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Testosterone, Men and Health: lo que necesita saber
You probably know testosterone (T) plays an important role in how boys physically develop into men. But is that all you know? What happens when a man's T levels are off? Are there symptoms men should look for? And what are the treatment options? Dr. Bobby Kahlon, MD, Renown Medical Group provides answers in a Testosterone Q&A. What does testosterone do for men? "Testosterone is known as the 'manly hormone' for a reason," says Dr. Kahlon. "Though women also naturally produce small amounts of it, men produce testosterone at much higher concentration levels. And it affects men in more physical and obvious ways. How much hair a man has on his chest, how deep his voice is, or how muscular he is are all attributable in some way to testosterone. It's also responsible in large part for sex drive and bone strength and affects how men think, learn and experience their surroundings." Testosterone in men: Powers virilization (male physical characteristics) and sexual function Builds muscle mass and strength Supports bone density Improves cognition T Trivia: Discover Magazine reveals that “manly” testosterone and other sex hormones evolved long before we did — 500 million years ago — from the ultimate “female” hormone, estrogen. Can you have too much or too little testosterone? Though high testosterone isn't a concern for most men, low testosterone or low T occurs more frequently and develops for two primary reasons. Dr. Kuhadiya explains, "Subnormal testosterone concentrations occur either due to pituitary or testicular failure and the causes for each need to be discussed with your physician." Pituitary failure: Approximately one-third of men with obesity, type 2 diabetes, or metabolic syndrome (which includes increased blood pressure, high blood sugar, excess body fat around the waist, and abnormal cholesterol or triglyceride levels) have low free — or "bioavailable" — testosterone. These health conditions can cause the pituitary gland to "fail" to release follicle stimulating hormone (FSH) and luteinizing hormone (LH) which are essential for triggering testosterone and sperm production. And that can cause low testosterone (hypogonadism). Testicular failure: Though less common than pituitary failure, testicular failure may also be responsible for low T. It's caused by diseases or illnesses affecting the testicles, injury or trauma to the testicles, or certain medicines and treatments such as chemotherapy or opioid pain medication. Providing your complete medical history to your doctor is always the first step toward a proper diagnosis. What are the symptoms of low T? The following indicators could be a sign that you have low T, say the doctors. Lack of motivation and determination, including mild depression Loss of physical endurance and muscle strength Loss of or diminished early morning erections Reduced libido (sex drive) Erectile dysfunction (ED — difficulty achieving or maintaining an erection) Gynecomastia (male breasts) Small testes T and Time: T levels in men naturally begin to decline by about 1% a year starting at age 30. How do you test for low T? "There are different methods for testing testosterone levels," says Dr. Kuhadiya. "Each approach uses a blood sample to evaluate total testosterone, which includes free and attached testosterone that combines with proteins albumin and sex hormone-binding globulin (SHBG). For the most accurate results, testing is based on samples collected in the morning after fasting, and from tests on two different days." What treatment options are available? "Well, your best natural option may be YOU," says Dr. Kahlon. "Men with pituitary failure are often able to treat their low T by losing weight to increase levels of the hormone. And even if you don't lose weight, exercise can help boost your testosterone. Unfortunately, if you have testicular failure, weight loss and exercise may not have the same effect." So, are there other options? "You may want to consider Testosterone Replacement Therapy (TRT)," says Dr. Kuhadiya. "TRT is only available to men who are hypogonadal — with a clinical diagnosis of low T. Injection, gel, skin patch and nasal spray are available TRT options. The best option is the one that works best for the patient. Convenience, insurance coverage and cost are all factors to consider." Dr. Kahlon's TRT preference? Daily gel treatments, which are applied directly to the skin. On the other hand, Dr. Kuhadiya recommends intramuscular injections, which take place once a week or every two weeks. But both doctors agree on this: physicians and their patients need to weigh the benefits and risks of TRT before proceeding with treatment — especially if your low T condition may require lifelong treatment. "In my clinical practice, I have seen some very good long-term results with an improved quality of life," says Dr. Kuhadiya. "However, in certain situations, TRT may increase the risk of heart disease and is not recommended for men with a history of prostate cancer." Dr. Kahlon adds, "Patients receiving any type of hormone therapy need to be closely monitored throughout the treatment process for any changes in their health." How do you feel about steroids and T boosters? "I don't recommend them, certainly not for hypogonadism," advises Dr. Kahlon. "There is no evidence to support anabolic-androgenic steroids or testosterone boosters as a safe or effective treatment for low T in men." "In fact, there continues to be emerging evidence they may lead to side effects that could potentially harm the liver and the pituitary and endocrine functions of the body," warns Dr. Kuhadiya. "And that damage may be irreversible."
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Manténgase sano: opte por las actividades virtuales durante las fiestas
The community is invited to virtual community gathering from 'The Hello Project' to stay connected and engaged through the holidays. The holidays are sure to look and feel a little different this year amid the COVID-19 pandemic as health officials continue urging community members to stay home as much as possible. While the stay at home guidelines undoubtedly impact people of all ages, they can be particularly difficult for aging adults who may live alone. To help address loneliness and isolation this holiday season, The HELLO Project is making spirits brighter for older adults through a series of festive, virtual gatherings called It Starts with Hello, hosted every Tuesday and Thursday at noon. “The holidays are a special time to gather and experience the many joys of the season with those we love,” said Kindle Craig, Director of Renown Health’s Healthy Aging Institute. “Leading up to this time of year, our HELLO community members shared their concerns in not being able to physically be with their children, grandchildren, siblings, friends and other loved ones this holiday season. Hearing this, a series of virtual events have been created to give all community members festive and fun learning opportunities to participate in, all season long. We invite others to join us.” Events include a holiday cooking demonstration, holiday wreath and bow making; festive dessert preparation; composing and hearing seasonal poetry; competing in an ugly sweater contest; virtual home tours and more. It Starts with Hello is open to all adults and is free of charge. Access the complete event schedule here (Note that event dates are subject to change). “This is an innovative approach to reach our local seniors, and to help combat loneliness and isolation,” said Sharon Zadra, executive director of Truckee Meadows Healthy Communities. “Since launching the first programs of It Starts with Hello back in May, we were overwhelmed by the positive response we’ve received from participants. Now, we’re thrilled to connect with all those in our community looking for some extra holiday cheer.” “Participating in The HELLO Project is a chance to be part of an amazing community of people who enjoy learning, laughing, and celebrating life,” said member Ann Kent. “I look forward to creating special memories with the group as we make new holiday traditions, make new friends and support each other during these times.” It Starts with Hello takes place Tuesdays and Thursdays at noon, and people can attend by calling in or joining on their computers via Zoom. Each show features a timely topic, factual information, a chance to chat with others in the community, and ends with some good news – The Daily Dandelion. Participation is free. For more information, visit HelloStartsNow.org. Click on Blogs & Updates to learn on how to access the Zoom virtual gatherings. Las personas también pueden participar por teléfono llamando al 1-669-900-6833 (pueden aplicarse cargos de llamadas de larga distancia). About Renown Health Renown Health is a locally governed and locally owned, not-for-profit integrated healthcare network serving northern Nevada, Lake Tahoe and northeast California. Renown es uno de los mayores empleadores privados de la región y cuenta con una fuerza laboral de más de 7,000. It comprises three acute care hospitals, a rehabilitation hospital, the area’s most comprehensive medical group and urgent care network, and the region’s largest and only locally owned not-for-profit insurance company, Hometown Health. Renown has a long tradition and commitment to continually improve the care and the health of our community. Visite renown.org para obtener más información. About Truckee Meadows Healthy Communities Truckee Meadows Healthy Communities is a collaborative of thought leaders and influencers who seek to make an impact on the health of their community. The collaborative seeks to build a model where all community members strive toward a culture of health in the Truckee Meadows. This model will include the intersection of the health, education and community development sectors in our region. Truckee Meadows Healthy Communities seeks to create a healthier community through a collective impact project. More info can be found here. About the Washoe County Health District The Washoe County Health District has jurisdiction over all public health matters in Reno, Sparks, and Washoe County through the policy-making Washoe County District Board of Health. The District consists of five divisions: Administrative Health Services, Air Quality Management, Community and Clinical Health Services, Environmental Health Services and Epidemiology & Public Health Preparedness. More info can be found here.
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Takesha Cooper, M.D., Appointed Chair of Psychiatry & Behavioral Sciences
Takesha Cooper, MD, has joined the University of Nevada, Reno School of Medicine and Renown Health as Department Chair of Psychiatry and Behavioral Sciences. Dr. Cooper comes to the area from the University of California, Riverside School of Medicine where she served for seven years as clinical associate and then full professor in the Department of Psychiatry and Neurosciences, and associate training director for Child and Adolescent Psychiatry. Dr. Cooper previously served as associate medical director for the Riverside University Health System and Riverside County Department of Mental Health providing clinical and operational oversight for four regional psychiatric county clinics, and as an adjunct instructor of psychiatry at Stanford University School of Medicine. As a double board-certified child, adolescent, and adult psychiatrist, she also established a successful solo private practice serving patients from diverse backgrounds. At UC Riverside, Dr. Cooper held significant academic and leadership roles including vice chair of education, residency program director, chair of the Admissions Committee and equity advisor. Dr. Cooper will now build on the strong foundation established by Dr. Josh Fitzgerald, interim chair of the department, who will now serve as director of research for the department. Dr. Cooper will be responsible with Steve Shell, vice president of the Stacie Mathewson Behavioral Health & Addiction Institute at Renown Health, for leading the Behavioral Health Program at the Institute where a team of nine psychiatrists, nurse practitioners and licensed professionals and counselors provide intensive outpatient treatment, partial hospitalization programs, Transcranial Magnetic Stimulation, Esketamine, hospital-based assessment and medication-assisted treatment to serve those struggling with mental illness and addiction across northern Nevada, Lake Tahoe and northern California. “We are delighted to have Dr. Cooper join the UNR Med/Renown team,” said Paul J. Hauptman, MD, dean of UNR Med and chief academic officer for Renown Health. “She brings a wealth of experience in multiple clinical settings, and we are confident that she will have a significant impact at a time of great need for mental health services, education, and research in northern Nevada. Dr. Cooper will do much to advance the mission of UNR Med which includes a commitment by the Department of Psychiatry to train the next generation of psychiatrists through a Psychiatry Residency and Child & Adolescent Psychiatry Fellowship training program. Education and training are provided in both urban and rural areas of northern Nevada.” Dr. Cooper earned her Doctor of Medicine Degree from the Keck School of Medicine at the University of Southern California and completed her residency at San Mateo County and fellowship at Stanford University. Prior to medical school, she obtained a Master of Science degree in Biochemistry and Molecular Biology from UC Riverside and her bachelor’s degree in Biochemistry and Molecular Biology from UC Santa Barbara. Dr. Cooper’s research explores the impact of Adverse Childhood Experiences on mental health outcomes in children and adults. She served as a clinical co-PI on a U54 funded grant aimed at reducing health disparities by engaging in community-based participatory research partnerships. “Dr. Cooper is an energetic, collaborative physician, researcher and mentor who cares deeply about improving the mental health and well-being of adults and children,” said Brian Erling, MD, MBA, President and CEO, Renown Health. “This is an exceptionally exciting time to advance health equity and to help improve mental health outcomes for people and communities across northern Nevada. We are excited that Dr. Cooper is joining our team. I know her talent, energy and leadership will further elevate our mission of outstanding care, exceptional training, innovative research, impactful advocacy and innovative community partnerships in mental health and addiction medicine.” Dr. Cooper is recognized for her passion for high-quality patient care and supports future practitioners through rigorous and culturally informed undergraduate and graduate medical education, research, and community collaboration. A 2022 graduate of the Executive Leadership in Academic Medicine (ELAM) program offered through Drexel University, she also maintains active involvement in national and state committees and journal editorial boards. The University of Nevada, Reno School of Medicine (UNR Med), Nevada’s first public medical school, is a community-based, research-intensive medical school with a statewide vision for a healthy Nevada. Desde 1969, UNR Med ha capacitado a más de 3,900 estudiantes, residentes y becarios. UNR Med continues to improve the health and well-being of all Nevadans and their communities through excellence in student education, postgraduate training and clinical care, research with local, national and global impact and a culture of diversity and inclusion. For more information, visit med.unr.edu. Renown Health is the region’s largest, locally governed, not-for-profit integrated healthcare network serving Nevada, Lake Tahoe and northeast California. Con una fuerza laboral diversa de más de 7,000 empleados, Renown ha fomentado una cultura de excelencia, determinación e innovación de larga data. The organization comprises a trauma center, two acute care hospitals, a children’s hospital, a rehabilitation hospital, a medical group and urgent care network, and the locally owned not-for-profit insurance company, Hometown Health. Visite renown.org para obtener más información.
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7 Important Vasectomy Questions for Your Doctor
If you and your partner are looking for a more permanent birth control method, you might consider a vasectomy. Although vasectomies are common, knowledge about them isn’t quite as common or talked about. If you are considering a vasectomy, talking with your primary care doctor is a great way to learn more and start the process. We consulted with Dr. Aurosis Reddy a primary care doctor with Renown Health – South Carson, about key topics to discuss with your doctor when considering a vasectomy. What is a vasectomy? A vasectomy – also called male sterilization – is a form of male birth control that blocks sperm from reaching semen, according to the American Urological Association (AUA). How effective and safe are vasectomies? Vasectomies are one of the most effective methods of birth control with a long-term success rate of over 99%. A vasectomy has been a safe and successful birth control method for many years. More than 500,000 men elect to have vasectomies every year in the U.S., and the number is rising. A vasectomy is also generally a low-risk procedure with a low complication rate ranging between 1-2%. What does the recovery period look like? A vasectomy is typically a quick procedure that takes under thirty minutes and can be performed in an outpatient setting under local anesthesia. Recovery from a vasectomy is also considered relatively easy. After a vasectomy, most can: Resume everyday activities within two to three days Resume normal exercise in one week Start engaging in sexual activity again in one week Your doctor can provide more details on what your individualized recovery process will look like.
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