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Category Archives: Hormone Replacement Therapy
Osteoarthritis is more common among women than men. Blame it on gender differences – Hindustan Times
Posted: June 27, 2017 at 5:45 am
Osteoarthritis a disease of joints is reported more among women than men. According to experts, fluid in the knee holds clues why women are more prone to it. They have found in the synovial fluid of this joint, clear differences in the messages cells are sending and receiving via tiny pieces of RNA, called microRNA, in males and females with the common and debilitating condition osteoarthritis.
The differences may help explain why the disease is more common in women as it points toward a more targeted way to diagnose and treat this wear and tear arthritis, said Dr. Sadanand Fulzele, bone biologist in the Department of Orthopaedic Surgery at the Medical College of Georgia at Augusta University. Osteoarthritis, which affects more than 30 million Americans, is fundamentally a destruction of the cartilage that provides padding between our bones. In the past, obesity has also been considered a factor.
Its a huge problem, says Dr. Monte Hunter, chair of the MCG Department of Orthopaedic Surgery and a co-author of the study in the journal Scientific Reports. Todays treatment addresses symptoms, like inflammation and pain, and the bottom line for some patients is knee replacement. Synovial fluid is known to provide clues about joint health, so MCG researchers decided to look at what messages cells in the region were sending and receiving by looking inside travelling compartments in the fluid called exosomes, says Fulzele, corresponding author.
Men are less impacted by osteoarthritis than women and estrogen is a key factor for that. (Shutterstock)
What we found is there is no change in the number of exosomes, but a change in the microRNA cargo they carry, Fulzele says. They isolated the mostly round exosomes in discarded human synovial fluid from patients with and without osteoarthritis. They found in the males that 69 microRNAs were significantly downregulated and 45 were upregulated. In females, however there were 91 downregulated versus 53 upregulated.
Females just seemed more impacted: In total, they had more than 70 biological processes altered compared to males who had closer to 50, the researchers report. Fulzele and Hunter suspect that the gender differences they found in exosome content helps explain gender differences in disease incidence and that estrogen was key to the differences.
Particularly in the females, they found microRNA that should be sending messages that are good for the joints, like promoting estrogen signaling and collagen-producing cells, turned off or otherwise altered. Lower estrogen levels, like those that occur following menopause, prompt production of more cells that destroy bone. In this environment, those bone-consuming cells also tend to live longer, which can result in a net bone loss. Conversely, reduced osteoarthritis risk is considered a benefit of hormone replacement therapy.
MCG researchers hypothesize that estrogen plays an important role in determining which microRNAs the exosomes contain. In fact, when they used aromatase inhibitors to reduce the availability of estrogen, they found a small lineup of microRNAs decreased in number. When they treated cartilage cells from healthy females with exosomes from males and females with osteoarthritis, significantly fewer healthy cartilage cells lived after exposure to the exosomes from patients with disease.
All cells excrete exosomes as one way to communicate. They carry cargo like protein, lipids as well as microRNA, which can impact the expression and actions of many different genes. In the case of the synovial fluid, Fulzele says the exosome source is likely cells in the synovial membrane that lines the joints and produces the fluid. Wear and tear that comes with aging, and can be accelerated and aggravated by injury, can inflame the membrane, which may alter the cargo in the exosomes and the messages they carry, Fulzele says.
Knee replacement becomes the endgame for patients whose dwindling cartilage can literally translate to one bone rubbing against another. People understand bone on bone when they hear that, Hunter says of the potentially excruciating and debilitating pain that may result. Early interventions include icing a swollen knee, taking anti-inflammatories and avoiding activities that are hard on the joints, says Hunter.
Treatment for osteoarthritis addresses symptoms like inflammation and pain. (Shutterstock)
They can also inject hyaluronic acid, the major component of synovial fluid, into the knee in an attempt to normalize the environment. Today, a diagnosis is made based on the joint pain and stiffness patients report, a physical exam and X-ray. Physicians also often examine the synovial fluid, Hunter says. When a knee is swollen and warm to the touch, they will extract some of the fluid to look for problems other than wear and tear, like an infection and/or uric acid crystals, Hunter says.
The crystals could be an indicator of gout, a type of arthritis that results from the bodys reaction to excessive levels of uric acid, which results from the breakdown of purines, chemicals found in meat, poultry and seafood. Hunter hopes that soon he and his colleagues will also examine exosomes in the fluid for indicators of that patients specific instigators of cartilage destruction. They then hope to devise a cocktail potentially a mix of microRNA inhibitors and joint health promoting microRNA mimics delivered in manmade exosomes that can be injected into the knee to target and help resolve the debilitating destruction. MCG researchers already are exploring ways to block the microRNAs that are causing destruction.
While osteoarthritis is considered normal wear and tear, its multifactorial, says Hunter, the Dr. Charles Goodrich Henry and Carolyn Howell Henry Distinguished Chair at MCG. There is a genetic component. Some of us have stronger cartilage than others. Some of us are made differently so the angle of our joints puts more pressure in some places.
Risk factors include injury, overuse, increasing age, obesity, a family history, as well as being female, according to the Centers for Disease Control and Prevention. Sports with repetitive high impact, like running and basketball, can increase the risk.
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Posted: June 26, 2017 at 10:48 am
Basically, my soul is like male, JakeZyrus told Oprah Winfrey in 2014, then identifying as a lesbian. But Im not going to go through that stage where I change everything.
Three years later in June 2017, Zyrus changed his name to Jake Zyrus online and officially came out as transgender. The change brought about massive support across the internet for the formerGlee star, as Zyrus joined the ranks of such transgender celebrities asJanet Mock, Ian Harvie, and Laverne Cox.
Of course, Zyrus isnt alone by any means. Trans celebrities are on the rise, and theyre more prominent thanever.
Thats because transgender representation is increasing in media, and there are plenty of trans actors, musicians, comedians, and entertainers out there making their work known. Other times, transgender people find themselves thrust into the spotlight thanks to their extraordinary stories. Take Chelsea Manning, Americas most controversial whistleblower in the nations history. Being a transgender woman most certainly changes the mainstream discussion on her actions and treatment in prison.
Of course, there are too many trans celebrities out there to list. But here are a few out, open, and proud activists you should know about.
Screengrab via Janet Mock/Instagram
Janet Mock is one of the most famous transgender women of color in media today.First enteringthe world of journalism as a staff editor for People magazine, in 2011 she came out as transgender for womens magazineMarie Claire.Mock has sincehosted the MSNBC interview series So POPular!, featuring such popular figures as Lena Dunham and Amber Rose. And shes also served as a producer and interviewerfor the HBO documentary The TransList, exploring the lives and times of popular trans celebrities.
As long as people are targeted because of their identities, our politics and our movement and our actions need to be just as targeted, Mock told Ellein an interview forThe Trans List.We need to be exacting about who is most vulnerable, who is not being served. Its the poor, the incarcerated, the condemned, the feminine, the trans, the queer. Its the uneducated. Thats what we need to center in our politics. And when we center our most vulnerable, we actually are a stronger society.
Alongside her work in entertainment media, Mock came into critical acclaim with her memoir,Redefining Realness:My Path to Womanhood, Identity, Love & So Much More.Released in 2014, Mocks book opens up about her transition as a transgender woman, her life struggles from a young age, and her growth into the person she is today. Redefining Realnessis considered a staple in trans non-fiction literature, showing how transgender writers can talk about their pasts in honest and thoughtful ways.
Screengrab via Jen Richards/Instagram
Jen Richards broke out into the spotlight with her 2016 webseriesHer Story, a romantic dramaexploring transgender womens romantic lives in a hostile and transphobicworld.But Richards has been working for years as a trans activist in entertainment, writing several editorials on trans representation in media, and hosting the Trans 100 project celebrating 100 influential trans figures in the community.
Most notably, Richards reached popular and critical acclaim asphysical therapist Juliette on CMTs series Nashville. In an interview with NewNowNext, Richards praised the shows writers, pointing out how her characters transgender history ishandled through subtle and layered dialogue that isnt too explicit. She believes that, through open and visible representation on TV, trans actors and actresses can change the publics perception of transgender women.
The first trans death of 2017 was a young, black trans woman in Mississippi. One of the ways we can combat things like H.B. 2 in North Carolina is by getting trans people on television, Richards told NewNowNext. That law is only possible by peoples projections of their own fears. They buy into this image of some burly predator who throws on a wig and says theyre a trans woman and can get access to a womens bathroom. Which is fiction for people like me, who have been invisible.
Screengrab via Laura Jane Grace/Instagram
Frontwoman for the band Against Me!, Laura Jane Grace has been making headlines for years as an out and open transgender punk rock musician.After initially comingout to her band and the public in 2012, Graces story sparked public awareness for trans rights in punk rock, with many musicians openly supporting Grace through her transitioning. Since then, Against Me! has released the studio album Transgender Dysphoria Blues, discussing the gender dysphoria and disassociation Grace felt with her body before coming out.
Years later, Grace has continued to work as an LGBTQ activist both inside and outside of the music industry.She also released a memoir in 2016, Tranny,exploring her coming out as largely inspired through her journal entries. In an interview withRolling Stone, Grace sheds light on her transitioning, calling it a process that changes and grows with the person undergoing gender transitioning.
This idea of what youre going to transition into or who youre going to be, thats not how youre going to end up, Grace told Rolling Stone. You dont know who that person youre going to transition into is. You just have to see.
Screengrab via Thomas Beatie/Instagram
American transgender activist Thomas Beatie shows that theres more than one way tobecome a father.Beatie hit national fame after a report for the Advocaterevealed that he had faced discrimination across the country for being a pregnant man. Doctors objected to having him as a patient, citing religious reasons, and Beaties prenatal care quickly became difficult. But as mainstream news outlets began covering Beaties story, his pregnancy gave rise to national and international interest in transgender parenthood, paving the way for a larger discussion on fatherhood and pregnancy for transgender men.
Beaties story has also introduced another important issuefor the trans community: transgender parental rights.
After Beatie and his former wife Nancy began divorce proceedings, Beaties relationship with his wife and his children created a national precedent for transgender child custody cases. Amessy and complicated proceeding with the Arizona court system followed, which repeatedly wavered on Beaties gender identity as well as his relationship with his children. By 2013, the courts refused toallow Beatie to separate from his wife, citingBeaties transgender status to claim that the marriage was actually a same-sex relationship. At the time, Arizona did not allow same-sex marriage, so ironically the judge ruled that Thomas Beatie was in a same-sex marriage and thus could not get a divorce for a marriage that the state did not recognize.
The ruling was riddled with transphobia. But in 2014, the Arizona Appeals Court ruled that the Beaties marriage was legitimate, andThomas Beatie and his ex-wife Nancy were allowed to finalize their divorce.Both Beatie and his ex- have equal custody rights. While trans activists still have a lot of work to do before transgender parenthood is widely respected across the U.S., Beatie opened up a legal precedent that legitimizes trans parenthood bytreating transgender fathers as legitimate parents.
Screengrab via Ian Harvie/Instagram
Transgendercomedian and actor Ian Harvie has starred in Amazons series Transparentas Dale for a while now,but Harvie has been performing stand-up since 2002. Touring with Margaret Cho and appearing in the LGBT talk show The Ian Harvie Show,Harvie has since featuredin shows from Roadtrip Nation to Young & Hungry.
Harvie is different from other standup comedians. Hes open about everything in his stand-up, from using restrooms to getting top surgery, from his sex life to being trans. As an out and open trans man, Harvie has worked as an activist for trans representation in entertainment for years, both in front of the camera and behind the scenes. He thinks that producers should employ more trans people to tell trans stories and that by including trans people in productions, transgender writers, actors, and editors can create better stories to share with the world.
I think that people are understanding that they must include trans people in the storytelling behind the camera, in front of the camera, in the writers room, producer, and all aspects because its passing through so many hands before the consumers actually see it and having us involved in the storytelling is gonna get the story right, Harvie said during an interview withthe Mary Sue. When you get the story right, it can be lifesaving so representation matters.
Screengrab via Caitlyn Jenner/Instagram
Highly controversial both inside and outside the trans community, Caitlyn Jenner is one of the most prominent transgender celebrities in the United States. Andfor many, her story features the first compassionate coverage ofgender transitioning in the American mainstream media.
Jenner first came out in2015, during an interview with Diane Sawyer on ABCs20/20.She revealed that, from a young age, she had dealt with gender dysphoria and identified as a woman. Back in the 90s, Jenner had experimented with her gender identity and even began hormone replacement therapy, but she stopped after her relationship with Kris Kardashian grew into marriage.
Since coming out, Caitlyn Jenner has constantly been in the public spotlight as a visible trans woman. And for many Americans, Jenner is also their first exposure to gender transitioning and transgender women.Vanity Fair ran a feature story on Jenner at the time, she received an ESPY award for her bravery, and activists (initially)turned to Caitlyn Jenner as a role model for the trans community. Jenner didnt bring trans issues into the mainstream, but her transitioning certainly cemented their presence.
Since then, Jenner has stirred some major disagreement among both LGBTQ Americans and outsiders. Transgender Americans have largely criticized Jenner for her Republican leanings, including hersupport for Ted Cruz and herbizarrely apathetic gay marriage statementon Ellen.More recently, Jenner received bipartisan scorn after joking about the Alexandria GOP shooting that left Rep. Steve Scalise in critical condition. But the LGBTQ community has cometo her support in multiple occasions, including defending Jenner after she was harassed in the United Kingdomover her gender identity.
America may remain mixed on Caitlyn Jenner, but when it comes to trans celebrities, shes out, proud, and isnt going away anytime soon.
Screengrab via Laverne Cox/Instagram
Laverne Cox may just be the most famous transgender actress in TV and film today, thanks in part to her role onOrange Is the New Black. Shes also the first openly transgender person to receive a Primetime Emmy nomination in history.
Cox stars as Sophia Burset inOrange Is the New Black,a transgender woman sent to prison for credit card fraud while attempting to fund her gender transitioning. For many viewers, Burset was the first sympathetic trans character ever seen on TV. Since then, Coxs career has grown, and shes starred in a variety of projects and series, from CBSsDoubt to Foxs remake ofThe Rocky Horror Picture Show.
Although most Americans recognize Cox through her appearance onOrange Is the New Black,Laverne Cox has been cast intoa variety of shows and movies since first appearing on the show, from Paul Weitzs comedy-drama film Grandma tothe upcoming drama film Freak Show.She also ran, produced, and starred in her own show, TRANSform Me, in which three transgender women give a cisgender woman a makeover.
With each new show, Cox has become a more visible openly transgender woman in media. And offset, Cox works on behalf of transgender women of color across the U.S., raising up trans voices and making room for visibility in a world where most trans people of color are looked at with disdain and scorn. By far, she is one of the most important trans women actresses in the world to date, along with one of the most important transgender activists of color.
Cox also agrees that transgender women should primarily play trans rolesbecause trans characters can help cisgender viewers build empathy for transgender women. My experience as a trans woman playing a trans character is that I have found that audiences not only have empathy for the character that I play but they find themselves having empathy for the actor who plays that character, Laverne Cox said. And I think theres a lot of evidence that this moment happening with me and Orange has created an enormous amount of social change. Right? I mean, like just look at the resume! The proof is there.
Screengrab via Chelsea Manning/Instagram
Easily one of the most internationally famoustransgender activists in the United States, Chelsea Manning rose to fame as a whistleblower that shed light onto civilian casualties amassed during the Iraq War. Imprisoned for years, her sentence was later commuted by President Obama, and she was released in May 2017. But during her years in military prison, Manning came out as a transgender woman and began working as an activist for trans rights for both incarcerated trans people as well as trans citizens across theU.S.
An interview with theNew York Times reveals the turbulent years Manning spent in prison, discovering her identity while fighting to stay alive in grueling and isolating conditions. She opened up about some of the struggles she experienced on hormone replacement therapy, including the emerging and conflicting emotions she felt as estrogen began giving her a wider range of feelings.
Id built all these defenses and walls around my emotions over the years, since being a teenager. When my testosterone levels plummeted, I suddenly became more vulnerable emotionally. I could no longer just hide my emotions: I had to deal with them, usually right there and then, Manning told the Times. Good ones, like confidence, and a sense of connection with my friends, mixed in with a lot of bad ones, like doubt, loneliness, uncertainty and loss.
Mannings activism not just gives hope to young trans people, but her story also sheds light onto some of the haunting experiences that transgender women face while incarcerated. And they look at Manning with hope for the future, showing how transgender womencan survive even the most oppressive conditions.
See more here:
Transgender celebrities – The Daily Dot
Posted: at 10:48 am
The Most Recent Advances in the Treatment of Erectile Dysfunction
Impotence is one of the most common forms of male s*xual dysfunction. In fact, one in every 10 men has a problem achieving and/or sustaining an erection at some point or another. If you have struggled with this yourself, its worth seeking out medical help. Due to advances in this area, there are multiple treatments available that you may find effective.
Counseling It is estimated that up to 90 percent of erectile problems have a psychological cause.
This encompasses everything from relationships difficulties to performance anxiety even more complex psychological issues. An experienced counselor or therapist can help. You can learn techniques to decrease your anxiety and stress that you may associate with s*x. Your partner may also learn how to help with these techniques.
Lifestyle Changes to Eliminate Underlying Causes Erectile dysfunction (ED) is linked to several lifestyle habits that you can modify. ED can be the motivation it may take for you to address these. These changes will reduce your health risks even if you opt for other forms of treatment.
Stop smoking. Smoking causes circulatory problems that affect the ability to achieve or sustain an erection. Reduce or stop drinking alcohol. Alcohol can impair your ability to have an erection. Increase your physical activity. Getting regular exercise keeps your circulatory system healthy, including your ability to have an erection. Vacuum Pump Treatments A vacuum pump is a plastic, cylindrical device that is placed over the man-hood. Sucking out air from the tube creates pressure that causes blood to be forced into the man-hood. A ring can then be applied temporarily to the base of the man-hood to stop the blood from draining away too quickly, thereby sustaining the erection. This may be a preferable treatment to using medications as there is no ongoing expense or risk of drug interactions.
Medication Treatments There are multiple medications that have been developed for the treatment of erectile dysfunction. The oral medications work by enhancing the effects of nitric oxide, allowing more blood flow into the man-hood. They require s*xual stimulation for you to have an erection.
Viagra (sildenafil) is one of the best-known medications for erectile dysfunction. It takes effect within an hour and usually lasts for three to four hours. Cialis (tadalafil) must be taken 30 minutes before s*xual activity. Levitra or Staxyn (vardenafil) must be taken from 10 minutes to one hour prior to s*xual activity. It can be effective for up to 12 hours. Stendra (avanafil) can be taken 15 minutes before s*xual activity. These medications produce an erection without requiring s*xual stimulation:
Muse (alprostadil) intraurethral therapy is a small pellet of a medication that is put directly into the urethra. The drug is then absorbed into the erectile tissue of the man-hood. It provides an erection within five to 10 minutes. Alprostadil or combination medication self-injections: You inject the medication directly into the shaft of the man-hood whenever you want to have s*x. The medication usually works within about 15 minutes.
Alternative medicine supplements are widely marketed but the FDA has issued warnings about herbal Viagra as they can contain potentially harmful drugs in unknown dosages. They are especially dangerous for men who take nitrates and shouldnt take the prescription oral medications for ED. Sometimes the supplements illegally contain the prescription medication and there can be a dangerous interaction.
Hormone Treatments Hormonal problems are rarely the cause of impotence, though some find hormone replacement therapy to be effective. Hormone replacement therapy to boost your levels of testosterone should only be pursued after undergoing tests to confirm a deficiency.
Penile Prosthesis Treatments You should not consider a penile prosthesis (implant) until other forms of treatment have been tried. There are two types of penile implants:
Semi-rigid man-hood implant: this implant keeps the man-hood rigid all the time. The man-hood can be bent downwards when youre not having s*x. Hydraulic man-hood implant: a pump is implanted into the scrotum. Surgical Treatments There are a number of surgical procedures that can be carried out if, for example, there are abnormalities in the blood flow in and out of your man-hood. If you are struggling with erectile dysfunction, there are many forms of treatment that can help. ED can signal that you have other health problems, so it is wise to get a checkup to assess your health. Discuss your options with your doctor to find the best treatment for your lifestyle.
Posted: at 4:42 am
Hormone therapy is an effective treatment for vasomotor symptoms and genitourinary syndrome due to menopause among certain women, according to recommendations from the North American Menopause Society (NAMS).
In an update of their 2012 Hormone Therapy Position Statement, NAMS suggested the benefits of hormone therapy, particularly for vasomotor symptoms, outweigh the risks among women under age 60, within a decade of the onset of menopause without other contraindications, who also have an increased risk of fracture or bone loss.
Current FDA-approved indications for hormone therapy include the treatment of vasomotor symptoms, prevention of bone loss, genitourinary symptoms, and premature hypoestrogenism caused by castration, hypogonadism, or primary ovarian insufficiency.
The 2017 position statement appears in Menopause: The Journal of The North American Menopause Society.
“There continues to be confusion and fear for women and their providers about the use of hormone therapy for menopausal women,” said JoAnn V. Pinkerton, MD, executive director of NAMS to MedPage Today. “The availability of new clinical trial data, observational studies, and analyses of large trials prompted NAMS to decide to update its position statement.”
Pinkerton, who is a co-author of the position statement, added that “New data includes updates on the large Women’s Health Initiative; new analyses focused on age and time since menopause; and new observational studies providing information about effect of hormone therapy during and after its use.”
An advisory panel of clinicians and researchers in the field reviewed the 2012 NAMS position statement on hormone therapy, and conducted an evidence-based analysis from a literature review.
They stated that the use of estrogen therapy in the right candidates should be administered in the lowest, effective dose that meets treatment goals for the patient and healthcare provider. Progestogen therapy among patients with a uterus should be considered in the context of the dosage of estrogen it is combined with, as well as its own potency.
The statement noted that prescribers should acknowledge “different types and doses of progestogens, routes of administration, and types of regimen (sequential or continuous-combined) may have different health outcomes.”
The group suggested there are notably higher risks with initiation of hormone therapy after a decade of the onset of menopause, or among women who are over the age of 60, citing an increased absolute risk for cardiovascular harms including stroke, coronary heart disease, venous thromboembolism, and dementia.
The statement also noted that for women who exclusively have genitourinary syndrome symptoms, such as urinary, vulvar, and vaginal-related symptoms alone, low-dose vaginal estrogen therapy, such as creams, rings, and tablets that contain estradiol or conjugated equine estrogens are considered “generally safe,” but should be more closely considered among women with breast cancer.
Patients who require longer durations of hormone therapy, such as to treat persistent vasomotor symptoms or continued bone loss, should determine the benefit-risk profile with her healthcare provider in addition to reassessment during treatment, the statement recommended.
The updated statement also noted there are differing benefit-risk profiles when it comes to various hormone therapy administration, such as whether the treatment is given orally, through transdermal patches, vaginal rings, or through sprays or gels. Duration of treatment, progestogen-accompaniment, and the age of the patient at treatment in relation to the onset of menopause are all important factors in regards to hormone therapy, Pinkerton highlighted.
However, the U.S. Preventive Services Task Force (USPSTF) recently released a draft recommendation statement, which recommended against combined estrogen and progestin treatment for postmenopausal women for the primary prevention of chronic conditions. Specifically, the disease-prevention benefits from hormone therapy, for chronic diseases such as diabetes and heart disease, were outweighed by the cardiovascular risks, according to the task force.
Additionally, the USPSTF recommended against use of estrogen therapy among postmenopausal women who have undergone a hysterectomy with the goal of prevention of chronic conditions (“D” recommendation), noting that “there is moderate or high certainty that the service has no net benefit or that the harms outweigh the benefits.”
This echoes NAMS’ findings regarding the increased absolute risk for certain populations. However, their updated position statement specifically assessed hormone therapy for symptomatic treatment for menopausal symptoms, not chronic disease prevention.
Despite the range of recommendations regarding hormone therapy, the NAMS updated position statement was endorsed by several medical organizations around the world, including the American Association of Clinical Endocrinologists.
Pinkerton told MedPage Today she hopes the updated position statement will take fear out of the conversations about hormone therapy for menopausal women.”
“Our goal is that this comprehensive review of hormone therapy by national and international experts will give women and providers confidence about using hormone therapy when it is indicated,” she said.
NAMS advisory panel members disclosed relevant relationships with Merck, Radius, Tarsa, Amgen, Eli Lilly, Mithra, Up ToDate, Allergan, Shionogi, TherapeuticsMD, Bayer, AMAG, Endoceutics, Novo Nordisk, Pfizer, Strategic Scientific Solutions, TherapeuticsMD, Hologic, New England Research Institutes, Pharmavite, and PulseNMore.
last updated 06.22.2017
Posted: at 4:42 am
AUGUSTA, Ga. (WJBF)-Augusta Pride Weekend 2017 has arrived.
This is the eighth annual pride celebration in Augusta, and this year, organizers are hoping between 12,000 and 15,000 people attend the weekend of celebration.
Alyssa Fredericks of Thomson came to Beats on Broad, the Friday night celebration at the common, with her girlfriend, andshe says she feels the CSRA is a pretty welcoming place for the LGBTQ community.
Its good to be out here with everybody, Fredericks said. Its like a community as one.
Even though its a party, some groups are taking advantage of the celebration to offer important health services, includingfree HIV testing.
We caught up with a volunteer from the Equality Clinic of Augusta, which is a free student-run clinic for uninsured and underinsured people.
A lot of our patients are from the LGBTQ population, said Matthew Luo, who is treasurer of the Equality Clinic of Augusta.
Luo says about 70 percent of their patients are transgender people seeking hormone replacement therapy. He says they are one of the only clinics in the region that provides that service to those in need.
We have people coming from Charleston, from Mississippi from like Kentuckyall over the Southeast to come, he said. They drive hours and hours to come to our clinic because were one of the only people that offers this service.
Its a reflection of what Augusta pride is trying to dooffering people in the CSRA and beyond a chance to be themselves.
Its about love, respect, tolerance, being able to live your most authentic life, said Augusta Pride President Lonzo Smith.
The pride parade kicks off on Broad Street at 10:30 a.m. Saturday.After that the pride festival will be at the Augusta Common till 5 p.m.
Posted: June 24, 2017 at 8:44 am
The risk of heart attack, stroke or breast cancer due to hormone replacement therapy has been overstated, and that has scared away some women who could benefit from it, the Society of Obstetricians and Gynaecologists of Canada said at its annual conference in Ottawa this week.
The SOGCsays HRT is not the scourge it was once considered to be.
“I do think that a generation of women were denied the opportunity to have better health,” said Dr. Robert Langer, who spoke at the conference.
For decades, HRT was the go-to treatment for women experiencing symptoms of menopause that can include night sweats, insomnia, depression, anxiety and hot flashes,and was even thought to have a protective effect against bone density loss and heart disease.
In 2002, however, the U.S. National Institutes of Health (NIH) prematurely ended a massive study involving thousands of women when it was discovered HRT failed to protect against heart disease andincreased the risk of heart disease as well as blood clots, stroke and breast cancer.
Shirley Weir, founder of the Menopause Chicks website, says most women dont have anyone to talk to about menopause (Shirley Weir/menopausechicks.com)
That finding “seemingly turned the world upside down,” said Langer, medical director of the Jackson Hole Center for Preventive Medicine anda lead investigatorin theoriginal NIH research.
The fear “spread like wildfire and turned the tides so that women stopped considering HRT even for symptom relief, which is the most important use of it and the reason that most women would start.”
Symptoms canstart five to 15 years (perimenopause) before a woman reachesmenopause, defined as the point at which she has gone without a menstrual period for a year.
“Women who are having disruptive symptoms of menopause, they do not need to be made fearful of making a decision that makes a huge improvement in quality of life,” said Dr. Jennifer Blake, CEO of the SOGC.
Blake said that before it was stopped,the NIH study found there was an increased risk for breast cancer in older women undergoing hormone therapy the average age of the subjectswas 63, long past the average age of menopause, which is around 51.
The study also confirmed that the risk was higher for women who were using the combination of estrogen and progesterone, and that treatment using estrogen alone actually lowered breast cancer risk.
“A relook at that data and a number of studies of younger women gives an even more interesting set of findings,” Blake said. For young women, the heart benefits of hormone therapy are “very real,” and the risk of breast cancer “remains a small number.”
‘Women who are having disruptive symptoms of menopause, they do not need to be made fearful of making a decision that makes a huge improvement in quality of life,’ said Dr. Jennifer Blake, CEO of the SOGC. (Courtesy Dr. Jennifer Blake)
The confusion about the safety of HRT came from misapplying the findings to younger women, and the fear that generated has persisted, Blake said. She said doctors themselves takehormones for menopause because”we are familiar with the whole body of knowledge.”
Langer called the study results “most inflammatory” and said, “It has taken us 15 years … to come back to where we were in 2002 and recognize that for younger women,this is an appropriate treatment. In fact, major societies in this field have now come around with revised recommendations.”
The NIH revised its guidance in 2013, saying hormone therapy is “not recommended for the prevention of chronic disease but may remain a reasonable option for the short-term management of menopausal symptoms for younger women.”
But not everyone is in full agreement.
The Canadian Cancer Society recommends that women “avoid taking HRT for any reason other than to relieve severe menopausal symptoms that have not responded to other treatment.”
Health Canada continues to warn of “significant risks” associated with the therapy on a webpage that hasn’t been updated since 2006.
Experts generally agree HRT can be beneficial in certain cases, with certain types of patients, and that it is generally safe if used judiciously.
“The pendulum … may have swung too far, because for some women in some circumstances it can be a very effective treatment,” said Dr. Danielle Martin, a family doctor at Women’s College Hospital in Toronto.
“What we need to have is the grown-up conversation about risks versus benefits, and we need to make that conversation personal and individual to each woman,” said Martin, the author of Better Now: Six Big Ideas to Improve Health Care for All Canadians.
The founder of the Menopause Chicks website said women have to arm themselves with information, ask questions and decide on the best course of action for themselves.
HRT can be a very effective treatment “for some women in some circumstances, says Dr. Danielle Martin, a family doctor at Womens College Hospital in Toronto. (Danielle Martin/6bigideas.com)
“I think it comes down to the fact that we have never been taught how to be our own best health advocates,” Shirley Weir said.
“Messages from the media, messages from advertisers…we kind of get convinced that there’s a magic-wand solution or a one-size-fits-all solution. The reality is that the future of health care is personalized: what’s right for me today at this age is not going to be what’s right for you.”
The bigger problem, Weir said, is that the majority of women she speaks to don’t have anyone to talk to about menopause.
“The first leap we need to make is to create a space where women can access information that is going to help them make the best decision for them.”
Posted: at 8:44 am
Brooke Baxa Photo: Human Rights Campaign, via YouTube.
The Human Rights Campaign has released a video highlighting the important role that Planned Parenthood plays in providing culturally competent health care to the LGBTQ community.
The video, which was launched Friday, is in response to a provision in the Senate version of a Republican-led health care reform effort that would prohibit Planned Parenthood from receiving Medicaid dollars. Because Senate Republicans plan on using reconciliation to pass the bill, the defunding of Planned Parenthood would only last one fiscal year, as opposed to a permanent ban. But the damage likely forcing several Planned Parenthood clinics to close would be done by the time the prohibition expired.
Brooke Baxa, a 22-year old non-binary transgender healthcare advocate, is featured in the video explaining how they were able to get medical treatment through Planned Parenthoods clinic in Denver, Colo. Baxa says they first met other transgender people living authentically through a Planned Parenthood youth conference, which aided them in coming out as transgender and non-binary.
In the fall of 2015, after seeking medical care from Planned Parenthood, Baxa began taking hormones, including testosterone, to help with their transition. Baxa also discovered that Planned Parenthood was well-versed in providing culturally competent health care to LGBTQ patients.
I grew up in rural Nebraska, and there isnt a lot of access to inclusive health care here, especially in regard to being LGBT. Theres not a lot of resources for us here, Baxa says. What I discovered from moving to Colorado and being a low-income person who needed healthcare, I was able to go to Planned Parenthood and receive care.
Because of provisions the Affordable Care Act allowing youth to stay on their parents plan until age 26, Baxa is still able to receive insurance coverage, which covers their hormone treatments. But Baxa remains passionate about ensuring that other LGBTQ people who are less fortunate are able to access medically necessary care.
For some, covering hormones and hormone replacement therapy is seen as a luxury. But for the vast majority of transgender patients, being on hormones and receiving that care is lifesaving, Baxa says. You shouldnt have to go bankrupt just to get the medication you need to be who you are.
The Human Rights Campaign and Planned Parenthood will be holding events on social media highlighting the symbiotic relationship between Planned Parenthood and the LGBTQ community, and encourage people to protest the defunding of Planned Parenthood. The organizations will also be alerting people to the dangers posed to the LGBTQ community and others by the repeal of the Affordable Care Act and the protections it provides in terms of access to coverage for medically necessary treatment.
David Stacy, HRCs director of government affairs, notes that the Affordable Care Act took significant steps to connect LGBTQ people, particularly those who are low-income, with health insurance coverage through the expansion of state Medicaid programs. Provisions in the ACA that prohibited discrimination against transgender people and barred insurance companies from denying coverage based on pre-existing conditions also helped significant numbers of LGBTQ people obtain access to health care reducing the disparities in coverage between the LGBTQ community and the broader public.
The rollback of the Medicaid expansion and the cuts to Medicaid that are in both the House and Senate bill would be absolutely devastating to people living with HIV, says Stacy, detailing the numerous ways that a repeal of the ACA would effect the LGBTQ community. The same goes for transgender people who are poorer than average because of discrimination and challenges in employment. So transgender peoples health continues to be a challenge, but the ACA has helped increase insurance coverage for those folks, and thats really critical.
Baxa says the transgender community is particularly concerned about the reduction of services that could result if Planned Parenthood loses out on Medicaid dollars, which could impact whether clinics offer hormone replacement therapy or other treatments, not to mention preventative care and family planning services that would also be endangered by such cuts.
With respect to the possibility of repealing the ACA, Baxa says getting treatments covered by insurance is always a concern, particularly for the trans community.
Even by todays standards, where we think that most of these treatments are covered by insurance, Ive seen, in the last few months, people trying to get gender-confirming surgeries and being denied coverage when they have the same insurance that someone was approved for less than a year ago, says Baxa.
As I look to the future and what my medical future looks like, it is always a concern that our coverage or our care in general is on the chopping block.
See HRCs video featuring Brooke Baxa below:
Posted: at 8:44 am
23 Jun 2017
Of all the diseases that afflict people in old age, people fear Alzheimers most. How can they protect themselves? A report from the National Academies of Science, Engineering, and Medicine (NASEM) acknowledges some possible steps, but stops short of issuing concrete recommendations. They base their report on a thorough review of the literature that finds modest but inconclusive evidence that cognitive training, blood pressure management, and regular physical activity prevent or delay cognitive decline. However, the data are still too weak to issue specific guidelines to the general public, wrote the committee of senior scientists led by Alan Leshner, CEO emeritus of the American Association for the Advancement of Science, and Story Landis, director emeritus of the National Institute of Neurological Disorders andStroke.
The evidence has not yet matured to the level that would support an assertive public health campaign, the authors wrote. However, the report does identify those interventions, supported by some evidence of benefit, that should be discussed with [people] who are actively seeking advice on steps they can take to maintain brain health as theyage.
Its a very balanced report that truly reflects the level of evidence currently available, said Edo Richard, Radboud University, Nijmegen, Netherlands, who did not contribute to the reportapartfrom presenting ata workshopthat helped inform it.We should always be open and honest with patients and the general public, so cannot tell people that by doing this they will prevent cognitive decline. We do notknow.
An NIH report in 2010 argued that there wasnt sufficient evidence to recommend any intervention to prevent cognitive decline or dementia (see May 2010 news). Since then, researchers have published more clinical trials, and have chipped away at the mechanisms underlying dementia pathology. In 2015, the National Institute on Aging commissioned the Agency for Healthcare Research & Quality (AHRQ) to review the latest evidence on prevention and write a reporton what they found. The NIA then asked the NASEM to put together a committee of experts to review the report and make recommendations for public health messaging and futureresearch.
Based on the AHRQ report, the NASEM committee highlights three areas where evidence is encouraging but inconclusive. The first is cognitive training, where a large, 10-year, randomized trial called ACTIVE (Advanced Cognitive Training for Independent and Vital Elderly) provided modest evidence that over time, an interactive intervention improved long-term cognitive function and helped people stay independent in their daily activities, provided they started out with normal cognition. No evidence yet suggests that training helps prevent or delay mild cognitive impairment or Alzheimers disease, theywrote.
Blood pressure control in midlife may also be helpful. Treating hypertension prevents stroke and cardiovascular diseaseboth risk factors for ADand a majority of dementia patients have some sign of these. Though clinical trial results disagree, prospective cohort studies and understanding of the cerebrovascular contribution to disease mechanisms suggest that controlling blood pressure could be protective. These authors deem this enough evidence to suggest careful management of blood pressure as a way to prevent, slow, or delayAlzheimers.
Lastly, they point to exercise as a possible protective factor. Many, but not all, clinical trials suggest it can reduce age-related cognitive decline. Positive trials take added support from prospective cohort studies and known biological mechanisms underpinningAlzheimers.
Leshner and colleagues suggest this information be featured on the NIH website and other publicly accessible outlets. That way, it can inform people who are interested in bettering their chances of healthy brain aging. They also support clinicians working cognitive benefits into their patient conversations when they prescribe these interventions for other conditions. Even so, the evidence remains too weak to warrant a broad-based public health campaign, the authors said. Richard brought up the added argument that since many of these studies, particularly the randomized controlledtrials, sample from selected populations, its questionable whether their results would generalize to the public atlarge.
How can researchers build a stronger case for prevention? More and better-quality randomized controlled trials, the committee wrote. Consistent results in those would increase their confidence. They recommend that the National Institutes of Health invest more money in this type of research. They also urge researchers to compare different types of cognitive training, blood pressure therapy, and exercise, to see which are most effective. In addition, studies must include more diverse racial, ethnic, and socioeconomic groups; studies should start when people are younger and follow them longer. Incorporating biomarkers could greatly improve these trials, they wrote. Recruiting people at higher risk for decline is also important, as is harmonizing cognitive outcomes across studies so scientists can poolresults.
Aside from the three interventions recommended in this report, the authors suggest scientists conduct randomized controlled trials on additional interventions that are supported by either observational and risk-factor studies or that make sense biologically. Possibilities include new anti-dementia, diabetes, depression, or lipid-lowering treatments; sleep and social-engagement interventions; and vitamin B12 plus folic acid supplements. The authors call out hormone replacement therapy, vitamin E, and gingko biloba as having no evidence ofbenefit.
The report can be download for free, though email registration is required.Gwyneth DickeyZakaib
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Preventing Dementia: Getting Closer to Recommendations – Alzforum