Androgens may be called “male hormones,” but don’t let the name fool you. Both men’s and women’s bodies produce androgens, just in differing amounts. In fact, androgens have more than 200 actions in women, and they are present in higher amounts than estrogens.
Antidepressants such as SSRIs, TCAs, and MAOIs work by increasing levels of serotonin, norepinephrine, or both in the brain. SSRIs are generally first-line treatment and safer in overdose than TCAs, but TCAs may be better for severe depression. Both classes of drugs can cause side effects like dry mouth, nausea, and sexual dysfunction. Antidepressants may take 10-20 days to work and should be continued for at least 6 months after symptoms improve to prevent relapse. Combining certain antidepressants can be dangerous due to increased serotonin levels.
This document provides an overview and review of common types of headaches for medical students preparing for an exam. It begins by explaining that headaches are commonly assessed on medical exams and provides background on why this guide was created. It then briefly outlines some of the major headache types that will be covered, including migraines, cluster headaches, trigeminal neuralgia, and increased intracranial pressure. The document is intended as a quick reference for students to review presenting symptoms, typical characteristics, diagnostic criteria and management approaches for common headache conditions.
This document discusses the management of seizures. It defines seizures and epilepsy, and outlines common causes of seizures including genetic, infectious, neoplastic, vascular, traumatic and metabolic factors. It describes how seizures are classified and the typical presentation and investigations after a seizure episode. The acute management of status epilepticus is explained. Common antiepileptic drugs are discussed along with factors to consider when prescribing them such as side effects, drug interactions and driving restrictions.
This document discusses male sexual dysfunction in multiple sclerosis (MS), including loss of libido, ejaculatory issues, infertility problems, and erectile dysfunction. It notes that 55% of males with MS report sexual dysfunction, most commonly lack of sexual interest and erectile dysfunction. The document outlines various types of sexual dysfunction and their neurological causes. It also discusses evaluations, treatments, and management strategies for different sexual issues like premature ejaculation, retrograde ejaculation, and erectile dysfunction. Treatments may include counseling, medications like phosphodiesterase type 5 inhibitors, penile rehabilitation exercises, and assistive devices.
The Role of the Pharmacist in Fetal Alcohol Spectrum DisorderPASaskatchewan
The role of the pharmacist in fetal alcohol spectrum disorder (FASD) involves prevention, counseling, and treatment. Regarding prevention, pharmacists should counsel women of childbearing age on contraception and the risks of alcohol use during pregnancy, as unplanned pregnancies are common and alcohol use is prevalent. When patients report lost or stolen medications, pharmacists should consider non-adherence due to diversion or misuse as well as the complex needs of those with FASD. Treatment of patients with FASD may involve psychostimulants, alpha-2 adrenergic agonists, or other medications to target symptoms like inattention and impulsivity.
These are the final two lectures given by Dr. Cady in Salt Lake City, UT on June 1, 2012. The first lecture deals with the use of hormones in traditional psychiatry and medicine, as supported by the peer reviewed literature. The second lecture, which is in this slide deck "back to back" with the first one, is on what Dr. Cady refers to as "Pedal to the Metal Allopathic Psychiatry." That is - using medications with finesse and, when indicated, with forcefulness. Functional and integrated medicine does not mean sitting around eating fruits, nuts, and flakes, but rather using the best techniques and tools that we have available to us from all fields of medicine (including traditional, classical allopathic medicine).
Pharmacotherapy of sp and depressive disordersSaleem Cology
The document discusses the pharmacotherapy of schizophrenia and depression. It defines schizophrenia as a complex psychiatric disorder characterized by disorganized thoughts, delusions, and hallucinations. Symptoms are thought to involve dopamine and glutamate dysfunction in the brain. Treatment involves second-generation antipsychotics like clozapine and olanzapine to alleviate symptoms and improve functioning, though negative symptoms respond less well. For depression, definitions and pathophysiology involving biogenic amines are outlined. Symptoms include sadness, loss of interest, and cognitive changes. Antidepressants aim to produce remission in 65-70% of patients, though some require longer treatment or ECT. Evaluation of both disorders involves monitoring for side effects and assessing symptoms.
Schizophrenia is a chronic mental disorder that affects about 1% of the population. It involves disruptions to cognition, emotion, perception and behavior. Symptoms typically emerge in young adulthood. While the exact causes are unknown, genetics and environmental factors like prenatal infection or malnutrition may play a role. Treatment primarily involves antipsychotic medications, which can help control symptoms but do not provide a cure. Both first-generation antipsychotics that target dopamine receptors and newer second-generation atypical antipsychotics are used.
Antidepressants such as SSRIs, TCAs, and MAOIs work by increasing levels of serotonin, norepinephrine, or both in the brain. SSRIs are generally first-line treatment and safer in overdose than TCAs, but TCAs may be better for severe depression. Both classes of drugs can cause side effects like dry mouth, nausea, and sexual dysfunction. Antidepressants may take 10-20 days to work and should be continued for at least 6 months after symptoms improve to prevent relapse. Combining certain antidepressants can be dangerous due to increased serotonin levels.
This document provides an overview and review of common types of headaches for medical students preparing for an exam. It begins by explaining that headaches are commonly assessed on medical exams and provides background on why this guide was created. It then briefly outlines some of the major headache types that will be covered, including migraines, cluster headaches, trigeminal neuralgia, and increased intracranial pressure. The document is intended as a quick reference for students to review presenting symptoms, typical characteristics, diagnostic criteria and management approaches for common headache conditions.
This document discusses the management of seizures. It defines seizures and epilepsy, and outlines common causes of seizures including genetic, infectious, neoplastic, vascular, traumatic and metabolic factors. It describes how seizures are classified and the typical presentation and investigations after a seizure episode. The acute management of status epilepticus is explained. Common antiepileptic drugs are discussed along with factors to consider when prescribing them such as side effects, drug interactions and driving restrictions.
This document discusses male sexual dysfunction in multiple sclerosis (MS), including loss of libido, ejaculatory issues, infertility problems, and erectile dysfunction. It notes that 55% of males with MS report sexual dysfunction, most commonly lack of sexual interest and erectile dysfunction. The document outlines various types of sexual dysfunction and their neurological causes. It also discusses evaluations, treatments, and management strategies for different sexual issues like premature ejaculation, retrograde ejaculation, and erectile dysfunction. Treatments may include counseling, medications like phosphodiesterase type 5 inhibitors, penile rehabilitation exercises, and assistive devices.
The Role of the Pharmacist in Fetal Alcohol Spectrum DisorderPASaskatchewan
The role of the pharmacist in fetal alcohol spectrum disorder (FASD) involves prevention, counseling, and treatment. Regarding prevention, pharmacists should counsel women of childbearing age on contraception and the risks of alcohol use during pregnancy, as unplanned pregnancies are common and alcohol use is prevalent. When patients report lost or stolen medications, pharmacists should consider non-adherence due to diversion or misuse as well as the complex needs of those with FASD. Treatment of patients with FASD may involve psychostimulants, alpha-2 adrenergic agonists, or other medications to target symptoms like inattention and impulsivity.
These are the final two lectures given by Dr. Cady in Salt Lake City, UT on June 1, 2012. The first lecture deals with the use of hormones in traditional psychiatry and medicine, as supported by the peer reviewed literature. The second lecture, which is in this slide deck "back to back" with the first one, is on what Dr. Cady refers to as "Pedal to the Metal Allopathic Psychiatry." That is - using medications with finesse and, when indicated, with forcefulness. Functional and integrated medicine does not mean sitting around eating fruits, nuts, and flakes, but rather using the best techniques and tools that we have available to us from all fields of medicine (including traditional, classical allopathic medicine).
Pharmacotherapy of sp and depressive disordersSaleem Cology
The document discusses the pharmacotherapy of schizophrenia and depression. It defines schizophrenia as a complex psychiatric disorder characterized by disorganized thoughts, delusions, and hallucinations. Symptoms are thought to involve dopamine and glutamate dysfunction in the brain. Treatment involves second-generation antipsychotics like clozapine and olanzapine to alleviate symptoms and improve functioning, though negative symptoms respond less well. For depression, definitions and pathophysiology involving biogenic amines are outlined. Symptoms include sadness, loss of interest, and cognitive changes. Antidepressants aim to produce remission in 65-70% of patients, though some require longer treatment or ECT. Evaluation of both disorders involves monitoring for side effects and assessing symptoms.
Schizophrenia is a chronic mental disorder that affects about 1% of the population. It involves disruptions to cognition, emotion, perception and behavior. Symptoms typically emerge in young adulthood. While the exact causes are unknown, genetics and environmental factors like prenatal infection or malnutrition may play a role. Treatment primarily involves antipsychotic medications, which can help control symptoms but do not provide a cure. Both first-generation antipsychotics that target dopamine receptors and newer second-generation atypical antipsychotics are used.
Neuropsychiatric manifestations of endocrine disordersDheeraj kumar
This is a subject seminar of neuropsychiatric manifesations of endocrine disorders.It took a lot of time to prepare,it helps fellow residents of Gen medicine to download and present as it is.
Obsessive compulsive disorder (OCD) affects 1-3% of the world's population. There is evidence of a genetic vulnerability to OCD, with increased rates of mental illness in relatives of those diagnosed and higher concordance rates in identical twins compared to fraternal twins. Common symptoms include obsessions, compulsions, or both. Selective serotonin reuptake inhibitors in high doses are the first-line treatment approach approved by the FDA, though adding additional agents that target other neurotransmitter systems can augment treatment effectiveness.
Erectile Dysfunction Symptoms And TreatmentManas Das
This presentation describes Symptoms And Treatment of Erectile Dysfunction which is a very common diseases in men.Erectile Dysfunction can be cure easily if proper treatment will be taken.To identify Erectile Dysfunction some symptoms are there which can help you.
This document discusses the neurobiology of schizophrenia. It covers the dopamine, serotonin, glutamate, and other neurotransmitter pathways involved in the disorder. The dopamine hypothesis proposes that dopamine is dysregulated in schizophrenia, being either overactive, underactive, or "out of tune" in different brain areas. This leads to both positive and negative symptoms. The document outlines key brain regions and circuits impacted, including the prefrontal cortex, mesolimbic pathway, and others. It also discusses various pharmacological targets for antipsychotic drugs that aim to modulate these neurotransmitter systems.
This document provides information about obsessive-compulsive disorder (OCD). It discusses the prevalence of OCD, noting it has a lifetime prevalence of 1.6% and typically has an onset in late adolescence/early adulthood. It is usually chronic and equally affects both genders. The document also examines the pathology of OCD, including increased activity in brain regions like the basal ganglia, orbitofrontal cortex, and thalamus. Signs and symptoms include obsessions, compulsions, and repetitive behaviors. Treatments discussed are cognitive behavioral therapy, pharmacotherapy using SSRIs, and psychosurgery for severe cases.
The document discusses antidepressants and antipsychotics used to treat mental disorders like depression, anxiety, psychoses, and affective disorders. It describes the pathophysiology involving biochemical imbalances and provides examples of drug categories and specific medications used, including their mechanisms of action, indications, side effects, cautions, and monitoring considerations for safe and effective use. Nursing care involves patient education, monitoring for therapeutic effects and side effects, and ensuring safe administration of these medications.
Hypogonadism occurs when the gonads produce little or no sex hormones. There are two types: primary, where the problem is in the gonads, and secondary, where the issue is in the brain. Causes include genetic disorders, infections, tumors, and injuries. Symptoms vary between males and females but include impaired sexual development and function. Hormone tests and imaging exams diagnose and identify the cause of low hormone levels. Treatment replaces missing sex hormones through medications, supplements, or hormone therapy tailored to the individual.
Hirsutism is defined as excessive hair growth in a male pattern in women. It is caused by increased androgen levels and the most common causes are idiopathic hirsutism and polycystic ovary syndrome. Virilization refers to hirsutism accompanied by other signs of androgen excess like acne, balding and deepening of the voice. Investigations aim to determine the cause of excess androgen levels and treatment options include lifestyle changes, cosmetic hair removal techniques, oral contraceptives, anti-androgens and metformin. Hirsutism can negatively impact quality of life and mental health.
Diagnostic approach to a case of Hirsutism RANJANDASH12
Hirsutism, or excessive body hair in women, can have significant psychosocial impacts. It is important to distinguish normal variations from true hirsutism through a diagnostic approach involving history, clinical evaluation, and biochemical testing. This helps determine if the cause is ovarian or adrenal hyperandrogenism, which may indicate conditions like PCOS, CAH, or tumors. A thorough workup is needed to identify treatable causes and rule out serious underlying pathology while alleviating psychological distress.
The document discusses hormone therapies, specifically bioidentical hormones. It notes that not all hormone therapies are equal and the clinic offers high-quality bioidentical hormones produced in PCCA-accredited pharmacies to pharmaceutical grade standards without unnecessary additives. The providers at the clinic believe pellets are not the best way to administer hormones and prefer other methods like creams or oral medications.
its all about thyroid gland,functions of thyroid gland,disorders of thyroid gland,signs and symptoms and medications.hope it will be useful for you.thank you,
Andropause is similar to menopause but affects men as they age. It involves a gradual decline in testosterone levels starting in the 40s. Symptoms include fatigue, weight gain, mood changes, and sexual issues. Ayurveda views andropause as a hormonal imbalance caused by aging. Herbs like tribulus, fenugreek, and ashwagandha can help by boosting testosterone levels. Lifestyle changes like exercise, meditation, and avoiding alcohol are also recommended for andropause treatment.
The endocrine system is a network of glands that secretes hormones to regulate bodily functions such as metabolism, growth, reproduction, and mood. The glands communicate via hormones released into the bloodstream rather than nerves. Some major glands are the hypothalamus, pituitary, thyroid, parathyroid, adrenals, ovaries, and testes. Imbalances in hormones produced by these glands can result in conditions such as hyperthyroidism, hypothyroidism, Cushing's syndrome, Addison's disease, and diabetes.
"Learn about hirsutism and find effective solutions for excessive hair growth. Discover treatments to manage this condition and restore confidence. Learn more now!"
The document discusses hyperandrogenism and virilization. It begins by defining androgens and their effects on male characteristics. It then discusses the relationships between hormones and the sources of androgens. Several conditions are covered that can cause hyperandrogenism and virilization including polycystic ovary syndrome (PCOS), Cushing's syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors. The signs, symptoms, causes, and pathophysiology of each condition are described. Laboratory tests and ultrasound are discussed for evaluating patients. Lastly, a case scenario is presented of a woman with irregular periods and potential diagnosis of PCOS is discussed.
Female hair loss is becoming more common, affecting around 30 million women in the United States, with some cases reported in women as young as 15 or 16 years old. While hair loss is psychologically more impactful for women than men, it typically presents as decreased hair density all over the scalp rather than a receding hairline. Causes of female hair loss can include androgens like testosterone and DHT, though androgenic alopecia may not be the primary cause as previously believed, and female pattern hair loss tends to be more diffuse across the scalp. Other potential causes are menopause, pregnancy, birth control pills, polycystic ovarian syndrome, thyroid issues, anemia, chronic illness
Two Docs Talk - Cady & Gabhart "On the road again" - Owensboro, KYLouis Cady, MD
This document summarizes a talk given by two doctors on balancing thyroid, adrenal, and sex hormones. It discusses how these hormones can impact fatigue, depression, and other symptoms when suboptimal, and how testing and treatment can help optimize hormone levels to support health and well-being. Functional medicine testing and bioidentical hormone replacement therapies are presented as alternatives to conventional approaches.
This document discusses the endocrine system and various endocrine disorders. It outlines the major glands of the endocrine system including the hypothalamus, pituitary, thyroid, parathyroids, adrenals, pancreas, ovaries/testes, kidneys, thymus and pineal gland. It then provides details on various disorders that can affect these glands such as disorders of the pituitary including tumors and growth hormone deficiency. It also discusses thyroid disorders including hypothyroidism, hyperthyroidism and Graves disease. Disorders of the parathyroids including hyperparathyroidism are outlined as well as hypoparathyroidism.
The document discusses the endocrine system and various endocrine disorders. It describes the major endocrine glands including the hypothalamus, pituitary gland, thyroid gland, parathyroid gland, adrenal glands, pancreas, ovaries, testes, thymus, pineal gland, kidneys, and prostaglandins. It then examines disorders of the pituitary gland including pituitary tumors and diabetes insipidus. Finally, it discusses thyroid disorders like hypothyroidism, hyperthyroidism, Graves' disease, and thyroid storm.
Primary amenorrhea is defined as the absence of menstruation by age 14 with no secondary sex characteristics or by age 16 with or without secondary sex characteristics. Secondary amenorrhea is defined as the absence of menstruation for 6 months or more after menstruating previously. The document provides detailed information on the causes, diagnosis, and treatment of primary and secondary amenorrhea. For primary amenorrhea, the most common causes are chromosomal abnormalities, hypothalamic hypogonadism, and Mullerian agenesis. The diagnosis involves assessing secondary sex characteristics, family history, laboratory tests of FSH, prolactin and thyroid levels, and imaging tests. Treatment focuses on treating the underlying cause and replacing any
This lecture on the relevance of hormonal optimization in mental health, was presented by Dr. Cady in Salt Lake City, UT at the 2012 Medical Seminar Series coordinated by World Link Medical.
Neuropsychiatric manifestations of endocrine disordersDheeraj kumar
This is a subject seminar of neuropsychiatric manifesations of endocrine disorders.It took a lot of time to prepare,it helps fellow residents of Gen medicine to download and present as it is.
Obsessive compulsive disorder (OCD) affects 1-3% of the world's population. There is evidence of a genetic vulnerability to OCD, with increased rates of mental illness in relatives of those diagnosed and higher concordance rates in identical twins compared to fraternal twins. Common symptoms include obsessions, compulsions, or both. Selective serotonin reuptake inhibitors in high doses are the first-line treatment approach approved by the FDA, though adding additional agents that target other neurotransmitter systems can augment treatment effectiveness.
Erectile Dysfunction Symptoms And TreatmentManas Das
This presentation describes Symptoms And Treatment of Erectile Dysfunction which is a very common diseases in men.Erectile Dysfunction can be cure easily if proper treatment will be taken.To identify Erectile Dysfunction some symptoms are there which can help you.
This document discusses the neurobiology of schizophrenia. It covers the dopamine, serotonin, glutamate, and other neurotransmitter pathways involved in the disorder. The dopamine hypothesis proposes that dopamine is dysregulated in schizophrenia, being either overactive, underactive, or "out of tune" in different brain areas. This leads to both positive and negative symptoms. The document outlines key brain regions and circuits impacted, including the prefrontal cortex, mesolimbic pathway, and others. It also discusses various pharmacological targets for antipsychotic drugs that aim to modulate these neurotransmitter systems.
This document provides information about obsessive-compulsive disorder (OCD). It discusses the prevalence of OCD, noting it has a lifetime prevalence of 1.6% and typically has an onset in late adolescence/early adulthood. It is usually chronic and equally affects both genders. The document also examines the pathology of OCD, including increased activity in brain regions like the basal ganglia, orbitofrontal cortex, and thalamus. Signs and symptoms include obsessions, compulsions, and repetitive behaviors. Treatments discussed are cognitive behavioral therapy, pharmacotherapy using SSRIs, and psychosurgery for severe cases.
The document discusses antidepressants and antipsychotics used to treat mental disorders like depression, anxiety, psychoses, and affective disorders. It describes the pathophysiology involving biochemical imbalances and provides examples of drug categories and specific medications used, including their mechanisms of action, indications, side effects, cautions, and monitoring considerations for safe and effective use. Nursing care involves patient education, monitoring for therapeutic effects and side effects, and ensuring safe administration of these medications.
Hypogonadism occurs when the gonads produce little or no sex hormones. There are two types: primary, where the problem is in the gonads, and secondary, where the issue is in the brain. Causes include genetic disorders, infections, tumors, and injuries. Symptoms vary between males and females but include impaired sexual development and function. Hormone tests and imaging exams diagnose and identify the cause of low hormone levels. Treatment replaces missing sex hormones through medications, supplements, or hormone therapy tailored to the individual.
Hirsutism is defined as excessive hair growth in a male pattern in women. It is caused by increased androgen levels and the most common causes are idiopathic hirsutism and polycystic ovary syndrome. Virilization refers to hirsutism accompanied by other signs of androgen excess like acne, balding and deepening of the voice. Investigations aim to determine the cause of excess androgen levels and treatment options include lifestyle changes, cosmetic hair removal techniques, oral contraceptives, anti-androgens and metformin. Hirsutism can negatively impact quality of life and mental health.
Diagnostic approach to a case of Hirsutism RANJANDASH12
Hirsutism, or excessive body hair in women, can have significant psychosocial impacts. It is important to distinguish normal variations from true hirsutism through a diagnostic approach involving history, clinical evaluation, and biochemical testing. This helps determine if the cause is ovarian or adrenal hyperandrogenism, which may indicate conditions like PCOS, CAH, or tumors. A thorough workup is needed to identify treatable causes and rule out serious underlying pathology while alleviating psychological distress.
The document discusses hormone therapies, specifically bioidentical hormones. It notes that not all hormone therapies are equal and the clinic offers high-quality bioidentical hormones produced in PCCA-accredited pharmacies to pharmaceutical grade standards without unnecessary additives. The providers at the clinic believe pellets are not the best way to administer hormones and prefer other methods like creams or oral medications.
its all about thyroid gland,functions of thyroid gland,disorders of thyroid gland,signs and symptoms and medications.hope it will be useful for you.thank you,
Andropause is similar to menopause but affects men as they age. It involves a gradual decline in testosterone levels starting in the 40s. Symptoms include fatigue, weight gain, mood changes, and sexual issues. Ayurveda views andropause as a hormonal imbalance caused by aging. Herbs like tribulus, fenugreek, and ashwagandha can help by boosting testosterone levels. Lifestyle changes like exercise, meditation, and avoiding alcohol are also recommended for andropause treatment.
The endocrine system is a network of glands that secretes hormones to regulate bodily functions such as metabolism, growth, reproduction, and mood. The glands communicate via hormones released into the bloodstream rather than nerves. Some major glands are the hypothalamus, pituitary, thyroid, parathyroid, adrenals, ovaries, and testes. Imbalances in hormones produced by these glands can result in conditions such as hyperthyroidism, hypothyroidism, Cushing's syndrome, Addison's disease, and diabetes.
"Learn about hirsutism and find effective solutions for excessive hair growth. Discover treatments to manage this condition and restore confidence. Learn more now!"
The document discusses hyperandrogenism and virilization. It begins by defining androgens and their effects on male characteristics. It then discusses the relationships between hormones and the sources of androgens. Several conditions are covered that can cause hyperandrogenism and virilization including polycystic ovary syndrome (PCOS), Cushing's syndrome, congenital adrenal hyperplasia, and androgen-secreting tumors. The signs, symptoms, causes, and pathophysiology of each condition are described. Laboratory tests and ultrasound are discussed for evaluating patients. Lastly, a case scenario is presented of a woman with irregular periods and potential diagnosis of PCOS is discussed.
Female hair loss is becoming more common, affecting around 30 million women in the United States, with some cases reported in women as young as 15 or 16 years old. While hair loss is psychologically more impactful for women than men, it typically presents as decreased hair density all over the scalp rather than a receding hairline. Causes of female hair loss can include androgens like testosterone and DHT, though androgenic alopecia may not be the primary cause as previously believed, and female pattern hair loss tends to be more diffuse across the scalp. Other potential causes are menopause, pregnancy, birth control pills, polycystic ovarian syndrome, thyroid issues, anemia, chronic illness
Two Docs Talk - Cady & Gabhart "On the road again" - Owensboro, KYLouis Cady, MD
This document summarizes a talk given by two doctors on balancing thyroid, adrenal, and sex hormones. It discusses how these hormones can impact fatigue, depression, and other symptoms when suboptimal, and how testing and treatment can help optimize hormone levels to support health and well-being. Functional medicine testing and bioidentical hormone replacement therapies are presented as alternatives to conventional approaches.
This document discusses the endocrine system and various endocrine disorders. It outlines the major glands of the endocrine system including the hypothalamus, pituitary, thyroid, parathyroids, adrenals, pancreas, ovaries/testes, kidneys, thymus and pineal gland. It then provides details on various disorders that can affect these glands such as disorders of the pituitary including tumors and growth hormone deficiency. It also discusses thyroid disorders including hypothyroidism, hyperthyroidism and Graves disease. Disorders of the parathyroids including hyperparathyroidism are outlined as well as hypoparathyroidism.
The document discusses the endocrine system and various endocrine disorders. It describes the major endocrine glands including the hypothalamus, pituitary gland, thyroid gland, parathyroid gland, adrenal glands, pancreas, ovaries, testes, thymus, pineal gland, kidneys, and prostaglandins. It then examines disorders of the pituitary gland including pituitary tumors and diabetes insipidus. Finally, it discusses thyroid disorders like hypothyroidism, hyperthyroidism, Graves' disease, and thyroid storm.
Primary amenorrhea is defined as the absence of menstruation by age 14 with no secondary sex characteristics or by age 16 with or without secondary sex characteristics. Secondary amenorrhea is defined as the absence of menstruation for 6 months or more after menstruating previously. The document provides detailed information on the causes, diagnosis, and treatment of primary and secondary amenorrhea. For primary amenorrhea, the most common causes are chromosomal abnormalities, hypothalamic hypogonadism, and Mullerian agenesis. The diagnosis involves assessing secondary sex characteristics, family history, laboratory tests of FSH, prolactin and thyroid levels, and imaging tests. Treatment focuses on treating the underlying cause and replacing any
This lecture on the relevance of hormonal optimization in mental health, was presented by Dr. Cady in Salt Lake City, UT at the 2012 Medical Seminar Series coordinated by World Link Medical.
The adrenal glands are small endocrine glands located above each kidney that produce important hormones. They have an outer cortex that produces steroid hormones like cortisol and aldosterone. The inner medulla produces catecholamines like adrenaline. The hormones regulate processes like stress response, metabolism, blood pressure, and sexual development. Disorders can occur if the glands overproduce or underproduce hormones, leading to issues like Cushing's syndrome, Addison's disease, or primary aldosteronism.
Sex is biologically determined by X and Y chromosomes, which trigger development of either male or female internal reproductive systems before birth. Hormones like testosterone and estrogen then influence further physical sex differentiation and sexual maturation. Studies have found correlations between higher levels of testosterone and more masculine behaviors in both males and females, such as increased aggression and preference for stereotypically male toys. Sex chromosome abnormalities can also influence physical and behavioral traits, like Klinefelter syndrome causing feminine characteristics in XY males or Turner syndrome resulting in short stature and infertility in XO females.
The document discusses gender differences in depression across the female life cycle. It notes that depression is the leading cause of disease burden for women. Some key points made include that women have higher lifetime prevalence of depression compared to men, and are more likely to experience atypical symptoms. Depression risk for women varies at different life stages like puberty, reproductive years, menopause, and is also impacted by hormonal fluctuations, pregnancy, and hormone treatments. The document provides an overview of neurobiological factors like the role of estrogen and progesterone in mood, as well as sex differences in antidepressant response. It also discusses depressive disorders specific to women like premenstrual dysphoric disorder and postpartum depression.
Polycystic ovary syndrome (PCOS) is a hormonal disorder common among women of reproductive age where the ovaries may develop numerous small fluid collections and fail to regularly release eggs. Women with PCOS often have irregular or prolonged menstrual periods and excess male hormone levels, which can cause irregular periods, excess facial/body hair growth, acne, and enlarged ovaries with cysts. The exact causes are unknown but may include excess insulin, low-grade inflammation, heredity, and excess androgen production. Complications can include infertility, gestational diabetes, miscarriage, nonalcoholic steatohepatitis, metabolic syndrome, type 2 diabetes, sleep apnea, depression, abnormal uterine bleeding, and obesity
The word “hypertension” means regular increase in arterial pressure. Blood pressure is increased when arteries and arterioles are narrowed. Arteries are like water channels feeding the earth and connecting the seas. But in a human body they are filled with the blood circulating between the heart and other bodies. Vasoconstriction may be observed because of regular spasms. The vessels remain narrowed due to thickenings of arterial walls.
Blood pressure is the pressure of circulating blood on blood vessel walls. Abnormal blood pressure and cardiovascular issues are major causes of chronic diseases in men. The normal blood pressure range for men depends on factors like age and time of measurement. Men under 50 typically have a systolic blood pressure of 108-90 and a diastolic blood pressure of 65-48 during the day and night, respectively. Men over 50 typically have a systolic blood pressure of 108-87 and a diastolic blood pressure of 65-50 during the day and night. Maintaining a healthy lifestyle and regular blood pressure monitoring can help men stay within a normal blood pressure range and reduce health risks.
High or low blood pressure may be the symptom of many diseases and pathologies. Control and a regular blood pressure measurement help to timely start a drug treatment and reducing the risk for health.
If you have high blood pressure, it does not mean that you should use anti-hypertensive pills right away. There are many natural ways to lower blood pressure.
Home remedies for high blood pressure instantlyIshita Patel
According to data of American Heart Association, over 74 millions of people have high blood pressure (hypertension). The danger of hypertension lies in that this disease poses a serious risk for the cardiovascular system.
Systolic pressure refers to the pressure in the blood vessels when the heart contracts and pushes blood into the arteries. It normally increases with age. Abnormal systolic pressure is a major risk factor for conditions like heart disease and stroke. Symptoms of high systolic pressure include dizziness and headaches, while low systolic pressure causes reduced energy and concentration problems. Maintaining a normal systolic pressure of 120 mm Hg or lower through lifestyle changes like exercise, diet, avoiding smoking and limiting alcohol can help control blood pressure without medication for many people. For those who need medication, doctors can prescribe different drug classes including diuretics and ACE inhibitors to safely stabilize systolic pressure.
High blood pressure is also known as hypertension. Blood pressure is the amount of force exerted against the walls of the arteries as blood flows through them.
Every year, nearly five million Americans need blood transfusions. An estimated 43,000 pints (or units) of donated blood are used each day in the United States, and one in seven people entering the hospital needs blood. Women are critical to the country’s blood supply, since their role as caregivers sends a message that donating blood is the right thing to do. However, they are also more likely than men to be temporarily restricted from donating because of low hematocrit, or red blood cell levels if they are still menstruating.
Blood donation and transfusion guidelinesIshita Patel
Every year, nearly five million Americans need blood transfusions. An estimated 43,000 pints (or units) of donated blood are used each day in the United States, and one in seven people entering the hospital needs blood. Women are critical to the country’s blood supply, since their role as caregivers sends a message that donating blood is the right thing to do. However, they are also more likely than men to be temporarily restricted from donating because of low hematocrit, or red blood cell levels if they are still menstruating.
Since the U.S. Food and Drug Administration (FDA) approved “the pill” in 1960, it has become the most popular and one of the most effective forms of reversible birth control ever invented. According to The Guttmacher Institute, among U.S. women who use birth control, more than 27 percent use the pill. A 2013 National Health Statistics Report says that 82 percent of women who use contraceptionhave used the pill at some point.e most popular and one of the most effective forms of reversible birth control ever invented. According to Planned Parenthood, among U.S. couples who use birth control, more than 30 percent use the pill.
Most men consider care to prevent pregnancy feminine duty. And yet, to take active part in the defense of their partners from unintended pregnancy, men can and should. Here are some examples of all currently existing methods of male contraception. Let’s consider the most common and used methods of methods of birth control for men and check their efficacy profile.
After 45-50 years of age, you can feel certain natural changes of health state: from well-known vasomotor disorders to essentially affecting the life quality and potential reasons of serious health problems (cardiovascular diseases and osteoporosis). At the same time, women of mature age have got their life experience and they have reached their career top, however, worsening of health state make them avoid any communication and even leave their job position. With estimation of their healthy life way and their care of own health which are the base of good health state in senior age, it should be noted that a good advice in the period of adaptation to a new stage of life is necessary for any woman. And if in the XIX century there was no reason to discuss this problem, because an average woman’s life did not exceed forty years, nowadays success of modern medicine put new tasks.
Activity of female reproductive system is controlled by sex glands: ovaries produced the female sex hormones, such as estrogen and progesterone. Influence of sex hormones is evident in the development of so-called secondary sexual character: constitution, breast, typical female hair pattern.
Hormones are chemical agents, transmitters among different tissues of our organism. Hormones are produced by the endocrine glands. For example, sex hormones are produced mainly by ovaries and in insignificant quantity by adrenal glands. Hormones penetrate in the blood and make a targeted organ start its function activity or stop its work. The blood contains a large quantity of various biologically active agents at the same time, however, different hormones find their targeted organs. How it is going on?
When using oral contraceptives (oral pills), chances of getting pregnant do not exceed 1%. The duration of using oral pills does not affect the chances of getting pregnant. Therefore, women can take oral pills for many years, without worrying about unplanned pregnancy.
The absolute majority of mature women use hormonal contraceptives to prevent pregnancy. When planning a pregnancy, many women are wondering «How effective is birth control?
Bipolar disorder is a mental illness marked by extreme mood swings from high (mania) to low (depression) and low to high. The mood swings may even become mixed, so you might feel elated and depressed at the same time.
Biofeedback is a technique that teaches people how to control involuntary bodily functions like breathing, muscle tension, and heart rate through the use of electronic or electromechanical devices that provide feedback on these physiological processes. It involves learning to control external signals and eventually internal cues to gain awareness and control over one's body. Biofeedback sessions with a trained professional typically involve sensors attached to the body to monitor functions and provide audio or visual feedback to help the individual learn control through relaxation techniques and practice. While not a cure, biofeedback has been shown to help treat various conditions involving muscle tension and stress and is gaining wider acceptance in mainstream healthcare.
1. The document provides information on self-care options for lower back pain, which is very common and costly.
2. It recommends trying ice or heat, rest, gentle exercise, alternative treatments like acupuncture, and over-the-counter or prescription medications to manage pain.
3. Maintaining good posture, losing weight, reducing stress, and heat/cold therapy can also help lower back pain.
Many men experience symptoms of erectile dysfunction (ED) as they age. Also known as impotence, ED is an occasional (or prolonged) inability to get or maintain an erection. When ED occurs frequently, you might need treatment for an underlying health issue.
Osteoporosis - Definition , Evaluation and Management .pdfJim Jacob Roy
Osteoporosis is an increasing cause of morbidity among the elderly.
In this document , a brief outline of osteoporosis is given , including the risk factors of osteoporosis fractures , the indications for testing bone mineral density and the management of osteoporosis
ABDOMINAL TRAUMA in pediatrics part one.drhasanrajab
Abdominal trauma in pediatrics refers to injuries or damage to the abdominal organs in children. It can occur due to various causes such as falls, motor vehicle accidents, sports-related injuries, and physical abuse. Children are more vulnerable to abdominal trauma due to their unique anatomical and physiological characteristics. Signs and symptoms include abdominal pain, tenderness, distension, vomiting, and signs of shock. Diagnosis involves physical examination, imaging studies, and laboratory tests. Management depends on the severity and may involve conservative treatment or surgical intervention. Prevention is crucial in reducing the incidence of abdominal trauma in children.
Local Advanced Lung Cancer: Artificial Intelligence, Synergetics, Complex Sys...Oleg Kshivets
Overall life span (LS) was 1671.7±1721.6 days and cumulative 5YS reached 62.4%, 10 years – 50.4%, 20 years – 44.6%. 94 LCP lived more than 5 years without cancer (LS=2958.6±1723.6 days), 22 – more than 10 years (LS=5571±1841.8 days). 67 LCP died because of LC (LS=471.9±344 days). AT significantly improved 5YS (68% vs. 53.7%) (P=0.028 by log-rank test). Cox modeling displayed that 5YS of LCP significantly depended on: N0-N12, T3-4, blood cell circuit, cell ratio factors (ratio between cancer cells-CC and blood cells subpopulations), LC cell dynamics, recalcification time, heparin tolerance, prothrombin index, protein, AT, procedure type (P=0.000-0.031). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and N0-12 (rank=1), thrombocytes/CC (rank=2), segmented neutrophils/CC (3), eosinophils/CC (4), erythrocytes/CC (5), healthy cells/CC (6), lymphocytes/CC (7), stick neutrophils/CC (8), leucocytes/CC (9), monocytes/CC (10). Correct prediction of 5YS was 100% by neural networks computing (error=0.000; area under ROC curve=1.0).
Cell Therapy Expansion and Challenges in Autoimmune DiseaseHealth Advances
There is increasing confidence that cell therapies will soon play a role in the treatment of autoimmune disorders, but the extent of this impact remains to be seen. Early readouts on autologous CAR-Ts in lupus are encouraging, but manufacturing and cost limitations are likely to restrict access to highly refractory patients. Allogeneic CAR-Ts have the potential to broaden access to earlier lines of treatment due to their inherent cost benefits, however they will need to demonstrate comparable or improved efficacy to established modalities.
In addition to infrastructure and capacity constraints, CAR-Ts face a very different risk-benefit dynamic in autoimmune compared to oncology, highlighting the need for tolerable therapies with low adverse event risk. CAR-NK and Treg-based therapies are also being developed in certain autoimmune disorders and may demonstrate favorable safety profiles. Several novel non-cell therapies such as bispecific antibodies, nanobodies, and RNAi drugs, may also offer future alternative competitive solutions with variable value propositions.
Widespread adoption of cell therapies will not only require strong efficacy and safety data, but also adapted pricing and access strategies. At oncology-based price points, CAR-Ts are unlikely to achieve broad market access in autoimmune disorders, with eligible patient populations that are potentially orders of magnitude greater than the number of currently addressable cancer patients. Developers have made strides towards reducing cell therapy COGS while improving manufacturing efficiency, but payors will inevitably restrict access until more sustainable pricing is achieved.
Despite these headwinds, industry leaders and investors remain confident that cell therapies are poised to address significant unmet need in patients suffering from autoimmune disorders. However, the extent of this impact on the treatment landscape remains to be seen, as the industry rapidly approaches an inflection point.
Basavarajeeyam is an important text for ayurvedic physician belonging to andhra pradehs. It is a popular compendium in various parts of our country as well as in andhra pradesh. The content of the text was presented in sanskrit and telugu language (Bilingual). One of the most famous book in ayurvedic pharmaceutics and therapeutics. This book contains 25 chapters called as prakaranas. Many rasaoushadis were explained, pioneer of dhatu druti, nadi pareeksha, mutra pareeksha etc. Belongs to the period of 15-16 century. New diseases like upadamsha, phiranga rogas are explained.
8 Surprising Reasons To Meditate 40 Minutes A Day That Can Change Your Life.pptxHolistified Wellness
We’re talking about Vedic Meditation, a form of meditation that has been around for at least 5,000 years. Back then, the people who lived in the Indus Valley, now known as India and Pakistan, practised meditation as a fundamental part of daily life. This knowledge that has given us yoga and Ayurveda, was known as Veda, hence the name Vedic. And though there are some written records, the practice has been passed down verbally from generation to generation.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of the physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar lead (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
6. Describe the flow of current around the heart during the cardiac cycle
7. Discuss the placement and polarity of the leads of electrocardiograph
8. Describe the normal electrocardiograms recorded from the limb leads and explain the physiological basis of the different records that are obtained
9. Define mean electrical vector (axis) of the heart and give the normal range
10. Define the mean QRS vector
11. Describe the axes of leads (hexagonal reference system)
12. Comprehend the vectorial analysis of the normal ECG
13. Determine the mean electrical axis of the ventricular QRS and appreciate the mean axis deviation
14. Explain the concepts of current of injury, J point, and their significance
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. Chapter 3, Cardiology Explained, https://www.ncbi.nlm.nih.gov/books/NBK2214/
7. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Rasamanikya is a excellent preparation in the field of Rasashastra, it is used in various Kushtha Roga, Shwasa, Vicharchika, Bhagandara, Vatarakta, and Phiranga Roga. In this article Preparation& Comparative analytical profile for both Formulationon i.e Rasamanikya prepared by Kushmanda swarasa & Churnodhaka Shodita Haratala. The study aims to provide insights into the comparative efficacy and analytical aspects of these formulations for enhanced therapeutic outcomes.
TEST BANK For Community Health Nursing A Canadian Perspective, 5th Edition by...Donc Test
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1. WHAT IS ANDROGEN?
Overview
Androgensmaybe called“male hormones,”butdon’tletthe name fool you.Bothmen’sandwomen’s
bodiesproduce androgens,justindifferingamounts.Infact,androgenshave more than200 actionsin
women,andtheyare present inhigheramountsthanestrogens.
The principal androgensare testosteroneandandrostenedione.Theyare,of course,presentinmuch
higherlevelsinmenandplayan importantrole inmale traitsandreproductive activity.Otherandrogens
include dihydrotestosterone(DHT),dehydroepiandrosterone(DHEA) andDHEA sulfate (DHEA-S).
In a woman’sbody,one of the mainpurposesof androgensisto be convertedintothe female hormones
calledestrogens.
Androgens in Women
In women,androgensare producedinthe ovaries,adrenalglandsandfatcells.Infact,womenmay
produce too muchor too little of these hormones––disordersof androgenexcessanddeficiencyare
amongthe more commonhormonal disordersinwomen.
In women,androgensplayakeyrole inthe hormonal cascade that kick-startspuberty,stimulatinghair
growthin the pubicand underarmareas.Additionally,thesehormonesare believedtoregulate the
functionof manyorgans,includingthe reproductive tract,bone,kidneys,liverandmuscle.Inadult
women, androgensare necessaryforestrogensynthesisandhave beenshowntoplayakeyrole inthe
preventionof bone loss,aswell assexual desireandsatisfaction.
Androgen-Related Disorders
High Androgen Levels
Excessamountsof androgenscan pose a problem,resultinginsuch“virilizingeffects”asacne,hirsutism
(excesshairgrowthin“inappropriate”places,likethe chinorupperlip) andthinningof haironthe head
(balding).
About10 percentof womenwithhighlevelsof aform of testosterone called“free”testosterone have
polycysticovarysyndrome (PCOS),characterizedbyirregularorabsentmenstrual periods,infertility,
bloodsugardisorders(prediabetesandtype 2 diabetes),and,insome cases,symptomslike acne and
excesshairgrowth.Most womenwithPCOSare overweightorobese,thoughasmall percentage have a
normal bodyweight.Leftuntreated,highlevelsof androgens,regardlessof whetherawomanhasPCOS
or not, are associatedwithserioushealthconsequences,suchasinsulinresistance anddiabetes,high
cholesterol,highbloodpressure andheartdisease.
In additiontoPCOS,othercausesof highandrogenlevels(calledhyperandrogenism) includecongenital
adrenal hyperplasia(ageneticdisorderaffectingthe adrenal glandsthatafflicts aboutone in10,000 to
2. one in18,000 Americans,abouthalf of whomare women) andotheradrenal abnormalities,andovarian
or adrenal tumors.Medicationssuchasanabolicsteroids,occasionallyabusedbybodybuildersand
otherathletesforperformance enhancement,canalsocause hyperandrogenicsymptoms.
Low Androgen Levels
Low androgenlevelscanbe a problemaswell,producingeffectssuchaslow libido(interestinordesire
for sex),fatigue,decreasedsense of well-beingandincreasedsusceptibilityto bone loss,osteoporosis
and fractures.Because symptomslikeflaggingdesire andgeneral malaise have avarietyof causes,
androgendeficiency,like hyperandrogenism,oftengoesundiagnosed.
Low androgenlevelsmayaffectwomenatanyage,but mostcommonlyoccur duringthe transitionto
menopause,or“perimenopause,”aterm usedtodescribe the time before menopause(usuallytwoto
eightyears).Androgenlevelsbegindroppinginawoman’s20s, and by the time she reachesmenopause,
have declined50percentor more fromtheirpeakas androgenproductiondeclinesinthe adrenal
glands,andthe mid-cycle ovarianandrogenboostlessensorevaporatesaltogether.
Furtherdeclinesinthe decade followingmenopause indicate ever-decreasingovarianfunction.For
manywomen,the effectsof thisfurtherandrogendeclineinclude aggravationof hotflashesand
acceleratedbone loss.These effectsmaynotbecome apparentuntil the womenare intheirlate 50s or
early60s.
Treatment for Low Androgen Levels
Combinationestrogen/testosteronemedicationsare availableforwomeninbothoral andinjected
formulations.Smallstudiesfindtheyare effective inboostinglibido,energyandwell-beinginwomen
withandrogendeficiencies,aswell asprovidingaddedprotectionagainstbone loss.One studyshowed
some increasedrisksof breastandendometrial cancer,alongwithseveral otheradverse effects,from
one oral formof combinedestrogenandtestosterone,buttheseriskshave notbeendemonstratedwith
otherformsof treatment.
Testosterone isalsoaneffective treatmentforAIDS-relatedwastingandisundergoingstudiesfor
treatingpremenstrual syndrome (PMS) andautoimmune diseases.WomenwithPMSmayhave below-
normal levelsof testosteronethroughoutthe menstrual cycle, suggestingthatatestosterone
supplementmayhelp,butsuchtreatmentshave notbeenproveneffective.
Diagnosis
Your androgenlevelsmaybe normal,toohigh(hyperandrogenism) ortoolow (hypoandrogenism).A
healthcare professional canassesswhetheryoursymptomssuggestabnormal levelsandcanorder a
bloodtestto measure hormone levels.Butresultsfrombloodtestsare oftenmisleadingandmaynotbe
conclusive because thereisnoagreementonjustwhatconstitutes“normal”androgenlevelsinwomen.
Plus,levelsfluctuatedependingonawoman’sage,the timingof hermenstrual cycle andher
menopausal status.Further,manystandardlaboratorytests,optimizedformeasuringtestosteronein
3. men,maynot be sensitive enoughtoaccuratelymeasure women’s levels.Asaresult,itiseasierto
diagnose androgenlevelsthatare too high,ratherthan levelsthatare toolow.
If you suspectyouhave a hyperandrogeniccondition,itisimportanttoseeka diagnosisanddevelopand
begina treatmentplan.Hyperandrogenismcanproduce bothersomecosmeticsymptomslikeunwanted
hair onyour upperlipandchin.Psychologically,the clinical manifestationsof hyperandrogenemia
(persistentacne,excessfacial orbodyhair,thinningof haironthe scalpand obesity) canbe devastating
to younggirlsand womenof reproductive age andmaycontribute tofeelingsof low self-esteem,
anxiety,depressionandantisocial behavior.Womenwithexcessive,uncomfortable sexual tensionmay
alsohave highlevelsof androgens.
Hyperandrogenicconditionsare alsoassociatedwithserioushealthproblemslikeinsulinresistance (a
precursorto diabetes),diabetesandheartdisease.
Hyperandrogenicsyndromesoftengoundiagnosed,eventhoughsymptomsmaybe treated.For
example,youmaybe treatedforacne,withoutbeingevaluatedforglucose toleranceoraskedabout
menstrual regularity.Itmaybe up to youto tie togethersome of yourhyperandrogenicsymptomsand
ask fora more integratedevaluationandtreatmentapproach.
The signs and symptoms of hyperandrogenism are:
Hirsutism(excessfacial orbodyhair)
Persistentacne and/oroilyskin
Alopecia(thinninghaironthe head)
Insulinresistance
Acanthosisnigricans(rough,darklypigmentedareasof skin)
Highbloodpressure
Low HDL cholesterol (“goodcholesterol”) andhighLDLcholesterol (“badcholesterol”)
Obesityaroundthe mid-abdomen
Irregularor absentperiodsorfrequentskippedcycles
Enlargementof the clitoris
Deepor hoarse voice
If your symptomsinclude irregularorabsentperiods,youmayhave polycysticovarysyndrome (PCOS)––
the most commonconditionassociatedwithhyperandrogenism.The menstrualirregularityindicates
infrequentorabsentovulation,makingPCOSaleadingcause of female infertility,whichisoften
treatable.
Some womenwithhyperandrogenismmayexperiencespontaneousovulation,andpregnanciesmay
occur. However,womenwithhighandrogenlevelsalsohave anincreasedriskof miscarriage.
Hyperandrogenicsymptomsmayalsobe causedbya geneticdisease calledcongenital adrenal
hyperplasia(CAH).Severe casescanresultinsuchextreme effectsasgenital malformationand
virilization(facialhair,acne) ata youngage.
4. Mildercasesmay looka lotlike PCOS,withsymptomspossiblyincludingfacial hair,irregularperiodsand
highbloodpressure.WomenwithmildCAHmayalsobe shorterthan theirparents,vulnerable to
infectionsandhave asomewhat“masculine build,”withsquare shouldersandnarrow hips.
A thoroughmedical historyandphysical examination provide the mostimportantinitial diagnostic
information.Laboratorytestsusuallyserve toconfirmthe presence of hyperandrogenemia,amedical
termmeaningtoomuch androgeninthe blood.A bloodtestfortotal and free testosterone maybe
ordered,as well asa lipidprofile (tomeasure cholesterol levels),luteinizinghormone(LH),follicle-
stimulatinghormone(FSH),prolactinanda fastingglucose test.Several endocrinefunctiontestsmay
alsobe orderedtodetermine the site(s) of abnormal androgen secretion,suchasDHEA or its sulfate
form,DHEAS. Thyroidtestsare usuallyincludedinthe evaluation.Inflammationisalsoacomponentof
PCOS,so a physicianmaychoose tomeasure some inflammatorymarkersaswell.
Hormone therapy(HT),whichconsists of eitherestrogenandprogestin(sometimesreferredtoas
hormone replacementtherapy,orHRT) or estrogen-onlytherapy(ET),andbirthcontrol pillscontaining
estrogen,are othertreatmentoptions.Oral estrogensboostlevelsof sex hormone bindingglobulin
(SHBG),a proteinmade inthe liverthatbindstestosterone andestrogen.Thisreduceslevelsof free
testosterone,whichmaybe triggeringsymptoms.Glucocorticoids(cortisone),whichare often
prescribedforasthmaor inflammation,canalsosuppressproductionof androgens.
Androgen Deficiency
Androgenlevelsinwomenpeakduringtheir20s.Thena decline indailyproductionbeginsthat
continuesthroughoutawoman’slife.The onlytime asuddendrop-off inandrogenlevelsoccursisin
womenwhohave theirovariesremoved(abouthalf of all androgensare producedinawoman’sadrenal
glandsand half inherovaries).Bythe time a womanreachesmenopause,bloodandrogenlevelsare
abouthalf of whattheywere at theirpeak.
Low androgenlevelsinwomenduringtheirreproductive years,aswell asfollowingmenopause,result
inthree noticeable symptoms:lowlibido,fatigueandareducedsense of well-being.Low androgen
levelsalsohave beenlinkedtobone lossandosteoporosis(adisease thatcausesthin,fragile bones),
possiblyexplainingthe phenomenonof excessivebone lossinsome womenwhogothroughovarian
failure orsurgical removal of the ovaries.
Low sex drive andvaginal drynessare twocommonsymptomsexperiencedbysome womenduringthe
transitiontomenopause,makingsex uncomfortableorpainful.Thesechangeshave beenrelatedtolow
estrogenaswell aslowandrogenlevels.If yourecognize anyof the followingchanges,youshouldsee
your healthcare professional todiscussyourconcerns.
1. Have you noticedthatit takeslongerforyourvaginato become lubricatedbefore orduringsex?
2. Have you noticedthatthe amountof vaginal lubricationisless?
3. Do youhave discomfortor painduringvaginal penetration?
4. Do youhave sex lessfrequently?
5. Do youand/or yourpartner wishyouhadsex more often?
5. 6. Are you lessresponsive tosexual stimulation?
7. Do youhave difficultyreachingorgasm?
8. Has your desire forsex decreased?
To diagnosisandrogendeficiency,yourhealthcare professional will considersymptomssuchaslow
libidoandfatigue.Otherconditionsthatcancause similarsymptomswillalsoneedtobe ruledout.
Bloodtestsfortestosterone andSHBGwill likelybe partof your evaluation.SHBGbindstotestosterone,
makingitlessavailable forinfluencingcellularactions.SHBGlevelscanvarydramaticallyinresponse to
oral estrogentherapyfollowingmenopause ortooral contraceptives.Insome women,SHBGchanges
are modestandhave minimal effectonfree androgenlevels,while inothers,itcanincrease greatlyand
give rise toloweredsex drive (undesirable) orreducedfree testosterone andaresultingdecreaseinside
effectssuchas acne and hirsutism(desirable)
Bloodtestingfortestosteroneinhypoandrogenicwomenisproblematic.Healthcare professionalshave
not reacheda consensusaboutwhatconstituteslow levelsinwomen,andlevelsatthe lowerendof the
female range are difficulttomeasure withmanycommerciallyavailablelaboratorytests.Forthisreason,
Endocrine SocietyClinical Practice Guidelinesrecommendagainstmakingaformal diagnosisof
androgendeficiency.
The causes of androgendeficiencyare varied.The mostcommoncause of low androgen isaging.If your
symptomsbotheryou,youmaywant to talkto yourhealthcare professional aboutandrogen
replacement.
Androgen deficiency may be a particularproblem if:
Your ovarieshave beenremoved
You have undergone earlymenopause(generallydefinedasmenopauseoccurringpriortoage
40)
You have Turner’ssyndrome,ageneticgrowthdisorderthatoccursinabout one in2,000 girls
that ariseswhenone,orpart of one,of the two Xchromosomesismissing(twoX’scode fora
female,anXYfor a male). Thisisa conditioninwhichthe ovariesfail todevelop.
You are postmenopausal
You have undergone chemotherapyorradiationtreatmentforcancer
Otherconditionsassociatedwithlowtestosteroneinclude hypothalamicamenorrhea(absence of
menstrual periodsresultingfromexcessive dietingandexercising)andhyperprolactinemia
(characterizedbyhighlevelsof prolactin,the hormone thatdrivesmilkproductionwhenawoman
breastfeeds).Additionally,avarietyof pituitaryglandtumorsare alsoassociated withlow productionof
testosterone,aswell asotherhormones.
Sometimesthere isnoobviouscause of androgendeficiency.Otherwisehealthywomenof reproductive
age can sufferfromlowandrogens,whichcanbe confirmedwithbloodtestsandafterother potential
causesof lowlibidoandfatigue are eliminated.
6. To exclude otherpotential causesof lowlibidoandfatigue,yourhealthcare professional mayaskyou
aboutpast psychological orrelationshipproblemsandcheckforotherpotential causesof fatigue,such
as depression,hypothyroidismandirondeficiency.
If you are postmenopausal andare takinghormone replacementtherapy(estrogenalone oran
estrogen/progestincombination),yourestrogenlevelsmaybe checkedtoensure yourestrogendosage
ishighenough.Therapywithoral estrogens(oral estradiol) andconjugatedestrogens(conjugated
equine estrogenorsyntheticconjugatedestrogens) oresterifiedestrogenscanbe difficultbecauseoral
estrogensare metabolizedtoestrone,whichcanbe difficulttomeasure,andconjugatedandesterified
estrogensare largelycomposedof estrogeniccompoundsnotmeasuredincommerciallyavailable
hormone tests.Transdermal estrogens(patches,gels,injections,etc.),are more easilyassessedwith
commercial laboratorytests.
Treatment
Androgendisorderscannotbe curedbuttheycan be treated,usuallywithmedication.If youare
overweight,losingaslittle as5 to 10 percentinbodyweightcan restore fertilityanddecrease hirsutism
insome womenwithandrogen excess.
Treatmentmayalsoinclude oral contraceptives.Keepinmindif youare of reproductive age,the right
oral contraceptive choice canreduce hyperandrogenicsymptoms,while the wrongone canmake them
worse.Whenyouhearthe termoral contraceptivesorbirthcontrol pills,itmostoftenrefersto
“combinationpills”—pillsthatcontainbothestrogenandprogestin.The estrogenusedisalmostalways
ethinyl estradiol invaryingdoses,butnumerousprogestinsare used,alsoinvaryingdoses.The keyi s
the type of progestinincluded.Someprogestinscanmimicandrogensandmake symptomsworse,but
some avoidthisproblem,allowingthe estrogeninbirthcontrol pillstoraise levelsof sex hormone
bindingglobulin(SHBG),reducingbloodlevelsof free testosterone andimprovingsymptoms.Standard-
dose birthcontrol pills,whichcontain35 mcg of ethinyl estradiol,maybe preferable inthese
circumstancestopillscontaininglowerdosesof ethinyl estradiol.Talktoyourhealthcare professional
abouta pill formulationwithprogestinsthatdonot have an androgeneffectandwhichare knownto
elevate SHBG,suchas norgestimate,drospirenoneordesogestrel.
For some women,the mostbothersome symptomsof highlevelsof androgenare acne and hirsutism.
For womenwithsuchsymptoms,spironolactone(Aldactone orSpironol) maybe prescribed.The drug,a
diuretic,hasfewside effects,andathighdosescan clearoilyskinandmake unwantedhairfiner.The
combinationof spironolactone andoral contraceptivesis frequentlyused.If youare tryingtoconceive,
however,donottake thisdrug because itcan harm an unbornbaby.
Bear inmindthat itcan take up to nine monthstosee effectsonhairgrowthand a yearto achieve peak
effect.The hairwill still be there,butwill generallygrow more slowlyandwill be lighterandfiner.
Electrolysisorrepeatedlasertreatmentsare the onlywaystogetrid of the hair for extendedperiodsor
permanently.
7. A classof drugscalled5-alphareductase inhibitorsmayhelpsome women,thoughtheyshouldbe taken
onlywithextreme caution.These drugsinhibitanenzyme crucial toconvertingtestosterone to
dihydrotestosterone (DHT).Finasteride (PropeciaandProscar) andflutamide (Eulexin)are inthisclass.
Theywere designedtotreatprostate growthandcancer inmen(whichisexacerbatedbyexcessive
androgenlevels),whilePropeciaisalsoprescribedasatreatmentformale patternbaldness.
These drugsare notspecificallyapprovedbythe U.S.Foodand Drug Administrationforuse inwomen,
and manufacturersadvise againstwomentakingthem.If one isprescribedforyou,youwill have tobe
especiallyvigilantaboutbirthcontrol,because bothcause birthdefects.Flutamidehasthe potential,
althoughinfrequent,adverse effectof fatal livertoxicity.
Treatingcongenital adrenal hyperplasia(CAH) isabitmore complex,because CAHischaracterizednot
justby highlevelsof androgens,butbylow levelsof twootherhormones,cortisol andaldosterone.
Treatmentinan adultwomanmay incorporate aglucocorticoid,suchasprednisone,tomake upforthe
missingcortisol.
Androgen Deficiency
If you are androgendeficient,the benefitsof ahormonal supplementcanmake itworth yourwhile to
investigatewhethersuchadrug is rightfor you.Althoughnottypicallyprescribedsolelytoprevent
osteoporosis,testosteronesupplementshave beenshowninseveral studiestonotonlyslow bone loss,
but alsoto stimulate bone formationinpostmenopausal womenandwomenwithsurgicallyinduced
menopause.
Some compoundingpharmaciesmaybe able toprovide testosterone creamsthatare appliedtothe
vulvaformore targeteddeliveryof the hormone,butsuchformulationsare notwidelyavailable.And
there isa lack of publisheddatademonstrating safety,whetherornottheyare effectiveandif the
speciallymade batchwill be exactlythe same eachtime.
There’salsoa prescriptioncombinationestrogen(esterifiedestrogens)andtestosterone (oral
methyltestosterone) pill thatmayhelpcombatandrogendeficiency.These pillshave neverbeen
formallyapprovedbythe FDA forsuch usages,andtheymay varygreatlyby potency.There isconflicting
evidence andopinioninthe medical communityconcerningwhetherornotthe benefitsof the
combinationof estrogenandtestosterone outweighthe risks,whichmayinclude increasedriskof
breastand endometrialcancer,adverse effectsonbloodcholesterol andlivertoxicity.
Informationfromthe Nurses’HealthStudyindicatedthatthe combinationof estrogenandandrogen
usedto treathypoandrogenismcouldincrease breastcancerrisk.However,otherstudiesindicated
androgensmaydecrease breastcancerrisk.Follow-upstudiesonthe Women’sHealthInitiative found
womenwhoreceivedestrogenandnoprogestogen showedasignificantdecreaseincardiovascular
disease (CVD) andbreastcancer.Thishascauseda reconsiderationof androgensaddedtoestrogens.
Still,the FDA requiresdemonstrationof CVDandbreastcancer safetyforany productcontaining
androgens orestrogenplusanandrogen;that has notbeendone.
8. Womenwithandrogendeficiencymaybenefitfromtreatmentwithdehydroepiandrosterone (DHEA),a
hormone producedbythe adrenal glands.DHEA isavailable over-the-counterwithoutaprescriptionin
the UnitedStatesand isnot FDA-regulated.Itmayimprove suchandrogen-deficiencyside effectsas
sexual dysfunction.However,while the hormone isavailableoverthe counter,itshouldnotbe taken
withoutmedical guidance.
The quantityand qualityof DHEA containedinavailable preparationsare notroutinelymonitoredor
testedforcontaminantsorconsistency.Therefore,it’simportantthatyourhealthcare professional
monitorbloodlevelsof DHEA,itsmetabolicproducts(estrogensandandrogens)andanyside effectsif
you’re takingthe hormone.
Since DHEA isconvertedtoestrogenandtestosterone inwomen,the levelsof these hormonesshould
alsobe measuredwhentakingDHEA.The resultsof studiesonthe benefitsof DHEA supplementationin
bothmenand womenwithandrogendeficiencyhave beenmixed.A recentreviewof studiesfoundno
convincingevidence forthe effectivenessof oral DHEA in treatingsymptomsof hypoandrogenismin
women.
Androgensupplementsare generallysafe atthe dosagesprescribedforwomen,butpossible sideeffects
include facial hairgrowth,deepeningof the voice,thinninghairandacne.
Noncosmeticside effectscan include fluidretention,livertoxicityandunfavorablechangesinyour
cholesterol levels,whichshouldbe monitoredperiodically.If theyoccur,side effectscanbe minimized
or eliminatedwithlowerandrogendosesandcan usuallybe reversedbydiscontinuingtherapy.Higher
dosescan cause deepeningof the voice orclitoral enlargement,whichmaybe irreversible.However,
thisisnot oftenseenindosesproperlyprescribedforwomen.Earlyside effects(thoseseeninthe first
90 days of treatment) usuallyincludeoilyskinormildacne.These affectsmaybe temporaryandgo
away ontheirown.If theyoccur, talk to yourhealthcare professional aboutdecreasingyourdose
before more seriousside effectsoccur.
Researchcontinuesontestosterone patches,skingelsandvaginal suppositoriesorcreamsthat could
raise androgenlevelsinwomen.Testosterone patchesforwomen,soldunderthe brandname Intrinsa,
have beenapprovedforuse inCanadaand Europe but notin the UnitedStates.These patcheshave
recentlybeenwithdrawnfromthose marketsforcommercial reasons,notmedical ones.A testosterone-
containingskingel,nasal sprayandvaginal suppositoriesare inclinical trialsorpendingFDA approval.
DHEA containingvaginal suppositoriesare alsobeinginvestigatedforvulvarandvaginal atrophy.
Androgensupplementsare notthe answerforeveryone withaslumpinglibidoandfatigue—particularly
if you have anysignsof androgenexcess,suchashirsutism, acne orthinninghair.Suchmedicationsare
alsoruledoutif youare pregnantor nursing.
As yourbodychanges,itis veryimportanttocommunicate withbothyourpartnerand yourhealthcare
professional.Tell bothaboutyoursymptomsandthe changesinyourbody.Your partner’ssupportcan
be helpful toease the stresscausedbysymptomsthataffectintimacy.Because everywomanisunique,
9. youand your healthcare professionalwillneedtoworktogethertodetermine whichtreatmentoption
bestmeetsyourmedical andpersonal needs.
Prevention
Researchersare still workingtocharacterize fullythe role of androgensinwomenandthe nature of
androgendisorders.Youcan,however,preventsome of the worstconsequencesof androgen-related
disorders.If youare hyperandrogenic,youmaybe at higherrisk forglucose intolerance,diabetesand
highcholesterol.Medicationtoreduce yourandrogenlevelscanreduce these risks,butyoumaywant
to talkto a healthcare professionalaboutmonitoringforthese conditionsandaboutlifestyle changes
(suchas dietand exercise) thatmighthelpreduce risk.
If you are hypoandrogenic,supplementingwithtestosteronemayhelppreventbone lossand
osteoporosisandmayprovide alifttoyour sex life andenergylevels.Rememberthatcommunicating
withyourpartner and healthcare professional aboutyoursymptomsisvital tomaintainingahealthy
lifestyle andsex life.
Andbe sure to tell yourpartneraboutthe treatmentsrecommendedbyyourhealthcare professional.
Beingopenaboutproblemsandtreatmentsisthe best waytomaintaina healthyrelationship.
Facts to Know
1. Mistakenlythoughtof asonlya male sex hormone,androgensare alsonatural tothe female
body,where theyare producedinthe ovaries,adrenal glandsandothertissues.
2. Testosterone isthe androgenyou’veprobablyalreadyheardabout.Othersinclude
dihydrotestosterone (DHT),androstenedioneanddehydroepiandrosterone (DHEA) andDHEA
sulfate (DHEA-S).
3. Androgensare partlyresponsible forthe growthspurtat pubertyandare believedtoregulate
the functionof manyorgans, includingthe reproductivetract,bone,kidneys,liverandmuscle.
4. Androgenshave beenreportedtoplaya keyrole ina woman’ssex drive,orlibido,cognitive
abilities,energylevel andsense of well-being.
5. Androgens,eitherdirectly orindirectlythroughconversiontoestrogen,affectbone cellsorthe
environmentsurroundingbone cells,leadingtobetterbone health.
6. Androgenproductiondropsasyouage.By the time you reachmenopause,ithasdropped50
percentor more fromits peakinyour 20s.
7. The onlytime a suddendrop-off inandrogenlevelsoccursisinwomenwhohave hadtheir
ovariessurgicallyremoved(abouthalf of all androgensare producedina woman’sadrenal
glandsand half inherovaries).
8. If you take an androgensupplement,watchoutfor“virilizing”side effects,suchasfacial hair
growth,thinninghaironyourheadand changesin yourvoice.If an androgendose istoohigh,it
can have adverse effectsonyourcholesterollevels.
9. The right oral contraceptive choice canreduce hyperandrogenicsymptoms,while the wrongone
can exacerbate them.The keycomponentisthe type of progestinincluded.Talktoyourhealth
10. care professionalaboutapill formulationwhose progestincomponentisdrospirenone,
desogestrelornorgestimate.
10. If you have symptomsof hyperandrogenism(hirsutism,acne and/orirregularperiods),seea
healthcare professional.If the symptomsstemfrompolycysticovarysyndrome,youcouldbe at
higherriskforheart disease anddiabetes.
Key Q&A
1.Why do women need androgens?
Androgenswere formerlythoughtof asthe “male sex hormones,”butnow we know thattheyhave an
importantrole inwomenaswell,eventhoughwomen’slevelsare muchlowerthanmen’s.Inwomen,
androgenshave more than200 cellularactions,includinghelpingmaintainahealthysex drive,
preventingfatigue andcontributingtoa woman’soverall senseof well-being.Theyalsopreventbone
lossand bone disease andplayarole inthe formationof estrogen.
2. What happens if my body does not produce enough androgens?
Your sex drive,orlibido,maydrop,andyou mayexperiencefatigueanda decline inyouroverall sense
of well-being.Lowandrogenlevelscanalsocontribute tobone lossandbone disease.
3. What happens if my body produces too much androgen?
Androgenlevelsinwomenpeakduringtheirtwenties.Thenadecline indailyproductionbeginsthat
continuesthroughoutawoman’slife.The onlytime asuddendrop-off inandrogenlevelsoccursisin
womenwhohave hadtheirovariesremoved(abouthalf of all androgensare producedinawoman’s
adrenal glandsandhalf inher ovaries).Bythe time awomanreachesmenopause,bloodandrogenlevels
are abouthalf of whattheywere at herpeak.
As yourandrogenlevelsriseabove the normal range,youmayexperience such“virilizing”effectsas
facial hairgrowth,androgenicalopecia(thinningof the hairon yourhead),acne and oilyskin.Inaddition
to these cosmeticeffects,if yourandrogenexcessisrelatedtopolycysticovarysyndrome (PCOS),you
may experience irregularperiodsthatindicate youare notovulating.HyperandrogenismorPCOScan
alsoput youat riskof heart disease,glucose intolerance anddiabetes.
4.Is medication available to treat hypoandrogenism?
Yes,oral methyltestosteroneisavailable incombinationwithesterifiedestrogensbyprescription.This
combinationisnotwithoutitsrisks,however,soif youare consideringthistreatment,discussthese
riskswithyourdoctor. Inaddition,DHEA,a hormone thatis convertedintobothestrogensand
androgens,isavailable withoutaprescriptioninthe UnitedStatesbutisnotFDA regulated.Therefore,
monitoringof serumestradiol andtestosteronelevelsandside effectsisessentialinanyone takingthis
hormone.Some compoundingpharmaciesmayalsobe able toprovide vulval creamsformore targeted
delivery.Remember,efficacyandsafetystudiesare lackinginnon-FDA regulatedproducts.
11. 5.What are the side effects of those medications?
If the dosage istoo high, youmayexperiencesymptomsof hyperandrogenism, suchasfacial hair
growth,acne or oilyskin,clitoral enlargementandsensitivityora deepeningof yourvoice.Androgen
supplementsmayalsonegativelyaffectcholesterol levels(thusincreasingyourrisk of heartdisease).If
younotice any side effects,tell yourhealthcare professional atonce.A lowerdose canusuallyresolve
side effects,andstoppingtakingitmayreverse themaltogether.
6.I clearly have the symptoms of hypoandrogenism, so why won’t my health care professional
prescribe supplements?
The symptomsof lowandrogenlevels—reducedlibidoandenergy,sense of malaise—mirrorthose of
manyother disorders.A healthcare professional shouldbe cautiousandrule outothercommon
problemsbefore consideringtestosterone replacement,particularlyif youare under40 andhave no
otherconditionthatwouldcause hypoandrogenism,suchasovarianfailure.A healthcare professional
may wantto explore yourhealthhistoryandtestforconditionslike hypothyroidismandirondeficiency.
7. Is medication available to hyperandrogenism?
Yes,a varietyof medicationsmayhelpreduce testosteroneorpreventitsconversionintoanactive
form.Theyinclude oral birthcontrol pills(withdrospirenone,desogestrelornorgestimate);
spironolactone (Aldactone orSpironol),adiuretic;andflutamide (Eulexin) andfinasteride(Propecia),
whichare usedinmento treatprostate growthand cancer and male patternbaldness.
8. What precautions should I take with those medications?
You shouldadhere toa birthcontrol regimenwithaddedvigilance if ahealthcare professional
prescribesanandrogen-inhibitingdrug.These medicationscancause birthdefectsif takenwhile
pregnant.Talkto a healthcare professional aboutotherpossibleside effects.See the oral
contraceptivestopiconthissite fora complete discussionof the side effectsof birthcontrol pills.
9. What is polycystic ovary syndrome (PCOS)?
Polycysticovarysyndrome isahyperandrogenicdisorder;it isdistinguishedbyirregularorabsent
periods,whichindicateawomanmaynot be ovulating.
For more informationvisitusourwebsite:http://www.healthinfi.com