Archive for the ‘Hormone Clinic’ Category

Study group

The study group was differentiated by several sociodemographic factors, most importantly age of the participants, as it ranged from 45 to 65years. Obviously, it was due to the inclusion criteria adopted in this study, which referred not to the chronological age, but to the time which lapsed since the last menstrual period, and also due to quite large time span (between 2 and 10years of the menopause) accepted for the study. Participants of this study went through menopause between the age of 40 and 60. This is consistent with population studies concerning Poland [26] and other highly developed countries [27, 28].

The diversity concerning the place of living provides, according to some authors, the possibility of identifying beneficial as well as adverse aspects of living in urban and rural areas [29, 30]. It is worth emphasizing that the differences between these areas are becoming less and less noticeable. In this study the number rural residents was significant (40.4%). The vast majority of the respondents (75.5%) declared to have completed secondary education. Study groups in similar studies conducted by other authors also comprised women with similar educational background [31], however some other authors noted a higher percentage of participants with basic vocational education [32]. According to broad population studies, middle aged women are characterized by a lower level of education than the study group in the presented material [33].

Hormone replacement therapy was used by 10.6% of respondents at the time of the study. In the light of reports from literature, this percentage should be considered as relatively low, because, as some authors claim, climacteric syndrome symptoms appear in 75% of perimenopausal women, and 25% of them require treatment [34]. Hormone replacement therapy is effective in relieving menopausal symptoms, i.e. hot flushes, night sweats, dyspareunia, sexual dysfunction and insomnia, as well as in the prevention of osteoporosis [34, 35]. However, there are some contraindications to the use of this therapy [36].

In the presented material, an attempt was made to define the concept of being healthy as understood by the postmenopausal women. The obtained results proved that the respondents perceived health primarily as a feature (to have all parts of the body functioning well and not to feel any physical discomfort) and/or condition (to experience happiness most of the time). These results are similar to the results obtained in other studies which were carried out on groups of elderly people [37, 38]. There are also studies showing that health is perceived as a feature also by younger people, i.e. over 40years of age [39], and by chronic patients [40].

The analysis of the presented results showed that the definition of health was related to the self-assessment of health. The study proved that women with low self-assessment of their health more frequently understood health instrumentally. Interestingly, these participants selected the statements which defined health as a feature of a body (to take medications only occasionally, not be sick or only suffer from flu, cold or indigestion, not need to make appointments with a doctor and/or hardly ever go to the doctor). On the other hand, those who assessed their own health better were more likely to choose claims that corresponded to the definition values of the result (to eat properly) or purpose (to accept oneself, to know your capabilities and deficiencies). In his study, Juczyski noted that low self-assessment of health was associated with attaching greater importance to the physical criteria of health [25]. Moreover, there are differences in the way health is understood in the case of loss of health or the occurrence of chronic illness [3]. Thus, health self-assessment is gaining popularity in the field of epidemiological research where is employed to assess the health condition of entire populations [41]. Additionally, some authors notice a correlation between health self-assessment and the results of laboratory tests and the prevalence of various civilization diseases [42]. In this study self-assessment of health proved to be surprisingly high. It was rated as good by more than half of the respondents, even though they were undergoingcontinuous treatment for various chronic diseases. The literature review shows that hypertension, coronary heart disease and atherosclerosis are the main medical problems in the postmenopausal period [43, 44].

The overall rate of health behaviours of the women in the studied group was average (M=86.18, SD=13.08). The results proved to be comparable with the normalized results of Juczyski (M=85.98, SD=12.70) who observed that the postmenopausal women exhibit more behaviours that have a positive effect on health than younger women. Juczyski claims that the only exception to this observation are the younger women who are affected by some chronic diseases [25]. Recent years indicate a fairly constant tendency among older women to improve their health behaviours. According to some authors, seniors may even show above-average results [45]. However, the study by Kurowska and Kierzenkowska [32] shows the opposite trend women over 60 have worse results in the area of pro-health behaviours. The results of the present study indicate that prevailing pro-health activities encompass prophylactic behaviours. Postmenopausal women should be under a regular care of a gynaecological clinic, just like younger women, and the frequency and type of appointments should be agreed individually, depending on the needs [46]. Nevertheless, gynaecological check-ups should take place at least once a year [14].

Our study revealed that slightly more than a half of the respondents regularly had a prophylactic gynaecological examination, and only 32.0% of them did so in line with the above-mentioned recommendations. In addition, the study confirmed that some women (11.7%) had never had a prophylactic gynaecological examination performed. It is probable they would never see a doctor without a serious reason, which could be considered a risky behaviour once they reached the postmenopausal period. According to literature, the frequency of women reporting for gynaecological examinations decreases with age, and women between 41 and 60 report to the gynaecologist less frequently than every 20months [47]. This situation should be considered as both worrying and requiring improvement. This study shows that in many cases (37.3%) the only reason for making an appointment with a gynaecologist was the appearance of disturbing symptoms. Such appointments do not have a prophylactic character. Some authors claim that such appointments are perceived by many women as a compulsion or an indispensable duty. They feel exempt from this duty if there are no disturbing symptoms [14]. Sometimes even when symptoms do show up (including the climacteric syndrome), it does not increase the regularity of gynaecological check-ups [48]. Breast self-examination is the first step in the secondary prophylactics of breast cancer. It is a simple, inexpensive, fast and non-invasive examination and all women should be encouraged to be more actively responsible for their own health [49]. It is the self-examination of breast that increases the number of early detections of breast cancers and therefore women should be encouraged to perform this self-check on a regular basis [14]. Our study indicated that 72.4% of women perform breast self-examination, although only a few (13.8%) did it regularly on a monthly basis. Similar trend was observed by other researchers [50]. One of the possible manifestations of womens concerns for their own health is taking advantage of free prophylactic examinations. According to the National Health Fund (NFZ), in 2015 only one in five women took part in the Population-Based Breast Cancer Early Detection Program, and in 2018 nearly two times more women participated. The Population-Based Cervical Cancer Screening Program attracted even fewer women-9.34 and 17.89%, respectively [51]. Our study indicated that 72.4% of the respondents declared undergoing regular mammography examinations and 69.4% confirmed they undergo regular smear tests of the cervix. However, it is not known to what extent this was a participation in a population-based screening programme. Perhaps some of them decided to undergo these examinations on their own initiative, i.e. without an invitation. What is more, some women sign up for test in private clinics. Anyway, the attendance rate is still unsatisfactory [52]. The reasons for such low attendance rate may be numerous and include a lack of faith in their effectiveness, ignoring the problem of cancer, the fear of pain and nudity associated with the examination, as well as fear of detecting the disease [53].

As regards health behaviours concerning positive mental attitude (PMA), the following categories were taken into account: avoidance of upsetting and depressing situations, avoidance of excessive emotions and tensions, and social life. The analysed material showed quite high psychometric properties of this factor (M=3.60; SD=0.70), which can be considered beneficial for the mental health of postmenopausal women. This is good news, as in this age group the incidence of various mental disorders, especially depression and anxiety, is generally on the increase [9]. These women, when compared to younger women, feel more negative emotions, such as anxiety, sadness and exhaustion [49].

Proper eating habits (PEH) are the third important health criterion and a number of factors were taken into account including the frequency of consumption of fruit, vegetables and wholegrain bread, and decrease in the consumption of animal fats, sugar, salt and heavily salted foods. The literature emphasizes the importance of following the principles of healthy nutrition and proper diet in the prophylaxis of diseases typical for the postmenopausal period (metabolic syndrome, ischemic heart disease, diabetes, malignant tumors, osteoporosis and depressive disorders) [14, 54].

It is worth noting that Juczyski [25] presented an identical distribution of results for all categories of health behaviours in his study. It is undeniable, however, that the results obtained by the authors of this study as well as the results obtained by other authors show that women are not sufficiently concerned about their own health. The average results which were obtained in reference to health-related behaviours cannot be considered satisfactory, due to the fact that women in this period are more susceptible to various psychophysical disorders [9, 14, 55, 56].

Choosing pro-health behaviours is usually characteristic of people who are satisfied with their health [57]. In the presented material higher self-assessment of health was significantly associated with a higher general indicator of health-related behaviours. In addition, in both age groups women who regularly performed prophylactic gynaecological examinations obtained higher score of the general indicator of health-related behaviours, proper eating habits (PEH), prophylactic behaviours (PBs) and health activities (HA). Moreover, women over 55years of age, who achieved higher scores in prophylactic behaviours (PBs) had mammography screening and preformed self-examination of breasts more regularly.

The obtained results concerning the concept of health, health self-assessment and the type of health behaviours undertaken by postmenopausal women may be further used in broadly defined health promotion programs, including new prophylactic programs. Most of these programs are aimed at convincing women that the proposed health-related behaviours will not only improve their lives but also they will be beneficial for their families and society. However, the programs need to be constantly improved and adapted to changing needs.

This study has several important limitations that may affect the obtained results. First and foremost, the selection of the study sample using convenience sampling methodology. Next, the broad age range of women included in the study. Therefore, for the purpose of statistical analysis, the study group was divided into two age groups. This way it was possible to show in more detail any possible differences in health behaviours and in the undertaken prophylactic activities. Another limitation is connected with the inclusion of women who had reported that they were undergoing continuous treatment for chronic diseases at the time of the study, which could have modified their health behaviours. However, due to the age of the participants, it is difficult, if at all possible, to include only women without any ongoing health problems. Therefore, to minimize this limitation, a statistical analysis was performed to check any potential differences in health behaviours presented by women in these two groups (with and without chronic diseases). The analysis showed that there is no statistically significant difference between these women in terms of health behaviours. It has to be noted that the claim of an undergoing treatment for a chronic disease was made subjectively by the participants. Their health history was not examined to objectify the results, neither were their former health behaviours investigated. Therefore, it was impossible to compare and analyse any changes, which could have occurred in this regard. It would be advisable to carry out such analyses in the future using a mix-method methodology, supplementing the collected material with qualitative research, which would allow for a more in-depth analysis of the issue.

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Perception of health, health behaviours and the use of prophylactic examinations in postmenopausal women - BMC Blogs Network

When Dr Phil McGraw was 29, he had a vasectomy. At the time his wife was pregnant and he had made up his mind that he didnt want more children. Six years later, he would walk back into the clinic and demand for a reversal. Six months later, his wife was expectant.Having the procedure at such a young age was the biggest mistake I ever made.It is for this reason that doctors advice that when going for some long term family planning measures, you need to be absolutely sure. Vasectomy offers 99 per cent effectiveness and is suitable for men who are certain that they do not want any more children. According to Marie Stopes Kenya, this male sterilisation surgical procedure takes approximately 15 minutes and its failure rate is about 1 in 2,000 men. The Kenya Obstetrical and Gynecological Society reports that only one per cent of Kenyan men have undergone vasectomy despite its high effectiveness and surgical simplicity. However, since most vasectomies are performed in private facilities rather than in the public health system, the statistics could be an underestimation.It is estimated that 40 per cent of pregnancies globally are unplanned. In addition, most women are shunning hormonal contraceptives due to associated side effects. The modern man has grown more aware of the struggles their female partners go through and is more willing to take up family planning options. The options are nevertheless limited for men. Condoms, withdrawal (coitus interruptus and vasectomies are the most readily available artificial methods men can use. A man produces over 1,500 sperms per second which makes it challenging to come up with the most suitable reversible family planning method for men. But not to worry, there are options in the pipeline that will give the man more options and power over how many children he can have.WATCH OUT FOR:1. The Contraceptive gel

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Birth control options for the man who wants to take charge - Standard Digital

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Outlook on the Thyroid Hormone Disorder Drug Market to 2025 by Application, E - News by aeresearch

The coronavirus pandemic has caused strain and hardship in so many ways and for so many peoplebut one demonstrable effect is that it has made the vulnerable more vulnerable. If it was already difficult to be an LGBTQ youth whose parents or caretakers dont understand or accept their sexuality/gender identity, that stress is magnified during a time when we, as a society, have been advised to stay indoors. The situation can effectively trap these people between the forces of a global pandemic outside and virulent bigotry inside.

The New York-based Ali Forney Center (AFC) continues to serve homeless LGBTQ youth, even during a global pandemic, providing housing, mental health support, meals, and a transitional living program that teaches youth to live independently. Though the AFC has been impacted by covid-19 in several ways, it is largely meeting the increased demands, according to executive director Alex Roque, who talked to Jezebel last week about the AFCs operation in the midst of a crisis. The organizations drop-in center, which serves new clients with no place to go, remains open (though it has moved to the organizations Bea Arthur Residence in Manhattans East Village). Theres been an increased demandin part because many of their former clients who were in college have been sent home, which means needing to return to one of the 18 AFC facilities around the city. Despite this, AFC has managed to increase its meal budget and spending for its recentlyout-of-work clients. (An info sheet sent out by AFCs communications department says that 90 percent of the organizations housed clients have lost their jobs as a result of the pandemic). Further, salaries of AFCs essential workers have increased by almost 50 percent. We really felt strongly that we needed to recognize how critical and how valued our essential workers are, Roque told me.

In our conversation, Roque explained how AFC has managed to do it, and how it is managing in general. Our interview has been edited and condensed.

JEZEBEL: Overall, how as the Ali Forney Center been managing during this pandemic?

ALEX ROQUE: AFC is in a unique because we are an essential services provider thats caring for a largely disenfranchised, uncared for population of young people who are rejected by their families because of their LGBTQ identity. Around the country and across the world, people have been asked to stay home and to shelter in place and find safety in their homes, and comfort in their families. Our young people dont have any of that, so its kind of a punctuation to what their realities are that even in these dark days and awful circumstances, they have nowhere to go.

Things are pausing. Pollution is down. Wild animals are running free. Critical care hospitalizationlike, heart attacks and strokeshave also declined significantly, according to the New York Times. I thought that maybe homophobia and transphobia would also just take a little pause. That hasnt been the case. Were seeing an increase in young people in our care and a demand for our work. A lot of it has to do with young people who were in our care before who went off to college and then were sent back because of shut-downs and we were their home before college. Some of it has been with young people who left their homes at younger ages because of homophobia and transphobia and were employed and have lost their jobs and now have no family to rely on. And another part of it is that a number of youth services providers have shut down in the city. A number of the shelters have shut down as a result of staffing issues, a number of community spaces and things like that have closed their doors. Thats increased the demand for our work. But theres this understanding that covid-19 is disproportionately affecting communities of color, disproportionately affecting communities struggling with poverty and lacking access to care. Its true for our young people. Among the most marginalized communities, our young people are still marginalized. Among LGBT youth, our young people are homeless LGBT youth.

Are you able to provide the same services that you were providing pre-coronavirus?

The drop-in center was moved to the Bea Arthur Residence at the recommendation of our medical provider. We have an onsite medical clinic and when covid started, we retained our medical provider to advise us on how to operate following CDC protocol. The CDC protocol was that there should be no more than 10 people congregating in a space. Thats difficult for us to do at the drop-in center, especially because we had on average anywhere between 60 and 80 young people coming there a day. We moved to a smaller facility where we can structure it more: housing referrals, offering meals, and offering crisis intervention for young people at Bea Arthur, and then more importantly, making sure were getting them into a stable bed as we work through this. Initially, it was a big increase and then when the new protocols came into place on March 23 about stay at home and 10 people or less, we moved it to Bea Arthur. A bulk of our services that were drop-in related were moved online. About 70 percent of our counseling, mental health, psychotherapy, medical, and educational services moved online. Were offering those online to young people and were still doing a structured drop-in program.

So, if someone is sheltering in place with a homophobic or transphobic parent, they still can leave and come to you?

Correct. They can come and access a meal, they can come and access support, and they can come and access solutions to housing options. We have 18 sites throughout New York City, and so we have beds at all those sites, except for the drop-in center. So if a young person is unstably housed, they can come to us, have the crisis de-escalation, have the intervention they can offer, and then have a housing referral to our program, which is preferred, or to another program that we work with.

What is the process in place for someone who comes in and has been potentially exposed to covid, and could expose other people? Is there any sort of quarantine?

Young people across all of our sites are assessed twice a day for their symptoms: temperature and a health check-in. Similarly, for clients that were intaking, were following a protocol. Outside of covid, when a young person would come into our care, they would have a medical evaluation and a check-in. Part of that evaluation now also includes covid, but also assessing them on their experiences and other health issues. We do have an isolation option at each of our housing sites. We have an isolation protocol at all of our sites so were not rejecting anyone from housing regardless of their exposure. Were working with the citys Department of Youth and Community Development on running a hotel to service isolation. If a young person is needing isolation, instead of isolating at our site, they will be picked up by a transportation service that will bring them to the hotel. At the hotel, they will be given a room. There will be 24-hour staff on site, like there is in our housing sites, and there will also be medical staff on sitea nurse and a medical doctor providing care.

You have increased demandare you able to meet it? Is it stretching your resources?

The increased demand has been largely from clients who were accessing care in other places, like meals and group activities and access to employment or employment help. Right now, were facing a lot of applications for unemployment. There are young people that we work with that are facing immigration issues, legal services. Young people are very resilient and resourceful, so typically wed piece together different resources throughout the city they could go to. And now because all of those have closed, weve had to increase our access to meals, consultation, mental health services and therapy, medical care, and also just access to a person. Were one of the few providers that are providing access to in-person care. So its an increase in volume, but not to the extent that we have to bring in a new staff team for that. We have the staff in place.

Youve been able to manage this extra demand?

We have.

Was it a challenge to get the youth on board with sheltering in place?

Yeah. Its been a challenge for most people around the world and our young people are no different. We definitely have struggled and had to rethink our work. We started having conversations with young people that went: What can we do to keep you here? We heard some really awesome things. When we really had to start to enforce the stay at home order, which came about a week after we started the covid response, they had some great ideas. They wanted more groups online, they wanted to be able to see their friends and they needed technology for that. They wanted to have pizza parties and ice cream socials and taco nights. They all wanted their own Hulu accounts. We had experiences with young people who lost employment and young people who didnt have conventional employment and needed help getting money because they still want to buy their own things.

We came up with a way of offering incentives. If you are covid compliant, you get a weekly stipend for staying at home and following those protocols. The reality is this is what families are dealing with across the country. I have a five-year-old and Im having these conversations about staying at home and why were here and why he cant see his friends. I think any supportive or loving environment is going to creatively brainstorm around that. So now we do Zoom dates with our friends and are playing more video games and he has all the junk food he wants, which he never has before. Were embracing it. Were all in this together and were going to do everything we can to keep you happy and support that. Whats different for us than a traditional family is that we are dealing largely with young people who are traumatized by their family rejection, who are dealing with some really, really awful backgrounds related to living on the streets and what theyve had to do to survive. This is retraumatizing, so were also infusing this approach to being creative during covid with a host of mental health services, a host of direct care and support groups and activities that are clinically based to help cope.

Youve increased spendingwhere did that money come from?

Fortunately, a number of agencies have come together to help. The city is offering help for their programs. We have city, state, and federal programs. Our meal program is largely unfunded. We serve over 220,000 meals a year and thats a largely unfunded program so weve had to shoulder that ourselves. Weve been able to petition to get more funding in those areas. Weve also reached out to our community, thats helping. We reached out to restaurants that sent food. We reached out to other partners who are meal providers. A lot of that has been helpful in getting food to our clients. The reason the number went up so much is because in our transitional living program, which is a graduating part of our work, the people in that program learn to buy their own groceries, the learn to cook for themselves, theyre required to have a job or being in school. And with them losing their jobs, weve had to increase our food expense, which is already difficult to meet. Weve been reaching out and securing meals. Were okay this week. Its kind of like Groundhog Day in many ways: Okay, here we go again. How are we finding meals this week? But were getting through it.

It sounds like youre doing well, all things considered.

Were very fortunate. Were a very young and scrappy organization thats also very mighty and driven by an incredible staff team. Many have the lived experiences of many of our clients, many come from communities that represent our clients, and many understand this calling, that we are these young peoples family. We are their comfort. We are their safety. Theres a lot of unity and compassion in the work and its something that were very proud of. Were stable. We have over 200 employees, and at any given time the average has been 30 staff members out because of covid, either because theyre at higher risk or because theyve had covid. The number of staff members whove had covid is much, much lower but its been rotating. Staff will be out for a two-week period and then theyll come back around and someone else is out. What struck me is the commitment of our team to being there. Our call-outs having to fill slots hasnt been out of the ordinary. Its been what we typically see, and we thought we were going to see a big decline in staff being able to show up for work. Weve been very fortunate and as a result weve been reaching out to providers and offering help because so many of them are not as fortunate as we are.

With staff members out and new clients coming in, are you secure in your ability to keep everyone safe from infection?

Weve had no shortage of young people who have been symptomatic and who have been put in isolation. We havent had outbreaks. Were following the protocols closely, were following the isolation closely, were following the cleaning. Were making sure the young person is cared for in a way that theyre not exposing [anyone else]that theres ventilation, theres a number of protocols in place. Were a month in, knock on wood, and we havent had an outbreak. Whats also to our benefit is that were in small, home-like environments and we have the same staff working our sites mostly, so its kind of like a family.

Can you give me a sense of what the increasing of staff salaries has looked like, in terms of a percentage?

Theres been a 44 percent or almost 50 percent increase in our pay for this period. We really felt strongly that we needed to recognize how critical and how valued our essential workers are, and thats 90 percent of our staff team is essential workers, frontline workers. So weve increased that in appreciation and support and recognizing that they are doing the extraordinary. At any given time, we have over 70 to 85 people on site, on staff, working around the clock. Theyre showing up for our young people and we really needed to recognize that. Theres so much gratitude across the board, and there is that moment of unity and this abundance of love that were feeling and a call to humanity right now. It definitely feels that way.

Do you have a sense of the morale among the youth?

Its gone up and down. Initially, there was a shock in seeing other programs close, in watching this starting to happen. There was a big moment of fear. Theres some restlessness right now. For some young people, theres been an increase in depression. This is isolating. The homeless population is largely isolated from the world and we work really hard so that people dont have that isolation. We mitigate and disrupt these feelings of isolation and now were re-isolated. Were doing meditation and yoga.

Has there been any change in your trans youths access to hormones?

During Week 2, after the stay at home order and we started to move our services to teleservices, we introduced a protocol to address hormone replacement therapy. We have a transgender housing site that has 18 young TG and T individuals. Our medical provider offers a guided live session with a staff person and a young person, so theres two people helping a young person with the administration of HRT.

What can people do who want to help?

Visit our website. It doesnt have to be money. Money is obviously needed, its helping us make the decisions for the purchases we need, but obviously thats not available to everyone and some people want to help in a different way. We have set up an [Amazon] wishlist, which allows you to understand the unique needs of an individual young person and also we have a way to sign up to engage in other ways. You can interact with a young person in a safe and secure way, or if you want to write a card, if you want to host a yoga session or talk about meditation or your job. Were open to connecting. At the core of our work is demonstrating to young people that theres nothing wrong with them, that there are people in our world who care about them, who value them, and who wish nothing but the best for them in spite of what their parents contend. So connecting with people is so important.

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How One Center for Vulnerable LGBTQ+ Youth Is Helping Its Clients During the Pandemic - Jezebel

The majority of the time, periods arrive like clockwork. But sometimes, periods are late or skipped entirely.

There are all sorts of reasons for a missed period. Pregnancy tops the list, of course. But other factors including taking some medications, hormonal issues, and menopause can also delay your period.

In fact, stress is a common reason for a period that doesn't arrive on schedule.

"A woman's menstrual cycle can be a great barometer for her stress level both acute stress and chronic stress," says Lisa Valle, DO, OB/GYN at Providence Saint John's Health Center.

Stress leads to an increase in cortisol, known as the stress hormone. As this hormone increases, it "can wreak havoc on the menstrual cycle by altering the normal hormonal patterns that allow for ovulation and menstruation to occur," says Valle.

Hormones play an essential role in the menstrual cycle, so it's not surprising that an increase in the cortisol hormone has an impact.

Here's how your cycle typically progresses: Hormones are released by the hypothalamus and pituitary gland, which in turn cause a response in the ovaries. "It is a fine, delicate balance between your hormones estrogen and progesterone that determines your menstrual flow," Valle says. Stress upends these hormonal patterns.

"This can result in a missed period, delayed bleeding, breakthrough bleeding, or an early period depending on when the stress occurs during the cycle," Valle says.

According to Cleveland Clinic, amenorrhea is the absence of a monthly period. This can occur as a result of issues with the ovaries, reproductive organs, or hormones and stress is a known cause.

In a study that examined the connection between menstrual problems and stress, female students who had high perceived stress were four times more likely to experience amenorrhea. Other studies have found a similar connection between stress and irregular menstruation.

Stress can also lead to a longer cycle, a condition known as oligomenorrhea, says Briana Livingston, MD, OB/GYN at MemorialCare Medical Group. A late or skipped period can be a cause of additional stress, notes Livingston, especially if you're not trying to get pregnant.

From your body's perspective, the type of stress you're experiencing doesn't matter. "Any type of stress can affect your period. This can be emotional, mental or physical," says Valle.

If you are stressed, Livingston advises trying meditation, exercising regularly, and discussing problems with loved ones or a mental health professional. The good news is that once your stress passes, your period should go back to normal.

"When major stress in your life resolves, your period will almost always resume its regular schedule without any long lasting effects on your cycle or your fertility," says Livingston.

Like stress, depression can also have an effect on hormones. Depression is one of the factors that can lead to amenorrhea, according to the Cleveland Clinic. The two conditions are often linked people with chronic stress in their life have a higher risk of developing depression, notes the Mayo Clinic.

There's another consideration when it comes to depression and your period: Some antidepressant medications including SSRIs can increase the levels of a hormone called prolactin, according to a March 2015 review published in The Journal of Clinical Endocrinology & Metabolism. This can delay your period or skip it entirely.

Plus, people experiencing depression often shift their eating habits and experience a loss of appetite. Not eating sufficiently, and having a low body weight, are potential causes of amenorrhea, per the U.S. Department of Health and Human Services.

If your period is irregular or doesn't occur at all for more than three months, you should talk to your gynecologist, Livingston says.

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Can stress delay your period? Yes, and it's a common reason - Insider - INSIDER

A man who spent 11 years living as a trans woman has trained as a counsellor to help people accept their gender, after detransitioning back to being male.

Brian Belovitch, 63, decided to transition to a woman when he was 19 years old, having treatment including hormone therapy and breast implants.

Brian, of Brooklyn, New York, said he felt uncomfortable in his own skin at the time.

I was so uncomfortable as an effeminate, chubby gay boy I thought it would be easier just to be female. Looking back now, I realise I never felt like a woman.

Brian continued: It was more that my gender had always been in question and the idea that something wasnt quite right was forced on me.

It was like, Well, if people think Im a girl, Ill be a girl.'

Brian is speaking out about his extraordinary life, which has seen him battle addiction as he tried to fathom who he really was, just as a British woman has been given the go-ahead to pursue legal action against an NHS gender clinic, saying they should have challenged her more ardently before allowing her to transition from female to male.

Known as a detransitioner a trans person who has reverted back to the sex they were assigned at birth Brian believes we are seeing the tip of the iceberg when it comes people making the decision to change gender in this way.

He said: Youd be shocked by how many people are already coming out in the community to talk about this.

I think people have this idea that transitioning is a great fix all and end up doing it for the wrong reasons.

People like myself have a duty to speak out and be vocal its the only way to stop the same mistakes being made again.

Brian certainly enjoyed a colourful existence after transitioning living as the showgirl Natalia Tish Gervais, through the late 70s and early 80s and performing in legendary New York nightspots like Dancetaria, the Limelight Club and Studio 54, made famous by artist Andy Warhol.

But beneath the glamorous surface was a seedy underbelly that saw Brian, who is now happily married to horticulturist Jim Russell, 61, develop crippling drug and alcohol addictions.

Hitting rock bottom in the 1980s and seeking therapy, in 1986 Brian decided he was fundamentally unhappy in his own skin and decided to transition back to being male.

It was such a relief, he said. I finally felt at peace in myself for the first time.

It felt like my world had become a lot simpler by the decision and I could finally live the life I wanted to.

Brian became confused about his gender as a child, when he remembers strangers mistaking him for a girl to his mothers chagrin.

One of my first memories is being out shopping with my mother and a group of women gathering around and saying, Oh how cute, how sweet. Where does she get those curls and thick eyelashes from?' he said.

My mum didnt deal with it very well and pulled me away shouting that I was a boy.

He continued: My father, Isadore, who passed away when he was 80, would say, Why are you walking that way? Stop shaking your a** like that.'

Targeted by his peers throughout his childhood and into his teenage years, Brian says he was lucky to have survived the experience.

Kids would follow me home and throw rocks at me, he recalled.

He continued: I was scared for my life and I was even more scared my father would hear what they were calling me.

You have to remember this was the 60s. It was pre-Stonewall a series of demonstrations that spearheaded gay liberation and there were only the rumblings of the gay rights movement.

Exploring the local gay scene aged 16 brought Brian some solace, especially when he made a like-minded friend in Paul Bricker, then 17, who tragically passed away from an aneurysm, aged just 27.

Describing Paul as his mentor, Brian said: We were like two peas in a pod from the night we met.

He took me home that night it wasnt sexual and he taught me everything I know. He was like a mentor to me.

Soon after, Brian moved in with Paul and his mother, Gloria Walker, now 93.

In the bohemian household, he could be open about his sexuality and he and Paul began dabbling in the world of drag.

By todays standards, I was what would be called a gender non-conformist, meaning that I trod the line between what is seen as male and female, Brian explained.

It was a mixed bag. We called it scare drag, because we were scaring the straight people that couldnt put us into one of their boxes.

Outgrowing his hometown of Providence, Rhode Island, USA, Brian moved to New York City with $100 (80) in his pocket and started performing with drag queens to earn an extra buck, alongside working in a thrift store.

Taken under the wing of a group of trans women, Brian was still struggling with his own gender identity and began to question if transitioning from male to female might be the answer to his problems.

So, less than a year after arriving in New York, aged just 19, he was given the name of a no questions asked doctor who could help him to transition.

I turned up at this doctors office no questions asked and handed over $10 (8), he recalled.

It was pretty much, Come in, drop your pants, Ill stick you with a needle.'

Describing how the hormone therapy worked very effectively, within a matter of months Brian developed small breasts, had a softened appearance and his voice sounded more feminine.

Changing his name legally that year, Brian officially became Natalia going on to spend the next 11 years living as Tish.

In 1979, four years into his hormone therapy and still not feeling like his authentic self, Brian took the next step in his transition, spending $500 (405) having silicone breast implants fitted.

It felt like the right thing to do at the time, he said. In hindsight, it wasnt very well thought out, but none of my decisions were back then.

He continued: I would just react to the situations around me. I was never 100 per cent committed to being female there was always this niggling question.

I was never assessed. They didnt really do that kind of thing back then.

I just saw the breast implants as another quick fix.

Although struggling personally, Brians professional life as Tish went from strength to strength.

Working seven nights a week, he would run the gauntlet of New Yorks hottest clubs, performing as a big, busty showgirl.

At the height of the 80s, I was a club personality, Brian said. I had a band and would do a live show with a mix of comedy and musical numbers.

He continued: I met some famous faces and was hanging out at VIP parties it was a very exciting time to be alive.

Living both as a man and then as a woman also gave Brian a rare insight into the way society treats people based on their gender.

Discussing the downside of life as a woman, he said: The worst part of living as female was the endless exploitation by men.

He continued: The misogyny and attitude that because I looked like a beautiful, sexy woman, I couldnt possibly have a thought in my head.

And men were constantly trying to have sex with me.

Also, it took much longer to get ready to go out leaving time for hair, make-up etc.

But life as a member of the gentler sex also had benefits, according to Brian.

He continued: The best thing about living as a female was the power of beauty in itself.

I used it to my best advantage and believe I got as far as I did because of my looks.

He continued: I had a lot of fun with make-up and costumes and experiencing life fully in the role of a woman gave me a unique perspective. I know what its like to be a man and a woman in a way in which not many people can understand.

But the party scene and life as a showgirl eventually took its toll on Brians physical and mental health and, in 1986, he hit an all time low.

I was relying on drugs and alcohol to get through each day, he said.

He continued: I was broke, had spent all my money and ended up living on a friends couch.

Putting his life back together, with the help of friends, he kicked his alcohol and drug addiction.

But being stone cold sober meant he could no longer ignore what was staring him in the face that he was not happy living as Tish.

I was as sober as a judge and that really was the beginning of the end for Tish, Brian said.

I always wanted to be my authentic, true self and I realised I wasnt.

After having therapy in which he discussed gender issues and what constitutes a male and a female identity, Brian felt his only option was to revert back to the gender he was assigned at birth.

I was beautiful and young, but I wasnt happy as that person, he said. I was at a crossroads. I knew I had to have surgery on my genitalia or go back to being Brian.

There was no question which path to take. Times had changed a lot since Id made the transition and there were more gay men embracing their effeminate side.

I was in the gym one day and saw a fellow who reminded me of myself before I transitioned.

He continued: He was very effeminate, but he was muscly and buff and I thought that could be me.

So, Brian decided after much consideration, to make the transition back to being male, stopping his hormone therapy and cutting off his shoulder-length hair.

Then, six months later, in February 1987, he spent $750 (609) having his silicone implants removed.

I felt a great sense of relief after the operation, he said. I woke up crying not from the pain but because it felt like a huge burden had been lifted.

Visiting the gym up to five times a week, Brian slowly built up his muscles and, with his hormone replacement out of the window, he started growing more body hair and his shape filled out.

He also came out for the third time.

Ive come out as gay, Ive come out as a trans woman and now I was coming out as a detransitioner, he said.

People would come up to me in the street and say, Hi Tish, and Id have to tell them, No its Brian now.

The whole thing just clicked this was who I was always meant to be.

Saying goodbye to Tish meant leaving the glitz and glamour of the New York drag scene, after which Brian established himself as a successful photography agent and editor.

But, after the economic crash of 2008, he decided to re-train again as a counsellor, specialising in drug and alcohol addiction.

Describing his second time around at being Brian as the the best years of his life, recently he has become alarmed about the amount of trans people following in his footsteps, by reverting back to the gender they were assigned at birth.

Hoping to shine a light on the issue, Brian released his autobiography, Trans Figured: My Journey from Boy to Girl to Woman to Man, in 2018.

He said: I wanted to break the stigma of people who have detransitioned and to provide some insight to anyone struggling with gender confusion.

I hoped to add my voice to the ever expanding understanding of gender and identity.

Nurses and others - employed by the NHS and any other part of health and care - we have never needed them more.

So lets show them some love, and create a living map of gratitude from every corner of Britain.

By dropping a heart on this map, youre saying you appreciate the efforts undertaken daily in the NHS.

Now, Brian who met his husband while walking his Jack Russell Terrier, Bricker, 18 years ago and married in 2013 is hoping to specialise in gender identity counselling, to help other detransitioners with their journey.

He concluded: We need to make sure people are definitely happy with the idea of transitioning and properly inform them of the pros and cons.

I want to help people do that. Im the perfect man for the job.

He concluded: Just look at the life Ive lived Im a self-proclaimed expert.

See the article here:
Brian lived as trans woman Natalia for 11 years before 'detransitioning' back to male - Cambridgeshire Live - Cambridgeshire Live

The approval of the humanized monoclonal antibody trastuzumab in 1998 changed the trajectory of treatment and subsequent outcomes for patients with human epidermal growth factor receptor 2 (HER2)-positive breast cancer and is now the standard of care in the neoadjuvant, adjuvant, and metastatic settings. However, as with most biologic drugs, trastuzumab comes with a relatively high price tag compared with traditional cytotoxic chemotherapy and contributes to healthcare budgets. Three engineered products related to trastuzumab2 antibody-drug conjugates, ado-trastuzumab emtansine and fam-trastuzumab deruxtecan-nxki, as well as the subcutaneous trastuzumab/hyaluronidasehave since been approved and have expanded the treatment options for this patient population. The approval of 5 trastuzumab biosimilars as of the end of 2019 holds the promise of considerable cost savings, but challenges to integrating their use into patient care must be addressed. Barriers to their use, including physician uncertainty to switch patients from the reference drug to the therapeutic biosimilar and patients lack of understanding about biosimilars, are common in the United States. It is also important that all stakeholders, including managed care professionals, pharmacists, and practice administrators, understand how to incorporate trastuzumab biosimilars into formulary discussions, clinical care plans and processes, and educational initiatives for healthcare providers and patients.Introduction

An estimated 268,600 new cases of invasive breast cancer were diagnosed in women in 2019, making it the most common cancer in women in the United States. Although approximately 42,260 women died from the disease that year, the overall death rate from breast cancer has fallen by 40%, from 33.2 per 100,000 in 1989 to 20.0 per 100,000 in 2016.1 This is due not only to earlier diagnosis through screening but also to the emergence of agents with new mechanisms of action and more targeted therapies that address the presence or absence of 3 key molecular markers in breast cancer: estrogen receptor (ER), progesterone receptor (PR), and human epidermal growth factor 2 (HER2). These molecular markers are the basis for classifying breast cancer into 3 subtypesHER2-positive, hormone receptor-positive (ER+ and/or PR+), or triple-negativeand for determining the appropriate initial treatment approach in early-stage disease.2 Genomic and molecular testing is now standard practice in patients with advanced-stage breast cancer in order to determine the most appropriate targeted therapies based on hormone and HER2 status as well as PIK3CA, BRCA1, BRCA2, and PD-L1 biomarker status.3

An estimated 15% to 20% of women with newly diagnosed breast cancer have tumors that overexpress HER2. These tumors tend to be more aggressive, more likely to invade lymph nodes, and more likely to recur and metastasize than other subtypes. They have also been historically associated with shorter patient survival compared with hormone receptorpositive breast cancer.2,4 However, with the 1998 approval of trastuzumab, a humanized monoclonal antibody (mAb) that targets the extracellular domain of the HER2 protein, the trajectory of HER2-positive breast cancer shifted dramatically. Based on substantially improved outcomes in multiple clinical trials, including significant survival benefits across all stages of the disease, trastuzumab-based regimens are considered the gold standard of treatment for women with HER2-positive breast cancer.2,3

Trastuzumab

Cochrane Database of SystematicReviews found that trastuzumab-based regimens in early breast cancer (EBC) improved overall survival (OS) by 33% (hazard ratio [HR], 0.66; 95% CI, 0.57-0.77; P<.00001) and disease-free survival (DFS) by 40% (HR, 0.60; 95% CI, 0.50-0.71; P <.00001),5 and in the metastatic setting improved OS by 18% (HR, 0.82; 95% CI, 0.71-0.94; P = .004) and progression-free survival by almost 40% (HR, 0.61; 95% CI, 0.54-0.70; P <.00001).6

Dosage and Administration

Trastuzumab has a variety of dosing regimens, with the dose, combination of agents, and duration depending on its use in the neoadjuvant, adjuvant, or metastatic setting. Trastuzumab is administered via intravenous (IV) infusion and requires a loading dose followed by a maintenance dose. The National Comprehensive Cancer Network (NCCN) lists 10 potential regimens in the preoperative and adjuvant settings.3

The NCCN guidelines list 4 potential trastuzumab-containing regimens for metastatic treatment in premenopausal women with trastuzumab in combination with an antiestrogen, either as monotherapy or in combination with lapatinib. For postmenopausal women, the preferred regimens are pertuzumab, trastuzumab, and docetaxel (category 1) or pertuzumab, trastuzumab, and paclitaxel. Several other regimens are also recommended.3 The NCCN notes that an FDA-approved biosimilar is an appropriate substitute for trastuzumab in all settings.3

Safety

Overall, trastuzumab is well tolerated and does not require any supportive care medications before or after administration. The most common adverse effects (AEs) affecting at least 5% of women in the adjuvant setting are headache, diarrhea, nausea, and chills (most grade 2 in severity), whereas fever, chills, headache, infection, congestive heart failure, insomnia, cough, and rash were the most common AEs affecting at least 10% in the metastatic breast cancer (MBC) setting.7,8

Trastuzumab labeling carries a black box warning of the risk of cardiomyopathy. In the pivotal phase 3 clinical trial published by Slamon and colleagues, combining trastuzumab with anthracyclines caused cardiac dysfunction and heart failure in up to 27% of patients with metastatic disease compared with 7% in the anthracycline monotherapy group.9 Since then, large observational studies have also identified higher rates of cardiotoxicity in women receiving trastuzumab compared with anthracycline alone.10,11 This led to a change in clinical trial design to give the 2 drugs sequentially rather than concurrently, which demonstrated a much lower rate of cardiovascular effects.12 Whether the cardiovascular changes are reversible when trastuzumab is discontinued remains a key question.12

Trastuzumab/hyaluronidase-oysk

Trastuzumab/hyaluronidase-oysk received FDA approval in February 2019. The product uses a patented drug delivery technology to facilitate subcutaneous (SC) administration, with recombinant human hyaluronidase (also called rHuPH20) acting as a temporary spreading factor. It degrades hyaluronan, a large glycosaminoglycan that otherwise limits SC administration of large volumes of fluid.13 Although delivered SC, this product is not self-administered and must be administered by healthcare professionals in an outpatient setting.

Trastuzumab/hyaluronidase-oysk was compared with trastuzumab IV in the open-label, phase 3, noninferiority HannaH (Enhanced Treatment with Neoadjuvant Herceptin) trial. Eligible patients received 8 cycles of chemotherapy with either fixed-dose SC trastuzumab/hyaluronidase-oysk (600 mg) or IV trastuzumab (loading dose, 8 mg/kg; maintenance dose, 6 mg/kg) every 3 weeks in the neoadjuvant setting. Patients received an additional 10 cycles of SC trastuzumab/hyaluronidase-oysk or IV trastuzumab (according to their initial randomization) for 1 year following surgery.14

Rates of grade 3 or higher AEs were similar in the 2 groups, with neutropenia, leukopenia, and febrile neutropenia most common. However, 21% of patients in the SC group versus 12% of patients in the IV group had serious AEs, primarily infections and infestations (8.1% vs 4.4%).15 With 6 years of follow-up in the 591 women in the intention-to-treat population, the event-free survival rate of 65% (HR, 0.98; 95% CI, 0.74-1.29) with an 84% OS (HR, 0.94; 95% CI, 0.61-1.45) were similar between the SC and IV study groups.

The faster administration time provides a much improved experience for patients as demonstrated in the PrefHER and MetaspHer studies. Results of the multicenter, crossover PrefHER trial, which randomized 240 women undergoing neoadjuvant or adjuvant treatment for HER-positive breast cancer to 4 cycles each of IV trastuzumab or SC trastuzumab/hyaluronidase-oysk, found that 91.5% of women preferred the SC formulation primarily because they spent less time in the clinic.16 Similar results were seen in the MetaspHer study, which randomized 113 women to 3 cycles of trastuzumab/hyaluronidase-oysk SC or trastuzumab IV, followed by 3 cycles of the IV formulation.17 Several studies have been conducted outside the United States attesting to the cost-savings potential of an SC delivery approach for healthcare systems; the savings are accrued from less preparation and delivery time as well as direct medical cost savings.18-24 However, with the quickly evolving biosimilars market, the cost-savings potential of an SC delivery approach is not yet known in the United States.

It remains unknown if trastuzumab/hyaluronidase-oysk SC delivery will pose a threat to uptake of the biosimilars, all of which are administered by IV.25 This version of trastuzumab does increase the potential for reducing the cost of trastuzumab IV therapy by adding more market competition. In evaluating costs, stakeholders must consider the complete episode of care; these include differences in drug administration costs and in revenue potential between the 2 different routes in practice settings.

The phase 3 PERSEPHONE trial was designed to investigate the hypothesis, demonstrated in other studies, that 6-month adjuvant trastuzumab treatment is noninferior to 12-month delivery.26 The open-label, noninferiority trial randomized 4089 patients with HER2-positive EBC to either 6-month or 12-month trastuzumab delivered every 3 weeks IV or SC in combination with chemotherapy. Switching from the IV to the SC route was allowed at the prescribers discretion. Eighty-two percent of the trastuzumab cycles were given IV and 18% were given SC. The 6-month cohorts met the primary end point of DFS noninferiority to 12 months of treatment, with increased adherence and fewer cardiac and other serious AEs in the 6-month group.26 A cost analysis estimated an average savings of $12,800 for 6 months of trastuzumab versus 12 months, regardless of administration route, for a 100% cost-effective approach with no decrease in quality of life.27 If such a change were adopted as a standard of practice with biosimilars, the cost savings could be even more significant.

Economic Issues Related to Trastuzumab

As with most biologics, the cost of trastuzumab started high and has continued to climb, even as other biologics with similar mechanisms of action entered the market.28 One potential reason for this price increase is that there has not been competition in the marketplace prior to the advent of trastuzumab biosimilar, SC trastuzumab/hyaludronidase-oysk, and antibodydrug conjugate approvals. Trastuzumab has consistently ranked in the top 20 drugs for sales revenue in the United States, with sales of $2.87 billion in 2018.29

Although trastuzumabs high price does not limit access for patients with the need for lifesaving treatment in the United States due to coverage of the therapy by Medicare Part B as well as Medicaid plans, there are significant financial impacts to organizationsincluding practices and health systemsand to patients due to out-of-pocket costs. The cost-effectiveness of trastuzumab with or without concurrent or consecutive therapies in the neoadjuvant, adjuvant, and metastatic setting has been extensively studied, but results vary depending on the setting, breast cancer stage, and treatment regimen.30-33 In a survey of 45 US oncologists, one-third cited high out-of-pocket costs for patients as a barrier to prescribing trastuzumab in the early and curative stages, and 10% reported at least 1 instance of delaying or canceling treatment because of reimbursement issues. Reimbursement issues also played a role in 60% of instances in which physicians did not prescribe the drug in the metastatic setting.34 In the same survey, one-third of physicians reported that they would increase the use of HER2-positive antibody therapy if a lower-cost biosimilar version of trastuzumab were available.34

Ado-trastuzumab emtansine, fam-trastuzumab deruxtecan-nxki, and Other AntibodyDrugConjugates

Read the original post:
Integrating Trastuzumab Biosimilars and HER2-Directed Therapies into HER2-Positive Breast Cancer Management - AJMC.com Managed Markets Network

You might find yourself struggling to sleep during the current COVID-19 outbreak, as stress, uncertainty and changes in our usual routine make it more difficult to relax at night and drop off.

Here, we round up some expert advice on how you can try to maintain a regular sleep pattern and get a more restful nights shut-eye.

Try to stick to the same bedtime and wake-up time

Waking up and starting your day at the same time every day is the most important way to stabilize your body clock, says Professor Greg Murray, at Swinburne University of Technology, Australia. He advises sticking to consistent sleep and wake times which fit your natural rhythm. If you are a night owl, it is okay to stay up a little later and get up a little later, just make sure these bedtimes and wake up times are the same every day, he says.

Dr. Elizabeth Cozine, a Mayo Clinic family medicine physician, agrees, Try to go to bed at the same time every night, maybe sleeping in a little bit later than you normally would because youre not rushing to get to the office. And see if you can try to get somewhere between seven and nine hours of sleep, which is what most adults need, and make that a regular part of your day.

Avoid napping

Professor Murray also advises trying not to nap during daylight hours, as it can make it hard to fall asleep at night. If you must nap, he says to restrict your sleep to just 30 minutes.

Get some sunlight during the day

Professor Kevin Morgan, who is a sleep expert at the University of Loughborough, United Kingdom, says that staying indoors means we do not soak up enough sunlight, and this can affect our sleep patterns and our need to nap during the day. To help synchronize our body clock, we should try to get enough sunlight during the day, particularly in the morning, to let our body know its daytime. He recommends exercising outdoors, if you can, or at least just walking to the grocery store or sitting in the garden.

Read also: Why you should still get sunlight even during self-quarantine

And avoid bright light in the evening

In the evening, Professor Murray says we should avoid bright light, as this suppresses the production of the hormone melatonin, which makes us feel sleepy. This also includes avoiding the blue light from computer screens and smartphones, so try to read a book or take a bath instead of watching TV to help you relax.

Avoid alcohol and caffeine

Be careful how much caffeine you have every day, says Professor Morgan, who adds that working from home, or just being at home, offers more opportunities for tea and coffee breaks. Caffeine suppresses the chemical adenosine which contributes to sleepiness and promotes sleep. He also advises limiting your alcohol intake, as although it can help you fall asleep it can also cause you to wake up early, as well as affect the quality of your sleep so you actually feel more tired the next day.

Try to relax

Psychiatry professor Adam Abba-Aji at the University of Alberta, Canada, says that if you are feeling anxious during the COVID-19 outbreak, usually the first sign of it will be a lack of sleep. It becomes difficult to switch our brains off, he said. Where theres a lack of sleep, people sometimes resort to alcohol or some other sedatives. Instead, Abba-Aji suggests trying to relax and switch off with some yoga before you head to bed.

Try meditation

You might not have tried meditation before, but Dr. Cozine says there is a lot of evidence to suggest it can improve sleep, as well as help ease stress and anxiety. Ive found that it helps me turn off those hamster wheels of thoughts that are rolling in my brain, and it also helps me to get ready for the next step, she says. Im not talking about sitting Zen, cross-legged for three hours thinking about I dont know like a desert or something. Im talking about maybe five minutes where you just reset.

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Excerpt from:
How to sleep better during the COVID-19 outbreak - The Jakarta Post - Jakarta Post

Its never easy to be living with a cancer diagnosis, but for the millions of Americans being treated for cancer right now, these are particularly trying times.

Cancer can compromise the immune system sometimes the cancer itself does this, and sometimes it's the therapies used to treat it. And what we know so far from data reported during the COVID-19 pandemic is that, not surprisingly, people with cancer are at higher-than-average risk of infection with the virus and severe consequences if infected.

For instance, an article published February 2020 in the journal theLancet Oncology reported that in China, patients with a cancer diagnosis, patients being treated with chemotherapy, and patients with lung cancer were more likely to end up on a ventilator or die with a COVID-19 infection compared with healthy people.

It was undoubtedly data like this that prompted the publication of a March 2020 article in the journal Annals of Internal Medicine, which stressed the importance of delaying cancer therapy when possible during the pandemic.

Its a good article, and it's the right recommendation.

Delaying therapy may have two benefits: It will keep vulnerable patients out of hospitals and treatment facilities, where theyre more likely to become infected, and it may relieve patients of the potentially immune-dampening effects of therapy at a time when everyone needs an optimally functioning immune system.

The million-dollar question, for patients and doctors, is what delaying treatment might mean, ultimately, for patients' survival.

RELATED: How Will COVID-19 Affect Cancer Research?

In normal times we generally encourage people not to delay. I used to tell my patients that unless you have a good reason for delay, start treatment as soon as possible.

But urging patients not to delay was often just a way of being consistent. If a treatment program that produced good results for postoperative chemotherapy for breast cancer when started four weeks after surgery has been tested and proved to work, for instance, its best to do it that way so all patients are treated alike, and so that we can predict the benefit a patient might get out of it. This then takes the issue of scheduling out as a variable.

Truthfully, four weeks was not necessarily selected because we know its the best time to start treatment; eight weeks might have worked as well or better. These kinds of variables are usually not put under stringent tests.

Have we allowed delays of treatment in the past? Sure. Sometimes a patient may have wanted to wait until after a daughters wedding, or a special trip they had planned. Depending on the type of cancer, and the stage, we tried to accommodate them.

The truth is, we dont have good data on what delays mean, because its not something weve had to consider on a grand scale.

Right now, though, we have to weigh the risk of patients getting and succumbing to COVID-19 against the risk of delaying a work-up and treatment. In most cases, delaying treatment is the less risky path. It's confusing when oncologists tell patients this, and probably scary. But the truth is, many cancers take years to develop, and in most cases, a few months' delay is probably not that risky, especially compared with the risk of getting COVID-19.

RELATED: 6 Dangerous COVID-19 Home Remedies to Avoid

Theres no one-size-fits-all template when deciding who needs immediate treatment and who can delay. Each case really should be addressed individually.

One of the most critical factors that will go into the decision is the age of the patient. Age is a critical factor in defining risk of dying from COVID-19. In most data reported, the case fatality rates are highest in patients over 70 and especially high in those over 80. Many in this age group also have a co-morbid (more than one) health condition, which puts them at increased risk.

If two patients have the same stage of the same cancer, but one is 75 with emphysema and the other is 55, their different risks if they get COVID-19 will affect the decision about treatment. The bottom line is that, when age is a factor, its in everyones best interest to keep high-risk older patients out of hospitals and clinics for a while. Most likely, older patients are going to be advised to wait.

Some cancers are an easier call than others. Prostate cancer, which tends to occur in older men, falls into this category. Low and even intermediate risk patients with prostate cancer are often offered the option of watch and wait even in normal times, so they can wait three more months for sure.

Even high-risk patients with prostate cancer can be offered hormone deprivation therapy to tide them over.

But some cancers grow rapidly, like acute leukemias and aggressive lymphomas, and many times they are the ones we can cure with aggressive treatment. In those cases, delay may well be detrimental, and arrangements need to be made to provide care in a way that minimizes, as much as possible, the risk of contracting COVID-19.

At Yale, where I am a professor, our oncologists have reorganized our outpatient facilities so that those who must go ahead can do so as safely as possible. We moved an outpatient cancer clinic to a facility 15 miles away from the main hospital, which is treating COVID-19 patients. From what I hear, other centers that have the option to repurpose clinics are doing the same thing.

And while most centers have stopped initiating new clinical trials and have stopped accruing new patients to ongoing studies, patients already participating in studies will continue to get treatment.

Of course, the usual precautions (use of protective gear like masks and, for doctors, face shields) still need to be taken for those undergoing chemo in this environment, because we know some apparently well individuals are unknowingly harboring the COVID-19 virus.

Being keeping people being treated for cancer away from the center of the action, by distancing them from the main hospital, can only help protect them right now.

It goes almost without saying that all these are decisions that oncologists need to share with their patients.

We are in an unusual time for cancer patients. Two major things have happened to them their cancer, and a pandemic washing over their community. The latter is moving very fast. The former, in many cases, more slowly.

For most patients, its best to delay treatment if your doctor thinks its possible, and let the pandemic wave crash by. This will reduce the risk for most patients of getting COVID-19 and also make a safer, less-crowded space for cancer patients who dont have the option of delaying treatment.

The 21stCentury Cures Act passed by Congress in 2016 urged the U.S. Food and Drug Administration (FDA) and the entire medical field to make better use of real-world data to make decisions in drug development. Were seeing that put into practice now with the use of hydroxychloroquine in patients infected with COVID-19. Perhaps, if we are clever enough, we can glean some useful data and insight on the impact of delaying cancer treatment when this pandemic ends.

RELATED: Cancer and COVID-19: What You Need to Know to Protect Yourself

Read more from the original source:
Should You Delay Cancer Treatments During the COVID-19 Pandemic? - Everyday Health

Posted April 11, 2020 06:04:01

It's a secret of unspoken heartache doing the rounds in rural Australia.

Regional folk may be happy to spout volumes about the fertility of their livestock, but find it much harder to talk about their own battles to conceive.

Raine Holcombe is a tough-as-nails contract musterer, raised on a crocodile farm in the Northern Territory.

She's able to stare down just about any rogue animal and withstand the toughest of conditions alongside her husband, Potter Holcombe.

The couple envisioned growing old wrangling their cattle and kids in the rugged landscape they love.

"Ever since I was a little girl playing with dolls and looking after our friends' young siblings, I've always loved children and dreamed of having our own family," Ms Holcombe said.

After they got married, Mr and Ms Holcombe faced a flood of questions from well-meaning but sometimes insensitive friends, who didn't grasp the silent battle the couple was waging.

"In the first 12 months you sort of brush it aside, and then the next 12 months was the harder part," Mr Holcombe said.

"If you're on social media, there'll be a birth announcement sometimes there's six in a week [and] that really gets you down, but at the same time you have to be happy for them and thankful they've had better luck and good fortune," Mrs Holcombe said.

It's been a gruelling process.

The couple have had two egg collections and seven embryo transfers.

The logistics of fertility treatment are 10 times harder from a remote cattle station.

"Our local closest IVF clinic is Darwin and because we travel around for work, it's up to six hours [travel], sometimes further," Ms Holcombe said.

"We can't really go to the local clinics that are close by because we need the blood results the next day or a couple of days later and those remote clinics take a week or longer to get the results."

Much of the treatment also puts the Holcombes substantially out of pocket.

"There are some payments that come from Medicare for your egg collection surgeries, there's nothing available for your embryo transfers, and there's no subsidies for travel if you live remotely," Ms Holcombe said.

All of the couple's IVF attempts have failed, and in a cruel blow, they have only recently learned that the $100,000 process was never going to work.

Undiagnosed for years has been a rare genetic condition. Both Raine and Potter carry the same DQ alpha gene, which causes an embryo to self-abort.

It has forced them to explore a different path at a clinic in Melbourne, 4,500 kilometres away from where they work.

It's their last hope and the only treatment option left.

The process involves mixing Potter and Raine's blood to create a serum, which will ideally give them up to six months to try more IVF.

If that doesn't work, it's back to the drawing board.

According to the Fertility Society of Australia, difficulty conceiving is a nationwide trend.

It estimates one in seven couples will experience some form of infertility within one year of trying.

This is partly due to the rising age of women and their declining fertility, as well as more diagnoses of fertility conditions, like endometriosis and polycystic ovary syndrome.

This is made all the more difficult by scarcity of clinics in regional Australia.

Doctors like Nicky Purser know only too well the barriers facing remote couples, particularly when it comes to hormone and fertility tests.

"Sometimes the woman might need blood tests every two or three days, and if you are 300 or 400 kilometres from a blood collecting centre and you've got to do a 600- or 800-kilometre round trip every two or three days, that's just an enormous thing to have to undertake," she said.

For testing in Darwin or Adelaide, the couple would have to spend two or three weeks in town, a trip many find logistically impossible.

"For a lot of people in IVF generally, often it is all too hard and [they] give up, besides all the extra issues that happen in the bush," Dr Purser said.

Healthcare delivery across all areas of medicine is no doubt harder in the bush, but fertility experts say addressing limited ultrasound availability, reducing sluggish turnaround times on blood tests at remote clinics, and increasing access to financial assistance could make it easier.

"The issue about blood tests and ultrasounds with a population like we have, it's not something that's going to be solved easily," Dr Purser said.

"It's always going to be a big source of sadness for people. I don't think that's really going to change."

Kimberley Mackay and her husband Angus welcomed their third baby in January.

Umbearra, their sprawling cattle station on the South Australian and Northern Territory border, is a kids' paradise, with poddy calves, motorbikes and endless plains to explore.

But while their herd of cattle boasts some impressive fertility rates, their own journey was taxing.

"A lot of people can't relate, so it was quite awkward with the people you were talking with and we did feel quite alone and isolated, especially living out here where you don't see too many people," Ms Mackay said.

She was diagnosed with polycystic ovary syndrome and fertility help was a 13-hour drive away in Adelaide.

She began treatment with a fertility drug, Clomid, which forces egg production and enabled her to fall pregnant with their first child, Ollie.

Their second attempt was more heartbreaking.

The couple went through six cycles of Clomid and then three rounds of IVF, resulting in a pregnancy that didn't last.

But they persisted, and 37,000 kilometres and four rounds of IVF later, they had Millie and considered their family of four complete.

It was a complete surprise when they found Ms Mackay was pregnant with their third child, naturally-conceived Aubrey, last year.

"We didn't believe it," Ms Mackay said.

"It was a miracle baby, really.

"We were told it wasn't going to happen. Sometimes you get lucky."

Watch this story on ABC TV's Landline on Sunday at 12:30pm or on iview.

Topics:health,fertility-and-infertility,reproduction-and-contraception,rural,rural-women,healthcare-facilities,healthcare-clinic,nt,australia,melbourne-3000,alice-springs-0870

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The long, lonely journey of infertility in the bush can involve a six-hour drive for one blood test - ABC News

Share thisinformation with your clients, in your newsletter and social media, to educatethem on the benefits of your massage therapy. They will need healthy touchsoon, once the pandemic is over and your practice is back online.

Editors note: A healthy immune system is important at any time. This article is not suggesting that massage therapy, or any other known health care practice, can prevent coronavirus (COVID-19) or any other illness.

The healthbenefits of massage are well-known, and according to the MayoClinic include the treatment of soft tissue strains or injuries; headache relief;and help with digestive disorders.

Massageis also great to increase circulation within the body, which improves tissuequality and allows people to move and function better, Kipp Dye, MSPT,owner of OrthosportsMED PhysicalTherapy, told MASSAGE Magazine.

Crucially,massage therapy also relieves pain, which can significantlyaffect your immune response. Research confirms thatpain has a significant immunosuppressive effect on the human body. Scientistshave also found strong evidencethat pain reduces the levels of important parts of the immune system that dealwith infection and even help fight cancer.

Clinicalresearch also suggests that regular massage naturally increases the healthy immunesystems ability to kill certain cells, while decreasing the number of T-cells,for an improvement of the bodys overall immune function.

In this study, 20 HIV-positivemen received five 45-minute massages per week, for a month. The participantsshowed both an increase in serotonin and in the cells that comprise the immunesystems initial defense against infection and disease.

Theoretically,said Dye, [massage] allows for faster recovery due to increased circulation ofthe lymph and blood vascular systems, said Dye.

A randomizedcontrolled trial involving 52 healthy pregnant women examined whetheraromatherapy massage offered immune-boosting benefits.

The womenwere split into two groups: one receiving 70 minutes of aromatherapy massagewith 2% lavender essential oil every other week, the other no massage at all.

Researchersfound that the group receiving aromatherapy massage showed significantly reducedlevels of the stress hormone cortisol, and improved levels of other immune markers.

Accordingto researchers, this study presents evidence that aromatherapy massage couldsignificantly decrease stress and enhance immune function in pregnant women.

Thefindings can guide clinicians or midwives in providing aromatherapy massage towomen throughout the pregnancy, the studys authors wrote.

Recent research from Cedars-Sinai findsthat people who undergo even one session of massage experience significant changesin their immune and endocrine responses. The researchers compared the effectsof either a 45-minute session of Swedishmassage or light touch.

Participatingmassage therapists were trained in the delivery of Swedish and light touchusing specific and identical protocols.

Massageis popular in America, with almost 9% of adults receiving at least one massagewithin the past year, said Mark Rapaport, MD, chairman of the Department ofPsychiatry and Behavioral Neurosciences and lead study author, said in a statement.

He emphasized,People often seek out massage as part of a healthy lifestyle but there hasntbeen much physiological proof of the bodys heightened immune responsefollowing massage until now.

Bloodsamples were collected at various intervals before and after each session, andresearchers found that those who received Swedish massage experiencedobservable changes in lymphocytes,which play an important role in a healthy immune system that protects us fromdisease.

TheSwedish massage group also had decreased levels of arginine vasopressin (AVP),a hormone associated with increased stress hormone (cortisol) levels, and adecrease in inflammatory cytokines,which are produced by infection-fighting white blood cells.

Thisresearch indicates that massage doesnt only feel good, it also may be good foryou, said Rapaport. More research is ahead of us but it appears that a singlemassage may deliver a measurable benefit.

Does thismean a relaxing massage session can help reduce your risk of catching a cold orflu?

Massage offers relaxation and stress relief, and when people are less stressed, theyre much less likely to fall ill. This is because chronic stress impairs your bodys inflammatory immune response, increasing your susceptibility to infection, according to research published in theProceedings of the National Academy of Sciences.

Researchersrecruited 34 post-surgery breast cancer patients, diagnosed with stage 1 or 2breast cancer, to a massage therapy group receiving 30-minute massages threetimes per week for five weeks, or a control group.

On thefirst and last day of the study, participants were assessed for both theirpsychological state and levels of immune system markers in their urine samples.

Accordingto the studyfindings, immediate effects of massage therapy included reduced anxietylevels, depression and anger, while longer-term benefits showed direct impacton the bodys immune markers such as increased dopamine, improved serotoninvalues and better lymphocyte levels.

Theresearchers concluded that breast cancer patients experience significantlyimproved immune, NK-cell(natural killer cell) and neuroendocrinefunction after receiving massage therapy.

There is still so much unknownabout the coronavirus, but having a healthy, functioning immune system willalways be helpful in reducing the effects of the virus, if contracted, and,could possibly be helpful in prevention of even contracting the virus at all,said Vicky Karr, LMT, aCE provider and owner of Spa Success.

Becausemassage therapy aids in improving the immune system, it is generally assumedthat it could help reduce the risk of coronavirus infection, she added.

However, accordingto Karr, because of the close bodily proximity between a massage therapist andtheir client, all of us should be following the social distancing guidelinesthat have been put into place, and not seek massage therapy until the pandemichas subsided.

Even after the pandemic is over, Karremphasizes the important of frequent hand-washing and that whenever yourenot feeling well, the best course of action is always to reschedule a massageappointment.

George W. Citroneris a freelance health journalist and author who covers breaking news in medicine and healthfor a broad range of publications. His articles for MASSAGE Magazine include Bill Introduced to License Minnesota Massage Therapists.

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This is How Massage Helps Build a Healthy Immune System (Share This with Your Clients Now) - Massage Magazine

You have seen the packages of low-fat bologna or hot dogs in the grocery aisles. The food industry has long altered the content of fats and other nutrients in meats, dairy, and eggs to promote them as healthy choices. To date, manufacturers of such products have not been permitted to label these foods as healthy but that may change soon. Under a proposed rule, USDA-inspected products will be able to use the word healthy on labeling and advertising if their fat content consists mostly of mono- or polyunsaturated fats, as opposed to saturated fat. This labeling would apply even if the total fat content is higher than what FDA guidelines allow.

Can meat that is altered to be high in mono- and polyunsaturated fats really serve as a healthy choice? If we focus on eating meat and the reactions it causes, it is quite clear that whatever the fat content, meat is not a healthy choice. Here are nine reasons why this is true that go beyond fat alone.

Elevations of hs-CRP predict the development of serious illness including cardiovascular disease. Multiple studies have found that, even after correcting for confounding factors, meat consumption associates with increased hs-CRP. A recent basic science study performed in mice demonstrated that an amino acid found in high levels in meat, methionine, increased oxidative stress and inflammation and actually reduced heart strength too. A human study just published related meat intake to higher levels of arachidonic acid, another mediator that promotes inflammation and aging, and a diet low or absent in meat was recommended for optimal health.

Another route by which cellular aging may progress is the development of insulin resistance. Scientists looked at how eating certain foods affects the release of insulin. Surprisingly, some protein-rich and fat-rich meats induced as much insulin secretion as did some carbohydrate-rich foods (e.g., beef was equal to brown rice). The researchers found that fish, beef, cheese, and eggs had larger insulin responses per gram than many carbohydrate foods. The scientific fact that meat is insulinogenic is rarely mentioned and may contribute to aging.

IGF-1 is a peptide hormone stimulating cell growth. Its also linked to higher risk of breast and prostate cancers. Meat eaters consistently have higher levels of IGF-1 than vegetarians or vegans. Breast and prostate cancers are rare in traditional Asian communities, which have a very low intake of meat products. Okinawans, some of the longest-living people on the planet, eat a diet with less than 10 percent of their daily calories from meat. A plant-based fasting-mimicking diet has been shown to reduce levels of IGF-1, which has an anti-aging effect.

In 2011, researchers from the Cleveland Clinic demonstrated that meat eaters produced a metabolite that promotes heart disease, called TMAO. Of great interest, TMAO was not elevated in vegans who were asked to eat a meat meal for the purposes of the study. Egg yolks cause the same reaction. In my clinic, I routinely measure levels of TMAO, and my patients eating meat and egg yolks on a regular basis have elevated measurements. I worry they are aging prematurely and counsel them to substitute beans for beef and chickpeas for eggs.

POPs are toxic synthetic chemicals that accumulate in fat. Some of the POPs are PCBs, dioxins, DDT, and flame retardants used in clothing and furniture. They disrupt endocrine pathways and are linked to cancer, heart disease, hypertension, obesity, and diabetes. POPs enter our body largely from animal products that we eat. For example, levels of PCBs in animal fat found in meat is much higher than the levels found in vegetables, fruits, and cereals.

AGEs are naturally occurring compounds in food and can be increased by cooking on dry heat, such as on a grill. AGEs are associated with a variety of diseases including brain inflammation, diabetes, heart disease, and cancer. Levels of AGEs found in meat are many multiples higher than in any fruit or vegetable. The irony of the chemical term AGE is not to be missed as increased levels of AGEs lead to premature aging and are best avoided by skipping the meat entirely.

Recently, a bizarre addition to the tale of meat and inflammation has been described and a tick is to blame. New data exists that the bite of the lone star tick, quite common in certain areas like Virginia, can cause an antibody to form that reacts to a carbohydrate in meat (yes there are carbohydrates in meat from the blood groups in the flesh) called alpha-gal.

These antibodies can cause a severe allergic reaction the next time and every time red meat is eaten after the antibody forms. In an even newer research study, over 25 percent of heart patients tested had the antibody for alpha-gal, a component of red meat, and those that had the antibody had more advanced heart disease than those that did not have the antibody.

Although studies have linked the consumption of animal foods in general, and red meat in particular, with heart disease in humans, we are still learning new pathways. One new route to develop damaged heart arteries was described in detail in a new animal research study. In most species, a compound called Neu5Ac is produced and converted by an enzyme to Neu5Gc which can be found on blood vessels and other tissues. It turns out that humans lost the enzyme and therefore cannot produce Neu5Gc.

Red meat is rich in Neu5Gc. In this new study, an animal model was created that mimicked humans, unable to convert the A to the G version of the compound. When the lab animals were then fed a diet rich in Neu5Gc and fats (like meat), they developed 2.4 times the atherosclerosis of arteries of the control animals. This elegant science indicates that another biological pathway makes humans poorly suited to depend on red meat for nourishment.

Methionine is an essential amino acid found in animal and plant foods, but it exists in much higher concentrations in red meat, pork, poultry, fish, and eggs compared with plant foods. A theory that a low methionine diet (plant strong) may slow aging and improve insulin responsiveness has been proposed. Researchers at Duke University studied two models of cancer in mice fed on an average and a low methionine diet.

They reported that there were differences in the one carbon metabolism and cancer growth and responsiveness to therapy was enhanced by the low methionine diet. They then showed in healthy human volunteers that eating a low methionine diet for three weeks produced the same changes in one carbon metabolism as the mice. The easiest way to achieve a lower methionine intake is to limit or eliminate animal foods on the plate.

Based on the multiple ways in which animal foods, particularly red meat, initiate adverse reactions that are far from healthy, labelling meat that has a reduced saturated fat content may be and advance, but it is a long way from earning labelling as a healthy food choice.

Dr. Joel Kahn is Professor of Cardiology, Summa cum Laude grad, Kahn Center for Longevity and GreenSpace & Go, author, The Plant Based Solution.www.drjoelkahn.com@drjkahn.

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Healthy Labels on Meat Are a Really Bad Idea

Description

Can meat ever really have a "heathy" label? Meat, particularly red meat, is linked to health risks including heart disease and certain forms of cancer.

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Dr. Joel Kahn

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LIVEKINDLY

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Healthy Labels on Meat Are a Really Bad Idea - LIVEKINDLY

Has your skin been breaking out like crazy or drier than usual since we all started self-isolating? Because mine certainly has. And after talking to other POPSUGAR editors and posting about it on Instagram, we've learned that a lot of people feel like their skin is freaking out right now. Much of it can be attributed to higher levels of stress and anxiety, sure, but we couldn't help wondering if there might be more to it. Turns out we were on to something. As dermatologist Shari Marchbein, MD, explained: "I do think a lot of it is stress, although many of us have altered sleep, work, life, and skin-care routines right now, so there's no way to pinpoint just one reason."

Obviously, we can't generalize everyone's situation, because there are a million and one factors that go into why someone's skin might be flaring up or acting like a moody teenager. But it seems to be too much of a coincidence that almost everyone is having the same problem since lockdown began even dermatologists. "I have to be honest; my skin just has a mind of its own and lifestyle factors make relatively little difference to what it wants to do," admitted London-based consultant dermatologist Anjali Mahto. The same might be true for a lot of us, but we still wanted to find out if there is anything specific causing our isolation breakouts and if there's anything we can do to help clear them.

By no means are we telling you that you need to "fix" or "improve" your skin right now. We'll lay out all the expert opinions for you, so you can take the advice you want and need whether that's all of it or none of it. We know the appearance of your skin may not be your top priority right now, but as beauty editors, we found the number one question we're being asked right now isn't how to perfect our at-home facial massage technique but: "why is my skin breaking out so badly since lockdown?" So, we're going to help answer it.

To get to the bottom of it, we spoke with six dermatologists and skin experts who listed six possible reasons spots are popping up quicker than we can control. These include humidity levels, lack of vitamin D, protective mask friction, and the inevitable stress.

Listing stress as a reason for increased breakouts feels both helpful and unhelpful right now. Given it's such an unsettling time, we're all stressed to some degree, and while practicing mindfulness or meditating can help, telling us to chill out is easier said than done. But here's the thing, nearly every expert we spoke to mentioned stress as one of the main reasons we're all seeing more spots than usual.

Stress can trigger elevated levels of cortisol (the stress hormone), causing an overall metabolic imbalance in the body (which also affects sleep). For women specifically, this decreases our oestrogen production, which subsequently means we have a higher amount of androgen (male hormone). "Androgen, when in abundance, will send messages to our sebaceous glands to produce more oil. The reaction makes our pores unhappy, causing them to swell internally, creating an inflammatory response on the skin, therefore producing a spot," explained Pamela Marshall, clinical aesthetician and founder of London-based clinic Mortar & Milk.

So, how do you avoid this happening? Well, we're not going to tell you to meditate and do yoga because, honestly, in these times, you do you (although, if you want help relaxing, we have talked to experts about how to do that right). But take some comfort in knowing that these unusual times aren't forever, nor is your skin freakout. While the condition of your skin might not be your usual, it's probably happening due to this totally normal response.

Stress leads us onto the next possible factor, differing sleep patterns. "When sleep deprived, the body makes more cortisol, which causes inflammation and can worsen skin conditions such as eczema, acne, and psoriasis," Dr. Marchbein explained. Trying to keep your sleep as consistent as you can will only do good things for your overall well-being and skin.

Another big reason for your skin taking a turbulent ride since lockdown could be the changes in humidity levels, especially since most of us have been indoors a lot more. "Heated indoor air loses a lot of moisture, typically containing just 10 percent of the moisture your skin needs," said Anne Wetter, MD, dermatologist and cofounder of Alll DNA skincare. "When you are inside in the dry air, the moisture transfers through your pores in the skin, giving you a very dry skin surface, even though you might normally have oily or combined skin. This will put your skin into a sort of 'turbo mode' where it tries to remoisturize, but instead it gives you irritated and red skin, or even acne."

To combat the low humidity level, Dr. Wetter recommends making sure you're keeping your skin hydrated with moisturizers containing the ingredients urea or glycerin. In addition to this, if you have access, use a humidifier. If you don't, she advises leaving bowls of water in your house and next to the computer or the place you're working/spending most of your time. It might seem strange and a bit precarious (make sure the bowls aren't close enough to spill on your computer), but it's worth a shot, right?

You've seen the pictures of doctors and nurses with their faces dry, chapped, and irritated from wearing multiple masks all day long. But wearing a mask can mess up your skin even if you're just wearing it to the supermarket or on your commute to work if you're an essential worker. This is because continual use of masks and protective equipment can cause friction on the skin, which can lead to sensitivity and irritation. Dr. Marchbein explained that this is basically a form of acne mechanica, which can be triggered by excessive pressure, friction, heat, or rubbing of the skin. "We see this with helmets, chin straps, and anything the rubs the face or occludes it." This can start out as smaller patches of irritated or bumpy skin but then form into larger spots. Now, to be clear, we are by no means telling you not to wear a face mask when going out in public (editor's note: while the UK government advises not to wear one unless you're sick, other areas around the world are encouraging it, including New York City); we're just noting that this is another factor to consider when trying to figure out what's going on with your skin.

To treat this form of acne, do not excessively scrub the area; this may cause further irritation. Instead, cleanse the affected area gently to remove any grime and sweat, and treat with a mild alpha hydroxy acid like salicylic acid and an oil-free moisturizer.

While discussing this article in our morning edit meeting, I told my fellow editors how many experts mentioned alcohol as a factor but that I didn't think I was drinking more than usual. My teammates agreed, but then 15 seconds later, we all copped to the fact that, yes, we have been drinking a lot more wine in lockdown. And based on our Instagram Stories, I don't think we're alone in that practice.

"When we drink alcohol, our skin becomes dry and can look wrinkly, in addition to causing puffiness in the face." said Susan Mayou, consultant dermatologist at the Cadogan Clinic in London. While drinking likely won't be the root cause of your skin woes, it probably isn't helping. It's up to you whether that extra glass of wine is worth it for dry and puffy skin in the morning. But if I'm being totally honest, for me, that extra glass is absolutely worth an extra spot or two right now.

An hour outdoors, at most, is a dramatic decrease in what most of us and our skin are used to. Our dry, dull, and angry skin could be due to a "lack of vitamin D synthesis from not spending much time outdoors," Marshall said. "Vitamin D is crucial to cell differentiation and development." Dr. Wetter agreed, noting that "UV light in moderation has a beneficial effect to some skin conditions like acne. Staying inside will prevent this." According to the NHS, "your body can't make vitamin D if you're sitting indoors by a sunny window because ultraviolet B (UVB) rays (the ones your body needs to make vitamin D) can't get through the glass." For this reason, Marshall and the NHS both recommend increasing your intake of vitamin D from food sources and potentially taking a vitamin D supplement (although, please consult your GP before adding any nutritional supplements into your diet).

Now that we understand a little bit more about what may be causing our breakouts, we wanted to know exactly why our skin is full of both spots and dry patches.

Acne occurs when the hair follicles in your skin get clogged, which is usually caused by oil, dead skin cells, leftover makeup, and dirt. "The skin relies on its lipid layers to keep out potential irritants, such as bacteria, viruses, and fungi, and to maintain a consistent cell turnover," Dr. Wetter explained. "When your skin becomes dry, its ability to perform these tasks is limited, causing buildup of dead skin cells on the surface of the skin, which can easily become irritated and inflamed, creating a potential breeding ground for acne." To combat this, she stresses the importance of still cleansing morning and evening, even if you aren't wearing makeup as normal.

Having said that, don't be tempted to run to your beauty stash and apply every chemical exfoliator and foaming cleanser you own to try to clear your skin. "I believe less is more when it comes to skin care," Dr. Mahto said. "It's about picking ingredients wisely that have multipurpose ingredients." For acne, she recommends using evidence-based ingredients such as AHAs and retinoids in your routine to control oil production and blemishes. Board-certified dermatologist Erin Gilbert's view also reflects this: "Harsh exfoliation can worsen the inflammation you are experiencing with an acne breakout. This is why you want to use a mild AHA," such as salicylic acid. She likes the Skinceuticals Blemish + Age Cleanser ($92) and Vichy Normaderm Phytosolution Purifying Cleanser ($18).

"Be judicious, and don't overuse these to the point of excess dryness. I see so many patients who have overused harsh antiacne regimes and complain of severe irritation and redness," Dr. Gilbert said. "If that happens, you'll be tempted to apply a heavy moisturizer, but then the cycle of breakouts will start all over again." For moisturizers, she recommends creams with the ingredient niacinamide as it has anti-inflammatory properties, such as CeraVe Hyaluronic Acid Face Moisturizer ($14), and we like Paula's Choice Skin Balancing Moisturizer ($29).

Another treatment, recommended by Dr. Marchbein, are spot patches. These are "hydrocolloid adhesive stickers that contain certain active ingredients such as salicylic acid and/or tea tree oil, which are delivered to the spot while it's in place. By covering the pimple, these active ingredients are able to penetrate the skin more deeply, allowing them to potentially work better." We love Zitsticka Killa Patches ($29), which uses 24 microdarts to dispense the ingredients (don't worry, it doesn't hurt), and the pack also contains antiseptic wipes. We're also using Starface Patches ($22), which come in the most adorable box ever.

More:
6 Dermatologists and Skin Experts Explain Why Your Breakouts Are Out of Control Right Now - POPSUGAR

Has your skin been breaking out like crazy or drier than usual since we all started self-isolating? Because mine certainly has. And after talking to my fellow POPSUGAR editors and posting about it on Instagram, we've learned that a lot of people feel like their skin is freaking out right now. Much of it can be attributed to higher levels of stress and anxiety, sure, but we couldn't help wondering if there might be more to it. Turns out we were on to something. As Dr Shari Marchbein, a board-certified dermatologist in New York City, explained: "I do think a lot of it is stress, although many of us have altered sleep, work, life, and skin-care routines right now, so there's no way to pinpoint just one reason."

Obviously, we can't generalise everyone's situation, because there are a million and one factors that go into why someone's skin might be flaring up or acting like a moody teenager. But it seems to be too much of a coincidence that almost everyone is having the same problem since lockdown began even dermatologists. "I have to be honest; my skin just has a mind of its own and lifestyle factors make relatively little difference to what it wants to do," admitted London-based consultant dermatologist Dr Anjali Mahto. The same might be true for a lot of us, but we still wanted to find out if there is anything specific causing our isolation breakouts and if there's anything we can do to help clear them.

By no means are we telling you that you need to "fix" or "improve" your skin right now. We'll lay out all the expert opinions for you, so you can take the advice you want and need whether that's all of it or none of it. We know the appearance of your skin may not be your top priority right now, but as beauty editors, we found the number one question we're being asked right now isn't how to perfect our at-home facial massage technique but: "why is my skin breaking out so badly since lockdown?" So, we're going to help answer it.

To get to the bottom of it, we spoke with six dermatologists and skin experts who listed six possible reasons spots are popping up quicker than we can control. These include humidity levels, lack of vitamin D, protective mask friction, and the inevitable stress.

Listing stress as a reason for increased breakouts feels both helpful and unhelpful right now. Given it's such an unsettling time, we're all stressed to some degree, and while practising mindfulness or meditating can help, telling us to chill out is easier said than done. But here's the thing: nearly every expert we spoke to mentioned stress as one of the main reasons we're all seeing more spots than usual.

Stress can trigger elevated levels of cortisol (the stress hormone), causing an overall metabolic imbalance in the body (which also affects sleep). For women specifically, this decreases our oestrogen production, which subsequently means we have a higher amount of androgen (male hormone). "Androgen, when in abundance, will send messages to our sebaceous glands to produce more oil. The reaction makes our pores unhappy, causing them to swell internally, creating an inflammatory response on the skin, therefore producing a spot," explained Pamela Marshall, clinical aesthetician and founder of London-based clinic Mortar & Milk.

So, how do you avoid this happening? Well, we're not going to tell you to meditate and do yoga because, honestly, in these times, you do you (although, if you want help relaxing, we have talked to experts about how to do that right). But take some comfort in knowing that these unusual times aren't forever, nor is your skin freakout. While the condition of your skin might not be your usual, it's probably happening due to this totally normal response.

Stress leads us onto the next possible factor, differing sleep patterns. "When sleep deprived, the body makes more cortisol, which causes inflammation and can worsen skin conditions such as eczema, acne, and psoriasis," Dr Marchbein explained. Trying to keep your sleep as consistent as you can will only do good things for your overall well-being and skin.

Another big reason for your skin taking a turbulent ride since lockdown could be the changes in humidity levels, especially since most of us have been indoors a lot more. "Heated indoor air loses a lot of moisture, typically containing just 10 percent of the moisture your skin needs," said Dr Anne Wetter, dermatologist and cofounder of Alll DNA skincare. "When you are inside in the dry air, the moisture transfers through your pores in the skin, giving you a very dry skin surface, even though you might normally have oily or combined skin. This will put your skin into a sort of 'turbo mode' where it tries to remoisturise, but instead it gives you irritated and red skin, or even acne."

To combat the low humidity level, Dr Wetter recommends making sure you're keeping your skin hydrated with moisturisers containing the ingredients urea or glycerin. In addition to this, if you have access, use a humidifier. If you don't, she advises leaving bowls of water in your house and next to the computer or the place you're working/spending most of your time. It might seem strange and a bit precarious (make sure the bowls aren't close enough to spill on your computer), but it's worth a shot, right?

You've seen the pictures of doctors and nurses with their faces dry, chapped, and irritated from wearing multiple masks all day long. But wearing a mask can mess up your skin even if you're just wearing it to the supermarket or on your commute to work if you're an essential worker. This is because continual use of masks and protective equipment can cause friction on the skin, which can lead to sensitivity and irritation. Dr Marchbein explained that this is basically a form of acne mechanica, which can be triggered by excessive pressure, friction, heat, or rubbing of the skin. "We see this with helmets, chin straps, and anything that rubs the face or occludes it." This can start out as smaller patches of irritated or bumpy skin but then form into larger spots. Now, to be clear, we are by no means telling you not to wear a face mask when going out in public (editor's note: while the UK government advises not to wear one unless you're sick, other areas around the world are encouraging it, including New York City); we're just noting that this is another factor to consider when trying to figure out what's going on with your skin.

To treat this form of acne, do not excessively scrub the area; this may cause further irritation. Instead, cleanse the affected area gently to remove any grime and sweat, and treat with a mild alpha hydroxy acid like salicylic acid and an oil-free moisturiser.

While discussing this article in our morning edit meeting, I told my fellow editors how many experts mentioned alcohol as a factor but that I didn't think I was drinking more than usual. My teammates agreed, but then 15 seconds later, we all copped to the fact that, yes, we have been drinking a lot more wine in lockdown. And based on our Instagram Stories, I don't think we're alone in that practise.

"When we drink alcohol, our skin becomes dry and can look wrinkly, in addition to causing puffiness in the face." said Dr Susan Mayou, consultant dermatologist at the Cadogan Clinic in London. While drinking likely won't be the root cause of your skin woes, it probably isn't helping. It's up to you whether that extra glass of wine is worth it for dry and puffy skin in the morning. But if I'm being totally honest, for me, that extra glass is absolutely worth an extra spot or two right now.

An hour outdoors, at most, is a dramatic decrease in what most of us and our skin are used to. Our dry, dull, and angry skin could be due to a "lack of vitamin D synthesis from not spending much time outdoors," Marshall said. "Vitamin D is crucial to cell differentiation and development." Dr Wetter agreed, noting that "UV light in moderation has a beneficial effect to some skin conditions like acne. Staying inside will prevent this." According to the NHS, "your body can't make vitamin D if you're sitting indoors by a sunny window because ultraviolet B (UVB) rays (the ones your body needs to make vitamin D) can't get through the glass." For this reason, Marshall and the NHS both recommend increasing your intake of vitamin D from food sources and potentially taking a vitamin D supplement (although, please consult your GP before adding any nutritional supplements into your diet).

Now that we understand a little bit more about what may be causing our breakouts, we wanted to know exactly why our skin is full of both spots and dry patches.

Acne occurs when the hair follicles in your skin get clogged, which is usually caused by oil, dead skin cells, leftover makeup, and dirt. "The skin relies on its lipid layers to keep out potential irritants, such as bacteria, viruses, and fungi, and to maintain a consistent cell turnover," Dr Wetter explained. "When your skin becomes dry, its ability to perform these tasks is limited, causing buildup of dead skin cells on the surface of the skin, which can easily become irritated and inflamed, creating a potential breeding ground for acne." To combat this, she stresses the importance of still cleansing morning and evening, even if you aren't wearing makeup as normal.

Having said that, don't be tempted to run to your beauty stash and apply every chemical exfoliator and foaming cleanser you own to try to clear your skin. "I believe less is more when it comes to skin care," Dr Mahto said. "I think it's about picking ingredients wisely that have multipurpose ingredients." For acne, she recommends using evidence-based ingredients such as AHAs and retinoids in your routine to control oil production and blemishes. Board-certified dermatologist Dr Erin Gilbert's view also reflects this: "Harsh exfoliation can worsen the inflammation you are experiencing with an acne breakout. This is why you want to use a mild AHA," such as salicylic acid. She likes the Skinceuticals Blemish + Age Cleanser (40) and Vichy Normaderm Phytosolution Purifying Cleanser (13).

"Be judicious, and don't overuse these to the point of excess dryness. I see so many patients who have overused harsh antiacne regimes and complain of severe irritation and redness," Dr Gilbert said. "If that happens, you'll be tempted to apply a heavy moisturiser, but then the cycle of breakouts will start all over again." For moisturisers, she recommends creams with the ingredient niacinamide as it has anti-inflammatory properties, such as CeraVe Hyaluronic Acid Face Moisturiser (13), and we like Paula's Choice Skin Balancing Moisturiser (28).

Another treatment, recommended by Dr Marchbein, are spot patches. These are "hydrocolloid adhesive stickers that contain certain active ingredients such as salicylic acid and/or tea tree oil, which are delivered to the spot while it's in place. By covering the pimple, these active ingredients are able to penetrate the skin more deeply, allowing them to potentially work better." We love Zitsticka Killa Patches (27), which use 24 microdarts to dispense the ingredients (don't worry, it doesn't hurt), and the pack also contains antiseptic wipes. We're also using Starface Patches (17), which come in the most adorable box ever.

See the article here:
Is Your Skin Breaking Out Like Crazy? 6 Experts Explain Why This Might Be Happening - POPSUGAR United Kingdom

If youre struggling to sleep during the virus outbreak, experts have some advice on how to get more shut-eye. (Rawpixel pic)

You might find yourself struggling to sleep during the current Covid-19 outbreak, as stress, uncertainty and changes in our usual routine make it more difficult to relax at night and drop off.

Here, we round up some expert advice on how you can try to maintain a regular sleep pattern and get a more restful nights shut-eye.

1. Try to stick to the same bedtime and wake-up time

Waking up and starting your day at the same time every day is the most important way to stabilise your body clock, says Professor Greg Murray, at Swinburne University of Technology, Australia.

He advises sticking to consistent sleep and wake times which fit your natural rhythm. If youre a night owl, its okay to stay up a little later and get up a little later, just make sure these bedtimes and wake up times are the same every day, he says.

Dr Elizabeth Cozine, a Mayo Clinic family medicine physician, agrees, Try to go to bed at the same time every night, maybe sleeping in a little bit later than you normally would because youre not rushing to get to the office.

And see if you can try to get somewhere between seven and nine hours of sleep, which is what most adults need, and make that a regular part of your day.

2. Avoid napping

Professor Murray also advises trying not to nap during daylight hours, as it can make it hard to fall asleep at night. If you must nap, he says to restrict your sleep to just 30 minutes.

3. Get some sunlight during the day

Professor Kevin Morgan, who is a sleep expert at the University of Loughborough, UK, says that staying indoors means we dont soak up enough sunlight, and this can affect our sleep patterns and our need to nap during the day.

To help synchronise our body clock, we should try to get enough sunlight during the day, particularly in the morning, to let our body know its daytime. He recommends exercising outdoors, if you can, or at least just walking to the grocery store or sitting in the garden.

4. And avoid bright light in the evening

In the evening, Professor Murray says we should avoid bright light, as this suppresses the production of the hormone melatonin, which makes us feel sleepy.

This also includes avoiding the blue light from computer screens and smartphones, so try to read a book or take a bath instead of watching TV to help you relax.

5. Avoid alcohol and caffeine

Be careful how much caffeine you have every day, says Professor Morgan, who adds that working from home, or just being at home, offers more opportunities for tea and coffee breaks.

Caffeine suppresses the chemical adenosine which contributes to sleepiness and promotes sleep. He also advises limiting your alcohol intake, as although it can help you fall asleep it can also cause you to wake up early, as well as affect the quality of your sleep so you actually feel more tired the next day.

6. Try to relax

Psychiatry professor Adam Abba-Aji at the University of Alberta, Canada, says that if youre feeling anxious during the Covid-19 outbreak, usually the first sign of it will be a lack of sleep.

It becomes difficult to switch our brains off, he said. Where theres a lack of sleep, people sometimes resort to alcohol or some other sedatives.

Instead, Abba-Aji suggests trying to relax and switch off with some yoga before you head to bed.

7. Try meditation

You might not have tried meditation before, but Dr Cozine says theres a lot of evidence to suggest it can improve sleep, as well as help ease stress and anxiety.

Ive found that it helps me turn off those hamster wheels of thoughts that are rolling in my brain, and it also helps me to get ready for the next step, she says.

Im not talking about sitting Zen, cross-legged for three hours thinking about I dont know like a desert or something. Im talking about maybe five minutes where you just reset.

Follow this link:
7 ways to sleep better during the Covid-19 outbreak - Free Malaysia Today

A man who spent 11 years living as a trans woman having treatment including hormone therapy and breast implants has trained as a counselor to help people accept their gender, after 'detransitioning' back to being male.

Constantly mistaken for a girl, from childhood onwards, Brian Belovitch, 63, decided to transition to a woman when he was just 19 years old, instead of embracing his "effeminate gay identity" as he does today.

Brian, of Brooklyn, New York, said:

She continued:

Brian is speaking out about his extraordinary life, which has seen him battle addiction as he tried to fathom who he really was, just as a British woman has been given the go-ahead to pursue legal action against an NHS gender clinic, saying they should have challenged her more ardently before allowing her to transition from female to male.

Brian aged three in 1959 (PA Real Life/Collect)

Known as a 'detransitioner' a trans person who has reverted back to the sex they were assigned at birth Brian believes we are seeing "the tip of the iceberg" when it comes to people making the decision to change gender in this way.

He said:

He continued:

Brian certainly enjoyed a colorful existence after transitioning living as the showgirl Natalia 'Tish' Gervais, through the late 70s and early 80s and performing in legendary New York nightspots like Dancetaria, the Limelight Club, and Studio 54, made famous by artist Andy Warhol.

But beneath the glamorous surface was a seedy underbelly that saw Brian, who is now happily married to horticulturist Jim Russell, 61, develop crippling drug and alcohol addictions.

Hitting rock bottom in the 1980s and seeking therapy, in 1986 Brian decided he was fundamentally unhappy in his own skin and decided to transition back to being male.

"It was such a relief," he said. "I finally felt at peace in myself for the first time."

"It felt like my world had become a lot simpler by the decision and I could finally live the life I wanted to."

Brian aged five, with his parents Dolores and Isadore (PA Real Life/Collect)

Brian became confused about his gender as a tiny child, when he remembers strangers mistaking him for a girl to his mother's chagrin.

"One of my first memories is being out shopping with my mother and a group of women gathering around and saying, 'Oh how cute, how sweet. Where does she get those curls and thick eyelashes from?'" he said.

"My mom didn't deal with it very well and pulled me away shouting that I was a boy."

He continued:

Targeted by his peers throughout his childhood and into his teenage years, Brian says he was lucky to have survived the experience.

"Kids would follow me home and throw rocks at me," he recalled. "They'd call me 'f***** and queer.'"

He continued:

Exploring the local gay scene at age 16 brought Brian some solace, especially when he made a like-minded friend in Paul Bricker, then 17, who tragically passed away from an aneurysm, aged just 27.

Brian in 1972 (PA Real Life/Collect)

Describing Paul as his 'mentor,' Brian said:

Soon after, Brian moved in with Paul and his mother, Gloria Walker, now 93.

In the bohemian household, he could be open about his sexuality and he and Paul began dabbling in the world of drag.

"By today's standards, I was what would be called a 'gender non-conformist,' meaning that I trod the line between what is seen as male and female," Brian explained.

"It was a mixed bag. We called it 'scare drag,' because we were scaring the straight people that couldn't put us into one of their boxes."

Outgrowing his hometown of Providence, Rhode Island, Brian moved to New York City with $100 in his pocket and started performing with drag queens to "earn an extra buck," alongside working in a thrift store.

Taken under the wing of a group of trans women, Brian was still struggling with his own gender identity and began to question if transitioning from male to female might be the answer to his problems.

So, less than a year after arriving in New York, aged just 19, he was given the name of a "no questions asked" doctor who could help him to transition.

Brian and Paul Bicker in 1973 (PA Real Life/Collect)

"I turned up at this doctor's office no questions asked and handed over $10," he recalled.

"It was pretty much, 'Come in, drop your pants, I'll stick you with a needle.'"

Describing how the hormone therapy worked "very effectively," within a matter of months Brian developed small breasts, had a "softened" appearance and his voice sounded more feminine.

Changing his name legally that year, Brian officially became Natalia going on to spend the next 11 years living as Tish.

In 1979, four years into his hormone therapy and still not feeling like his "authentic self," Brian took the next step in his transition, spending $500 having silicone breast implants fitted.

"It felt like the right thing to do at the time," he said. "In hindsight, it wasn't very well thought out, but none of my decisions were back then."

He continued:

Natalia in a 1977 beauty pageant (PA Real Life/Collect)

Although struggling personally, Brian's professional life as Tish went from strength to strength.

Working seven nights a week, he would run the gauntlet of New York's hottest clubs, performing as a "big, busty showgirl."

"At the height of the 80s, I was a club personality," Brian said. "I had a band and would do a live show with a mix of comedy and musical numbers."

He continued:

Living both as a man and then as a woman also gave Brian a rare insight into the way society treats people based on their gender.

Discussing the downside of life as a woman, he said:

He continued:

Natalia performing at Dancetaria in 1986 (PA Real Life/Collect)

But life as a member of the 'gentler sex' also had benefits, according to Brian.

He continued:

He continued:

But the party scene and life as a showgirl eventually took its toll on Brian's physical and mental health and, in 1986, he hit an all time low.

"I was relying on drugs and alcohol to get through each day," he said.

He continued:

Putting his life back together, with the help of friends, he kicked his alcohol and drug addiction.

But being stone cold sober meant he could no longer ignore what was staring him in the face that he was not happy living as Tish.

Brian at Miami Beach in 1990 (PA Real Life/Collect)

"I was as sober as a judge and that really was the beginning of the end for Tish," Brian said.

"I always wanted to be my authentic, true self and I realized I wasn't."

After having therapy in which he discussed gender issues and what constitutes a male and a female identity, Brian felt his only option was to revert back to the gender he was assigned at birth.

"I was beautiful and young, but I wasn't happy as that person," he said. "I was at a crossroads. I knew I had to have surgery on my genitalia or go back to being Brian."

"There was no question which path to take. Times had changed a lot since I'd made the transition and there were more gay men embracing their effeminate side."

"I was in the gym one day and saw a fellow who reminded me of myself before I transitioned."

He continued:

So, Brian decided after much consideration, to make the transition back to being male, stopping his hormone therapy and cutting off his shoulder-length hair.

Then, six months later, in February 1987, he spent $750 having his silicone implants removed.

Brian and his husband, Jim, in 2002 (PA Real Life/Collect)

"I felt a great sense of relief after the operation," he said. "I woke up crying not from the pain but because it felt like a huge burden had been lifted."

Visiting the gym up to five times a week, Brian slowly built up his muscles and, with his hormone replacement "out of the window," he started growing more body hair and his shape filled out.

He also 'came out' for the third time.

"I've come out as gay, I've come out as a trans woman and now I was coming out as a detransitioner," he said.

"People would come up to me in the street and say, 'Hi Tish,' and I'd have to tell them, 'No it's Brian now.'"

"The whole thing just clicked this was who I was always meant to be."

Saying goodbye to Tish meant leaving the glitz and glamour of the New York drag scene, after which Brian established himself as a successful photography agent and editor.

But, after the economic crash of 2008, he decided to re-train again as a counselor, specializing in drug and alcohol addiction.

Describing his "second time around" at being Brian as the "the best years of his life," recently he has become alarmed about the amount of trans people following in his footsteps, by reverting back to the gender they were assigned at birth.

Brian now (Jay Mathews Photography/PA Real Life)

Hoping to shine a light on the issue, Brian released his autobiography, Trans Figured: My Journey from Boy to Girl to Woman to Man, in 2018.

He said:

Now, Brian who met his husband while walking his Jack Russell Terrier, Bricker, 18 years ago and married in 2013 is hoping to specialize in gender identity counseling, to help other detransitioners with their journey.

He concluded:

Brian now (Jay Mathews Photography/PA Real Life)

He concluded:

See the original post:
Man Who Lived For 11 Years As A Trans Woman Explains Why He Decided To 'Detransition' To Live As A Man Once Again - Comic Sands

BRADFORD singer Abi Otway has turned to music to highlight how her husband saved her life.

Abi discovered she had a lump the size of a pea in her breast after her husband Marc felt it as they cuddled. She was diagnosed with Grade 2-3 breast cancer and had recent surgery to remove the lump.

Now recovering, in self isolation, at her Low Moor home, she and Marc, who are in local band Mookie + the Bab, have posta Cheeky Fondle song on Facebook - to the tune of Matt Lucass Thank You Baked Potato internet hit.

Abi, 34, says that, although their song is fun, it has a serious message. I never checked my boobs because, like a lot of women, I was scared of what I might find. If Marc hadnt found the lump, it might have been too late, she said. I couldnt feel it at all when I was sitting down or standing up. I only felt it while lying down, on my side. When Marc found it I knew it was something sinister, but the doctor initially struggled to find a lump and told me to go back in 14 days. Im young and healthy, with no family history of breast cancer.

Abi was referred to the breast clinic at St Lukes Hospital. I had an ultrasound then a biopsy and a mammogram, which didnt show up the lump. It was under the breast, quite far back. I had to wait a week then I was diagnosed, on February 27.

The next day, she and Marc had a concert booked in Bradford. That was a very hard gig to do, said Abi, who managed to have surgery shortly before the Government put the UK on lockdown. I feel lucky that I had my operation on March 10, because so many people with cancer are now having their treatments put on hold. Its a horrible situation to be in, she said. I was already isolating, as I didnt want to catch the virus from anyone ahead of my surgery. But its at times like this that you really want to see family and friends, and that cant happen right now.

But then I think Im lucky because Marc and I were meant to be spending March singing on a cruise ship in Tahiti. Its something we dont normally do, but we were being paid and thought wed treat it as a holiday too. We could have ended up stuck on a ship, with my lump going untreated.

While Abi doesnt need chemotherapy, because the cancer hasnt spread to her lymph nodes, she is due to start radiotherapy later this month. Thats unless I get the virus, or they dont have enough staff, she said.

She is urging women to check their breasts for lumps or other abnormal signs. If your partner is checking, that helps, but if youre on your own Id say schedule a check into your diary, said Abi. And dont just do it standing up or sitting down - you need to check yourself lying down and on your side too.

I try to eat healthily and Im generally careful about my lifestyle. My cancer was hormone-related, so Ive been looking into what kind of things can affect hormones.

Fitness instructor Abi has worked as an actor, appearing in Coronation Street and Hollyoaks, as well as a singer. As Issimo, she and Marc gained a UK-wide fanbase and now they have a new band, Mookie + the Bab, and plan to release a single shortly.

Were a four-piece, with a stripped back, acoustic folk sound, said Abi. We cant get in the studio at the moment but were going to release a live single, called I Will Be. Its an upbeat song, which I think we all need right now.

Visit link:
Abi Otway's 'Cheeky Fondle' song highlights breast cancer ordeal - Bradford Telegraph and Argus

OKLAHOMA CITY (KFOR) According to the Mayo Clinic, a leader in healthcare, acts of kindness arent just good for the soul, they are good for the body too, so the Oklahoma State Department of Health is sharing some ideas to spread the love.

When we participate in acts of kindness our body releasesoxytocin, a hormone that helps regulate our social and emotional response.

The more oxytocin released, the more generous, kind and peaceful you are likely to feel.

In addition, higher amounts of oxytocin is associated with less stress and better sleep.

The best part? It is so easy for each of us to participate in acts of kindness. Here are a few ways to get that oxytocin boostand still follow social distancing guidelines:

Are you picking up dinner at a local drive thru? If you have the extra cash, pick up the tab for the person pulling up behind you.Did you run to the grocery store to pick up some rolls of toilet paper or get the last few boxes of tissues? Leave your extras on a neighbors doorstep or in a mailbox.Get your kids involved in acts of kindness and create springtime version of Secret Santa by leaving small arts and crafts or drawings for randompeople in your community.

Everyone will smile a little more and sleep a little better, with a bit more kindness in the world.

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Acts of Kindness are good for your health - KFOR Oklahoma City

Infantile Spasms Therapeutics market report:

The Infantile Spasms Therapeutics markets business intelligence research comprehensively provides a quick of crucial facts consisting of the merchandise catalogue, analytical elaboration, and other industry-linked information.

The study also covers the key aspects related to the on-going events such as mergers & acquisitions, new product launches, and synergisms. The study further harmonies a rigid preliminary for gaining loads of insights that potential buyers can use for ensuring better profits at low capitals. The demonstration of information on market segmentation by type, application, and geography delivers a critical viewpoint of, what manufacturers are seeking for the stipulated timeframe, 2020 2026.

Scope of the Report:

The global infantile spasms therapeutics market is growing at a slow pace. This is due to the increased availability of generic drugs and less approved therapies in the market and the less awareness of the disease and the available treatment options, especially in the low- and middle-income countries.The classification of Infantile Spasms Therapeutics includes Oral, Injection. The proportion of Injection in 2016 is about 45%, and the proportion of Oral in 2016 is about 55%.Based on application, the nitinol medical devices market is segmented into Hospital, Clinic and others. Clinic segment accounted for larger market share in terms of sales in 2016, Clinic segmented accounted for more than 45% of the market share in 2016.United States is the largest consumption place, with a consumption market share nearly 83% in 2016. Following United States, Europe is the second largest consumption place with the consumption market share of 12.6% in 2016.The US market is dominated by two approved products H.P. Acthar Gel (adrenocorticotropin hormone) and Sabril (vigabatrin). Sabril was the first drug to be approved by the Food and Drug Administration (FDA) in 2009 and H.P. Acthar Gel (adrenocorticotropin hormone) was approved for infantile spasms in 2010. Both have Orphan Drug Exclusivity (ODE) in the US.In the future, the Infantile Spasms Therapeutics will have a good future; the price fluctuation has relationship with the raw material. The technology will more mature and the industry is more dispersion.

The worldwide market for Infantile Spasms Therapeutics is expected to grow at a CAGR of roughly 3.0% over the next five years, will reach 150 million US$ in 2024, from 130 million US$ in 2019, according to a new Globalmarketers.biz Research study.

This report focuses on the Infantile Spasms Therapeutics in global market, especially in North America, Europe and Asia-Pacific, South America, Middle East and Africa. This report categorizes the market based on manufacturers, regions, type and application.

This article will help the Infantile Spasms Therapeutics manufacturers identify the volume inflation prospect with affecting trends.

This handout will assist you to know the quantity, growth with Impacting Trends. Click HERE to urge SAMPLE PDF (Including Full TOC, Table & Figures) @https://www.globalmarketers.biz/report/life-sciences/global-infantile-spasms-therapeutics-market-2019-by-manufacturers,-regions,-type-and-application,-forecast-to-2024/130415#request_sample

An in-depth list of key vendors in Infantile Spasms Therapeutics market includes:

MallinckrodtH. LundbeckInsys TherapeuticsOrphelia PharmaValerion TherapeuticsCatalyst PharmaceuticalsAnavex Life SciencesRetrophinGW Pharmaceuticals

Infantile Spasms Therapeutics Market segment by Type, the merchandise are often split into

OralInjection

Market segment by Application, split into

HospitalClinic

Market segment by Regions/Countries, this report covers

North America

Europe

China

Japan

Southeast Asia

India

Central & South America

Make an Inquiry About This Report @https://www.globalmarketers.biz/report/life-sciences/global-infantile-spasms-therapeutics-market-2019-by-manufacturers,-regions,-type-and-application,-forecast-to-2024/130415#inquiry_before_buying

The study objectives of this report are:

In this study, the years considered to estimate the market size of Infantile Spasms Therapeutics are as follows:

For the info information by region, company, type and application, 2019 is taken into account because the base year. Whenever data information was unavailable for the bottom year, the prior year has been considered.

The market study discusses the highlighted segments on the idea of BPS, market share, profit, and other vital factors. Our business report elaborates the impact of various subdivisions to the growth of the global Infantile Spasms Therapeutics market. It also delivers information on key trends associated with the subdivisions covered in the report. This aids market participants to address worthwhile areas of the global Infantile Spasms Therapeutics market. The marketing study also delivers analysis on the subdivisions supported absolute dollar opportunity.

The research answer many questions as follows:

Ask for Detailed Table of Content with Table of Figures:

https://www.globalmarketers.biz/report/life-sciences/global-infantile-spasms-therapeutics-market-2019-by-manufacturers,-regions,-type-and-application,-forecast-to-2024/130415#table_of_contents

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Infantile Spasms Therapeutics Market Size, Share, Trends and Competitive Outlook during forecast period 2020-2026 - Curious Desk

Global Bone Marrow Transplant Rejection Treatment Marketreport contains exhaustive data on the most important factors the growth of the company. The report contains a study on the change in the dynamics of competition. It also delivers specific awareness that helps you choose the right business executions and steps. The Bone Marrow Transplant Rejection Treatment Market report systematically presents information in the form of organizational charts, facts, diagrams, statistical charts, and figures that represent the state of the relevant trading on the Global and regional platform. Additionally, the report comprises the overall business chain, through which the growth rate and decline rate of the specific industry in the market can be analyzed. The total cost spent on manufacturing the product and analysis of its assembling procedure is also described in the report.

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Bone Marrow Transplant Rejection Treatment Market Segmentation by Product Type:AzathioprineAdrenocorticotropic HormoneCyclophosphamideCyclosporine AIndustry Segmentation:HospitalClinic

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As Krista Petruzziello puts it herself, she picked a hell of a time to get cancer.

She got the diagnosis early last month: Breast cancer. An early stage with an excellent prognosis, but still, shed need surgery and then hormone treatments. The surgery was scheduled for mid-April.

Then the coronavirus hit full force and turned the world upside down and her treatment plan as well. Her surgery was postponed indefinitely.

Right now, the risks outweigh the benefits for me, says Petruzziello, 48. The risk of infection and they need the ventilators in the OR.

Instead, shell start hormone treatment first, not a bad option because it could shrink the tumor in advance of surgery, she says, and is often used first in women with larger tumors. But its still disconcerting to know this is not the usual order.

Its like, 'Here's what we'd be doing in a normal world. But we can't do that for you, " she says. "So there are just concerns that come with that, obviously.

And I tend to be an anxious person anyway, she adds. So, you know, your mind just spins. And with her job as a licensed insurance agent also taken by the pandemic, there's nothing else to do but think about it right now.

Petruzziello is far, far from alone in grappling with concerns about a postponed procedure and wondering what the consequences will be.

In Massachusetts and around the country, hospitals are putting off all but the most urgent treatment to free up space and staff for coronavirus care and to keep vulnerable patients out of buildings that are documented infection hot spots.

Postponing elective procedures may sound like the care is optional, like cosmetic surgery. But the category comprisesmany much-needed treatments. They include hip and knee replacements for patients living in constant pain, mammograms and colonoscopies to screen for cancer, hernia surgery, kidney donation and much, much more.

At Massachusetts General Hospital, the orthopedics department which has 45 surgeons whose patients include sports stars is uneasily quiet now, running at only 3% to 5% of its usual volume, says its chief, Dr. Mitchel Harris. It has even given up its entire sports medicine clinic to be transformed into a respiratory care clinic, where the X-ray machines can serve COVID-19 patients instead of athletes.

Its treating only patients with urgent, time-sensitive issues," he says: broken bones and other trauma-related injuries, infections and spinal surgery where delay could lead to permanent damage.

Red Sox pitcher Chris Sale, who recently underwent elbow surgery in Los Angeles despite the pandemic, would not have been able to have surgery done here, Harris says.

Challenging Conversations, Uncomfortable Decisions

Across health care, disciplines from orthopedics to cardiology are having to figure out whats best for non-coronavirus patients during the pandemic.

These are complex adjustments, and they can be tricky to present to patients, says Dr. Harold Burstein, a medical oncologist at Dana-Farber Cancer Institute who has been working on national guidelines for breast cancer treatment during the pandemic.

We often map out a roadmap for patients, and we say something like, The first step is surgery, and then you'll get radiation, and then you'll get these hormone therapies, he says.

These days, with most surgeries canceled, many women will begin treatment with hormone therapies first, like Krista Petruzziello. Extensive evidence shows that for many patients, the outcomes can be just as good whether surgery comes first or second, Burstein says.

So for our patients, it's a real win-win, he says, in the sense that we can preserve these precious health care resources at a time of crisis, but we can also deliver very effective therapy without compromising long term results.

The trick is getting that across, he says: I liken this sometimes to going into a three-star Michelin Guide restaurant and saying, 'Instead of the appetizer and then the salad and then the main course and then the dessert, tonight we have a special: We're going to do the main course first and then we're going to have a salad and then an appetizer afterwards, then finish with a dessert. The point is, it all ends up in the same place, .

Overall, Dr. Burstein says, I think it is fair to say that we can come up with a good plan so that the vast majority of patients will have outcomes every bit as good as otherwise.

Thats particularly true for patients with early cancer, whether breast or prostate or other types that lend themselves to re-ordering the treatments. Theres more concern about patients with more advanced cancers who need to continue intensive treatment.

And research on disasters like Hurricane Katrina does suggest that they take a toll on how cancer patients fare, says Dr. Len Lichtenfeld, deputy chief medical officer for the American Cancer Society.

When we start postponing screenings for cancer early detection, when we start postponing chemotherapy, when we start postponing surgeries, I unfortunately have no doubt that we're going to see impact when we look back at this, he says. Obviously, patients who have more advanced disease, if any of their treatments are delayed, the impact is going to be more severe.

Normally, patients caught in a disaster area can be sent somewhere else for care, but there is no somewhere else for American cancer patients right now. And the disruption is likely to continue for months, Lichtenfeld says.

We're in uncharted territory, he says of treatment adjustments and delays. We don't know the impact of these changes. These are not things we want to do. These are delays that we have to do.

Hospitals will undoubtedly still treat severe, serious cancers, Lichtenfeld says, but may say no to some last-ditch treatments with low odds of success.

Right now, we're in a situation where we're going to have to make decisions that are not comfortable, he says.

It Doesnt Feel Elective To Them

Researchers have looked at the impact of delayed treatment in other contexts particularly long waiting lists and inability to afford care.

In the VA system, we found that longer appointment wait times negatively impact health care outcomes for very frail, geriatric populations, says Julia Prentice, who is now research director for the Betsy Lehman Center for Patient Safety. But these effects were not seen for less frail populations.

Not enough is understood about the impact of delays to be able to predict what effect the pandemic-related deferrals will have, she says.

But it is clear that telemedicine care is critical to make up for what would normally be office visits to monitor chronic conditions like diabetes. In the VA system, Prentice says, people with diabetes who had to wait longer to see doctors tended to have worse blood sugar control.

She has several extended family members whose elective procedures joint replacements and other orthopedic surgeries have been delayed, And it doesnt feel elective to them right now, she says.

But I will emphasize that the health care system is still doing the right thing by canceling these elective care procedures to protect the capacity, she says. It is just a very difficult tradeoff that we're grappling with.

And there could be an upside: The pandemic is creating an unfortunate but potentially illuminating natural experiment, says Dr. Bapu Jena, a professor of health care policy at Harvard Medical School. It could be that in some cases, people who must delay treatment end up better off, because their medical problem resolves on its own and treatment could have caused more harm than good. The widespread delays could bring such benefits to light, he says.

Krista Petruzziello, whose breast cancer surgery is on hold, is doing her best to find upsides, too. She has confidence in her doctors, including Dr. Burstein.

I'm lucky that I'm not a case where it's like if I don't get this surgery, I'm going to die, she says. No one is saying that. And they are telling me it's treatable and curable.

And luckily, I have a great support system at home and all my friends, she adds. One thing, though: I just miss hugging my friends.

Original post:
'A Heck Of A Time To Get Cancer': Hospitals Defer All But The Most Urgent Treatments - WBUR

A little bit of stress can push you to perform at your best. Let it get out of control, and you're at risk of burnout and serious health issues. While it's a simple enough concept to understand, effectively managing stress is much harder in practice. Case in point: 30 percent of Americans that visited a doctor between mid-2017 and mid-2018 went for stress-related issues, according to a survey conducted by media company Everyday Health.

Finding that Goldilocks-esque middle state--enough pressure to encourage mental sharpness, not enough to wear out the body and mind--is where most leaders want to be most of the time. Fortunately,psychologists and performance coaches say you can train your brain to get there--and even leverage stress in high-stakes situations.

It starts with understanding the roles that two hormones, adrenaline and cortisol, play in stress. Here's what you need to know:

Adrenaline and Cortisol

Whenever your body perceives a threat, like receiving an angry email or one more assignment on top of anoverwhelming workload,it releases a surge of adrenaline and cortisol into your system. A March 2019 article published by the Mayo Clinic effectively sums up each hormone's function:

Adrenaline increases your heart rate, elevates your blood pressure, and gives you an energy boost.

Cortisol suppresses functions that are unhelpful in fight-or-flight situations, like the digestive and reproductive systems, and sends signals to the parts of your brain that control mood, motivation, and fear.

Together, they can be a game-changer in high-stakes situations, says Jarrod Spencer, a sports psychologist and author who has worked with college athletes at the University of Maryland and Princeton University, among others. Stress, he says, can sharpen your focus to an extreme degree. That's why deadlines and time pressure can be so effective for performance: Cortisol enables above-average productivity, while adrenaline gives you energy to push your physical and mental capabilities.

A Double-Edged Sword

At the same time, staying levelheaded while stressed can be a challenge--and the same two hormones are to blame. "Your body is kicking into survival mode, and 99.9 percent of the time, you're not actually in a life-or-death situation," explains Graham Betchart, a mental skills coach who has worked with basketball stars like Ben Simmons and Karl-Anthony Towns, as well as staffers at venture capitalfirm True Ventures and Silicon Valley Bank. "You might just be having a talk with someone you work with, and all of a sudden, bang, you're in this very limited, primal state of thinking. You're basically dealing with old, hardwired instincts."

If you don't find ways to recover from stressful situations, you're subjecting your body to overexposure to adrenaline and cortisol, according to the Mayo Clinic. Over the long term, chronic stress increases your risk of anxiety, depression, digestive problems, headaches, heart disease, sleep issues, memory and concentration impairment, and other conditions.

Strategies for Stress

Humans have a built-in mechanism for managing stress as it's happening: The ability to breathe deeply. It's a short term, temporary fix--but a powerful one, says Louisa Sylvia, a staff psychologist at Massachusetts General Hospital and Harvard Medical School professor who often works with military veterans and service members. Sylvia explains that taking "big, deep belly breaths" helps with cardiorespiratory coupling--the synching of your heart rate, blood pressure, and breathing--which, in turn, helps you stay clearheaded under pressure.

Long term, Betchart adds, you can train your brain totake advantage of stress's positives while ignoring its negatives. He refers to his favorite method as the MVP technique:

Meditation, which trains your breathing and ability to stay mentally grounded in tough situations.

Visualizing yourself overcoming obstacles, which gives you the perspective you need to consistently realize that your stressors aren't life-or-death situations.

Positive self-talk, which motivates you to work hard at regularly managing your stress.

Practicing all three daily, Betchart says, can help you reframe the very nature of stress. "Stress is just energy, right? It's stress when you don't want the energy there, or you can't handle it," he says. "The person who understands how to reframe it into energy and opportunity already has a massive advantage--but you need that training on how to harness it. If you don't, it can overwhelm you."

Published on: Apr 1, 2020

Continue reading here:
How Stress Hormones Work--and How to Harness Them - Inc.

Your thyroid gland plays a key role in making sure that yourbody operates at peak performance. It releases just the right amount of thyroidhormone to help regulate the bodys functions.

Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services.Policy

But if something is out of whack with your thyroid, you mayexperience:

Thyroid diseases generally arent preventable. (If youve been avoiding soy or cauliflower to decrease your risk thats just a myth.) But according to endocrinologist Christian Nasr, MD, many thyroid diseases do run in families.

Knowing your family history can help you stay one stepahead of complications from a thyroid disorder and related conditions, he says.

More than 75% of the time, patients with thyroid disease tell me that someone on one side of their family has thyroid disease, says Dr. Nasr.

The more family members that have thyroid disease, the greater the likelihood that there is a hereditary root. And the higher the chances the patient will experience a thyroid problem.

Autoimmune disorders seem to be a genetic link for some of the familial thyroid disorders, he notes. Autoimmune disorders occur when white blood cells go haywire and attack the cells that regulate body functions. The immune systems foul play could cause the thyroid gland to produce too much or too little hormone. So having an autoimmune disease may increase your risk for thyroid disease, Dr. Nasr says.

But this same action the white blood cells attacking bodycells could result in other autoimmune disorders like diabetes, lupus orrheumatoid arthritis, too.

In a family, the same person could have an autoimmunedisorder that causes hypothyroidism and another that causes diabetes, says Dr.Nasr. And you may have a different family member who has diabetes, but notthyroid disease.

The takeaway: Inform your healthcare provider if any autoimmune diseases run in your family, even if there isnt an obvious thyroid connection.

Dr. Nasr has found that even thyroid cancers that arentconsidered hereditary can have a family link. Ive had situations wheremultiple family members have had the type of thyroid cancer thats usually nothereditary, he says.

Clustering of cancers in families isnt unique to thyroidcancer. Some families carry a mutation that suppresses good genes in thebody, which can put them at risk for a variety of cancers.

Different syndromes can increase someones risk for certain types of cancer, Dr. Nasr explains. Cowdens syndrome, for example, increases your risk of thyroid, breast and uterine cancers. Your family history may not include thyroid cancer, but if we see a lot of breast and uterine cancers, we may want to investigate whether there is a syndrome that puts you at risk for thyroid nodules or cancer.

The takeaway: As with the autoimmune disorders, knowyour family history. This information helps your healthcare team find patterns thatmight indicate thyroid disease-causing gene mutations lurking in the background.

What if you dont know about your familys history withthyroid disease? These symptoms may indicate its time to seek medical care:

Once youve addressed your symptoms with your provider, theywill likely perform a neck exam and a simple blood screening test. If allsystems appear to be operating well, your doctor may recommend monitoring overtime. If any of the results are concerning, your doctor may refer you to anendocrinologist or order an imaging test. And if you have a strong family history, genetictesting may help you make important healthcare decisions.

See the rest here:
Thyroid Disease May Run in Your Family and You Might Not Know It - Health Essentials from Cleveland Clinic

Human Growth Hormone (HGH) therapy has been around for decades but has been reserved for specific patients. Those with HIV or children with a hormone deficiency were some of the patients who benefitted. However, in recent years, a new focus has targeted therapy to help adults with hormone deficiencies.

HGH is aproteinproduced by the pituitary gland. The hypothalamus and hormones in the intestinal tract and pancreas help to balance it. It thrusts into production during sleep, exercise or trauma with more produced at night than in the daytime, given rising to the term beauty rest as the hormone is also linked to anti-aging.

Production of the hormone decreases as we age and that can lead to problems typically associated with getting older like:

The purpose of the growth hormone in children is to help bones and muscles grow. It also helps with organ function. Hormone therapy in adults is linked to:

Manycelebritiesare reportedly using hormones, but many are doing it illegally. They do it for anti-aging or for muscle mass. This is something all doctors warn against because the growth hormone has some possible side effects including water retention, high blood sugar, and joint and muscle pain. Plus, for those who have normal hormone levels, illegal use of it and then stopping will cause your body to produce less. That leaves you worse off than before.

Most celebrities who take legal hormone therapy dont like to talk about it for a variety of reasons. Its a controversial subject and many deem it private. However, a handful of aging stars have come out to talk about their decision to go on legal hormone therapy.

Benefits of therapy were noted in a New EnglandJournal of Medicine study. Men on six months of therapy increased their muscle mass 8.8 percent and reduced body fat by more than 14 percent. While it is linked to anti-aging, there are no conclusive studies to prove that.

Those considering hormone therapy must get a prescription in order to go to Hormone Clinic. That includes going to a doctor, getting a blood test and probably some specialized testing on the pituitary gland and hypothalamus. Or, you can just call for free consultation toHGH Therapy Clinicand get all the instructions. This clinic, as long as other top-rated clinics, does not provide therapy for bodybuilders and only provides it to those with a hormone deficiency.

This therapy is administered by injection and should be part of a routine health management plan under a doctors care to avoid side effects. For more information about hormone therapy, fill in the contact form and the knowledgeable advisor will call you back.

Link:
Celebrities that take HGH: Why do they need it? - - VENTS Magazine

MD Medical Group now has drive-thru COVID-19 testing facilities at seven Dallas-Fort Worth locations. (Courtesy MD Medical Group)

The drive-thrus are open to adults and children age 2 and older from 8 a.m.-5 p.m. Monday-Friday. According to MD Medical Group, select locations have the ability to administer 1,200 tests per day.

Those looking to get tested must schedule an appointment by calling or texting 888-776-5252. Same-day appointments are available.

The drive-thru sites are intended to allow people to get tested for COVID-19 while reducing demand at local hospitals, according to the medical group.

Julia Robles, lead medical assistant at Clinicas Mi Doctor, said the health professionals at the clinic start by assessing whether a patient is showing symptoms of COVID-19 and whether they have been exposed to the disease.

We do a quick questionnaire, and then, we will test them for flu and strep first, Robles said. And then, if they meet the criteria, well go ahead and do COVID-19 testing on them as well.

MD Medical Group has drive-thru testing facilities at the following Dallas-Fort Worth locations.

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MD Medical Group opens COVID-19 drive-thru testing sites at 7 locations in Dallas-Fort Worth - Community Impact Newspaper