Showing posts with label Dr. Margaret Ferrante. Show all posts
Showing posts with label Dr. Margaret Ferrante. Show all posts

Monday, October 7, 2013

Archives of the Vagina: A Journey through Time


by Dr. Margaret Aranda

For my Caring Friends, here's a preview of my newest book, written before the doctor dropped me on the floor in March, 2013. I wrote this book (many of you will understand) because I'm not sure if I'll live long enough to see my daughter live through all the stages of womanhood: the maiden, the mother, and the crone.

                                   Book Cover Photo. Archives of the Vagina: A Journey through Time.

The book starts with my first period, and is very tongue-in-cheek humorous, because we all know where we were when we started our first period. Then I go through history, sociology, anatomy, and the endocrinology of the ovaries.

I discuss what Aristotle thought of menstruation and menopause, how William T. Stead is a hero we never hear about for rescuing children out of prostitution in London's brothels. This book is filled with the sociology of menstruation, including whether women on their periods can fly a plane, and whether women who are camping on their periods attract bear attacks that lead to death.

One of the most surprising statistics that I learned in my research and interviews of women is that in the USA, in women over 45 years old, 40% have had a hysterectomy. Of these, nearly 50% have had normal ovaries removed without proper Informed Consent. I dedicate an entire chapter to "Ovarian Conservation" (i.e., keeping your ovaries), and give you all the risk factors you need to know so you can put yourself on the Chart to see if you are at risk for ovarian cancer, and hence should get them removed. So my next book will be Hysterectomy can be Hell. I hope to get an Army behind me on this one, because it will take a Movement to change our culture. And changing a culture always means that people won't like you. Believe me. I've been there before.

I discuss the HPV vaccination for girls aged 11-12, starting your period, how to put in a tampon, and introduce what most women don't know: the menstrual cup, and the nondisposable pad. I promote a certain program that helps girls in Africa obtain menstrual pads so they don't have to miss school, be drop-outs, get pregnant, contract HIV, attain a lower socioeconomic status, and die earlier than the girls that are more educated. So expect a Movement there, too, ladies and girls.

I go through the Women's Health Initiative and basically tear it to shreds, because it had, in my opinion, no application to women in menopause suffering symptoms of vaginal dryness and hot flashes. I let you skip a very medical chapter if you would like, but I also put it in there for medical personnel to evaluate it for themselves. I dissect menopause and give the man's perspective, too, hopefully leading you to more self-discovery and compassionate understanding. Pretty funny stories there, too, my friend.

The last half of the book is dedicated to such things as Invisible Diseases, the Low Glycemic Diet, Immunonutrition and Fish Oil, Telemeres, Living for not only Health & Wellness but also for Quality of Life, Caregiving (and the effects on women, by ethnicity), Long-Term care, and death and dying. I empower you to ask questions, eat Spoon by Spoon, and Don't Fall when you are elderly. I tired of seeing women come into the Operating Room for hip fractures from a fall. You need to know your bone density, and take your Vitamin D or Calcium. The role of an Endocrinologist in your care can not be underestimated. I also believe that Cenegenics has an excellent program for Concierge Medicine, private pay by cash, that is mostly utilized by Presidents and CEOs of companies. They are mostly men. This needs to change, because there are plenty of millionaire women out there. And women need to stop spending all their time nurturing others, and start spending some time nurturing themselves. So I took all this knowledge in my head and told it to you before my traumatic brain injury and DI occurred; and I thank God that I did it.

There. I said it. My opinion rings throughout this book, and it is backed up by over 200 Stanford-quality references that are NIH-funded. I list them all for you, and many of them are dated in 2012 and 2013. Nothing but the best for you, my friends. Nothing but the best. Be prepared to learn, to grow, and to  ROCK your WORLD. You can PRE-ORDER the book (February launch date perhaps) on The Aranda MD ShoppeMy official site is Coming Soon....and I hope you like it. 

God Bless You in all that you do.


Sunday, October 28, 2012

Surgical Menopause and Testosterone for Women

There is a common misconception that only men need testosterone.  The idea that women naturally produce testosterone, that they need testosterone, and that they can take testosterone supplementation to correct a testosterone hormone deficiency needs to be defended.

In women before menopause, about 300 mcg, or 1040 nmol of testosterone are produced each day.  Half of the testosterone production comes from the ovaries.  The other half comes from the adrenal glands.   If you are having a hysterectomy, this is one huge thing to think about before removing the ovaries, too.  Especially if your ovaries are normal.

Some women undergoing a hysterectomy are still being told:




"You don't need your ovaries any way."


Studies show that if you have not gone through natural menopause, and you have a hysterectomy and the ovaries are taken out, too, you could experience a 50% decrease in testosterone production and an 80% decrease in estrogen production.  The ovaries can continue to produce hormones for up to 10 years after the onset of menopause. 

When checking testosterone hormone levels in the blood, it is important to know that there are three possibilities:  
Free Testosterone (pg/ml) 
Bioavailable Testosterone (ng/dl)
Total Testosterone (ng/dl)

Also, an increased sex-hormone binding globulin level leads to a decrease in free testosterone. Related testosterone-pathway hormones that may also be checked include dihydrotestosterone, dehydroepiandrosterone (DHEA), estrone, and estradiol.  So how much of these does a normal pre-menopausal women have in her body?  Here are the normal levels:

DRUG                                                                  NORMAL VALUE*                UNITS
Free Testosterone                                                       1.3 - 6.8                                 pg/ml
Bioavailable Testosterone                                          1.6 - 12.7                               ng/dl
Total Testosterone                                                       14 - 54                                  ng/dl
Sex-hormone binding globulin                                   36 - 185                                 nmol/l
Dihydrotestosterone                                                  4.4 - 20.4                                ng/dl
Dehydroepiandrosterone (DHEA)                             60 - 255                                 mcg/dl
Estrone                                                                       32 - 159                                 pg/ml
Estradiol                                                                     34 - 225                                 pg/ml


There are many variables that go into deciding whether to remove the ovaries at the time of hysterectomy.  If your ovaries are normal, their estrogen, progesterone, and testosterone production may serve to protect you from heart disease, bad moods, insomnia, vaginal dryness, fatigue, losses in bone density, and hot flashes, to name a few.  

If you are at increased risk of ovarian cancer, most doctors would recommend that you do get your ovaries removed.  How do you know if you are at an increased risk?  Family history of ovarian or breast cancer may put you at risk.  If your ovaries have been popping eggs out every month all your life and you have never had a baby or breastfed, this may put you at increased risk but that also depends on your age.  It's more complicated than that, but those are the basics.  If you are at increased risk and you are getting your ovaries out, you may be considered for estrogen and testosterone replacement; many doctors also check the thyroid gland at this time.


Keep your ovaries unless you are at increased risk of ovarian cancer: 
It may be that this is the general word.


Talk to your doctor about what is right for you.
Every woman is different, and you should get a Second Opinion from a different surgeon on the matter of a hysterectomy.


Oh.  And treatment with higher doses of testosterone in women after hysterectomy and oopherectomy have shown marked improvement in both psychological well-being and sexual function.  So don't enter your operation for a hysterectomy wondering whether or not to get your ovaries removed, as the general sentiment today has to do with "ovarian conservation".   

Your ovaries could be your future quality of life.


Medical Disclaimer:  Nothing in this blog is meant to give an individual specific medical advice, treatment,  or recommendation.  Each medical decision must be made between a women and her doctor.  



* = Endocrine Sciences, Calabasas, CA

Full Disclosure:  Dr. Margaret Ferrante is an Institute Physician with Cenegenics Medical Institute, which practices Age Management Medicine components of diet, exercise, hormones, and a balanced lifestyle. She may be contacted at mferrante@cenegenics.com for a Free Consultation.


References:  

Abraham GE.  Ovarian and adrenal contribution to peripheral androgens during the menstrual cycle.  J Clin Endocrinol Metab 1974;39;340-6.

Davis S., et al.  Testosterone enhances estradiol's effects on postmenopausal bone density and sexuality.  Maturitas 1996;21:227-36.

Shefrin, J.L., et al.  Transdermal testosterone treatment in women with impaired sexual function after oophorectomy.  N Engl J Med; Sept 7, 2000;  Vol. 343 (10); 682-8.

Shefrin, J.L., et al.  Incidence of sexual dysfunction in surgically menopausal women.  Menopause 1988;5:189-90.