RECENT NEWS
The Sexual Medicine Society of North America met in November 2009 and the meeting was on Better Sex Through Better Living! This month's newsletter is committed to making my patients aware of some of the findings at that meeting.
TESTOSTERONE AND VASCULAR DISEASE
One topic was the role of the hormone, testosterone, in a man's vascular health.
Testosterone regulates metabolism of carbohydrates, lipids, and proteins. It modulates muscle and fat tissue physiology and body composition. Many physicians at the meeting felt that testosterone was a very important independent determinant of blood fat level.
The people at the meeting determined that "middle-aged men with symptoms of testosterone deficiency are at a high risk for both carotid and heart disease". The likelihood of having a cardiovascular event (heart attack) in a patient with a low serum testosterone was four times higher compared to patients with normal testosterone.
Taking serum testosterone appeared to decrease the risks for heart disease and to reduce total cholesterol. This is a novel idea that has not been widespread in medicine. Several studies suggested that testosterone may have a protective affect on the development of atherosclerosis and that low testosterone accelerates plaque formation when in combination with elevated cholesterol.
Several doctors had studied this theory in the animal model. They were able to demonstrate that in animals, testosterone replacement therapy showed a markedly inhibited development of atherosclerosis.
What does all of this mean to my male patients?
If you are a middle-aged man and have low testosterone, it may be more difficult for your internist to manage your diabetes, insulin resistance, obesity, hyperlipidemia, and metabolic syndrome.
Our office is happy to participate in checking your testosterone and happy to work with your internist to maximize your hormone therapy.
SMOKING AND ERECTILE DYSFUNCTION
Another topic at the meeting was smoking and erectile dysfunction. The World Health Organization has estimated that about five million people die worldwide every year due purely to tobacco use.
A little known fact is that 50% of all bladder cancers are related to cigarette smoking. Nicotine appears to cause vasoconstriction through epinephrine and norepinephrine release; what this means is that you have decreased blood flow not only to your heart and other vital organs, but also decreased blood flow to your penis. If you have been or currently are a smoker you have a three time greater chance of developing erectile dysfunction! More importantly, erectile dysfunction in a smoker is a large predictor of vascular disease.
The take-home message is if you want to keep your erectile function, throw away the cigarettes!
Another hot topic at the meeting is something called the metabolic syndrome. What is the metabolic syndrome? It is postulated that increasing abdominal obesity leads to increased activity of an enzyme called aromatase. This is present in fat tissue. It converts testosterone to estrogen. The result is low testosterone, which increases triglycerides and can further lead to increasing obesity and insulin resistance. Patients with metabolic syndrome will frequently have problems with managing their diabetes, their insulin resistance, and their hyperlipidemea, all these things lead to atherosclerosis, cardiovascular disease, and poor quality of life. Ultimately, mortality is increased.
Studies presented at this meeting showed that replacing testosterone has helped to improve the ability to manage blood sugar and lipid levels in patients with metabolic syndrome.
Of great interest is the combination of diet, exercise, and testosterone; when these things are combined in a middle-aged, overweight male patient, a great increase in life satisfaction can be seen.
We have known for quite a while since the articles came out in The New England Journal of Medicine, that diet appears to have a great deal to do with health. The Okinawans have the lowest death rate from cancer, heart disease, and stroke and the highest life expectancy for both males and females. We also know that the Sardinians have the second best longevity and that in America, the Seventh-day Adventists have the best longevity. Throughout these three groups most people do not smoke. Most people put family first and remain socially engaged. Lastly, each of these groups is known to eat a lot of fruits, vegetables, and whole grains. All three groups also appear to have a high rate of exercise and a much lower rate of smoking.
There was also data presented at this meeting that there is a significant association between beef consumption and fatal heart disease. An increased rate of beef consumption was considered to be more than three ounces in eight days.
The Mediterranean diet, which we have all heard so much about, has a high consumption of olive oil, vegetables, legumes, whole grain products, fruits, and nuts. The intake of saturated animal fat is extremely low. Moderate fish consumption, moderate red wine consumption, and moderate calorie intake in general, also comprised the diet.
This diet, when transferred over to the standard American, appeared to work!
So from this meeting, much of what we already knew about health was confirmed. We did learn a new piece of information regarding testosterone level and how it might affect metabolic syndrome.
Information about cigarette smoking and erectile dysfunction has been known for a long time. Please pass the word that cigarette smoking causes bladder cancer!
All of this research was done in males.
I hope that you find this information interesting and our next newsletter will be on testosterone deficiency.
Have a great, hot July.
Respectfully,
Martha B. Boone, MD, LLC
Dear Fabulous Patients,
Please remember that we are moving our office June 3rd and June 4th. Our new address is: 960 Johnson Ferry Rd., Suite 245, Atlanta, GA 30342.
Also, please remember that the primary cause of kidney stones is DEHYDRATION. If you are a kidney stone patient, drink, drink, drink, during those hot months. Or, you'll get to see my new office earlier than you had hoped!
Yesterday, I saw a gorgeous 94 years old woman who looked about 70. I asked her, "How did you do it?"
I thought I'd share with you, her responses:
1) LAUGH A LOT
2) DON'T EAT TOO MUCH
3) EXERCISE A LITTLE EVERY DAY
4) DO SOMETHING COMPLETELY NEW EVERY YEAR!
5) PRAY
6) SAVE MORE MONEY THAN YOU SPEND, SO YOU DON'T HAVE TO WORRY WHEN UNEXPECTED THINGS HAPPEN, BECAUSE THEY ALWAYS DO!
7) Don't be afraid of a little plastic surgery! (LOL)
THIS LOVELY WOMAN HAD SURVIVED BREAST CANCER, THE DEATHS OF HER SON AND HER HUSBAND AND MOST OF HER FRIENDS. SHE WAS HAPPY AND GRACEFUL AND POISED. (I actually caught her "flirting" with Corwin, my male receptionist!)
Her words reminded me of the "simplicity" of a really good life.
I hope that they help you too.
Fondly,
Dr. Boone
Dear Valued Patient,
Topical Treatment for Vulvodynia /Post Coital Pain (Post Sex Pain)
There is an over-the-counter product with capsaicin 0.025% gel or cream that can be applied to the vulvar area two to four times per day. This medication has been shown to down regulate pain receptors. In layman's terms, that means it can make the pain receptors on the vulvar area less sensitive.
One important caveat is that this medication can burn on application. So, if you choose to use this form of therapy, please apply a topical agent to numb the vulva prior to application. The most common numbing agents are lidocaine, Xylocaine and EMLA cream.
If your past treatments for vulvadynia have failed, you may be interested in learning more about this new therapy.
Post Coital Pain (Post Sex Pain)
Do you suffer from post coital pain? Dr. Kristene Whitmore, Medical Director of the Pelvic and Sexual Health Institute in Philadelphia, PA, suggests her "Sex Pack":
If no relief, B & O suppositories may help.
Sincerely,
Martha Boone, M.D.
Dear Valued Patient,
URINARY TRACT INFECTIONS/ PASSING KIDNEY STONES
UTI
Recent research has shown the following regarding Recurrent Urinary Tract Infections in Women:
The immunotherapy URO-VAXOM decreases the incidence of UTI by 50%.BUT, IT IS NOT CURRENTLY AVAILABLE IN THE USA.
PLEASE KEEP YOUR EYES PEELED IN CASE THIS BECOMES AVAILABLE IN THE USA! AND, WRITE THE FDA TO LET THEM KNOW THAT YOU WANT THIS DRUG FOR AMERICA!!
SO, the "take home message" for ladies suffering from recurrent urinary infections is to take theracran every 12 hours, drink no more than 60ozs. of water per twenty four hours, avoid spermacide as a birth control method, get a vaginal estrogen product if you are 40-80 years old and write the FDA to help get the Uro-Vaxom in America!
Please use every prevention method available to you. For the first time in 25 years, I know of NO urinary tract antibiotic that is in development. What that means for my patients, is that when you become "resistant" to all currently available oral antibiotics, you will need intravenous antibiotics! So, it behooves us to use as few antibiotics as possible.
Kidney Stones
Evidence from the University of Michigan demonstrates that the drug, Flomax, can greatly increase the chances of your passing a kidney stone that is coming down your ureter!
So, any patient who is actively passing a stone should consider taking an alpha blocker medicine at night until the stone passes!
"ADVERSE EVENTS" were decreased by 30% by using the drug to help pass stones!
HAPPY SPRING!
Dr. Boone
Dear Wonderful Patients,
January was a difficult month at our office. I diagnosed more patients with bladder cancer during the first two weeks of January, than I usually diagnose in 7 months! To my great horror, I diagnosed a 19 year old with a large bladder cancer. Previous to finding this cancer in this very young adult, the youngest person that I had ever diagnosed with bladder cancer was 34 years old.
This surprising diagnosis has caused me to rethink what I have learned in 24 years of treating bladder cancer.
Subsequently, I have spoken to two very well known uropathologists (one is from the Mayo Clinic) who have told me that "they have seen bladder cancer in people as young as 11"! But, bladder cancer in people younger than 40 remains a "rare" phenomenon.
I am writing to you, to remind you that the ONLY warning that we get of bladder cancer is a little bit of blood in the urine. This is usually found by your doctor on your yearly urine analysis. Please make sure that you and your loved ones get your urine checked every year with your yearly physical. The blood would be found under the microscope, by your doctor. As urologists, we check everyone's urine for blood on every visit.
Please remember that 95% of people who have blood in their urine, do NOT have cancer. And, please remember that you need to be checked by a urologist if you ever have blood in your urine.
Let's focus on PREVENTION. What can you do?
I have had three patients who have ovarian cancer make a couple of recommendations of things that were helpful to them.
As always, early detection is the key to curing cancer. And as for preventing it, I am a big believer in managing your stress, exercise and excellent nutrition.
On a positive note, rarely do we have to do any invasive surgery for bladder cancer. Most of our patients are detected early and can be treated with "out patient" and minimally invasive procedures.
Of our many patients diagnosed in January, only one person will have to have a major surgery. Everyone else was detected early and appears to be "cured".
Please check our website for new videos on blood in the urine (hematuria) and please send them to your family and friends!
Have a great spring,
Dr. Martha Boone
News from the world of urology!
Dr. Boone has reviewed the meeting from the latest International Continence Society meeting for you.
Researchers have found:
For more information, go to Toviaz.Com
Finally, the National Cancer Institute has definitely shown a link between volume of red meat eaten and PROSTATE CANCER. In a ten year study of over 175,000 men, there was definitely an increased risk for prostate cancer based on red meat consumption.
SO, PLEASE HAVE ALL THE MEN YOU LOVE DECREASE THEIR RED MEAT CONSUMPTION!! (They have not yet determined how much you can safely eat. So, the less, the better.)
HAPPY AND HEALTHY 2010.
WARM REGARDS,
Dr. Martha Boone
HAPPY NEW YEAR TO OUR WONDERFUL PATIENTS!!
I am not one to make "New Year's Resolutions". I am already "doing the best that I can".
But, the end of one year and the beginning of another has always been a time of reflection and gratitude for me.
This past year, I have seen an unpatrolled level of "fear" in my patients. The job market, the healthcare bill, the economy, and international politics have really had many of my patients very concerned, all year long. I share your concern and we are most definitely "not out of the woods" yet.
But, "worry" over these things will not improve our health. And our health is the "well spring" of our lives.
So, without making any sweeping resolutions, what can we do to be "younger next year"?
Nothing is more important than your health. Plan for it. DON'T WAIT UNTIL THE END OF THE YEAR. EVERYONE HAS PAID THEIR DEDUCTIBLE AND IT IS JUST CRAZY AFTER NOVEMBER 15TH. DON'T DO THAT TO YOURSELF. PLAN WELL FOR GREAT HEALTH.
I am so happy to have each of you as my patient. I hope that 2010 is your best and healthiest year ever!!!
Dr. Martha Boone