February 8, 2017

Infertility is defined as the inability to conceive a pregnancy after 12 months of unprotected sexual intercourse. Infertility is a disease that results in the abnormal functioning of the male or female reproductive system. Infertility affects approximately 10% of the population. Since infertility strikes diverse groups-affecting people from all socioeconomic levels and cutting across all racial, ethnic and religious lines- chances are great that a friend, relative, neighbor or perhaps you are attempting to cope with the medical and emotional aspects of infertility.

Causes of infertility are many and varied and involve male, female or a combination of factors. This includes problems with the production of sperm or eggs, the structure or function of male or female reproductive systems; and/or hormonal and immune conditions.

In 40% of couples the cause of infertility is attributed to a sperm factor, in another 40% the cause is found within the female reproductive system, and a third will have a combination of male and female factors.

Pregnancy is the result of a process that has many steps. To get pregnant –

  • A woman’s body must release an egg from one of her ovaries (ovulation).
  • The egg must go through a fallopian tube toward the uterus (womb).
  • A man’s sperm must join with (fertilize) the egg along the way.
  • The fertilized egg must attach to the inside of the uterus (implantation).
  • Sufficient embryo quality

Finally, for the pregnancy to progress to full term the embryo must be healthy and the woman’s hormonal environment adequate for its development.  If just one of these factors is impaired, infertility can be the result. The diagnosis of infertility is usually given to couples who have been attempting to conceive for at least 1 year without success.

About 6% of married women 15–44 years of age in the United States are unable to get pregnant after one year of unprotected sex (infertility). Also, about 12% of women 15–44 years of age in the United States have difficulty getting pregnant or carrying a pregnancy to term, regardless of marital status (impaired fecundity). Studies found that 7.5% of all sexually experienced men younger than age 45 reported seeing a fertility doctor during their lifetime—this equals 3.3–4.7 million men. Of men who sought help, 18% were diagnosed with a male-related infertility problem, including sperm or semen problems (14%) and varicocele (6%).

Risk Factors

  • Age – A woman’s fertility starts to drop after she is about 32 years old, and continues doing so. A 50-year-old man is usually less fertile than a man in his 20s (male fertility progressively drops after the age of 40).
  • Smoking – Smoking significantly increases the risk of infertility in both men and women. Smoking may also undermine the effects of fertility treatment. Even when a woman gets pregnant, if she smokes she has a greater risk of miscarriage.
  • Alcohol consumption – A woman’s pregnancy can be seriously affected by any amount of alcohol consumption. Alcohol abuse may lower male fertility. Moderate alcohol consumption has not been shown to lower fertility in most men, but is thought to lower fertility in men who already have a low sperm count.
  • Being obese or overweight – In industrialized countries overweight/obesity and a sedentary lifestyle are often found to be the principal causes of female infertility. An overweight man has a higher risk of having abnormal sperm.
  • Eating disorders – Women who become seriously underweight as a result of an eating disorder may have fertility problems.
  • Being vegan – If a person is a strict vegan you must make sure your intake of iron, folic acid, zinc and vitamin B-12 are adequate, otherwise your fertility may become affected.
  • Over-exercising – A woman who exercises for more than seven hours each week may have ovulation problems.
  • Not exercising – Leading a sedentary lifestyle is sometimes linked to lower fertility in both men and women.
  • Sexually transmitted infections (STIs) – Chlamydia can damage the fallopian tubes, as well as making the man’s scrotum become inflamed. Some other STIs may also cause infertility.
  • Exposure to some chemicals – Some pesticides, herbicides, metals (lead) and solvents have been linked to fertility problems in both men and women.
  • Mental stress – Studies indicate that female ovulation and sperm production may be affected by mental stress. If at least one partner is stressed it is possible that the frequency of sexual intercourse is less, resulting in a lower chance of conception.


In Men –

Infertility in men can be caused by different factors and is typically evaluated by a semen analysis. A specialist will evaluate the number of sperm (concentration), motility (movement), and morphology (shape). A slightly abnormal semen analysis does not mean that a man is necessarily infertile. Instead, a semen analysis helps determine if and how male factors are contributing to infertility.

Conditions that can contribute to abnormal semen analyses include—

  • Varicoceles, a condition in which the veins on a man’s testicles are large and cause them to overheat. The heat may affect the number or shape of the sperm.
  • Medical conditions or exposures such as diabetes, cystic fibrosis, trauma, infection, testicular failure, or treatment with chemotherapy or radiation.
  • Ejaculation disorders – for some men it may be difficult to ejaculate properly. Men with retrograde ejaculation ejaculate semen into the bladder. If the ejaculatory ducts are blocked or obstructed the man may have a problem ejaculating appropriately.
  • Unhealthy habits such as heavy alcohol use, testosterone supplementation, smoking, anabolic steroid use, and illicit drug use.
  • Environmental toxins including exposure to pesticides and lead.

In Women

Ovulation – Regular predictable periods that occur every 24–32 days likely reflect ovulation. Ovulation can be predicted by using an ovulation predictor kit and can be confirmed by a blood test to see the woman’s progesterone level. A woman’s menstrual cycle is, on average, 28 days long. Day 1 is defined as the first day of “full flow.”

A woman with irregular periods is likely not ovulating – This may be because of several conditions and warrants an evaluation by a doctor. Potential causes of anovulation include the following –

  • Polycystic ovary syndrome (PCOS)
  • Functional hypothalamic amenorrhea (FHA)
  • Diminished ovarian reserve
  • Premature ovarian insufficiency
  • Menopause
  • Salpingitis (Pelvic inflammatory disease) caused by sexually transmitted disease.


Frequency of intercourse – The couple may be advised to have sexual intercourse more often. Sex two to three times per week may improve fertility if the frequency was less than this. Some fertility experts warn that too-frequent sex can lower the quality and concentration of sperm. Male sperm can survive inside the female for up to 72 hours, while an egg can be fertilized for up to 24 hours after ovulation.

For Men

Erectile dysfunction or premature ejaculation – Medication and/or behavioral approaches can help men with general sexual problems, resulting in possibly improved fertility.

Varicocele – If there is a varicose vein in the scrotum, it can be surgically removed.

Blockage of the ejaculatory duct – Sperm can be extracted directly from the testicles and injected into an egg in the laboratory.

Retrograde ejaculation – Sperm can be taken directly from the bladder and injected into an egg in the laboratory.

Surgery for epididymal blockage – If the epididymis is blocked it can be surgically repaired. The epididymis is a coil-like structure in the testicles which helps store and transport sperm. If the epididymis is blocked sperm may not be ejaculated properly.

For Women

Ovulation disorders – If the woman has an ovulation disorder she will probably be prescribed fertility drugs which regulate or induce ovulation. These include –

Clomifene (Clomid, Serophene) – This medication helps encourage ovulation in females who do not ovulate regularly, or who do not ovulate at all, because of polycystic ovary syndrome (PCOS) or some other disorder. It makes the pituitary gland release more FSH (follicle-stimulating hormone) and LH (luteinizing hormone).

Metformin (Glucophage) – Women who have not responded to Clomifene may have to take this medication. It is especially effective for women with PCOS, especially when linked to insulin resistance.

Human menopausal gonadotropin, or hMG, (Repronex) – This medication contains both FSH and LH. It is an injection and is used for patients who don’t ovulate on their own because of a fault in their pituitary gland.

Follicle-stimulating hormone (Gonal-F, Bravelle) – This is a hormone produced by the pituitary gland that controls estrogen production by the ovaries. It stimulates the ovaries to mature egg follicles.

Human chorionic gonadotropin (Ovidrel, Pregnyl) – This medication is used together with clomiphene, hMG and FSH. It stimulates the follicle to ovulate.

Gn-RH (gonadotropin-releasing hormone) analogs – For women who ovulate prematurely, before the lead follicle is mature enough during hmG treatment. This medication delivers a constant supply of Gn-RH to the pituitary gland, which alters the production of hormone, allowing the doctor to induce follicle growth with FSH.

Bromocriptine (Parlodel) – This drug inhibits prolactin production. Prolactin stimulates milk production in breast feeding mothers. If non-pregnant, non-breast feeding women have high levels of prolactin they may have irregular ovulation cycles and have fertility problems.

Fallopian tube surgery – If the fallopian tubes are blocked or scarred surgery may repair them, making it easier for eggs to pass through them.

Laparoscopic surgery – A small incision is made in the woman’s abdomen. A thin, flexible microscope with a light at the end (laparoscope) is inserted through the incision. The doctor can then look at internal organs, take samples and perform small operations. For women with endometriosis, laparoscopy removes implants and scar tissue, reducing pain and often aiding fertility.

Intrauterine insemination (IUI) is an infertility treatment that is often called artificial insemination. In this procedure, specially prepared sperm are inserted into the woman’s uterus. Sometimes the woman is also treated with medicines that stimulate ovulation before IUI. IUI is often used to treat—

  • Mild male factor infertility.
  • Couples with unexplained infertility.

Assisted Reproductive Technology (ART) includes all fertility treatments in which both eggs and sperm are handled outside of the body. In general, ART procedures involve surgically removing eggs from a woman’s ovaries, combining them with sperm in the laboratory, and returning them to the woman’s body or donating them to another woman. The main type of ART is in vitro fertilization (IVF).

Alternative Treatment


Vitamin D- Vitamin D deficiency is very common in America, especially during the winter, and can be very detrimental to overall health. Recent studies link inadequate vitamin D with infertility and miscarriage.

Vitamin C– A potent antioxidant, vitamin C is good for both male and female infertility.

Folic Acid– Folic acid is well known as a necessary vitamin in early pregnancy to prevent complications, but it is most beneficial when taken for several month before the pregnancy as well as during. It helps cell division and promotes ovulation.

Zinc– It is very important for cell division including sperm production and ovulation.

Selenium– Helps protect the body from free radicals and protects sperm and egg.

B-Vitamins– Deficiency of b-vitamins is common in anyone who consumes large amounts of processed foods, grains or sugars. Optimizing b vitamin levels can increase lutenizing hormone and follicle stimulating hormone to improve fertility.

Bioflavonoids – Helps strengthen the uterus by promoting healthy blood vessels.

Flaxseed oil – A healthy fat that can help normalize hormones and is essential to health.


Black cohosh (Cimicifuga racemosa)—Balances hormones.

Chaste tree (Vitex castus)—Raises progesterone levels, lowers estrogen levels, and helps correct ovarian dysfunction.

Dong quai (Angelica sinensis)—Nourishes and balances the female reproductive system.

False unicorn (Helonias dioica)—Has a reputation for promoting fertility, is recommended for ovarian dysfunction and as a uterine tonic.

Licorice (Glycyrrhiza glabra)—Balances hormones and is anti-inflammatory and sweet tasting (good flavoring for teas).

Red raspberry (Rubus strigosus)—Nourishes and strengthens the female reproductive system.

Squaw vine (Mitchella repens)—Also known as partridge berry. Recommended for fertility as a uterine tonic.

Wild yam (Dioscorea villosa)—Has a reputation for promoting fertility.

To Avoid –

Avoid Estrogen – Estrogen can have a negative effect on the development of the male reproductive tract, semen volume, and sperm count. Therefore, it is important to reduce or eliminate excess estrogen or estrogen-like chemicals in your body. Avoid all dairy products where cows have been fed hormones. The drop in sperm counts since the 1940s parallels a rise in the consumption of dairy products.

Chemicals, such as PCBs, dioxin, etc. are weakly estrogenic and degenerate very slowly, they hang around for years in our environment. Avoid the use of toxic substances such as fertilizers, cleaners. Also avoid all fatty animal products where chemicals may be stored up without being degraded.

Avoid Heavy Metals – Sperm are affected by lead, cadmium, arsenic, and mercury. There are many sources of exposure to these heavy metals such as deep-sea fish, cigarette smoke, and water from old pipes. Just as with men, lead, cadmium, or mercury can impair fertility by affecting sex hormones.

Avoid free radicals – We have all heard that free radicals (the hungry and unstable oxygen in our bodies) can cause cancer, heart disease, and increase the aging process. Like –

  • Cigarette smoke
  • Sunlight
  • Unsaturated oils (corn oil may be the worst)
  • Heating oils to too high a temperature when cooking
  • Foods left out of the refrigerator (oxidation causes butter to turn a slight yellow and cut apples to turn brown)

Caffeine and Alcohol – Both can impair female fertility. Excessive alcohol causes prolactin to rise and too much or too little prolactin is associated with infertility. Caffeine causes a decrease in serum prolactin. Caffeinated soft drinks may also reduce the chance of conception.


  • Flower Essences – The flowers of plants may be prepared in a similar way to homeopathic remedies so that the “essence” of the plant is harnessed in a medicinal way. An example is Pomegranate. Its use is described as a treatment for imbalance, i.e., women who are ambivalent or confused about the focus of feminine creativity, home or career, creative or procreative, those who attempt to balance both possibilities may feel drained and the psychological tension may be profound resulting in physical illness especially in the female organs.
  • Stress Reduction/Relaxation Therapies
  • Diaphragmatic Breathing Exercise


Reference –












February 8, 2017

Idiopathic Hypersomnia

Hypersomnia means “excessive sleep.” Patients with idiopathic hypersomnia sleep a reasonable amount at night (at least six hours) but have difficulty waking up and always feel tired and sleepy. In addition to excessive daytime sleepiness, people with idiopathic hypersomnia may:

  • Sleep enormous amounts every day (10 hours or more)
  • Display “sleep drunkenness,” such as extreme sleep inertia, difficulties waking up with alarm clocks and feeling groggy for long period of times.

Idiopathic hypersomnia (IH) belongs to a class of sleep disorders known as Central Disorders of Hypersomnolence. This group of sleep disorders includes narcolepsy types I and II, idiopathic hypersomnia, Kleine-Levin syndrome, insufficient sleep syndrome, and hypersomnia due to medical, hypersomnia due to medication or substance, and hypersomnia associated with a psychiatric disorder.

IH is a chronic disorder that remits in less than 1 in 6 cases, and that responds poorly to traditional treatments. It often negatively impacts upon the patient’s life to such an extent that working, socializing and even driving eventually become impossible due to an inability to sustain vigilant wakefulness.


The exact cause of idiopathic hypersomnia is unknown.  Researchers suspect that a genetic link may be possible because it appears to run in families, but there is no proof of this.  It seems to be a rather uncommon type of sleep disorder.  The condition usually develops slowly before the age of 30.  In the vast majority of cases, idiopathic hypersomnia is a lifelong condition.

Idiopathic hypersomnia causes people to sleep a long time during the night.  People may sleep more than 10 hours a night.  Despite such long periods of sleep, people with idiopathic hypersomnia feel very sleepy during the day.  No matter how much they nap during the day, they still feel very sleepy.  This condition can be very disabling, limiting a person’s ability to maintain employment, relationships, and quality of life.


The most common symptoms shared by sufferers of IH are –

  • Greater than 10 hours sleep per 24 hour period – often as much as 16+ hours per 24 hour period
  • Long, unrefreshing naps that typically last several hours
  • Awakening from sleep feeling unrefreshed, often with significant sleep inertia (commonly known as ‘sleep drunkenness’)
  • An inability to be woken from sleep – even multiple alarm clocks or physical attempts made by family/friends are largely unsuccessful.
  • Cognitive problems caused by the overwhelming desire to sleep (commonly referred to as ‘brain fog’)

As the condition progresses less common symptoms can include –

  • Anxiety and depression – often as a result of the limits this disorder imposes upon what the patient is able to do with their limited time awake
  • Raynaud’s type phenomena – freezing cold hands and feet
  • Loss of impulse control – especially in regard to food
  • Impotence

Those with IH often describe themselves as experiencing two types of sleepiness –

  • A physical exhaustion that ‘normal’ people might experience after missing several nights sleep in a row.
  • A cognitive exhaustion similar to Executive Dysfunction that can make even simple tasks like reading, conversation with friends, or watching a movie beyond their reach.



There are no medicines specifically designed to treat idiopathic hypersomnia, but medications used for narcolepsy can often help. The main medications used are stimulants, such as modafinil, dexamphetamine and methylphenidate, which help to keep people awake during the day. See treating narcolepsy for more information on these medicines. Antidepressants may be prescribed if emotional problems are interfering with the sleep.

The most common treatments prescribed are:

  • Amphetamines (such as Dextroamphetamine® or Adderall®)
  • Methylphenidate (such as Ritalin® or Concerta®)
  • Modafinil (such as Provigil® or Modavigil®)
  • Armodafinil (such as Nuvigil® or Waklert®) (Currently unavailable in Australia)
  • Sodium Oxybate (such as Xyrem®) (Currently unavailable in Australia)
  • Antidepressants

Lifestyle Changes

  • Keep a consistent sleep schedule
  • Avoid caffeine and alcoholic beverages
  • Talk to others about the condition.
  • Don’t over extend oneself.
  • Avoid operating motor vehicles or using dangerous equipment
  • Avoid working at night or social activities that delay the bedtime

Alternative Treatment

Exercise – Regular exercise not only helps people to lose weight and gain strength, it can also help treat sleep disorders naturally. Regular exercise increases feel-good chemicals such as serotonin in the brain, which can help ease feelings of anxiety and encourage restful sleep.

Nutrients that can help manage IH include calcium and magnesium, choline, chromium picolinate, coenzyme Q10, omega-3 fatty acids, B vitamins, vitamin C complex (including bioflavonoids) and vitamins D and E.

St John’s wort is an herbal remedy recommended for IH because of its action as a nervous system treatment. The herb might improve sleep quality and calm the nerves, which can be affected by the disorder as well as the emotional effects of living with the disease.

Ginkgo biloba nourishes the nervous system in two ways: It protects cells with its antioxidant effects and it improves circulation to the brain. Both of these functions might improve the condition of IH. The active constituents in ginkgo leaves are flavonoids and terpenoids. Balch recommends not taking the herb if you have a bleeding disorder or upcoming surgical procedure.

Gotu kola is an ayurvedic herb native to subtropical climates and has long been used in India as a treatment for the support of veins. It works by strengthening connective tissues. When veins are strong, blood flow is improved and the brain receives more oxygen and nutrients, which might be an effective treatment for narcolepsy, according to Balch.

Country mallow is an ayurvedic herb that stimulates the body and might help those suffering from IH stay awake. Be careful using this herb if you have a cardiovascular disorder, as it causes a rise in blood pressure.

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February 8, 2017

Hypothyroidism is an endocrine disorder condition identified by abnormally low thyroid production. It’s a condition wherein the thyroid gland is unable to make enough thyroid hormones to keep the body running normally. As the thyroid hormone play an important role in growth, development and many other cellular processes, inadequate thyroid hormone create across the board consequences on the body. People are called to be hypothyroid, when they have too little thyroid hormone in the blood.

To understand hypothyroidism, we first need to understand the thyroid gland. The thyroid gland is a butterfly shaped endocrine gland (system that secretes its hormones using ducts), which is normally located in the lower front of the neck just below the Adam’s apple. These glands produce the hormones, namely, tetraiodothyronine (T4) and triiodothyronine (T3), which are secreted into the blood and then carried to each and every tissue in the body.  Together these hormones regulate how the cells of our body use the energy to stay warm and keep the brain, heart, muscles and other organs working the way they should. This process is called metabolism. The hypothalamus and the pituitary in the brain control the normal secretion of thyroid hormones, which in turn control metabolism. In case the body does not have enough thyroid hormone, the system processes slows down, this means, the body makes less energy and the metabolism becomes sluggish.

The process is as follows:

  • The T4 and T3 hormones regulate the body’s metabolic functions like heat generation and utilization of carbohydrates, fats and proteins. I n children, these hormones are responsible for growth and development.
  • In the pituitary gland, thyrotropinstimulating hormone (TSH) is released when more thyroid hormone is needed and travels via the bloodstream to the thyroid gland. The TSH then stimulates the thyroid to produce T4 and T3.
  • The pituitary gland acts like a thermostat i.e. when there is too much or less thyroid hormones in the bloodstream, it releases TSH accordingly to signal the thyroid hormone production.

About 20 million people suffer from thyroid disorder in the U.S. It’s more common in women than in men and increase with age.

Causes of Hypothyroidism

There may be numerous reasons why the cells in the thyroid gland can’t make enough thyroid hormone. Following are some of the major causes:

  • Autoimmune Diseases – In some cases, the immune system that protects the body from invading infections can mistake thyroid glands and their enzymes for invaders and attack them, in turn there aren’t enough thyroid cells and enzymes left to produce enough thyroid hormones. This is more common in women than in men. Autoimmune thyroiditis can begin suddenly or may develop slowly over years. The most common forms are :
  • Hashimoto’s thyroiditis – An autoimmune disease causing chronic inflammation and consequential failure of thyroid gland. It is also called as chronic lymphocytic thyroiditis. It often leads to hypothyroiditism.
  • Grave’s Disease – It is an autoimmune disease in which the over activity of the thyroid gland causes over production of thyroid hormones. Grave’s disease is the most common cause of hypothyroidism. It has major negative impact on an individual’s mental and physical health.
  • Atrophic Thyroiditis – This condition is considered to be the opposite of Grave’s disease. In atrophic thyroiditis, TSH is blocked from activating thyroid cells. Tissue changes in atrophic thyroiditis are characterized by fibrosis and stunted cell growth, and hypothyroidism generally progresses to complete thyroid failure.
  • Radiation Treatment – Some patients with Grave’s disease, thyroid nodules or thyroid cancer, Hodgkin’s disease and lymphoma or cancer of neck or head are treated with radioactive iodine (I-131) in order to destroy or reduce the thyroid gland. All these patients can lose part or whole of their thyroid function.
  • Damage to the pituitary gland. The pituitary tells the thyroid how much hormone to make. When the pituitary is damaged by a tumor, radiation, or surgery, it may no longer be able to give the thyroid instructions and the thyroid may stop making enough hormones. 
  • Surgery – Some patients with thyroid nodules, thyroid cancer or Grave’s disease need to go under the thyroid removal surgery. If the whole thyroid is removed, there are 100 percent chances of hypothyroid, but if the part of gland is left, it may still produce enough thyroid hormone for the body. 
  • Medications – Certain medicines such as amiadarone, lithium, interferone alpha and interleukin-2 can affect the production of thyroid hormone. These medicines are most likely to trigger hypothyroidism in patients who have genetic tendency to autoimmune thyroid diseases. 
  • Congenital Hypothyroidism – A few babies are born without or with only a partly formed thyroid. In some cases babies have a part or their entire thyroid in wrong places. 
  • Too much or too little iodine in the diet – The thyroid glands need iodine to produce thyroid hormones. To maintain the thyroid hormone production in the body, right amount of iodine is needed. Taking in too much of iodine can cause or worsen hypothyroidism. 
  • Rare Disorders that infiltrate the thyroid – In some people, different diseases deposit abnormal substances in the thyroid and disturb its ability to function. For example, sarcoidosis can deposit granuloas, amydoilosis deposits amyloid protein etc. 


Hypothyroidism generally manifests as a slowing in the mental and physical activity of the affected person. As the symptoms are too variable and nonspecific, the only way to know for sure whether you have hypothyroidism is with a simple blood test for TSH.

The following are the symptoms for Hypothyroidism:

  • Fatigue, loss of energy, lethargy
  • Weakness
  • Sensitivity to cold
  • Dry skin
  • Hair loss
  • Sleepiness
  • Muscle pain, joint pain
  • Depression
  • Menstrual Disturbances and impaired fertility
  • Blurred vision
  • Brittle hair and nails
  • Constipation

If it is left untreated, the following symptoms can occur:

  • Puffiness of the face, hands and feet
  • Hoarseness
  • Decreased taste and smell
  • Thin eyebrows
  • Thickened skin
  • Slowed speech
  • Myxedema Coma
  • Altered Mental Status
  • Hypercarbia – abnormally elevated carbon dioxide (CO2) levels in the blood
  • Hypothermia – unusual and dangerous low body temperature
  • Bradycardia – abnormally slow heart action
  • Hyponatremia – low sodium concentration in the blood
  • Cardiomegaly, pericardial effusion, cardiogenic shock, and ascites may be present. 


Hypothyroidism can lead to following complications it left untreated:

  • Birth Defects – If the patient is pregnant and has an untreated thyroid disorder, the child may be at a higher risk of having birth defects than the ones born to healthy mothers. They may also have a significant mental  or physical development issues
  • Goiter – In situations when the thyroid in the body exerts itself in an effort to produce an adequate amount of hormones, the excessive stimulation results in an enlarged thyroid gland i.e. a bulge in the neck.
  • Heart Problems – Hypothyroidism even in its mildest form, can affect the heart conditions as it increases the levels of the bad cholesterol which leads to atherosclerosis, hardening of the arteries, therefore increasing the chances of heart attacks and strokes.
  • Infertility – If the thyroid hormone levels are too low, it affects ovulation and decreases women’s chances of conceiving.
  • Mental Health Issues


  • Thyroid Hormone Replacement Therapy – The goal of this replacement therapy is to compensate for the lack of hormones secreted by the thyroid gland. It is a very individualized treatment process. Its aim is to normalize the thyroid stimulating hormone (TSH) levels. In most cases, a daily dose of T4 pill is prescribed. The therapy is of variety of forms, including animal thyroid supplements.
  • Synthetic T4 Supplements – The standard form of treatment of hypothyroidism is synthetic forms of thyroid hormone T4 supplement, generally called as levothyroxine. There are 6 types of supplements available – Levo-T, Levothyroxine Sodium, Levoxyl,Novothyrox, Synthroid, UNITHROID.
  • Animal Thyroid Supplement – This type of treatment was once considered to be the standard treatment for hypothyroidism where in pig thyroid extract is used to make the supplement.

Side Effects of Drugs

The only dangers of thyroxin and other such drugs are caused by taking too little or too much. If it is taken too little, hypothyroidism will continue. If it is taken too much, development symptoms of hyperthyroidism—an overactive thyroid gland, is possible . The most common symptoms of too much thyroid hormone are fatigue but inability to sleep, greater appetite, nervousness, shakiness, feeling hot when other people are cold, and trouble exercising because of weak muscles, shortness of breath , and a racing, skipping heart. Patients who have hyperthyroid symptoms at any time during thyroxin replacement therapy should have their TSH tested. If it is low, indicating too much thyroid hormone, their dose needs to be lowered. 

Alternative Treatment

At our center we believe in treating the patients in every natural way possible. Our Comprehensive Treatment Approach helps us to study the patient’s health history and treat him accordingly.

  • Eating foods with high levels of B-vitamins and iron, such as whole grains, fresh vegetables and sea vegetables
  • Avoiding foods that interfere thyroid functions, such as, broccoli, cabbage, Brussels, sprouts, cauliflower, kale, spinach turnips, soybeans, peanuts, linseeds, pine nuts, cassava, millet and mustard greens.
  • Eating food that is rich in antioxidants, including fruits like blueberries, cherries and tomatoes and vegetables like squash and bell pepper.
  • Avoiding alcohol and tobacco.
  • Omega3 fatty acids such as fish oil to help reduce inflammation and enhance immunity.
  • Herbs like –
    • Coleus – for low thyroid function
    • Guggul – for low thyroid support
  • 100% Gluten free – The molecular composition of thyroid tissue is almost similar to that gluten. Hence, eating gluten can increase the autoimmune attack on the thyroid.
  • Acupuncture – It may be helpful in correcting hormonal imbalances including thyroid disorders.
  • Natural Desiccated Thyroid (NDT)

A natural alternative to Synthroid and all other synthetic thyroid medication is natural desiccated thyroid. It is made from pork thyroid glands. This natural source of thyroid has been used to treat hypothyroidism since a long time. It is natural, safe and well tolerated. NDT is commonly standardized by iodine content and not thyroid hormone content. As this contains other sources of iodine besides T4 and T3, it helps the patient, stimulate the thyroid hormone production. Therefore, desiccated thyroid can immediately relieve the symptoms of hypothyroidism by replenishing T3 and T4. It can as well as supply the active ingredient (iodine) required by the thyroid to natively produce its own thyroid hormones. In addition, iodine is another natural alternative to Synthroid. Some cases of hypothyroidism can be treated with natural sources of iodine such as iodized salt and sea vegetables such as kelp (as mentioned earlier). 


The patients need TSH to be checked about every 6 to 10 weeks after a thyroxine dose change.  The patients may need tests more often if they are pregnant or in case they are taking a medicine that interferes with your body’s ability to use thyroxine. The goal of treatment is to get and keep the TSH in the normal range. Babies with hypothyroidism must get all their daily treatments and have their TSH levels checked as they grow, to prevent mental retardation and stunted growth. Once gained a settled thyroxine dose, the patient can return for TSH tests about once a year.

Keeping other people informed

The patients are advised to inform their family members. Because thyroid disease runs in families, people should explain their hypothyroidism to their relatives and encourage them to get regular TSH tests. Informing  other doctors and  pharmacist about their hypothyroidism and the drug and dose with which it is being treated. If at all the patient starts seeing a new doctor, the doctor should be informed about hypothyroidism condition and the need of TSH test every year.

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February 8, 2017

Hyperthyroidism, or overactive thyroid disease, means your thyroid gland makes and releases too much thyroid hormone. The thyroid gland is located in the front of your neck, just below your Adam’s apple. It makes hormones that control your metabolism. Metabolism is the pace of your body’s processes and includes things like your heart rate and how quickly you burn calories.

Hyperthyroidism can affect your metabolism. It can also cause nervousness, increased perspiration (sweatiness), rapid heartbeat, hand tremors, difficulty sleeping and weight loss.

Hyperthyroidism is sometimes called thyrotoxicosis, the technical term for too much thyroid hormone in the blood. Thyroid hormones circulate throughout the body in the bloodstream and act on virtually every tissue and cell in the body. Hyperthyroidism causes many of the body’s functions to speed up. About 1 percent of the U.S. population has hyperthyroidism.

The thyroid gland is an organ located in the front of your neck and releases hormones that control your metabolism (the way your body uses energy), breathing, heart rate, nervous system, weight, body temperature, and many other functions in the body. When the thyroid gland is overactive (hyperthyroidism) the body’s processes speed up and you may experience nervousness, anxiety, rapid heartbeat, hand tremor, excessive sweating, weight loss, and sleep problems, among other symptoms.


Hyperthyroidism has several causes, including –

Graves’ disease is an autoimmune disorder that frequently results in thyroid enlargement and hyperthyroidism. In some patients, swelling of the muscles and other tissues around the eyes may develop, causing eye prominence, discomfort or double vision

Silent Thyroiditis can cause Transient (temporary) hyperthyroidism, a condition which appears to be the same as postpartum thyroiditis but not related to pregnancy. It is not accompanied by a painful thyroid gland.

Toxic Nodule – A single nodule or lump in the thyroid can also produce more thyroid hormone than the body requires and lead to hyperthyroidism.

Toxic Multi-nodular Goiter – Multiple nodules in the thyroid can produce excessive thyroid hormone, causing hyperthyroidism. Often diagnosed in patients over the age of 50, this disorder is more likely to affect heart rhythm. In many cases, the person has had the goiter for many years before it becomes overactive.

Excessive Iodine Ingestion – Various sources of high iodine concentrations, such as kelp tablets, some expectorants, amiodarone (Cordarone, Pacerone – a medication used to treat certain problems with heart rhythms) and x-ray dyes, may occasionally cause hyperthyroidism in certain patients.

Sub-acute Thyroiditis – This condition may follow a viral infection and is characterized by painful thyroid gland enlargement and inflammation, which results in the release of large amounts of thyroid hormones into the blood. Fortunately, this condition usually resolves spontaneously.

Postpartum Thyroiditis – 5% to 10% of women develop mild to moderate hyperthyroidism within several months of giving birth. Hyperthyroidism in this condition usually lasts for approximately 1 to 2 months. It is often followed by several months of hypothyroidism, but most women will eventually recover normal thyroid function.

Over Medication with Thyroid Hormone – Patients who receive excessive thyroxine replacement treatment can develop hyperthyroidism. They should have their thyroid hormone dosage evaluated by a physician at least once each year and should NEVER give themselves “extra” doses.

Rarely, hyperthyroidism is caused by a pituitary adenoma, which is a noncancerous tumor of the pituitary gland. In this case, hyperthyroidism is due to too much thyroid-stimulating hormone (TSH).

Who is at Risk?

Women are two to 10 times more likely than men to develop hyperthyroidism. Certain factors can increase the chances of developing thyroid disorders. People may need more regular testing if they –

  • have had a thyroid problem before, such
  • as goiter or thyroid surgery
  • have a family history of thyroid disease
  • have pernicious anemia, a B12 deficiency; type 1 diabetes; or primary adrenal insufficiency, a hormonal disorder
  • eat large amounts of food containing iodine, such as kelp, or use iodinecontaining medications such as amiodarone, a heart medication
  • are older than age 60
  • were pregnant or delivered a baby within the past 6 months


  • Rapid heart rate and palpitations
  • Shortness of breath
  • Goiter (swelling of the thyroid gland)
  • Moist skin and increased perspiration
  • Shakiness and tremors
  • Anxiety
  • Heat intolerance and sweating
  • Increased appetite accompanied by weight loss
  • Insomnia
  • Irritability
  • Swollen, reddened, and bulging eyes (in Graves disease)
  • Occasionally, raised, thickened skin over the shins, back of feet, back, hands, or even face
  • In crisis: fever, very rapid pulse, agitation, and possibly delirium
  • Changes in menstrual periods


  • Heart problems – A rapid heart rate, a heart rhythm disorder (called atrial fibrillation) or congestive heart failure can result.
  • Brittle bones (osteoporosis) – Too much thyroid hormone can interfere with your body’s ability to incorporate calcium into your bones.
  • Eye problems due to Graves’ opthalmopathy
  • Red, swollen skin on the shins and feet due to Graves’ disease
  • Thyrotoxic crisis 


Betablockers – Betablockers are a group of drugs that tend to improve some of the symptoms and manifestations of hyperthyroidism. In particular, they can improve palpitations, slow the heart down and improve tremor. They have no effect on curing the thyroid overactivity, but do make many people feel better.

Antithyroid drugs – Carbimazole (Neomercazole) and propylthiouracil are antithyroid drugs that are effective in reducing the production of thyroid hormones in the majority of people with hyperthyroidism. In people with Graves’ disease, treatment with one of these drugs for between 6 months and 2 years results in a long-term remission in around half of patients, once the drug is stopped. Both drugs have the common side effects of rash and joint pains, and more rarely (less than 1 in 500 cases) a serious reduction in the circulating white blood cells (agranulocytosis) may occur during treatment.

Radioiodine – Radioiodine is a radioactive isotope of iodine that is taken up and concentrated selectively by the thyroid gland. In most people, this small dose of radioactivity is sufficient to gradually destroy the thyroid tissue.

Thyroid surgery – Surgery to remove most or all of the thyroid gland (subtotal or total thyroidectomy) is another way of definitively treating thyroid overactivity. This is a straightforward operation when carried out by an experienced thyroid surgeon, with a low risk of complications. Hypothyroidism is a recognized side effect of surgery for which levothyroxine replacement will be needed, lifelong. Thyroidectomy is a good treatment option for people with a large goitre and for those with thyroid eye disease.

Alternative Treatment

A daily multivitamin, containing the antioxidant vitamins A, C, E, the B-complex vitamins, and trace minerals, such as magnesium, calcium, zinc, and selenium.

Omega-3 fatty acids such as fish oil, helps to reduce inflammation and boost immunity. Omega-3 fatty acids can have a blood-thinning effect.

Vitamin C act as an antioxidant and for immune support.

Alpha-lipoic acid for antioxidant support. It can potentially interfere with certain chemotherapy agents.

L-carnitine for decreasing thyroid activity. It may have blood-thinning effects and therefore increase anticlotting effects of certain medicines, such as warfarin (Coumadin).

Probiotic supplement (containing Lactobacillus acidophilus) for maintenance of gastrointestinal and immune health. Some acidophilus products may need refrigeration. Read labels carefully.


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February 8, 2017

Hyperparathyroidism is a condition in which the parathyroid glands, located in the neck, secrete too much parathyroid hormone (PTH). Parathyroid hormone regulates the amount of calcium and phosphorus (minerals necessary for strong bones and teeth) in the body, by controlling how much calcium is taken from bones, absorbed in the intestines, and lost in urine. When too much parathyroid hormone is secreted, levels of calcium in the blood and urine rise, and bones may lose calcium, leading to osteoporosis.

In the United States, about 100,000 people develop hyperparathyroidism each year. Women outnumber men two to one, and risk increases with age. In women 60 years and older, two out of 1,000 will develop hyperparathyroidism each year.

This excess PTH triggers the release of too much calcium into the bloodstream. The bones may lose calcium, and too much calcium may be absorbed from food. The levels of calcium may increase in the urine, causing kidney stones. PTH also lowers blood phosphorus levels by increasing excretion of phosphorus in the urine.

Calcium is essential for good health. It plays an important role in bone and tooth development and in maintaining bone strength.

Calcium is also important in nerve transmission and muscle contraction. Phosphorus is found in all bodily tissue. It is a main part of every cell with many roles in each. Combined with calcium, phosphorus gives strength and rigidity to the bones and teeth.


  • Primary Hyperparathyroidism, which is usually tied to an enlargement (hyperplasia) of a parathyroid gland, a benign (non-cancerous) growth (adenoma) or (in rare cases) a malignant (cancerous) tumor. The reasons for enlargement are usually undetermined but can be hereditary.
  • Secondary Hyperparathyroidism, when certain medical conditions skew the levels of calcium and a related mineral, phosphate. That prompts the parathyroid glands to compensate and is caused by such problems as a vitamin D or calcium deficiency, or by kidney failure.


In most cases nobody knows. Something happens within the parathyroid gland to cause the cells to replicate over and over until the gland grows into a tumor.

Some rare causes of tumor development are –

  • Lithium – People who take Lithium on a daily basis for 10 or more years may develop parathyroid problems.
  • Radioactive iodine therapy – Radioactive iodine therapy for previous thyroid problems causes approximately 3 percent of all parathyroid problems.
  • Radiation therapy – Radiation treatments to the head, neck and face as a child or teenager account for 1 percent to 2 percent of all parathyroid patients.
  • Family history – Hereditary forms of hyperparathyroidism account for about 2 percent of all parathyroid patients.
  • Kidney failure – Secondary hyperparathyroidism occurs in patients who have renal failure, and almost always in patients who have been on kidney dialysis for several years.

A small number of patients will have two parathyroid adenomas while having two normal parathyroid glands. An even smaller number of patients will have an enlargement of all four parathyroid glands, a term called parathyroid hyperplasia. This is much less common but the end results on the body are identical.

Risk Factors

People are at risk if they –

  • Are a woman who has gone through menopause
  • Have had prolonged, severe calcium or vitamin D deficiency
  • Have a rare, inherited disorder, such as multiple endocrine neoplasia, type I, which usually affects multiple glands
  • Have had radiation treatment for cancer that has exposed the neck to radiation
  • Have taken lithium, a drug most often used to treat bipolar disorder


Most people who have hyperparathyroidism do not experience any symptoms. Some people may have one or more of the following symptoms –

  • Feeling weak or tired most of the time
  • General aches and pains throughout your body
  • Abdominal pain
  • Frequent heartburn (because the high calcium level in your blood causes the stomach to make too much acid)
  • Nausea
  • Vomiting
  • Loss of appetite
  • Bone and joint pain
  • An increase in bone fractures or breaks
  • Confusion and memory loss
  • Kidney stones
  • Excessive urination
  • High blood pressure


  • Osteoporosis – a weakening of the bones that can make them more susceptible to fractures
  • Osteopenia – a condition that often precedes osteoporosis
  • Kidney Stones – hard deposits that result from excess calcium getting in the urine and getting filtered by the kidneys
  • Cardiovascular Disease – research suggests that high-calcium levels are associated with high blood pressure (hypertension) and some types of heart disease


Surgery –

  • Standard parathyroid surgery – The standard parathyroid operation begins with an anesthesiologist putting people to sleep under general anesthesia.
  • Minimal parathyroid surgery – Minimal parathyroid surgery (radio-guided parathyroid surgery) is dramatically changing the way surgeons treat parathyroid disease.

Medications –

Calcimimetics – A calcimimetic is a drug that mimics calcium circulating in the blood. The drug may trick the parathyroid glands into releasing less parathyroid hormone. This drug is sold as cinacalcet (Sensipar)

Hormone replacement therapy – For women who have gone through menopause and have signs of osteoporosis, hormone replacement therapy may help bones retain calcium. This treatment doesn’t address the underlying problems with the parathyroid glands.

Bisphosphonates – Bisphosphonates also prevent the loss of calcium from bones and may lessen osteoporosis caused by hyperparathyroidism. Some side effects associated with bisphosphonates include low blood pressure, fever and vomiting.

Alternative Treatment

Multivitamin – A daily multivitamin, containing the antioxidant vitamins A, C, E, the B-complex vitamins and trace minerals, such as magnesium, calcium, zinc, and selenium.

Calcium citrate is used for bone support.

Vitamin D is for immunity.

Ipriflavone (soy isoflavones) is helpful in for bone loss. Because hyperparathyroidism may lead to osteoporosis, taking ipriflavone may help treat this cause of bone loss. Ipriflavone can lower white blood cell counts and has the potential to interact with a variety of medications.

Chaste tree (Vitex agnus castus) for support of the parathyroid gland. Chaste tree extract has many possible drug interactions and can have hormone-like effects in the body.

Dandelion is used for its high mineral content.


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February 8, 2017

Hypercalcemia is an elevated calcium level in the blood. Hypercalcemia can be asymptomatic in laboratory results, but high calcium levels are often an indicator of multiple myeloma. Hypercalcemia related to multiple myeloma is caused by the breakdown of bone which leads to the release of calcium into the blood. This can be a serious problem if appropriate treatment is not given immediately. Severe hypercalcemia can result in coma or cardiac arrest.

Hypercalcemia develops in 10%–20% of adults with cancer, but it rarely develops in children. When it develops in people with cancer, it may be called hypercalcemia of malignancy (HCM)

Calcium enters the blood in different ways. The level of calcium in the blood is controlled by hormones and the kidneys.

Calcitriol is a hormone form of vitamin D. It helps the intestines take up calcium from foods and drinks. The intestines then release calcium into the blood. Parathyroid hormone (PTH) helps control the level of calcium in the blood. When blood calcium levels are low, the parathyroid gland releases PTH. PTH stimulates cells in the bones to break bone down and release calcium into the blood. It also tells the kidneys and intestines to absorb more calcium. The kidneys help control the amount of calcium in the body. They can remove large amounts of calcium from the blood and pass it into the urine.

Severe hypercalcemia can have serious consequences, including kidney damage, dementia, and coma. Treating the underlying disorder is often sufficient to restore blood levels of calcium to normal. However, some of the problems associated with severe hypercalcemia are irreversible.


Calcium is important to many body functions, including –

  • Bone formation
  • Hormone release
  • Muscle contraction
  • Nerve and brain function

Parathyroid hormone (PTH) and Vitamin D help manage calcium balance in the body. PTH is made by the parathyroid glands, which are four small glands located in the neck behind the thyroid gland. Vitamin D is obtained when the skin is exposed to sunlight, and from dietary sources such as –

  • Egg yolks
  • Fish
  • Fortified cereals
  • Fortified dairy products

Primary hyperparathyroidism is the most common cause of hypercalcemia. It is due to excess PTH release by the parathyroid glands. This excess occurs due to an enlargement of one or more of the parathyroid glands, or a growth on one of the glands. (Most of the time, these growths are not cancerous).

Other conditions can also cause hypercalcemia –

  • An inherited condition that affects the body’s ability to regulate calcium (familial hypocalciuric hypercalcemia)
  • Being bed-bound (or not being able to move) for a long period of time (this occurs most often in young people)
  • Calcium excess in the diet. This is called milk-alkali syndrome. It is most often due to at least 2,000 milligrams of calcium per day. Taking too much vitamin D may add to the problem.
  • Hyperthyroidism
  • Kidney failure
  • Medications such as lithium and thiazide diuretics (water pills)
  • Some cancerous tumors (for example, lung cancers, breast cancer)
  • Some infectious and inflammatory diseases such as tuberculosis, Paget’s disease and sarcoidosis

Women in their 50s are the population at highest risk of overactive parathyroid glands.


The symptoms of hypercalcemia often develop slowly and may be similar to the symptoms of cancer or cancer treatment. How serious a person’s symptoms are is not related to the calcium level in the blood. Many patients have no symptoms. And, older patients usually experience more symptoms than younger patients.

People with hypercalcemia may experience the following symptoms –

  • Loss of appetite
  • Nausea and vomiting
  • Constipation and abdominal pain
  • Increased thirst and frequent urination
  • Fatigue, weakness, and muscle pain
  • Confusion, disorientation, and difficulty thinking
  • Headaches
  • Depression

Symptoms of severe hypercalcemia may include –

  • Kidney stones, a painful condition in which salt and minerals form solid masses called stones in the kidneys or urinary tract
  • Irregular heartbeat
  • Heart attack
  • Loss of consciousness
  • Coma

Patients and their families should be familiar with the symptoms on this list. Relieving side effects is an important part of cancer care and treatment. This is called palliative care. Talk with your health care team about any symptoms or side effects you may experience. This includes any new symptoms or a change in symptoms.


  • Pancreatitis
  • Peptic ulcer disease
  • Calcium deposits in the kidney (nephrocalcinosis)
  • Dehydration
  • High blood pressure
  • Kidney failure
  • Kidney stones
  • Depression
  • Difficulty concentrating or thinking
  • Bone cysts
  • Fractures
  • Osteoporosis

These complications of long-term hypercalcemia are uncommon today.


Removal of the abnormal and hyperfunctioning parathyroid tissue results in a long-term cure of HPT in 96% of patients and significant improvement in associated symptoms. The following criteria were proposed as indications for parathyroidectomy based on a National Institutes of Health–sponsored panel and endocrine specialty societies –

  • Serum Ca level more than 1 mg/dL above the upper limit of normal
  • Marked hypercalciuria higher than 400 mg/day
  • Creatinine clearance reduced more than 30% compared with age-matched controls
  • Reduction in bone mineral density of the femoral neck, lumbar spine, or distal radius of more than 2.5 standard deviations below peak bone mass (T score lower than -2.5)
  • Age younger than 50 years
  • Patients for whom medical surveillance is not desirable or possible
  • Presence of any complications (e.g., nephrolithiasis, overt bone disease)
  • An episode of hypercalcemic crisis

Medications – In some cases, the doctor may recommend:

Calcimimetics – This type of drug mimics calcium circulating in the blood, so it can help control overactive parathyroid glands.

Bisphosphonates – Intravenous osteoporosis drugs can help rebuild bone weakened by hypercalcemia. Risks associated with this treatment include osteonecrosis of the jaw and certain types of thigh fractures.

Prednisone – If the hypercalcemia is caused by high levels of vitamin D, short-term use of steroid pills such as prednisone might be helpful.

IV fluids and diuretics – Extremely high calcium levels can be a medical emergency. Hospitalization for treatment with IV fluids and diuretics to promptly lower the calcium level may be needed to prevent heart rhythm problems or damage to the nervous system.

Dialysis – If the kidneys fail due to cancer or its treatment, you may need dialysis. Dialysis removes wastes from the blood when the kidneys don’t work properly.

Alternative Treatment

  • Probiotics – Vitamin K2 (menaquinone) is one of many vitamins that probiotic microbes make in the digestive tract. If the bacteria in the gut are out of balance, people may be deficient in K2 and several other B vitamins. A deficiency of vitamin K2 causes deposition of calcium on the artery walls and atherosclerosis.
  • Drink plenty of fluids, especially water – Drinking fluids can help keep the person from dehydration and help prevent kidney stones from forming.
  • Exercise – Once the calcium levels return to normal, and if the person is otherwise healthy, it’s important to remain active to help maintain bone density. Try to combine strength training with weight-bearing exercises.
  • Don’t smoke – Smoking has been shown to increase bone loss as well as dramatically increase the risk of a number of serious health problems.


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February 8, 2017

Hormones are incredible chemical messengers in the body that affect the brain, heart, bones, muscles, and reproductive organs and are an essential part of the workings of every cell in the human body. Hormones work best when balanced. However, hormones can become imbalanced.

Hormone imbalances are caused by –

  • Higher than average levels of stress
  • Poor food choices
  • Inadequate sleep
  • Taking synthetic hormones
  • Sedentary lifestyle (lack of movement or exercise)

Endocrine glands, which are special groups of cells, make hormones. The major endocrine glands are the pituitary, pineal, thymus, thyroid, adrenal glands and pancreas. In addition, men produce hormones in their testes and women produce them in their ovaries.

Hormones work slowly, over time, and affect many different processes, including –

  • Growth and development
  • Metabolism – how your body gets energy from the foods you eat
  • Sexual function
  • Reproduction
  • Mood


Symptoms of hormone imbalance are experienced during puberty, menstruation, pregnancy and post-partum, premenopausal and menopause. That makes up a sizeable portion of a woman’s life.

The common hormone imbalance symptoms include –

  • Premenstrual syndrome
  • Acne or skin breakouts
  • Urinary tract infections
  • Temperature changes
  • Anxiety and irritability
  • Headache/migraines
  • Cravings for sweets
  • Excess hair growth

Other symptoms include

  • Allergy symptoms
  • Problem sleeping
  • Irregular periods
  • Feeling fatigued
  • Water retention
  • Oily or dry skin
  • Endometriosis
  • Mood swings
  • Weight gain
  • Depression

Natural or Bio-identical Hormone Balancing

Bioidentical hormones – or bio identical hormones – are derived from naturally occurring sources, such as yams and soy, and are designed to replicate the same chemical structure as the hormones that are produced naturally by our bodies. Based on your hormone levels, a specialized compounding pharmacy can individually tailor a bioidentical hormone regimen specifically designed for you.

These include –

Estrogen – Bi-estrogen (Bi-Est), a combination of estriol and estradiol. From 50% to 80% of Bi-Est is estriol, which has been shown to protect against breast cancer in animal studies. Estriol causes little or no stimulation to the uterine lining and is clinically effective for the treatment of symptoms caused by estrogen deficiency, such as vaginal dryness and atrophy, painful intercourse, and urinary tract disorders (incontinence, frequent urinary tract infections). Estradiol relieves symptoms such as vaginal thinning and dryness. It decreases hot flashes and night sweats; improves mood, energy level, sleep patterns, memory, and cognitive function; and reduces bone loss and the risk of developing type 2 diabetes. It also helps to lower blood pressure.

Tri-estrogen (Tri-Est) a combination of 80% estriol, 10% estradiol, and 10% estrone. Only a few women may need supplemental estrone, which is the primary estrogen produced after menopause.

Progesterone is a hormone commonly prescribed for women with too much estrogen relative to the level of progesterone produced by the body. Progesterone minimizes the stimulating effects of estrogen on coronary arteries, and when given alone or combined with estrogen, it may improve bone mineral density. Progesterone improves sleep, may increase libido, acts as a diuretic, lowers blood pressure, and improves the insulin-glucose balance to facilitate blood glucose control.

Dehydroepiandrosterone (DHEA) is prescribed for women whose hormone profile as determined by saliva, blood or urine testing indicates a low level of DHEA. DHEA enhances libido, helps to build bone mass, lowers the levels of cholesterol and triglycerides, improves the sense of well-being, and increases alertness.

Testosterone is prescribed for women deficient in that hormone. It can help to improve libido, help to build bone mass, improve mood and the sense of well-being, increase muscle mass and strength, lower levels of cholesterol and triglycerides, normalize blood glucose levels, and decrease body fat.

Bioidentical hormones are more appealing to the masses when dealing with menopause or andropause because they are derived naturally and our bodies can metabolize them properly. Another advantage of using bioidentical hormones is that they are specifically designed to match your individual hormonal needs – unlike synthetic hormones, which use a one-size-fits-all approach to symptom relief.





February 8, 2017

Hashimoto’s disease is a condition caused by chronic inflammation of the thyroid gland. The resulting inflammation often leads to hypothyroidism, an underactive thyroid gland. The condition is also known as chronic lymphocytic thyroiditis or autoimmune thyroiditis. The most common cause of hypothyroidism is Hashimoto’s disease.

The thyroid gland, located in front of your neck just below the voice box (larynx) produces two hormones namely thyroxine (T4) and triiodothyronine (T3) that regulate body metabolism.

The thyroid is a small, butterfly-shaped gland located in the front of the neck that produces hormones, notably thyroxine (T4) and triiodothyronine (T3), which stimulate vital processes in every part of the body. These thyroid hormones have a major impact on the following functions –

  • Growth
  • Use of energy and oxygen
  • Heat production
  • Fertility
  • The use of vitamins, proteins, carbohydrates, fats, electrolytes, and water
  • Immune regulation in the intestine

These hormones can also alter the actions of other hormones and drugs.

With Hashimoto’s disease, the immune system makes antibodies that damage thyroid cells and interfere with their ability to make thyroid hormone. Over time, thyroid damage can cause thyroid hormone levels to be too low. This is called an underactive thyroid or hypothyroidism (heye-poh-THEYE-royd-ism). An underactive thyroid causes every function of the body to slow down, such as heart rate, brain function, and the rate your body turns food into energy. Hashimoto’s disease is the most common cause of an underactive thyroid. It is closely related to Graves’ disease, another autoimmune disease affecting the thyroid.

Who’s at Risk?

Genes – Some people are prone to Hashimoto’s disease because of their genes. Researchers are working to find the gene or genes involved.

Gender – Sex hormones also might play a role. This may help to explain why Hashimoto’s disease affects more women than men.

Pregnancy – Pregnancy affects the thyroid. Some women have thyroid problems after having a baby, which usually go away. But about 20 percent of these women develop Hashimoto’s disease in later years. This suggests that pregnancy might trigger thyroid disease in some women.

Too much iodine and some drugs may trigger the onset of thyroid disease in people prone to getting it.

Radiation exposure has been shown to bring on autoimmune thyroid disease. This includes radiation from the atomic bomb in Japan, the nuclear accident at Chernobyl, and radiation treatment of Hodgkin’s disease (a type of blood cancer).


Hashimoto’s thyroiditis is an autoimmune disease. The patient’s own immune system creates antibodies that attack and damage the thyroid gland.

Our immune system is designed to protect us against harmful invaders, such as viruses, bacteria, parasites and fungi. In patents with Hashimoto’s thyroiditis, their immune system mistakenly recognizes normal thyroid gland cells as harmful, foreign tissue and attacks them.

Experts are not sure why the immune system becomes activated in such a way. Some suggest that perhaps a virus or bacterium may play or role, maybe a genetic fault, or possibly a combination. So far, none of these environmental or genetic factors have been compellingly proven to be the cause of Hashimoto’s thyroiditis.


Many people with Hashimoto’s disease have no symptoms for years. An enlarged thyroid, called a goiter, is often the first sign of disease. The goiter may cause the front of the neck to look swollen. You or your doctor may notice the goiter. If large, it may cause a feeling of fullness in the throat or make it hard to swallow. It rarely causes pain.

Many people with Hashimoto’s disease develop an underactive thyroid. They may have mild or no symptoms at first. But symptoms tend to worsen over time. Symptoms of an underactive thyroid include –

  • Fatigue
  • Weight gain
  • Pale, puffy face
  • Feeling cold
  • Joint and muscle pain
  • Constipation
  • Dry, thinning hair
  • Heavy menstrual flow or irregular periods
  • Depression
  • A slowed heart rate
  • Problems getting pregnant


Medication – Some medications and supplements may interfere with levothyroxine absorption. Some foods may affect absorption as well, including soy products or very high fiber foods.

The following medications and supplements may interfere with proper levothyroxine absorption –

  • Blood thinners, such as warfarin
  • Estrogen-containing medications, such as birth control pills
  • Sodium polystyrene sulfonate
  • Antacids that contain aluminum hydroxide
  • Calcium supplements
  • Iron supplements (many multivitamins contain iron)
  • Some cholesterol-lowering drugs, such as cholestyramine

Synthetic hormone treatment – For patients with goiter or hypothyroidism, thyroid hormone therapy is required. The patient needs to take one tablet of levothyroxine each day. People with an underlying heart disease or severe hypothyroidism start off on a low dose which is gradually increased.

The treatment may take a few months before any improvements in symptoms are noticed. There may be some hair loss during the first few months of treatment. This effect is temporary.

Alternative Treatment

Lithium – Prescription lithium carbonate is well known to cause hypothyroidism. Small studies have shown that lithium carbonate is also effective at controlling symptoms of hyperthyroidism. There are also case reports where patients who were prescribed lithium for other reasons and went on to develop Hashimoto’s disease remained asymptomatic while on lithium

Selenium – A dose of slenium may show effective in reducing symptoms of Hashimoto’s disease, including ophthalmopathy.

Carnitine – L-carnitine helps to improve symptoms of hyperthyroidism.

Probiotics like acidophilus – These can help the immune system as well.

Omega-3 Fatty Acids – Omega-3s such as those that are found in fish oil decrease inflammation and improve immunity.

Iodine – Iodine is a vital nutrient in the body and essential to thyroid function; thyroid hormones are comprised of iodine. While autoimmune disease is the primary cause of thyroid dysfunction in the United States, iodine deficiency is the main cause worldwide.

Vitamin D – Hyperthyroidism, particularly Graves’ disease and Hashimoto’s disease, is known to cause bone loss, which is compounded by the vitamin D deficiency commonly found in people with hyperthyroidism. This bone mass can be regained with treatment for hyperthyroidism, and experts suggest that adequate bone-building nutrients, such as vitamin D, are particularly important during and after treatment.

  • Goitrogens – Cruciferous vegetables such as broccoli, cauliflower, and cabbage naturally release a compound called goitrin when they’re hydrolyzed, or broken down. Goitrin can interfere with the synthesis of thyroid hormones. Soy is another potential goitrogen


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February 8, 2017

Grave’s Disease also known as ‘Diffuse toxic goitre’ is characterized by hyperthyroidism and diffuse goiter. Graves’ disease is an autoimmune disorder where misplaced attacks from the immune system cause the thyroid gland to become overactive. It is caused by a generalized overactivity of the entire thyroid gland (hyperthyroidism). It is named for Robert Graves, an Irish physician, who described this form of hyperthyroidism about 150 years ago.

Graves’ disease is very common and affects about 1 in 200 people and is the most common cause of hyperthyroidism in the United States. Graves’ disease it is most often seen in women ages 20 to 40.

The thyroid gland is a butterfly-shaped endocrine gland that is normally located in the lower front of the neck. The thyroid’s job is to make thyroid hormones, which are secreted into the blood and then carried to every tissue in the body. Thyroid hormone helps the body use energy, stay warm and keep the brain, heart, muscles, and other organs working as they should.

With Graves’ disease, the immune system makes antibodies that act like thyroid stimulating hormone (TSH), causing the thyroid to make more thyroid hormone than your body needs. This is called an overactive thyroid or hyperthyroidism. An overactive thyroid causes every function of the body to speed up, such as heart rate and the rate your body turns food into energy. Graves’ disease is one cause of overactive thyroid. It is closely related to Hashimoto’s disease, another autoimmune disease affecting the thyroid.

Who gets Grave’s Disease?

Both men and women can get Graves’ disease. But it affects women 10 times more often than men. Graves’ disease occurs in people of all ages, but most often starts in the 20s and 30s. People who get Graves’ disease often have family members who have thyroid or other autoimmune diseases. People who get Graves’ disease sometimes have other autoimmune diseases, such as:

  • Vitiligo — A disease that destroys the cells that give the skin its color
  • Rheumatoid arthritis — A disease that affects the lining of the joints throughout the body
  • Addison’s disease — A disease that affects the adrenal glands, which make hormones that help the body respond to stress and regulate the blood pressure and water and salt balance
  • Type 1 diabetes — A disease that causes blood sugar levels to be too high
  • Pernicious anemia — A disease that keeps the body from absorbing vitamin B12 and making enough healthy red blood cells
  • Lupus — A disease that can damage many parts of the body, such as the joints, skin, blood vessels, and other organs


Genetic factors – High prevalence of Graves’ disease in family members and relatives of Graves’ disease and Hashimoto’s thyroiditis support that genetic factors are involved in causation of Graves’ disease. There is also evidence that occurrence rate of Graves’ disease is higher in monozygotic twins than dizygotic twins. The concordance rate in monozygotic twins is only 17-35% which indicate low penentrance of genes.

Environmental Factors – From very early it has been suggested that Graves’ disease is associated with infectious agents, but this hypothesis has not been confirmed. Incidence of viral infections is high in patients with Graves’ disease. The association of Graves’ disease with infectious agents can be explained by molecular mimicry. Infection might play a role in the onset of Graves’ disease, but no studies have shown infection to directly cause Graves’ disease.

Stress – Severe emotional and physical stress, like separation from the loved one or following road traffic accident, cause release of cortisol ad corticotrophin releasing hormone. So, stress is a relatively immune suppression state. Immune system overcompensates once stress is over which can precipitate disease similar to postpartum period. In conclusion there is limited but significant evidence that stressful life events can precipitate the onset of Graves’ disease in genetically susceptible individuals.

Gender – Typically Graves’ disease is more prevalent in females than males. It is about 5-10 times more common in females at any age. But Graves’ disease also occurs in men and postmenopausal women. These observations have suggested that it is the X-chromosome, not the sex steroids, which is responsible. But most of the x-linked disorders are only present in man, it has been thought that a gene with dose dependent effect on X-chromosome is responsible.

Pregnancy – Postpartum period is an important risk factor for both the onset and relapse of Graves’ disease. Postpartum period is associated with a fourfold to eightfold increased risk for the onset of Graves’ disease. However in women with Graves’ disease who became pregnant, successful pregnancy outcome is low because Graves’ disease causes increased pregnancy loss and its complications.

Smoking – Smoking is a minor risk factor for Graves’ disease; however it is a major risk factor for Graves’ ophthalmopathy. There are number of studies showing relationship between Graves’ disease, Graves’ ophthalmopathy and smoking.

Other Factors – Direct trauma to the thyroid gland, ethanol injection for the treatment of autonomously functioning thyroid nodules, or thyroid injury following radio-iodine treatment for toxic adenoma or toxic multinodular goiter are associated with an increased risk of Graves’ disease. Radio-iodine treatment may also cause onset or worsening of ophthalmopathy. Possible explanation is that thyroid injury by any means cause massive release of thyroid antigens, which in turn stimulate an autoimmune reaction to TSHR in susceptible individuals.


The overproduction of thyroid hormones can have a variety of effects on the body due to the important role these hormones play to regulate a person’s metabolism.

The onset of Graves’ disease can have a number of effects on the body.

The influx of thyroid hormones can increase these processes, symptoms of this include –

  • Increased sweating
  • Weight loss
  • Nervousness
  • Hand tremors
  • Anxiety
  • An irregular or rapid heartbeat
  • Enlargement of the thyroid gland (goiter).

One distinct feature of Graves’ disease, compared with other causes of hyperthyroidism, is its effects on the eyes. Graves’ disease is the only type of hyperthyroidism that is associated with the swelling and inflammation of the eye tissue.

Graves’ eye disease is also known as ophthalmopathy (exophthalmos) and is a common symptom of patients with Graves’s disease with 30% of patients suffering from the condition. In this instance, the eyes become painful, red and watery. Patients may also experience extreme sensitivity to sunlight and blurred vision.


Conventional Treatment – People with Graves’ disease have three conventional treatment options – radioiodine therapy, medications, and thyroid surgery.  Radioiodine therapy is the most common treatment for Graves’ disease in the United States.  Graves’ disease is often diagnosed and treated by an endocrinologist—a doctor who specializes in the body’s hormone- secreting glands.

  • Radioactive iodine therapy – Radioactive iodine is taken orally and directly targets the thyroid gland. Iodine is required to produce the thyroid hormones. When medication is taken, the radioactive iodine soon accumulates in the thyroid gland and slowly destroys any overactive thyroid cells. This results in the reduction of the thyroid gland and fewer thyroid hormones being produced. Although there have been concerns regarding the relationship between head and neck irradiation and the increased risk of thyroid cancer, so far no study has revealed any relation.
  • Medications
    • Beta blockers.Health care providers may prescribe a medication called a beta blocker to reduce many of the symptoms of hyperthyroidism, such as tremors, rapid heartbeat, and nervousness. But beta blockers do not stop thyroid hormone production.
    • Anti-thyroid medications.Health care providers sometimes prescribe anti-thyroid medications as the only treatment for Graves’ disease.  Anti-thyroid medications interfere with thyroid hormone production but don’t usually have permanent results.  Use of these medications requires frequent monitoring by a health care provider.  More often, anti-thyroid medications are used to pretreat patients before surgery or radioiodine therapy, or they are used as supplemental treatment after radioiodine therapy
  • Thyroid Surgery – Surgery is the least-used option for treating Graves’ disease. Sometimes surgery may be used to treat
    • pregnant women who cannot tolerate anti-thyroid medications
    • people suspected of having thyroid cancer, though Graves’ disease does not cause cancer
    • people for whom other forms of treatment are not successful

Alternative Treatment 

Lithium – Prescription lithium carbonate is well known to cause hypothyroidism. Small studies have shown that lithium carbonate is also effective at controlling symptoms of hyperthyroidism. There are also case reports where patients who were prescribed lithium for other reasons and went on to develop Graves’ disease remained asymptomatic while on lithium

Selenium – A dose of slenium may show effective in reducing symptoms of Graves’ disease, including ophthalmopathy.

Carnitine – L-carnitine helps to improve symptoms of hyperthyroidism.

Probiotics like acidophilus – These can help the immune system as well.

Omega-3 Fatty Acids – Omega-3s such as those that are found in fish oil decrease inflammation and improve immunity.

Iodine – Iodine is a vital nutrient in the body and essential to thyroid function; thyroid hormones are comprised of iodine. While autoimmune disease is the primary cause of thyroid dysfunction in the United States, iodine deficiency is the main cause worldwide.

Vitamin D – Hyperthyroidism, particularly Graves’ disease, is known to cause bone loss, which is compounded by the vitamin D deficiency commonly found in people with hyperthyroidism. This bone mass can be regained with treatment for hyperthyroidism, and experts suggest that adequate bone-building nutrients, such as vitamin D, are particularly important during and after treatment.

Goitrogens – Cruciferous vegetables such as broccoli, cauliflower, and cabbage naturally release a compound called goitrin when they’re hydrolyzed, or broken down. Goitrin can interfere with the synthesis of thyroid hormones. Soy is another potential goitrogen


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February 8, 2017

Fibrocystic breast disease (FBD), or fibrocystic breast condition or changes, is described as common, benign changes involving the tissues of the breasts. Common breast symptoms are swelling and tenderness, nodularity, palpable lumps, nipple discharge, and inflammation. These changes are typically accompanied by breast pain. The discomfort associated with fibrocystic breast disease is often in the upper outer quadrant, is diffuse, and may radiate to the axilla or upper arm. The incidence of fibrocystic breast disease is estimated to be up to 70% of all women. It can occur in women aged 18 or older, but is most common in women between the ages of 30 and 50, and rare in postmenopausal women.

Fibrocystic changes occur during ovulation and just before menstruation. During these times, hormone level changes often cause the breast cells to retain fluid and develop into nodules or cysts (sacs filled with fluid), which feel like a lump when touched. The nodules or cysts can spread throughout the breast, may be located in one general area or simply appear as one or more large cysts. If the lump is not filled with fluid, it is called a fibroadenoma. A fibroadenoma is a solitary, firm distinct lump, composed of a mass or lump of fibrous tissue.

Having fibrocystic breasts does not place women at a higher or lower risk of developing breast cancer. This generalized breast lumpiness is known by several names, including fibrocystic breast condition, fibrous breasts, fibrocystic breast disease, fibrocystic changes and benign breast disease. There even exist several types of fibrocystic breast condition.

Unfortunately, many women and even doctors think that fibrocystic breast disease is a “normal” condition for women. However, large, palpable cysts have been linked to an increased risk of breast cancer, not to mention the pain the women experience, so women need to be concerned about pain and cysts in their breasts and not let it go on thinking it is “normal”.


Fibrocystic breasts occur from changes in the glandular and stromal (connective) tissues of the breast. These changes are related to a woman’s menstrual cycle and the hormones, estrogen and progesterone. Women with fibrocystic breasts often have bilateral cyclic breast pain or tenderness that coincides with their menstrual cycles.

During each menstrual cycle, normal hormonal stimulation causes the breasts’ milk glands and ducts to enlarge, and in turn, the breasts may retain water. Before or during menstruation, the breasts may feel swollen, painful, tender, or lumpy. The severity of these symptoms varies significantly from woman to woman. Some women only experience mild breast swelling during menstruation, while others experience constant breast tenderness. Because the condition is hormone-related, it will usually affect both breasts (bilaterally). Symptoms of fibrocystic breasts usually stop after menopause but may be prolonged if a woman takes hormone replacement therapy.

Risk Factors

Women who have a family history of benign breast disorders, particularly in a mother or sister, are most likely to develop FCBD. It is also more common among women who have not had children, who are Jewish or Caucasian, or who have experienced severe PMS.


Symptoms usually get better after women go through menopause. If some take birth control pills, they may have fewer symptoms. If the patient is on hormone therapy, you may have more symptoms.

Symptoms are usually worse right before the menstrual period and improve after the period starts.

Symptoms can include –

  • Pain or discomfort in both breasts
  • The pain commonly comes and goes with the period, but can last through the whole month
  • Breasts that feel full, swollen, and heavy
  • Pain or discomfort under the arms
  • Thick or lumpy breasts

Women may have a lump in the same area of the breast that becomes larger before each period and shrinks afterward. This type of lump moves when it is pushed with the fingers. It does not feel stuck or fixed to the tissue around it. This lump is common with fibrocystic breasts.

Some may have discharge from the nipple. If the discharge is clear, red, or bloody, talk to the health care provider right away.


Supportive therapy treats the symptoms caused by fibrocystic breast changes, but it does not treat the underlying cause of the breast condition. Supportive care options for fibrocystic breast changes may include –

  • Wearing a fitted, supportive bra
  • Over-the-counter pain medicines
  • Ibuprofen (Advil, Motrin)
  • Acetaminophen (Tylenol)
  • Diclofenac cream (Voltaren)
  • Fine needle aspiration to relieve pain from a breast cyst
  • Adding ground flaxseed to the diet

If supportive care measures do not reduce the symptoms, or if the symptoms are severe, other treatment options may be offered.

Oral contraceptives (birth control pills)

Surgery – Sometimes done to remove a lump

Drug treatment – Rarely offered for fibrocystic breast changes due to concerns about side effects

  • Danazol (Cyclomen, Danocrine) – decreases the production of estrogen
  • Tamoxifen (Nolvadex, Tamofen) – blocks the effects of estrogen

Alternative Treatment

Vitamin E has been used for managing fibrocystic breast disease for more than 35 years. Vitamin E reduces pain, relieves tenderness, and limits the development of nodules.

Evening Primrose Oil – The pain and tenderness of benign breast disease associated with “cyclic mastalgia” have been alleviated with evening primrose oil, the only one of the fatty acids to be scientifically studied in relation to fibrocystic breasts.

Chasteberry, also called vitex, adjusts imbalances between the menstrual hormones estrogen and progesterone and can stop excess production of prolactin, thereby reducing discomfort. It helps with painful bloating and may clear up PMS-related complaints, such as irritability and depression, in the process.

Essential fatty acids (EFAs) have an anti-inflammatory action that soothes breast pain and also helps the body absorb iodine. An iodine deficit is associated with fibrocystic breast changes. Good sources of EFAs are evening primrose oil, flaxseed oil, and borage oil

Magnesium is a versatile mineral that appears to reduce the pain and inflammation of fibrocystic breast changes and may also help with PMS and menstrual cramps. It’s less likely to upset the stomach if taken with food; cut the dose if diarrhea develops.

Vitamin B6 helps the liver process any extra estrogen and, like some of the supplements above, also can relieve PMS symptoms. Though this vitamin is essential to nerve health, it can cause nerve damage when taken in very high doses (over 500 mg a day) for a long period of time. Vitamin B6; will be most effective for this condition if used during the two weeks before your menstrual period.

A coenzyme Q10 deficiency has been reported in some cases of both breast cancer and fibrocystic breast changes. Supplementing with this high-potency antioxidant may be helpful in the prevention and treatment of these and other disorders in the body.

Herbal therapies for addressing the symptoms of breast pain, swelling, and cystic nodules in the breast are largely arrived at from traditional uses of herbal medicines and from observational empirical evidence in clinical practice. Herbal diuretics can be useful in decreasing breast swelling and the discomfort associated with it. The most effective of these is dandelion leaf (Taraxacum officinale). Other diuretics to consider are cleavers (Galium aparine), yarrow (Achillea millefolium) and uva ursi (Arctostaphylos uva ursi).

Lifestyle Advice – Start and maintain an exercise program that addresses three key components of health: duration (aerobics), strength (weight resistance), and flexibility (stretching). A moderate daily exercise routine will promote weight loss and hormonal balance, stabilizing your mood and the overall feeling of well being.


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February 8, 2017

Female sexual dysfunction is a complex and poorly understood condition that affects women of all ages. Sexual dysfunction is defined as a disturbance in, or pain during, the sexual response. This problem is more difficult to diagnose and treat in women than it is in men because of the intricacy of the female sexual response. A woman has female sexual dysfunction, also called FSD, when she is upset or unhappy about her sexual health.

Sexual activity includes a wide variety of intimate activities, such as fondling, self-stimulation, oral sex, vaginal penetration and intercourse. Every woman differs in her sexual interest, response and expression. A woman’s feelings about sexuality can change according to the circumstances and stages of her life. Women also can experience a variety of sexual problems, such as lack of desire, difficulty becoming aroused, difficulty having an orgasm or pain during sex. When a physical or emotional problem associated with sex persists, it’s time to contact a health care professional.

Sexual Dysfunction can be described as –

  • Low Sexual Desire – Diminished libido, or lack of sex drive.
  • Sexual Arousal Disorder – The desire for sex might be intact, but may have difficulty or are unable to become aroused or maintain arousal during sexual activity.
  • Orgasmic Disorder – Women may have persistent or recurrent difficulty in achieving orgasm after sufficient sexual arousal and ongoing stimulation.
  • Sexual Pain Disorder – Women may have pain associated with sexual stimulation or vaginal contact.
  • Low Libido Associated with Menopause 

A woman’s sexuality is a complex interplay of physical and emotional responses that affects the way she thinks and feels about herself. When a woman has a sexual problem, it can impact many aspects of her life, including her personal relationships and her self-esteem. Many women are hesitant to talk about their sexuality with their health care professionals, and many health professionals are reluctant to begin a discussion about sexuality with their patients. Instead, women may needlessly suffer in silence when their problems could be treated.

A woman might have more than one of these issues, which are often related to each other.  Sexual dysfunction can be lifelong or temporary.  It can happen all the time, only with a certain partner, or only at certain times, such as after pregnancy. A healthy sex life depends on a complex mix of many factors.  The same is true for a troubled sex life. Health issues, certain prescription medicines, changes in hormone levels, partner or family issues, and psychological concerns can all contribute to FSD.

Types of Sexual Dysfunctions

Hypoactive Sexual Desire Disorder – When sexual fantasies or thoughts and desire for sexual activity are persistently reduced or absent causing distress or relationship difficulties, the problem is known as hypoactive sexual desire disorder, or inhibited sexual desire disorder. The Merck Manual estimates hypoactive sexual desire disorder occurs in about 20 percent of women.

Sexual aversion disorder: Diagnosed when a women avoids all or almost all genital sexual contact with a sexual partner to the point that it causes personal distress and relationship difficulties. This condition may affect women who have experienced some type of sexual abuse or who grew up in a rigid atmosphere in which sex was taboo.

Sexual arousal disorder – The persistent or recurrent inability to reach or sustain the lubrication and swelling reaction in the arousal phase of the sexual response to the point that it causes personal distress. It is the second most common sexual problem among women, affecting an estimated 20 percent of women, and most frequently occurs in postmenopausal women. Low estrogen levels after menopause can make vaginal tissue dry and thin and reduce blood flow to genitals.

Female orgasmic disorder – The persistent absence or recurrent delay in orgasm after sufficient stimulation and arousal, causing personal distress. According to the Association of Reproductive Health Professionals, 24 to 37 percent of women have problems reaching orgasm. Most women are biologically able to experience orgasm. Never having an orgasm, or not having one in certain situations, are problems that can often be resolved by learning how the female body responds, how to ensure adequate stimulation and/or how to overcome inhibitions or anxieties.


Once thought to be purely psychological, doctors now know the causes of female sexual dysfunction can be physical, psychological or both. It’s important to rule out physical causes in order to properly address hormonal causes, psychological causes and social causes.

These are some of the possible physical causes of female sexual dysfunction –

  • Nerve damage caused by trauma or surgery
  • Infection in the pelvis
  • Gynecological disease
  • Lubrication insufficiency
  • Fatigue
  • Heart disease
  • Diabetes
  • Hormone causes and imbalances
  • Menopause hormonal changes
  • Insufficient stimulation
  • Medications that decrease sex drive

Psychological causes and social causes of female sexual dysfunction include the following –

  • Anxiety about sexual intercourse or anxiety disorders
  • Partner-to-partner communication problems
  • Fear of pain, pregnancy or infection caused by sexual intercourse
  • Feeling guilty or shameful
  • Stress
  • Fatigue
  • Depression
  • Marriage/relationship problems

Interpersonal relationship causes may include –

  • Partner performance and technique
  • Lack of a partner
  • Relationship quality and conflict
  • Lack of privacy

Sociocultural influence causes may include –

  • Inadequate education
  • Conflict with religious, personal, or family values
  • Societal taboos

While periodic female sexual dysfunction can be normal, a physician should examine lasting symptoms. Some females are at a higher risk for developing dysfunction. Risk factors include past sexual abuse, including rape.

Risk Factors

Risk may increase if the women –

  • Single, divorced, widowed or separated
  • Not a high school graduate
  • Experiencing emotional or stress-related problems
  • Experiencing a decline in the economic position
  • Feeling unhappy, or physically and emotionally unsatisfied
  • A victim of sexual abuse or forced sexual contact


Up to 70% of couples have a problem with sex at some time in their relationships. Most women will have sex that doesn’t feel good at some point in her life. This doesn’t necessarily mean the women has a sexual problem.

Inhibited sexual desire — This involves a lack of sexual desire or interest in sex. Many factors can contribute to a lack of desire, including hormonal changes, medical conditions and treatments (for example cancer and chemotherapy), depression, pregnancy, stress and fatigue. Boredom with regular sexual routines also may contribute to a lack of enthusiasm for sex, as can lifestyle factors, such as careers and the care of children.

Inability to become aroused — For women, the inability to become physically aroused during sexual activity often involves insufficient vaginal lubrication. The inability to become aroused also may be related to anxiety or inadequate stimulation. In addition, researchers are investigating how blood flow disorders affecting the vagina and clitoris may contribute to arousal problems.

Lack of orgasm (anorgasmia) — This is the delay or absence of sexual climax (orgasm). It can be caused by sexual inhibition, inexperience, lack of knowledge and psychological factors such as guilt, anxiety, or a past sexual trauma or abuse. Other factors contributing to anorgasmia include insufficient stimulation, certain medications and chronic diseases.

Painful intercourse — Pain during intercourse (dyspareunia) can be caused by a number of problems, including endometriosis, pelvic mass, ovarian cysts, inflammation of the vagina (vaginitis), poor lubrication, the presence of scar tissue from surgery and a sexually transmitted disease. A condition called vaginismus is a painful, involuntary spasm of the muscles that surround the vaginal entrance. It may occur in women who fear that penetration will be painful and also may stem from a sexual phobia or from a previous traumatic or painful experience.


Providing education — Education about human anatomy, sexual function and the normal changes associated with aging, as well as sexual behaviors and responses, may help a woman overcome her anxieties about sexual function and performance.

Enhancing stimulation — This may include the use of erotic materials (videos or books), masturbation and changes to sexual routines.

Providing distraction techniques — Erotic or non-erotic fantasies; exercises with intercourse; music, videos or television can be used to increase relaxation and eliminate anxiety.

Encouraging non-coital behaviors — Non-coital behaviors (physically stimulating activity that does not include intercourse), such as sensual massage, can be used to promote comfort and increase communication between partners.

Minimizing pain — Using sexual positions that allow the woman to control the depth of penetration may help relieve some pain. The use of vaginal lubricants can help reduce pain caused by friction, and a warm bath before intercourse can help increase relaxation.

Hormonal treatment

  • Estrogen therapy – Localized estrogen therapy comes in the form of a vaginal ring, cream or tablet. This therapy benefits sexual function by improving vaginal tone and elasticity, increasing vaginal blood flow and enhancing lubrication.
  • Androgen therapy – Androgens include testosterone. Testosterone plays a role in healthy sexual function in women as well as men, although women have much lower amounts of testosterone.

Other medicines

  • Non-prescription treatments, which are hormone-free and have few side effects, can help. They include moisturizers applied to the vagina several times a week or lubricants for the vagina, used just before intercourse.
  • Testosterone, when used short-term (a year or two), may increase sex drive in some women. Testosterone products for women are approved in some countries but not in the U.S.  The long-term safety of testosterone for women has not been proven and is being studied.

Devices – A prescription device called the Eros can help with arousal by increasing blood flow to the genital area and enhancing sensation.

Complementary & Alternative Treatment

Vitamin C may help both men and women, as it increases blood flow. One study suggests vitamin C may increase libido in women.

Essential fatty acids, found in evening primrose oil, fish oil, and borage oil, help improve blood flow.

Dehydroepiandrosterone (DHEA), a hormone made by the body’s adrenal glands, has been studied for both men and women. DHEA levels get lower as women grow older.

L-arginine is an amino acid that has numerous functions in the body. It is needed by the body to make nitric oxide, a compound that helps to relax blood vessels and allow blood to flow through arteries.

Ginkgo biloba is a herb used for centuries in traditional Chinese medicine as a folk remedy for respiratory conditions, cognitive impairment, and circulatory disorders.

Yohimbe – The bark of the herb yohimbe (Pausinystalia yohimbe) was historically used as a folk remedy for sexual dysfunction. The active constituent in the bark is called yohimbine.

Damiana (Turnera diffusa) is a herb used traditionally by the Mayan people of Central America to enhance sexual function in men and women. It is reported to be an aphrodisiac, stimulant, mood enhancer, and a tonic.

Tribulus terrestris – Studies of women who use this herb report greater desire, increased arousal, lubrication, more intense orgasms, and satisfaction.

Suma root – Sometimes called Brazilian Ginseng, this herb is extremely popular with the native population in South America for the way it aids female hormonal balance and excites libido. Science has confirmed suma root increases levels of estradiol-17beta, the primary estrogen hormone during a woman’s reproductive years.

Avena sativa – Generations of women stand by oats (Avena sativa) for its aphrodisiac and libido-stimulating qualities.

Acupuncture is the practice of inserting tiny needles into pressure points all over the body. In traditional Chinese theory, the purpose of acupuncture is to rebalance the energy flow of the body. Many women have claimed that acupuncture has helped decrease sexual pain during intercourse.

Meditation is another way in which women can feel more in touch with themselves and their bodies. Practicing controlled breathing and experiencing the ability to “just be” without life stressors or external judgment has shown to have positive results with their sexuality.


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