Urinary Incontinence on The Morning Scramble

Pregnancy, childbirth, and menopause are most often to blame for Stress Incontinence, the most common form of bladder leakage. Generally, urinary incontinence can be a symptom of obesity, brain injury, diabetes or other illness, but for women, the problem is most often due to a weakened pelvic floor or damaged nerves from childbirth, estrogen deficiency or a combination of these factors. The good news is that it’s treatable.

If you’re having issues with bladder leakage, call 480.619.4097 to discuss scheduling a Urodynamic Study.

When a Bad Day Happens Every Day

shutterstock_285862436Q: Normally I’m very easy going person, but lately I’m feeling anxious and snapping at everyone and I don’t even know why. I lose my temper easily, or go on a crying jag. My life is otherwise great, and I don’t have any history of mental health issues. What is going on?
– Female, age 43 –

Given the frenetic pace of life in this world of 24/7 information and stimulation, it’s a wonder that more of us aren’t feeling this way! While anxiety, moodiness, irritability and weepiness can simply be hallmarks of having a bad day, when they become the norm, something is wrong. Too many doctors will tell women it’s all in their heads, and hand them a prescription for antidepressants. In most cases, they’re wrong.

From my experience, here’s what’s more likely to be going on: The early- to mid-40s is when most women start to feel major changes due to hormone deficiencies. Anxiety and irritability are common, and often the earliest symptoms of perimenopause.

Since women get so little education about our hormones, it’s hard to know what’s normal and what’s not. (Sadly, this is true for most doctors as well!) You see, as women approach menopause, lower levels of estrogen and testosterone usher in unpleasant symptoms like anxiety, memory loss, weight gain, irregular or heavy periods, mood swings, hot flashes, low libido, vaginal dryness, night sweats and insomnia, heart palpitations, and skin changes. Ouch!

These two little hormones play big parts in all of our biological systems, so when they decline, it’s like a chain of dominoes falling. Testosterone deficiency can cause irritability and mood swings, and can also lead to depression. The last thing you want is an antidepressant when your core problem is actually testosterone deficiency, as many types of antidepressants also dramatically lower libido. That’s adding insult to injury, as the old saying goes!

These recent changes in your mood are most likely hormone-related, and can likely be alleviated through bio-identical hormone replacement therapy, eating healthy, and taking regular exercise. So don’t despair, and don’t wait any longer. Get your hormone levels checked. If your hormonal balance is normal, and your symptoms persist, speaking to a therapist or counselor can be helpful in establishing good coping and relaxation skills.

Symptoms sound familiar? Call and schedule an appointment today! 480.619.4097

Mammograms or self-exams? Understanding the Breast Cancer detection confusion.

shutterstock_26939806As a doctor and specialist in Women’s Health and Hormonal Health in particular, I have been concerned for years about misconceptions and misinformation about breast cancer, its causes and methods of early detection. Each new study highlighted in the media comes with an increased risk for women and their doctors of developing the wrong ideas about how breast cancer begins and the best methods of detection and treatment.

Risk factors for developing breast cancer include gender – as a woman, you are far more likely to develop breast cancer than a man. Aging is another factor – as you get older and your hormone levels fall, your risk increases. Other risk factors to consider are genetic mutations, family history of breast cancer in a close relative, race and ethnicity. Lifestyle risk factors include smoking, excess alcohol consumption, being overweight or obese, lack of regular exercise, poor dietary habits, long-term use of oral contraceptives and chemical exposure from the environment.

How Often Should You Have Breast Cancer Screenings?

In February of 2013, the U.S. Preventive Services Task Force examined U. S. Breast Cancer screening strategies and concluded that biennial mammograms achieved most of the benefits of annual screens, and cause less harm to women. The conclusion is a controversial one, as evidenced at the San Antonio Breast Cancer Symposium held in December of 2013. During the sometimes heated debate, many physicians expressed their opinion that ductal carcinoma in situ (DCIS is the presence of abnormal cells inside a milk duct in the breast) should not automatically carry a diagnosis of Stage 1 breast cancer. Others advocate invasive treatments that designed to prevent the DCIS from becoming invasive breast cancer.

When the follow up results of the Canadian National Breast Screening Study were released, it appeared to indicate that it doesn’t matter if cancer was found on a mammogram or during clinical or self-exams – statistically, the death rate for each group was the same.

Early Detection is Key to Improving Breast Cancer Survival Rates

Early detection is key to improving breast cancer survival rates, which is why regular self-exams, clinical exams and mammograms remain important to early diagnosis. The American Cancer Society guidelines recommends that women in their 20s and 30s have clinical breast exams every three years, and suggest annual mammograms after the age of 40. Women should preferably have a baseline exam performed in their mid-30s for future reference.

Have you had your Well Woman exam this year? If not, it’s time to stop procrastinating! Call us at 480.619.4097  and get your exam scheduled today.


Feeling sick? Check your gut.

Q&AQ: As I’m getting older, I’m finding that I get sick more often. How can I build my immune system?

A: Researchers believe that older people become more vulnerable to infectious diseases than younger people due to impaired or reduced immune response. That’s why a leading cause of death in people over the age of 65 is respiratory infections like influenza and pneumonia. There are a variety of factors that contribute to a healthy immune system, and even more that contribute to tearing it down. One theory is that the aging immune system actually loses its memory – it forgets that its job is to fight microbes or fails to recognize microbes as the enemy when they appear, so the body is less able to mount an immune defense. Other researchers believe that nutrition is the key, and that micronutrient malnutrition is responsible for the impaired immune response.

Assuming you have no other underlying health issues, the first and best line of defense is living a healthy lifestyle. This means don’t smoke, don’t drink too much alcohol; eat well, get outside in the sun to boost your Vitamin D levels naturally, take regular exercise and get plenty of sleep. Take a good multi-vitamin daily. Avoid overuse of antibiotics and antibacterial products as they can inhibit the growth of good flora in the gut. The good flora is there to keep the bad flora at bay, as well as to stimulate our immune system function. Once things get out of balance, the door is opened to ill health.

Recent studies show that identifying and understanding the role of microbes in the gut may lead to better treatments for health issues like autoimmune disorders, allergies, obesity, and depression. While researchers continue to explore immunity and devise treatments that can potentially prevent disease before it begins – your diet and nutrition are still the biggest boosters you can give to your gut and immune system.

If you feel like you’re getting sick more often as you age, then it’s time to find out what’s going on. Book an appointment today. 480.619.4097

HRT: Not Just for Menopause Anymore

Today we’ve reached the end of the first chapter of my book, “How Your Doctor is Slowly Killing You: A Woman’s Health Survival Guide” – I hope you’ve enjoyed it!

HRT: Not Just for Menopause Anymore

Some of you are probably thinking, “Wait. Isn’t menopause just a natural state of aging that all women go through? Why fight it?” My answer is this: Yes, it’s natural and if we live long enough, we’ll all go through it. But think about it this way: Not all that long ago in the scheme of history, fewer women lived to see menopause because so many didn’t survive their vulnerable childbearing years. Men who didn’t die fighting some war or another would soldier on, often remarrying and fathering children well into their old age. Women died before, during and after childbirth due to complications and infections. They died from sexual violence, misinformation, misogyny and political or religion-fueled madness. Women and young girls were accused of witchcraft, and then drowned or burned at the stake. Yes, menstrual cycles and fluctuating hormone levels can make us feel pretty witchy, but c’mon guys!

However, karma has a way of coming around. While hormone imbalances can and do occur at almost any age, today most women can expect to live anywhere from one third to one half of their lives in menopause; so of course we want these years to be healthy, happy and fulfilled. HRT can help us achieve it, so why is it so hard to get?

Unfortunately, when it comes to women and their health and reproductive issues, misinformation and misogyny continue to be dominant forces, along with political or religion-fueled madness. And money. Oh, so much money. It’s well past the time that we start taking control of the conversation and of our own health, or women will continue to get the shaft.

Recognize these signs and symptoms? Call DeRosa Medical to schedule a hormonal health checkup today. 480.610.4097


The Axis of Evil Takes Control

Over the next few posts I’ll be sharing the first chapter of my book, “How Your Doctor is Slowly Killing You: A Woman’s Health Survival Guide” – I hope you enjoy it!

The Axis of Evil Takes Control

Now imagine having a combination of hormone deficiencies, and low testosterone and low estrogen have decided to team up with hypothyroidism. Your whole body is working against you. The Axis of Evil has risen to power, conquered your republic, and is now soundly kicking your ass.

Now we’re not only unhappy and feeling physically rundown, our body image, mental health, psychological health and overall energy levels are also impacted. Collectively, the Axis of Evil is sapping our basic ability to cope with life. Again, all too often our doctors are telling us it’s all in our heads. It’s not.

Hell Slowly Begins to Break Loose

With all our body systems breaking down, it’s inevitable that everything going on begins to spill over into our relationships, and the most adversely affected is our love life. This is pretty important stuff. Let’s hear from Virginia Kelley, a licensed clinical social worker who specializes in relationships and intimacy:

Simply stated, couples who are the happiest tend to be those with good sex lives. Sexual intimacy allows us to experience closeness, vulnerability and sharing with our partner. Humans have a general desire to belong, to love and feel loved, which is usually satisfied in physically and emotionally intimate relationships. Sexual intimacy eases life’s tensions. Once you start paying attention to your sexual relationship, your partner will be happier. As a result you’ll enjoy being around them more so you’re happier.

Sadly, when there is little or no appetite for sexual intimacy by one partner, the relationship becomes more vulnerable to extramarital affairs. Most affairs occur out of opportunity. For example, if your partner would like more of a sexual relationship, and then finds an attentive and interested party, you may have the awful experience of finding infidelity in your relationship.

Infidelity is very, very difficult to overcome. Rebuilding trust and recommitting to the relationship can’t always be done. The hurt and pain is miserable on both sides.

Another aspect of the lack of physical intimacy is that partners in relationships will tend to become more and more distant. Communication decreases and in turn, conflicts increase,

further draining your relationship. You stop being an intimate team and become the “Bickering Bickersons” or worse, two people who simply happen to live together.

When one partner is hesitant, ambivalent or not “in the mood,” it’s harder to have a caring and loving sexual experience (which doesn’t need to be a sex romp for hours), but if you continue to do so, you’ll feel better about yourselves and each other.

I asked Virginia to share a specific example of a relationship that fell apart due to lack of intimacy. Here is a case study:

I recall a couple I’ll call Alyssa and Jim. They were in their early fifties, had no children, and great careers. Alyssa and Jim were very physically fit and enjoyed multiple outdoor activities together. They supported each other’s careers and were best friends. But they had very little sexual intimacy.

Alyssa hadn’t felt any sexual interest for about five years. Despite that, everything seemed fine between them until Jim had an affair and left Alyssa. He later told her that her lack of interest in him sexually made him feel inadequate and unattractive. Alyssa complained that he never communicated how important this was to him. Jim said he tried to ignore it until, of course, another woman made him feel sexually desirable. This is one scenario that probably could have turned out differently had they addressed the issue of lack of intimacy.

The lack of libido, and the resulting lack of intimacy can be a relationship killer. Virginia continues:

Other typical cases are couples that come in for marital counseling and all they can do is argue and find fault with each other. When I ask them about their sexual relationship, they admit that they rarely have time for intimacy, or are not interested and haven’t been for years. When we begin to unravel the history of their relationship, we find that as their sexual intimacy waned, their arguing and complaining increased. Once again they could have changed the course of their marriage had they been able to communicate with each other the need to be physically close. Or, for that matter, even been aware of how important it was to them.

Now, we get to the physical, hormone-heavy part of the relationship equation, which used to be the “hot and heavy” part. I asked Virginia if perimenopause or menopause makes things worse:

I have seen many couples in trouble with their relationship for various reasons, including lack of sexual intimacy due to perimenopause/menopause. Typically, the female is either afraid of hormone replacement or is on an incorrect HRT regimen which is not helping her with libido. So they give up and take the route of living like roommates. The husband usually speaks of his wife’s irritability, mood swings and lack of ability to enjoy sex. The wife speaks of feeling unattractive, having little or no interest in sex and/or painful intercourse. So they avoid the whole issue and continue a less than satisfying marriage, believing that this is an avoidable part of aging. This, of course, does not have to be how we end our golden years!

Amen, sister! Hormone replacement therapy (HRT) not only improves a host of age-related issues, it can also help save relationships and restore sex lives.

NEXT: HRT: Not Just For Menopause Anymore

Recognize these signs and symptoms? Call DeRosa Medical to schedule a hormonal health checkup today. 480.610.4097


Welcome to Menopause (at last)

Over the next few posts I’ll be sharing the first chapter of my book, “How Your Doctor is Slowly Killing You: A Woman’s Health Survival Guide” – I hope you enjoy it!

In our lifetimes, we only have a certain number of eggs in our ovaries, and when they’re gone, they’re gone. The age of menopause can vary. Ask your mother when she went through it as the timeline tends to run in families. You will know you’re there when you haven’t had a period for more than 12 months. While there are blood tests (follicle stimulating hormone, or FSH, and anti-mullerian hormone levels) we can use to verify it, that’s the main marker. You may still have unpleasant symptoms like hot flashes, insomnia and forgetfulness along with a few new ones, but at least you’re not bleeding all the time.

Thyroid: The Wild Card

The other big hormone in play is the thyroid. The thyroid gland is a small, bow tie-shaped organ located at the front and middle of the neck that secretes the thyroid hormone thyroxine, or T4. It converts to the active thyroid hormone triiodothyronine, or T3, at the direction of the brain. These thyroid hormones fuel and control your metabolism overall.

Imagine your thyroid as the engine of your body. Ideally, we want to be in a BMW, Lexus or Mercedes, not in a Formula One car or a go-kart.

A Formula One thyroid is hyperthyroid, and is burning fuel too fast. Everything in the body is on overdrive. This leads to weight loss, hair loss, diarrhea, high temperatures and excessive sweating.

A go-kart thyroid, or hypothyroid, is too slow. This causes weight gain, dry skin, constipation, hair loss, low body temperature, slow heart rate, extreme fatigue and swelling or numbness of hands and/or feet.

The BMW/Lexus/Mercedes thyroid, like a finely tuned machine, is running just right. Women with normal thyroid function have appropriate energy levels and feel good, assuming they have no other health issues. Their bodies are firing on all cylinders.

But here’s the kicker: by the age of 50, one in three women will have a thyroid disorder; most commonly, they’ll be hypothyroid. It can be caused from the aging process, autoimmune disorder, environmental factors or a combination. (We’ll cover this in more depth later.)

NEXT WEEK: The Axis of Evil Takes Over

Recognize these signs and symptoms? Call DeRosa Medical to schedule a hormonal health checkup today. 480.610.4097


Women’s Health Week – Do You Know What Screenings You Need?

National Women’s Health Week and Health Screening Awareness Weeks are this month, so it’s time to set the record straight and take health matters into your own hands. Preventative health screenings are some of the most effective ways we have to fight disease. Early detection allows for early intervention, which increases the chances of a better outcome.

Have you had your Well Woman exam yet? Schedule yours today – call 480.619.4097.