor Statistics, healthcare employment is likely to grow 16% from 2020 to 2030, much faster than the average for all occupations, with about 2.6 million new jobs. This projected increase is primarily due to an aging population, which indicates a higher demand for healthcare services. In May 2021, the median annual wage for healthcare practitioners and technical sectors (such as registered nurses, physicians and surgeons, and dental hygienists) was US$ 75,040, which was higher than the economys median annual wage of US$ 45,760.

Download Sample Report, SPECIAL OFFER (Avail an Up-to 30% discount on this report-https://www.astuteanalytica.com/request-sample/gene-therapy-market

The European legislature and decision-makers should be aware that EU health systems are facing challenges arising from an aging population, citizens rising expectations, migration, and mobility of patients and health care professionals. Statista data shows the number of individuals employed in Europes hospitals in 2019. In 2019, there were more than 1.5 million people employed in hospitals in the UK, the largest number in Europe.

Impact Analysis of COVID-19

Global COVID-19 cases have climbed above 516 million as of May 2022, and the death toll has exceeded 6.25 million. COVID-19 has disproportionately impacted specific racial and ethnic minority groups, as well as underserved and marginalized communities, highlighting the persistent challenges of health equity and health outcomes.

COVID-19 is causing a great deal of emotional, physical, and professional stress among health care personnel. The changing attitudes and behaviors of consumers, the integration of life sciences and health care, fast-growing digital health technology, new talent, and care delivery models, and clinical innovation advanced by COVID-19.

Request Full Reporthttps://www.astuteanalytica.com/request-sample/gene-therapy-market

As sector players and the customers, they serve to adapt to a new world of remote working, virtual doctor visits, and a supply chain plagued by shortages of medical goods, employees, and services, the sector is reforming to become more customer-centric.

About Astute Analytica:

Astute Analytica is a global analytics and advisory company that has built a solid reputation in a short period, thanks to the tangible outcomes we have delivered to our clients. We pride ourselves in generating unparalleled, in-depth, and uncannily accurate estimates and projections for our very demanding clients spread across different verticals. We have a long list of satisfied and repeat clients from a wide spectrum including technology, healthcare, chemicals, semiconductors, FMCG, and many more. These happy customers come to us from all across the globe.

They are able to make well-calibrated decisions and leverage highly lucrative opportunities while surmounting the fierce challenges all because we analyze for them the complex business environment, segment-wise existing and emerging possibilities, technology formations, growth estimates, and even the strategic choices available. In short, a complete package. All this is possible because we have a highly qualified, competent, and experienced team of professionals comprising business analysts, economists, consultants, and technology experts. In our list of priorities, you-our patron-come at the top. You can be sure of the best cost-effective, value-added package from us, should you decide to engage with us.

Get in touch with us:

Phone number: +18884296757

Email: sales@astuteanalytica.com

Visit our website: https://www.astuteanalytica.com/

SOURCE Astute Analytica

Original post:
Gene Therapy Market Size, Share Key Facts and Forecast Predictions Presented 2021-2027 SMU Daily Mustang - SMU Daily Mustang

Recommendation and review posted by Bethany Smith

Pompe disease is a rare genetic disorder that disables the heart and skeletal muscles.

The inherited disorder can develop at any age, although the often-fatal disorder has faster progression and greater disease severity in earlier onset diagnoses.

Pompe disease occurs in every 1 in 40,000 births and can sometimes be mistaken for other genetic diseases. Thats because Pompe disease has symptoms similar to those of other genetic conditions.

There are, however, certain distinctions that can help physicians determine if its Pompe disease or something else.

Heres what you need to know about the symptoms of Pompe disease and how it compares to similar genetic diseases.

Pompe disease is an inherited disorder caused by a total absence of acid alpha-glucosidase, or GAA, an enzyme that helps break down glycogen in the body.

Since individuals with Pompe disease dont have GAA activity in their bodies, they experience a rapid buildup of glycogen in their heart and skeletal muscles. This rapid buildup then contributes to a host of symptoms associated with Pompe disease.

Because its a rare disorder, Pompe disease often requires a team of specialists, including internists, neurologists, pediatricians, orthopedists, cardiologists, dietitians, and physical therapists to manage treatment.

Pompe disease treatment plans are based on self-descriptions or descriptions provided by a caregiver. They often include enzyme replacement therapy (ERT), which involves intravenous administration of the GAA enzyme. ERT can help extend the life expectancy for people with Pompe disease. However, the disorder has no known cure.

Supportive therapy, like physical or speech therapy, is also a common part of treating Pompe disease, particularly in those diagnosed with the infantile onset subtype. Speech therapy may be needed as weakened facial muscles may make it difficult to articulate speech. Difficulty swallowing and even breathing call for further therapies.

Symptoms of Pompe disease generally affect the heart and skeletal muscles.

People who have an infantile form of Pompe disease, which usually presents within the first three months of life, experience the most severe symptoms. These include:

When these symptoms are combined, they often result in cardio-respiratory failure within the first 2 years of life. Infants with Pompe disease will often have a large, protruding tongue and an enlarged liver. Their legs may rest in a frog position and feel firm to the touch.

Childhood and adult Pompe disease often sees progressive weakness in the arms and legs, which can affect mobility and balance. Progressive respiratory weakness can also occur from dysfunction of the diaphragm and muscles between the ribs.

Younger individuals with Pompe disease may also experience scoliosis, or an abnormal curvature of the spine. This typically occurs at puberty due to muscle weakness in the spinal area.

As a result, people with Pompe disease may require wheelchairs or ventilators.

Other symptoms of Pompe disease include:

There are several genetic diseases that Pompe disease can be mistaken for.

Werdnig-Hoffman disease, or spinal muscular atrophy type 1 (SMA type 1), is a rare genetic disorder that can be confused with Pompe disease. Like Pompe disease, its characterized by progressive muscle weakness. Poor muscle tone is another symptom of Werdnig-Hoffman.

However, unlike Pompe disease, SMA type 1 doesnt affect the heart an important distinction.

Danon disease is another genetic disorder that can mimic symptoms of Pompe disease.

It also causes muscle weakness and cardiomyopathy, a disease of the heart muscle that can lead to heart failure. Because of this, men with Danon disease may need a heart transplant at some point in their lives.

The disease can cause intellectual disability as well, though the majority of associated cognitive deficits tend to be mild.

Neurological symptoms arent generally linked to Pompe disease.

Endocardial fibroelastosis, which can occur as a result of genetics, affects the heart. This disease is characterized by a thickening of the muscular lining of the heart chambers due to an increase in supporting connective tissue and elastic fibers.

Like Pompe disease, individuals with endocardial fibroelastosis experience impaired heart and lung function. However, the reason behind the impaired function differs.

Facioscapulohumeral dystrophy (FSHD) can mimic some symptoms of childhood and adult Pompe disease. It includes weakness of upper arm muscles, face, and shoulders.

Limited movement of the lips and difficulty raising the arms over the head may lead a physician to perform a confirmatory diagnostic test on chromosome 4. The mutations that occur in Pompe disease are localized to chromosome 17.

Duchenne muscular dystrophy, or DMD, is a genetic muscle disorder that, like Pompe disease, includes muscle weakness. It often occurs in early childhood or infancy.

DMD is the result of changes or mutations of the DMD gene on the X chromosome. It typically causes individuals to develop cardiomyopathy and respiratory difficulties. In addition, muscles in the upper legs, upper arms, and pelvic area become weakened.

Molecular genetic tests, a thorough clinical evaluation, and a detailed patient history are all part of reaching a DMD diagnosis.

Becker muscular dystrophy is characterized by similar muscle weakness as seen in Duchenne muscular dystrophy but often occurs at a later age. People with this condition are often able to walk independently into their 20s.

Doctors reach a Becker muscular dystrophy diagnosis through a close assessment of a persons physical symptoms, their family history, and testing that shows an elevated concentration of creatine kinase (CK) in the blood.

Pompe disease falls into a category of conditions known as glycogen storage diseases, which include changes in the way bodies use and store glycogen.

Other glycogen storage diseases that Pompe disease can sometimes be mistaken for are McArdle disease (GSD type V) and Hers disease (GSD type VI). McArdle disease, however, only affects the skeletal muscles, while Hers disease affects the liver.

Although some effects of Pompe disease can overlap with other genetic diseases, its important to keep a close eye on symptoms and their severity. This is the first step in obtaining an accurate diagnosis.

Consider making a list of all symptoms, when they occur, what causes them to worsen, and how they affect you. This is an important part of the patient analysis your doctor will perform.

You can also expect your doctor to take a blood sample to study and count the enzymes in your blood.

Several other tests are used to diagnose Pompe disease:

Although Pompe disease is similar to some other genetic disorders, treatments differ, and its important to get an accurate diagnosis for proper care and improved quality of life.

See the rest here:
Pompe Disease and Other Genetic Disorders - Healthline

Recommendation and review posted by Bethany Smith

Every year millions of people cross borders to undergo medical treatments that are either unavailable in their home country or too expensive. For many, this is a last resort to ease the pain of a debilitating disease or defy a terminal diagnosis; for others the goals are purely cosmetic. But in the past few years a new type of medical tourist has emerged: those seeking to radically extend their lives.

There are more older people than ever before and more people in search of longevity. In the UK, people over the age of 65 made up 19% of the population in 2019, a jump of 23% from 2009, in a period when the total population only increased by 7%. And recent advancements in the science of ageing have given them hope that they dont have to go so gently into that good night after all.

But while science has made some promising breakthroughs in studying the causes and implications of ageing, real solutions are some way off. In that gap between supply and demand, a host of fraudsters and scam artists are ready to take advantage of anyone gullible enough to believe they can pay a little extra for a few extra years among the living. Many offer their services abroad, in countries where regulation is light.

Medical tourism has produced a steady stream of horror stories since cheaper air travel kickstarted a rise in its popularity, from botched nose jobs and broken smiles to a fair number of deaths. Despite this, it remains a gigantic industry. According to Patients Beyond Borders, the global medical tourism market was worth $74bn-$92bn (59bn-73bn) in 2019.

A prime example is stem cell therapies, regenerative treatments aiming to use the bodys building-block cells to rejuvenate and fix damage caused by disease or deterioration an area of research with a lot of potential but relatively few established and approved treatments available to patients. However, the potential effects, most often exaggerated or unsubstantiated, lure the desperate to travel far and wide to seek treatments, sometimes from practitioners of ill repute. According to research published last year, the leading countries for stem cell tourism are the US, China, India, Thailand and Mexico. The same report states that stem cell technologies are often associated with inflated expectations of their therapeutic potential.

Stem cell therapies can also help with cancer and other illness, but during my reporting for my book The Price of Immortality: The Race to Live Forever, I found a number of examples of US-based stem cell companies offering miracle cures and solutions to ageing. One clinic in Iowa was found to have made outrageous claims in presentations to potential clients. Anti-Aging: Mesenchymal Stem Cell infusions turned back the hands of Father Time about three years! Would you like to get back three years? read one slide of sales material, collected by the state attorney generals office that was suing the company for false advertising.

Even when prosecuted or disciplined in one country, stem cell practitioners have been known to move on and continue to offer the same services elsewhere. One in Florida had his medical licence revoked in 2015, after two of his patients undergoing stem cell therapy had died. When I looked up the name of the doctor, he was listed as the chief science officer at another stem cell company. A cheerful receptionist told me on a call that the clinic was still operational and carrying out procedures in the Dominican Republic, a medical tourism hotspot.

Stem cell therapies are not the only anti-ageing offerings luring people abroad for treatment. The nascent field of gene therapies is in a similar position, where promising research has yet to result in accessible interventions. I also recently heard from a life extension enthusiast in the US who planned to travel to France to undergo plasmapheresis, a procedure he claimed would rejuvenate his blood and give him a better chance of living until he was 500.

In some cases, patients dont need even need to fly abroad to access drugs that have the potential to make them live longer. I spoke to an elderly woman in London who buys the cancer drug dasatinib from a website in India, and takes it in the hope it will destroy senescent cells, which are thought to play an integral role in the ageing process.

Gerontologists and other researchers find the practice frustrating. Several scientists I spoke to, particularly in the stem cell field, are worried these clinics are making a quick buck on the back of their breakthroughs while damaging the reputation of these nascent medical technologies. They preach patience, a virtue in short supply for people who see the end of their lives on the horizon.

Medical tourism presents clear dangers. Patients may not find the same standard of care they are used to at home, and it is harder to establish that the doctor or clinic is legitimate. Patients can also suffer from side-effects if they fly home too early after a procedure; communication barriers can also cause issues.

For someone seeking treatment they cant afford at home or a last-gasp unapproved cure for a deadly disease, these risks are worth taking. But for people merely seeking to improve their chances of living radically extended lives, the gamble is much larger, particularly when theres no evidence that any medical intervention could work. In a best-case scenario, they leave with a lighter wallet. In the worst, their quest to live a little longer is cut ironically short.

The Price Of Immortality by Peter Ward (Melville House, 20). To support The Guardian and Observer, order your copy at guardianbookshop.com. Delivery charges may apply.

Link:
Medical tourists are travelling the world in search of the elixir of life - The Guardian

Recommendation and review posted by Bethany Smith

Hormone therapy consultations are provided by Dr. Maddie Deutsch, the Medical Director of UCSF Transgender Care, an Associate Professor of Clinical Family & Community Medicine,and aninternationally recognized expert in gender affirming health care, and by Michael Snavely, MD, a Family Physician with special training in gender affirming health care. Patients can be seen only for hormone therapy and consultation, or in conjunction with receiving primary care.In many cases, visits can be conducted using video visits / telemedicine. It is strongly advised that all patients being seen by Dr. Deutsch for hormone therapy consultation only have an outside primary care provider; in the case of co-existing health issues, patients may be required to establish a primary care relationship either with an outside medical provider, or with Dr. Deutsch.

Dr. Deutsch offers the placement of testosterone pellets in the office for her own patients.

Dr. James F. Smith, MD, MS in the UCSF Department of Urology also offers this service for patients who are already on testosterone and have a doctor who is managing their hormone therapy and who is available to collaborate.

Contact us to arrange a consultation.

Read this article:
Hormone Therapy | Gender Affirming Health Program

Recommendation and review posted by Bethany Smith

Getting older gets a bad rap, especially when it comes to maintaining peak performance at work, in the gym, and even in the bedroom. But even though its normal for your body to experience changes as you age, there are simple, proven steps you can take to stop any negative effects in their tracks.

Testosterone treatment, HGH therapy, and other anti-aging treatments from Ehormones MD are the real-life, doctor-supervised fountain of youth everyone has been searching for. Safe, effective, and 100% customized to suit your goals, our therapies are the key to living your best life.

Think of TRT and HGH therapy as a way to bridge the gap between your present and a better, brighter future and you dont have to wait a single second longer to take action. You deserve to be in charge of your health and wellness. All you have to do is take that first step towards making the most of your masculinity for years to come and Ehormones MD is ready when you are.

Follow this link:
Ehormones MD: HGH Therapy | Testosterone Replacement Therapy

Recommendation and review posted by Bethany Smith

If youve been diagnosed with breast cancer, endometrial canceror prostate cancer, your cancer team may recommend hormone therapy as part of your treatment plan. You likely have lots of questions about this type of treatment, its advantages and its potential downsides.

Also referred to as hormonal or endocrine therapy, this cancer treatment is different from menopausal hormone replacement therapy (HRT), which refers to the prescription of supplemental hormones to help relieve the symptoms of menopause.

Certain cancers rely on hormones to grow. In these cases, hormone therapy may slow or stop their spread by blocking the bodys ability to produce these particular hormones or changing how hormone receptors behave in the body.

Breast and prostate cancers are the two types most commonly treated with hormone therapy. Most breast cancers have either estrogen (ER) or progesterone (PR) receptors, or both, which means they need these hormones to grow and spread. By contrast, prostate cancer needs testosterone and other male sex hormones, such as dihydrotestosterone (DHT), to grow and spread. Hormone therapy may help make these hormones less available to growing cancer cells.

Hormone therapy is available via pills, injection or surgery that removes hormone-producing organs, namely the ovaries in women and the testicles in men. Its typically recommended along with other cancer treatments.

If hormone therapy is part of your treatment plan, discuss potential risks or side effects with your care teamso that you know what to expect and can take steps to reduce them. Let doctors know about all your other medications to avoid interactions.

Aromatase inhibitorssuch as anastrozole (Arimidex), letrozole (Femara) and exemestane (Aromasin)work by inactivating aromatase, which your body uses to make estrogen in the ovaries and other tissues.

When and why theyre used: These medications are used primarily in women who have gone through menopause. Estrogen production declines dramatically after menopause. Premenopausal women produce too much aromatase for the inhibitors to work effectively. (Aromatase inhibitor drugs may be prescribed for younger women if theyre given with a drug to suppress ovarian function.)

Ask your care team whether you may benefit from aromatase inhibitors based on your cancers characteristics. Patients may receive aromatase inhibitors before surgery to shrink tumors for easier removal, or after treatment to prevent breast cancer from returning. These drugs may also play a role in breast cancer prevention for certain people who are at high risk.

Risks: While side effects differ based on the type of hormone therapy, the main ones in women with all types of hormone therapy (including aromatase inhibitors) are:

These are similar to symptoms of menopause, as both hormone therapy and menopause reduce the amount of estrogen in the body. In relatively rare instances, aromatase inhibitors may also increase the risk for heart attack, chest pain (angina), heart failure, high cholesterol, bone loss, joint pain, depression and mood swings.

Selective estrogen receptor modulators (SERMs)including tamoxifen (Nolvadex), raloxifene (Evista) and toremifene (Fareston)selectively block estrogen from certain tissues, namely the breast, while increasing its availability in other areas such as the bones.

When and why theyre used: Doctors may recommend SERMs after surgery for early ER-positive breast cancer in menor women, to reduce the chances that it recurs. Theyre also approved to treat advanced breast cancer, and may be used to prevent breast cancer in high-risk individuals. Toremifene is only approved for advanced stage breast cancer that has spread.

Risks: In addition to more common side effects of hormone therapy such as hot flashes, tamoxifen risks may include blood clots, stroke, bone loss, mood changes, depressionand loss of sex drive. Men who take tamoxifen may experience headaches, nausea, vomiting, rashes, impotence and loss of sex drive. Raloxifene may increase a patients chances of having a stroke or developing potentially fatal blood clots in the lungs or legs. Fortunately, these side effects are considered relatively rare. Have your doctor explain the potential side effects associated with each SERM when discussing the pros and cons of these medications with you.

Fulvestrat binds to estrogen receptors, completely stopping the hormone from attaching to the receptors.

When and why its used: Fulvestrant is approved for women who have advanced ER-positive breast cancer that has spread following treatment with other types of hormone therapy. Its also prescribed for postmenopausal women with ER-positive, HER2-negative cancers(meaning they have normal levels of human epidermal growth factor receptor-2) who have not undergone other hormone therapy.

Risks: Fulvestrant may cause nausea, vomiting, constipation, fatigue, back pain, bone pain, joint pain, headaches, hot flashes and breathing issues.

Ovarian suppression may involve surgery, drugs or radiation therapy.

The surgical procedure, called an oophorectomy, removes the ovaries to stop them from producing estrogen, while drugs prescribed for this purpose include gonadotropin releasing hormone (GnRH) analog and luteinizing hormone-releasing hormone (LHRH) analog.

When and why theyre used: These types of therapies may be recommended with either tamoxifen or an aromatase inhibitor for premenopausal patients.

Risks: Ovarian suppression may cause bone loss, mood swings, depression and loss of libido, along with hot flashes, night sweats, and vaginal dryness or atrophy.

Hormone therapy may be part of prostate cancer treatment if the cancer has spread and cant be cured by surgery or radiation therapyor if the patient isnt a candidate for these other types of treatment. It may also be recommended if cancer remains or returns after surgery or radiation therapy, or to shrink the cancer before radiation therapy.

Additionally, hormone therapy may be combined with radiation therapy initially if theres a high risk of cancer recurrence. It can also be given before radiation therapy to shrink the cancer and make other treatments more effective. Other types of hormone therapy for prostate cancerinclude:

This type of therapy includes LHRH agonists, also called LHRH analogs or GnRH agonists, such as Leuprolide (Lupron, Eligard), Goserelin (Zoladex), Triptorelin (Trelstar) or Histrelin (Vantas).

When and why theyre used: Intended to lower the amount of testosterone produced by the testicles, these drugs are injected or placed as a small implant under the skin. Doctors may refer to this as medical castration. Orchiectomy or surgical castration is the removal of the testicles.

Risks: Side effects may include:

These drugs sometimes cause an initial increase in male sex hormones, which may be dangerous. LHRH antagonists are another type of androgen deprivation therapy that doesnt cause this initial rise or flare. Both LHRH agonists and antagonists may stop the testicles from making androgens but dont control production in other parts of the body, such as the adrenal glands. This means that a tumor may still have access to the hormones it needs to grow. Drugs are available that block androgen madeby cells outside of the testicles.

These pills prevent male sex hormones from promoting tumor growth.

When and why theyre used: Doctors may suggest androgen blockers if an orchiectomy or an LHRH agonist or antagonist is no longer working. (An anti-androgen is also sometimes prescribed for a few weeks when an LHRH agonist is first started to prevent a possible flare.)

Newer anti-androgens, available as daily pills, include enzalutamide (Xtandi), apalutamide (Erleada) and darolutamide (Nubeqa).

Risks: Side effects may include diarrhea, fatigue, rash and worsening hot flashes. Dizziness and seizures are more severe, but less common, side effects.

Estrogens may be tried for prostate cancer if other hormone treatments are no longer working.

Cancer of the uterus or its lining, the endometrium, may respond to hormone therapy with progestins. Other types of hormone therapy for endometrial cancer include:

When and why theyre used: Hormone therapy is typically reserved for advanced uterine or endometrial cancer, or for cancer that has returned after treatment. Its often combined with chemotherapy.

Risks: Side effects are similar to those seen with hormone treatment for other types of cancer.

See original here:
Hormone Therapy For Cancer: Benefits, Risks & Reasons

Recommendation and review posted by Bethany Smith

Many women expect hot flushes, dry skin and night sweats when they reach the menopause. But the effect the menopause can have on the brain is rarely mentioned. This is something a recent Channel 4 documentary presented by Davina McCall explored.

The documentary, called Sex, Mind and the Menopause, discussed how the menopause can cause a range of brain-related symptoms, including brain fog, mood changes and memory problems. It also suggested that taking hormone replacement therapy (HRT) some years before the menopause may be the solution to these problems alongside potentially halving a womans risk of developing dementia.

With around 4.4 million women of working age going through the menopause in the UK, its clear that we need solutions to help those suffering from brain-related and other menopause symptoms. But HRT might not live up to what the documentary suggested it to be.

Around 23% of women experience measurable changes in brain function during menopause especially to their memory. These changes typically occur in the early stages, during perimenopause (the transitional period before menopause, typically between 40 and 44 years of age when oestrogen levels begin to drop and the frequency and intensity of periods start changing).

This is something the documentary touched on, with one doctor using brain scans of perimenopausal women to show that brain activity was 25% lower compared with premenopausal women (the time before perimenopause). However, the documentary did not show viewers that these brain changes are usually temporary often reversing a couple of years after reaching the menopause when a woman no longer has periods. This is typically between 45 and 55 years of age.

These temporary brain changes may be caused by other menopause symptoms that can affect sleep, such as night sweats. Since sleep plays an important role in brain function, not sleeping properly could lead to concentration and memory problems. No evidence to date has conclusively shown whether or not the hormonal changes that happen during this period are the cause of brain changes in humans.

While there is good evidence that HRT can help reduce the severity of some menopause symptoms (including hot flushes and night sweats), its less certain whether such treatments have any long-term benefit on memory and brain function.

Another argument the documentary makes is that taking HRT can significantly reduce a womans risk of developing Alzheimers disease the most common form of dementia. They drew on the results of an American study of over 400,000 women that showed those who used HRT had a 50% lower risk of dementia. This was especially true if they were taking natural hormones, such as oestradiol (an oestrogen steroid hormone).

But there is one key issue with this type of observational study. Previous studies have shown that women who decide to take HRT were better educated, exercised regularly, had a healthier weight and lower blood pressure and cholesterol levels compared with women who chose not to take HRT. All of these factors are known to decrease dementia risk.

While the study took these factors into account, having a good education or a healthy lifestyle may still have had a greater influence on reducing dementia risk than taking HRT by itself during the menopause did.

While a large UK study showed that taking HRT during the menopause can lower a womans risk of being diagnosed with dementia, this effect was much smaller (only around 8-12% lower) and was only seen in women taking the hormone oestradiol. It is worth noting that this study looked a both women who had experienced natural menopause as well as those who had early menopause because of surgery. Its believed that premature surgical menopause (before the age of 40) increases dementia risk unless these women take a replacement oestrogen treatment such as oestradiol. So while the study showed lower dementia risk in some women taking this hormone therapy, this might only have been the case for those who had an already elevated risk because of early menopause. Its also worth noting that overall, there was no association between taking hormones during the menopause and dementia in the UK study.

This UK study also showed that taking oestrogen alongside progesterone (the standard hormone treatment for the menopause prescribed to women who still have a womb), either eliminated the beneficial effect of oestrogen treatment alone or even increased the risk of dementia slightly. Previous studies have also shown an increased risk of dementia when taking a combination hormone though this risk was typically seen in women who were over 60 or if they were taking hormones for more than ten years. Giving these older women sex steroids has been associated with negative effects, accelerating damage to the brain cells.

Its also worth noting that taking combined hormone treatments for more than five years is linked to a greater risk of breast cancer though this risk is small, especially when compared with, say, the risk of cancer from being overweight or smoking. As such, most medical guidelines suggest that taking combined hormones for menopause symptoms is safe for up to five years after the menopause.

Hormone replacement therapy can be effective for many women in alleviating a range of menopausal symptoms, particularly hot flushes. Whether HRT can prevent dementia or alleviate brain-related symptoms due to the menopause is still unclear. But fortunately, any brain changes that happen because of the menopause are usually temporary.

Continued here:
Menopause: HRT's brain-protecting effect may be overstated - The Conversation Indonesia

Recommendation and review posted by Bethany Smith

Cameron Wright, 16, has always seen himself as a dude. As a young child, Cameron didnt have the words to explain the disconnect between how he saw himself and how the world saw him. But he knew that despite being born in a girls body, he was meant to be a boy.

After taking reversible puberty blockers that pause a teenagers body changes, Cameron considered whether he wanted to begin hormone therapy to physically transition more permanently. He did not take the decision lightly. Cameron said his doctor made him spend almost a year mulling over the question, working with his therapist, and thinking through the life-altering implications before the doctor believed he was ready to start taking the medications in 2020.

I thought about if I stayed a girl, life would be so much easier, said Cameron, who uses the pronouns he and him. But this is what I want, and Im not going to let anything stop me from being who I want to be, whether its hard or not.

Then in November 2021, the GENder Education and Care, Interdisciplinary Support clinic in Dallas, known as Genecis, stopped taking new patients for gender dysphoria hormone treatment because of pressure from Republican activists and politicians. Although doctors can continue to see patients like Cameron whom they were already treating, the clinic was dismantled. Cameron and his family now have concerns about what this means for them.

The Texas attorney general, Ken Paxton, also opened investigations into pharmaceutical companies whose products are used by transgender patients, and Republican Gov. Greg Abbott and the state GOP are increasingly focusing legislative and reelection efforts on a record number of bills that target transgender young people, their parents, and their doctors.

Since then, Texas Childrens Hospital in Houston announced it would stop offering hormone therapy. The Texas Tribune reported that Legacy Community Health, also in Houston, quietly paused hormone therapy for teens as well. And doctors throughout the state are telling patients they will no longer prescribe the medications under pressure from insurance companies.

Transgender young people and their families across Texas are now scrambling to find providers and maintain access to their medications, with some exploring options outside the state. An estimated 17,000 transgender people ages 13-17 live in Texas, according to Equality Texas, an LGBTQ+ education and advocacy organization.

For Chloe Ross, 15, who uses the pronouns she and her, the crackdown on her care has been distressing. Im just as human as everyone else, she said.

Chloes doctor is still seeing her and prescribing her hormones. But her mother, Kathryn Ross, has started researching options for out-of-state care. The family has been saving money in case they need to move, Ross said, but they hope it doesnt come to that.

Having just moved, and Chloe making good friends, the last thing we want to do is uproot her, said Ross. Moving would be the last option.

During the pandemic, the family relocated to a larger city within Texas, leaving behind bullies, and the teen found acceptance from new schoolmates who know her only as Chloe, someone who loves theater and wants to study genetics. But Abbotts orders to investigate parents who allow their children to receive gender-affirming care, and legislative threats to criminalize such care, weigh heavily on Chloe.

Im just trying to get through high school and stuff, Chloe said through tears. Having Gov. Abbott make me worry about that kind of stuff is terrible because I dont get a normal life anymore, you know? Right now, Im having to go to my teachers to ask them to please not turn me in for being trans. I shouldnt have to worry about something like that.

For as long as she can remember, Chloe said, she has favored wearing jewelry, playing volleyball, and participating in theater. She did not know how to express what she was feeling and thought she was gay. Chloe and her mom said strangers regularly assumed Chloe was a girl even as she presented as a boy and had not yet come out as transgender.

Echoing other parents, Chloes mother said that even though she was already deeply involved in LGBTQ+ support and advocacy, Chloes coming out as transgender was a gut punch. Never once did she disbelieve Chloe, but she feared for her daughters future. She feared for what is happening now.

Young people receiving gender-affirming care include those who are socially transitioning for example, wearing clothing that reflects their gender identity and those taking puberty blockers or hormones.

Not all young people who identify as transgender, however, move beyond social transitioning or experience the condition known as gender dysphoria, which means that they experience psychological stress when their body doesnt match their identity. And people who take puberty blockers dont necessarily decide to take gender hormones. Surgery is not recommended for people younger than 18.

Although gender-affirming care for trans young people remains politically controversial in many parts of the U.S., a study published by JAMA Network Open showed a reduction in suicidal ideation in trans youths who received such care. Health care organizations that include the Endocrine Society, the American Academy of Pediatrics, and the American Medical Association endorse gender-affirming health care.

Despite the changes to Genecis, Cameron is scheduled for a May appointment with Dr. Ximena Lopez, the doctor overseeing his care. His mom, Myriam Reynolds, however, worries it wont take place. Lopez has filed a lawsuit against UT Southwestern Medical Center, which jointly operated Genecis with Childrens Medical Center Dallas, alleging that the facility discriminated against some patients by preventing them from receiving gender-affirming care based on their gender identity.

In the meantime, Reynolds picks up Camerons hormone refills as soon as they are available to maintain a constant supply. She also said the family is considering all options to ensure Cameron can continue receiving care despite the state crackdown.

They dont care at all about trying to help my kid, Reynolds said. Its all political theater.

Its especially hard because access to Genecis was a consideration when the family decided to relocate from Colorado to Texas in 2017. Cameron had already come out as transgender, and, after researching the clinic, his mother believed he would receive compassionate, thoughtful care as he transitioned. Now the family is concerned about what kind of care Cameron will be able to get in Texas.

Cameron, who hopes to study music production or become a firefighter, tries to be optimistic that politicians will stop cracking down on medical care for people like him.

I cant control the way I am, said Cameron. This is not my moms doing or my doctors doing. This is just me trying to be myself.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

This story can be republished for free (details).

By Sandy WestKaiser Health News is a nonprofit news service covering health issues. It is an editorially independent program of the Kaiser Family Foundation, which is not affiliated with Kaiser Permanente.

Original post:
The Families of Trans Kids in Texas Consider Their Options Amid Crackdown on Care - Physician's Weekly

Recommendation and review posted by Bethany Smith

Diabetes is a chronic health condition that affects how your body turns food into energy. If you have diabetes, your body either doesn't make enough insulin or can't use the insulin it makes as well as it should. Over time this can cause serious health problems such as heart, vascular, Alzheimer's disease, or cancer, vision loss, neuropathy and kidney disease. To-date, there are three traditional types of diabetes: type 1, type 2, and gestational diabetes.

According to the CDC, diabetes is one of the nation's leading causes of death and disability. In 2019, diabetes was the seventh-leading cause of death in America and claimed more than 87,000 lives. Diabetes-related deaths surged by 17% in 2020 and 15% in 2021 compared to the pre-pandemic level in 2019. And many more who are living with diabetes suffer from disease-related cardiovascular damage, and other chronic diseases of aging, vision loss, and lower-limb amputation.

There isn't a cure for diabetes, so self-management and a healthy lifestyle regimen are necessary to reduce the impacts of diabetes on the human body. As a medical practitioner, specializing in endocrinology, diabetes and metabolism, I help my patients understand and manage their diabetes. 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.

It's believed that Type 1 diabetes is caused by an autoimmune reaction that attacks the body by mistake. If you have Type 1 diabetes, your pancreas is unable to make the hormone insulin, which normally regulates the level of sugar (glucose) in your blood stream. Without insulin to clear out the excess glucose, levels rise, wreaking havoc on the blood vessels. This is what causes all the vascular damage throughout the body.

Type 1 diabetes can be autoimmune-related or non-autoimmune-related. The autoimmune forms of diabetes may manifest in childhood, adolescence, or adulthood. Adult-onset autoimmune diabetes accounts for about 20% of adult-onset cases (which means that 80% of cases are not autoimmune-related).

The presence of certain antibodies in the blood are considered markers of diabetes. These include glutamic acid decarboxylase (GAD) and pancreatic insulin-producing islet cell antibodies (ICA). When GAD-positive antibodies are seen in adult-onset diabetes, it's a form of disease called latent autoimmune diabetes in adults ("LADA," or "type 1.5 diabetes"). This type of diabetes is often misdiagnosed as Type 2 diabetes, because it's adult-onset. This misdiagnosis unfortunately leads to poor therapeutic choices, worsening of glycemic (blood sugar) control, and may speed up progression to fulminant insulin-deficient Type 1 disease (a condition where the insulin-producing beta cells of the pancreas are swiftly and completely destroyed). Most early childhood onset Type 1 diabetes involves autoimmune dysfunction, where antibodies attack and destroy the insulin-producing cells

Some in the medical community now suspect that non-autoimmune forms of insulin-deficient (Type 1) diabetes are, in fact, autoimmune in nature, but they involve antibodies that have not yet been identified.

The main cause of Type 2 diabetes is obesity. Type 2 diabetes is also called "insulin resistance," because it's not a lack of insulin that causes blood sugar to rise, but an inability of the body's cells particular muscle and fat cells to utilize it. The pancreas still makes insulin as it should, but the insulin is rendered nonfunctional because the cells "resist" it. This has the same negative effect as having no insulin. Sugar levels rise, leading to vascular damage throughout the body. Moreover, the compensatory hyperinsulinemia itself plays an important pathogenic role in the chronic diseases of aging, including heart, vascular, Alzheimer's disease and cancers.

Type 2 diabetes used to be known as adult-onset diabetes, but both Type 1 and Type 2 diabetes can begin during childhood and adulthood. Type 2 is more common in older adults, but the increase in the number of children with obesity has led to more cases of Type 2 diabetes in younger people.

On the other hand, 20% of adult-onset diabetes is an autoimmune form (positive GAD antibody) of type 1 diabetes, so called latent onset diabetes of the adult, or LADA.

A variant of type 2 diabetes is ketosis-prone diabetes type 2. These individuals are typically older than adolescents, or childhood-onset type 1 diabetics, and are typically obese. This group is commonly racially identified as black, Hispanic, Asian, or Indian. Ketosis or ketoacidosis is characteristically an initial onset disease presentation, requiring insulin treatment that subsequently is manageable with oral agents. The pathogenic cause of ketosis-prone type 2 diabetes is not clear.

Another factor contributing to the development of Type 2 diabetes is the consumption of "non-food" dietary additives (for example, artificial sweeteners). These substances cause oxidative stress in the liver and subsequently the pancreas, resulting in excessive secretion of insulin and resistance to that insulin in the muscle, liver and fat cells. As mentioned above, insulin-antibody-mediated diabetes in childhood is often considered Type 1 disease, although the presence or absence of insulin deficiency independent of autoimmunity, also differentiates Type 1 versus Type 2 diabetes.

Long-standing Type 2 diabetes eventually leads to exhaustion destruction of the pancreas's insulin-producing beta cells with declining insulin levels. When this happens, the disease evolves into a non-autoimmune form of Type 1 (insulin-deficient) diabetes, sometimes referred to as diabetes type 1 1/2. When this happens, the person will need to start taking insulin shots, because their body no longer produces its own insulin.

Another insulin-resistant or Type 2 form of diabetes is known as steroid-induced diabetesan unexpected increase in blood sugar that's related to the use of steroids.

This can occur with prolonged steroid use and is one reason prescribed courses of steroid medications are generally short and taper off quickly. Such marked rises in blood glucose levels may occur in people with or without a history of diabetes. The most characteristic feature is skeletal-muscle insulin resistance with blood-sugar spikes that occur after meals. The muscles do not take up the sugar as they should. Steroid-induced diabetes is more similar to Type 2 diabetes than Type 1. In both steroid-induced diabetes and Type 2 diabetes, your cells do not respond appropriately to insulin. In Type 1 diabetes, your pancreas does not create insulin.

Gestational diabetes is a type of diabetes that can develop during pregnancy in women who don't already have diabetes. Gestational diabetes occurs when your body becomes resistant to the actions of insulin during your pregnancy. Insulin is a hormone made by your pancreas that lets blood sugar into the cells in your body for use as energy.

Both hormones produced by the placenta (progesterone and human placental lactogen) promote resistance to the actions of insulin. The placenta also produces a hormone called corticotrophin releasing hormone (CRH) which increases cortisol production during pregnancy. This also antagonizes the actions of insulin. In addition, excessive weight gain and poor dietary choices during pregnancy promote insulin resistance.

Having gestational diabetes can also increase your risk of high blood pressure during pregnancy, due to insulin resistance induced compensatory hyperinsulinemia, promoting arterial vasoconstriction and kidney mediated salt retention.

The term Type 3 diabetes has recently been coined in reference to the insulin-resistance component of the pathogenesis (course of development) of Alzheimer's disease. Type 3 diabetes occurs when neurons in the brain become unable to respond to insulin, which is essential for basic tasks, including memory and learning. Some researchers believe insulin deficiency is central to the cognitive decline of Alzheimer's disease.

Maturity-onset diabetes of the young (MODY) are a group of inherited diabetes subtypes that are passed from parent to child through the genes. Symptoms typically begin in older childhood or young adulthood, before age 30. This group is characterized by having abnormally high blood sugar levelsblood sugar arises from reduced production of insulin. Severity depends on the particular genetic variety, and can range from symptomless to severe. MODY in contrast to types 1 and 2 diabetes, only accounts for 1-2 % of the prevalence of diabetes.

6254a4d1642c605c54bf1cab17d50f1e

Anyone experiencing ongoing dry mouth, excessive thirst, frequent excessive urination, lightheadedness, unintended weight loss, or blurred vision should have their blood glucose level checked immediately. A doctor should do bloodwork that includes an endogenous insulin level (the best test is a C-peptide level). If this level is low or mid-range, a GAD antibody test should be done.

If pre-diabetes or insulin-resistant type 2 diabetes is diagnosed, the best course of action is to lose weight, develop an exercise plan that includes at least 30 minutes of walking or other movements most days of the week, quit smoking (if applicable), limit alcohol, follow a Mediterranean diet (there are many forms of it that can be adapted to any ethnic preference) and find ways to reduce stress. Learning what constitutes a healthy, balanced diet (that included not only the Mediterranean but a low glycemic ndex-based diet and limiting the processed and "nonfood" additives to the diet) is a great first step to better health, and may help prevent the onset or progression of type 2 diabetes. 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.

Dr. Brian Fertig, M.D., F.A.C.E., is the Founder and President of the Diabetes & Osteoporosis Center in Piscataway, NJ, serves as an Associate Professor at Robert Wood Johnson Medical School and as the Chair of the Department of Diabetes and Endocrinology at Hackensack Meridian Health, JFK University Medical Center. He is also the author of "Metabolism & Medicine," a two-volume series detailing a scientific approach for predicting and preventing disease.

See the rest here:
This is the #1 Cause of Diabetes, Says Physician Eat This Not That - Eat This, Not That

Recommendation and review posted by Bethany Smith

WASHINGTONFemale rats exposed to a scream sound may have diminished ovarian reserve and reduced fertility, according to a small animal study published in the Endocrine Societys journal, Endocrinology.

Ovarian reserve is the reproductive potential left within a woman's two ovaries based on the number and quality of eggs. A woman is born with a finite number of eggs and her body cannot create any more. Diminished ovarian reserve is the loss of normal reproductive potential in the ovaries due to a lower count or quality of the remaining eggs.

We examined the effect of stress on ovarian reserve using a scream sound model in rats, said Wenyan Xi, Ph.D., of the Second Affiliation Hospital of Xian Jiao Tong University in Xian, China. We found that female rats exposed to the scream sound had diminished ovarian reserve and decreased fertility.

The researchers used a scream sound model to investigate the effect of stress on ovarian reserve in female rats. They exposed female rats to a scream sound for 3 weeks and analyzed the effect on their sex hormones, the number and quality of their eggs and their ability to get pregnant and have babies after mating.

They found the scream sound decreased the rats estrogen and Anti-Mullerian hormone levels. Estrogen is a group of hormones that play an important role in growth and reproductive development, and Anti-Mullerian hormone is a hormone made by the ovaries which helps form reproductive organs. The scream sound also lowered the number and quality of the women's eggs and resulted in smaller litters.

Based on these findings, we suggest stress may be associated with diminished ovarian reserve, Xi said. It is important to determine an association between chronic stress and ovarian reserve because doing so may expand our appreciation of the limitations of current clinical interventions and provide valuable insight into the cause of diminished ovarian reserve.

Other authors of this study include: Hui Mao, Haoyan Yao and Ruiting Shi of the Second Affiliation Hospital of Xian Jiao Tong University; and Zhiwei Cui of the First Affiliation Hospital of Xian Jiao Tong University in Xian, China.

The study received funding from the Natural Science Foundation of Shaanxi Provincial Department of Education.

The manuscript, Scream Sound Induced Chronic Psychological Stress Results in Diminished Ovarian Reserve in Adult Female Rat, was published online, ahead of print.

# # #

Endocrinologists are at the core of solving the most pressing health problems of our time, from diabetes and obesity to infertility, bone health, and hormone-related cancers. The Endocrine Society is the worlds oldest and largest organization of scientists devoted to hormone research and physicians who care for people with hormone-related conditions.

The Society has more than 18,000 members, including scientists, physicians, educators, nurses and students in 122 countries. To learn more about the Society and the field of endocrinology, visit our site at http://www.endocrine.org. Follow us on Twitter at @TheEndoSociety and @EndoMedia.

Disclaimer: AAAS and EurekAlert! are not responsible for the accuracy of news releases posted to EurekAlert! by contributing institutions or for the use of any information through the EurekAlert system.

Continue reading here:
Stress may be associated with fertility issues in women - EurekAlert

Recommendation and review posted by Bethany Smith

Menopause brings about a number of physical changes. Ovaries stop releasing eggs, periods cease, hot flashes begin, and vaginal dryness becomes more common. Along with the dryness, vaginal pain may also increase during and after menopause.

Most pain after menopause can be traced to one issue: A drop in estrogen. This hormone is responsible for lubricating the skin in and around the vagina, making the tissues more flexible, and maintaining the vaginas pH balance. (This helps keep infections at bay.)

The greater the drop in estrogen, the higher the likelihood of issues like vaginal dryness, tightness, and pain.

Learn more about what causes vaginal pain after menopause and what can help relieve the pain. This article will also look at other issues not related to menopause that could be responsible for vaginal pain or discomfort.

In most cases, vaginal discomfort and pain after menopause are related to sex. In fact, according to the North American Menopause Society, 17 to 45 percent of postmenopausal women say they find sex painful.

As estrogen levels drop, the vagina makes less of its own natural lubrication and moisture. The tissues become thinner and more fragile.

As a result, penetrative sex may cause tearing and irritation. Discomfort and pain after sex are more likely, too. In fact, its not uncommon for postmenopausal people to experience soreness, burning, and irritation in the vagina or vulva after sex.

Pain after menopause may also be the result of vaginal tightness during sex. Without estrogen, your vagina can shorten and narrow at the opening. Penetration may be painful.

This dry, thin vaginal tissue and the resulting inflammation and irritation is a condition called vaginal atrophy or atrophic vaginitis. Other symptoms can include:

Without treatment, people may experience tearing and bleeding after sex. People may be less inclined to have sex because they fear post-sex discomfort and pain.

Vaginal atrophy can also lead to chronic vaginal infections like yeast infections after menopause. Because of the changes in the vaginas pH, bacteria, yeast, and other organisms can grow and thrive more easily. These issues can lead to pain and discomfort, among other symptoms.

Urinary function issues are common in people with vaginal atrophy, too. This includes urinary tract infections (UTIs) and bladder infections. These conditions cause pain and discomfort.

Vaginal pain after menopause is often easily treated. Your doctor will want to pinpoint the underlying cause of any pain or discomfort. This will help ensure youre receiving the proper treatment. Some of these treatments include:

Hormonal changes arent the only reason for vaginal pain after menopause. The following issues may also cause vaginal pain and discomfort:

You dont have to live with vaginal pain after menopause. Lower estrogen levels do cause many changes to the body, including vaginal pain and discomfort. However, most of the underlying causes of this pain can be treated and corrected with your doctors help.

Pain during sex after menopause is a common issue. Many of the other issues that can cause vaginal pain after menopause are common, too. Despite that, many people simply do not talk about it with their doctors or clinicians.

It may be a fear of embarrassment. It could also be simply not knowing how to bring up the topic. But if you dont discuss this issue, you wont have the opportunity to get help and treatment.

After menopause, vaginal pain is typically the result of changes to the vagina caused by low estrogen levels. Less estrogen in the body leads to thinner, drier, and less elastic vaginal tissues. Penetrative sex may be more painful as a result of these changes, especially if you do not use lubrication.

Typically, vaginal pain after menopause is easily treatable. Over-the-counter lubrication or moisturizers can help during sex. Sometimes, people need a prescription from their doctor for estrogen supplements or creams. These treatments can help boost your estrogen levels and restore the vaginas natural moisture and flexibility.

If youre experiencing vaginal pain after menopause, talk with your doctor, who will be able to help you find the right treatment.

Continued here:
Menopause and Vaginal Pain: Causes and Treatment - Healthline

Recommendation and review posted by Bethany Smith

Ten percent of women in the United States between the ages of 15 and 49 currently use some form of long-acting reversible contraception, a category that includes intrauterine devices, or IUDs.

Research has found the vast majority of people with IUDs are satisfied with their contraceptive method, but some women find the insertion process much more painful than they expected.

It was, I would say, the most painful thing Ive ever had done, said Amy Halldin, 40, who had an IUD inserted last week. I broke out into a sweat. I threw up.

She is not alone. In recent months, many women and some womens health care providers have used social media platforms like TikTok to draw attention to the broad range of patients experiences during IUD placement and to advocate for better pain management options.

IUDs have also made headlines recently as the leak of a draft Supreme Court opinion on Roe v. Wade has raised questions about whether states might be able to increase their regulation of contraceptives.

In light of the attention on IUDs right now, The New York Times spoke to several obstetrician-gynecologists about how women who are considering an IUD can prepare themselves beforehand.

An IUD is a type of long-acting, reversible contraceptive. The small, T-shaped device is placed in the uterus and left in place to prevent pregnancy for between three and 12 years, depending on the type. It is one of the more effective forms of birth control available, in part because it decreases opportunities for human error unlike, for instance, the birth control pill, which must be taken daily.

IUDs are really safe and theyre highly effective, said Dr. Sarita Sonalkar, an assistant professor of obstetrics and gynecology at the Perelman School of Medicine at the University of Pennsylvania. There are both hormonal and non-hormonal types, because people want different types of options in pregnancy prevention.

Hormonal IUDs (Mirena, Kyleena, Liletta and Skyla are the brands available in the United States) use the hormone progestin to prevent pregnancy, and work by thickening mucus in the cervix to keep sperm from reaching an egg. They can also suppress ovulation. The copper IUD (Paragard), which does not rely on hormones, is wrapped with a small piece of copper that is toxic to both sperm and eggs.

Research also shows that IUDs can be an effective form of emergency contraception if the device is placed within five days of unprotected sex.

To insert an IUD, a health care provider which might be an OB-GYN, a midwife, a nurse practitioner or another practitioner trained to do the procedure puts a speculum into the vagina, then uses a special insertion tube to pass the IUD through the opening of the cervix and into the uterus. This process typically takes a few minutes.

Some pain is expected. Most women tolerate insertion very well, although it can be associated with moderate cramping, so taking either Ibuprofen or Tylenol within the hour before insertion can certainly help, said Dr. Margaret Boozer, associate professor in the department of obstetrics and gynecology at the Heersink School of Medicine at the University of Alabama at Birmingham.

Women considering an IUD should have an in-depth conversation with a trusted health care provider about the basics, including potential benefits and side effects, as well as their personal history and family-planning goals.

But it is also important to have a conversation about the procedure itself.

An IUD insertion can be painful for some people, but there are interventions, Dr. Sonalkar said. I think its really important to know providers can offer local numbing medication at the time of insertion. And that has been shown to significantly decrease pain at the time of insertion.

Ask your provider what pain management options they offer. There is no way to predict with certainty what your personal experience will be, but there are factors health care providers can use to make an educated guess. For example, Dr. Maria Rodriguez, an associate professor of obstetrics and gynecology at the Oregon Health and Science University School of Medicine, said she generally asks her patients what their monthly periods are like and how they cope with strong menstrual cramps.

She also considers whether they have given birth vaginally before. Some providers believe IUD insertions are easier and less painful among women who have, because their cervix has been dilated. Some providers prescribe a medication taken orally before an IUD placement, which can help dilate the cervix, but research looking at its safety and efficacy has been mixed.

Women who are nervous about the procedure or who have a history of trauma may be particularly good candidates for pain relief options that go beyond taking an over-the-counter medication ahead of time.

For women whove had a history of trauma, I like to talk to them about what they need to feel comfortable and safe while Im doing any kind of exam, and that would include an IUD placement, Dr. Rodriguez said. She added that it is important for women to know they can always ask their providers to stop.

Dr. Jonas Swartz, an assistant professor of obstetrics and gynecology with the Duke University of School of Medicine in North Carolina, said he will sometimes offer patients who are really anxious about IUD placement oral medicine that can help with anxiety, but only if they have someone who can drive them to and from the appointment.

We also see patients who really are uncomfortable with the idea, or the pain, or who have a history of trauma and really dont want a clinic procedure. We can offer them a procedure either with moderate sedation or in the operating room where theyre asleep, he added.

There isnt a magic number of IUD placements a health care professional must perform before they become particularly skilled or sensitive. But Dr. Rodriguez said women should feel empowered to ask their providers if it is something they do regularly.

In my experience, if you see a provider who has placed a lot of IUDs, it tends to go quicker and more smoothly, she said.

It may be useful to ask your provider about their availability for IUD removal. Research shows that the majority of women who get them are satisfied with their choice a year later, but they arent a good fit for everyone, Dr. Sonalkar said.

People have a lot of trouble these days making an appointment for any type of care, and if theres a point where they really dont like their method they feel its not the right one for them, or they want to become pregnant it is really frustrating if they cant have access to removal, she said. So I think thats an important thing to ask your provider.

Continued here:
IUD Insertion: What to Know and Expect - The New York Times

Recommendation and review posted by Bethany Smith

Endometriosis is a chronic condition that affects women of childbearing age and causes severe pelvic pain, painful sexual intercourse, abdominal bloating and sometimes infertility. According to the World Health Organization, as estimated 190 million women worldwide live with endometriosis and comedian and actress Amy Schumer is one of them. The mother of one documented her health journey with the disease and shared that she had her appendix and uterus removed after struggling with endometriosis, a condition where the tissue that usually lines the uterus grows outside of it., for years. Schumer posted on Instagram, "I feel good. Finally. It's been a journey thanks for helping me get my strength back @seckinmd(endo) @jordanternermd (lipo)," she began. "Never thought i would do anything but talk to me after your uterus doesn't contract for 2.5 years and you turn 40. @paulvincent22 vickie Lee (acupuncture) my girl Nicole from the tox my friends and fam. Let's go!" Eat This, Not That! Health spoke with Dr. Tomi Mitchell, a Board-Certified Family Physician with Holistic Wellness Strategies who explained what to know about endometriosis and signs that indicate you could have it, As always, please consult with your physician for medical advice. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Mitchell says, "Endometriosis is a chronic and progressive condition that affects women of reproductive age. The main symptom of endometriosis is pelvic pain, ranging from mild to severe. Other symptoms include painful periods, pain during sex, and difficulty conceiving. Endometriosis occurs when the tissue lining the uterus (the endometrium) grows outside the uterus. This displaced tissue continues to act as it would inside the uterus, thickening and shedding each month in response to hormonal cues. However, because this tissue cannot exit the body, it becomes trapped, leading to inflammation and pain. Endometriosis most commonly affects the ovaries, fallopian tubes, and tissue lining the pelvis; however, it may also occur in other parts of the body in rare cases. There is no cure for endometriosis, but symptoms can be managed with medication or surgery," Dr. Mitchell emphasizes. "Some women also find relief from complementary and alternative therapies such as acupuncture or massage. If you think you may have endometriosis, talk to your doctor about your symptoms and treatment options."

According to Dr. Mitchell, "Endometriosis is a condition that can be difficult to diagnose due to its varied symptoms. Common symptoms include painful cramping, heavy bleeding during menstruation, and discomfort or pain during sex or bowel movements. To determine if a woman has endometriosis, her doctor will typically perform a pelvic exam to look for potential lesions and tissue growths in the reproductive organs. They may also order an ultrasound, CT scan, MRI scan, or laparoscopy to take a closer look at the reproductive organs. Once a woman has been diagnosed with endometriosis, several treatment options are available. Treatment may involve over-the-counter medications such as painkillers or hormonal medicines like birth control pills for mild cases. More severe cases of endometriosis require surgery to remove any tissue growths and lesions from the affected areas of the body. Additionally, lifestyle changes such as stopping smoking and maintaining a healthy weight can help alleviate some of the symptoms associated with this condition. Ultimately, by speaking with your doctor about your unique situation and taking all of your symptoms and treatment preferences into account, you can find the right approach for managing endometriosis and feeling better again."

"Endometriosis occurs when tissue that usually lines the inside of the uterus grows outside the uterus," says Dr. Mitchell. "This tissue can attach to the ovaries, fallopian tubes, or other parts of the pelvis. When this happens, it can cause inflammation, pain, and scarring. The exact cause of endometriosis is unknown, but there are several theories about what might contribute to the development of the condition. One theory suggests that some of the uterine linings back up through the Fallopian tubes and into the pelvis during menstruation. This tissue then implants itself on organs in the pelvis and begins to grow. Another theory suggests that endometrial cells may be present at birth and migrate to other parts of the body during puberty. There is also evidence that endometriosis may run in families. If you have endometriosis, you may be at higher risk of developing ovarian cancer or cancer of the uterus lining. However, most women with endometriosis do not develop cancer."

Dr. Mitchell explains, "Endometriosis is a condition that can affect fertility by causing tissue growth outside of the uterus. This tissue growth, also known as lesions or implants, can affect the ovaries and fallopian tubes, vital for fertility and carrying a pregnancy to term. In addition to these physical changes, endometriosis can also cause painful symptoms such as severe cramping and heavy bleeding. These disruptions in normal functioning make it difficult for the body to carry out essential biological processes that allow for conception and fetal development. Despite these challenges, however, treatment options are available that can help women suffering from endometriosis conceive successfully. For example, certain hormone-based medications or surgery may be able to help reduce or eliminate pain and restore normal functioning of the ovaries and Fallopian tubes. Ultimately, though fertility is sometimes affected by endometriosis, many treatment options are available that can help women with this condition achieve their goal of welcoming a healthy baby into their family."

"Endometriosis is a common condition that affects millions of women across the globe," Dr. Mitchell states. "However, despite its prevalence, many people know very little about this condition or how to treat it properly. That's why it's so crucial for people to learn more about endometriosis and what they can do to manage their symptoms and seek appropriate treatment if necessary. At its most basic level, Endometriosis occurs when tissue from the uterus lining grows in other parts of the body, such as the fallopian tubes, bladder, or even on other organs. The most apparent symptom of Endometriosis is painful menstruation, with some women also experiencing pelvic pain, heavy bleeding, painful intercourse, or difficulty conceiving. Fortunately, many treatments are available for managing these symptoms and reducing the flare-ups that characterize this condition. For example, medications such as NSAIDs can help to reduce pain, while hormonal therapies like birth control pills can help balance hormones to prevent endometrial tissue growth. Additionally, lifestyle changes like getting plenty of exercises and maintaining a healthy diet can also help manage Endometriosis and lessen its impact on one's life. With increased awareness and proper management strategies, women can live a more comfortable life."6254a4d1642c605c54bf1cab17d50f1e

"This is often the most common symptom of endometriosis," says Dr. Mitchell. "For women with endometriosis, pelvic pain is often one of the first signs of something wrong. This pain can manifest in several different ways, ranging from a dull ache to sharp cramps. In some cases, the pain may be so severe that it interferes with a woman's ability to work or walk. Pelvic pain is caused by the growth of endometrial tissue outside the uterus. This tissue can attach to the ovaries, fallopian tubes, or other organs in the pelvis. It responds to the hormonal changes of the menstrual cycle in the same way that the tissue lining the uterus does. This tissue builds up and breaks down every month, causing inflammation and pain. This pain is the only symptom of endometriosis for many women, but others may also experience heavy bleeding, pain during sex, or difficulty getting pregnant. If you are experiencing pelvic pain, it is essential to talk to your doctor to make a diagnosis and treatment can begin."

Dr. Michtell shares, "Endometriosis is a condition in which the tissue that usually lines the inside of the uterus, called endometrium, grows outside of the uterus. Since this tissue is shed each month during menstruation, wherever it exists out of the uterus will be subjected to this same shedding. This can result in severe pain and discomfort with sex, including burning sensations, pain during penetration, and overall tenderness in the pelvic area. Unfortunately, endometriosis is often misdiagnosed or overlooked as a cause of such pain. However, identifying and treating this condition early can prevent more severe complications from developing over time. For example, if you experience pain with sex and suspect that you may have endometriosis, it is essential to see your doctor for an evaluation. With proper diagnosis and treatment, patients can achieve relief from their symptoms and go on to enjoy healthy and satisfying sexual relationships."

According to Dr Mitchell, "Painful bowel movements or urination are the most common symptoms associated with endometriosis. This devastating condition occurs when tissue that usually grows inside the uterus instead starts to grow outside of it. As a result, these growths may exert pressure on surrounding organs, leading to discomfort and pain in the pelvic region. Symptoms like painful bowel movements and urinary frequency can thus be important indicators that one has endometriosis. Beyond this general association, however, the exact mechanisms that underlie these painful symptoms are still not fully understood. Some researchers have speculated that it might be related to changes in nerve signals originating from affected organs. Still, others believe that inflammation may be involved, as inflammation has been linked with pain sensation in other bodily areas. Whatever the cause, it is clear that painful bowel movements and urinary frequency should never be ignored and should always be discussed with a healthcare professional if they persist for more than a few days. Doing so may help serve as an early warning sign indicating that one's body is under stress due to this condition and perhaps more severe complications down the line. So remember: pain doesn't have to mean something serious, but only speaking up about it could help save your health!"

Dr. Mitchell explains, "Endometriosis is a chronic, often painful condition in which the tissue that usually lines the inside of the uterus grows outside of it. This displacement can cause the misplaced tissue to attach to organs in the pelvic region, including the ovaries, Fallopian tubes, and bowel. Endometriosis can cause fertility problems in several ways. One is by inhibiting ovulation or disrupting the Fallopian tubes' normal function. The misplaced tissue may also attach to the ovaries, causing them to twist or distort. This can lead to inflammation and scarring, which can interfere with fertility. In addition, endometriosis is often associated with an imbalance of hormones that can adversely affect fertility. Infertility is often one of the first signs of endometriosis for all these reasons. If you are struggling to conceive, it is essential to consult with your doctor to rule out this condition."

Dr. Mitchell says, "Heavy periods, or menorrhagia, are a common symptom of endometriosis. According to the Endometriosis Foundation of America, as many as 80 percent of women with endometriosis experience heavy bleeding during their period. While heavy periods can be a nuisance, they can also signify a more severe condition. For women with endometriosis, heavy bleeding can be caused by the buildup of tissue outside the uterus. This tissue can grow on the ovaries, fallopian tubes, and even the abdominal cavity lining. When this tissue sheds during menstruation, it can cause severe cramping and heavy bleeding.In some cases, the bleeding can be so heavy that it leads to anemia. If you are experiencing heavy periods, it is essential to talk to your doctor. Heavy bleeding can signify endometriosis, and early diagnosis and treatment are necessary for managing this condition."

Excerpt from:
Sure Signs You Have Endometriosis Like Amy Schumer Eat This Not That - Eat This, Not That

Recommendation and review posted by Bethany Smith

Back in 2017, Lady Gaga shared on Twitter she has fibromyalgia and "wished to raise awareness," for the debilitating condition. Since then she's rescheduled tours due to the severe nerve pain she suffers from fibromyalgia and revealed to Vogue, "I get so irritated with people who don't believe fibromyalgia is real," the singer said. "For me, and I think for many others, it's really a cyclone of anxiety, depression, PTSD, trauma, and panic disorder, all of which sends the nervous system into overdrive, and then you have nerve pain as a result." And she's not alone. According to the Centers for Disease Control and Prevention, fibromyalgia affects roughly four million American adultsan estimated 2 percent of the U.S. population and at times it can be hard to diagnose because its symptoms mimic other diseases. Fibromyalgia is a chronic condition that causes sleep problems and widespread pain throughout the body that can severely interrupt a person's daily activities and lifestyle and Eat This, Not That! Health spoke with experts who explained what to know about it and signs that indicate you could have it. Read onand to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.

Dr. Jacob Hascalovici, the Chief Medical Officer with Clearing, a telehealth platform for chronic pain patients says, "Some people who develop fibromyalgia may have experienced a physically or emotionally traumatic event. For others, fibromyalgia may appear without any discernible 'trigger' event. Previous infections appear to increase the risk of developing fibromyalgia, and the risk may also be higher when the body becomes very sensitized to pain and to having to deal with pain triggers and memories of pain."

Board certified internist Dr. Jacob Teitelbaum, MD, bestselling author of From Fatigued to Fantastic! says, "CFS, and it's painful cousin fibromyalgia (CFS/FMS), represent an energy crisis that trips a key circuit breaker in the brain called the hypothalamus. This controls sleep, hormones, and autonomic function, so the circuit breaker going off-line causes widespread dysfunction and is often crippling. Anything that causes people to spend more energy than they can make (including viral and other infections, including COVID) can trip the hypothalamic circuit breaker and trigger CFS/FMS."

Dr. Andrew Neville, ND, one of the top experts in fibromyalgia and Adrenal Fatigue explains, "Ultimately, it's a dysfunction of the Stress Response System, and it starts in the adrenals. Cortisol, your main stress hormone, serves as your body's primary anti-inflammatory function. Your adrenal glands produce that cortisol. If the adrenals are taxed, and you cannot produce adequate anti-inflammatory cortisol, you will be overly inflamed. Inflammation causes pain. Chronic inflammation also acts as an additional biochemical stress, which perpetuates the entire body's dysfunction and causes it to over-perceive its environment. This is called 'Central Sensitization.' If this continues to occur over time, it develops into chronic pain and/or chronic fatigue for others. This is often diagnosed as Fibromyalgia."

Megan Anderson, APN Nurse Practitioner at The California Center for Functional Medicine says, "A lot of newer research has shown that many of the symptoms in fibromyalgia syndrome (FMS) are caused by antibodies that increase the activity of pain-sensing nerves throughout the body. The results show that fibromyalgia is a disease of the immune system, rather than the currently held view that it originates in the brain. One study published in the Journal of Clinical Investigation, demonstrated that the increased pain sensitivity, muscle weakness, reduced movement, and reduced number of small nerve-fibers in the skin that are typical of FMS, are all a consequence of patient antibodies. From a functional medicine lens, we tend to view it as a syndrome that falls somewhere along the autoimmune spectrum and likely has multiple triggers, and therefore multiple ways to potentially address it."

"Fibromyalgia is characterized by widespread musculoskeletal pain, so you might have fibromyalgia if you're suffering from widespread muscular pain," says Dr. Hascalovici.

Dr. Teitelbaum says, "Most of you have likely noticed that after a workout, when energy levels in the muscles are low, your muscles go tight rather than loose and limp. This is because it takes more energy to relax a muscle than to contract it. The energy crisis in fibromyalgia causes chronic muscle shortening and secondary widespread pain. When the muscle pain becomes long-term, it triggers secondary brain pain (called central sensitization and nerve pain."

Gita Castallian, MPH Public Health Analyst at The California Center for Functional Medicine states, "The main sign of fibromyalgia is pain and tenderness in muscles and joints throughout the body, often ranging and roaming over time. This is an indicator of fibromyalgia when the pain lasts for three months or longer and typically becomes chronic. It is often described as a constant, dull and widespread ache and often worsens after too much activity, poor sleep, not enough exercise, stress and weather changes. Some people with fibromyalgia describe the pain as stabbing, shooting, throbbing or aching."

Dr. Hascalovici shares, "You may have fibromyalgia if the pain makes it difficult to concentrate. This symptom is known as 'fibro-fog.'"

Dr. Teitelbaum adds, "Difficulty with short-term memory and word finding and substitution can be quite severe. This has been labeled the brain fog, and is caused by numerous factors. These include inadequate energy in the brain cells, decreased blood flow to the parts of the brain responsible for speech (temporal lobe), chronic infections because of the immune dysfunction CFS and fibromyalgia (people have experienced brain fog when they have the flu), and numerous other contributing factors."

Castallian says, "Brain fog, sometimes called 'fibrofog' in this context, is common for people with fibromyalgia, making it hard to focus and concentrate on mental tasks, a lack of mental clarity and affects memory. They particularly have issues with memory when dealing with complex tasks while multitasking or having divided attention. One study showed that fibromyalgia patients have memory impairments mimicking about 20 years of aging. Since there are many causes for brain fog, it is important to rule out other causes (like B12 deficiency or iron-deficiency anemia) before pinning it on fibromyalgia."

Dr. Teitelbaum says, "Normally with severe fatigue, people can sleep all weekend. But because the hypothalamic circuit breaker which controls sleep malfunctions in CFS/FMS, severe insomnia accompanies the fatigue. When both of these are present for over three months, I would presume a CFS/FMS -related process is present until proven otherwise. Even if other conditions are present."

Castallian adds, "A common sign of fibromyalgia is waking up tired, even after a full night's sleep. There is often severe and chronic fatigue. Other sleep issues are also associated with fibromyalgia, including restless leg syndrome, insomnia and sleep apnea. Additionally, because lack of sleep can decrease your ability to process pain, insomnia and other sleep issues can aggravate and intensify fibromyalgia symptoms. Therapies that are targeted toward managing the pain can help with sleep and vice versa working to improve sleep can help to make the pain more manageable. Chronic pain can be exhausting in many ways."

"Pain from fibromyalgia may shift locations or have an erratic pattern, so it could be affecting different areas of your body at different times," states Dr. Hascalovici.

Dr. Neville states, "With an unregulated nervous system and a trigger-happy limbic system, sensory nerves connected to smell are always on high alert."6254a4d1642c605c54bf1cab17d50f1e

"Stress tolerance bottoms out with fibromyalgia, making even simple decision-making stressful and sometimes even impossible," says Dr. Neville.

According to Dr. Neville, "The heightening of senses that results from Fibromyalgia tends to put patients on high-alert. The slamming of a door may feel like an earthquake. The phone ringing makes the heart race."

According to Dr. Hascalovici. "Fibromyalgia can cause widespread and often disruptive pain throughout the body, often in your muscles and soft tissues. Difficulty sleeping, pronounced fatigue, and memory issues like trouble concentrating frequently characterize fibromyalgia as well. It's not uncommon for people with a challenging or traumatic background to develop fibromyalgia, and the condition is often also accompanied by depression, anxiety, TMJ, and IBS."

Dr. Teitelbaum says, "Although some people are able to continue working, they are usually able to do little else. More severe cases often leave the person crippled and even bedbound."

Castallian explains, "Fibromyalgia is a complex, chronic and painful syndrome affecting the musculoskeletal system that can result in widespread pain throughout the body, extreme fatigue, brain fog, sleep disorders and other physical and cognitive issues. These symptoms can be debilitating, keeping some with FMS from maintaining their ability to work or do normal daily functions of life. Additionally, it is considered an invisible illness because it is not readily visible from the outside. It is not easily recognized that someone may be suffering or in pain just by looking at them. Because of this, there is an added layer of stress to the impact that fibromyalgia already has on the quality of day to day life. Invisible illnesses often do not receive the empathy or credibility that readily visible illnesses do, often fueled by doubt, denial, stigma and feelings of isolation. Additionally, because the symptoms of fibromyalgia are common in many other conditions, receiving an accurate diagnosis can be a challenging and frustrating process, taking many years of searching for answers for most people with this chronic illness."

Dr. Neville explains, "There are many ways a chronically active stress response, such as occurs in Adrenal Fatigue, can cause pain. The main stress hormone, cortisol, is also our main anti-inflammatory molecule in the body. When this hormone is out of balance, a variety of inflammatoryhence painfulphysiologic conditions can arise. Excess cortisol and adrenaline also "hyper-sensitize" peripheral nerves, which basically turns up the volume on the nervous system, creating a situation where patients 'feel' all bodily sensations at a higher level. This is a process called introception. Last but certainly not least, the excess stress hormone 'sensitizes' the brain, including the limbic system (the CEO of the stress response system). This phenomenon is called Central Sensitization. This also occurs in the sensory nerves, so that many of my patients with Adrenal Fatigue are also overly sensitive to bright lights, loud sounds, and harsh chemicals and smells. Even touch sensation has its volume cranked up; someone could simply touch one of my patients, and the patient's brain registers that as pain. We know from functional MRI studies that the PTSD notably originates in the amygdala, which is part of one's limbic system. As I mentioned earlier, the limbic system is the CEO of the stress response system.

As we only have one stress response system dealing with any and all stress, I compare it to a bucket. All stress in our livespast and presentis in the bucket, including past trauma and abuse. It is well documented that past trauma and abuse of any kind predisposes someone to stress-related diseases in adulthood, such as anxiety, depression, insomnia, and even fibromyalgia and Chronic Fatigue Syndrome.

When we take this into context, Lady Gaga is absolutely correct in that her fibromyalgia was triggered by her PTSD. (The singer told TODAY she has PTSD from being sexually assulated by a producer when she was 19.)

Adrenal Fatigue, as well as fibromyalgia, can be effectively treated when we look at it in terms of an overactive stress response system. Comprehensive holistic treatment can desensitize the system, creating space in one's stress bucket so that the system becomes less and less trigger-happy. As that happens, we turn off the chronic stress responseor fight or flightwhich perpetuates chronic wear and tear in the body. During treatment, we're also turning on the healing and repair mechanisms in our bodies. As this occurs, the symptoms of an overactive stress response (such as fatigue, pain, anxiety, depression, and insomnia) gradually decrease over time in intensity, frequency, and duration, until they finally fade away completely."

Dr. Hascalovici states, "Fibromyalgia doesn't necessarily shorten your life expectancy. With treatment, you can maintain your mobility, manage your symptoms and practice healthy ways to change the way your body perceives pain. People with fibromyalgia can experience the best of what life has to offer, with the proper treatment and support. Having a strong support system is important and may be one of the biggest indicators of how successful your treatment could be. You can take control of your pain by educating yourself and by building a team of friends and medical professionals who can support you."

Dr. Neville says, "Fibromyalgia is medical jargon for chronic transient pain of unknown cause with no known effective treatment. Doctors recommend general health advice and pain killers. You'll have good days and bad, and you're told that you need to learn to live with it. After years of research and treating patients with fibromyalgia, and dealing with it myself, I've found that the cause of chronic pain is a dysfunction of your stress response system, commonly known as Adrenal Fatigue. Adrenal Fatigue can be properly treated, effectively ridding your body of fibromyalgia.,"

Dr. Teitelbaum reveals, "I had CFS/FMS myself back in 1975 which knocked me out of medical school and left me homeless for a year. I have dedicated the last 45 years to researching and teaching about effective treatments. Anything that triggers an energy crisis in the body can cause fibromyalgia. For example, about 11 30% of people with lupus, rheumatoid arthritis, and multiple sclerosis will have a secondary fibromyalgia."

Dr. Teitelbaum also shared his additional thoughts about fibromyalgia.

"Lady Gaga has been blessed with finding excellent physicians familiar with the illness, which is part (along with being so determined) of what allows her to continue. But as I mentioned, fibromyalgia occurs along a wide spectrum of severity. Some, like Lady Gaga, are among the "walking wounded" that are still able to function. Where others are house or bed bound. But having treated thousands of people with these conditions successfully, the vast majority of people can benefit with proper treatment and support. Often dramatically. The problem is that the treatments tend to be low cost (relative to patentable medications), and therefore nobody is teaching physicians about them. There are literally dozens of treatments that are very effective. Most fall under the SHINE acronym as discussed earlier. It is important to start by addressing sleep. This can be done with a host of natural and prescription therapies, usually in low-dose and in combination, until the person is getting their eight hours of sleep nightly.

Nutritional support is critical for optimizing energy. This begins by eliminating sugar and increasing salt and water intake. Then adding a high dose B complex vitamin along with magnesium 200 mg a day. Our published research has shown that Ribose 5 g 2 to 3 times a day, red ginseng, Ashwagandha, Rhodiola, and other herbal support can be very helpful as well.

If the person is getting hangry (irritable when hungry) then adrenal support is helpful. Cold intolerance and weight gain suggestive thyroid support may be needed despite normal testing. Worsening of fatigue and insomnia around the menses suggested bioidentical estrogen and progesterone may be needed. It is helpful to remember that the hypothalamic circuit breaker that goes off-line controls virtually the entire hormonal system. Resulting in hormonal deficiencies despite normal blood tests. There are countless other treatments that need to be considered, but the above gives a good start."

Read the original here:
Sure Signs You Have Fibromyalgia Like Lady Gaga Eat This Not That - Eat This, Not That

Recommendation and review posted by Bethany Smith

Eric Liu, MD, FACS, reviews treatment options, pitfalls of diagnoses, andthe importance of involving specialists and advocates early in neuroendocrine tumors.

Complex in their development, diagnosis, and treatment, neuroendocrine tumors (NETs) present a challenge to clinicians who may only see a few cases during their career. NETs are slow growing with a symptom burden that may be attributable to other disease states. Delayed diagnoses result in patients presenting with late-stage disease.

NETs are what I call an unusual disease, Eric Liu, MD, FACS, said in an interview with OncologyLive. NETs used to be considered quite rare [and] its one of those diseases where we do not receive that much education on it in medical school or in our training process. So, its kind of an unusual, unknown disease, but it affects a lot of [individuals]. Liu is surgical director of the Neuroendocrine Institute at Rocky Mountain Cancer Centers in Denver, Colorado.

As a community oncologist with a specialty in NETs, Liu highlighted the most important aspect of the disease: awareness. The neuroendocrine system is [one] that no one ever talks about. We talk about the respiratory tract and the digestive tract and the central nervous system and even the endocrine system. But the neuroendocrine system is more like what we call the diffuse endocrine system that controls a lot of things in the background. There are tiny little cells scattered all throughout the bodyin the lungs, through the digestive tract called neuroendocrine cells, and they can turn into cancers, he said.

In a discussion of the disease state, Liu reviewed treatment options chronic [disease]; some of my colleagues call it cancer in slow motion. (Figure1-4), pitfalls of diagnoses, and the importance of involving specialists and advocates early. NETs are a disease for which, luckily, we have many clinicians who are experts in and really specialize in them, he said. Unfortunately, it is not a well-known disease that [all practitioners] can take care of. I always encourage [colleagues], if they see this unusual diagnosis, to seek expert opinions.

The diagnosis of neuroendocrine cancer is very complicated, and the reason is because the symptoms can be extremely mild. Neuroendocrine cancers tend to be more of a chronic [disease]; some of my colleagues call it cancer in slow motion.

Because it can linger for a long time, the diagnosis can be tough to make [and] in lots of cases [individuals] have mild symptoms [including] abdominal pain, a little flushing here and there, maybe some diarrhea, and [they] come and go in some cases. For example, a patient will present with abdominal pain in the emergency department and an x-ray will look normal, and [a clinician] wont see [any sign of NETs]. This pain will come again [and] eventually, the patient may get a CT scan, and [receive a] diagnosis of NETs. [Other times], there are no symptoms at all, and the patient can present all out of the blue with sudden abdominal pain or NETs can even be found incidentally on a CT scan for another reason, or possibly even [during] an endoscopy or a colonoscopy.

It is a tough diagnosis to make. [Lets take an example of] a 50-year-old woman who presents with flushing, a very common symptom for NETs. If that is the situation, a gynecologist may present a diagnosis of menopause. [What if a] patient has persistent diarrhea? A gastroenterologist may prescribe a colonoscopy and results may not show anything but the symptom persists. The gastroenterologist may give a diagnosis of irritable bowel syndrome. You can see how these mild symptoms can very easily be misinterpreted, and the diagnosis of NETs is not made for a long time.

Unfortunately, the treatments for irritable bowel syndrome and menopause do not treat cancer and so as the symptoms persist, the disease persists. Thankfully, its a slow growing disease in general and individuals can live with it for a long time. It is a very challenging diagnostic dilemma. But once the diagnosis is made, thankfully there is a lot we can do to help patients.

Luckily, we do have good diagnostic techniques to [confirm NETs]. The easiest one is a CT scan, [which is] quick, standard, lots of [individuals] can get it, its not very expensive, and it provides a survey of the lungs, stomach, and pelvis. That is frequently how we make the diagnosis of NETs by seeing a mass either in the intestines, the pancreas, or the liver.

We also have different blood tests as well; however, they are not quite as good. Unfortunately, [because] NETs are slow growing, and individuals can have them for many years without any symptoms, [they] frequently [are] diagnosed very late, usually stage IV. Stage III [disease] tends to include spread to the local lymph nodes, but stage IV is when it spreads far, for example to the liver, bones, or lungs.

NETs typically start in the lungs, pancreas, or small intestine, which are the 3 most common points of origin [and] even though it has a reputation for being a very slow disease, it is aggressive in the way that it spreads. Neuroendocrine disease is not benign; it is a highly metastatic disease that can be life threatening.

We must consider comorbidities and age [at the time of diagnosis], which is usually 60 years, but can be seen in a patient who is age 40 or 50 years. Treatments can be quite varied and include medicines, surgery, special kinds of radiation, and different kinds of therapies for the liver. [We must] take into consideration the overall general health of the patient.

For example, if the patient has many comorbidities, such as diabetes, or a history of stroke, and they are elderly and very frail, maybe the treatment for the neuroendocrine disease needs to take a back seat to something else, because if a patient is going to die, for example due to a stroke or a heart attack, NETs may not be the most life-threatening aspect of their health. But if a patient is quite healthy, they dont smoke, and are doing well, my goal is always to keep the patient healthy. And our goal, as it should be for everything, is to heal the patient so that they can live a high quality of life. If I can help improve quality of life, thats always my No. 1 priority.

Despite neuroendocrine [disease] being a relatively unusual and rare, we have many different types of therapies. And the reason that I encourage patients to see specialists is because choosing the tools in the toolbox can be very challenging. We need to decide what is best for the patient and one tool clinicians forget is surveillance. Then we have other types of medicines, because neuroendocrine [cancer] is a hormonal disease, and one of the unusual things is that NETs may affect blood sugar [and] they may cause pain. And so, getting those hormones under control is very important.

But theres no question that up front one of the most powerful therapies that we have for neuroendocrine disease is surgery. If we can remove a lot of the bulk of the tumor, we can remove a fair amount of the hormone burden, which is not usually the case for other cancers.

However, a lot of the times the disease goes to the liver, and we can use embolization. Additionally, one of the most exciting therapies we have is called PRRT, or peptide receptor radionuclide therapy, which combines hormonal therapy with radiation that goes straight to the tumor and the radiation treatment [is delivered] from the inside out. Its very effective in helping to control the disease. It is not a cure, but it can help patients with symptoms and can help slow down the growth of their tumors.

I always say, have a buddy. Have a friend who specializes in neuroendocrine disease who you can talk to. I should stress that I am community physician, so I understand what it is to be out there working with patients in their community. Ive seen 2000 cases of NETs and Ive learned how vastly complicated the disease really is. What I always tell clinicians is, dont be shy, order all the tests, gather all the information up front so you can have all the correct data and can make the best decision.

One of the problems I see frequently as a specialist who receives referrals is that sometimes the patient did not have a complete workup. [In some cases] the clinicians jumped to [one type of] surgery, when in fact maybe you could have done a little better surgery if you had more information. Or in other cases, the wrong therapy was administered because the pathology was misinterpreted. There are lots of different ways that the devil is in the details.

I always encourage my colleagues across the United States [to see this as] a team effort. I am happy that the patient always has their [primary oncologist] at home because they get their treatments, shots, and their scans [locally] and they dont have to fly to Denver, Colorado to see me every single month; that would be ridiculous. If we can work together, and I can share some of my experience with you, we can come up with the best plan for the patient. That is always the best that we can do.

I dont know everything about brain cancer, bone cancer, or bladder cancer but I know a lot about neuroendocrine cancer. And so, I am happy to rely on my colleagues who really specialize in those other things.

There is one other thing I do want to share, neuroendocrine disease really isnt that rare, and there is a lot we can do to help patients. Unfortunately, the information is not readily and easily available, which means that individuals need to advocate for themselveseither the patient needs to advocate, or the physician needs to advocateget the right tests, seek second opinions, dont worry about having to travel because you might have to do that.

Luckily, if anything has come from the COVID-19 pandemic, it is that we do a lot more telemedicine now. Reach out and see [whether] some of the experts in the United States would be willing to see you through telemedicine and review your case. A lot of the time, a physician at home can conduct the physical exam and with the advanced scans that we have, I can see right into their bodies. So, most of the time, they just need me to think about the case.

Think about getting a second opinion, think about working with a specialist, make sure you get a comfortable team around you. If they say something is impossible, that might not always be true.

See more here:
Unmasking NETs Requires a Multifaceted Approach to Care - OncLive

Recommendation and review posted by Bethany Smith

Emergency contraception methods, like Plan B, help prevent pregnancy up to five days after having unprotected sex. (Photo: Getty Images)

Although emergency contraception has been around for years the FDA approved it as a prescription pill in 1998, followed by an over-the-counter option in 2006 there are still some people who either dont understand how it works or confuse it with abortion pills. But they are not the same thing.

Emergency contraceptive pills prevent pregnancy up to five days after having unprotected sex, according to Planned Parenthood. They do not induce abortion, Dr. Emily Godfrey, associate professor of ob-gyn at the University of Washington Medical Center, tells Yahoo Life, adding that if youre already pregnant, it does not harm a pregnancy if you use it.

Heres what you need to know about emergency contraception.

Dr. Melissa Myo, clinical instructor of obstetrics and gynecology with the Keck School of Medicine of USC, tells Yahoo Life, In broad terms, emergency contraception refers to any method that can be used shortly after unprotected intercourse to prevent pregnancy.

The most commonly known method is in pill form, of which there are two types on the market.

The first type contains levonorgestrel, such as over-the-counter Plan B One-Step, My Way, Take Action and generic versions. Levonorgestrel is a type of progestin thats found in other oral contraceptive pills, but for emergency contraception its at a higher, one-time dose to delay ovulation, explains Myo.

The second type contains ulipristal acetate and is sold under the brand name Ella, which requires a prescription, and it also comes in generic form. Ella acts on progestin receptors and also inhibits ovulation, says Myo.

Essentially, both pills work by delaying the presence of an egg, explains Myo, so that a sperm cant find one and fertilize it.

Both types of pills can be taken up to five days after having unprotected sex to prevent pregnancy. But Planned Parenthood notes that they work much better if you take them during the first three days.

Story continues

But pills arent the only form of emergency contraception. Theres another type that people sometimes do not know about, says Myo and thats a copper IUD. She explains that copper IUDs, which are inserted by a health care practitioner, primarily work by interfering with sperm function and can be a good option for someone who is interested in not only preventing this pregnancy but also in starting a longer term contraceptive method.

Experts recommend that the copper IUD be inserted within five days of unprotected intercourse, but is found effective up to 10 days in some studies, points out Myo.

Theres also a hormonal type of IUD with the same levonorgestrel hormone as Plan B, which was recently found to be just as effective as the copper IUD for the purposes of emergency contraception when placed within five days after intercourse, she says.

According to the World Health Organization (WHO), when a copper IUD is inserted within five days of unprotected sex, its more than 99% effective in preventing pregnancy.

Emergency contraceptive pills can prevent up to over 95% of pregnancies if taken within five days of unprotected sex, according to WHO.

Weight appears to be a factor, though, when it comes to the effectiveness of emergency contraceptive pills. According to Planned Parenthood, emergency contraceptives that contain levonorgestrel may not work well in people who weigh 155 pounds or more in that case, prescription Ella would be a better option.

However, Planned Parenthood says that Ella may not work in people weighing 195 pounds or more. IUDs, on the other hand, work regardless of a persons weight.

Godfrey says that, when it comes to emergency contraception, the best and most effective type is an IUD. Its been proven over and over again that it will absolutely prevent an unplanned pregnancy, she says.

According to Cleveland Clinic, the copper IUD is the most effective of all, working 99% of the time, no matter your weight. Thats followed by the prescription pill Ella, which Cleveland Clinic states is more effective than over-the-counter methods because it works closer to the time of ovulation.

However, over-the-counter emergency contraceptive pills have an advantage since theyre easier for most people to access (and have no age restrictions), while Ella and IUDs require getting an appointment to see a health care practitioner.

Above all, the best method to use is the most effective method you have available, notes Cleveland Clinic.

Common side effects that people might experience include headache and nausea. Some people experience changes to their menstrual bleeding during that month, and most changes resolve without any other treatment, says Myo, who points out that no serious complications have been linked to the use of emergency contraceptive pills in scientific research.

Also, because emergency contraceptive pills are taken as a one-time dose, even people who have medical issues that might prevent them from being able to safely take oral contraceptive pills long-term can take emergency contraceptive pills, she says. But its always smart to check with your health care provider first.

Experts, like Myo, say that its incredibly important to have access not only to emergency contraception, but also to all forms of contraception. No one form of contraception is perfect for everyone, and every individual has their own goals for their life and their wishes for how they live in their body, Myo says.

This is particularly important as reproductive rights are being restricted in certain parts of the country. The threat of reducing or eliminating contraception is a direct threat to peoples abilities to live the life they want, says Myo. The logic espoused by Justice Alito in the [Supreme Court] draft opinion also hints at future attempts to restricting our access to contraception. In clinical practice, we often will ask our patients their reproductive goals: Do you plan to be pregnant in the next year? When do you plan to be pregnant? How many children, if any, would you want in your lifetime? These questions help us tailor our recommendations for contraceptive methods that will hopefully help our patients reach their goals.

In light of the threats to Roe v. Wade, Myo says that its now more important than ever to discuss issues such as contraception, including emergency contraception, with your doctor. You can fill a prescription or purchase pill-form emergency contraceptives, she says. You can ask your doctor for a prescription of a years worth of oral contraceptive pills so that you dont risk missing doses.

But, Myo adds, even with all the preparations, all methods have risk of failure, and it is not a replacement for access to safe abortion. Even if contraception remains available to us, we will still have to continue to push for abortion access for everyone.

Want lifestyle and wellness news delivered to your inbox? Sign up here for Yahoo Lifes newsletter.

Go here to see the original:
What is emergency contraception and how does it work? Experts explain. - Yahoo Life

Recommendation and review posted by Bethany Smith

FREIENBACH, Switzerland--(BUSINESS WIRE)--EffRx Pharmaceuticals SA, a commercial-stage company that commercializes niche and orphan medicines in Switzerland and Europe, today announced it has recently entered into an exclusive license agreement with Diurnal Group plc, for the registration and commercialization of Efmody as treatment for congenital adrenal hyperplasia (CAH) in Switzerland. Under the terms of the agreement EffRx has received the exclusive rights to register and commercialize Efmody in Switzerland.

Efmody is a modified-release preparation of hydrocortisone that has been specifically designed for the treatment of patients with CAH, a rare condition caused by a genetic deficiency of adrenal enzymes. According to our estimates, there are approximately 450 patients in Switzerland suffering from CAH.

EffRx intends to submit a Market Authorisation Application (MAA) to Swissmedic as treatment for adolescent and adult patients (12 years and older) with the rare condition congenital adrenal hyperplasia (CAH) in Switzerland during the second half of 2022. The MAA submission to Swissmedic for Efmody will be based on the European regulatory dossier and published clinical trial data, with EffRx expecting potential market launch in Switzerland in 2024.

We are excited to sign this additional agreement with Diurnal, enabling us to build on the momentum we have achieved with Alkindi in Switzerland following approval from Swissmedic in November 2021. We believe the unique release profile of Efmody, that mimics the bodys natural cortisol circadian rhythm, could have a genuine impact on CAH patients symptoms. We are aligned with Diurnals strategy to address the unmet medical need in patients suffering from diseases of cortisol deficiency and look forward to working with the Diurnal team to bring Efmody to patients suffering from CAH in Switzerland, Lorenzo Bosisio, Chief Executive Officer of EffRx, commented.

In May 2021, Efmody was granted marketing authorisation in the European Union and was subsequently launched in Germany, Austria and the UK in September 2021. We are pleased to deepen our relationship with EffRx to include the distribution and marketing of Efmody in Switzerland. We have been impressed by the progress EffRx has made with the regulatory approval and reimbursement of Alkindi and look forward to continuing to work with them as they prepare to submit an MAA to Swissmedic for Efmody, Richard Bungay, Interim Chief Executive Officer of Diurnal, commented.

--------

About congenital adrenal hyperplasiaCongenital adrenal hyperplasia (CAH) is an orphan condition caused by deficiency of adrenal enzymes, most commonly 21-hydroxylase. This enzyme is required to produce the adrenal steroid hormone, cortisol. The block in the cortisol production pathway causes the over-production of male steroid hormones (androgens), which are precursors to cortisol. The condition is congenital (inherited at birth) and affects both sexes. The cortisol deficiency and over-production of male sex hormones can lead to increased mortality, infertility and issues during sexual development including ambiguous genitalia, premature (precocious) sexual development and short stature. Sufferers, even if treated, remain at risk of death through an adrenal crisis.

Current therapy for CAH uses a variety of generic glucocorticoid (steroid) preparations including hydrocortisone, dexamethasone, prednisolone and prednisone in the US, with no standard treatment regimen. Approximately two-thirds of CAH patients are estimated to have poor disease control, leading to elevated androgen levels. The condition is estimated to affect a total of approximately 16,000 patients in the US, with over 400,000 in the rest of the world.

About Efmody (hydrocortisone modified-release hard capsules)Efmody is a preparation of hydrocortisone that has been specifically designed to mimic the circadian rhythm of cortisol when given in a twice-a-day "toothbrush" regimen (administered last thing at night before sleep and first thing in the morning on waking) to control androgen excess and chronic fatigue in patients with diseases of cortisol deficiency. The first indication for Efmody is congenital adrenal hyperplasia (CAH) in adults and adolescents (children older than 12 years of age). Efmody has been extensively studied in 239 human subjects including 138 CAH patients who have taken part in clinical trials in Europe and the US.

The MHRA and European Commission marketing authorisation approval of Efmody was based on a Phase 3 study conducted in a total of 122 patients enrolled across 11 clinical sites, including sites in Great Britain, the largest ever interventional clinical trial completed in CAH. The Phase 3 data was supported by detailed analysis of data from an open-label safety extension study for patients completing treatment in the Phase 3 study, which is assessing the impact of treatment with Efmody over an extended period, with a number of patients on this trial having been treated for over five years. Summary of Product Characteristics (SmPC) for UK (Northern Ireland) can be found here.

About EffRx PharmaceuticalsEffRx Pharmaceuticals is a commercial-stage pharmaceutical company focused on the late stage development and commercialization of prescription medications for niche and orphan indications. The business model is centered around providing superior clinical and commercial value propositions for physicians, payers and patients.

EffRx pro-actively seeks in-licensing opportunities for Europe in niche therapeutic areas, with a primary interest for rare diseases, where EffRx has received an orphan drug designation (ODD) from the FDA. EffRxs go-to-market competence is proven by the development, launch and lucrative expansion of Binosto in a highly competitive European market. Our lead commercialized product, Binosto for the treatment of osteoporosis, is marketed in the US as well as selected European and Asian countries.

About Diurnal Group plcDiurnal Group plc is a European, UK-headquartered, specialty pharmaceutical company dedicated to developing hormone therapeutics to aid lifelong treatment for rare and chronic endocrine conditions, including congenital adrenal hyperplasia, adrenal insufficiency, hypogonadism and hypothyroidism. Its expertise and innovative research activities focus on circadian-based endocrinology to yield novel product candidates in the rare and chronic endocrine disease arena.

For further information about Diurnal, please visit http://www.diurnal.com

Continued here:
EffRx Pharmaceuticals Signs Exclusive License Agreement With Diurnal for the Registration and Commercialization of Efmody in Switzerland - Business...

Recommendation and review posted by Bethany Smith

Far-right talking heads like Tucker Carlson love bemoaning the state of masculinity, as measured by their very narrow and stereotypical lens, as though it is in some sort of crisis. To that end, Carlson recently humored the internet (and world?) by offering up a wellness solution for this so-called crisis in his "Tucker Carlson Original" documentary, title "The End of Men." And Carlson's prescription, to stop the death spiral of the American man, was something called "testicle tanning."

"The solutions are actually really simple," fitness professional Andrew McGovern told Carlson. "Red-light therapytesticle tanninghas massive benefits."

Testicle tanning, more formally known as red-light therapy for testosterone, involves exposing one's scrotum to infrared light; this, supposedly, increases testosterone levels. Trailers for Carlson's documentary feature multiple images of a naked white man appearing to plug his testicles into some sort of infrared light device. As his bottom half lights up, the man's arms slowly raise, indicating some sort of victory or enlightenment has been achieved. Presumably with the help of testicle tanning.

RELATED: What is a "warrior poet?"

"Half the viewers right now are like, 'What?! Testicle tanning, that's crazy!'" Carlson responded. "But my view is: Okay, testosterone levels have crashed and nobody says anything about it, that's crazy, so why is it crazy to seek solutions?"

This isn't the first time the idea of testicle tanning has entered the public discourse. In 2015, former Major League Baseball player Gabe Kaplermade headlinesfor promoting testicle tanning as a solution to Vitamin D deficiencies in men. "If you want to be your strongest, get some sun on your boys. And by boys, I mean your testicles," Kapler said.

"Half the viewers right now are like, 'What?! Testicle tanning, that's crazy!'" Carlson responded. "But my view is: Okay, testosterone levels have crashed and nobody says anything about it, that's crazy, so why is it crazy to seek solutions?"

In 2017, self-proclaimed "biohacker" Ben Greenfield wrotein Men's Health magazine about his experience trying red-light therapy on his testicles to increase his testosterone levels. After, Greenfield claimed to have "never felt better."

But despite these anecdotes, there has been little written about whether this is actually a therapy that many people are doing or, if there is there any scientific evidence to suggest it works. A related trend, ofperineum sunning, was briefly a wellness trend in 2019 and 2020. Yet in my research, I could find no spas that offered the testicle tanning service. Indeed, in 2020,Inverse reportedthat it is more of an "at-home treatment" rather than something being offered as a service.

In any case, those interested in testicle tanning can purchase in-home devices such as light beds, lamps, lasers, and infrared saunas, which range in price from hundreds to thousands of dollars. In 2019, researchers estimated that the global light therapy market was expected to surpass $1 billion by 2025, though light therapymostly includes non-testicle related treatments for things like eczema and psoriasis.

The greatest irony behind the testicle tanning fad, however, is that it seems to do the opposite of what boosters like Tucker Carlson say that it does. Indeed, urologists do not recommend red-light therapy to boost testosterone, noting exposure of infrared light can negatively affect a male's testicles and may actually lower testosterone levels.

Want more health and science stories in your inbox? Subscribe toSalon's weekly newsletter The Vulgar Scientist.

"Any extreme chronic exposure can prove harmful for the testes leading to decreased testosterone, decreased sperm counts and subsequent infertility," reproductive urologist Dr. Ranjith Ramasamy told Salon via email. "However, the true efficacy of testes-focused light therapy in improving testosterone levels is currently unknown and not backed by the scientific literature."

Ramasamy said that there have been some studies to show that red-light therapy can improve the destruction of cells on a person's skin. Indeed, it is sometimes used to treat wrinkles, redness, acne, scars and other signs of aging. But "the true effectiveness of this therapeutic modality remains unknown," Ramasamy notes.

Advocates of the therapy often point to one study from researchers at the University of Siena in Italy from 2016 who claimed that "bright light increases testosterone levels and leads to greater sexual satisfaction in men with low sexual desire." Professor Andrea Fagiolini recruited 38 men who had been diagnosed with hypoactive sexual desire disorder or sexual arousal disorder, both conditions that are characterized by a lack of interest in sex.

Fagiolini divided the study participants into two groups, one of which received treatment with a specially adapted light box and the other which received a placebo. Both groups received an hour of treatment from a light box for two weeks. The researchers claimed there were significant differences in the groups, with increased testosterone levels in the group exposed to a light box, but they recognized the study was small and thus they couldn't "recommend this as a clinical treatment." Notably, the study wasn't published in a peer-reviewed journal, and participants' testicles were directly exposed to the light.

Ramasamy added that too much sunlight could negatively affect male testicles, too, and lead to decreased sperm count and "intratesticular testosterone levels."

"This study fails to mention that the men in this study were likely suffering from hypogonadism given the low testosterone level and presence of symptoms (in this case low sex drive or libido)," Ramasamy told Salon. "Testosterone levels are very dependent on quantity and quality of sleep and the use of aids to optimize such as light therapy could theoretically increase endogenous testosterone production," Ramasamy said, adding that this study doesn't indicate that light therapy focused on the testicles specifically could increase testosterone.

"Previous studies examining the use of light therapy focused on the testicles have often been done in men suffering from fertility issues such as azoospermia or asthenozoospermia with no indication or studies supporting its use in healthy men," Ramasamy continued. "The few studies demonstrating the use of red-light in increase testosterone levels have been done in animal subjects which are very imperfect models of humans and do not fully represent our own physiology."

Ramasamy added that too much sunlight could negatively affect male testicles, too, and lead to decreased sperm count and "intratesticular testosterone levels."

"The testicles are vital organs responsible for producing the majority of testosterone and source of sperm, both of which are essential for maintaining fertility," Ramasamy said. "Normally the testicles prefer to be in a slightly cooler environment than the core body temperature which is one of the reasons they move in response to local temperature."

Read more about right-wing health misinformation:

Visit link:
Tucker Carlson hawks testicle tanning to boost testosterone. Experts say it may do the opposite - Salon

Recommendation and review posted by Bethany Smith

Most people don't want to live forever. "It would be too boring. I would have explored everything," said Shekhar Biswas, a data scientist from Berlin. He speaks for most people I quizzed one afternoon in Berlin's Alexanderplatz no one said they'd be interested in eternal life. (Also read: Loss of neurons makes Alzheimer's patients drowsy: Study)

But what Biswas and many others would be interested in, I learned, is a long life maybe to the age of 100. Biswas said when he must die, he wants it to happen without the burden of any painful disease and sickness in his final years.

Nothing's going to stop death, most researchers conclude. But there could be ways to make life last longer, and the process of death shorter.

The gerontologists vs. the quacks

There are two horizons in the world of aging science, according to Dr. Nir Barzilai, who heads the Institute for Aging Research at the Albert Einstein College of Medicine in New York.

"One is people who are anti-aging," he said, like the people who sell multivitamins promising life extension through cellular renewal. "They're usually charlatans. They tell you to take this drug and you'll live forever. If you die, nobody sues them. Then there's geroscience. Those are scientists who are working on the biology of aging, who know which things to target, and they are very legitimate."

Barzilai, of course, is a geroscientist. He's been following a cohort of 750 centenarians (people who have lived to the age of 100) for years. He recently announced plans to expand his study to 10,000 people.

The new study isn't being backed by government grants but rather by a 26-year-old Bitcoin millionaire named James Fickel. This non-traditional funding stream may sound unusual. But when you start making sense of the logic behind aging research, the puzzle starts to fit together.

Healthspan, not lifespan

First things first: Geroscientists will tell you they aren't interested in prolonging lifespan the number of years you live but rather "healthspan," the number of years you are healthy and capable of living a normal life without complications or setbacks due to illness or disease.

Scientists estimate that more than 50% of deaths worldwide are due to diseases caused by aging like Alzheimer's, cardiovascular disease, cancer, type 2 diabetes and hypertension. That number increases in industrialized countries where access to modern medicine and healthcare means that people live long enough to contract age-related diseases and not die of diseases like malaria and dengue at a younger age.

If scientists like Barzailai can find a medication to help prolong people's healthspans, death will be quicker and less painful, they say.

James Kirkland, a professor of medicine at the Mayo Clinic and president of the American Federation for Aging Research, said they're looking to find a way to prevent something called "multimortality at the end of life.

If you've watched an elderly family member pass away, you probably know what that is. It starts with a cancer or dementia diagnosis and is then followed by a range of other issues. Problems like arthritis, cataracts, forgetfulness and osteoporosis all come together during the person's final years, making life feel like a daily fight.

Kirkland says it doesn't have to be like this. Instead, he said, death could look more like "going out and having a five-mile run and then just not waking up the next morning."

This concept is called compressed mortality decreasing the number of years or months in which a person goes through the process of dying.

Nature vs. nurture

Barzilai has been following centenarians for over 20 years now, looking to see if they can provide some clues on how to live to reach our 100s. Along with living long healthy lives, these people, he observed, often experienced "compressed mortality," dying over the course of a few weeks rather than years.

Is it something they eat, somewhere they live? Are they non-smokers or vegetarians? Are there certain things these elderly people are doing or have done during their lives that have allowed them to live so long?

The answer is no, Barzilai found.

"60% of the men are smokers, 30% of the women. More than 50% of them are overweight or obese and do not exercise. Only 2% were vegetarian. They're not special," he said.

A healthy lifestyle plays a role in longevity, so don't stop eating your vegetables. But Barzailai's research means that the elixir to youth will likely come in the form of a drug capable of targeting specific "longevity genes."

"It's 80% genetics and 20% the environment," he said. The question, then, is what do they have that people who die at 80 don't?

Centenarians don't have perfect genes or even obvious gene mutations protecting them from diseases like Alzheimer's, Barzailai said they just develop those diseases much later than non-centenarians.

Some of them had genes that prevented the functioning of growth hormones, Barzilai said. Through his research on centenarians, he's looking to identify genes or gene mutations that appear to influence aging. Once those pathways are identified, medications can be developed and tested to target them.

Drugs to halt aging processes

Barzilai is already in the process of testing how the medication Metformin, a diabetes drug, works to halt some effects of aging in the body. That's just one of many drugs that are being tested to see whether they're able to counteract aging; Matt Kaeberline, a University of Washington biologist, is running a trial to see if the drug Rapamycin impacts aging in dogs, with the hope to later test it in humans.

Aging can't be attributed to a single process that happens in the body. It's a combination of many different processes, and each of the medications is looking to address different variations of them.

One thing that causes the body to age is something called cell senescence. The cells in our body are constantly going through a process called cell division. But scientists have found that this process gets disrupted over time, causing some cells to stop dividing. Although these cells are dead, they don't leave the body and instead accumulate, causing health problems like inflammation.

Kirkland's work centers around developing drugs that would kill the unnecessary senescent cells in our bodies. Barzilai and Kaeberline's drugs try blocking the senescent cells from causing problems like inflammation, but don't extinguish the cells altogether.

Kirkland said it will probably be at least a decade before we know whether these drugs work to halt negative aging processes. But once they find the right solution, he's convinced it will be transformative.

"If some of these things actually work, it would be like the discovery of antibiotics," said Kirkland. "It would be that big, because these fundamental aging processes are root-cause contributors to everything."

The billionaires want in

Fickel, the backer of Barzailai's study, isn't the only uberwealthy interested in aging research. Russian-Israeli billionaire Yuri Milner-backed Altos Labs, a California-based biotechnology startup interested in aging research that's paying its scientists million-dollar salaries, launched early this year on a mission to "reverse disease to transform medicine."

It's not the first billionaire-backed attempt to unlock the secret to eternal youth. Google parent Alphabet's unit Calico Labs launched in 2013, but the company has so far been tight-lipped about its research and development.

Altos Labs is looking into many different solutions to a long life, some of which involve the processes being trialed by teams like Barzilai's, Kirkland's and Kaeberlein's. But they're also looking into more experimental science the kind that may not be able to receive support through traditional academic grants because it's so new.

Barzilai said that although Altos is a corporation, they aren't the textbook anti-aging charlatans. They've recruited some of the best scientists in the field of anti-aging research including Nobel Prize winners to look into another potential solution to increasing healthspan, called cell reprogramming.

The idea behind cell reprogramming, which is also sometimes called cell rejuvenation, is relatively simple to understand. Old cells would be transformed into the fresh, unblemished cells you were born with, cells that haven't been impacted by things like smoking or beer consumption, for example.

The science behind this is based on discoveries made through the cloning of Dolly the sheep. One of the biggest scientific developments to come based on that research was Shinya Yamanaka's discovery that four proteins can bring cells back to their original state. He won a Nobel Prize in 2012 for the research, which has been applied to several disciplines.

The scientists at Altos are looking to see if they can apply it to aging processes.

Scientists cautious but optimistic

There are a lot of obstacles to this research, one of the main ones being the cell's loss of identity once it's replicated. And we likely won't see any results for a long time even once researchers find a method that works, it will take years to test it on animals and people, and even longer for any potential medication to pass clinical trials to make it to the market for general use.

The medications being investigated by Barzilai, Kirkland, Kaeberlein and others will also need some time, but could hit the market in the coming decades if they pass clinical trials, Kirkland says.

That's a big if. The scientists are cautious about stoking any kind of excitement about the medications. Lots can fall apart in clinical trials; Kirkland said that of the dozens currently underway, most will fail. But they're optimistic that when the right treatment comes, it could have a great impact.

"I think most of us do believe that this is coming," said Kaeberlein. "I don't know if it's going to be 10 years, 20 years, 30 years, but it is happening and it is going to change things."

Edited by: Ashutosh Pandey

Read the rest here:
So you want to live forever? - Hindustan Times

Recommendation and review posted by Bethany Smith

Festival of Fresh 2022 is promising a rich mix of fantastic speakers across two tents as it throws the spotlight on the present and future of the UK fresh produce industry.

Hosted outdoors at Berry Gardens new packing and distribution site near Maidstone on 8 June, the event features a packed programme of interactive content focused on both Inspiration and Innovation.

Inspirational thinking

In the Inspiration Tent, following an introduction by Berry Gardens CEO Nick Allen, the day begins with an industry leaders panel discussion, where attendees will have the chance to put their questions to new NFU Horticulture Board chair Martin Emmett, British Growers CEO Jack Ward, British Apples & Pears executive chair Ali Capper and British Summer Fruits chief Nick Marston.

Talks and interviews follow on the subject of Production & Trade, with speakers including co-MDs of fast-growing fresh produce giant Jupiter Group, Mark and Yvonne Tweddle, as well as NCGM tenants association chair Gary Marshall and Tropical Directs Nigel West.

Looking at the major issues facing modern business, APS Groups Phil Pearson will address the topic of producing and innovating at a time of intense cost pressure, while MDS operations director Sapphira Waterson will explain how the graduate scheme is both expanding, and helping recruit ex-army personnel into industry jobs.

After a delicious lunch and opportunity to see displays of sumptuous fresh produce in the FOF22 Market Street, the focus of the Inspiration Tent switches to Retail & Marketing, with expert analysis of the sector from grocery commentator Steve Dresser, and inspirational branding with Barfoots Kim Barfoot-Brace and Berry Gardens Rob Harrison. Retailer participation is expected to be confirmed shortly.

Innovating for the future

Over in the Innovation Tent, meanwhile, the morning programme focuses on the road to net-zero production. NFU Energy director Jon Swain will discuss some of the new technologies helping the horticultural sector, while former AHDB Horticulture Board chair and sustainability consultant Hayley Campbell-Gibbons will look at how producers can navigate the tricky world of carbon-neutral products. Oli Kaberry, head of business operations at The Jones Food Company, will also outline some of the companys industry-leading work in vertical farming.

In the afternoon, science is under the microscope with the University of Lincolns Simon Pearson outlining the work of the Agricultural Universities Council, ItsFreshs Rob Ward talking shelf-life extension, robotics demonstrations and a series of quickfire presentations revealing groundbreaking PhD research that could solve a raft of industry problems.

Lively and interactive

The programme follows Fruitnet events trademark quick-fire format, with short and punchy presentations combined with a mixture of panel discussions, one-to-one interviews and lighthearted elements. There will be opportunity to ask questions and make comments, as well as relax and network throughout at the various social stations and stands across the festival. Further speakers will also be announced in the coming weeks.

Tours of Berry Gardens brand new packhouse will also give delegates a chance to see an industry-leading, environmentally friendly production facility up close.

Tickets will go on sale shortly atwww.fpjlive.com.

Read more:
Inspiration and innovation at Festival of Fresh 2022 - Fruitnet

Recommendation and review posted by Bethany Smith

Total measured and indicated mineral resources, which are inclusive of mineral reserves, now total1.3 million gold ounces, of which928,000gold ounces are open pit, a 65% increase sincethe 2020 resource estimate.

We have successfully replaced 2021 mining depletion and added another 1.5 years to the open-pit mine life at Tucano, Great Panther chairman and interim CEOAlan Hairsaid in a news release.

The Tucano tenement portfolio covers over 197,000 hectares over land along the Vila Nova greenstone belt, centred around the Tucano mining licence. The mine operation currently comprises eight open pits, the Urucum North underground project, a processing plant and tailings dam. Production to date has been sourced from all pits except Urucum East.

The company noted that it hascompleted a 19,000-metre drilling campaign on the Urucum North underground project, with engineering studies currently underway.

Going forward, a major objective is to progress the Urucum North underground project, with development scheduled for Q4 2022, while aggressively advancing opportunities for additional resource growth and mine life extension on multiple fronts, Hair added.

In the second half of the year, Great Panther is expected to actively pursue drilling to increase resources within the mine sequence and on near mine (20-kilometre radius) priority targets in the regional land package.

Read the rest here:
Great Panther increases Tucano open-pit resources by 65%, reserves by 24% - MINING.COM - MINING.com

Recommendation and review posted by Bethany Smith

Pronovias Atelier Unveils 2023 Bridal Collection In First Runway Show In 2 Years

After a long pause of 2 years, Pronovias makes its return to physical runway on April 22, marking the official start of a booming season for the bridal giant.

The new 2023 Versailles Collection by Pronovias Atelier, the high end couture brand of Pronovias Group, showcased a series of stunning bridal gowns in front of 1,800 guests on the final day of Barcelona Bridal Fashion Week. The event was broadcasted on a number of social media channels including Instagram, Facebook, YouTube and Twitch. Each and every dress that carries the Pronovias Atelier label is handmade by expert seamstresses in Barcelona using the finest fabrics and laces imported from France and Italy.

Alessandra Rinaudo, Artistic Director of Pronovias, says: Versailles has come to define luxury and beauty, which to me fits perfectly with Haute Couture bridal. This collection stands out for attention to detail and head-to-to exquisiteness. Its a modern, innovative interpretation of one of the most lavish periods in fashion history.

Rosa Crespo (left) and Sarah Mikaela (right), attending as UK VIPs wearing Vera Wang Bride ... [+] collection for Pronovias

Comprising 44 exquisite and opulent designs, the new Versailles Collection emanates a sense of royal luxury whilst staying true to the feminine beauty the brand is known for. Inspired by the glittering character of Versailles, the collections intricate embellishments and plush fabrics are complimented by extravagant veils, elegant elbow-length gloves, bustle-up capes and detachable, oversized sleeves. The casting is decidedly inclusive, with models of all age, body shape, ethnicity and gender diversity walking the runway and iconic supermodel Esther Canadas closing the show.

Marking Pronovias Groups commitment to cutting edge digital innovation in product design and technology and the first of its kind in the bridal industry Rinaudo has also helped create three NFTs, each reproducing the patterns, textures, beading of three dresses from the Versailles Collection. The three NFTs are uploaded to the OpenSea platform and can be viewed on the Pronovias website.

Pronovias Atelier debuts "Versailles Collection" at Barcelona Bridal Fashion Week

Speaking to Amandine Ohayon, the CEO of Pronovias Group, it is clear that the international bridal maison is looking into the future with Metaverse, sustainability as well as social responsibility on its mind.

My aim hasnt changed, says Ohayon in Barcelona a few days ahead of the show, referring to her goal of significantly accelerating the Groups international development when she first joined in 2018. And with the opening of the our Shanghai and New York flagship stores, we will continue with the expansion. The focus for the next 2-3 years will also be servicing the rising demand due to cancelled weddings over the pandemic.

Pronovias Atelier debuts "Versailles Collection" at Barcelona Bridal Fashion Week

Despite the difficulties posed by the closed shop floors and restrictions in personal contact during the past two years, Ohayon made sure each clients wishes were catered to, even if it meant shipping a gown across from Malaga to Houston for final alteration before sending it to the happy bride.

People want to party like they never partied before, Ohayon says with a smile as we discuss the trends for weddings. I see two major trends one being people wanting to have two or more dresses, as an increasing number of weddings consist of not just the big day itself, but also an event for the day before and another for the day after.

Pronovias Atelier debuts "Versailles Collection" at Barcelona Bridal Fashion Week

The second trend is the increasing appetite for more couture dresses. Ohayon tells me, Brides want things that are more dramatic and special, and we are seeing double digit growth in sales of the bridal accessories veil, cape, gloves, with lots of styling.

Coming from a background of beauty where the focus on sustainability is a lot more advanced than other areas of fashion and retail, especially the bridal industry, Ohayon was keen to identify and incorporate eco-friendly fabrics in the brands designs, as well as establish a sustainable practice within the Group. She and Rinaudo has since launched the EDEN collection, featuring a selection of sustainable #WeDoEco gowns.

Pronovias after party guests

In January this year, Ohayon furthered her sustainability initiative by launching Second Life at Pronovias, the wardrobe life extension initiative, releasing dresses designed specifically to be altered after the wedding and thus encouraging more wears and the longevity of wardrobe items. Rinaudo has designed a collection which can be transformed free of charge into a new style after the wedding, with the first launch consists of over 50 carefully selected bridal gowns that can be converted by altering the length, eliminating sleeves, or by adding belts, straps, sashes and other details to create a totally new look. The number of dresses that can be given a Second Life will increase with each new bridal collection launched by the brand.

The pandemic was the reason we did all these, Ohayon says, stating that the uncertain and at times dark experience in fact brought some great things and taught her, and the brand, to be agile and adaptive. We signed the deal with Vera Wang in 2020 over Zoom calls we now do business and develop relationships in a whole new way.

The Pronovias Atelier Versailles Collection will be available in store in September 2022.

Read more here:
Pronovias Unveils 2023 Bridal Collection With First Runway Show In 2 Years - Forbes

Recommendation and review posted by Bethany Smith

MANAGEMENT'S DISCUSSION AND ANALYSIS OF OPERATIONS AND FINANCIAL CONDITION

This Management's Discussion and Analysis of Operations and Financial Condition ("MD&A") should be read in conjunction with Yamana Gold Inc.'s (the "Company" or "Yamana") condensed consolidated interim financial statements for the three months ended March 31, 2022, and the most recently issued annual Consolidated Financial Statements for the year ended December 31, 2021 ("Consolidated Financial Statements"). All figures are in United States Dollars ("US Dollars") unless otherwise specified and are in accordance with International Financial Reporting Standards as issued by the International Accounting Standards Board ("IFRS").

The Company has included certain non-GAAP financial performance measures, which the Company believes, that together with measures determined in accordance with IFRS, provide investors with an improved ability to evaluate the underlying performance of the Company. Non-GAAP financial performance measures do not have any standardized meaning prescribed under IFRS, and therefore they may not be comparable to similar non-GAAP financial performance measures employed by other companies. The data is intended to provide additional information and should not be considered in isolation or as a substitute for measures of performance prepared in accordance with IFRS. The non-GAAP financial performance measures included in this MD&A include:

Cash costs per gold equivalent ounce ("GEO") sold;

All-in sustaining costs ("AISC") per GEO sold;

Net free cash flow;

Free cash flow before dividends and debt repayment; and

Average realized price per ounce of gold/silver sold

Reconciliations and descriptions associated with the above financial performance measures can be found in Section 11: Non-GAAP Financial Performance Measures in this MD&A. In addition, each non-GAAP financial performance measure in this MD&A has been annotated with a reference to endnote (1).

Cautionary statements regarding forward-looking information and mineral reserves and mineral resources can be found in Section 12: Disclosure Controls and Procedures in this MD&A.

Endnotes can be found on the final page of this MD&A.

1. HIGHLIGHTS AND RELEVANT UPDATES

For the three months ended March 31, 2022 unless otherwise noted

Operational, Earnings and Cash Flow Highlights:

Gold production of 210,533 ounces exceeded plan, following standout performances from Jacobina with 47,124 ounces, El Pen with 41,330 ounces and Cerro Moro with 25,254 ounces, and with gold production at other mines in line with plan, including at Minera Florida, where production was modestly impacted early in the quarter as a result of a previously disclosed labour action which has been resolved and resulted in a new long term collective bargaining agreement. Within the quarter, March was a standout month for Jacobina, with the mine achieving record monthly production and throughput. Quarterly gold production also exceeded the prior year comparative quarter.

Silver production of 2,198,669 ounces exceeded plan, following an exceptional performance from Cerro Moro. Quarterly silver production also exceeded the prior year comparative quarter.

GEO(2) production from Yamana mines(4) of 238,617 GEO(2) was in line with plan, despite a lower gold to silver ratio than anticipated in the plan and guidance. With the budget gold equivalent ratio, GEO(2) production would have exceeded plan as well. Quarterly GEO(2) production also exceeded the prior year comparative quarter production of 231,988 GEO(2), on the back of strong gold production. Cerro Moro in particular exceeded the prior year comparative period GEO production by 27%.

Quarterly total cost of sales, cash costs(1) and AISC(1) on a per GEO(2) basis of $1,212, $734, and $1,084 respectively. Costs were lower than plan, despite the first quarter being the lowest planned production quarter of the year, and the lower than plan and guidance gold to silver ratio which also impacted GEO(2) production. The Company continues to monitor the impact of inflationary pressures on its cost structure and notes that in the first quarter, the price of certain consumables, primarily diesel and mill balls, increased while certain others have remained relatively constant. Furthermore, higher base metal prices have had a positive impact on by-product credits allocated to GEO(2) costs. The impact of inflation on costs remains uncertain mostly because it is unclear if the geopolitical events that have occurred since the Company provided its guidance earlier in the year, which have driven price increases on certain items, will continue, or whether the events will continue to impact the price of those items. Equally, in the first quarter, the Company successfully mitigated inflationary trends through productivity improvements and overall, as aforementioned, costs in the first quarter were lower than plan and in line with guidance. While the Company plans to increase capital

| 1

spending in each of the following quarters, as compared to the first quarter, this will coincide with increases in production and generation of cash flows and free cash flows. Further, the Company notes that cash flows in the second half of the year will also increase as higher income tax installments will have been paid, as normal, in the first half of the year.

Cash flows from operating activities before net change in working capital for the three months ended March 31, 2022 were $197.3 million, an increase of 7.6% compared to $183.4 million in the comparative period in 2021.

As at March 31, 2022, the Company had cash and cash equivalents of $516.4 million, including $218.3 million available for utilization by the MARA Project. Further, the Company has available credit of $750.0 million from its undrawn revolving credit facility. The Company notes that while production for the year is expected to be consistent quarter-over-quarter, except for a modestly lower first quarter as compared to other quarters, free cash flow is expected to steadily increase quarter-over-quarter, with the strongest free cash flow generation expected in the second half of the year, and in particular during the fourth quarter. The Company expects cash balances to increase steadily throughout the year with the strongest contribution in the latter half of the year.

Net earnings(3) for the three months ended March 31, 2022 were $57.8 million or $0.06 per share basic and diluted, compared to net earnings(3) of $54.7 million or $0.06 per share basic and diluted for the three months ended March 31, 2021. Adjusting items of $25.8 million(3), that management believes may not be reflective of current and ongoing operations, and which may be used to adjust or reconcile input models in consensus estimates, decreased net earnings(3) for the current period. For a complete list of adjustments attributable to Yamana Gold Inc. equity holders, refer to the Financial highlights section below.

The Company employs a balanced approach to capital allocation, which is expected to generate significant and growing cash balances during the guidance period. The cash balances are expected to be more than sufficient to finance and support the Company's planned growth campaign, while maintaining financial strength, and strengthening and increasing returns of capital to shareholders through dividends and share buybacks. To achieve this, the Company employs a disciplined capital spend framework during the guidance period with a target of $150 per GEO(2) of sustaining capital and net expansionary capital to not exceed $175.0 million per year on average. The Company expects to be in a position to further consider its cash return level later this year.

Please refer to Section 2: Core Business, Strategy and Outlook of this MD&A for further details on the capital allocation strategy of the Company, the ten-year production outlook and Yamana's investment and exploration strategy.

Strategic Developments, Construction Developments and Advanced Stage Projects:

Positive Development Decision on the Wasamac Project, Quebec

During 2021, the Company made a positive development decision on its wholly owned Wasamac project in the Abitibi-Tmiscamingue region of Quebec, Canada. Wasamac, a top-tier gold project in a region where Yamana has deep operational and technical expertise and experience, solidifies the Company's long-term growth profile with Yamana's average annual gold production in Quebec, including production from Wasamac and the Odyssey underground at Canadian Malartic, has the potential to increase to approximately 500,000 ounces by 2028, and continue at this level through 2041.

Yamana expects to receive all permits and certificates of authorization required for project construction by the third quarter of 2024. Construction time to processing plant commissioning is estimated at two and a half years, with the underground crusher and conveyor system scheduled for commissioning six months later and first gold production scheduled for 2026. Initial capital cost is expected to be relatively modest for a 7,000 tpd underground operation, at approximately $416 million.

During the first quarter, the Company continued to advance the bulk sample permitting process for Wasamac and expects to obtain the required approvals in the first quarter of 2023. The bulk sample permit would allow construction to commence on the ramps, enabling earlier access to the deposit to increase the level of confidence in metallurgical and geotechnical assumptions and optimize the processing flow sheet and mining sequence. Construction on surface facilities to support the ramp development activity and associated environmental requirements would also advance. The Company anticipates that a detailed update will be provided mid-year.

Exploration activities progressed as planned during the first quarter, with a focus on infill drilling on the Wasamac resource. Work on the Francoeur property during the quarter included ongoing modelling and compilation of drilling and other historic data. Field work is planned to start at Francoeur in the second quarter, including mapping and surface sampling and target definition in preparation for exploration drilling. For additional information on the planned Wasamac exploration initiatives, please refer to Section 6: Exploration.

| 2

Canadian Malartic Underground Construction

The Company and its partner made a positive construction decision for the Odyssey project at Canadian Malartic in 2021. A National Instrument ("NI") 43-101 technical report completed in March 2021 included a full summary of the Odyssey underground project and demonstrated robust economics, a significant increase in mineral resources, first production from the Odyssey South deposit expected in 2023, and a mine life extension to at least 2039. As Canadian Malartic transitions from open pit to underground mining, underground production will offset a significant portion of the corresponding decline in open pit production. On a 100% basis, production from open pit mining from 2021 through 2028 is expected to be approximately 3.9 million ounces; the Odyssey underground mine plan supports annual gold production of 500,000 to 600,000 ounces when fully ramped up on a 100% basis. Furthermore, the Odyssey underground mine plan currently only includes about half of the project's 2.4 million ounces of Indicated Mineral Resources and 13.2 million ounces of Inferred Mineral Resources (on a 100% basis). Further upside from grade improvements and underground mine life extensions are expected to be realized through infill drilling to improve geological confidence, exploration drilling to extend known deposits and make new discoveries and engineering efforts, especially close to historical underground excavations and at depth at East Malartic.

Following significant advancement of the project in 2021, the Odyssey team is focusing on two key milestones:

Initiation of shaft sinking by the fourth quarter of 2022

First gold production from Odyssey South in the first quarter of 2023

The project continues to be on budget, and on schedule, and the Company shares the following updates:

The concrete pour to construct the 93-metre-tall headframe was completed on schedule in the fourth quarter of 2021, in preparation for shaft sinking slated to begin in the fourth quarter of 2022. Structural steel installation inside the headframe is ongoing. The production shaft will be 6.5 metres in diameter and 1,800 metres deep, with the first of two loading stations at 1,135 metres below surface. Construction of the temporary hoist building and waste silo is on schedule.

Ventilation is now provided directly through a fresh air raise to surface and two bays in the maintenance garage are now available.

As an employer of choice in the Abitibi, the Odyssey project is successfully building a highly skilled team and development rates are planned to continue increasing throughout the year.

Priority continues to be placed on the main ramp and also the level 16 exploration drift for infill drilling of the Odyssey South and Internal zones. The compressor building is expected to be completed in the second quarter and construction of the paste fill plant and 120 KV power distribution line are on schedule to support the Odyssey South stoping sequence.

Decree amendment and the mining lease process continue to be on target and all required permits to commence production from Odyssey South are expected by the end of 2022.

With a significant production platform, material cash flow generation and a prominent position within Quebec's Abitibi District, Canadian Malartic will remain one of the Company's cornerstone assets and one of the more prolific and generational mines in the world, particularly as the Odyssey mine is developed and comes into production. The Company is taking a disciplined approach to the development of Odyssey with a conservative outlook for initial throughput and production. While the Odyssey mine is expected to initially process 20,000 tonnes per day and produce 500,000 to 600,000 ounces per year, based on the current mine plan, the Company recognizes that there is a large inventory of ounces that is not currently in the mine plan.Odyssey ores will be processed through a plant with an original design capacity of over 55,000 tonnes per day, processing closer to 60,000 tonnes per day, which far exceeds the initial expected throughput of Odyssey. The plant was designed for the larger open pit operations that will end later this decade, and while the Company will scale the plant to the level required for the underground operation, that plant capacity will always be there. The Company's approach at its other mines has been to conduct extensive exploration which provides flexibility to maximize and increase throughput, and a similar approach will be taken with Odyssey, where delineation of extensions of underground mineralized zones and new zones of mineralization is already occurring. The extension of East Gouldie and discovery of Titan are examples of these underground exploration successes and opportunities. The Company's efforts at Camflo, East Amphi and Rand provide potential to add tonnage and production. The Company firmly believes that in its 10-year outlook period, these efforts will lead to more mining areas that will allow the Company to take advantage of available plant capacity, resulting in ore processing that will exceed 20,000 tonnes per day, and sustainable production will then significantly exceed the initial production plan of 500,000 to 600,000 ounces per year.

Jacobina Expansion Strategy

The Company's expansion strategy at Jacobina is well advanced and the Company anticipates that the low-cost operation will have a mine life that exceeds several decades, taking reserves and high conviction mineral resources into consideration. Production is expected to materially increase with phased expansions providing a

| 3

pathway to sustainable production of 350,000 ounces per annum. This will increase the already excellent cash flow generation of the mine and deliver meaningful value. With well-below average costs at Jacobina, cash flows exceed those from mines that produce significantly, and as much as fifty per cent, more ounces. The mine currently has a reserve life of over 15 years plus a pipeline of resources and exploration targets that we believe will further extend mine life. Work performed since 2019 has allowed for the systematic exploration of the Company's large land package in the Jacobina district, which covers 155 kilometres of exploration potential, allowing for the definition of a fourteen-kilometre long belt of gold-bearing conglomerate located north of the mine complex and also extending the known mineralized reefs south of Joo Belo in a continuous area extending 2,200 metres. Further areas have been identified during reconnaissance exploration programs. Work will continue to define mineralized reefs exposed on surface and follow up with drill testing targeting both extensions of the mine complex and new standalone mine targets. Consequently, the Company sees significant opportunities to grow its regional presence and continue to build the world-class Jacobina Complex.

The Phase 2 expansion is progressing ahead of schedule and the mine is now expected to achieve the Phase 2 throughput objective approximately one year ahead of schedule, by the middle of 2022. Throughput in the first quarter averaged 7,850 tpd, a 3% increase over the previous quarter. During the fourth quarter of 2021, Jacobina received the expansion permit, allowing throughput to increase to 10,000 tpd, as announced in the December 6, 2021 press release "Yamana Gold Receives Permit at Jacobina, Initiating Ramp Up of Phase 2 Expansion, Expects Fourth Quarter Company Wide Production to Exceed 270,000 GEO With Costs Tracking to Be the Lowest of the Year". Receipt of the permit not only marks a significant milestone in the Phase 2 ramp up to 230,000 ounces of gold per year, but also facilitates the future Phase 3 expansion to increase production up to 270,000 ounces per year.

With the Phase 2 expansion advancing ahead of schedule, the Company is now pursuing the Phase 3 expansion to 10,000 tpd through continued incremental debottlenecking. With the permit to 10,000 tpd already in hand, Phase 3 is expected to increase gold production to approximately 270,000 ounces per year by 2025 with a modest capital expenditure of $20 million to $30 million.

The Phase 4 expansion, of up to 15,000 tpd, would increase gold production in excess of 350,000 ounces per year. To achieve the target throughput rates, a third grinding line would be added as well as an expansion of the leaching and CIP circuits. As the third ball mill was originally planned as part of the Phase 2 Feasibility Study, engineering for Phase 4 is well advanced. A comprehensive plan, aligning the processing plant, underground mine, and tailings management strategy, while managing capital expenditures and cash flow, is underway.

The Company is further evaluating the strategic options and direction related to Jacobina and the significant exploration that is available along the greenstone belt which hosts the mine. Jacobina is being envisioned as a complex of multiple mines, and more emphasis is being placed on regional and generative exploration.

Cerro Moro Scalable Plant and Heap Leaching Upside Opportunities

The objective at Cerro Moro is to create a sustainable ten-years of production of at least 160,000 GEO(2) per year, and up to 200,000 GEO(2) per year. If the Company successfully develops both the plant expansion and heap leach projects, which represent significant upside opportunities, along with conversion of the exploration targets to mineral resources, Cerro Moro could produce at least 200,000 GEO(2) per year.

During the first quarter, Yamana advanced the plant expansion, envisaged as a low-risk, phased expansion for Cerro Moro with quick payback from the initial phase used to fund subsequent phases. The Company is considering using fine screens instead of cyclones for classification to improve the efficiency of the existing ball mill which, combined with a slightly coarser grind size, is expected to increase throughput to at least 1,500 tpd, a 40% to 50% increase in capacity, without impacting gold and silver recoveries. The incremental capacity could be used for processing of lower grade mineralization, which is expected to increase annual gold and silver production, and in turn reduce fixed costs per unit at the mine, as those costs would be distributed over additional ounces. Preliminary analysis based on current operating data indicates that the existing crushing and flotation circuits are adequate for the higher throughput rate and reconfiguration of the leaching circuit could achieve the target throughput without requiring additional leach tanks. Upgrades to the concentrate thickener, clarifying filters, flocculant make-up system, and pumping would likely be required. The capital cost of this initial phase is estimated at a modest $15 million to $20 million. Many of the upgrades in phase 1 expansion would be sufficient for a second expansion phase to increase plant throughput to approximately 2,200 tpd, double the existing capacity, further increasing production and reducing operating unit costs. Capital estimates for the Phase 2 expansion are also $15 million to $20 million, for a total capital investment over the two expansion phases estimated at $30 million to $40 million. The Company is currently evaluating two options for phase 2 expansion,

| 4

the addition of a high pressure grinding rolls ("HPGR") unit before the existing ball mill or the addition of a regrind unit. An expansion of the flotation circuit would also be required.

In parallel, a technical study on the potential heap leach project is underway following promising results from metallurgical testing conducted in 2021. Conceptual capital and operating cost estimation is expected to be completed in the second quarter, and an initial mineral inventory estimate, based on results from 2021 drilling, is planned for mid-2022. The results of testing indicate good potential for leaching of both oxidized near-surface vein material, zones with hypogene oxides (hematite) and some low sulphide gold-bearing veins, with extractions from column leaching averaging 68.6%. Gold recoveries at the Domos La Union and Michelle zones were particularly impressive, averaging 85.6% and as a result, exploration is focusing on these zones, with an objective of defining a heap leachable inventory of 5 to 8 million tonnes. Conceptual engineering for a 5,000 tpd heap leach operation commenced in the fourth quarter. A conventional heap leach configuration is envisaged with three stages of crushing. The leach pad, solution storage ponds, and Merrill-Crowe plant are conceptually planned to be located approximately 2 kilometres east of the current tailings storage facility. Average feed grade is estimated at approximately 1.0 to 1.4 g/t of gold, adding 45,000 to 65,000 ounces of gold production per year in addition to gold and silver production from the existing processing plant.

As Cerro Moro's mineral inventory increases, the Company will evaluate its options for alternative sources of power, which include a connection to the grid and wind power. Both options are expected to improve costs and further reduce greenhouse gas emissions, thereby accelerating the achievement of the Company's 1.5C science-based carbon emissions reduction target. The transition of Cerro Moro from high-cost diesel-generated electricity to wind power is the most attractive and compelling of several viable greenhouse gas reduction options. The conversion of approximately 50% of Cerro Moro's electricity requirements from diesel to wind power would meet the greenhouse gas emission reductions required between now and 2030 to achieve the Company's 1.5C science-based target. Further, it is expected that the transition to wind power would reduce operating costs, expand mineral reserves and mine life. A detailed evaluation, including a third-party feasibility study of this opportunity is underway. The third-party study to finalize the Company's evaluation of wind power indicates there should be a sufficient and sustainable supply of power as the Cerro Moro area of southern Argentina is considered one of the best on-shore locations in the world for wind energy. The results of the alternative power analysis will be considered in the plant expansion pre-feasibility and heap leach studies to explore synergies between the projects.

MARA Project Advances

The MARA Project represents a significant strategic value opportunity and a solid development and growth project. The Company intends to pursue all available avenues to continue to advance and unlock its value through its controlling interest while also considering strategic alternatives that could unlock significant value along the way. During the last year, several proposals were presented to the Company for its interest in MARA and, after consideration, the board determined that any strategic initiatives will be considered closer to the completion of the feasibility study and application for permitting as the certainty of the project from these events is expected to create more value for the project. The MARA Joint Venture is held by the Company (56.25%), Glencore International AG (25%) and Newmont Corporation (18.75%). The pending feasibility study, which is being overseen by the Technical Committee comprised of members of the three Companies, will provide updated mineral reserves, production and project capital cost estimates. The engineering effort for the feasibility study is expected to be completed by the end of 2022 and the finalized report in early 2023, however a considerable amount of information in the pre-feasibility study is already at feasibility study level as a result of the Integration. MARA is conducting field campaigns to complement the Environmental and Social Impact Assessment ("ESIA") baseline data. Preliminary results and advancement of the project are being shared with the Intergovernmental Commission of Catamarca, prior to filing the full ESIA. The Company plans to complete the ESIA definition for MARA by the end of 2022.

Work during the first quarter of 2022 focused on continuing the progress in 2021: advancing the feasibility study engineering, mine design and planning, metallurgical and geotechnical drilling campaigns, field work at site, baseline social and environmental studies, as well as permitting and working with local stakeholders. The field work plan continues, with the drilling campaign now covering the Agua Rica infrastructure and is expected to be completed by the third quarter of 2022.

MARA is the combined project comprised of the Agua Rica site, Alumbrera site as well as the Alumbrera plant and ancillary buildings and facilities, and will rely on processing ore from the Agua Rica mine at the Alumbrera plant. The project design minimizes the environmental footprint of the project incorporating the input of local stakeholders. MARA will be a multi-decade, low cost copper-gold operation with annual production of 556 million pounds of copper equivalent during the first ten years of production, and life-of-mine annual production of 469 million pounds of copper equivalent on a 100% basis. MARA will be among the top 25 copper producers in the world when in production, and is one of the lowest capital intensity copper projects globally.

| 5

For full details on the aforementioned updates, please refer to Section 5: Construction, Development and Other Initiatives.

OPERATING

First quarter GEO(2) production of 238,617 ounces was in line with plan and exceeded prior year first quarter production of 231,988 GEO. Standout GEO production performances were delivered by Jacobina and Cerro Moro. First quarter total cost of sales, cash costs(1), and AISC(1) on a per GEO(2) basis were $1,212, $734, and $1,084 respectively. Costs were lower than plan, despite the first quarter being the lowest planned production quarter of the year, and the lower than plan and guidance gold to silver ratio which also impacted GEO(2) production. The Company continues to monitor the impact of inflationary pressures on its cost structure and notes that in the first quarter, the price of certain consumables, primarily diesel and mill balls, increased while certain others have remained relatively constant. Furthermore, higher base metal prices have had a positive impact on by-product credits allocated to GEO(2) costs. The impact of inflation on costs remains uncertain mostly because it is unclear if the geopolitical events that have occurred since the Company provided its guidance earlier in the year, which have driven price increases on certain items, will continue, or whether the events will continue to impact the price of those items. Equally, in the first quarter, the Company successfully mitigated inflationary trends through productivity improvements and overall, as aforementioned, costs in the first quarter were lower than plan and in line with guidance. While the Company plans to increase capital spending in each of the following quarters, as compared to the first quarter, this will coincide with increases in production and generation of cash flows and free cash flows. Further, the Company notes that cash flows in the second half of the year will also increase as higher income tax installments will have been paid, as normal, in the first half of the year.

GEO is calculated as the sum of gold ounces and the gold equivalent of silver ounces using a ratio of 78.29 for the three months ended March 31, 2022, and 68.84 for the three months ended March 31, 2021. GEO calculations are based on an average market gold to silver price ratio for the relevant period.

GEO(2)

Production

Sales

Per GEO sold data

Total cost of sales(6)

Cash costs(1)

AISC(1)

Production (ounces)

Sales (ounces)

Average realized price per ounce(1)

Average market price per ounce*

Production (ounces)

Sales (ounces)**

Average realized price per ounce(1)

Average market price per ounce*

* Source of information: Bloomberg.

** Included in three months ended March 31, 2022 silver sales ounces are 378,088 ounces, delivered under the silver streaming arrangement (2021: 335,699 ounces).

HEALTH, SAFETY, AND SUSTAINABLE DEVELOPMENT

Yamana's health, safety and sustainable development ("HSSD") approach is guided by the Company's corporate-level standards and programs; these are integrated into all operations, development projects, and exploration activities. Yamana recognizes the importance of striving to meet and exceed its HSSD responsibilities and objectives, and the role these efforts have in delivering on the overall objective of creating value for all stakeholders. Since early 2020, one of the most important considerations, in addition to the on-going priorities of safeguarding worker health and safety, protecting the environment and building privilege to operate with host communities has been the Company's response to the global COVID-19 pandemic.

| 6

Through the Company's active responses to COVID-19, the Company has demonstrated its commitment to environmental, social and governance ("ESG") excellence in action and resilience. Consistent with the mission to mine precious metals profitably and responsibly, the Company is prepared to forego production to safeguard its efforts to promote health, safety and well-being of its workforce and host communities.

High vaccination rates amongst the Company's employees and contractors at all locations continue to protect people, host communities and our business. In the first quarter of 2022 host countries began to experience increases in the number of reported COVID-19 cases, although the rapid rise in caseloads that occurred in North American and Europe has yet to appear in our operating jurisdictions. The Company continues to actively monitor Omicron-related caseloads and healthcare system capacity in South America, government responses, and vaccination availability. Yamana also works closely with local and regional governments to ensure prevention procedures are followed.

As the pandemic transitions to an endemic situation, we continue to have low numbers of worker COVID-19 cases at sites. The Company's continued implementation of its highly successful prevention, monitoring, testing, quarantine and contact tracing protocols has limited their spread. Infected people are being isolated successfully with no operational impact. The number of active cases at the end of the first quarter 2022 was in the single digits, rates of third booster vaccine doses are climbing and fourth doses are currently being administered in Chile.

The Company continues to manage its business in a way that respects, and is mindful of, the impact that COVID-19 has had and could have on host communities.

As part of the continuing implementation of its Climate Action Strategy, the Company completed its inaugural Climate Action Report disclosing information on the recommendations of the Task Force on Climate-related Financial Disclosures ("TCFD"), which was published on the Company's website at http://www.yamana.com on April 11, 2022. The report builds on the Company's 2021 climate action work and includes information on the Company's approaches to climate governance, strategy, risk management, and targets, metrics and performance. The report also describes how the Company will achieve its 1.5C science-based target compared to pre-industrial levels by 2030. The Company is well positioned to achieve its 2030 climate action target with only modest expenditures. The transition of Cerro Moro from high-cost diesel-generated electricity to wind power is the most attractive and compelling of several viable greenhouse gas reduction options. The conversion of approximately 50% of Cerro Moro's electricity requirements from diesel to wind power would meet the greenhouse gas emission reductions required between now and 2030 to achieve the Company's 1.5C science-based target. Further, it is expected that the transition to wind power would reduce operating costs, expand mineral reserves and mine life. A detailed evaluation, including a third-party feasibility study of this opportunity is underway. The third-party study to finalize the Company's evaluation of wind power indicates there should be a sufficient and sustainable supply of power as the Cerro Moro area of southern Argentina is considered one of the best on-shore locations in the world for wind energy. The results of the alternative power analysis will be considered in the plant expansion pre-feasibility and heap leach studies to explore synergies between the projects. Work will continue during 2022 to progress other climate action objectives, including advancing the evaluation of other operational projects to reduce greenhouse gas emissions and estimation of our Scope 3 emissions.

Other recent highlights relating to HSSD are as follows:

The Company's Total Recordable Injury Rate ("TRIR") for the first quarter 2022 was 0.75*. We have modified our TRIR reporting to align with our financial reporting standards which include our wholly-owned operations, exploration projects, development projects (Wasamac and MARA), proportional consolidation of Canadian Malartic (50%), and closed projects. For comparison, the corresponding full-year 2021 result was 1.07*.

As of April 5, 2022 more than 99%** of the Company's employees and contractors at its wholly-owned operations and exploration projects have received at least one dose of a COVID-19 vaccine and more than 96%** have received two doses. Approximately 76%** of workers have received a third dose booster shot.

The Wasamac project opened a dedicated community relations office in Evain, QC to further enhance and bring focus to its commitment to open and transparent dialogue with host communities and the broader group of stakeholders.

* Calculated on a 200,000 exposure hours basis including employees and contractors.

** Vaccination rates are exclusive of Canadian Malartic, in which we hold a 50% interest. Vaccination rates at Canadian Malartic are in line with the high Abitibi-Tmiscamingue regional rates.

FINANCIAL

Here is the original post:
Yamana Gold : MANAGEMENT'S DISCUSSION AND ANALYSIS OF OPERATIONS AND FINANCIAL CONDITION - Form 6-K - Marketscreener.com

Recommendation and review posted by Bethany Smith