To keep or not to keep the ovaries.
~ Rachel Spieldoch, MD

However, recent observational studies suggest that removal of both ovaries is associated with an increased risk for coronary artery disease (CAD), lung cancer, as well as a significantly increased risk for osteoporosis and hip fracture. Additionally, performing a bilateral oophorectomy in the premenopausal woman appears to have an even higher risk for coronary artery disease, fracture, as well as mental impairment. In the premenopausal woman, there may be an increased risk for parkinsonism, dementia, anxiety and depression.

Of additional interest, the actual rate of reoperation for adnexal pathology when the ovaries remain at the time of a hysterectomy is only 2.8%. This is very low! A concern for every woman with ovaries is the risk for ovarian cancer. Unfortunately, we do not have reliable screening for the detection of early-stage ovarian cancer in the general population. Furthermore, when women are diagnosed with ovarian cancer, the disease is often advanced and with a low long-term survival rate. This is because women are often asymptomatic until the ovarian tumors have progressed. However, only 1.4% of the general female population has a lifetime risk of ovarian cancer. This risk drops significantly to 0.3% for Caucasian women who have carried term pregnancies and who have been on the oral contraceptive pill for at least 4 years. Studies suggest that less the 1% of women who retain their ovaries at the time of hysterectomy develop ovarian cancer.

Many more women in the United States are afflicted each year with heart disease, life threatening hip fractures, and dementia than with ovarian cancer. Based on this reasoning, it is felt by many providers that the benefits of keeping the ovaries at the time of a hysterectomy outweigh the risks. Even after menopause, the ovaries continue to produce testosterone and other androgens which are converted to a form of estrogen. Both estrogens and androgens stimulate new bone formation.

While removing the ovaries at the time of a hysterectomy may be the most appropriate treatment, it is important to discuss these options with your physician prior to surgery. Additionally, the current studies did not include women who received hormone replacement therapy following a hysterectomy and removal of both ovaries. Clearly, there is still a lot to learn.

Come join us June 19th at Lifetime Fitness for a special event!

"What you need to know about menopause and hormone therapy: the nuts and bolts" presented by Rachel Spieldoch, MD.

LOCATION

Lifetime Fitness - Scottsdale
6850 East Chauncy Lane
Scottsdale, AZ 85054

WHEN

Saturday, June 19
1:00 pm to 2:00 pm

Please contact Dr. Wilson's office at 480-860-4791 to RSVP — ask to speak with Sandy L. Guests will receive a free 24-hour pass to Lifetime Fitness!

Hormone pellets for men!

Due to popular demand, Robin Parry, Family Nurse Practitioner, will be offering testosterone pellets for men on Thursday evenings starting June 11th. Robin has completed Preceptorship Training in the field of sexual medicine at San Diego Sexual Medicine under Dr. Irwin Goldstein. 

If you are interested, please schedule a consultation with Robin. Consultations will be scheduled on Thursday late afternoon/evening. Robin will discuss the pros and cons of testosterone therapy, the laboratory testing necessary before testosterone therapy can be instituted, cost, risks, and protocol. Partners are welcome to attend. 

Do you fall asleep right after dinner? Has your "get up and go" got up and left? Have you lost your interest in sex? Are your erections not as firm as they used to be? These and the following other symptoms are sometimes indicative of low testosterone levels. Testosterone levels start to decline in most men by the time they are 40 and in some men this decline begins earlier. These problems, however, are potentially reversible with testosterone therapy. Restoring your testosterone level just may help you feel young again!

Symptoms of testosterone deficiency include:

• Reduced sexual desire
• Decreased spontaneous erections
• Loss of body and axillary hair
• Small or shrinking testes
• Height loss, bone loss
• Reduced muscle bulk and strength
• Hot flushes and night sweats
• Decreased energy, motivation, initiative, and self-confidence
• Feeling sad or blue
• Poor concentration and memory
• Sleep disturbance
• Increased sleepiness
• Mild anemia
• Increased body fat
• Diminished physical or work performance

Make your appointment for an evaluation with Robin Parry now. Call 480-860-4791.

Hormone replacement options — why are non-oral options better?

We read conflicting reports weekly about the safety of postmenopausal hormone replacement therapy. One of the known risks of hormone therapy is blood clots or venous thromboembolism (VTE) – pulmonary embolism being the most dangerous. Oral hormones raise the risk of VTE but non-orally administered hormones do not.

Non-orally administered hormones include pellets, patches, creams, and vaginal preparations. No significant association was found between progesterone users (Prometrium, progesterone cream) users and VTE.

Given this research, we recommend non-oral methods of estrogen replacement over oral methods. If you are taking oral hormones and doing well, you do not necessarily need to switch, but it is something to consider.

Visit us on-line at www.skintiquemd.com or call 480.860.9383 for a free consultation!

The importance of summer skin care

Everyone loves spring and summertime with its blue skies and perfect picnic weather. However, those warm days can also bring a new host of skincare issues you need to know how to deal with, from UVA rays to pool chlorine. It’s important that you are ready and prepared to keep your skin healthy and protected from the elements of the summer.

1. Sunscreen
Sunscreen should always be part of your daily skin care routine, no matter the season. A minimum of SPF 30 should be used on the face, neck and chest.

2. Exfoliate
Dead skin can make skin look dull and old. Scrubbing off those dead skin cells is one of the best ways to revitalize your skin during this transition. Facial cleanser with a clarifying bead scrub, remove with warm water and washcloth is a great start, and extra steps like microdermabrasion or chemical peels can be an added benefit.

3. Change your moisturizer
Your normal, run of the mill moisturizer isn't going to maintain its effectiveness.You will need to upgrade to a more rich formula to heal the sun damage and protect your skin from upcoming dry weather. Finding a rich moisturizer that has all natural ingredients is the best recommendation.

4. Healthy inside means healthy outside
In taking the daily recommended doses of water (8 glasses or more) will help to keep your skin healthy. Your best defense against skin damage is to keep healthy habits. Eating right, exercise and drinking lots of water are great ways to keep skin revitalized year round.

5. Fashion tips to good skin
Hats protect your face from harmful UV rays during the summer and harsh winds during the winter. Pick out some fashionable hats this season and you will find the added benefits of healthy skin under the brim. These can be fun additives to your favorite outfit in addition to the skin benefits.

June’s featured treatment —
Muscle Toning & Lift Facial System
Muscle tone is one of the most important aspects of youthful, firmed skin tissue. This is a great skin fitness program in just 30 days skin will appear years younger. The program is 3 treatments one a week and after only one a month. Start up package includes all 3 treatments for only $250.

Current specials

• Corrective facials – $85
• Dermaplane – $80
• IPL hands – $40
• Skin tightening eyes or smile lines – $75
• Laser hair removal for under arms – $65
• IPL on face, neck and chest – $300 (you save $75 a treatment)

I look forward to hearing from you! Please call today for a free consultation 480-890-9383.

Are birth control pills dangerous in the long run?
~ Dr. Deborah Wilson

It appears that the answer is no, and they might even cause you to live a little longer statistically!

A study done in England looked at 23,000 women — some users of "the pill" and some non users. Ever users of oral contraceptive agents had 12% lower all-cause mortality, 15% lower all-cancer mortality, 14% lower all-circulatory disease mortality, and 25% lower ischemic heart disease mortality.

Interestingly, however, ever users were 50% more likely to suffer violent deaths than were never users.

It is thought that perhaps the decrease in mortality associated with the use of birth control pills is related to the protection against ovarian and uterine cancer.

Pelvic ultrasound and Ca-125 levels to screen for ovarian cancer.
~ Dr. Deborah Wilson

It's our strong belief in this office that regular pelvic ultrasounds as a screen for ovarian cancer is just as valuable as regular mammograms. A recent study published in the Journal of Ultrasound Medicine supports this notion. Their results provide strong support for regular pelvic ultrasounds as an effective screening tool, particularly when combined with Ca-125, a blood test that can detect ovarian cancer.

Ovarian cancer is a deadly disease. By the time it is detected, it is usually at an advanced stage. The peak age for ovarian cancer is 63, but the age range is wide.

The pelvic ultrasound is a painless, harmless test that allows us to accurately evaluate the ovaries in most instances. Certainly, breast cancer is a far more common cancer than ovarian cancer, but ovarian cancer is generally more deadly. So the real question is — Why not?

Insurance generally covers a pelvic ultrasound, and it can save your life by detecting an ovarian cancer in the early stages.

Feel free to discuss the need for a pelvic ultrasound with your practitioner at your next visit. And if you have any of the symptoms of ovarian cancer (bloating, fullness, pressure, pain in the pelvic area), please come in for an evaluation.

Join us — Saturday June 5th — for a huge garage sale to benefit Circle L Ranch and Lucky Paws shelter. Please donate items and come to the garage sale.

• 5309 East Flower Street, Phoenix

We need your stuff!! Download a flyer (.pdf).

Lucky Paws Shelter offers rescue dogs and cats for foster or adoption. These animals have been taken off of the euthanasia list at the county shelters. All dogs and cats are from Circle L Ranch Rescue.

Check out our adoptable animals at www.luckypawsshelter.org. Adoption open house is every Saturday from 11 am to 2 pm. For information or to schedule an appointment for another day, call 602-955-1414. We are located at 5130 East Thomas Road, Phoenix, AZ 85018.