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When problems come in between a relationship

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It’s natural to encounter a sexual problem in a relationship at certain point, especially when it ages overtime. Sometimes difficulties can also show up because of illness and sometimes just because of natural reasons like lowered desire level after pregnancy, generally it gets neutralized with time and perfect understanding… but sometimes it gets out of the boundary of normal sexual disorder and things get really messy to a point when the whole relationship comes under threat. Reduced sexual disorder can be experienced by both partners, but usually women are more likely to experience the same earlier in a relationship. However problems like delayed orgasm, painful intercourse , problems with getting sexually aroused can be experienced, as I have told earlier …minor problems get neutralized on their own when given sufficient time but complex problems may require help of specialists.

 

In most of the cases the reason of the problem happens to be physiological, however the reason can also be psychological and related to the non sexual part of the relationship, it is said that the sexual relationship in bed actually represents the whole relationship, therefore an increased sexual problem could be a good indication that there might be something wrong outside the bedroom too.

Little things like unspoken anger, unfairness between partners can lead to low desire level, it has been seen that lowered desire level has a great impact on the relationship, on a close encounter it is seen that the reason is often a very shameful and a buried secret deep inside the relationship.Spending more time together, working together towards finding solution can enliven the desire, a sex therapist could help in reaching that point. Stress, anxiety, fear can also lead to physiological problem like erectile dysfunction. This condition does not allow the patient to get erection which is required for doing intercourse. This condition is actually curable by means of medication and counseling, however depending on the severity of the condition only counseling can prove to be good enough for the treatment and the patient can get back his confidence after a few meetings with the counselor.

Things get worse when one partner puts the blame on the other one for the problem, try to be a little more positive towards your partner and ask him/her gently about the struggling, this will show that you are willing to share your partner’s problem and this could be the start of the healing process.

If you are the one who is having problem, say it clearly and describe it properly to your partner. Say it clearly if you want to get more sexually aroused before having intercourse or if you just want him/her  to change the approach. Doing the same wouldn’t leave your partner blank and will only strengthen the bond between you two. An honest and clear communication during sex is always preferable than just hiding it from the other one which will do nothing but make the situation more complex.

 

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Dr. Henry Williams is a specialist in treating sexual disorders and has been practicing for last ten years. He is also a regular blogger and has written many articles about sexual disorder treatments and anti impotence medicines like Viagra generika , Cialis generika , levitra etc.

 

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Preparing Your Body for Egg Donation

(image credit goodbadugly.com)

 

In Vitro Fertilization (IFV) is a method of providing couples, who are otherwise physically incapable, the opportunity to create a family and have a child of their own. This amazing technological achievement allows for a woman to become pregnant through an artificial process by means of creating an embryo outside the woman’s body rather than inside. The process can a complex multistage ordeal. Due to all the steps involved, failure of a successful pregnancy can occur at any point. However, there are steps one can do to ensure the best chances for success are in place. The most important thing you can do beforehand is quite simply, prepare. Preparation for all aspects of the IFV process is quite important, like selecting the best clinic and doctor, or the best donor if required. But one facet of preparation stands out significantly above the rest, which is preparing your body for this jarring and often stressful procedure.

 

Preparing your body for IFV is the single most important thing you can do to ensure the success and health of your coming baby. However, the key to preparing your body for IFV is to understand what the process entails and what effects it will have on your body as well as what it will require of you.
 

Mind

 

Making sure your mind is ready for the challenges of IFV is the first step in preparing for it. Preparing in this sense does not have to be all inclusive either; take it slowly and create a proper mental inventory.  Emotional preperation should of course include things like considering the stresses of the IFV processes and the consequences of being a parent, but try to remember things like what-if scenarios. Be prepared by talking with your doctor, not about every possible problem that could arise since that causes unnecessary stress and does not help anyone, but rather about known previous problems you might have that could complicate things. Also remember to be able to adjust to the new stresses involved with IFV and the changes in schedules it will cause by allowing time for relaxation and natural stress reduction activities. Also make sure to communicate with your partner, they will share some of the same stresses you may have.  Having a strong support system is the foundation for great emotional preparation.

 

Body- Nutrition

 

The next step in making sure your IFV is as successful as possible is to make sure your body has the necessary energy and nutrients to support yourself, accept the new embryo, and subsequently support it. The standard “eat healthy” tactic still applies, such as a balanced diet including healthy vegetables, fruits, meats, etc., but that alone is sometimes not enough. A daily multi-vitamin can be important in covering for any missed vitamins and minerals, but it is equally important to consume enough water and stay hydrated. The other side of nutrition is avoiding certain things in your daily life. There are obvious one like tobacco, alcohol and illicit drugs, all of which can cause damage to the embryo and elevates the chances of a birth defect. But there are some lesser known things to avoid in the IFV processes and during pregnancy itself. Chocolate and foods with a high-count of simple sugars and fats should be avoided, along with caffeine and other stimulants. But the one people forget about the most are the prescription drugs that are already being taken. It is important to discuss any medications currently being taken with your doctor. Many times the prescription drugs are harmless to the IFV and pregnancy process, but it is better to be safe and check with your doctor beforehand if the drug you are taking will create any complications.

 

Body- Physical

 

The last step in preparing your body for IFV is to make sure it can handle the physical stresses that appear in the process. When beginning IFV, one should be neither overweight or underweight. Both make it difficult for the embryo to be successful in becoming attached to the uterine wall due to the changes made to your body from being either over or underweight. Try to be at a median healthy weight as discussed by your doctor, just be practical in trying to obtain the target weight. Over exercise or extreme diets can be more detrimental to your health than helpful, and they lower the success rates of IFV. Light exercise, such as walking, is the best option for women trying to become pregnant through IFV since it allows for a much less stressful and jarring physical stimulus, which can be detrimental to the development of an embryo.

 

Making preparations is the safest thing one can do if you are thinking about, or about to begin IFV. Preparing your body mentally, nutritionally and physically will allow for a greater chance of success and allow for a healthier, more enjoyable IFV experience. 

 

Cynthia Dorsch loves writing about health and wellness. In her free time she can often be found researching and catching up on trending techniques and new innovations in the medical field. She currently writes and blogs forMyEggBank

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What is In-Vitro Fertilization

Photo Credit: Steven Johnson

IVF is the most technologically advanced and most successful form of fertility therapy available. Across every age bracket the pregnancy rates associate with IVF are the highest of all fertility treatments. The success rates vary based on the age of the patient and the reason for the infertility. There is a very good reason for why it has the highest success rate, because it optimizes all of the natural steps associate with the reproductive process. It does so by stimulating the eggs to grow, fertilizes them directly in the laboratory (in vitro) and placing multiple embryos into the uterus.  

Technically “in vitro fertilization” is actually only referring to the process of fertilizing the egg outside of the body in the Petri dish. However the term “IVF” has become the coined term to describe the entire treatment cycle.

IVF has three phases:  ovarian stimulation and the retrieval of the egg; fertilization; and embryo transfer.

Phase One – Egg Recruitment and Retrieval: It really starts with a woman’s period, that’s when all of the new eggs are ready to go. They will often keep those eggs from growing by giving you birth control pills. Or injection’s of additional medicines for the purpose of keeping all the eggs at the same starting line. Once they’ve achieved that over a two or three periods the woman enters the next stage with is ovarian stimulation, this is done with the hormonal injection FSH. Daily injections for about 10-12 days and four or five visits to the fertility clinic to monitor the growth of the egg follicles, to measure the woman’s estrogen levels, and to make sure the woman’s on the right dosage. At the end of those 10-12 days they trigger the maturation of the egg follicle with a second shot. After which they then take the patient to the operating room where she’ll undergo IV anesthesia, which is through her veins so she’ll be sleeping during the process. Then a needle is passed through her nether region into the ovary and directly into the egg follicle where it suctions out the egg.

Phase Two – Egg Fertilization: The egg is immediately handed to the embryologist who finds the egg and then injects it with sperm or puts it in a Petri dish with thousands of sperm, this is called intracytoplasmic sperm injection (ICSI). Embryos can even be frozen for later use.

Phase Three – Embryo Transfer: They look the next day to see if they have fertilized eggs called embryos, and allow those embryos to grow anywhere from two to five days before transferring them back to the woman’s uterus. That’s a painless procedure done at a clinic that is similar to a pap-smear where they put a soft plastic catheter directly into the uterus with the embryos’. Seven to twelve days later they find out if the woman’s pregnant.

And that is the basics of in-vitro fertilization, where we try to pull and end around a malfunctioning human body that is hard wired to reproduce. The technology has come so far in the last 20 years and hopefully will only continue to get better and more cost effective, so that anyone who has a desire to get pregnant and to be parents can be afforded that opportunity. Make certain you pick a clinic that has plenty of experience in the fertilization process as the process is quite delicate.

Clay Hunter is part of the marketing and development department of Santa Monica Fertility clinic. He freelance writes on infertility and reproductive issues as often as he can to bring light to the plight of so many who deal with these issues.

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Artificial Insemination: Why You Need It And What To Expect

For both men and women dealing with infertility, there are several techniques that fertility clinics use to help them achieve pregnancy. Artificial insemination is a category of techniques in which sperm from the man is directly deposited into the uterus, fallopian tubes, or cervix of the woman. With these procedures, the chances of becoming pregnant increase, since they are intended to bypass certain obstacles that make natural fertilization impossible.

Intrauterine insemination is the most widely used artificial insemination technique. During this simple medical procedure, semen from the male is collected, prepared and injected directly into the uterus of the female. The success/failure rate of intrauterine insemination is similar to that of other advanced procedures, however IUI has a much more compelling advantage: the procedure is much less complicated than other artificial insemination techniques, such as intracervical or intratubal insemination, and the side effects on the patient are minimal. These important factors will influence any physician to recommend this course of action as a primary treatment for couples dealing with infertility.

Applications for Artificial Insemination

Artificial insemination has many applications for different fertility problems in both men and women. It is ideal for men who have low sperm count due to an inability to produce sperm at all, or have sperm with morphological problems such as poor motility. Women may also choose to undergo this medical procedure if they have been diagnosed with reproductive organ anomalies such as endometriosis, a medical ailment that refers to abnormal growth of tissue on the lining of the uterus, or uterine myoma, which is a benign tumor of the smooth muscle layer of the uterus.

Women are also good candidates for artificial insemination if they have unreceptive cervical mucus, a condition wherein the mucus in the cervix is toxic to sperm, preventing them from entering the uterus or the fallopian tubes to fertilize the egg. By circumventing the cervical mucus and injecting the sperm where it needs to go, artificial insemination can yield the desired results.

What You Can Expect

Prior to the procedure itself, the patient undergoes a complete medical history and physical examination, laboratory tests for blood and urine, diagnostic imaging such as ultrasound, x-rays and more advanced radiology examination. She may be prescribed medications to stimulate ovulation as well. Once the patient approaches ovulation in her menstrual cycle, the husband is requested to provide a sperm sample, either through masturbation or by using a collection condom.

How To Prepare

Artificial insemination, in-vitro fertilization and other fertility treatments can be physically and emotionally demanding. Before attempting any fertility procedure, it is important that you and your partner are both ready. Understanding the fertility problem, the procedure used to remedy it, as well as the inherent risks will help you be prepared for pregnancy and childbirth.

 

About Victory A.R.T. Laboratory Phils, Inc.

Victory A.R.T. Laboratory Phils Inc. is part of the Hong Kong based Victory Group of A.R.T. Laboratories and is the pioneer IVF laboratory here in the Philippines and have done the most number of successful IVFs in the country, up to 300 cases yearly under the leadership of its Medical Director, Dr. Gregorio Pastorfide.

Follow us at:

Facebook: facebook.com/ivfvictoryphilippines

Twitter: twitter.com/gpastorfide

Pinterest: pinterest.com/gpastorfide/

LinkedIn: linkedin.com/in/gpastorfide

 

Tags: artificial insemination, ivf, fertilization

 

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5WaitingWombs

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Surrogacy: the new trend in reproductive tourism

Surrogacy, something which was quite taboo just a few years ago, has become quite acceptable, even mainstream. This may be partly due to the publicity that celebrities like Rick Martin to Elton John, Sarah Jessica Parker and Nicole Kidman generated.

But for each surrogacy case, there are 2 sides to the coin: the “gestational carrier” (a term out of Kidman’s mouth) and the would-be parents. Although these roles are rather easy to define, the terms “biological parents”, “genetic parents” and “adoptive parents” are sometimes needed to clarify the issues. However, confusion remains so that there is need for us to look at the terminologies.

According to surrogacy.org. uk:

Traditional (straight) surrogacy – “the surrogate uses her own egg fertilised with the intended father’s sperm. This is done by artificial insemination…”

Gestation (Host IVF) surrogacy – “the surrogate carries the intended parent’s genetic child conceived through IVF…”

In many countries, surrogacy is legal. In some, it is not. It is a well-known fact that surrogacy is a big business in India and some countries in eastern Europe and South America where surrogacy laws are very lax if at all existent.

During the recent economic crisis, there was a recent surge in the number of women in the US who were willing to sell their eggs or serve as surrogates in return for a fee. Although the money involved is not well-publicized, it can range from as little as $3000 in India to $20,000 in the US. In many cases, the women had a valid reason for going into surrogacy – money for a loved one’s treatment, children’s education, etc.

Recently, Guatemala hit the headlines as a strong completion to India when it comes to “reproductive tourism.” Unfortunately, the laws in Guatemala are not ready for this rapidly increasing market. According to Karen Smith Rotabi, Assistant Professor of Social Work at Virginia Commonwealth University:

“Those developing surrogacy services in this desperately poor nation should take caution as they pioneer in this area of global fertility practice. As a business model, they are stepping into a grey area of human rights which will challenge us all to consider what is right and wrong and how far to take the privilege of purchasing power. Developing an expanded or more precise definition of human trafficking and a new area of regulatory control will become important considerations in this next wave of the global baby business.”

This and the highly publicized surrogacy cases of celebrities triggered heated debates on the ethics and legalities of surrogacy.

Here are some issues to ponder on:

• Is surrogacy about renting wombs or helping infertile couples?
• If surrogacy, which is illegal in many western European countries, is done in a country where it is legal, tantamount to a crime when the parents bring the baby home?
• Does the baby have the right for its parent’s nationality even though it has been conceived and delivered through surrogacy, which may have been legal in its country of birth but not in its home country?
• How do countries define the difference between surrogacy and intercountry adoption?

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BPA exposure and semen quality

The controversial BPA aka bisphenol A makes the headlines again. And this time it is the men that should pay attention. A new study recently published in the journal Fertility and Sterility found strong correlations between BPA levels in the urine and sperm quality in male humans.

If you may remember, BPA is a compound used in the manufacture of certain types of plastics. Unfortunately, it leaches out from the plastic products into our food and drink.

The study looked at factory workers in China exposed to high levels of BPA in their job. This occupation exposure to BPA was measurable by urinalysis and was linked to poor semen quality, as indicated by low sperm count and decreased motility. These two properties of semen strongly determine the ability of the sperm to fertilize the egg. In other words, BPA exposure impacts a man’s fertility and reproductive potential.

According to study author Dr. De-Kun Li, MD, PhD, a reproductive and perinatal epidemiologist at Kaiser Permanente’s Division of Research in Oakland.

“The higher the BPA exposure, the worse the semen quality. The findings add more weight to the evidence about the effects of BPA on sperm quality.”

BPA remains a controversial chemical and health agencies worldwide are divided in their stand on this chemical. Only two years ago, US health regulators did not believe that BPA may be dangerous, citing lack of scientific evidence as its basis. This year, the FDA finally admitted that the BPA may have some “potential health concerns.” Several American states have banned the chemical from baby products. Canada, however, is in the front line when it comes to eradicating BPA. Canadian health authorities recently placed BPA on its list of toxic (thus banned) chemicals). In Europe, BPA use is still widespread and no legislation is in place to regulate it.

Researchers believe that BPA is an endocrine-disrupting substance that plays havoc with our hormones, including sex hormones. Endocrine disruptors are also called “gender-bender” chemicals.

According to Dr. Laura V. Vandenberg of Tufts University in Boston:

“This study clearly shows that BPA exposures adversely affect men in a serious way: by influencing their semen quality, which could have obvious impacts on their ability to have children… [It] also shows that adult men are sensitive to BPA, and even small amounts of the chemical can have pretty drastic effects. What remains to be seen is whether the effects of BPA on semen quality are permanent after the kinds of low, chronic exposures that most adults experience.”

There are easy ways of protecting yourself and your family from BPA exposure.

Check out:

• Food ingredients and packaging: BPA
• Bisphenol A (BPA) Information for Parents from the US Department of Health and Human Services.
• Full Update on Bisphenol A for Use in Food Contact Applications: January 2010
• Tips to avoid BPA exposure by the Environmental Working Group

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When hugs and medications don’t mix

A hug can mean a lot of things, almost always positive. Unless it comes with something else. Hormones, for example.

Many medications contain hormones, medications that can be in the form of creams, gels and sprays. An example is Evamist, a drug that is prescribed to menopausal women suffering from hot flashes. Evamist contains estradiol, a form of estrogen hormone. It is administered as a spray inside the forearm between the elbow and wrist.

The US FDA issued a warning in July this year regarding adverse events associated with accidental exposure to Evamist, especially children and pets. Exposure may be through direct contact when Evamist is not safely stored or when a child or pet is hugged by an Evamist user and come in contact with area of application. The reported adverse effects in children are:

• premature puberty, nipple swelling, and breast development in girls
• breast enlargement in boys

Other accidental exposure includes pets licking application area or pet owners petting their animals after drug application, without proper hand washing. The effects in pets include:

• Enlargement of the nipples and swelling of the vulva in females in pets
• Fur loss
• Undersized sexual organs in male pets

To avoid inadvertent exposure to Evamist, the FDA gives the following recommendations:

• Do not allow children to come in contact with the area of the arm where Evamist was sprayed.
• Do not allow pets to lick or touch the arm where Evamist was sprayed. Small pets may be especially sensitive to the estrogen in Evamist. Contact a veterinarian if your pet shows signs of nipple and/or vulvar enlargement, or any other sign of illness.
• Wear a garment that covers the arm where Evamist was sprayed if they know they cannot keep a child or pet from making contact with it.
• Talk with their health care professional if they have questions about the possibility of exposing a child to Evamist.
• Read the patient package insert when picking up a prescription for Evamist.

Another drug called Dovonex, which is a hormone derivative of vitamin D, can also possibly cause similar effects. Dovonex is a cream used to treat the skin disorder psoriasis. Pet who inadvertently lick the cream present with “unusual thirst, appetite loss, and severe vomiting or diarrhea.”

What should you do if your child or pet comes in contact with these drugs. The US FDA recommends:

• washing the child’s skin with soap and water as soon as possible.
• contacting the child’s health care professional if the child begins to have any of the following signs or symptoms: nipple or breast swelling or breast tenderness in girls, or breast enlargement in boys. Be sure to tell the health care professional that the child may have been exposed to Evamist.

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Viagra use in older men linked to increased STD infection risk

The late 90s witnessed the widespread use of erectile dysfunction drugs among men, especially in the middle-aged and older. These drugs were welcomed as treatment for sexual dysfunction among men which translated to increased quality of life.

The most popular of these drugs is Viagra (sildenafil) and it is easily available over-the-counter in many countries and is extensively marketed over the Internet. Estimates showed that since the introduction of Viagra in the US market in 1998, the rate of erectile dysfunction drug use increased. By 2002, about 20% of American men older than 40 have tried taking an erectile dysfunction drug.

The increased use of erectile dysfunction drugs also coincided with an increase rate of HIV infection among men in the same age group. Thus researchers investigated whether there is a link between erectile dysfunction drug use and increased risk for sexually transmitted disease (STD). Insurance records of more than 1.4 American men over 40 were analyzed. The results suggest that

“…those who used ED drugs were more likely to have sexually transmitted diseases than were non-users.”

The study thus suggests that erectile dysfunction drug use is linked to increased risk for sexually transmitted diseases (STD), with HIV infection as the most frequently acquired STD, followed by chlamydia. However, STD rates in the general population did not increase. It is thus possible that the use of erectile dysfunction drugs led to increased risky sexual behaviour that could lead to high risk for STD infection.

According to lead author Dr. Anupam B. Jena of the Massachusetts General Hospital (MGH) Department of Medicine

“Anyone who does not practice safer sex, no matter their age, can contract an STD. Even though STDs are quite rare among older men — on the order of 1 per 1,000 individuals — we found that STD rates in men who used ED drugs were two to three times higher, both before and after they filled their first prescription.”

It is possible that older men probably belong to a generation who were not well-educated on the topic of safe sex. This is in contrast to younger people whose generation grew up with warnings against the likes of incurable STD infections such as hepatitis C and HIV.

Doctors who are asked to prescribe erectile dysfunction drugs are also urged to discuss the importance of safe sex practices with their patients even with older patients. Remember, nobody is too old to learn and nobody is too old to catch STD.

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Bad food equals bad sperms

Guys, what you put on your plate may determine the quality of your sperms.  Fries, burger, chips and all those tasty food that are swimming in saturated fat result in low sperm counts and sperms of low vigor. This is according a study by Harvard researchers.

The study looked at the semen quality and the diet of 91 male patients of the Massachusetts General Hospital Fertility Center in Boston. What they found out were as follows:

Men with the highest intake of saturated fat had 41% fewer sperm than men who ate the lowest amount of saturated fat.

Men with the highest intake of monounsaturated fat had 46% fewer sperm compared with men with the lowest intake of monounsaturated fat.

On the other hand, those who eat healthy – especially food rich in polyunsaturated fats such as omega-3 and omega-6 fatty acids – are more likely to have healthy, vigorous sperms in normal numbers.

“Men who had a higher intake of omega-6 polyunsaturated fats had greater sperm motility, and a higher intake of omega-3 polyunsaturated fats was related to better sperm “morphology” — the size and shape of sperm.”

The authors point out that these results provoke some serious thoughts. Not only does a healthy or unhealthy diet affect a person’s health, it may also affect his reproductive potential as well as the health of his offspring. “The dietary pattern of a father-to-be is affecting the composition of the sperm that will be delivering half of the genes to a future son or daughter. So, it’s one more reason to choose our foods wisely.”

The mechanism behind the association between diet quality and semen quality is not clear but the authors speculate:

“Polyunsaturated fats are important components of sperm cell membranes and may influence the ability of sperm to fertilize an egg.”

Food which are rich in the “good” fats are fish, whole grains, some seeds and nuts, and olive and canola oil.

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IVF gets Nobel Prize after 32 years

Robert Edwards, pioneer of in vitro fertilization (IVF) and brought to the world the first “test tube” baby Louise Brown in 1978 was awarded the Nobel Prize in medicine this year.

What was controversial 30 years ago is now an established medical procedure. After Louise Brown, more than 4 million people worldwide were born via IVF. Imagine being instrumental in bringing to life this many people.

Current figures show that 1 in 10 couples have infertility problems.

According to Edwards:

“The most important thing in life is having a child. Nothing is more special than a child. Steptoe and I were deeply affected by the desperation felt by couples who so wanted to have children. We had a lot of critics but we fought like hell for our patients.”

Many colleagues and experts in the field believe that this honour for Edwards is long overdue. In fact, he founded the world’s first IVF centre, the Bourn Hall Clinic in Cambridge, together with English surgeon, Patrick Steptoe. Unfortunately, Steptoe cannot share the Nobel Prize with Edwards as he passed away in 1988. “The statutes of the Nobel Foundation stipulate that a prize cannot be awarded posthumously, unless the winner dies after the announcement of the prize itself.” Edwards himself is 85 years old and of failing health and may not enjoy his honor that long.

Indeed, IVF has changed human reproduction forever. It is currently estimated that worldwide, about 1 in every 10 couples have fertility problems. IVF enables them to procreate.

Nowadays, women as old as 70 could still bear children through IVF. The first “man to get pregnant” also did so via IVF.

However, despite being an established and widely practiced medical procedure, IVF remains controversial from an ethical and religious point of view, thus probably the reason of the delayed accolade.

Here are some quotes from family, friends and colleagues of Edwards about his Nobel Prize:

According to his wife Ruth:

“The success of this research has touched the lives of millions of people worldwide. His dedication and single-minded determination, despite opposition from many quarters, has led to the successful application of his pioneering research.”

Says Basil Tarlatzis of the International Federation of Fertility Societies

“This is a well deserved honour. IVF has opened new avenues of hope for millions of couples throughout the world. It has also had an immense impact on our understanding of medicine, leading directly to such developments as stem cell research, PGD, and many other fields. Edwards and Steptoe were real pioneers, and the award of the Nobel prize honours not just their work, but the whole field of reproductive science. After their breakthrough work, Robert went on to nurture the development of the assisted reproduction. No one deserves this award more, and we congratulate him on his award.”

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Menopause: symptoms and treatment options

I know it is waiting for me out there as I approach the 5^th decade of my life. I dread it but I also look forward when it is finally over. I am referring to that stage of a woman’s life called “menopause.”

According to the October issue of NIH News:

Menopause is defined as the final menstrual period.  On average, women have their last period around age 51, but it can also occur in their 40s or late 50s. Symptoms usually begin to appear several years before menopause. This time of change—called the menopausal transition, or perimenopause—extends to 1 year after your final period.

The symptoms

The reason why I dread menopause is the symptoms that come with it. I remember my mom’s menopausal years and they were not that easy, neither for her nor for her family.

Menopause can be physically and mentally challenging. The good news is that not all women suffer from severe symptoms that require treatment. The bad news is that “those bothered by symptoms, choosing the best treatment can be confusing.” Some of the most common symptoms of menopause are:

• Hot flashes
• Sleeping problems
• Mood changes

According to researcher Dr. Sherry Sherman:

“Hot flashes can be severe and highly disruptive. We used to think that they lasted for 2 or 3 years, but our studies have shown that for some women they can last a lot longer—up to 7 or 10 years.”

What causes these symptoms?

During perimenopause, levels of estrogen and progesterone—2 female hormones made in the ovaries—go up and down irregularly. This leads to changes in menstrual periods. The fluctuation in hormone levels that begins during perimenopause can affect many different parts of the body.

The heart, blood vessels, brain and brain are all affected by the hormone fluctuation, leading to a wide range of symptoms.

Treatment options

The convention treatment for menopause symptoms is hormone replacement therapy, especially estrogen. The hormone supplementation not only alleviates menopausal symptoms, it also has cardioprotective effects and benefits for bone health. Recent research evidence, however, indicates that this menopausal hormone therapy presents some risks including increased risk for breast cancer and stroke. Thus, “different therapies have benefits and risks that need to be weighed carefully.”

Alternatives to hormone therapy are being looked into, including

• mind-body approaches
• exercise
• different medications
• behavioral interventions
• alternative medicine approaches

On the other hand, I am looking forward to life after menopause, a life without contraceptive pills, pre-menstrual syndrome and tampoons.

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More bad news about BPA

The story of BPA aka bisphenol A is not yet over. In fact, researchers believe that what we currently know about this compound is just the tip of the iceberg. As you may recall, BPA is a compound used in the manufacture of plastics. It is also an endocrine disrupting compound and micmics estrogen. BPA has been linked to a wide range of health problems from cardiovascular disease, to impaired fertility, neurological and developmental disorders and cancer.

According to University of Missouri researcher Dr. Julia Taylor:

“For years, BPA manufacturers have argued that BPA is safe and have denied the validity of more than 200 studies that showed adverse health effects in animals due to exposure to very low doses of BPA. We know that BPA leaches out of products that contain it, and that it acts like estrogen in the body.”

A recent study published in NIH journal Environmental Health Perspectives shows that metabolism of BPA is similar in female humans, female monkeys, and female mice and BPA effects on the animals are grounds for major concern. According to study author Frederick vom Saal, professor of biological sciences at the University of Missouri:

“This study provides convincing evidence that BPA is dangerous to our health at current levels of human exposure. The new results clearly demonstrate that rodent data on the health effects of BPA are relevant to predictions regarding the health effects of human exposure to BPA. Further evidence of human harm should not be required for regulatory action to reduce human exposure to BPA.”

Furthermore, human exposure to BPA seems to higher than previously thought. It has always been assumed that BPA comes from the plastics that we use in our household. However, the current study results show that these sources alone cannot account for the amount of BPA we are exposed to, indicating that there are unidentified sources of contamination in our environment. The researchers, thus, are calling for “governmental agencies to require the chemical industry to identify all products that contain BPA.

Dr. Pat Hunt, co-author of the study, adds:

“We’ve assumed we’re getting BPA from the ingestion of contaminated food and beverages. This indicates there must be a lot of other ways in which we’re exposed to this chemical and we’re probably exposed to much higher levels than we have assumed.”

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The stress-infertility-stress cycle

Stress is linked to many health problems, including depression and cardiovascular diseases. Less known is the fact that stress can also cause infertility.

A joint study by the National Institutes of Health and the University of Oxford reports that stress can prevent a woman from becoming pregnant. The researchers identified the substance as alpha-amylase which is an enzyme secreted by the parotid gland via the saliva to help digest starchy food. However, starch is not the only thing that triggers alpha-amylase secretion. It is also secreted in response to the presence of catecholamines, “compounds that initiate a type of stress response.”

The researchers followed up 274 English women of reproductive age (18 to 40 years) who were trying to conceive and charted their ovulation cycles. The women were participants in the Oxford Conception Study that investigated whether daily information from a fertility-monitoring device would increase the chances of conception. The phases of their monthly cycles were tracked using home fertility test kits.

In the current study on alpha-amylase, the participants were asked to collect a saliva sample on the 6^th day of their ovulation cycles. The saliva samples were tested for stress-related substances, including alpha-amylase and the stress hormone cortisol. The saliva analyses were performed till the participant conceives or until 6 menstrual cycles were completed.

The results showed that women with high levels of alpha-amylase in their saliva are less likely to conceive compared to those with normal or low levels during the fertile window –e.g. the 6 days of the cycle when conception is likely to occur.

According to study author Germaine Buck Louis, director of the NICHD’s Division of Epidemiology, Statistics, and Prevention Research:

“Overall, the 25 percent of women in the study who had the highest alpha-amylase levels had roughly an estimated 12 percent reduction in getting pregnant each cycle in comparison to women with the lowest concentrations.”

Cortisol levels on the other hand were not associated with the chances of conception. Dr. Cecilia Pyper who heads the Oxford Conception Study comments:

“This is the first study to show an association between a biomarker of stress and a reduction in women’s chances of conceiving throughout the fertile window — underscoring the importance of considering stress when attempting to identify the determinants of conception.”

In addition, it also highlights the need for finding ways to alleviate stress in women who are trying to get pregnant. This is especially difficult since each failed attempt brings even more stress that sets off a vicious cycle.

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Atrazine – the nasty stuff in your herbicide

I have been lately struggling with our backyard, which although just a little bigger than a postage stamp, nevertheless is too much work, what with the dandelions, clovers and other weeds sprouting up all over. Add to this the fact the neighbors’ backyards, simply separated by low bushes, are neat and trim – weedless. My neighbor to the left was kind enough to give me a tip on how to fight the weeds – mainly of out fear that the undesirables make their way from my green to patch to hers – use herbicide. My first reaction was of course “No way will I use herbicides and other chemicals in my backyard!”. But then I realized the necessity (if only to avoid suburbia war) and so I decided to do some research on how to tackle the problem the safest and the most environmentally feasible way. I learned that there are organic alternatives to conventional herbicides, mainly consisting of biodegradable, naturally occurring compounds. I also learned that several compounds used in conventional herbicides are really nasty. And one of them is atrazine.

A recent study funded by the National Institutes for Health (NIH) investigated the effect of atrazine in animals. When pregnant rats were exposed to atrazine, the following were observed:

• Atrazine causes prostate inflammation in young male rats
• Atrazine-exposed young animals experienced delayed puberty that non-exposed animals.

What is concerning is the fact that the effects were observable even at low levels and increased with increasing doses of exposure.

Atrazine is a herbicide predominantly used to control weeds and grasses in crop plants such as corn and sugar cane. Atrazine may be good for the crops and food production but it is definitely not good for the environment and the people around. Long after the crops have been harvested, the herbicide and its byproducts persist in the environment and eventually find their way into the water supplies – and the water we drink.

We may not be aware of the exposure and its effects but it seems that, as the study suggests, exposure starts even at the womb and the tissues most especially targeted are the prostate and mammary (breast) tissues. The long-terms effects are not fully known but we can speculate about cancer and infertility.

It is not only atrazine that we should we should be wary of. Herbicides may contain other similar compounds belonging to the chlorotriazine family, such as propazine and simazine. And many more.

So next time you reach for that bottle of herbicide in your garden shed, read the label and what is written there. Watch out for the nasties.

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Do IVF children have increased risk for cancer?

The long-term effects of in vitro fertilization (IVF) on the mother and on the child have always been a topic of speculation. Louise Joy Brown, the first person born who was conceived via IVF (used to be called the “first test tube baby”) turned 32 last July and she herself is a mother to a 3-year old who was conceived naturally. Researchers could only monitor and record what they observe and know about Louise and thousands, maybe millions of IVF babies like her as they grow, reproduce and eventually die. Only time can tell whether there are long-term health effects associated with this type of assisted reproduction.

One of the first results on the ongoing observation of IVF children are out – coming from Sweden.

Swedish researchers at the University of Lund followed-up 26,692 children born after conception via IVF between 1982 and 2005. Cancer data were extracted from Swedish Cancer Register and comparison was made between cancer patients who were born after IVF and those were not. The results indicate an increased risk for cancer among those conceived by IVF.

The expected number of cancer cases in the general population is 38. Among the IVF children of the same age, 53 were diagnosed with cancer, equivalent to a 1.42 total cancer risk estimate. The most common forms of cancer diagnosed among IVF children were:

• 18 of them with hematologic cancer (15 of them acute lymphoblastic leukemia)
• 17 with eye or central nervous system tumors
• 12 with other solid cancers

In addition, 6 cases of Langerhans histiocytosis were reported where 1 case is expected.

The researchers ruled out maternal age, number of previous babies delivered, smoking, subfertility, previous miscarriages, body weight and multiple births as the cause of the increased cancer risk. Although, it can be speculated that the mode of conception might play a role, the researchers think this may not be the case.

Instead, factors that should be considered are genetic traits from the parents, many of whom may have had health problems that manifested in the infertility that made use IVF in the first place.

Another factor is the fact that IVF resulted in many multiple births that in return led to preterm delivery. Premature babies have higher risks for health problems than babies born at full term.

In addition, the study only looked at Swedish children, and the Swedish population has relatively lower biodiversity compared to say, the UK or the US where IVF is commonly used as assisted reproduction technique. Thus, findings in these children might not be true in IVF children elsewhere.

The authors are quick to reassure parents of IVF children that although they found “a moderately increased risk for cancer in children who were conceived by IVF”, absolute risks are still very low – less than 1%.

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Female sexual dysfunction and diabetes

Diabetes comes with a lot of complications, including sexual dysfunction. There has been a lot of research on the relation between type 2 diabetes and erectile dysfunction (ED) in male patients with reported prevalence of up to 50%, but little is known about female sexual dysfunction (FSD). FSD is characterized by lack of libido and sexual satisfaction, even discomfort and pain during intercourse.

Italian researchers decided to address this knowledge gap and investigated the factors that are correlated to FSD in diabetic patients.  Their results indicated that FSD was not linked to hemoglobin A1C or time since diagnosis, hypertension or smoking. However, FSD was shown to be most prevalent in women who are married or depressed. Whereas physical activity positive influences FSD, age, metabolic syndrome and poor lipid profile seem have a negative impact. Much more, FSD is more prevalent in menopausal women compared to non-menopausal women. The authors concluded that:

“Further studies are needed to elucidate in full the mechanisms underlying the evident differences between male and female sexual function. In the meantime, evaluation of female sexuality should become a routine evaluation in women with type 2 diabetes, such as other diabetic complications.”

The results indicate sexual dysfunction occurs in both men and women especially among those with diabetes. However, the determining factors seem to differ between sexes. Whereas ED is closely linked to cardiovascular risk factors, FSD seems to be more linked to neurological and social factors. In fact, several studies have linked FSD to depression and marital status

There is something that diabetic women can do to help prevent FSD – improvement in diet and more physical activity. Experts believe it is not just diabetic diet that would help but sticking to the so-called Mediterranean diet, according to the same team of researchers.

Mediterranean diet has been shown to be beneficial for the heart and blood sugar levels. However, this is the first study to demonstrate the positive effect of such a diet in reducing FSD.

Like many chronic diseases, diabetes and its many complications, including sexual dysfunction benefits from lifestyle change that involves diet and physical exercise.

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The controversy surrounding prenatal dex and manipulation of sexual orientation

The treatment seems straightforward enough at first glance. Using the steroid dexamethasone, clinicians are trying to treat a condition called congenital adrenal hyperplasia (CAH) right at from the womb. CAH is an in-born condition characterized by a malfunctioning adrenal glad that leads  toa serious hormonal disruption and the development of ambiguous genitalia. Children born with CAH have to be treated with steroids and hormones their whole life. Female babies born with CAH have a higher tendency towards tomboyism and lesbianism.

However, bioethicists at the Northwestern University Feinberg School of Medicine believe that the prenatal treatment goes beyond just CAH.  Researchers Alice Dreger and Ellen Feder believe that prenatal dexamethasone may be misused to prevent the occurrence of homosexuality.

Prof. Dreger states:

“This is the first we know in the history of medicine that clinicians are actively trying to prevent homosexuality.”

This came to light when parents who were carriers of the CAH genes had their babies checked for the abnormality while still in the womb.  An endocrinologist researcher at Mount Sinai Medical Center in New York City prescribes dexamethasone to pregnant women carrying babies with CAH. The only problem is that this kind of therapy using dexamethasone is off-label, e.g. the drug is approved for use in other conditions but not for this specific one – CAH. And the patients who received the steroid were not informed about this. Off-label use is not illegal and often done at the discretion of the doctor. However, there are certain procedures necessary to do this, including explain to the patient the risk and benefit and obtained a signed informed consent from the parents.

There are supporters for the dexamethasone (“dex”) treatment. It spares the baby the embarrassment of having ambiguous genitalia that would need to be corrected later. According to Dr. Ingrid Holm, a pediatric endocrinologist at Children’s Hospital in Boston.

“I see potential for benefits and I don’t see evidence there’s any negatives to this. There are lots of risks associated with surgery, and if this can prevent surgery, then it’s a good thing.”

However, there are those who question the safety of the treatment as the drug has not been fully properly tested in humans. In addition, although the drug addresses the problem of ambiguous genitalia, it does not address the real cause of the problem, e.g. the endocrine disruption. Some doctors believe it is the parents’ anxiety about the condition that is being treated but not necessary for the benefit of the child.

The controversy about dexamethasone is not new. It has been around for decades. However, with the advent of genetic prenatal diagnostics, more and more parents are asking for treatment long before the child is delivered with the embarrassing problem. However, it is not only the genitalia that may be abnormal. Girls with CAH would not behave like typical Barbie-touting girls. One researcher wrote:

“CAH women as a group have a lower interest than controls in getting married and performing the traditional child-care/housewife role. As children, they show an unusually low interest in engaging in maternal play with baby dolls, and their interest in caring for infants, the frequency of daydreams or fantasies of pregnancy and motherhood, or the expressed wish of experiencing pregnancy and having children of their own appear to be relatively low in all age groups.”

The bioethicists at Northwestern University are concerned that this treatment is being used to manipulate the sexual orientation of female babies while still in the womb. They were especially concerned about a paper that proposes using prenatal dexamethasone to change the behavior of girls with CAH to be “closer to the expectation of heterosexual norms.”

At the moment, the medical community is divided about the pros and cons of the dexamethasone. However, a new consensus from seven major medical organizations (including the American Academy of Pediatrics) is expected to be published in the coming months regarding this issue.

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Heart, Mind and Sex: how they are linked

When we think of erectile dysfunction, we think of infertility and impotence. However, there this sexual disorder actually goes deeper than just plain sex. Depression, sexual dysfunction and heart disease have common pathological mechanisms. At least in men. This is according to a study by researchers at the University of Florence, Italy.

Sexual dysfunction in men, mainly manifesting as erectile dysfunction can cause depressive symptoms. However, as we all know, negative emotions put a strain on the heart and much more so in this patient population when depression can be severe. by a team led by Dr Elisa Bandini (University of Florence, Italy).

According to study leader Dr. Elisa Bandini (to heartwire):

“In a large sample of men with erectile dysfunction, after controlling for other risk factors, we found that those with severe depression had increased risk of cardiovascular events. We know that depression and erectile dysfunction are both risk factors for heart disease, but this study shows that these risk factors are independent of each other.”

But what about obesity, which is also a risk factor for cardiovascular events and erectile dysfunction? The author checked whether obesity is the common denominator. However, although obesity does play a role, factoring it out doesn’t take away the fact that depression can lead to heart disease.

The results indicate that a healthy sexual life may also be linked to a healthy heart and a happy life. But does depression cause erectile dysfunction or is it the sexual dysfunction that brings about depressive symptoms? This is still something to be addressed in further research.

Dr. Bandini explains:

“Our results show that when evaluating patients for sexual dysfunction, doctors should think about general health as well. Erectile dysfunction may be the first disease or depression may be first disease, but we should look beyond these initial conditions to look at secondary consequences such as increased cardiovascular risk. If we treat depression and sexual dysfunction, we may be able to improve cardiovascular outcomes, too.”

Previous studies have identified common mechanisms between cardiovascular disorders and erectile function. German researchers have reported that both disorders are linked to endothelial dysfunction, endothelium being the inner lining of the blood vessels. And now depression also joins in. For such a multidimensional problem, a multidisciplinary approach is needed and cardiologists, psychotherapists and urologists should work together to help patients to improve their health status and quality of life.

“The wellness of the body, of the couple, and of the mind independently affects the cardiovascular fate of men with erectile dysfunction… the need for a regular screening for cardiac morbidity in men with erectile dysfunction is even greater in those patients showing depressive symptoms.”

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OTC vitamin supplement may enhance fertility in women

Over-the-counter (OTC) fertility pills for women? It seems too good to be true but this is exactly what researchers from the Tel Aviv University are saying.

The researchers found a statistically significant link between DHEA, a popular OTC vitamin supplement and improved fertility in women.

DHEA stands for 5-Dehydroepiandrosterone, “a naturally-occurring steroid found in the brain, which plays an important biological role in humans and other mammals. Produced in the adrenal glands, it is also synthesized in the brain. The pharmaceutical version of this molecule is known as Prastera, Prasterone, Fidelin and Fluasterone, and identical generics are widely available over the counter in the United States without a prescription.”

The researchers conducted a controlled trial that compared the effects of DHEA supplementation vs. no supplementation in women with fertility problems. The women who had ovulation problems underwent fertility treatments but half of the group received 75 mg dose of DHEA everyday for 40 days prior to the treatments, and continued for 5 months thereafter.

Their results indicate that those who took DHEA supplements were three times more likely to become pregnant than those who did not. In addition, the DHEA group also had higher likelihood of having a healthy pregnancy and delivery than the control group.

According to study leader Prof. Adrian Shulman of Tel Aviv University’s Sackler Faculty of Medicine:

“In the DHEA group, there was a 23% live birth rate as opposed to a 4% rate in the control group. More than that, of the pregnancies in the DHEA group, all but one ended in healthy deliveries.”

It is not clear how DHEA enhances fertility. The study authors, however, hypothesize that it could have a positive effect on the quality of the eggs or the follicles. They recommend that women with fertility problems should take DHEA supplements and continue doing so even during pregnancy. However, before undertaking such supplementation, women should first consult their doctor.

In the meantime, the researchers will continue to do research and try to understand the fertility-enhancing mechanism of DHEA. If DHEA really does work, then it will save infertile women a lot of pain, not to mention money that comes with fertility treatments, including IVF.

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