Aging

Researchers look at what makes people age successfully
Factors associated with the successful aging of the socially-active elderly in the metropolitan region of Porto Alegre. Rev Bras Psiquiatr. 2005 Dec;27(4):302-308. Moraes JF, Souza VB.

Writing in the medical journal Revista Brasileira de Psiquiatria, researchers studied some of the inhabitants of the metropolitan region of the Brazialian city Porto Alegre. What they sought to do was “identify the factors associated with aging of the socially-active elderly in the metropolitan region of Porto Alegre.” Read more

Predicting Mortality: Researchers Have A Formula
From the Journal of the American Medical Association (JAMA)
ABSTRACT: “Context Both comorbid conditions and functional measures predict mortality in older adults, but few prognostic indexes combine both classes of predictors. Combining easily obtained measures into an accurate predictive model could be useful to clinicians advising patients, as well as policy makers and epidemiologists interested in risk adjustment. Read more

Researchers Say Marital Strain Can Affect Aging
You make me sick: marital quality and health over the life course. Umberson D, Williams K, Powers DA, Liu H, Needham B.J Health Soc Behav. 2006 Mar;47(1):1-16.

From the press release of the American Sociological Association:
“Researchers have found that marital strain accelerates the typical decline in self-rated physical health that occurs over time and that this adverse effect is greater at older ages. As men and women age, they become increasingly vulnerable to marital stress, according to a team of sociologists from the University of Texas-Austin and Ohio State University. Their findings appear in an article on marital quality and health over the life course in this month’s Journal of Health and Social Behavior, a publication of the American Sociological Association.”

Click here to go to our links page for the press release from American Sociological Association

Aging Men and Their Hormones
Writing in the medical journal Minerva Ginecologica, researchers say that “The ability to maintain active and independent living for as long as possible is a crucial factor for (aging healthfully)” and that “Interventions such as hormone replacement therapy may alleviate the debilitating conditions of secondary partial endocrine deficiencies by preventing the preventable and delaying the inevitable.”

Why Do Some People Age Healthily and Happily, While others do not?
Coping with Stress and Adversity May Be A Key

Arizona State University researchers will begin a five year study to examine how “factors of risk and resilience contribute to health and well-being.” Read more

Healthwatch with Dr. Darrow on Intimacy and Libido

Male and Female Intimacy Dysfunctions

Researchers writing in the medical journal Lancet report on endocrine disease and male and female intimacy dysfunctions.

Bhasin S, Enzlin P, Coviello A, Basson R. Sexual dysfunction in men and women with endocrine disorders. Lancet. 2007 Feb 17;369(9561):597-611

Endocrine disease frequently interrupts sexual function, and sexual dysfunction may signal serious endocrine disease. Diabetic autonomic neuropathy and endothelial dysfunction impair erectile function, and phosphodiesterase inhibition produces only moderate benefit. The effect of diabetes on women’s sexual function is complex: the most consistent finding is a correlation between sexual dysfunction and depression. Reductions in testosterone level in men are associated with low sexual desire and reduced nocturnal erections and ejaculate volume, all of which improve with testosterone supplementation. The age-dependent decline in testosterone production in men is not associated with precise sexual symptoms, and supplementation has not been shown to produce sexual benefit. In women, sexual dysfunction has not been associated with serum testosterone, but this may be confounded by limitations of assays at low concentrations and by the greater importance of intracellular production of testosterone in women than in men. Testosterone supplementation after menopause does improve some aspects of sexual function in women, but long-term outcome data are needed. More research on the sexual effects of abnormal adrenal and thyroid function, hyperprolactinaemia, and metabolic syndrome should also be prioritised. We have good data on local management of the genital consequences of oestrogen lack, but need to better understand the potential role of systemic oestrogen supplementation from menopause onwards in sexually symptomatic women.

Desire, Arousal, and Satisfaction in Aging Women

Researchers writing ion the medical journal Minerva Ginecologica examined issues related to aging and desire and arousal.

Nappi RE, Albani F, Valentino V, Polatti F, Chiovato L, Genazzani AR. Aging and sexuality in women. Minerva Ginecol. 2007 Jun;59(3):287-298.

A large number of biological, psycho-relational and socio-cultural factors are related to women’s sexual health and they may negatively affect the entire sexual response cycle inducing significant changes in sexual desire, arousal, orgasm and satisfaction during the entire reproductive life span.

In spite of the high prevalence of sexual problems with increasing age, sexual retirement is not an inevitable consequence of the passage of time and a high proportion of men and women remains sexually active well into later life, a result of changing attitudes toward sexuality and the availability of effective treatments for sexual dysfunction.

Population-based studies reported an age-related decline of sexual functioning and an additional adverse effect of menopausal status. Ageing per se interferes with the level of sexual performance, but sexual behaviour of midlife and older women is highly dependent on several factors such as general physical and mental well-being, quality of relationship and life situation.

Sex hormones, mainly low levels of estradiol, are relevant for the lack of sexual awareness and vaginal receptivity in naturally menopausal women.

Even diminished levels of androgens, as it more frequently occurs in surgically menopausal women, has a negative impact on desire and sexual responsiveness.

Several hormonal treatments have been used locally or systemically to alleviate sexual symptoms, especially by using estrogen plus androgen preparations and tibolone, with noticeable results on drive, enjoyment, lubrication, ability to reach orgasm and initiation of sex. However, sexual counseling and individualized management is mandatory to obtain meaningful and long-lasting results in clinical practice.

Estrogen

There is a great deal of fear and confusion when it comes to menopause and hormone supplementation. First, the term Hormone Replacement Therapy or HRT can conjure up the image of a cancer, stroke, and heart disease causing cocktail of synthetic hormones.

Next there is the “alternative,” Natural Hormone Replacement Therapy (NHRT). There is no Natural Hormone Replacement Therapy. Hormones for use in humans need to be synthesized from something. While many use the term, it is the sometimes favorite of internet sites selling “hormones,” and thus an easy target for critics who still favor the use of horse hormones and point to the “NHRT” websites as those making unsupported claims and being medically dangerous.

Sometimes, but incorrectly added to the latter group are the aptly and descriptively named “Bio-Identical Hormones.” Bio-identical Hormone Replacement Therapy (BHRT) is not “natural” hormones and should never be referred to as that. Their sources are natural, being derived from plant sources, but, they must be chemically altered to exactly match the hormones produced in the body.

This is where the “natural” confusion comes in. Bio-identical Hormones are engineered to exactly match the natural hormones present in the body, but they themselves are not “natural” but indeed, bio-identical.

I would like to point out here that NOT every woman coming in with peri-menospausal, menopausal or post-menopausal complaints is put on hormone therapy at our clinic and there are no studies that clearly show that bio-identical hormones are any safer than synthetic hormones.

Sometimes the desired results a women wants can be achieved by quitting smoking or drinking, altering a diet to avoid foods that could aggravate symptoms, such as coffee, sugars, and foods loaded with chemicals, getting more exercise, reducing stress, reducing exposure to caustic elements and more.

There are options to Hormone Replacement Therapy and these can and should be discussed with a physician knowledgeable in understanding all the options available to the peri-menospausal and menopausal woman. Just because Grandma went through menopause naturally, doesn’t mean she was the better for it!

Hormone replacement, peri-menopause and menopause
For over four decades doctors freely prescribed synthetic estrogen replacement to women in the throes of menopause to alleviate the myriad of symptoms associated with the “Change of Life.” It was an easy thing to do. A women would come in with “hot flashes,” “mood swings,” and “fatigue,” among other complaints and the doctor would simply give them estrogen. Why not? The women who took estrogen seemed to be more youthful, enjoy life more, and “had control of their bodies.”

The problem became supplying the demand for estrogen. To which “Estrogen Farms,” were set up to capture the urine of pregnant mares (where the name Premarin comes from (Pre=Pregnant, Mar=Mare, In=Urine) to glean the estrogen from it.

Synthetic horse-urine estrogen replacement was now the vogue and over 10,000,000 women were “in style.” Physicians felt comfortable putting women on this estrogen, since many studies proclaimed the vast benefits of estrogen replacement therapy. In fact, once on horse-estrogen, many women refused and still refuse to give it up!

Happy with horse estrogen

After menopause, estrogen levels in a woman’s body declines.

Estrogen Replacement Therapy (ERT) alleviated the familiar symptoms of menopause for many women.
With this decline often comes the familiar symptoms of:
1. Vaginal dryness, painful intercourse
2. Vaginal mucosal atrophy
3. Hot flashes
4. Night sweats
5. Fatigue
6. Mood swings and memory problems
7. Fluid retention
8. Sleep problems
9. Decreased libido
10. Involuntary loss of urine (stress incontinence)
11. More frequent urinary tract infections

It seemed like an idyllic world. Women wanted estrogen, the doctors were eager to comply, and the pharmaceutical industry was happy to produce.

Then on July 12, 2002, the world of synthetic estrogen replacement abruptly collapsed and panic filled women across the world. The Journal of the American Medical Association (JAMA) reported that Hormone Replacement Therapy was too dangerous to research!

Estrogen Segments 1 2 3

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Testosterone For Women Studies and News

Testosterone and Libido in Post Menopausal Women
Researchers writing in the medical journal Gynecological Endocrinology say that there is emerging evidence that androgens are significant independent determinants affecting libido and satisfaction, as well as mood, energy and other components of women’s health.

Testosterone in postmenopausal women
An article in the medical journal Current Opinion in Obstetrics & Gynecology says that testosterone therapy is a promising option for treating women with HSDD (very low libido or desire)

Testosterone enhances libido and decreases depression
Researchers reporting in the Journal of Neuropsychiatry and Clinical Neurosciences say Testosterone enhances libido and decreases depression.

Schutter, et al. J Neuropsychiatry Clin Neurosci.2005; 17: 372-377. Depression Administration of Testosterone Increases Functional Connectivity in a Cortico-Cortical Depression Circuit.

From the abstract: “Increasing evidence suggests that the steroid hormone testosterone (T) enhances libido and decreases depression. Even a single administration of T (0.5 mg sublingually) in healthy young women is sufficient to enhance physiological sexual responsiveness….” Read the abstract

Testosterone For Libido Loss In Women
September 19, 2005’s Washington Post reported “a position statement from the North American Menopause Society (NAMS) and published in its journal, Menopause,” that testosterone therapy may aid many post-menopausal women dealing with loss of libido. You can read the Washington Post article here.

Study: An overview of testosterone deficiency and supplementation in women.
Davis SR, Androgen treatment in women. MJA 1999;170:545-549.

The researchers state: “Women reporting loss of libido may find physicians insufficiently empathetic, and a biological cause for sexual dysfunction in women is rarely sought. However, it is gradually becoming more accepted that androgen deficiency in women may underpin a variety of symptoms and pathophysiological conditions and that, in selected women, androgen replacement therapy is of clinical benefit.”

“Testosterone insufficiency in women: fact or fiction?”
Guay, A, Davis SR. Testosterone insufficiency in women: fact or fiction? World Journal of Urology 2002;20(2):106-10.

The researchers state: “Androgen deficiency is a true medical condition in both pre- and post-menopausal women. The most important recommendation is to listen to the patient and consider androgen deficiency when the symptoms are present, even if they seem non-specific…Treatment with androgens has to be monitored carefully because of the possible harmful effects of excessive levels of testosterone.”

Bone Loss and Testosterone in Women with Anorexia Nervosa
A study is being recruited, Anne Klibanski, M.D., Principal Investigator, by the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) and the National Center for Research Resources (NCRR) to determine among other things if low dose testosterone will be a benefit in preventing bone loss in women with Anorexia Nervosa.

From the abstract: “Women with Anorexia Nervosa have been found to have low bone density. The study will determine whether administration of low doses of a natural hormone, testosterone and/or risedronate, a medication to help prevent bone breakdown will improve or prevent bone loss in this condition.”

Testosterone Beneficial for Libido and Cholesterol
Researchers reviewing the current medical literature on the role of Testosterone in enhancing libido in post-menopausal women say; “The available evidence is that adding testosterone to estrogen therapy, with or without progestin, appears to be effective in improving sexual function in postmenopausal women and is associated with a reduction in high-density lipoprotein (HDL) cholesterol.”

The findings appear in The Cochrane Library, read the abstract and summary of this article .

HRT, Testosterone and Post Menopausal Women – Problems of Sexual Dysfunction
Researchers writing in the medical journal Maturitas say that HRT along with testosterone supplementation helps postmenopausal women who complain of problems related to intimacy.

Women, Testosterone and Cardiovascular Disease
Researchers writing in the medical journal Coronary Artery Disease say that their study “could suggest that the development of cardiovascular disease after menopause is due not only to estrogen decline but also to androgen decline.”

The Use of Testosterone with Estrogen and Progestogen and Its Effect on Breast Cell Proliferation

Researchers writing in the medical journal Menopause say “Addition of testosterone may counteract breast cell proliferation as induced by estrogen/progestogen therapy in postmenopausal women.”

Loss of Libido

Sexual activity and perceived health – middle-aged women
Finnish researchers asked women between 42-46 and other women between 52-56 years old, how important issues of libido and intimacy where to their quality of life. The reported their findings in Health and Quality of Life Outcomes.

Testosterone and Libido in Post Menopausal Women
Researchers writing in the medical journal Gynecological Endocrinology say that there is emerging evidence that androgens are significant independent determinants affecting libido and satisfaction, as well as mood, energy and other components of women’s health.

Testosterone in postmenopausal women
An article in the medical journal Current Opinion in Obstetrics & Gynecology says that testosterone therapy is a promising option for treating women with HSDD (very low libido or desire)

Older Men and Testosterone
From the study abstract: “Male hypogonadism is a clinical situation characterized by a low serum testosterone level in combination with a diversity of symptoms and signs such as reduced libido and vitality, decreased muscle mass, increased fat mass and depression.

Dr. Darrow Interviewed on KCAL-9
CBS News August 3, 2006

Desire, Arousal, and Satisfaction in Aging Women
Researchers writing ion the medical journal Minerva ginecologica examined issues related to aging and desire and arousal.

Male and Female Intimacy Dysfunctions
Researchers writing in the medical journal Lancet report on endocrine disease and male and female intimacy dysfunctions.

Intimacy, Urinary, and Depressive Problems In Women Who Have Partners With E.D.
Researchers writing in the medical journal World Journal of Urology say that FSD disorders, urinary symptoms and depressive symptoms are common in partners of men with ED.

Older Men and Testosterone

This study is sponsored by University Hospital of North Norway
From the study abstract: “Male hypogonadism is a clinical situation characterized by a low serum testosterone level in combination with a diversity of symptoms and signs such as reduced libido and vitality, decreased muscle mass, increased fat mass and depression. Similar symptoms in combination with subnormal testosterone levels are seen in some elderly men. Similar symptoms in combination with subnormal testosterone levels are seen in some elderly men. Low testosterone levels are associated with known cardiovascular risk factors, and men with diabetes and stroke have lower testosterone levels than healthy men. Even though several publications have suggested that testosterone treatment in hypogonadal men may have beneficial effects, it is still uncertain if testosterone substitution in the aging man is indicated. Despite this uncertainty the sale of testosterone has increased enormously the last few years.

We hypothesize that older men with subnormal testosterone levels have a varying degree of dysfunction/symptoms both physically and mentally, and that these dysfunction/symptoms can be improved with testosterone treatment.

Read more about this study at clinicaltrial.gov