Nutima Integrative Medicine Blog
As we get older, our steroid hormones (estrogen, progesterone, testosterone, etc.) levels naturally decline. With these declining hormones, we lose muscle mass, have less energy, have decreased exercise capacity and often, develop sexual dysfunction. Many physicians treat these changes by prescribing hormone replacement therapy (HRT), and many patients come knocking on doors, looking for these prescriptions. There is, however, large controversary around this practice and very conflicted data about whether HRT is helpful or harmful to patients (1).
Not what I learned in medical school
During my naturopathic medical training, we discussed hormone replacement therapy. Our teachers shared with us a very famous, very large set of research studies called the Women Health Initiative (WHI). We learned that because of the WHI, we have data that HRT increases several risks for women, including increased risk of strokes, other types of blood clots and breast cancer. Yikes! Not good. We learned that short-term, a small amount of HRT could help tie women over during the absolute hardest years of menopause. But we should use it for the shortest time possible and only for women with very severe menopausal symptoms.
However, once I got out into the “real world”, I started to hear a very different story, both from clinicians and patients. I heard from patients that HRT changed their lives. It gave them their mental clarity back, they actually enjoyed their romantic relationships, hormones “helped her not feel like carrying a shotgun and shooting everyone all the time” (actual quote from a patient!). Many of my patients were not interested in life without their hormones because they felt so terrible otherwise. From clinicians, I learned that in fact, the research is really debatable. There are very large, very high-quality research articles showing some harm and risk. There are also very large, very high-quality research articles showing benefits. The research is very conflicting and to declare any one perspective the absolute truth requires you to ignore a huge amount of research from the other perspective.
This is part three of my exploration into what science’s knows about anti-aging. To read more about the anti-aging benefits of caloric restriction, please click here. To learn more about the best herbal remedies for anti-aging, please click here. To learn more from me in person, please consider joining me for my free talk on anti-aging. Learn more by clicking here.
What Are Mitochondria?
Mitochondria are the tiny batteries of the cells in our bodies. They produce the majority of our energy molecules and are the main cellular site for our “metabolism”. Our mitochondria have a distinct set of DNA that is different from our nuclear DNA. In true science fiction fashion, it is believed that mitochondria originated as a symbiotic bacteria that we adopted into our cells which accelerated our energy production. Weird, huh?
For a long time, scientists believed that mitochondria were mostly just concerned with energy production. One reason people believed this was because organs in our bodies that have a stronger need for energy have significantly more mitochondria (the heart being one great example). However, newer research has started to reveal how mitochondria are critical for communication within the cell and between cells. In particular, mitochondria are essential for signaling many pathways that pertain to aging, such as inflammatory signals, signals telling the cell it is time to die, and signals that tell the cell it is time to stop growing (1-5).
I am continuing to dig into the research literature on the best that we know about anti-aging approaches as I prepare for my anti-aging class on January 22nd. My first blog discussed the science behind caloric restriction. For today’s article, I am looking into the best herbal remedies to help with aging.
First, it should be stated that many companies make grand claims about their products, claims that may or may not be research verified. Before your part with your hard-earned cash, please consider that there is very little regulation about what product companies can claim. Pharmaceuticals must provide proof that their products do what they say. However, skin creams and other anti-aging elixirs are not held to that same standard.
One other prudent point- before dropping hundreds of dollars on fancy topical products, try not to skip the lifestyle things that make a huge impact. Regular exercise, quality sleep, a diet rich in fruits, vegetables and whole grains and stress management may not make headline news. But these things are the bread and butter of graceful aging. Realize that in the absence of these important lifestyle choices, topical products are unlikely to yield terrific results. Your best likelihood of success with come from lifestyle changes combined with the best researched topical products.
In preparation for my upcoming class on anti-aging (Click here to learn more), I have begun sinking my teeth into the best published research on what we actually know about aging. There are many interesting emerging treatments, from supplements to medications to an ever-growing understanding of the genetic and cellular underpinnings of aging. But something that cannot be missed when researching aging is the startling results made possible by caloric restriction (CR).
In 1935, two researchers, McCay and Maynard, discovered that rats fed a calorically restricted, but nutritionally complete diet, had drastically increased life spans. The life spans of the rats fed the restricted diets were increased up to 50%! Since then, similar findings have been found in yeasts, spiders, worms, fish, mice and recently, monkeys (1). Additionally, animals given these CR diets had decreased markers of cardiovascular disease, better glucose regulation, less cancer and less brain atrophy as they aged (2).
Most women experience a decrease in sexual function around the time of menopause. In fact, up to 85% of women over forty experience a decrease in lubrication, up to 59% experience painful sex and up to 77% experience vaginal itching and irritation (1). If sex is painful, dry and irritating, it is unlikely something you will want, even with the best romantic partner.
Some time ago, one of my patients introduced me to “The Powers Method” of hormone transition for transgender patients. “The Powers Method” was created by Michigan based family practitioner Dr. Will Powers. Dr. Powers primarily treats transgender patients in his practice. Over the years, he has been brave enough to change his practice standards when he repeatedly saw better results through different dosing and medication regimens. His treatment of transgender patients looks very different today from the mainstream guidelines produced by the WPATH and UCSF.
Prescribing in a manner different from the WPATH and UCSF guidelines is a scary thought for me! There are only a few areas of my life where I am a pioneer (I went to Burning Man before most anyone else, as an example), but for the most part, I am fairly conservative with change. I am particularly conservative with medical change because I don’t particularly like to experiment on myself and my patients. I prefer the test of time for the best interventions to reveal themselves.
But so much of what Dr. Powers’ says makes sense! Dr. Powers graciously produced terrific free downloadable presentations about his method. He also has a two-hour video lecture going through the presentation as well. His presentation is full of excellent citations and he makes some really great points from the lens of biochemistry and physiology.
How common is erectile dysfunction?
Erectile dysfunction (“ED”) is defined as the recurrent inability to generate or maintain an erection sufficiently rigid for sexual intercourse. Erectile dysfunction is very common. As men age, ED becomes more common; 8% of men between 20 and 30 years old report ED where 37% experience this issue after 75 years of age (1). If you are suffering from this issue, you are not alone.
How do erections work?
Having and maintaining an erection is a biologically complex process, requiring functional cardiovascular, neurological, endocrine (hormonal) and psychological parts of our bodies. First, the male brain is triggered to have an erection through either erotic stimuli & fantasy or through physical sensations, such as stroking and touching. The blood vessels going into the penis (arteries) pump blood into the tissue faster than the veins can remove the blood which compresses the veins further, preventing blood outflow. Testosterone increases desire, which makes it easier to form erections from erotic stimuli & fantasy. Furthermore, testosterone is an important part of the hormonal signaling that allows an erection to form. Finally, male sexual function is also dependent on a healthy psychological system and issues related to communication, intimacy and self-esteem can all impact erectile function.