Mindful Holiday Cheer

Being mindful during the holiday season can actually be achieved – with a little moderation and helpful tips. Tis the season to be jolly and imbibe responsibly in holiday spirits.  As women, this is especially critical because we metabolize alcohol much more slowly than our male counterparts.

 

As William Shakespeare so eloquently wrote in Mac Beth, Act II, Scene III:

 

“ Drink, sir, is a great provoker….Lechery, sir, it provokes, and unprovokes; it provokes the desire, but it takes away the performance.- “

 

Women need to be especially mindful when consuming alcohol.  There are various reasons for this:  their smaller body size, different % of body fat and slower enzymatic metabolism of alcohol.  All of these create a higher blood alcohol level in women compared to men. 

 

A “standard” drink means any alcoholic drink that contains approximately 0.6 fluid ounces or 14 grams of “pure” alcohol.  This equates to:

 

  • ·        12 fluid ounces ( fl.oz)  of regular beer
  • ·        8 fl.oz. of malt liquor
  • ·        4-5 ounces of table wine
  • ·        3 ounces of fortified wine ( sherry or port)
  • ·        2 ounces of cordial, aperitif
  • ·        1.5 fl.oz of “hard” liquor – 80-proof ( 40% alcohol content).

 

5 Holiday tips to stay mindful (and not hung-over the next day!)

 

1)      Drink lots of water.  Before ordering that glass of cabernet or margarita on the rocks, remember to drink a glass of water.  Have one glass of water per each alcoholic beverage.  Hydration (and moderation) is key!

 

2)      Eat food:  Choose healthy options, if possible.  Skip the salted chips with onion dip and go for the veggies with hummus dip.  By eating food, you will slow the rate of alcohol absorption into your body.

 

3)      Alternate with water or non-alcoholic drinks.  This will keep your hands busy as well as keeping you hydrated.

 

4)      Don’t cave into peer pressure.  If you don’t want to have that extra drink, politely say “No”.  You’ll be happy for it in the morning.

 

5)      Have a plan to get home safely.  Designate a driver for the evening who agrees not to drink during the evening’s festivities and is responsible for getting everyone home safely.  Or, take a cab if needed.    The cost of fare is well worth it!

 

For tips on how to stay mindful with all parts of life, please register for the Vibrantly You Well Being Symposium.   For the month of December, we will be cutting the price for each ticket, from $97 to $75!

 

Please see discount code: R & C to obtain discounted price.

 

A savings of $22 dollars a ticket!  Invite some friends and celebrate January with a boost of healthy energy and excitement!  To register, go to: www.vibrantly-you.com 

 

 

 

 

 

Lighting the way…

Dr. Diana

 

Hot Flashes? Can’t take Hormones? Here’s some help with the Heat!

Hot flashes occur in over 85% of women during the years around menopause.  For many women, hormone therapy may not be an option for turning down the heat from night sweats and hot flashes.  After release of the Women’s Health Initiative (WHI) in July 2002, many women abruptly stopped their hormone therapy (HT) while others questioned their  safety.    Initial results from WHI showed an increase in breast cancer, heart attack, and stroke.  With a decade of hindsight we now better know the true risks and benefits of HT.  Even with this new evidence showing a major benefit in women starting hormone therapy near the time of menopause (within 10 years), there may still be many women who may not be able to take estrogen.   What are some of their options? 

Hot flashes, also known as hot flushes are very commonThese are commonly known “vasomotor symptoms” in the research and are categorized by severity and frequency:

  •  Mild: a feeling of warmth in the face, neck and chest.
  •  Moderate: feeling of warmth with sweating
  •  Severe: feeling of warmth, with sweating and loss of concentration

 

 

What are the options available for women who cannot take HT?

After reviewing numerous studies, I have compiled a list of non-hormonal prescription  and non-prescription medications which have been shown to decrease hot flashes.   Interestingly, many of these clinical trials were done in women with a history of breast cancer, receiving tamoxifen.  Furthermore, many of these trials had a very high placebo rate, i.e. those women not receiving the study medication   (placebo pill) showed  a high rate of benefit compared to those receiving the actual study medication.  This is known as the “placebo effect”.  In these studies, the placebo response rate ranged from 18-40%.

 

 

Non-hormonal/ Prescription Medications                                         

1)      SSRI’s/SSNRI’s : Best results occurred with Venlafaxine ( Effexor)  with 63% reduction in hot flashes in patients receiving 75 mg dose, vs. 45% in those receiving lower dose ( 37.5 mg) compared to 20% reduction in placebo group.  The next best was Paroxetine (Paxil), followed by Fluoxetine (Prozac).

2)      Gabapentin ( Neurontin); 45% decrease in hot flashes vs. 29% placebo, at dose of 300 mg three times a day.

3)      Clonidine ( Catapres): very few studies with only short term use, up to 12 weeks, reduces hot flashes by 15-20%., with dose of 0.1 mg/day.

4)      Belladonna/ergotamine tartrate/Phenobarbital combination ( Bellergal): decreased hot flashes by 75 % vs. 68% in placebo, dose of one tablet three times a day.

   Black Kohash plant

Non-hormonal /Non-prescription Options

1)      Black Kohash: This is the most studied and popular herb for treatment of hot flashes.   Results of studies show inconsistent results and dosages varied.  American College of Ob/Gyn ( ACOG) states that black kohash may be helpful in the short-term ( less than six months) treatment of women with vasomotor symptoms.

 

2)      Soy isoflavones: Studies showed inconsistent results. Some showed significant reduction in women with moderate to severe hot flashes.    ACOG recommends that soy and isoflavones  be used in the short-term , less than 2 years and that they should be used with caution in women with an estrogen-dependent cancer,  given the possible interaction with estrogen (39).

 

3)      Red Clover, Ginseng, Evening Primrose oil, Wild Yam: In clinical trials, no significant difference in hot flash reduction compared to placebo.  I have included these because many patients  frequently do use these remedies and do find some relief, although for only a short period of time

Take Home Tips:

1)      Hot flashes occur very frequently in women around the time of menopause and can significantly affect a woman’s quality of life.

2)      A thorough medical history should be taken to rule out other causes for hot flashes, such as thyroid disease.

3)      Evaluation of current medications and conditions should be considered with you and your health care provider to determine the best option for you, be it hormonal, or non-hormonal. 

4)      There are prescription medications available as well as herbal remedies.

5)      Consult with your health care provider before initiating any treatment.

Then you too, can be lying in the green grass…calm, cool and collected!

 

Lighting the way…

Dr. Diana

 

Citations:

  1. 1.      Roussouw, JE. Et al.  (2002) Writing Group for the Women’s Health Initiative Investigators.  Risks and benefits of estrogen plus progestin in healthy postmenopausal women: principal results from the Women’s Health Initiative randomized control trial.  JAMA; 288: 321-33.

 

  1. 2.      Carroll, DG. (2006). Nonhormonal Therapies for Hot Flashes in Menopause. Am Fam Physician, Feb 1; 73 (3): 457-464.

 

 

 

Is it “hot” in here? Getting Rid of the Heat- Introducing the “Kool Tool”!

Is it “hot” in here?  Getting Rid of the Heat- Introducing the “Kool Tool”!

Are you tired of those bothersome hot flashes?  Sweating during a meeting and losing your train of thought?  Soaking the sheets at night?

Well, you’re not alone!   Approximately eighty-five percent of the women in the United States are experiencing hot flashes of some kind as they approach menopause, and for the first few years after their periods stop.  In fact, 20-50% of women continue to experience them for up to 5 years and 15% will continue to have them their entire life!   Want some secret tips to turn down the heat?

 What are hot flashes?

A hot flash is a sudden, intense, warm feeling which occurs on the face, neck and upper body which can last for a few seconds, minutes or longer.   It can be accompanied by faster heart rate, sweating, and loss of thought.  Some women even experience an “aura”, an uneasy feeling just before the hot flash occurs, warning them of its imminent assault.   This flash is often followed by a flush, which leaves you reddened and perspiring.  At night, these same symptoms are called night sweats.

 

What causes hot flashes?

Hot flashes are usually caused by the hormonal changes occurring during menopause, specifically the precipitous decline in estrogen levels.   Some of these symptoms can also be affected by lifestyle and medications.  With the steep decline in estrogen levels during menopause, the brain experiences certain changes.  Specifically, the hypothalamus, the control center for appetite, sleep cycles, sex hormones and body temperature is affected.   The drop in estrogen confuses the hypothalamus to think that it’s “thermostat” is reading “too hot”.   

Because of this heat overload, your brain sends signals to vital organs to get rid of the heat.  Your heart rate quickens, blood vessels dilate and nervous system is activated with release of epinephrine, prostaglandins and serotonin.  Within seconds, the blood vessels in your skin dilate, radiating off heat, and sweat glands produce sweat to cool you off.    It has been reported that in some women the skin temperature can rise as much as six degrees Fahrenheit!  Your body cools down because it thinks it too hot, making you sweat during the middle of a board meeting or in the middle of a good night’s sleep.

Decrease hot flashes by avoiding these triggers:

  • Stress
  • Caffeine
  • Alcohol
  • Spicy foods
  • Tight clothing
  • Heat
  • Cigarette smoke

Get a Kool Tool!

This amazing product was developed by four incredible businesswomen living in San Diego, who are dear friends of mine.   I am an affiliate marketer with them.

 

 

Once I placed the Kool Tool around my neck a cooling sensation instantly spread across my neck and chest.  Wow, what a brilliant idea.  Now I’m using my Kool Tool at the office, on the tennis court, at the gym and while gardening outside.    It last for hours, is reusable, and is anti-microbial.  For me, it’s been a literal life-saver!

For my faithful blog followers, as an affiliate marketer, I am offering a special discount on the Kool Tool.  Simply go to my website: www.drdianahoppe.com and click the “store” button.  Then enter the following coupon codes:

Buy 2 and save $5: use coupon code:  DrD2for35

Buy 3 and save $10: use coupon code:   DrD3for50

Start feeling cooler today! 

 

 

 
Dr. Diana

Dr. Diana

Fifty Shades: From Baby Boom to Rope Shortage?

Fifty Shades : From Baby Boom to Rope Shortage?

Could this erotic trilogy be causing a virtual baby boom?   Not to mention an apparent shortage of certain rope in the United States?   The first of these queries was recently posed to me by an interviewer for Parent Magazine.  It piqued my interest into the possibility that this steamy, erotic novel is awakening women’s desire from water coolers to book club groups, and boardrooms to bedrooms.

 

Are Baby Boomers having more sex because of Fifty Shades of Grey? …

Yes,  according to Babycenter.com, a large online community of moms and expectant moms, over 150 women have posted that their pregnancies were directed related to sex inspired activity by the best selling trilogy.  The Huffington Post adds that an increasing number of women are reporting more spontaneity and frequency of sexual encounters (1).  Depending on whether contraception is being used, more pregnancies may be occurring due to the increased…More enthusiasm and creativity is entering the bedroom, not only leading to more conceptions, but also a boom in the sales of sex toys.  According to Lisa Lawless, Ph.D, creator of Holistic Wisdom website, “Women and men are benefiting from these books as it is allowing them to consider sexual creativity and exploration in ways that they perhaps had not considered.”(2)

 

Are Men interested in Fifty Shades? — Fifty Shades Too Boring?

According to a recent survey in the Village Voice, Fifty Shades of Grey: Do Dudes Even Care About E.L. James’ Steamy Trilogy?, the resounding answer was “no”. (3) One response from a 34 year-old business owner, summed it up.  “My wife is reading it right now.  I have no idea how it’s affecting our sex life.  I don’t know if it’s impacted it at all.  Maybe you should ask her.” Yet other sites have claimed that men are reaping the sexual benefits of their partner’s increased sexual desire, while not specifically reading the book themselves.

For those men who might not be so inclined to download it on their Kindle or i-pad, a special, shortened version  is available. Tom Paolangeli is the author of “A Guy’s Secret Guide to Fifty Shades of Grey”, a cliff note version of the original book by E.L.James written from a man’s perspective.   He advises, “Trust me – you do not want to read the book. It was written by a woman, for women. Most guys will find it dull, stupid, tiresome and waaaay too long. The ratio of tedious inner female monologue to sex scenes is about fifty shades of boring to one.”  But he also that by reading a few sections of the book, “…your odds of having hot sex with your sweetie will go up exponentially…” (4)

What does Dr. Oz think?

Recently, Dr. Oz offered his opinion regarding the impact of the E.L. James’ blockbuster trilogy.  “She has gotten people talking about sex in a way that no one else could get them to talk about it…. What it is about is people having an honest conversation about what sex should be like, what makes it feel better, what are the timing issues, how do we make it an important issue in our life rather than an afterthought.”

Well, Dr. Oz, I thought that was what my book, Healthy Sex Drive, Healthy You: What Your Libido Reveals About Your Life, was supposed to do!  Perhaps my book took on a too clinical and practical approach rather than a bondage and submission angle.  Maybe then my book would be on the New York best seller list, too.   Brings back vague memories of how I should have bought Starbuck’s stock back in the early 1990’s.

When will this “Fifty Shades” bonanza end? 

Not anytime soon.   Apparently, a movie series is in the making with the cast being set as we speak.  In addition, E L. James has chosen a company in the United Kingdom, Caroline Mickler Ltd, as the global licensing agent for merchandise based on her racy books with a line of Fifty-Shades’ based lingerie/sleepwear, apparel, fragrances, beauty products, bedding , etc.”.(5)    Sales of sex toys are sky-rocketing, including the sale of rope.

According to the New York Post, New York hardware stores have seen a run on sales of rope, and other bondage gear, bought by female fans of Fifty Shades (6).  Watch out for the soon-to-be shortage of  hand-cuffs and riding crops!!

Share your views on the book.   

Feel free to use an alias or your initials with your post.  It’s a tender topic and I respect your views and candor.

Has it impacted your sex life?  If so, in what way?

Has the frequency of sex increased for you and your partner?

Has your partner read it?

Citations:

1)   www.huffingtonpost.com/2012/07/26/fifty-shades-of-grey-names_n_1707842.html

2)   www.holisticwisdom.com/fifty-shades-james-sex-toys-bondage.htm.

3)   www.villagevoice.com/runninscared/2012/07/fifty_shades_of_gre_men_react.php

4)   www.amazon.com/Secret-Guide-Fifty-Shades-ebook/dp/8008080RDFRU

5)   www.theadvocate.com/utility/homepagestories/2675013-129/men-are-fans-too-of

6)  www.nypost.com/p/news/local/ny_gals_learning_the_ropes_at_fifty_sVWWKeksj9WKUto2ITg/KK

 


The Ultimate “Letting Go” – Clinging to a Rock in the Rapids

The Ultimate “Letting Go”: Clinging onto a Rock in the

Middle of the Rapids!

Yes, clinging onto a rock in the middle of the raging rapids along the Lower Fork of the Salmon River.  This is the exact spot where I found myself during a recent river rafting adventure in Idaho.  The trip was called, Reflections on the River, led by an amazing mindfulness and meditation instructor.  I imagined the journey to be filled with peaceful days – flowing down the river, lazily and carelessly.   But this wasn’t exactly what happened on this particular day…

My nails clawed onto the rock, attempting to gain a better grip which proved difficult because of the slippery green grass covering its sides.  I gasped for air and filled my lungs with deep breaths.

What was I doing propped against a rock in the middle of a raging rapid?

Wasn’t I supposed to be on vacation?!

Only a few minutes earlier, we had been “securely” nestled in our tandem kayak.

I was seated in front and the leader of our group, an adept rower and canoe expert, was in the back.  That morning, we had kayaked quite well together and I had started to feel more confident with my kayaking skills.  This abruptly changed when we came upon this particular set of rapids!

One thing that I’ve learned about rapids – you better “take” them the right way.  We didn’t exactly “take” them the right way as we headed straight down.  Within seconds, we were drawn down by the raging current then catapulted onto a steep rock face.  A ninety-degree angle with the water is never a position a kayak should be in!

The kayak flipped –  propelling the two of us into the raging water.   Paddles went flying.  Kayak went sailing down the river.  The force of the current pulled me down and I couldn’t determine which way was up.  I gasped for air and swallowed large gulps of water.   Then, amazingly, I found myself propped up against a rock.    I saw my kayaking partner going down the river, taking the rapid on the left side holding onto the kayak as it was being swept down.

 

 

What do I do now?   I first needed some deep breaths to realize what the hell just happened.  Did I really just get thrown off the kayak?  Was I really clinging onto to this rock in the middle of a raging Class 3-4 rapid?

Surprisingly, I was not filled with fear.  Yes, I was afraid, but fear did not overwhelm me.   I did realize that this wasn’t the best situation to find myself in – literally up a river…with no paddle or kayak!!

What were my options?   Luckily, my survival instincts kicked in and two options came to me.  Option #1: to be rescued by another boat.  Option #2: to let go and face the rapids by myself sans paddle or kayak.   At first, the possibility that another boat might “save” me, seemed plausible.  Yet after a few minutes surveying the water’s course, the probability of a paddle boat stopping in the midst of the rapid and snatching me up,  soon vanished.

Option #2.  Let Go!   I felt the surge of water against the side and back of my body.  I watched how the river’s powerful force carefully carved passages between the boulders studded in its path.  Downstream lay much calmer water, but not for some distance.

What about the rocks?  Would I hit one?

I looked around at the shore.  There was Lindsay, my “celestial” member of the group.  We had kayaked together the day before and developed a bond while navigating the rapids.   She had stopped with her kayak downstream on the left side of the river’s shore.    I spotted her there and my heart immediately filled with warmth and sense of connection.   She looked at me, smiled, and calmly signaled me with a “two thumbs up” sign.

Yes, this was my sign – I had to let go.  I had to let go of the rock. 

I took a few more deep breaths, knowing that there was about 150 feet of raging rapids to go down.    I was at the river’s mercy.  If this was my time, I needed to have faith and trust.  That morning, during our meditation, our leader said, “The river is our mother and we are her garden…”

 Well, “Mother River”, I said, “what do you have in store for me?”

One more deep breath before letting my fingers loosen from their death grip on the rock.   Then I was released –  into the powerful rapids, heading straight down with my feet in front of me and buttocks tucked under.   (Note:  This is what you’re supposed to do, should you ever find yourself in this situation!)   The strong current took me under and flailed me high over the waves.  I felt my body crashing down and then rising up against the powerful crests of water.  Wave after wave came with amazing force pulling me under and then shooting me to the top.  I couldn’t get any air.  I just kept telling myself that there was an endpoint – calmer water lay ahead.

It seemed to be an eternity before I could finally see my paddle group up ahead.   I had made it through!  I swam furiously towards the safety of the paddle boat.  I could tell by their facial expressions that they had feared the worst-  not seeing any signs of me for quite some time.   The rafting guide hoisted me up by the straps of my life vest into the paddle boat.  I felt an immediate sense of relief when my feet landed on the sturdy rubber surface.    I took deep breaths of wonderful air and gazed at their smiling faces.

 A metaphor for life….This amazing experience can be seen as a metaphor for life.  How many times have we felt the need to cling onto something and not let go?  Our “rocks” may take many forms – relationships, jobs, thought patterns, belief systems, etc?   We hold onto this false sense of security – believing that this “rock” will provide us permanent solace and safety.  In actuality, we all know that we need to let go and have the courage to face life’s challenges… no matter what situation is presented to us!

A wonderful passage by the late Irish poet, John O’Donohue, presents it beautifully:

“In our day to day lives, we often show courage without realizing it.  However, it is only when we are afraid that courage becomes a question.  Courage is amazing because it can tap into the heart of fear, taking that frightening energy and turning it towards initiative, creativity, action and hope.  When courage comes alive, imprisoning walls becomes frontiers of new possibility, difficulty becomes invitation and the heart comes into a new rhythm of trust and sureness.  There are great sources of courage inside every human heart; yet courage needs to be awakened in us….Courage is a spark that can become the flames of hope, lighting new and exciting pathways in what seemed  to be dead, dark landscapes.”

Lessons learned.

I am grateful to the river for many invaluable lessons.  This experience re-awakened the courage in me to face life’s challenges straight on and cherish each day as a true “gift”.   One major lesson was that I had survived this near death experience!  From this, came the  need to fulfill my mission in life – to be a leader in women’s health and  empower women ( and men!) to lead the most fulfilling lives possible.  To not hold back, but go for our dreams!

Life is not a dress rehearsal – it is here, right now, right in front of us.  We only have the present.  No need to waste energy on the past or worry about the future.  We may not have absolute control over what happens to us, such as being flipped from a kayak in the midst of a raging rapid,  but we can control how we choose to react to life’s challenges.

Over the past 2 weeks, I’ve pondered over the “rocks” in my life.   What things was I clinging onto?  What was I resisting and not letting go of?

Hopefully by reading this you will be inspired to look at the “rocks” lying in your river of life —and choose to ultimately let go!

Questions for reflection:

  • What things are you holding onto?
  • What do you need to let go of?
  • Do you have courage and faith in your river’s path?

Please share any of your thoughts or experiences of “letting go”.

 

Lighting the way…

Dr. Diana

Dr. Diana

Cranberry juice for Bladder Infections: Fact or Folklore?

 

We’ve all heard it.  ”Drink cranberry juice to flush out a bladder infection!”  Is this really a medical remedy?

The answer is, Yes!

According to new research published in Archives of Internal Medicine, cranberry- containing products, especially cranberry juice, protect women against bladder infections, especially those prone to recurrent infections. (1)
Bladder infections, or urinary tract infections (UTI’s), are on the most commonly acquired bacterial infections, leading to approximately 7 million office visits and 1 million visits to emergency departments each year in the US, with estimated annual cost of $1.6 billion dollars. Approximately, 40-50% of women will experience at least one episode of UTI during their lifetimes.   Some of my patients experience many more!

Fact or folklore?
For years, cranberry juice, and its derivative tablets and capsules, were perceived merely as a folk remedy to prevent UTI’s. Now, findings indicate that cranberry-containing products legitimately do contain powerful substances which protect against UTI’s – in the general population of women, as well as highly susceptible women, such as pregnant women or elderly patients.
The research reviewed 13 different randomized, controlled trials involving over 1,600 men, women and children of different populations including the elderly. The majority of trials were conducted in North America with the remainder performed in Finland, Italy and the United Kingdom.
How do cranberries help prevent bladder infections?
Cranberry ( genus Vaccinium) has been shown to contain a specific substance, known as A-type proanthocyanidins (PAC’s) which interfere with the way bacteria attach to the bladder wall.

To get a bit more technical, the PAC’s inhibit the adherence of P-fimbriated Escherichia coli (or E. coli, the most common bacteria leading to UTI) to urogenital mucosa. Cranberry juice was more effective than capsules or tablets, most likely due to the fact the women drinking the juice consumed approximately 2-3 glasses of cranberry juice /day and thus were better hydrated. The exact dose of PAC’s to prevent UTI’s has yet to be determined, so limit your intake of juice and increase water intake.
Here are 5 tips to decrease your risk of UTI.

1) Stay hydrated. Drink 6-8 glasses of water every day. If you feel some symptoms of UTI coming on, such as burning when you urinate or urinating more frequently, add 1-2 glasses of cranberry juice to your daily intake. (One caution: cranberry juice contains a large amount of sugar so if you are diabetic, speak with your physician before this.)

2) Be careful with personal hygiene. Always clean your genital area from front to back to avoid spreading bacteria from your rectum to your vagina.

3) Urinate after sex. This will help flush out the bacteria that may be heading towards your urethra, which is the opening where urine comes out from your bladder.

4) Avoid the use of scented soaps, feminine deodorants and colored toilet paper. These may contain chemicals which can irritate your genital area.

5) Avoid prolonged activities that may increase urinary tract infections such as prolonged bicycle rides, horse riding or motorcycles. Instead, take a break every 1-2 hours and empty your bladder.
If you are persistently prone to UTI’s, especially after having sex, your physician may prescribe an antibiotic which will prevent these infections.

So stock up on some cranberry juice! Your bladder will thank you for it.

Lighting the way…

Dr. Diana

Dr. Diana

Citations:

1) Wang, CH., et al(2012).  Cranberry-Containing Products for Prevention of Urinary Tract Infections in Susceptible Populations:  A Systematic Review and Meta-Analysis of Randomized Controlled Trials.  Arch Intern Med; 172 (13); 988-996.

Please share any other tips you may have to reduce or treat bladder infections.  The Listen To Your Libido Community is waiting to hear from you!

Unhealthy relationship…with your “in-box” ?

Unhealthy Relationship … with your “in-box’?  

Is e-mail bogging you down?

With so many social media networks, literally at our fingertips, it’s no wonder that we can’t keep up with them.  They are taking a toll on our nerves… as well as our libidos!  Every day we are bombarded by hundreds, or potentially thousands, of e-mails, texts, tweets and Facebook messages.

How are we supposed to juggle all of them?
Read More

Birth Control for Men?

Sounds like an oxymoron, right?  But it’s true.

Now it’s the man’s turn to assume some responsibility in the contraceptive arena!  No longer is it just a man’s choice between using condoms  or getting a vasectomy.  Amazing new options are on the horizon!  Researchers are investigating various forms, targeted solely towards men, which are showing very promising results.  These options range from a long-acting injectable gel to a quick-acting male pill that could potentially markedly reduce the transmission of HIV.

According to a recent survey conducted by the U.S. Government’s Center for Disease Control (CDC), more than 80 percent of heterosexual women have used birth control pills at some point in their lives to prevent pregnancy.    Birth control pills became available to women in the 1960’s and represent the most common contraceptive used in the United States today.  Interestingly, global demand for male birth control appears increasingly popular, with a 2005 German survey revealing that 60 percent of men in Spain, Germany, Brazil and Mexico are willing to use a male contraceptive.

What is this new injection procedure?

It’s called Vasalgel and involves an injection into a man’s genitals which inhibits sperm motility.  It’s a new form of contraception known as, RISUG, reversible inhibition of sperm under guidance (1).  Yes, many men may become queasy just imagining a needle being injected into these tender areas.  After receiving a local anesthetic, a small amount of polymer gel is inserted into the vas deferens of each testicle.   The vas deferens is the conduit which transports sperm from the testicle to the penis.  The procedure apparently takes less than 15 minutes, works by destroying the sperm, lasts up to 10 or more years and is more easily reversible than a vasectomy!

When and if the man decides to return his sperm back to speedy and motile swimmers, another shot is given.  Within 2-3 months, active, functional sperm are functioning again.

These studies have been ongoing for the past 25 years and found to be safe in both humans and animals.  Researchers are optimistic that the procedure will become available in the U.S. by 2015, with clinical trials beginning this year.  At present, trials are only being conducted in India.

What about the new male birth control pill

In Papua Island, Indonesia, tribesmen have discovered a shrub called “Gandarusa” that acts like a birth control pill for men.  Per one tribesman, “If you chew the leaves often enough, your wife won’t get pregnant.”  The potential benefits derived from this shrub are undergoing close evaluation and appear to work by slowing down the activity of certain enzymes in the sperm that allow them to penetrate a woman’s egg.  For fertilization to occur, a sperm must enter the egg.  According to Sugiri Syarief, the head of Indonesia’s state-run National Family Planning Coordination Board, multiple animal and human trials have been conducted since the 1990’s and the plant’s effective compound was patented in 2007.  Researchers have tested the pill on two different groups of male volunteers, the first 36 men, and later with 120 men.  Trials involving more than 350 men are presently being done to verify that the sperm remain healthy yet are incapable of this critical penetration process in fertilization.

What else is looming on the horizon? 

Possibly another type of male birth control pill may become available.  Discovered by accident while studying male infertility patients, a group of Scottish scientists recently found a key gene essential for sperm development.   Per Dr. Lee Smith at the University of Edinburgh in Scotland, if scientists are able to regulate the Katna1 gene in the testes, they could prevent sperm from maturing completely, making them ineffective without changing hormone levels (2).

So why hasn’t the male birth control pill become available in the United States?

Profit, or lack thereof, is the apparent culprit!   Per Elaine Lissner, director of the non-profit Male Contraception Information Project in San Francisco, the impasse to male birth control pills has been the lack of profitability for the pharmaceutical giants.  “It’s a nightmare from the ‘for-profit’ standpoint.  We have to accept that the needs of for-profit entities and the needs of the public don’t always perfectly match.”

Definitely makes one wonder – what are pharmaceutical companies actually pouring their financial resources into?  Another drug for erectile dysfunction which makes a hearty return on investment or a male birth control pill which yields little return but carries huge global population impact?  Well, time will tell but I’m thinking the former!

What do you think?  Please share your comments!

Citations:

1. http://www.globalpost.com/dispatch/news/asia-pacific/indonesia/110224/indonesia-birth-control-pill-papua-men

2. http://www.globalpost.com/dispatch/news/health/120525/sperm-gene-discovery-could-lead-to-male-birth-control-pill

 

Lighting the way…

Dr. Diana

Dr. Diana
 

Talking S-E-X With Your Doctor

When the last time your doctor asked you about sex?

Well, if you’ve been seen at my office, it was probably at your very last visit!

It is estimated that approximately 43% of women in the United States today are experiencing some form of sexual problem, with lack of sexual desire as the leading issue. Yet, in exam rooms across our nation, physicians are not bringing up the topic of sex with their patients.

According to a new University of Chicago survey of more than 1,000 obstetricians and gynecologists in the United States, less than half of the physicians asked their patients about any sexual problems or dysfunction (1). Only two-thirds asked how sexually active their patients are and less than one-third asked their patients about sexual satisfaction. Results of the study were published in Journal of Sexual Medicine with specific results highlighting only 63% routinely asked patients about their sexual activities, with 40% asking about sexual problems, 28.5% asked about sexual satisfaction and approximately 14% asked about pleasure with sexual activity ( 1 in 10 never asked this question at all).

The study’s senior author and associate professor at the University of Chicago Pritzker School of Medicine, Dr. Stacy Lindau, states “sexuality is a key component of a woman’s physical and
psychological health. Simply asking a patient if she’s sexually active does not tell us whether she has good sexual function or changes in her sexual function that could indicate an underlying problem.”

Which physicians are most likely to bring us sexual issues?

Female physicians were more likely than male physicians to discuss sexual activity as well as sexual orientation and identity with female patients. Physicians practicing solely gynecology and not providing obstetrical services were also more likely to screen for sexual dysfunction. Physicians aged 60 years and older were found to be the least likely to discuss a patient’s sexual orientation or identity compared to their younger colleagues ( 11% vs 28% of those aged 46-59 vs. 32% aged 45 or younger.)

According to researchers, about 25 percent of the doctors said they have expressed disapproval of patients’ sexual practices; these were primarily doctors who were foreign medical graduates or ones
who considered religion the most important part of their lives. Those who indicated a Roman Catholic religious affiliation were significantly less likely than others in the survey to ask patients about sexual activities.

Why don’t patients bring up the topic?

“Patients are often reluctant to bring up sexual difficulties because of fear the physician will be embarrassed or will dismiss their concerns,” lead study author Dr. Lindau said. “Doctors should be taking the lead.”

What if your doctor isn’t taking the lead and bringing up sex?

5 Tips for Talking Sex with Your Doctor

1. Acknowledge your discomfort. Start the conversation with being honest about your uneasiness with this topic.

2. Approach it from the health perspective. Sexual issues can signal a larger health problem, such as thyroid disorders, depression, hormonal changes or issues with medications.

3. Write down your questions before your visit. By preparing ahead of time, you won’t forget what you want to ask or feel flustered during the exam.

4. Don’t be rushed. If you’re asking your physician about sexual issues as he/she is leaving the exam room, there won’t be enough time to discuss your concerns. Make a separate
appointment if you need to allow adequate time for this conversation.

5. Find the right doctor. This might be the most challenging of all of these tips. Ideally, you want a physician whom you can confide in, feel comfortable asking questions of, and feel “listened to”. Also, this physician should have the appropriate knowledge regarding sexual issues to help you. A physician who dismisses your concerns or makes you feel ashamed is not the health partner you desire.

You deserve the best quality health care and doctor available – don’t settle for anything less!

Citations:

1. Journal of Sexual Medicine. “What we don’t talk about when we don’t talk about sex”. DOI:10.1111/j. 1743-6109.2012.02702.x
Janelle Sobecki, MA, et al, March 22, 2012.

Sex Improves Brain Health

Can’t remember the last time you had sex?

Well maybe it’s time to share some intimacy with your partner!

It has long been known that exercise may have many health benefits, decreasing mortality, improving cardiovascular function and decreasing risk of heart attack, enhancing cognitive functioning and improving depression. This effect has been shown in older individuals as well as in individuals who complain of memory difficulty. Many of us may fear that we are developing “pre-senile dementia” when we experience minor memory lapses during the day. Most likely these are due to fatigue and brain overload, rather than true brain pathology. Yet, if we implement new health strategies, like more sex and exercise, we will be improving our brain function.

When do we start seeing decreased mental sharpness?

It is now estimated there are more than 36 million people in the US over the age of 65 and that many of them will be impacted by cognitive decline and brain atrophy associated with normal aging. Strong evidence indicates that memory and cognitive skills start declining by age 50. (1). The prevalence of dementia ranges from 5% to 10% (2.) and that of mild cognitive impairment (MCI) ranges from 12% – 18% (3). This decline in cognitive tasks has a critical impact on the quality of life. To improve the quality of life, it is essential for individuals of all ages to implement healthy strategies to improve brain health –and wouldn’t having more sex be a fun way to do this?

How does having more sex help the brain?

With any form of exercise – and let’s face it, sex is a form of exercise – blood flow increases. The increased circulation of blood transports oxygen-enriched blood to the hypothalamus, the center of the brain for memory and learning. One study done by Yaffe and colleagues followed over 5,900 women (more than 65 years old) for 6 to 8 years with baseline self-report exercise measures (4). Women with a greater physical activity level at baseline experienced less cognitive decline during the 6 to 8 years of follow-up: cognitive decline occurred in 17%, 18%, 22% and 24% of those in the highest, third, second and lowest quartiles of blocks walked per week, respectively.

This also holds true for men. In a study of 2,257 men, the risk of dementia was 1.8 fold increased in men who walked the least (less than 0.25 miles/day) compared to those who walked more than 2 miles/day (17.8 versus 10.3/1,000 person-years) (5).

Interestingly, a recent review of over 11 studies of aerobic exercise programs for healthy older persons also indicated improved cognitive function with fitness improvement. The most consistent effects were seen with thought processing and attention, as well as memory, language and visuospatial skills (6).

So what are we waiting for?
Get out there and start spending some time with your partner frolicking in the hay!

Yet, if you or your partner is not physically able to have sex, think of some creative and romantic ways to be intimate. One idea: pack up a picnic lunch and go for a long stroll on the beach or in the mountains. Hold hands, enjoy the view and the connection with your partner— knowing that you’re helping your hearts, your brains and raising spirits!

Citations:

1. Salthouse, T.A. Memory aging from 18-80. Alzheimer Dis Assoc Disord. 2003; 17: 162-167.

2. Plassman, BL et al. Prevalence of dementia in the United States; the aging, demographics and memory study. Neuroepidemiology, 2007; 29: 125-132.

3. Petersen, R. et al. The Mayo Clinical Study of Aging: Incidence of Mild Cognitive Impairment. Alzheimers Dement 2008; 4: T130.

4. Yaffe,K et al. A prospective study of physical activity and cognitive decline in elderly women: women who walk. Arch Intern Med. 2001; 161: 1703-1708.

5. Abbott, RD et al. Walking and Dementiain physically capable elderly men. JAMA. 2004; 292:1447-1453.

Angevaren M, et al. Physical activity and enhanced fitness to improve cognitive function in older people without known cognitive impairment. Cochrane Database Syst Rev. 2008. P. CD005381