Archive for the ‘Hormone Clinic’ Category

Twelve papers were included for analysis. All passed the CASP checklist (summary provided in supplementary table 1). Qualitative studies ranged from open, unstructured and semi structured interviews with 1660 participants. Six studies recruited women from community, and six recruited from attendance to clinical consultation (Table2). All studies used a described method of qualitative analysis, such as thematic coding (Table3).

We identified three key themes across all papers in the context of barriers to women accessing care for abnormal or heavy menstrual bleeding.

Health literacy is the ability to interpret, maintain, understand and use health information to make informative health decisions and follow treatment instructions.

Half of the included studies identified general health literacy as a barrier to accessing care for AUB [12, 15, 19, 21,22,23]. One American study in 2010 noted the variability in 71 women in the perception of heavy and irregular bleeding [19]. Women described heavy bleeding by the number of pads used, the quality of the bleeding, and the length of bleeding [19]. The perception of blood loss was also described to be affected by the types of sanitary protection used [12]. Women found identification of normal challenging, and if experienced for long enough, heavy or excessive bleeding became normalised and did not warrant the trouble of medical investigation. This was true in the Chicago study where the most commonly cited reason for delayed fibroid diagnosis was the perception that heavy bleeding was normal [21]. A United Kingdom study of 21 women found that explanations of heavy bleeding were varied, including the appearance of blood and how it felt. In this study, women commented how it was difficult to describe experiences, particularly to someone who did not have similar feelings [13]. Only four women in this study had open discussions about periods with family or friends. In another study, even though women described discussing the menstrual experience with others, heaviness of blood loss was not often brought up [17].

A study of Pasifika womens knowledge and awareness of gynaecological cancer in New Zealand found that there was a need for culturally appropriate, easily accessible and correct information [23]. Many women in this study had never heard of the term gynaecology as there is no literal Tongan or Samoan translation of the word [23]. Women were aware of gynaecological cancers through personal experiences and relatives or friends that were diagnosed. This is re-iterated in another New Zealand study in womens experiences with gynaecological support services where women expressed need for appropriate and timely information [18], and a United Kingdom study where half of the women who were diagnosed with uterine fibroids had never previously heard of the condition and expressed frustration they that lacked this knowledge [21].

Some women who developed their understanding of gynaecological conditions from family often had a confused interpretation of their symptoms. For example, in a United Kingdom study [20], many women believed gynaecological cancer symptoms such as abdominal size and irregular periods were due to factors such as diet, and managed themselves through avoiding certain foods:

Id probably try and sort myself out first with eating and say right, thats enough of dairy

In the same study, one woman disclosed that twins ran in her family, and that her heaviness and period pain was caused by release of two eggs during ovulation:

My nan reckons that a double egg comes from one side thats why I have been told that I get those pains [20].

In a study of women previously diagnosed and treated for endometrial cancer [22], general uterine health and Pap smears were confused. Many women were upset that their routine cervical smear did not pick up EC:

It disappointed me as long as you go for a smear test your fine [22]

This was echoed in a UK study, where eight of eleven women had considered AUB as a risk of cancer, but reassured themselves that a normal smear meant this was not the cause [13]. Whilst most women were aware of the need for routine Pap smears, confusion meant that women did not receive or perceive the correct information.

Gynaecological health has historically remained a taboo subject, yet this stigmatisation has meant that many women today are not able to openly talk about issues such as menstruation. This has resulted in many women normalising symptoms or suffering in silence.

Women may seek advice from friends to find reasons for normalisation and/or because they feel embarrassed or ashamed. For example, one woman noted:

I couldnt talk to my mum because straight away shed say to me you have to go to the hospital [22]

Years of experience with menstrual cycles meant that for some women, change in vaginal discharge or spotting was no cause for alarm, especially when these symptoms varied from day to day. Over half of women with uterine fibroids minimised symptoms, by suck (ing) it up and dealing with it [21]. Some women attributed their heavy periods to natural events, and assumed they were unlucky in having bad flow [13]:

Theres not a lot of point in reading or listening to anything, because it cant be changed [13]

Women seemed to prioritise uterine/vaginal health lower than most other health issues, and ignored significant changes:

After I got out of bed the next morning it had eased off [22].

It doesnt happen the next day so you get on with your life [22]

Women were worried to seek medical consultation as they thought they would be wasting their time:

You tend to think you are wasting their time. You are not too sure whether it is happening to everybody [12]

For those with excessive heavy bleeding, social embarrassment is a major determinant for discussing these issues, as many women provided examples of staining their clothes in public [19]. These experiences resulted in fear of social activities and avoidance of situations in which they felt stranded. For some, fear of leakage due to irregular timing and difficulties of management was a factor for women seeking seek consultation, particularly if these were increasing (which also shows how much women tolerated before they would seek help) [16, 20]. Yet for others, this held them back from seeking care:

I cancelled my doctors appointments for that reason, cause I bleed through everything. Im afraid of sitting there and going through my clothes [19]

For women who identify as Pasifika, embarrassment of revealing private parts during medical investigation was a big deterrent [23]. Many women felt uncomfortable with showing personal body parts, and find gynaecological examinations (pelvic exam) painful and scary:

I dont even like seeing myself thats a huge barrier as to why I find it tricky accessing the doctor for smears or gynaecology troubles [23]

you know they may perform a test that hurts are very scary-if I can avoid it, I do [23]

Primary health care providers such as General Practitioners (GPs) are often the first medical point of contact for women with AUB. Therefore GPs have an important responsibility to take a thorough history and listen to all concerns to provide coordinated care with specialists when needed.

Most studies highlighted communication with health professionals as a key barrier to AUB investigation. Firstly, a regular or long term health care provider were viewed as preferential as these doctors know medical and family history [15, 22, 23]. Having an established and trusting relationship with a GP was found to be a positive facilitating factor for all women:

I have been with my GP for years and he knows what has happened to me I just trust him [23]

Many women felt they could not speak to a male doctor about anything related to uterine health, and almost all women preferred to see a female doctor [20, 22, 23].

Surprisingly, eight of the 12 studies all identified normalisation and dismissal of womens concerns by the health practitioner as an important barrier to accessing appropriate care [12,13,14,15, 17, 20,21,22] and was an issue that ran through studies from 1999 to 2017. In interviews with women 612months post endometrial cancer surgery, a participant noted her symptoms were brushed off as a cause of menopause [22]. This attitude lead to women feeling reluctant to complain about symptoms, and didnt want to bother GPs about their problems [17, 20]. In another, a womans period pain was dismissed, leading her to question the genuineness of her own experiences [14]. Women felt dissatisfied when doctors did not ask about how it was affecting their lives, their problem had not been given a name or had been explained vaguely, and felt that consultation had achieved little [13]. One woman found she had to fight for treatment as her prolonged and heavy bleeding was impacting her relationship with her husband:

The woman [doctor] said these are things women have to put up with. I dont think so. I wont sacrifice my sex life [16].

Two qualitative studies which were filtered in the selection criteria for this review were based on the perspective of health care providers. Supporting the challenges described, an American study found that of 417 GPs surveyed, 87% self-reported that they always ask a quality of life question (in relation to AUB) however only 17.5% ask a mood associated question. Only 18% of GPs thought that asking about quality of life was essential in evaluating women with AUB [25]. A United Kingdom study found that even GPs had difficulty in describing normal periods. Female GPs reported that they were likely to ask details such as how many pads or tampons were used during a patients cycle. However, male GPs were less likely to go into this detail [26].

Incorrect diagnosis or inappropriate treatment was also described by women. In one study [16], several women had been prescribed norethisterone, and oral hormone treatment for their symptoms. At the time of the study (2006) GPs were advised not to prescribe this drug as it had been shown to not be effective at reducing blood loss. Worryingly, in two other studies of gynaecological cancer, many participants were given clinically irrelevant treatment following initial consultation for AUB:

I went back and forth the doctors gave me tablets, nothing still wouldnt stop [22]

Youre just being silly, youre being paranoid [15]

My GP said I had an infection [15]

The doctor at the emergency said I had gastro [15]

The use of medical jargon by gynaecological specialists was noted in a number of studies, which left women feeling lost and fearful [15, 18, 22].

Logistics of attending appointments were often noted as barriers to seeking care, for example, long wait times, availability of doctors, and the demand of family, work and social commitments.

(GP) you ring now, you get an appointment in 3 weeks [22]

It would have to be easier to get an appointment with the GP. It really is that, that is such a bloody drama. [20]

I went to one she had a baby there was another doctor, then she left the clinic as well, then Ive got doctor L. Now hes only in every Wednesday [15]

It keeps moving down the list of priorities coz something else takes precedence. [20]

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Barriers to seeking consultation for abnormal uterine bleeding: systematic review of qualitative research - BMC Blogs Network

J.K. Rowling, author of the beloved "Harry Potter" series, published a lengthy blog post on her website this week, attempting to explain her controversial tweets about transgender women.

The author has been widely criticized for a history of making transphobic comments, including most recently writing on Twitter that trans activism was harming women, and reiterating her rejection of the existence of non-binary and intersex people.

Rowling said in her post that one of the reasons she's taken such positions is that she's "concerned about the huge explosion in young women wishing to transition," as well as the growing number who she says seem to be detransitioning, or returning to the sex they were assigned at birth.

They do so, Rowling wrote, "because they regret taking steps that have, in some cases, altered their bodies irrevocably, and taken away their fertility."

She added: "Some say they decided to transition after realizing they were same-sex attracted, and that transitioning was partly driven by homophobia, either in society or in their families."

Rowling also said that 10 years ago most people who wanted to transition were assigned male at birth, but now the UK "has experienced a 4,400% increase in girls being referred for transitioning treatment," adding that autistic girls are "hugely overrepresented."

Rowling's claims are not only unsupported by data, but perpetuate dangerous myths about trans people that can inhibit their access to life-saving care.

Demographers don't know exactly how many transgender people there are or how that number has changed, since there are a range of terms to describe transgender identities and population-based surveys have historically not asked about trans identities.

Rowling's 4,400% increase reference seems to come from a report finding that 40 people assigned female at birth in the UK sought gender treatment between 2009 and 2010, while 1,806 did between 2017 and 2018.

Polly Carmichael, a psychologist who heads The Tavistock and Portman mental health clinic's gender identity service (which was the only trans affirming service in the UK in 2016), told NBC that while she is seeing large increase in the number of patients in need of gender-affirming care, this is likely due to an increase in visibility for trans services and gender varience rather than a "trend."

"Young people experiencing gender dysphoria is a real phenomenon," Carmichael said. "It can be incredibly isolating. If you don't feel you belong in a particular category that you've been assigned to. Many adolescents do become very distressed and self-harm."

Rowling's assertion that being a trans boy or man is suddenly more common than being a trans girl or woman is also questionable. In fact, one 2019 survey from the UK government found 3.5% of the population were trans women (women who were assigned male at birth) while 2.9% were trans men (men who'd been assigned female at birth).

In this Aug. 23, 2007 file photo, a sign marks the entrance to a gender neutral restroom at the University of Vermont in Burlington, Vt. AP Photo/Toby Talbot, File

While more people who were assigned female at birth have transitioned in recent years, that's likely because gender-affirming treatments such as hormone replacement therapy (HRT) and surgeries weren't that accessible to transgender people until recently.

Insurance companies refused to cover gender-affirming care for decades and many primary-care physicians were unwilling to provide HRT, a medication also prescribed for menopause, to transgender and nonbinary patients because medical guidelines had not changed to include them.

It wasn't until 2017 that "gender identity disorder" was decategorized as a mental disorder in the American Psychiatric Association's Diagnostic and Statistical Manual of Mental Disorders. In fact the World Health Organization removed "transsexualism" from the International Classification of Diseases only in 2018 a move that, the WHO said, would allow for better "access to necessary health interventions."

Many trans people simply have more access.

While detransitioning does happen, it's very rare, with one analysis showing that less than a percent of 3,398 trans people said they'd experienced transitioned-related regret, or had detransitioned.

And contrary to Rowling's assertion that detransitioning means the person regretted transitioning, "the most common reason for detransition is the person couldn't cope with the family and community support they lost and the experiences of transphobia," according to the UK organization Stonewall.

Others may be unable to find a job or housing, or no longer identify the gender they transitioned to feel more valid in.

Research actually shows any feelings of regret are typically related to unsatisfactory surgical results.

Getty/Angela Weiss

These fears about detransitioning can be dangerous because they invalidate the gender identities of young trans people and make it more difficult to obtain access to care.

Across the United States, state representatives are attempting to pass legislation that would go against medical guidelines and ban doctors from providing gender-affirming treatments to transgender youth. Their arguments are based on the same logic of Rowling's assertion that transgender youth are simply going through a phase they will grow out of.

Studies have debunked this idea and shown children as young as four develop their gender in the same ways as their cisgender peers.

In a study released in 2019, researchers found no significant differences between the trans and cis kids' gender development, or how they grew to understand and formulate their gender.The findings also revealed that transgender children gravitate toward the same gendered toys, clothing items, and friends as cisgender participants, regardless of how long they had been socially transitioned.

"Gender-affirming health care saves lives," Shawn Meerkamper and Dale Melchert, senior staff attorney and staff attorney for the Transgender Law Center, told Insider for a previous story.

Frank Franklin II/Associated Press

In her essay, Rowling made the point that the gender dysphoria when a person feels as if their body doesn't match their gender identity that many young trans people are feeling is a "social contagion."

She cited a 2018 study from Brown University that argued the "rapid-onset gender dysphoria" (ROGD), typically for those assigned female at birth, came out of social pressures from peers rather than genuine feelings of being transgender.

This study has since been cited by media outlets and gender-critical feminists as an argument against transgender youth receiving gender-affirming care. Like Rowling, people have used this research to make the argument that being trans is a trend.

However, another recent study from Brown University debunked the claim that ROGD exists.

Arjee Restar, a transgender researcher at Brown, wrote a critique of the study that found themethodology including surveying parents of trans teens who had read anti-trans websites is flawed and pathologizes trans people.

PLOS One, the journal the 2018 study appeared in, published a revised version that said the data was based on observations of parents rather than data from the trans teens themselves. If a parent does not see their child's gender identity as valid, they are likely more susceptible to cite ROGD as the reason their child has started to openly identify as trans.

Restar told BuzzFeed News that the corrected version of the study was still flawed and "below scientific standards."

"It's important to use methods and terminologies that don't further stigmatize an already disenfranchised community," Restar said.

Read More:

Trans 'Harry Potter' fans say they are devastated by JK Rowling's transphobia but some say it's a distraction from the violence against trans Black people

'Transgender women are women': Daniel Radcliffe rebukes J.K. Rowling's comments and apologizes to 'Harry Potter' readers if their experience of the books is now tarnished

People are sharing hormones on Google Docs and turning to 'grey market' pharmacies to get gender-affirming care during the pandemic

Link:
JK Rowling falsely claims an 'explosion' of girls have de-transitioned - Insider - INSIDER

Many companies push testosterone-boosting supplements, but experts say theyre helpful only for certain conditions.

The popular ad features graying men whose female partners gaze longingly at them.

They proclaim: "Men: Feel younger and stronger," "Boost performance" and "Have sex again!"

The ads promote pills, creams and injections, and guide those yearning for their youth to clinics that can offer life-changing results.

Critics say the testosterone replacement therapy industry relies on aggressive marketing, touts some dubious claims and targets men who lack real medical needs.

Gahannas Low T Center has heard the good and the bad, and staff members must help new patients overcome objections and myths. Many customers are drawn in by ego and societys view of male virility.

"One of the main things that keeps guys from coming in is that they may think its like a hit to their man card," said Kortney Doss, a nurse at the Gahanna clinic.

The clinic and its sister location in Dublin each serves about 100 men daily, providing their weekly testosterone injections. The coronavirus pandemic has cut the visits in half, said Doss.

Its customers who continue coming, even during a health emergency, that clinics say are proof of the treatments effectiveness.

The same is true at Restorative Health in Dublin, which has as many as 900 regular patients many of them women, said Don Hale, the companys business consultant and spokesman.

Whether treating men or women, the marketing is driven by the male role in relationships, he said.

"A man will do anything to get and maintain an erection," he said. "I think it comes down to a mans ego."

A clinic typically performs a full physical, blood analysis and consultation at the first visit.

Even though testosterone is a natural hormone in both men and women, it can decline 1% per year after age 30 in men.

That "low normal" is not enough alone to prescribe testosterone, said Dr. Robert Murden, a geriatric specialist at Ohio State Universitys Wexner Medical Center.

Among his many patients, only six are doing TRT due to hypogonadism, an abnormally low hormone level, resulting in either low libido, erectile dysfunction, or loss of facial or body hair.

"Its specifically not recommended for people who are just tired. You shouldnt just try it. You dont give these things, with downsides, without clinical indications."

The risks include elevated red blood cell count, elevation in estrogen, acne or other skin reactions, testicular atrophy, and cardiovascular or liver complications.

Testosterone levels below 300 nanograms per deciliter put you in Low T territory, said Dr. Gregory Lowe, an OhioHealth urologist. That might cause fatigue, lack of sexual desire, worsening erections, issues with concentration and memory, or diminished recovery from workouts.

Some men come to him after seeing the ads.

"The main thing I hear from guys is to be able to put on muscle in the weight room and to be 18 again in the bedroom," he said.

But not all symptoms are caused by low testosterone. Lowe said they might instead be remedied by exercise, stress reduction, more sleep or improved diet.

"I always want my patients to be very critical of the therapy were providing, to tell me how it is helping," he said.

Lowe said he has no major complaints with private clinics where testosterone treatments include gels, patches or pellets injected in the buttocks to release the hormone slowly.

Dr. John Oliver DeLancey, an assistant professor of urology at Wexner Medical Center, said patients should first check with their primary care physicians before seeking treatment elsewhere.

"Testosterone replacement therapy gets sort of a bad rap for being overused and without appropriate testing and monitoring," he said.

"As long as you follow appropriate guidelines and put thoughtful care into why you are doing so and for the right reasons, it can be very safe and effective," DeLancey said.

Asked whether slowing down, and some of these changes, might not be just a normal part of aging, Hale, of Restorative Health, responded: "Is it normal to lose your teeth or hearing when you age, and do nothing about it?

"If so, I dont want to be normal."

Thirteen years ago, he and his wife, then both 57, began testosterone treatments and havent stopped.

"Weve been on a honeymoon ever since," Hale said.

The cost of treatment at the Dublin clinic is $3,950 per year for men and $2,950 for women. Some insurance plans reimburse up to half of that, whats considered routine blood work.

Dee Miller, a standout wide receiver for the Ohio State University football team (1994-98), said he was lethargic, overweight and often stressed out before beginning treatments in 2016.

"My wife even thought I was cheating on her" due to his lack of energy and romance, he recalled, laughing.

Since then, he said, "I feel mentally better. As for your libido, most honestly, yes."

An insurance agent, Miller is a paid endorser of Low T Center.

The treatments, he said, "are hitting all three facets: physical, emotional and socially."

dnarciso@dispatch.com

@DeanNarciso

The rest is here:
Ego might drive men to testosterone therapy, but it helps with certain conditions - The Columbus Dispatch

COVID-19 has been a really exhausting time for all Australians and people across the world. Particularly for those worrying about general health and limited or changed hours for medical services for anything other than directly COVID related medical issues.

These concerns are compounded within the transgender community.These patients require specialist one on one care required for their hormone replacement treatment, mental health and blood tests. All of which must be monitored regularly to ensure hormone levels are within the desired range.

These are requirements not just to ensure everything is going okay, not just for the doctor, but for the Australian government. As these prescription only medications are strictly controlled and monitored.

The Star Observer spoke with a number of members from the transgender community about their experience with medical services during this time.

Oestrogen which comes in three forms; oral pills, gel sachets and patches to put on the individuals skin.

Trans woman Jenny Doll, who relies on the oral pills for her transition, said, Due to COVID I couldnt get an appointment with the GP and it was cancelled twice. I started looking for another GP where I can get my hormones. One doctor in Burwood, NSW totally rejected me as soon as I said I am a trans woman. His opinion was to wait for my appointment with my regular specialist. I am on blood pressure medication so I also requested this GP to check my blood pressure and he suggested I can go to a chemist for that.

I am so shocked with this GP behaviour during a pandemic. But my main aim was to find my hormones scripts. I had reduced my dosage into half already so I dont run out completely. Then after two weeks I got hold of my specialist GP and asked for my scripts. She sent me an email and I didnt know it wouldnt be acceptable in the chemist. I went to at least Six chemists to get my medication for HRT. It was so shocking that the doctor didnt tell us that the email copy wont be accepted. Later I asked for another physical appointment with the same specialist later in mid-May. I was so depressed without my HRT medication.

Finn who is a trans man said, I have severe anxiety, and normally having to leave the house for an appointment or something is really a way of helping me deal with it. Since COVID, I havent had that, and that has meant I havent engaged with my trans-related medical care. The less I leave the house, the less I want to leave the house. This has meant that I am actually late for my testosterone shot, which makes me feel worse, and the cycle continues.

When I realised my mental health was affecting getting my T-shot, that was really upsetting. I felt worse, which made me want to leave the house less, and so on.

Non-binary person Olly Lawrence said, I only go to LGBTQI specific clinics like Northside. They have been booked out for weeks in advance recently which makes seeing my doctor difficult. I have a current script for Primoteston but as of April its again out of stock in pharmacies across the state. To get a new script for Reandron would mean being referred to a new Endocrinologist and having multiple appointments with my GP which arent easily available right now. Ive also had my six-month follow up for top surgery postponed for an indeterminate amount of time and havent been able to see my surgeon about revisions.

Its really frustrating and makes me feel rather helpless. My biggest concern is menstruation returning if Im off testosterone for a long period, as that would stir up my dysphoria and mental illnesses.

Another person from the community, Zoe Anne who is a trans woman, was meant to have voice feminisation surgery in April, which was put off indefinitely, meaning she will not be able to have this surgery.

My voice is a massive source of dysphoria for me and Ive been on the waiting list for this surgery since August 2019. I cried a lot. The downtime of isolation would have been the perfect recovery time too.

From speaking with these members of the community is seems that the biggest toll that this pandemic is having on the trans and non-binary community is the mental health and the lack of access to hormones administration or even access to the hormones in the first place.

Thorne Harbour Healthsupports the LGBTQI community to make sure everyone who fits under the acronym are treated with nothing but dignity and to have them participate in-full within society.

Services that are run by Thorn Harbour Healthcare include; Equinox, PRONTO! and The Centre Clinic.

Peter Locke from Thorne Harbour Health commented, Equinox has been able to continue providing nursing support for hormone injections and patients have access to tele health appointments where the doctors provide scripts, pathology requests and referrals as usual. However, there has been considerable concern in the community that these services are no longer available.

In general there is a shortage of transgender and non-binary affirmative medical services in Victoria, a situation that is being addressed by Thorne Harbour Healths participation in the Victorian Government funded The Trans and Gender Diverse in Community Health consortia. Thorne Harbour Health has developed an excellent clinician training and support package that is free for any Victorian based GP, nurse, or allied health professional to access. Unfortunately, due to physical distancing restrictions, the Equinox GP observation aspect of this package has been temporarily paused. However, the other training services remain available via video link platforms. We look forward to having GPs visit and observe our practice again when physical distancing restrictions are lifted and it is safe to do so.

We would like to be able to offer telehealth appointments into the future, however this all depends on ongoing MBS funding. At this time, it is expected that telehealth bulk billing item numbers will end at the end of September. If these benefits arent extended beyond this time, we will be unable to offer bulk billed telehealth services.

See more here:
COVID-19 Meant My Transition Needs Were Put On Hold! - Star Observer

"I know that I am making the right decision because whenever I think about changing my gender role, I am flooded with feelings of relief."

By: Ben Barres

Shortly before Ben Barres death in December 2017, the pioneering neuroscientist sent his friend Nancy Hopkins a heartbreaking email in which he told her hed been diagnosed with advanced metastatic pancreatic cancer and probably only had a few months left to live.

Barres, who was known as much for his advocacy for gender equality in science as for his groundbreaking work on glial cells, the unsung heroes of the brain, spent his final months writing The Autobiography of a Transgender Scientist, which was posthumously published in 2018. In the excerpt featured below, Barres candidly describes making the transition from female to male in the late 1990s and shares a coming-out letter he wrote to friends and colleagues. This has been a difficult decision because I risk losing everything of importance to me: my reputation, my career, my friends and even my family, he tells them. I know that I am making the right decision because whenever I think about changing my gender role, I am flooded with feelings of relief.

After about four years at Stanford, I was promoted to associate professor with tenure. One morning, I was reading a local newspaper, the San Francisco Chronicle, and came across and read with astonishment a four-page article about Jamison Green, a female to male transgender person and transgender rights activist. He was one of few openly transgender people at the time. In the article, Green described in detail his personal experiences with gender identity and to my surprise they mirrored my own very closely. This was the first time that I understood that there were others who had the same gender identity discordance that I had. It was also the first time that I had heard the word transgender.

The article mentioned the clinic of Don Laub, a Stanford plastic surgeon who was a Bay Area pioneer in helping transgender people. As I started to read more about other transgender people, I realized that I was likely transgender. I made an appointment to be evaluated at his clinic. It was the first time I was able to discuss my gender confusion with anyone. I met with Dr. Laub, as well as with an experienced psychologist who had worked with him for many years. The clinic concluded that I was transgender and offered to help me to transition from female to male.

At that time, transsexuality was still listed as a mental illness in the Diagnostic and Statistical Manual of Mental Disorders, a classification of mental disorders published by the American Psychiatric Association. Proponents of this view argued that it was wrong and harmful to help people change their sex. Did I have a mental illness? I did not think so. Moreover, reflecting on my experiences during psychiatry rotations during my neurology training days, my impression was that the incidence of serious mental illness was likely far higher in psychiatrists than in transgender people. So I did not see why they should get to categorize me as mentally ill! Moreover, I had been exposed to a testosterone-like drug during fetal development and my masculinization was consistent with relevant animal and human data.

I felt an irresistible desire to transition from female to male from the moment I was offered that possibility. But I thought about it for several weeks because I was worried about what the repercussions might be for my career. Even though I was already tenured and so did not have to worry about being fired a frequent outcome for transgender people in other professions at the time (in many states, transgender people are still not legally protected from being fired) there was much to consider.

Would new students or postdocs wish to join my lab? Would my colleagues reject me? Would I still be invited to meetings and so forth?

I did not know of any successful transgender scientists, and I worried whether, if I transitioned, I would be able to get any more grants (it was already nearly impossible). Would new students or postdocs wish to join my lab? Would my colleagues reject me? Would I still be invited to meetings and so forth? Reading about the experiences of other folks in other professions who had transitioned, I strongly feared that a transition would end my career. For about a week, I was almost unable to sleep from the stress as I pondered whether I should transition or commit suicide. I finally decided to open up to three friends whose opinion I valued very much: David Corey, Martin Raff, and Louis Reichardt. For the first time, I opened up to them about my gender confusion and told them that I was considering changing sex. Did they think that the repercussions would be so bad that it would harm my career? To my great relief, all three were immediately and strongly supportive. Based on their support, I decided to transition. I sent out the following letter to my colleagues, family, and friends late in December of 1997 to let them know of my gender dysphoria and my decision to transition.

Dear friends,

I am writing to disclose a personal problem that Ive been struggling with for some time. It is important for me to talk about it now in order that I can finally move forward.

Ever since I was a few years old, I have had profound feelings that I was born the wrong sex. As a child I played with boys toys and boys nearly exclusively. As a teenager, I could not wear dresses, shave, wear jewelry, makeup, or anything remotely feminine without extreme discomfort; I watched amazed as all of these things came easily to my sisters. Instead I wanted to wear male clothing, be in the boy scouts, do shop, play sports with the guys, do auto mechanics and so forth. Since childhood, I have been ridiculed and shunned by women and by men. At the age of 17, I learned that I had been born without a uterus or vagina (Mullerian agenesis), and that I had been exposed prenatally to masculinizing hormones. Despite plastic surgical correction of my birth defect, throughout my life I have continued to have intensely strong feelings of non-identity with women. Perhaps most disturbingly I feel that I have the wrong genitals and have had violent thoughts about them. My lack of female identity was brought home vividly to me recently after having bilateral mastectomies for breast cancer. This surgery, rather than being an assault on my female identity as it was for my mother, felt corrective as my breasts never seemed like they should be there anyway; the thought of reconstructive surgery has been repellent to me. Since the surgery, people who do not know me often call me sir, but that doesnt bother me either. It is not that I wish I were male, rather, I feel that I already am.

It would be difficult to describe the mental anguish that this gender confusion has caused me. Although I have never been clinically depressed, it has been the source of strong feelings of worthlessness, intense isolation, hopelessness and self-destructive feelings. I have never been able to talk to anyone about it because I felt so ashamed and embarrassed by it. It seemed that it must be my fault, that somehow I should be able to make myself be a woman. This is how things stood until two months ago, when I read in the newspaper about the existence of a gender clinic at Stanford. They found that I have a condition known as gender dysphoria. To my amazement, I learned that I am not alone and that my story is stereotypical of all of those who have this condition.

So what is gender dysphoria (also known as being transgendered or as gender identity disorder)? Those who have it feel from childhood a strong mismatch between their anatomical sex and their brain sex (gender identity). The cause is unknown but is thought to be biological, as some cases are clearly associated with a history of hormone exposure during development. Although it is not treatable by psychotherapy, the dysphoria is substantially lessened by a change in gender role. Treatment with testosterone induces normal male secondary sexual characteristics within 6 to 12 months. Most patients also opt for mastectomies, which I have already had, and hysterectomy, which nature has already done for me. In my case, testosterone treatment would have the added benefits of substantially lowering my chance of new or recurrent breast cancer, because it lowers estrogen levels, and would block the osteoporosis and menopausal symptoms that will otherwise follow when I have my ovaries removed because of my cancer susceptibility mutation.

After much reflection, I have made the decision to take testosterone. I will thus become a female to male transsexual. This has been a difficult decision because I risk losing everything of importance to me: my reputation, my career, my friends and even my family. Testosterone is a far from perfect solution; Im still not going to be normal and social isolation will undoubtedly continue. But testosterone treatment offers the possibility that for the first time in my life I might feel comfortable with myself and not have to fake who I am anymore. I know that I am making the right decision because whenever I think about changing my gender role, I am flooded with feelings of relief. I will begin taking testosterone in February. A change in my appearance will not be visible for several months. By summer, I will begin to dress in mens clothes and will change my name to Ben. Throughout this process I will continue to work normally and to conduct myself in all ways as usual (except that I will only use single occupancy bathrooms). Although the idea of my changing sex will take some time for you to get used to, the reality is that Im not going to change all that much. Im still going to wear jeans and tee shirts and pretty much be the same person I always have beenits just that I am going to be a lot happier.

Many transsexuals change jobs after their sex change in order to retain anonymity, but anonymity is obviously not an option for menor is it one I desire. I am tired of hiding who I am. More importantly I owe it to others who unknowingly endure this condition, as I did, to be visible. Despite my 7 years of medical training, which I undertook to understand what was wrong with me, until 2 months ago I had never heard of gender dysphoria (oddly I somehow picked the right organ to study!). Had it not been for the transsexual who allowed himself to be the subject of the news piece I read, I would still not know about it. Sure I knew that sometimes there were male to female transsexuals but I had thought that these people were perverts. I am not a pervert; I dont seek pleasureonly relief from pain. Most transsexuals hide because of shame and fear, perpetuating ignorance and oppression about their condition. Their suicide rate is so high that some experts have called gender dysphoria a lethal disease. This is why I cannot hide.

In my heart I feel that I am a good scientist and teacher. I hope that despite my trans sexuality you will allow me to continue with the work that, as you all know, I love. I am happy to answer any questions.

Sincerely,

Barbara A. Barres

Despite support from David, Martin, and Louis, sending out this letter was still very scary. I found that my family was immediately supportive and so were all of my colleagues. I heard back from many of them very quickly. Here is the very first response that I received. It is from Chuck Stevens at Salk, a colleague I had long admired for his science and his wonderfully generous mentorship of so many young scientists).

Dear Barbara,

Thanks for the letter and the personal info. I have always been fond of the person in there and the gender makes zero difference to meI expect you will find the same with all of your friends. Let me know when to change to Ben.

Best regards,

Chuck

All of the other responses I received were similarly supportive. And there it was: this shameful secret I had held inside of me for forty years was out, and within a few months I had transitioned to Ben simply by taking testosterone (mastectomies had already been done, but I did have my ovaries removed soon thereafter as they were a cancer risk because of my BRCA2 mutation; the testosterone prevented menopausal symptoms). My career went on as before without a hitch. I am not aware of a single adverse thing that has happened to me in the past twenty years as a result of my being transgender, but there was the immediate relief of all emotional pain as a result of my transition. Never did I think of suicide again and I felt much happier being myself (Ben), no longer having to pretend to be a woman. It is hard to explain how much relief I felt and how much happier I became. It was as if a huge weight had suddenly been lifted from my shoulders.

I should also say that Stanford as a whole was very supportive, including the provost, dean, and all my faculty colleagues. To be honest, I feared that some of the faculty in my department might be embarrassed by my transition. Back then the internet had only recently come into existence and there was still much ignorance about transsexuality. If they had any qualms they did not mention them and they were all completely supportive even the curmudgeonly clock is ticking guy!

I am not aware of a single adverse thing that has happened to me in the past twenty years as a result of my being transgender, but there was the immediate relief of all emotional pain as a result of my transition.

I would like to think that I eventually accomplished enough to fit in. I was elected to the National Academy of Sciences (NAS) in 2013. I was proud to be the first transgender scientist to be elected to NAS and was upset when the academy president refused to mention this in the NAS press release on the grounds that the academy had to deal with religious people. I was deeply disturbed by this as it denies LGBT people proper attribution for their accomplishments, particularly given the great need of LGBT students to be aware of successful role models. Fortunately other news writers soon mentioned it in pieces about me.

How did taking testosterone affect me? It is powerful stuff! There were some of the expected side effects such as increased sex drive for a while (almost like going through a second puberty) and the development of a male hair pattern. I was delighted to be able to grow a mustache and beard, but less thrilled with the rapid onset hair loss that began almost immediately upon start of testosterone (my photograph shows the extent of these effects). All cellulite quickly disappeared. Fat distribution changed from hips and buttocks to abdomen (but a lot stayed everywhere else too). I became much stronger even without doing any exercise. I had never been able to do a single pushup as Barbara, but after about six months of taking testosterone, I noticed that my triceps were beefing up. To my surprise, I was able to do ten pushups (and soon thirty, although I never really worked at it).

I did not particularly notice any change in mathematical, spatial, or verbal abilities, although I did notice on a test that was given to me before and after testosterone that my verbal abilities seemed a little worse and my spatial abilities seemed a bit improved. I still get lost every time I get in a car. Perhaps the most surprising and unexpected effect, though, was that I largely lost the ability to cry. Before testosterone I cried easily, and often cried myself to sleep because of the gender anguish. But after testosterone I found that I was almost entirely unable to cry any more. In response to some very strongly sad stimulus, perhaps I would shed a tear, but the feeling would almost instantly pass. Many other transgender men have told me this has happened to them also, whereas transgender women gain the ability to cry much more easily.

I hope that kids who are able to transition early will be spared the anguish of growing up in the wrong gender with the wrong body, will be able to have more normal social and romantic interactions, and will not have to keep shameful secrets from their families.

When I transitioned in 1997, it was thought that only one in about 20,000 people were transgender, but now, in 2017, it is thought that at least one in 200 people are transgender. LGBT people are often high achievers. Many LGBT people in my generation share growing up with a shameful secret and consequent low self-esteem. Perhaps this may drive us to work hard to succeed in order to prove our self-worth. Things are changing fast for transgender people. The internet has enabled relevant information to be easily researched and accessed, and the public is now being rapidly educated. TV shows often feature transgender characters, and transgender people can now serve openly in the military. There are still some battles being fought, such as gaining protection from being fired for being transgender, as well as bathroom protections, but the public is mostly sympathetic to and supportive of LGBT people, so I believe these battles will soon be won.

Most important, clinics are popping up to help trans children. As a result of public education, trans kids often self-identify, or are identified by their parents, even at grade school age. As they approach puberty, if their transgender identity persists, these kids can be treated with puberty blockers so they do not undergo permanent bodily changes inconsistent with their gender identity. Then when they are of age, at about sixteen years old, they can make the decision about whether they wish to transition. Up to now at least 40 percent of transgender people attempt suicide. I hope that kids who are able to transition early will be spared the anguish of growing up in the wrong gender with the wrong body, will be able to have more normal social and romantic interactions, and will not have to keep shameful secrets from their families. How I envy them!

I am happy to be an openly transgender scientist and to serve as a role model for young LGBT scientists. I hope that I have helped ease their way a little bit. LGBT students and postdocs at Stanford and other institutions frequently contact me to discuss whether or not to be open in their applications to various training programs. I always counsel them to be open about who they are, as it seems to me that currently the advantages far outweigh the risks. The vast majority of academics are highly supportive. It is very difficult to live life in a closet. It does not make sense to do this because of an occasional bigot. I have yet to have anyone tell me they regretted their decision to be open.

Ben Barres (19542017) was Professor and Chair of the Department of Neurology at Stanford University and one of the worlds leading researchers on the role of the brain cells known as glia. This article is excerpted from his book The Autobiography of a Transgender Scientist.

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The Coming Out of a Transgender Scientist - The MIT Press Reader

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With all the advice out there about leading a healthy lifestyle, staying hydrated is one of the basics that's repeated again and again. But you may be wondering what all the fuss is about.

The effects of dehydration can be seen across your entire body, from your brain to your skin.

Image Credit: LIVESTRONG.com Creative

If you get everything else right, how important is hydration, really? In a word: very.

"From a structural or functional standpoint, water is a detergent and cleaning agent for our bodies," says Zach Bush, MD, a physician who specializes in internal medicine, endocrinology and hospice care. Water is needed by every cell in your body to function properly, he explains, and is vital in helping our bodies work through the toxins we all breathe and eat every day.

Read on to discover dehydration's effects on your body and tips on how to keep your fluid intake where it needs to be.

When your body becomes dehydrated, your cells send a signal to your brain, which tells you that you're thirsty. But dehydration affects your brain in more surprising ways, too.

Although the mechanism isn't fully understood, dehydration is linked to a decrease in mood and cognitive performance. A June 2013 review in the Journal of the American College of Nutrition revealed that a dehydration level of just 2 percent was enough to impair performance in tasks that required attention, psychomotor and immediate memory skills.

And although it was small, a February 2012 study published in the Journal of Nutrition found that even mild dehydration was enough to cause mood disturbances.

Dehydration can also cause problems in the brain when electrolyte levels fall too low. Electrolytes are minerals like potassium and sodium that help the electrical signals pass between cells. If you are too low in electrolytes, you can experience a breakdown or disruption in these signals, which can cause involuntary muscle twitching and even seizures, according to the Mayo Clinic.

Your Kidneys and Urinary System

When you're dehydrated, your cells send a signal to your hypothalamus, which releases a hormone called vasopressin, known as the antidiuretic hormone (ADH). This hormone tells the kidneys to remove less water from the blood, which leads to peeing less and a darker, more concentrated urine.

The kidneys are the main filter for your blood, and without adequate fluid, they can't expel the natural breakdown products and toxins from your bloodstream, Dr. Bush says. "Amazingly, your kidneys are capable of moving as much as 55 gallons of fluid a day."

If you are consistently dehydrated over long periods of time, your kidneys have to work extra hard. This can cause something called acute kidney injury, a form of damage that puts you at higher risk for kidney disease, according to the National Kidney Foundation.

What's more: "Lack of fluid intake can be a major contributor to kidney stone formation," Julie Stefanski, RDN, LDN, registered dietitian and spokesperson for the Academy of Nutrition & Dietetics, tells LIVESTRONG.com. People who live in warm, dry climates and those who sweat a lot may be at higher risk than others, according to the Mayo Clinic.

Need a way to easily track your daily water intake? Download the MyPlate app to do the job, so you can stay focused and achieve your goals!

Your body needs fluid to make blood, so when your fluid levels drop, so does your blood volume.

"The bloodstream needs adequate fluid within the body to maintain an appropriate blood pressure," says Stefanski. Dehydration can lead to hypotension, or low blood pressure, which can cause you to faint.

At an extreme level, this can lead to an emergency condition called hypovolemic shock, where low blood volume leads to a big drop in blood pressure and the amount of oxygen in the blood, according to the U.S. National Library of Medicine. The heart is unable to pump enough blood around the body, which can lead to organ failure.

As your blood gets thicker, your body increases your heart rate and respiratory rate to compensate, essentially putting the body into a stress state.

"It's not unusual to then experience things like headache, fatigue, eye strain, decreased sex drive and decreased sleep quality, because the brain is in the fight-or-flight state," Dr. Bush says.

Your gut needs adequate hydration to function properly. Water is needed for optimal motility (the movement of waste through your digestive system) and gut health.

"Without regular intake of fluids, bowel movements can be hard and difficult to pass," Stefanski says.

Dehydration can also damage the mucosal lining of the gut and your microbiome, which are important to both your digestion and your overall health.

Although you may not realize it, your skin is actually the largest organ in your immune system, Stefanski says. Healthy skin acts as a natural barrier against germs from our environment, but insufficient fluid intake can cause cracked lips and dry skin, where pathogens can enter.

Good hydration is essential for healthy skin. Although a small sample size, an August 2015 study in Clinical Cosmetic and Investigational Dermatology found a positive correlation between skin health measurements and hydration.

A typical adult woman needs 11.5 cups of water a day, while a man needs 15.5 cups, per the Academy of Nutrition and Dietetics. The average person takes in around 20 percent of their water needs through food, which means women should drink about 9 cups a day and men should drink 12.5.

1. Don't Wait to Be Thirsty

Stefanski says everyone has differing levels of thirst instinct, which can mean you drink less than you need. "Rather than relying on thirst, schedule times throughout the day to drink a large glass of water," she says.

Remember: If you feel thirsty, you're already dehydrated.

Take cues from your bathroom breaks.

"Experts recommend that we should all be drinking enough to urinate every three to four hours. Urine should be a light yellow color," Stefanski says. "If you're not urinating at all or your urine is dark in color, you may not be drinking enough."

Any fluid counts toward your overall fluid intake, so if you don't like plain water, mix it up. Add lemon slices and cucumber to plain water to make it more interesting, or make a cup of tea. Herbal tea makes a good replacement for plain water, but Stefanski warns that it's important to check for interactions if you take medications or have a chronic medical condition.

4. Watch Out for Caffeine and Alcohol

Although that cup of coffee or cocktail technically count towards your daily quota, caffeine and alcohol are diuretics, meaning they can cause you to actually lose water. So make sure to balance your boozy drinks with at least the same amount of H2O.

It's not just about water. "A lot of the effective hydration we get is actually through our food," says Dr Bush. "So things like cucumber, celery these are powerful ways to get water into the body more effectively than a glass of water."

Consuming water-rich fruit and vegetables is a good way to increase your hydration levels while boosting your vitamin, mineral and fiber intake.

6. Paleo or Keto? Add More H2O

High-protein diets can be dehydrating, so it's especially important to hydrate regularly if you're following a paleo or keto plan.

"If you are on a protein-rich diet, you need to really work to increase the amount of water-carrying veggies in your diet to offset the potential dehydrating effect of protein," Dr. Bush says.

Tracking your water intake on an app like LIVESTRONG.com's MyPlate can help you make sure you're getting enough.

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What Really Happens to Your Body When You're Dehydrated - LIVESTRONG.COM

Avoid Sex for 30 Days, Thai Expert Advises Coronavirus Survivors

Many government health workers along with vehicles in Indonesia began to appear in towns and cities in May to announce "You can have sex. You can get married. But don't get pregnant." The government officials in the Asian country announced it while reading scripts that read, "Dads, please control yourself. You can get married. You can have sex as long as you use contraception."

The announcement may sound extremely weird and could be a topic to laugh about, but the fact is that the officials are concerned about a possible unintended consequence of Indonesia's Coronavirus restrictions.

In April, while people across Indonesia stayed at home due to the nationwide restrictions, around 10 million married couples stopped using contraception, revealed the National Population and Family Planning Agency, which collects data from clinics and hospitals that distribute birth control pills.

The agency noted that many Indonesian women failed to get their contraceptives as the healthcare providers were closed due to the pandemic restrictions, while others did not want to risk their health by getting outside their residents. Because of this, the Indonesian government is now expecting a wave of unplanned birth in 2021.

An obstetrician and gynecologist Dr. Hasto Wardoyo, who heads the family planning agency have estimated that there could be 370,000 to 500,000 extra births early next year. If a massive amount of childbirth takes place, it will be a disadvantage to the country's effort to promote small families that are required to fight against child malnutrition.

But, this is not the first time the country is making such efforts, Indonesian authorities' involvement in the family planning program dates back to 1970 when it was under the military dictatorship run by President Suharto. At that time soldiers promoted the use of contraception, while army doctors performed vasectomies and tubal obligations.

To encourage people for birth control, the government representative distributes free contraceptives to Indonesia's poor, and young married couples of various incomes. The government agency said that half of the country's women who use contraceptives, also receive hormone injections monthly or every three months.

It explains that while condoms are available but unpopular, mostly among the married couples, 20 percent of Indonesia women use birth control pills which they have to collect monthly if they were on government insurance.

But the regular clinic visits have disrupted due to the Coronavirus pandemic, which already killed 2,134 people. While in Jakarta, mosques, malls, and offices have been gradually reopening this month, cases are still rising in other parts of the country, including the provinces of East Java and Papua. As of now, Indonesia has reported more than 38,200 cases.

The Indonesia agency has planned to deliver the contraceptives to women at their residents and to let each one of them obtain more than a month's supply of birth control pills at a time. The government has already started home deliveries along with the emergency food supplies, which many families were receiving due to the Coronavirus pandemic restrictions.

See original here:
Why did Indonesian Healthcare Workers Announce 'You Can Have Sex, But Don't Get Pregnant' in Public? - International Business Times, Singapore Edition

Breastfeeding your baby can help reduce the risk of the following cancers in women:Breast CancerBreastfeeding can slightly lower a womans risk of breast cancer. Breastfeeding reduces a womans number of menstrual cycles thus decreasing a womans exposure to hormones like estrogen. Estrogen production can be a factor in the growth of breast cancer cells.

Ovarian CancerBreastfeeding may reduce a womans risk of developing ovarian cancer due to the delay of ovulation. The more a woman ovulates, the more the risk of cancer cell mutation that could trigger the onset of ovarian cancer.

Parrish Medical Center cares for women in every stage, whether through supporting a healthy pregnancy, diagnosing and treating disease or easing the transition to menopause. Parrish Medical Centers team-based care philosophy ensures your concerns will be heard, understood and treated appropriately.

PMCs Womens Care provides a full range of gynecologic services, from routine medical screenings and treatments to gynecologic surgery, oncology and health navigation services.

If you would like more information about how breastfeeding can help improve your overall health and reduce your risk of certain cancers, visit parrishhealthcare.com or call 321-268-6682. Our team of health care professionals is here to answer all of your questions and ease your concerns.

Continued here:
The Health Benefits of Breastfeeding | Parrish Medical Center - SpaceCoast Living

Mood, diet and lifestyle habits, and vitamin D status are all closely connected. Low vitamin D may trigger low mood, making it more difficult to sleep, eat well, and exercise regularly, says Choukri. Yet, she adds, These difficulties may be due to the mood itself rather than vitamin D.

On the flip side, research suggests that not getting enough sleep, having a poor-quality diet, and inactivity can contribute to low mood independently, regardless of vitamin D status.

Heres a closer look at the relationship among vitamin D status, these habits, and mood and health.

RELATED: 8 Smart Tips for Successfully Managing Stress

Theres a scientific link between getting adequate vitamin D and sleeping well, which plays a role in mood on its own. Vitamin D is important in the process of making serotonin, and you need serotonin to make melatonin, says Dr. Greenblatt. Melatonin is a hormone that promotes sleep, according to the Mayo Clinic.

A meta-analysis published in October 2018 in the journal Nutrients concluded that vitamin D deficiency is linked with a higher risk of sleep disorders.

Its all connected: Lack of sleep alone, regardless of vitamin D status, may contribute to depressive symptoms, along with anxiety, notes the National Sleep Foundation. According to the Mayo Clinic, symptoms of depression may include tiredness and a lack of energy, sleep disturbances like insomnia, and a loss of interest in pleasurable activities.

RELATED: The Relationship Between Insomnia, Anxiety, and Depression: Its Complicated

Low mood from vitamin D may make someone less likely to be active, says Penckofer. And inactivity can trigger a vicious cycle that further contributes to low mood. A study published in April 2019 in the International Journal of Environmental Research and Public Health found that sedentary behavior and low physical activity were linked to anxiety and depression. And a review published in June 2015 in Cognitive Behavior Therapy found that exercise can even help reduce anxiety symptoms and bad mood, the authors noted. Another study, published in September 2018 in The Lancet Psychiatry, found that all types of exercise from walking to cycling were associated with improved mental health.

According to the Mayo Clinic, exercise boosts endorphins, gets your mind off stressful situations, gives you confidence, and can provide social interaction.

Improving vitamin D status may improve mood, helping you to get out the door and move more.

Vitamin D may also independently offer benefits for physical health. A study published in July 2018 in the Journal of Orthopaedic Science found that for elderly people, exercise and taking a vitamin D supplement each on their own helped improve muscle mass and physical function. Therefore, getting the vitamin D you need not only boosts mood and may help compel you to move more, but it also may help you get more out of your workout.

RELATED: Why Exercise Boosts Mood and Energy

Research suggests a vitamin D deficiency is more prevalent in people with obesity. One smallstudy, published in July 2018 in the International Journal of Preventative Medicine, found that obese people who supplemented with a high dose of vitamin D for six weeks decreased their weight, body mass index (BMI), waist circumference, and hip circumference significantly.

Obesity is a complex disease: Both genetics and daily lifestyle habits affect risk, past research suggests. Yet having low mood, potentially due to vitamin D deficiency, may make you more likely to reach for potato chips or that bag of cookies rather than healthier choices, like carrot sticks or an apple. You can blame cortisol, the stress hormone, which can cause you to overeat when youre feeling emotional distress, according to Harvard Medical School.

What you eat similarly impacts mood, just like your sleep and exercise habits. For example, previous research suggests that chamomile may provide a soothing effect by producing more of the feel-good chemicals dopamine and serotonin. Carbohydrates can also boost the production of serotonin, according to the Massachusetts Institute of Technology (MIT), though make sure youre choosing healthy, whole grain options, rather than refined carbs like cookies and crackers.

Meanwhile, poor food and drinkchoices can contribute to low mood. Take sugar: Astudy published in July 2017 in Scientific Reports found that eating too much refined sugar could up your risk of depression. So, too, may caffeine and alcohol bring down your mood, according to the Mayo Clinic and past research, respectively.

RELATED: The Ultimate Diet Plan for a Happier, Less-Stressed You

Skimping on D may seem like no biggie in the grand scheme of things, especially in the time of COVID-19, but prioritizing getting enough of the sunshine vitamin is critical for your long-term health.

We do see deficient vitamin D levels are related to many different diseases type 2 diabetes, Alzheimers disease and dementia, and [some] types of cancers, says Mary Byrn, PhD, RN, associate professor in the Marcella Niehoff School of Nursing at Loyola University Chicago. Therefore, treating deficient vitamin D levels is not harmful, and I would recommend that everyone work with a healthcare provider to reach sufficient vitamin D levels.

The Cleveland Clinic also notesthat a vitamin D deficiency can cause other physical health issues, like osteoporosis and osteomalacia, and can even impact your nervous system and immune system, which is the last thing anyone needs during a pandemic like the current one.

RELATED: Can Supplements Protect Me Against the New Coronavirus?

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Are You COVID D-Prived and Down? How Low Vitamin D Can Cause Low Mood - Everyday Health

Perchlorate-induced natrium-iodide symporter (NIS) interference is a well-recognized thyroid disrupting mechanism. It is unclear, however, whether a chronic low-dose exposure to perchlorate delivered by food and drinks may cause thyroid dysfunction in the long term. Thus, the aim of this review was to overview and summarize literature results in order to clarify this issue.Authors searched PubMed/MEDLINE, Scopus, Web of Science, institutional websites and Google until April 2020 for relevant information about the fundamental mechanism of the thyroid NIS interference induced by orally consumed perchlorate compounds and its clinical consequences.Food and drinking water should be considered relevant sources of perchlorate. Despite some controversies, cross-sectional studies demonstrated that perchlorate exposure affects thyroid hormone synthesis in infants, adolescents and adults, particularly in the case of underlying thyroid diseases and iodine insufficiency. An exaggerated exposure to perchlorate during pregnancy leads to a worse neurocognitive and behavioral development outcome in infants, regardless of maternal thyroid hormone levels.The effects of a chronic low-dose perchlorate exposure on thyroid homeostasis remain still unclear, leading to concerns especially for highly sensitive patients. Specific studies are needed to clarify this issue, aiming to better define strategies of detection and prevention.

PubMed

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Interference on Iodine Uptake and Human Thyroid Function by Perchlorate-Contaminated Water and Food. - Physician's Weekly

Chrissy Teigen announced on social media today that she successfully underwent surgery to remove her breast implants after having them for 10 years.

On May 26, the cookbook author announced her upcoming surgery plans, which required a coronavirus test prior to the procedure.

The two Luna originals say "Have fun pulling your boobies out Love Luna," and "Bye boobies," with a mermaid sticker attached.

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"They've been great to me for many years but I'm just over it. I'd like to be able to zip a dress in my size, lay on my belly with pure comfort! No biggie! So don't worry about me! All good. I'll still have boobs, they'll just be pure fat," Teigen wrote on Instagram.

"Life-changing, you're gonna love it. I got mine out last year," Curry commented on Teigen's initial announcement post.

Michelle Visage and Yolanda Hadid have also been vocal about their decisions to have their breast implants removed.

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Chrissy Teigen had her breast implants removed after 10 years, and her daughter wrote a hilarious note to cele - Business Insider India

Endometriosis Market Forecast 2020-2026

The Global Endometriosis Market research report provides and in-depth analysis on industry- and economy-wide database for business management that could potentially offer development and profitability for players in this market. This is a latest report, covering the current COVID-19 impact on the market. The pandemic of Coronavirus (COVID-19) has affected every aspect of life globally. This has brought along several changes in market conditions. The rapidly changing market scenario and initial and future assessment of the impact is covered in the report. It offers critical information pertaining to the current and future growth of the market. It focuses on technologies, volume, and materials in, and in-depth analysis of the market. The study has a section dedicated for profiling key companies in the market along with the market shares they hold.

The report consists of trends that are anticipated to impact the growth of the Endometriosis Market during the forecast period between 2020 and 2026. Evaluation of these trends is included in the report, along with their product innovations.

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The Report Covers the Following Companies:AbbVieAstraZenecaBayer HealthCarePfizerAddex TherapeuticsAstellas PharmaDebiopharmElexoPharmEndoCeuticsEuroscreenForendo PharmaKissei PharmaceuticalNeurocrine BiosciencesNippon ShinyakuTakedaBayer AGNeurocrine Biosciences

By Types:Gonadotropins Releasing Hormone AgonistsNon-Steroidal Anti-Inflammatory DrugsProgestinOral Contraceptive Pills

By Applications:Hospital UseClinic UseOther

Furthermore, the report includes growth rate of the global market, consumption tables, facts, figures, and statistics of key segments.

By Regions:

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Years Considered to Estimate the Market Size:History Year: 2015-2019Base Year: 2019Estimated Year: 2020Forecast Year: 2020-2026

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About UpMarketResearch:Up Market Research (https://www.upmarketresearch.com) is a leading distributor of market research report with more than 800+ global clients. As a market research company, we take pride in equipping our clients with insights and data that holds the power to truly make a difference to their business. Our mission is singular and well-defined we want to help our clients envisage their business environment so that they are able to make informed, strategic and therefore successful decisions for themselves.

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Endometriosis Market Analysis With Key Players, Applications, Trends And Forecasts To 2025 - Surfacing Magazine

Dermatologist Dr. Sandra Lee tugged, snipped, and cut at a lipoma for over 40 minutes to try and remove it from a woman's back in a recent YouTube video posted June 4 to her infamous channel, "Dr. Pimple Popper."

The lipoma or lump caused by slowly overgrowing fatty tissue was particularly difficult to remove because of its "bubbly" nature. The lump was dispersed through different parts of a large area on her back, making it harder to remove than a lump all in a singular area.

To make sure all of the fatty tissue was gone, Lee zapped the area with a cauterizing instrument to stop any bleeding caused during the extraction process. Once all of the tissue had been removed, the skin flap that laid over the incision was visibly flatter.

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"Now my hand's gonna shake because I've been squeezing you so hard," Lee said as she sutured her patient's large incision.

Watch Dr. Pimple Popper remove a 9-pound lump that was growing on a man's arm for nearly a decade

Dr. Pimple Popper reveals her nighttime skincare routine, and it only includes 3 steps

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Dr. Pimple Popper removed a 'big bubbly' lump from a woman's back by tugging, snipping, and cutting for over 4 - Business Insider India

Hollings Cancer Center researchers at the Medical University of South Carolina (MUSC) and colleagues assessed the connection between dietary advanced glycation end products (AGEs) and breast cancer risk in a study first published online March 2020 in Cancer Prevention Research.

It supports an increasingly evident link between high levels of AGEs in the body and cancer risk, said principal investigator David Turner, Ph.D., who worked with colleagues Susan Steck, Ph.D., with the University of South Carolina, and Lindsay Peterson, M.D., with Washington University School of Medicine.

The study was part of a larger decade-long prostate, lung, colorectal and ovarian cancer screening trial (PLCO) designed and sponsored by the National Cancer Institute. It included over 78,000 women between the ages of 55 and 74 years who were cancer free at the start of the study. The women completed a food frequency questionnaire at the beginning and again at five years into the study. After an average of 11 years, 1,592 of the women were diagnosed with breast cancer. When the intake of high-AGE food was assessed, based on the questionnaires, increased AGE intake via the diet was associated with an increased risk of in situ and hormone receptor positive breast cancers.

Advanced glycation end products are proteins and lipids (fats) that go through a chemical alteration called glycation when they are exposed to sugars. This process occurs naturally in the body. However, processed foods and foods cooked at high temperatures are extremely high in AGEs, which can lead to a dangerous overabundance in the body.

Turner said AGEs are involved in nearly every chronic disease, in some way. The study of AGEs in cancer is just starting to get traction. The presence of AGEs has been known for at least 100 years, but the research has been challenging. In order to determine how they work, their mechanism of action, researchers first have to determine a role in various diseases.

Turner said this study is important because it adds to the evidence between high levels of AGEs in the body and cancer risk. Turner and his collaborators are promoting the connection between AGEs and lifestyle choices to help the public make better food choices.

This will become an even more popular area of study as researchers employ new tools to help study AGEs. A novel device, the AGE reader, is about to change how we look at AGEs in the clinic, Turner said. The AGE reader, made by Diagnoptics, is an easy to use noninvasive device where someone rests their forearm for just 12 seconds. It uses light at certain wavelengths to excite AGE autofluorescence in the human skin tissue.

This machine actually measures glow from some of the AGEs. The more AGEs that are in the skin, the higher the glow, explained Turner.

While the AGE reader has been used to show strong correlations between AGE levels and Type 2 diabetes, cardiovascular disease and even mortality, Turner is using a cancer center support grant to validate further the AGE reader for use in cancer patients. He and his colleagues plan to investigate whether pigmentation in the skin skews the reading and use the reader as part of a growing community outreach program.

Since a link between AGEs and breast cancer has been shown, the ultimate goal is to test all Hollings Cancer Center patients who are interested at each visit, Turner said. This will provide a huge amount of data about the link between AGEs and a wide variety of cancers. Turner and his collaborators expect that future multicenter grants will come out of this project.

While the connection between high AGE levels and cancer risk might be disconcerting, research is also being done to determine if there is a way to reverse the detrimental effects of AGEs.

Bradley Krisanits, a Ph.D. student in Turners lab, said that preliminarily, they have seen that physical activity reduces the amount of AGEs in the circulation.

In our prostate cancer models, we see that physical activity counteracts prostate cancer progression in mice fed a high-AGE diet. This may be occurring due to a reduction in AGEs and changes in the immune system that we need to study more.

Turner hopes that by educating people about AGEs, they can make informed lifestyle decisions and lower their risks for chronic diseases. The top three things that a person can do is learn what AGEs are, avoid processed foods and think about how you cook your food in order to make changes to avoid the highest AGE-inducing cooking methods such as frying, grilling and broiling.

AGEs build up in a cumulative way. Fats, sugars, everything that is bad for you leads to the accumulation of AGEs. One of our goals at Hollings is to reach out to the community to encourage the public to make healthier choices. Just making small changes in your diet can have a big effect.

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Study links elevated levels of advanced glycation end products with breast cancer risk - Mirage News

Acuwellness Center offers acupuncture for infertility. Research suggests that acupuncture, along with traditional Chinese medicine, can serve as an effective treatment for infertility and other reproductive disorders.

According to announcements released by Acuwellness Center, and Sharareh (Sherry) Daghighi DAOM, LAc, FABORM, the wellness center offers acupuncture for fertility. Research-backed evidence suggests that fertility acupuncture can be a useful treatment procedure to complement IVF and ART treatments. Combined with other TCM protocols, acupuncture can enhance physiological processes essential for fertility. Acupuncture as a treatment modality for infertility can assist in preparation for IVF, IUI, and other ART protocols. Fertility acupuncture helps control unwanted side effects associated with IVF and ART treatments. It improves implantation and pregnancy rates. The wellness clinic will coordinate with a subject's reproductive endocrinologist to prepare a custom infertility treatment plan to optimize her chances at conception.

Sources reveal that alternative treatment procedures that use acupuncture and herbs can improve the symptoms of many health conditions, including polycystic ovarian syndrome (PCOS), which is not an uncommon condition among women in the United States. PCOS can result in diabetes, hirsutism, infertility, and obesity. Acuwellness Center is also an established Encino dermatology clinic where eczema, psoriasis, acne, rosacea, fungal infections, etc. are treated using herbal formulations, dietary supplements, and acupuncture. The wellness clinic prescribes herbs for acne, and it has delivered excellent results in treating this condition. TCM eschews the use of topical ointments that may contain harsh chemicals. Acuwellness Center treats acne by recommending dietary and lifestyle changes, acupuncture, and herbal medicines. It prescribes Chinese herbs for eczema.

Sharareh (Sherry) Daghighi DAOM, LAc, FABORM, of Acuwellness Center said, At Acuwellness Center, we offer services such as acupuncture, herbal medicine, and nutritional consultation in a friendly, relaxing environment. Our areas of expertise are woman's health, fertility, internal medicine, and TCM dermatology. Our mission is to provide a tranquil, healing environment where your mind, body, and spirit can relax and recover from the stress of everyday living.

On acupuncture and herbs for premature ovarian failure, Daghighi said, Premature Ovarian Failure (POF) is defined as a cessation of ovarian function in women younger than 40 years of age. It is characterized by the occurrence of irregular and light menstruation (oligomenorrhea), primary or secondary amenorrhea (no menstruation) with elevated levels of gonadotrophins like follicle-stimulating hormone (FSH), and low estrogen levels. Women with POF will also have menopausal symptoms such as hot flashes, night sweats, vaginal dryness, irritability, difficulty concentrating, and decreased sexual desire.

She continued to say, Studies have shown that Acupuncture and herbal medicine can treat premature ovarian failure. Acupuncture can induce ovulation and regulate the menstrual cycle, other studies have shown some herbal formulas such as Zuo Gui Wan or a modification of this formula can induce ovulation, lower FSH levels, and regulate menstrual cycle for certain POF patients. At Acuwellness Center, we offer Acupuncture and herbal medicine services for infertility, including premature ovarian failure, we can help achieve your fertility goals or just reduce menopausal symptoms.

For more information, go to https://www.acuandherbs.com/infertility-acupuncture.html

Media ContactCompany Name: Acuwellness CenterContact Person: Sharareh (Sherry) DaghighiEmail: Send EmailPhone: (818) 642-3512Address:16260 Ventura Blvd, Ste LL16 City: EncinoState: CA 91436Country: United StatesWebsite: https://www.acuandherbs.com/infertility-acupuncture.html

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Acupuncture For Fertility And TCM Improve Chances Of Conception And Pregnancy And Mitigates Side Effects Of IVF Treatment - Press Release - Digital...

The coronavirus lockdown has led to rising interest in video games, sex toys, sourdough bread and alsobabies.

Or at least thats what may explain a spike in demand for some of Europes fertility startups over the past few months, according to founders interviewed by Sifted.

Startups such as ExSeed, which does at-home male fertility test, and Legacy, a sperm testing and freezing startup, have both recorded a jump in orders.

Switzerlands Legacy says its seen days where orders spiked to more than 10x usual volume and has had to launch additional capacity to handle the order volume for test samples.

Part of this is the natural growth of the company, but Id estimate at least 50% of the growth is attributable due to Covid-19 concerns, says chief executive Khaled Kteily.

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Kteily says there are worries that catching Covid-19 might affect male fertility. The increase in orders may have also been spurred by the temporary closure ofphysical clinics during lockdown, instead prompting couples to get treatment ready from home.

Meanwhile, Copenhagen-based ExSeed told Sifted the number of at-home male fertility tests priced at 150 have trebled during the lockdown. App-downloads, programme-subscriptions, and web traffic have also more than doubled since February across Denmark and the UK.

This boost is being matched by investor interest as well; ExSeed told Sifted it is now in the final stages of closing a round led by Hambro Perks, building on a previous raise of 1m.

Demand has also been way up for Paris-born Apricity, a digital-first fertility platform which offers at-home blood tests and consultations for women, followed by in-person treatment across a series of partner physical clinics.

Chief executive Caroline Noublanche thinks that the surge in interest is in part because people have had more time for themselves and to address important personal topics such as fertility

UK-based consultant Adrian Lower, who does not work with any of these startups but is a practising gynaecologist, agrees the lockdown has also given us the time to consider every aspect of our health, including our future fertility, adding he is not surprised that the pandemic has spurred a rise in demand for at-home services.

Covid-19 has highlighted just how precious our health is.

In recent years, the fertility industry has raised millions in venture capital funds, particularly in Northern Europe.

This is part of a broader rise in interest in digital doctor app startups such a Doctolib and Babylon Health which are reshaping our relationship with healthcare systems.

But it is also linked to the emergence of femtech as a significant investment category (set to be worth $50bn by 2025, according to Frost & Sullivan) dominated by big startups like Clue, Ava and Natural Cycles.

Now, coronavirus and the recent spike in demand for fertility tech has helped bring investment buzz back to this segment which stretches across supplements, ovulation trackers and testing kits for both men and women.

I have a lot of contact with potential investors during lockdown. Healthtech appears to them as one of the key areas of investment post-Covid and femtech is one of the subdomains VCs say they want to focus on, says Apricity chief executive Caroline Noublanche.

Spains WOOM a fertility tracker and community app for women also secured a $2m round just last month, pulling in two new investors.

Nonetheless, while people may have become more interested in their fertility in lockdown, it prompted some couples to delay parenthood for at least a short time.

Natural Cycles, a hormone-checking tool for women, told Sifted that the rate of users switching the app-mode from prevent to planning a pregnancy decreased by 3% week-over-week between March and April; perhaps triggered by fresh financial fears, relationship pressures, or illness. The company also said that it had seen a boost in orders for women wanting a natural birth control delivered right to the door.

Meanwhile, Maven a virtual womens clinic has recorded twice as many bookings for online mental health appointments across its fertility clients between March and May, suggesting the pandemic is putting an emotional strain on would-be parents.

WOOM also says it suffered a 25% traffic drop after the announcement of Covid-19 pandemic. Nonetheless, the startup says its traffic is now 19 points higher than pre-pandemic.

This boost seen by fertility startups will help shake off fears that the sector was at risk of seeing investment interest wane, as attention shifted to other areas of womens health like menopause, sex, endometriosis, and breastfeeding.

[Investors are] looking for the next big thing in femtech, Anya Roy, cofounder of Syrona Women told Sifted earlier this year, adding male investors were slowly seeing the investment benefits of womens health.

Two studies also recently cast doubt on the role of fertility apps and wearables role in assisting womens chances of conceiving, given their lack of scientific backing.

Nonetheless, investors say theres room for growth in the still-nascent fertility startup sector, with smartphones providing new tools to streamline the diagnosis and conception process. One in seven couples also still experience difficulties conceiving.

Its more crowded in the fertility and the contraceptive space, but theres no clear winner there yet, says Louise Samet, partner at venture capital firm Blossom Capital.

We havent seen a Spotify or a really large company come out in that space yet I think that theres still huge potential.

Traditional IVF clinics are also beginning to digitise to keep up with the boom of healthtech apps.

Salve is a startup that helps IVF with patient-doctor management via a white-labelled app, providing secure messaging and enhanced data sharing. Its chief executive Charlie Kenny tells Sifted they have signed over 30 new clinics worldwide since the coronavirus outbreak began, and has seen that rapid growth continue.

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Fertility startups see burst in demand as minds turn to baby-making - Sifted

SALT LAKE CITY, June 04, 2020 (GLOBE NEWSWIRE) -- Myriad Genetics, Inc. (NASDAQ: MYGN, Myriad” or the Company”), a global leader in molecular diagnostics and precision medicine, today announced the publication of a prospective study demonstrating that the EndoPredict® test predicts which patients with ER+, HER2- early-stage breast cancer will benefit from neoadjuvant therapy. The article titled, The EndoPredict score predicts response to neoadjuvant chemotherapy and neoendocrine therapy in hormone receptor-positive, human epidermal growth factor receptor 2-negative breast cancer patients from the ABCSG-34 trial,” appeared online in the European Journal of Cancer.

This study demonstrated that the EndoPredict (EP) test predicted response to neoadjuvant chemotherapy or neoadjuvant endocrine therapy in women with ER+, HER2 negative early-stage breast cancer,” said Peter Dubsky, M.D., lead author, speaking on behalf of the Austrian Breast and Colorectal Cancer Study Group (ABCSG). Based on these findings and prior studies, we are confident the EndoPredict test can add valuable information to aid in personalized treatment selection in neoadjuvant therapy and provides an important basis for future design of neoadjuvant clinical trials.”

The primary objective of this prospective study was to test the predictive value of the EndoPredict test regarding tumor response after neoadjuvant chemotherapy (NaCT) or neoadjuvant endocrine therapy (NET) within the ABCSG-34 trial. The analysis included data from 217 women with HR+ breast cancer. Of these, 134 patients were assigned to receive NaCT (eight cycles of anthracycline/taxane) according to aggressive clinico-pathologic tumor features. The remaining 83 patients were clinically identified as having luminal A-like types of breast cancer and were assigned to receive NET (six months of letrozole). The primary endpoint was residual cancer burden RCB0/I (i.e., good tumor response) vs. RCB II/III (i.e., poor tumor response) at time of surgery.

In the neoadjuvant chemotherapy group, 125 patients had high EP scores and nine had a low EP score. The results show that 26.4 percent of those with a high score showed a good tumor response (RCB0/I) to neoadjuvant chemotherapy, while all patients with a low score showed only a poor tumor response (Table 1). In the luminal A” group receiving neoendocrine therapy, 39 patients had a high EP score and 44 had a low EP score. The results show that 27.3 percent of those with a low EndoPredict score and 7.7 percent with a high score achieved excellent tumor response (RCB0/I) to neoendocrine therapy (Table 1).

EndoPredict Low Score

EndoPredict High Score

0.0

%

26.4

%

p=0.0001

In this prospective study, we demonstrated that the EndoPredict test is a useful tool pre-operatively,” said Ralf Kronenwett, M.D., director of International Medical Affairs at Myriad. In two distinct ER-positive, HER2-negative cohorts selected by clinicians to receive neoadjuvant chemotherapy or neoadjuvant endocrine therapy, EndoPredict identified patients with poor neoadjuvant treatment response. Clinicians can use information to determine who might forgo these therapies prior to surgery.”

About EndoPredict EndoPredict is a second-generation, 12-gene molecular prognostic test for patients diagnosed with breast cancer. The test provides vital information that helps clinicians devise personalized treatment plans for their patients. EndoPredict has been validated in more than 4,000 patients with node-negative and node-positive cancer and has been used clinically in more than 20,000 patients. In contrast to first-generation multigene prognostic tests, EndoPredict detects the likelihood of late metastases (i.e., metastasis formation after more than five years) and, therefore, can guide treatment decisions regarding the need for chemotherapy, as well as extended anti-hormonal therapy. Accordingly, therapy decisions backed by EndoPredict confer a high level of diagnostic safety. For more information, please visit: http://www.endopredict.com.

About Myriad Genetics Myriad Genetics Inc., is a leading personalized medicine company dedicated to being a trusted advisor transforming patient lives worldwide with pioneering molecular diagnostics. Myriad discovers and commercializes molecular diagnostic tests that: determine the risk of developing disease, accurately diagnose disease, assess the risk of disease progression, and guide treatment decisions across six major medical specialties where molecular diagnostics can significantly improve patient care and lower healthcare costs. Myriad is focused on three strategic imperatives: transitioning and expanding its hereditary cancer testing markets, diversifying its product portfolio through the introduction of new products and increasing the revenue contribution from international markets. For more information on how Myriad is making a difference, please visit the Company's website: http://www.myriad.com.

Myriad, the Myriad logo, BART, BRACAnalysis, Colaris, Colaris AP, myPath, myRisk, Myriad myRisk, myRisk Hereditary Cancer, myChoice, myPlan, BRACAnalysis CDx, Tumor BRACAnalysis CDx, myChoice CDx, Vectra, Prequel, Foresight, GeneSight, riskScore and Prolaris are trademarks or registered trademarks of Myriad Genetics, Inc. or its wholly owned subsidiaries in the United States and foreign countries. MYGN-F, MYGN-G.

Safe Harbor Statement This press release contains "forward-looking statements" within the meaning of the Private Securities Litigation Reform Act of 1995, including statements related to the EndoPredict test adding valuable information to aid in personalized treatment selection in neoadjuvant therapy and providing an important basis for future design of neoadjuvant clinical trials; and the Company's strategic directives under the caption "About Myriad Genetics." These "forward-looking statements" are based on management's current expectations of future events and are subject to a number of risks and uncertainties that could cause actual results to differ materially and adversely from those set forth in or implied by forward-looking statements. These risks and uncertainties include, but are not limited to: uncertainties associated with COVID-19, including its possible effects on our operations and the demand for our products and services; our ability to efficiently and flexibly manage our business amid uncertainties related to COVID-19; the risk that sales and profit margins of our molecular diagnostic tests and pharmaceutical and clinical services may decline; risks related to our ability to transition from our existing product portfolio to our new tests, including unexpected costs and delays; risks related to decisions or changes in governmental or private insurers’ reimbursement levels for our tests or our ability to obtain reimbursement for our new tests at comparable levels to our existing tests; risks related to increased competition and the development of new competing tests and services; the risk that we may be unable to develop or achieve commercial success for additional molecular diagnostic tests and pharmaceutical and clinical services in a timely manner, or at all; the risk that we may not successfully develop new markets for our molecular diagnostic tests and pharmaceutical and clinical services, including our ability to successfully generate revenue outside the United States; the risk that licenses to the technology underlying our molecular diagnostic tests and pharmaceutical and clinical services and any future tests and services are terminated or cannot be maintained on satisfactory terms; risks related to delays or other problems with operating our laboratory testing facilities and our healthcare clinic; risks related to public concern over genetic testing in general or our tests in particular; risks related to regulatory requirements or enforcement in the United States and foreign countries and changes in the structure of the healthcare system or healthcare payment systems; risks related to our ability to obtain new corporate collaborations or licenses and acquire new technologies or businesses on satisfactory terms, if at all; risks related to our ability to successfully integrate and derive benefits from any technologies or businesses that we license or acquire; risks related to our projections about our business, results of operations and financial condition; risks related to the potential market opportunity for our products and services; the risk that we or our licensors may be unable to protect or that third parties will infringe the proprietary technologies underlying our tests; the risk of patent-infringement claims or challenges to the validity of our patents or other intellectual property; risks related to changes in intellectual property laws covering our molecular diagnostic tests and pharmaceutical and clinical services and patents or enforcement in the United States and foreign countries, such as the Supreme Court decisions in Mayo Collab. Servs. v. Prometheus Labs., Inc., 566 U.S. 66 (2012), Ass’n for Molecular Pathology v. Myriad Genetics, Inc., 569 U.S. 576 (2013), and Alice Corp. v. CLS Bank Int’l, 573 U.S. 208 (2014); risks of new, changing and competitive technologies and regulations in the United States and internationally; the risk that we may be unable to comply with financial operating covenants under our credit or lending agreements; the risk that we will be unable to pay, when due, amounts due under our credit or lending agreements; and other factors discussed under the heading "Risk Factors" contained in Item 1A of our most recent Annual Report on Form 10-K for the fiscal year ended June 30, 2019, which has been filed with the Securities and Exchange Commission, as well as any updates to those risk factors filed from time to time in our Quarterly Reports on Form 10-Q or Current Reports on Form 8-K. All information in this press release is as of the date of the release, and Myriad undertakes no duty to update this information unless required by law.

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Myriad Genetics Announces Publication of a Prospective Clinical Study of the EndoPredict Test in Women with Early-Stage Breast Cancer | 2020-06-04 |...

Results presented at the 2020 ASCO Virtual Scientific Program demonstrated that once daily oral relugolix (Relumina), a gonadotrophin-releasing hormone (GnRH) antagonist, induced sustained castration in 96.7% of patients with advanced prostate cancer, meeting the trials primary endpoint. These findings met the superiority threshold for relugolix when compared with leuprolide (Lupron).

In an interview with CancerNetwork, Neal D. Shore, MD, FACS of the Carolina Urologic Research Center discussed the significance of these findings and the benefits of relugolix as a GnRH antagonist.

Transcription:

So, if I could summarize how this new once daily oral GnRH antagonist medication could change the landscape of treatment for our patients with advanced prostate cancer, I would say that historically and contemporaneously, we only have a parenteral administration of testosterone (T) suppression medications, whether they're given intramuscularly or subcutaneously, or by an implant. This trial, the HERO trial, now has established that once daily oral relugolix, a GnRH antagonist so you don't get surge of testosterone you avoid clinical flare, will offer patients and physicians another significant tool to consider for achieving testosterone suppression not only because it is highly effective in achieving testosterone suppression, but if patients choose to stop medication, their testosterone recovery is much faster so they get back to the benefits of having normal testosterone. And even more significantly, the mechanism of action of an antagonist over an agonist will afford patients and physicians some comfort in knowing that there's a marked decrease in the risk of having a cardiovascular event. Interestingly, during this time of concern, as it relates to the COVID pandemic, patients can take medication at home and don't necessarily need to come into the clinic and put themselves at risk for receiving a parental injection as well as the healthcare team. So, I think these are all very significant developments.

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Neal D. Shore, MD, FACS Discusses Impact, Treatment Implications of the Phase III HERO Trial - Cancer Network

Coming Together to Solve COVID-19 Mysteries

As the COVID-19 pandemic began to be felt, scientists at Penn started work todevelop a vaccineandassess possible treatments. But the scope of COVID-19 studies at the University goes much broader. Scientists whose typical work finds them investigating autoimmune disease, influenza, HIV/AIDS, Ebola, cancer, hemophilia and more, are now applying their deep understanding of biology to confront a novel threat.

What Does SARS COVID-19 Do To Our Lungs? Another respiratory infection, influenza, has been a focus of research led by Andrew Vaughan, Penn Vet assistant professor of biomedical sciences. But Dr. Vaughan didnt hesitate to begin studies of the novel coronavirus once its eventual impact became apparent. Now, graduate students and research specialists in his labworking no more than two together at a time to maximize social distancingare conducting new experiments focused more specifically on the biology of SARS-CoV-2, alongside parallel efforts by Edward Morrissey from PSOM. Knowing that the ACE2 receptor on lung cells is the gateway for the virus into the human body, theyre genetically manipulating alveolar type-two lung cells, which are particularly essential for continuing oxygen exchange deep in the lungs, to alter or block ACE2 gene expression to try to prevent viral entry.

Why are Men Worse Off Than Women? In a separate project, Dr. Vaughan is partnering with Montserrat Anguera, Penn Vet associate professor of biomedical sciences, to explore a curious feature of COVID-19 disease: the fact that more men than women become severely ill and die. A number of hypotheses have been put forward to explain the disparity, but the two labs are investigating one particular possibility.

Dr. Anguera had posted something on Twitter saying that the ACE2 gene happens to be on the X chromosome, meaning that women have two copies of it, said Dr. Vaughan. I immediately texted her and said, I think theres something to that.

Hormone expression levels are another factor that may influence sex differences in disease. Together, Drs. Anguera and Vaughans groups are both studying ACE2 expression and exposing alveolar type-two cells to various hormones to see how expression of viral receptors, ACE2 and others, changes. Ultimately wed like to see if this changes susceptibility to infection, working withSusan Weissand others, said Dr. Vaughan.

Do Genetics Influence Susceptibility? Individual differences in how people respond to infection may be influenced by their unique genomic sequences. PIK Professor Sarah Tishkoff of PSOM and SAS is probing the rich sources of genomic data her group already had in hand to look for patterns that could explain differences in disease susceptibility. Using genomic data from 2,500 Africans collected for another project, Dr. Tishkoffs team is looking for patterns of genetic diversity. Early findings suggest that natural selection may have acted upon on a version of the ACE2 gene, making it more common in some African populations with high exposure to animal viruses.

She is also collaborating withAnurag Vermaand Giorgio Sirugo of Penn Medicine to analyze genetic variation in samples from thePenn Medicine Biobank, looking in particular at people of African descent.

How is the Immune System Reacting? The immune system is what eliminates the virus, saidE. John Wherry, chair of Systems Pharmacology and Translational Therapeutics at PSOM. The immune system is what we need to activate with a good vaccine. But also, especially in many respiratory infections, the immune system is what also causes damage. A healthy outcome means your immune system is striking a balance between killing off the virus and not doing so much damage that it kills you.

Dr. Wherry and Michael Betts, professor of microbiology, have embarked on a study to discern both the magnitude of patients immune responses as well as their flavor, that is, what components in the immune system are being activated by the coronavirus. They are doing so by working with clinicians at HUP and, soon, atPenn Presbyterian Medical Center, to collect blood samples from patients with severe and more mild infections, as well as patients who have recovered from illness, to profile their immune reactions. Variety across patients strongly suggests that the treatments that work for one patient may not for another, Drs. Wherry and Betts note. They are speaking daily with their colleagues on the front lines of COVID-19 care, relaying what theyre finding out in the lab.

The PSOMs Ronald Collman, professor of medicine, andFrederic Bushman, William Maul Measey Professor in Microbiology, have been devoting attention to how the community of bacteria, viruses, fungi and parasites that dwell in the respiratory tract affect health and disease risk. They are now addressing that question in the context of COVID-19. According to Dr. Collman, The microbiome can help set the tone for the immune response to infections, influencing whether a patient ends up with mild or severe disease. And second, the microbiome is where infectious agents that can cause infection can arise from. So if a patient dies of an eventual pneumonia, the pathogen that caused that pneumonia may have been part of that individuals respiratory tract microbiome.

Working with nurses at HUP to collect samples, Drs. Collman and Bushman are analyzing the microbiome of both the upper and lower portions of the respiratory tract of COVID-19 patients. Their labs are using these samples to identify the types and quantities of organisms that compose the microbiome to find patterns in how they correlate with disease.

What Drugs Might Make An Impact? Absent a vaccine, researchers are looking to existing drugssome already approved by the US FDA for other maladiesto help patients recover once infected. Throughout his career,Ronald Harty, Penn Vet professor of pathobiology and microbiology, has worked to develop antivirals for other infections, such as Ebola, Marburg and Lassa Fever.

Though many of the biological details of how SARS-CoV-2 interacts with the human body are distinct from the other diseases Dr. Harty has studied, his group noticed a similarity: A sequence hes targeted in other virusesa motif called PPxYis also present in the spike protein of SARS-CoV-2, which the coronavirus uses to enter cells.

This caught our eye, said Dr. Harty, and piqued our interest in the very intriguing possibility that this PPxY motif could play a role in the severity of this particular virus. He is testing antivirals he has helped identify that block the replication of Ebola, Marburg and other viruses to see if they make a dent on the activity of SARS-CoV-2. Those experiments will be done in collaboration with colleagues whose labs can work in BSL-III or -IV laboratories.

Also of interest is the speculation that the coronavirus might disrupt cell-cell junctions in the human body, making them more permeable for virus spread.

Another faculty member is assessing whether a drug developed for a very different conditionpulmonary arterial hypertension(PAH)could serve coronavirus patients. Henry Daniell, vice-chair and W.D. Miller Professor in Penn Dentals department of basic and translational sciences, shared news that a drug grown in a plant-based platform to boost levels of ACE2 and its protein product, angiotensin (1-7), was progressing to the clinic to treat PAH. Dr. Daniell is now working withKenneth Margulies, PSOM professor of medicine and physiology and research and fellowship director of the Heart Failure and Transplant Program, to explore whether this novel oral therapy can improve the clinical course of patients with symptomatic COVID-19 infection.

Reduced ACE2 expression has been linked to acute respiratory distress, severe lung injury, multi-organ failure and death, especially in older patients. The earlier preclinical studies in PAH animal models showed that orally delivered ACE2 made in plant cells accumulated ten times higher in the lungs than in the blood and safely treated PAH. Now, new clinical studies have been developed to explore whether oral supplementation of ACE2 and angiotensin-1-7 can help mitigate complications of COVID-19 disease. The fact that freeze-dried plant cells can be stored at room temperature for as long as a year and can be taken at home by COVID-19 patients make this novel approach an attractive potential option.

This trial has been given a high priority by the Penn Clinical Trial Working Group, said Dr. Daniell. Im pleased that this looks to be on the cusp of moving forward to help the growing number of COVID-19 patients.

As the coronavirus began to spread in the US, Joshua Plotkin, Walter H. and Leonore C. Annenberg Professor of the Natural Sciences, began to raise alarms about Philadelphias St. Patricks Day parade. His studies of the 1918 flu pandemic had explored disease incidence and spread, and it was hard to avoid noticingthe role of the Liberty Loan paradedown Broad Street in triggering a rampant spread of flu back then. Now, with work conducted with two graduate students and faculty member Simon Levin fromPrinceton University, Dr. Plotkin has mathematically sound advice for policymakers hoping to effectively stem the spread of a pandemic. In apreprint on arXiv.org, they share optimal, near-optimal, and robust strategies.

Their analysis makes the realistic assumption that policymakers can only enforce social distancing for a limited amount of time and aims to minimize the peak incidence of disease. The optimal strategy, they found, is to start by introducing moderate social distancing measures to keep the incidence rate the same for a period of time. This would mean that every person with COVID-19 would infect one additional person. Then the intervention should switch over to a full suppressionthe strongest possible quarantinefor the rest of the period. At the end of that period, all restrictions would be lifted.

This works because you dont want to fully suppress disease spread right off the bat, said Dr. Plotkin, because then at the end, after you remove restrictions, there will be a second peak that is just as large as the first. By employing a moderate suppression at the beginning, youre building up a population of people who are going to recover and become immune, without letting the epidemic get out of control.

Dr. Plotkin and colleagues are hoping to share the findings widely to help navigate a likely second wave of COVID-19.

Adapted from a story by Katie Baillie, Penn TodayVisithttps://tinyurl.com/pennandcovid for the full story.

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Coming Together to Solve COVID-19 Mysteries | University of Pennsylvania Almanac - UPENN Almanac

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If you struggle with dark spots and discolouration, youre not alone. In fact, according to Dr. Dennis Gross, board-certified dermatologist and founder ofDr. Dennis Gross Skincare, the number one skin concern for women is not ageing or wrinkles, its hyperpigmentation. But what exactly is it and how do you treat it?

Hyperpigmentation, the term used to describe areas of unevenpigmentation, is caused when melanin (what gives your hair and skin its colour) is overproduced in certain spots, causing the area to look darker than your natural skin tone. Theses brown patches are most commonly caused by excessive sun exposure, hormone imbalances (as a result of birth control or pregnancy), and inflammation or injury to the skin (a breakout, abug bite, or even an area you might have scratched or picked at too much). Hyperpigmentation usually appears on the face, neck, and dcolletage.

Related article:15 Essential Beauty Treatments To Try Now That Youve Got The Time

Hyperpigmentation is notoriously difficult to treat, but it is doable. If youre really serious about it, its best to visit a dermatologist for in-clinic treatments such as light therapy and peels. However, theres also a host of pigmentation fighting products that you can add to your everyday routine. The key is to look for formulations that feature ingredients such as liquorice extracts, vitamin C and E, niacinamide, beta hydroxy acids, like salicylic, and alpha hydroxyl acids, like glycolic and lactic. Of course, the easiest way to deal with pigmentation is to avoid it altogether by using a good sunscreen and leaving spots alone, especially when theyre not ready. SPF will also help keep current pigmentation from darkening.

Related article:7 Zinc Oxide Sunscreens That Blend Like A Dream

While its unlikely a single product will completely erase dark spots, these ones will certainly help lighten them.

Emma Lewisham Skin Reset Pigmentation Correcting Serum

Emma Lewisham grew up worshiping New Zealands harsh summer sun and by her late 20s she started noticing discolouration and brown spots. But it was during her pregnancy that Lewishams uneven complexion really knocked her confidence. As a result, she set about creating a product that dealt with hyperpigmentation while remaining free of toxins, fillers, synthetic chemicals, and artificial colours and fragrances. Instead, Skin Reset is formulated from 24 of the most high-performing natural ingredients from around the world.

Each bottle contains 190 skin-beautifying ingredients such as organic prickly pear, which is known for its high concentration of vitamin E, and kakadu plum, which has the highest concentration of vitamin C in the world, alongside a host of other minerals, antioxidants, aminos, and omega fatty acids (3, 6, 9, and the rare beauty omega 7).

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Allies Of Skin Mandelic Pigmentation Corrector Night Serum

This next-generation overnight serum from home-grown clean skincare brand, Allies of Skin, is supercharged with a hardworking blend of 11% Mandelic, Lactic + Salicylic acid, 8 brighteners and 7 antioxidants and peptides, helping to treat stubborn pigmentation, melasma, large pores, persistent breakouts, uneven texture and even blackheads. While most AHA (Alpha-Hydroxy Acids) serums focus only on the exfoliation aspect that can sometimes lead to tightness and irritation, this multitasking booster is formulated to not only gently dissolve dead skin cells but also replenish moisture and strengthen the skins delicate barrier, with its hydrating blend of hyaluronic acid, niacinamide and essential fatty acids from organic rosehip and tamanu oil.

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Dr. Dennis Gross Skincare Professional Grade IPL Dark Spot Concentrated Serum

Part of Dr. Dennis Gross Skincares Clinical Grade range, the brands Professional Grade IPL Dark Spot Concentrated Serum boasts an innovative formula straight from his practice formulated to help fade the look of stubborn dark spots and discolouration for an even and radiant complexion.Jam-packed with 10% L-ascorbic acid, lactic acid, kojic acid,andarbutin, this pro-level formula is clinically shown to reduce the appearance of sunspots, age spots, and dark patches in just a few weeks.

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IDS Skincare Fair Complex

IDSis askincareline made to deliver highly visible results that surpass those achieved by most prescription products, without the side effects they often cause. The brands Fair Complex comes with a proprietary formulation of peptides and active ingredients that everyone can benefit from, regardless of skin tone. Alongside lines and wrinkles, skin dullness and hyperpigmentation it also works to target the signs of ageing. The skin-brightening formula is hydroquinone-free, but coupled with state-of-the-art ingredients and IDS patented NEULASTIN technology, it effectively prevents melanin over-production and visibly counteracts age spots and hyperpigmentation without irritations or side effects.

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Derma Lab Lumiclar Pure Vitamin C15

Formulated with 15% dermatological grade Vitamin C(one of the highest in the market), Derma Labs Lumiclar Pure Vitamin C15 penetrates deep into the skins epidermis and rapidly evens out the complexion for a radiant glow. Together with ultra-stable forms of ascorbic acid, skin becomes brighter, firmer, and more lifted. Vitamin Cs powerful antioxidant properties also reinforce the skins defence against free radicals, while the Derma Mimic Complex locks in moisture and strengthens skin barrier for hydrated, healthier skin.

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Drunk Elephant T.L.C Framboos Glycolic Night Serum

Drunk Elephants T.L.C Framboos Glycolic Night Serum is a high-tech gel that resurfaces dull skin, lifting dead skin cells away by gently dissolving the glue that holds them to the surface. Formulated with a combination of glycolic, lactic, tartaric, citric and salicylic acids, and blended with raspberry extract, T.L.C. Framboos sinks in easily and delivers an effective level of chemical exfoliation without the harsh side effects like dryness or sensitisation. Fine lines, wrinkles, and discolouration, along with excess oiliness and the appearance of pores, will appear dramatically reduced. Meanwhile, horse chestnut, bearberry, and white tea help to calm and soothe while improving the appearance of broken capillaries.

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Huxley Brightly Ever After Essence

A South Korean skincare brand that has recently launched in Singapore, Huxleys products are formulated around Sahara-sourced prickly pear, which is rich in vitamin E and brimming with antioxidants to prevent moisture from escaping while promoting healthy skin cell production for a more resilient, youthful appearance. The brands Brightly Ever After Essence offers a light, milky-textured formula that targets uneven skin tone, dark spots and hyperpigmentation. Its also enriched with niacinamide, a form of Vitamin B with brightening properties that aids in reducing dullness for an even skin tone.

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Related article:The Best Luxury Body Lotions To Try Now

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The Best Over-The-Counter Products For Treating Hyperpigmentation - Harper's Bazaar Singapore

During the first chaotic months of the Covid-19 pandemic, it was already clear that the novel coronavirus spreading around the world didnt affect everyone equally. The earliest clinical data out of China showed that some people consistently fared worse than others, notably men, the elderly, and smokers. It made some scientists wonder: What if the elevated risk of severe infection and death shared by these different people all boils down to differences in a single protein?

Here's all the WIRED coverage in one place, from how to keep your children entertained to how this outbreak is affecting the economy.

Jason Sheltzer, a molecular biologist at Cold Spring Harbor Laboratory, started talking about this possibility with his partner, Joan Smith, a software engineer at Google, during the early days of their New York lockdown. We thought maybe the simplest explanation could be if all these factors affected the expression of ACE2, says Sheltzer.

ACE2, which stands for angiotensin-converting enzyme 2, is a protein that sits on the surface of many types of cells in the human body, including in the heart, gut, lungs, and inside the nose. Its a key cog in a biochemical pathway that regulates blood pressure, wound healing, and inflammation. ACE2s amino acids form a grooved pocket, allowing it to snag and chop up a destructive protein called angiotensin II, which drives up blood pressure and damages tissues. But angiotensin II isnt the only thing that fits in ACE2s pocket. So does the tip of the mace-like spike proteins that project from SARS-CoV-2, the coronavirus that causes Covid-19. Like a key turning in a latch, the virus gains entry to the cell through ACE2, then hijacks the cells protein-making machinery to make copies of itself. An infection begins.

In the early days of the pandemic, the thinking went something like this: The more ACE2 a person has, the easier it should be for the coronavirus to invade and advance through their tissues, causing more severe forms of the disease. The more ways inside someones cells, the higher the persons risk. Thats the hypothesis Sheltzer and Smith were interested in investigating. They werent alone. As the virus spread beyond China, other high-risk groups surfaced: people with heart conditions, high blood pressure, diabetes, and obesity. Many people in these groups take medications that are known to boost ACE2 expression. So again, scientists wondered, could that protein be responsible?

But as researchers began to probe the relationship between ACE2 and this dangerous new disease, the data refused to line up in any neat, predictable patterns. What we know now is that there arent any simplistic, reductionist explanations that can unify all the clinical data thats been recovered so far, says Sheltzer. Instead, a more complicated picture has emerged. But its one that still has ACE2 at the center of the action.

Smoking Dials Up the ACE2

Sheltzer and Smith, confined to their home, couldnt run any experiments to tease out their initial hypothesis. Instead, they combed through existing data sets from both animal and human studies that measured the level of gene expression in various tissues. Over and over, they found that women and men produced similar amounts of ACE2 inside their lung cells. They also couldnt find any differences between young adults and older ones. Aging didnt change ACE2 one way or another. But the smokers were a different story.

When they looked at gene expression inside the lungs of smokers versus nonsmokers, they saw a huge spike in ACE2 coming from one particular kind of cell: secretory goblet cells. The job of these mucous-makers is to coat the inside of the respiratory tract, protecting it from any irritants you might breathe in (like say, tar, nicotine, or any of the other 250 harmful chemicals in cigarette smoke). The more people smoked, the more their goblet cells multiplied in an effort to trap these chemicals before they could damage surrounding tissue. Those expanding goblet cell army ranks fueled a surge in ACE2, as Sheltzer and his coauthors described in a study published in Developmental Cell in mid-May.

Read more:
Meet ACE2, the Enzyme at the Center of the Covid-19 Mystery - WIRED

The Adenomyosis Treatment Market report includes overview, which interprets value chain structure, industrial environment, regional analysis, applications, market size, and forecast. This is a latest report, covering the current COVID-19 impact on the market. The pandemic of Coronavirus (COVID-19) has affected every aspect of life globally. This has brought along several changes in market conditions. The rapidly changing market scenario and initial and future assessment of the impact is covered in the report. The report provides an overall analysis of the market based on types, applications, regions, and for the forecast period from 2020 to 2026. It also offers investment opportunities and probable threats in the market based on an intelligent analysis.

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About UpMarketResearch:Up Market Research (https://www.upmarketresearch.com) is a leading distributor of market research report with more than 800+ global clients. As a market research company, we take pride in equipping our clients with insights and data that holds the power to truly make a difference to their business. Our mission is singular and well-defined we want to help our clients envisage their business environment so that they are able to make informed, strategic and therefore successful decisions for themselves.

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Adenomyosis Treatment Market 2019 | Analyzing The Impact Followed By Restraints, Opportunities And Projected Developments | UpMarketResearch - Medic...

I went in to premature menopause in 2008 and I was 38 years old at that time. My OB/GYN put me on HRT but after one year and a half, I started having palpitations and dizziness. After so medical tests, my doctors decided not to give me their HRT any longer. My OB/GYN strongly suggested to me not to take any oral hormones and I follow that recommendation for 8 years until I realized that my marriage was suffering because my libido was inexistent and having intercourse was extremely painful. That was not a good combination and I decided to start looking for getting help. I had other symptoms but after 8 years in menopause, those were manageable. So, I did some research and found Dr. Matos. Now, after two pellet therapies and a 4-week booster, I feel like a teenager. Sounds funny but it is true. Dryness is gone for good and my libido is back. I am sleeping at least 7 hours every day, I am gaining more energy, and my memory is getting stronger. Last week, I got my second pellet therapy and I have never been so excited to go to a doctors appointment in my entire live.This treatment works perfectly fine and I am encouraging my husband to give it a try.Thank you, Dr. Matos.

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Advanced Hormone Solutions - HORMONE THERAPY

TUCSON For 17-year-old Fran Howard, receiving medical care has not always been easy. Howard identifies as nonbinary gender queer and uses they/them pronouns.

Years ago, Howard began seeking treatment to help transition but found it difficult to find a doctor who respected the decision and Howards medical needs.

I felt like I had to prove my identity, Howard said. Just being in a trans body and existing in the world is already so difficult, and going to the doctor is just this whole super invasive experience.

Legislation cropping up in statehouses across the U.S. could make that experience even more difficult.

In at least a dozen states, including South Dakota, Florida and Ohio, bills were introduced this year to make it harder for transgender minors to get medical treatment such as puberty blockers and other hormone therapies.

Some bills proposed criminalizing doctors who provide such treatment. Floridas measure carried a maximum penalty of up to 15 years in prison. Missouri physicians faced having their medical licenses revoked, and parents of children receiving treatment in that state would be reported to social services for child abuse.

Advocates for trans teens assert the proposals, though theyve not become law, are part of a larger push to discriminate against transgender people. They point to other bills including one passed by the Arizona House that would ban transgender athletes in girls sports. In Arizona, that measure stalled in the Senate.

The 2020 state legislative season has seen unprecedented attacks on LGBTQ people, and an alarming focus on bills that would harm trans youth, Rose Saxe, deputy director of the American Civil Liberties Union LGBT & HIV Project, wrote on the organizations website.

These efforts are part of an orchestrated national campaign led by groups like Heritage Foundation, Alliance Defending Freedom to demonize trans youth and drive a wedge among supporters of LGBTQ equality, Saxe continued. We cant let them succeed.

Ryan Anderson, a senior research fellow at the Heritage Foundation, disputed that.

He said the measures around medical treatment are meant to protect youth from making decisions they may later regret. He called treatments such as hormone therapy and puberty blockers experimental and unethical.

Its entirely appropriate for the government to say that physicians cant perform those procedures to protect children from the abuse of medicine, the misuse of medicine, he said.

In an email, Matt Sharp, senior counsel for the Alliance Defending Freedom, said: While approaches may differ, we should all agree that there is nothing natural or healthy about pumping kids full of puberty blockers and cross-sex hormones.

Children should not be pushed to receive experimental treatments that can leave them permanently sterile and physically marred for life.

Fran Howard, with the support of their mother, sought medical treatment at age 13 after questioning their gender identity. They found help at El Rio Health. After consultations, treatment started with puberty suppression and has progressed to testosterone.

Before transitioning, my mental health was in a really terrible place. Nobody saw me as who I was. I didnt see myself as who I was, Howard said.

Being able to transition has saved my life, and the fact that that is being challenged for other people is very frightening, because many people will not be able to survive.

Howards mother, Tina, said she raised her children in a gender-fluid home, avoiding assigning specific gender roles.

This is really about building a safe environment for trans individuals and their family, she said.

Pediatricians Andrew Cronyn and Tracey Kurtzman started the El Rio clinics transgender department five years ago, and theyve treated about 250 patients since.

Cronyn initially had planned to launch a program for the children of lesbian, gay and bisexual parents. But after posting a note on Facebook, he heard about a different need: appropriate primary care for transgender kids whose pediatricians wouldnt call them by their preferred names or pronouns or tried to convince them their gender assignment at birth was appropriate.

The kids we see will usually have been talking to their parents about gender at home for six months to a year before they even consider talking to a doctor about it, he said.

Cronyn works with patients parents to educate them about gender dysphoria, a condition in which people feel a conflict between the gender assigned them at birth and the gender they identify with.

For those beginning puberty, treatment may include drugs that inhibit or delay puberty. For older teens who have been persistent, consistent and insistent about their gender identity, Cronyn said, hormone therapy may be prescribed.

According to the Mayo Clinic, puberty blockers do not cause permanent changes in an adolescents body, and puberty can resume if the treatment is stopped.

A lot of people worry youre blocking it and youve changed their life completely, Cronyn said. And the truth is we havent. If they say, This isnt the right road for me, then we can stop the medicine and their puberty starts right where it was before.

Cronyn and other experts said they worry about efforts to try to restrict such care and the potential effects on the emotional health of transgender children.

Research published last year by the American Academy of Pediatrics found that transgender youth are more likely to consider suicide than other teens. The study found 34% of transgender adolescents reported experiencing suicidal ideation in the past year, while 61% reported having suicidal thoughts over their lifetime.

Alex Keuroghlian is an associate professor of psychiatry at Harvard Medical School, director of the Massachusetts General Hospital Psychiatry Gender Identity Program and also directs the National LGBT Health Education Center, a federally funded effort to improve health care for LGBTQ people. He co-authored a study published earlier this year in the journal Pediatrics showing a decrease in suicidal ideation among trans youth who had access to puberty blockers.

What we tell families is that in order to have a child who is healthy and happy and thrives, you need to affirm them in their gender identity, and these medical therapies help with that, Keuroghlian said. Its not a decision thats made thoughtlessly by patients families or their medical providers.

Research has found that among those who do seek to transition, a minority later change their minds. A 2015 survey of 28,000 people conducted by the National Center for Transgender Equality found 8% of respondents reported reversing their gender transition, and 62% of those who detransitioned did so only temporarily.

Fran Howard said such treatments changed their life.

I personally cant imagine that without the support of my family, and without medical intervention, that I would still be here today and that is true for a lot of kids, Howard said. For a trans person, this isnt the same as dyeing your hair color. Its being yourself. And to be denied that, it completely takes away somebodys human rights. People will die.

Read more:
Bills seek to limit puberty blockers, other treatment for transgender youth - KTAR.com