Menopause, Bio Identical Hormones, Sexual Health, Lack of Libido, Erection Problems, Gender Issues, Prostate Cancer, Psychiatry, Cancer

‘The optimal health news section offers you information and advice on aspects of health relating to our specialisms.

News items of interest will be updated or added to as the Medical literature and our experience in the Optimal Health clinic dictates.

From a study published in the Journal of Alzheimer's Disease. - The serum level of bioavailable testosterone (BT) can predict risk for Alzheimer's disease (AD) in older men and opens up the possibility of using testosterone as a treatment for men who are having early memory problems."

Although low levels of BT were associated with the onset of AD, higher levels may offer protective value against the disease report the researchers led by Leung-Wing Chu, MD, chief of geriatric medicine at Queen Mary Hospital at the University of Hong Kong.

"We found that low testosterone did predict a pretty rapid decline in memory and conversion to Alzheimer's.The take home message is we should pay more attention to low testosterone, particularly in people who have signs of cognitive impairment. We think it's exciting." John Morley, MD, professor of gerontology and director of the Division of Geriatric Medicine at Saint Louis University School of Medicine in Missouri.

Dr Mark Porter in The Times quotes research to say declining levels of testosterone puts men at higher risk of heart disease. Researchers at the University of Sheffield publishing in the latest edition of Heart have identified a correlation between low testosterone levels and premature heart disease. One in four of the 930 men with furred up coronary arteries that they followed during the study turned out to have testosterone deficiency and were more likely to die early than their peers with normal levels. If you replace testosterone in men whose levels are low it could lower the risk of a cardiovascular event. The findings are particularly pertinent as testosterone deficiency is common with levels declining from the forties.

An article in the Journal of the American Medical Association (JAMA) has reported a further study that links increased risk of breast cancer with a regime of HRT that combines an estrogen with a progestin. As with the Women’s Health Initiative study, which was stopped in 2002 because of the increased cancer incidence, the hormones in question were Premarin (a mix of equine oestrogens) combined with Provera (a synthetic form of progesterone ie a progestin, medroxyprogesterone acetate).

The present study shows an increase in mortality from use of this combination of HRT, in addition to the previously recorded increase in cancer. The overall risk, in fact, from this combination remains very small, namely 2.6 deaths from breast cancer each year for every 10,000 women taking them.

The point that we would like to make here is that the specific hormones used in this study are taken to be representative of all female HRT whereas a crucial distinction in our view is whether the hormones taken are physiological ie the same in chemical structure as those that the body normally metabolises. When they are not their attachment to receptor sites in breast, uterus and brain is different, and significantly, they are metabolised differently, remaining longer in the body. In the case of Premarin metabolites may remain in the body three months and include 4-hydroxy estrone, which is cancer inducing. The progestin, medroxyprogesterone acetate, increases blood clotting as well as abnormal cell division (a precancerous event), and also causes fluid retention, breast tenderness , irritability, insomnia and reduced libido. Furthermore the synthetic progestin suppresses the bodies own production of progesterone

By contrast the bio-identical form of progesterone moderates the action of estrogen in breast tissue, reduces irritability, is calming, helps insomnia and reduces water retention.

I am grateful to Alicia Stanton for bringing the study in JAMA, quoted above, to our attention in Medaeus newsletter, November 2010.

We suggest older trusted remedies still work and sufferers do well to tackle the problem on a broad front with an experienced doctor/therapist who can advise you.

But first PE the problem:

What is it?

PE is best thought of as a lack of ejaculatory control leading to ejaculation/emission before it is intended. In practice this typically means in less than 2 minutes.

Why does it occur?

Anxiety about sexual performance is the common denominator. It occurs commonly in two groups of people, young men at the beginning of a relationship and older men re-entering ‘the market place’ with a new partner.

How is it managed?

There are easy to learn techniques described in any recent sex manual, the so-called ‘squeeze’ and ‘stop-start’ methods of delaying ejaculation. Both of these may help the problem or may not be sufficient to fully improve the desired difference.

What is the new treatment on offer?

An anaesthetic gel and a pill to delay ejaculation are available. Both have had some success. What is new is that Boots are marketing a Delay Device and have Delay Condoms impregnated with local anaesthetic, and Lloyds Pharmacy are supplying a pill called Dapoxetine which is generally unavailable in the UK. It costs £64 for three tablets.

Our Comment:

In addition to the above we can offer you a full assessment medically and an opportunity to talk to us in confidence, We have over 25 years experience in the field of psychosexual medicine.