The laser treatment is safe, easy and requires no special after care. This allows you to achieve the results you want without changes in your daily routine.

Microdermabrasion
Microdermabrasion is one of the most popular treatments in the country today. This treatment (also known as "MD Peel") rejuvenates the skin by softening the surface, lightening sun damaged areas, and improving tone and texture. Facial wrinkles are minimized, also. As with Vasculight, there is no "down time," and the treatments are easy, painless, safe, and affordable.

Sun-hardy coffee plants also require more pesticides than shade grown, which further jeopardizes the songbirds by not only poisoning the birds directly, but by eliminating insect-eater's food source. Many pesticides used in Central and South America have been outlawed in the US for years.

Please consider buying your coffee from a Fair Trade coffee retailer who offers organic and shade-grown beans. Thanksgiving Coffee, The Organic Coffee Company, Equal Exchange, Santa Cruz Coffee Roasting Company, and Café Campesino are just some of the many companies who have taken this ethical stand. For more information, contact www.transfairusa.org.

First, let me point out that there were two arms of the WHI study, and both arms were compared to controls (no hormones). The arm of the study that was halted consisted of women with a uterus taking Prempro (estrogen and progesterone). The other group were post-hysterectomy patients who received Premarin without progesterone. The Premarin arm of the study is still going, and there has been no significant increase in breast cancer incidence over that of the control group (no hormones). So if you have had a hysterectomy and you are taking estrogen alone, nothing has changed. We know, and have known for years, that estrogen increases the risk of blood clots, so if you have a strong family history of early strokes or heart attacks, or if you have known heart disease, you probably shouldn't be on estrogen.

What we don't know is whether the increased incidence of breast cancer was due to any estrogen/progesterone combination or due specifically to Prempro. It could be that switching to another combination of estrogen/progesterone would be less risky. Prempro is a combination of estrogen derived from pregnant mare's urine and synthetic progesterone. The estrogen component of most of our other prescription estrogen pills and patches is derived from soybeans, and natural micronized estrogen is available in pill or gel form from formulation pharmacies. The only natural prescription progesterone available is Prometrium, which is derived from yams. Formulation pharmacies also make natural micronized progesterone pills and cream or gel.

Estrogen has been proven to prevent bone loss and colon cancer. It reduces hot flashes, night sweats and insomnia. Every brain cell has estrogen receptors, and estrogen raises serotonin levels, which improves mood and energy level. A recent report reveals that estrogen therapy, if begun at menopause, cuts the risk of Alzheimer's disease in half.

Progesterone, on the other hand, has none of these properties. In fact, it may increase the risk of breast cancer and in high doses, causes fatigue, sleepiness and depression. The progesterone added to estrogen in women with a uterus is to prevent uterine cancer. If a woman with a uterus takes "unopposed" estrogen (estrogen without progesterone) for a long period of time she will often develop uterine hyperplasia, which can be a pre-cancerous condition.

Last week, another announcement by the Women's Health Initiative even challenged the idea that estrogen improves sleep, memory and sexual function. Unfortunately, the study is marred by the fact that, as study participants were being chosen, women who were having symptoms of menopause were excluded from the study. In other words, only women who were not suffering with symptoms were studied because these are the women who could tolerate placebo. Personally, I think this flaw is deadly, and renders their conclusions questionable.

So should you take hormone replacement therapy? This question is currently impossible to answer. Each woman needs to weigh the issues for herself. If you have a strong family history of breast cancer you may want to avoid an estrogen/progesterone combination. It is unclear whether estrogen itself increases the risk of breast cancer. If you have a personal history of breast cancer, your oncologist will most likely recommend against hormone therapy, but at least one study exists that suggests that women who take estrogen after being treated for breast cancer have a lower risk of recurrence. If you have heart disease or a strong family history of early strokes or heart attacks, estrogen is not for you. There are, however, blood tests to determine whether you carry a gene that would cause you to form blood clots more easily than most.

An important factor to consider is whether you feel poorly without estrogen. Some menopausal women feel fine and some feel terrible. There are women who are so miserable without estrogen that the risks of taking it pale in the face of constant hot flashes, night sweats, insomnia, and crying jags. There are others who breeze through menopause and have few, if any, symptoms. It is true that fat cells will convert adrenal hormones to estrogen, so larger women maintain a natural level of estrogen that thin women do not have. Consequently, thin women tend to have more symptoms.

If you are menopausal or peri-menopausal and feel fine, do not have a family history of Alzheimer's disease and have no significant bone loss, our recommendation would be to stay off hormones. If you are one of those women who feels terrible without your estrogen, you have a family history of Alzheimer's disease or you have osteoporosis, you may want to take the risk.

Many studies are currently in progress and will be published over the next few years. We will keep you informed as more information becomes available.

We plan on evaluating 1,000 patients and performing surgery on 200. Preparation for this endeavor, since we must bring all of our own supplies, is intense and demanding, but we are making excellent progress. We all feel privileged to be able to offer our help to people who need it so desperately.

The process of vaginal birth, although a miracle, can have devastating effects on the pelvic support of the mother. Particularly after a lengthy, difficult labor or delivery of a large baby, hernias can occur between the bladder and the vagina, the rectum and the vagina, and in the pelvic floor. This results in prolapse of the uterus and bulging of the anterior and posterior vaginal wall. Symptoms vary in severity, but can include bulging of the cervix out of the vagina and/or bulging of the anterior or posterior vagina. Some women feel "pressure" and heaviness in the pelvic area. Some women simply feel something coming out, especially when they are on their feet for long periods of time. This general process can also result in stress incontinence, or losing urine with coughing or sneezing.

The technical terms for these processes include uterine procedentia, cystocele or cystourethrocele, and rectocele. All of these terms refer to hernias in the fascia, or strong tissue that is meant to hold organs in and support tissue. The hernias are originally associated with childbirth, but time and gravity worsen the defect. Symptoms may not appear for years after childbirth.

Women who have had a hysterectomy can also develop prolapse, and this is called vaginal vault prolapse. This usually occurs years after a vaginal or abdominal hysterectomy. The vagina can actually evert, almost like a sock turning inside out. This is usually accompanied by a cystocele or rectocele or both.

The vaginal vault can be re-suspended laparoscopically using permanent suture to suspend the apex of the vagina to the strong uterosacral ligaments. If the patient has not had a hysterectomy, this would be done immediately prior to the suspension. The cystocele and/or rectocele can be corrected vaginally. If the cystocele or rectocele are severe, mesh can be incorporated into the repair for additional strength. If stress incontinence is also an issue, a urologist should be involved in the surgical procedure. Urologists are having excellent results with simple vaginal urethral sling procedures, which correct most inadvertent urine loss (stress incontinence).

Prolapse is a problem that many women suffer with, but it is seldom spoken about. If you have symptoms of prolapse, talk to your practitioner. The symptoms of prolapse can be physically limiting and painful. Now that we have minimally invasive procedures to correct the problem, recovery can be expected to be swift and the results excellent.