Monday, 21 January 2013

National Shortage of Testosterone

Hormone replacement therapy aims to replace estrogen to control the effects, both short and long term, of estrogen deficiency. In addition, for women who still have their womb, some form of progestogen is given to protect the womb lining from being stimulated by the estrogen. Some women also benefit from the replacement of testosterone, particularly those who experience premature ovarian failure, or have surgical removal of their ovaries, since our ovaries produce about 50% of our testosterone, the rest being produced from the adrenal glands. The lack of testosterone in women can cause fatigue, low mood and low libido.

Previously, women could be given testosterone in the form of a twice weekly patch or a six monthly implant and many found these preparations very helpful. Unfortunately, the patch has now been withdrawn from the market, and implants of both estrogen and testosterone are not readily available in the UK, although some clinics have been able to purchase them from America.

This has caused much concern, reducing treatment options for some women and the British Menopause Society are trying very hard to provide pressure on relevant organisations to improve the situation. Meanwhile, for postmenopausal women, the HRT tablet tibolone provides a combination of estrogen, progestogen and testosterone and is a very useful option for postmenopausal women who wish to take HRT and for whom low libido is a symptom. For women who require to use a separate form of testosterone along with HRT, several brands of testosterone gel are available. While they are only licensed for use in men, they can be used for women “off-license” under specialist supervision.

Wednesday, 9 January 2013

New Year, New Me

A New Year is here again and many will be thinking about the year just gone, and forward to the year ahead. Inevitably, many, including myself, start the year determined to make changes, common areas being in diet and exercise. Yet again, I resolve to take more exercise by dragging my friend with me to Zumba at least once per week, walking whenever possible, and to increase my salad, vegetable and fish intake while cutting down on tempting biscuits and cakes. The difference this year is that now that I am officially postmenopausal myself, I realise that I need to actually follow this through since my hormonal changes will already be having an effect on my blood pressure control, cholesterol level and vessel function. I do take HRT which should be providing protection against these heart risk effects of estrogen deficiency, but it is vital that in the menopausal years in particular, we all do as much as we can to reduce our heart risk.

Let’s find healthy food that we can enjoy and stick to, and find an exercise that is fun and sustainable. Zumba works for me, especially since it has become my weekly catch-up time on the way there and back with my friend. The music is fab, the steps are fun and before you know it, you have stepped out, jiggled and shaken your bum for an hour without feeling like it was serious exercise. Going with a friend is not only fun but the commitment of picking up on the way makes it much harder to stay at home because of being “too tired”, or have “too much to do”.

So ladies, while the emphasis is frequently on breast cancer as a major health risk for women, take note that three times more women die from heart disease than breast cancer

We can all make changes this year to look after our hearts so let’s do it!

More information on heart disease and CVD.