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Hormone Therapy

Hormone therapy (HT) uses one or more female hormones, commonly estrogen and progestin and sometimes testosterone, to treat symptoms of menopause.

Symptoms of menopause include hot flashes, vaginal dryness, mood swings, sleep disorders, and decreased sexual desire. Hormone therapy comes as a pill, patch, injection, vaginal cream, tablet, or ring.
Information

Hormone therapy may help relieve some of the bothersome symptoms of menopause, such as hot flashes, vaginal dryness and pain with intercourse. The hormone estrogen protects against thinning of the bones ( osteoporosis).

However, taking hormones may also increase your risk for:

Blood clots
Breast cancer
Heart disease
Stroke

You and your doctor should decide whether hormone therapy is right for you. The key is to weigh the risks of taking hormone therapy against the benefits that you might have from taking these hormones. Every woman is different. Your doctor should be aware of your entire medical history before prescribing hormone therapy.

At this time, short-term use (up to 5 years) of hormone therapy at the lowest possible dose to treat the symptoms of menopause still appears to be safe for many women.

BENEFITS OF HORMONE THERAPY

Perhaps the largest benefit women receive from hormone therapy is relief from:

Hot flashes
Night sweats
Sleep difficulties
Vaginal dryness
Anxiety

Usually, hot flashes and night sweats are less severe after a couple of years, especially if hormone therapy is slowly reduced.

 

Direct Primary Care

Direct primary care is primary care offered direct to the consumer, without insurance intervention. It incorporates various health care delivery systems that involve direct financial relationships between patients and health care providers. One niche variant of direct primary care is concierge medicine. Direct primary care can remove many of the financial barriers to accessing care when needed. Often, there are no insurance co-pays, deductibles or co-insurance fees thus avoiding the overhead and complexity of maintaining relationships with insurers. Under this model, patients may pay a combination of visit fees and/or fixed monthly fees, which grant them access to a set of medical services, including same and next-day appointments, both in the form of house calls and office visits. A direct primary care arrangement benefits from pairing with either: a high-deductible health plan, as direct primary care alone will not cover catastrophic health care such as most surgeries, a health savings account, or health reimbursement account as the associated tax-benefits can generally be applied to direct primary care and other medical expenses. Direct primary care practices do not typically accept insurance payments, thus avoiding the overhead and complexity of maintaining relationships with insurers, which can consume as much as $0.40 of each medical dollar spent. Direct primary care payments are over time, rather than in return for specific services, the economic incentives are such that the long-term health of the patient is the most lucrative situation for the doctor. Preventative care gains greater emphasis under direct primary care. Because the primary care physician compensation is better than it would be under insurance billing, doctors can afford to spend more time with the patient, rather than simply referring them to a highly paid specialist after a short consultation. Boutique medicine is a type of medical practice now found in many metropolitan areas across the country. Also known as, concierge health care, concierge medicine, or retainer medicine, the concept has come to represent a higher level of healthcare for those who want a more personalized relationship with their physician. This model has proven successful for those physicians who want to see a fewer number of patients on a day to day basis, thus allowing them to spend more time nourishing individual patient relationships.

Heterosexuality

Heterosexuality is romantic and/or sexual attraction or behavior between members of the opposite sex or gender. As a sexual orientation, heterosexuality refers to an enduring pattern of or disposition to experience sexual, affection, physical or romantic attractions to persons of the opposite sex; it also refers to an individual’s sense of personal and social identity based on those attractions, behaviors expressing them, and membership in a community of others who share them. The term is usually applied to human beings, but it is also observed in all mammals. The demographics of sexual orientation are difficult to establish due to a lack of reliable data. However, the history of human sexuality shows that attitudes and behavior have varied across cultures.

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Auditions

The process of auditioning for a role in a performance, as in a demonstration of acting, dancing, singing ability. Auditions are used in the casting process to demonstrate the level and range of a performer's talent, and functions as a job interview for the performing arts. For actors, the audition piece is typically not from the show being considered. Some auditions involve cold reading, or performing a script that the actor is not familiar with. Likewise, musicians may be asked to sight-read music at various levels of difficulty. This is similar to many dance auditions, rather than showcasing prepared work. To learn more information about the audition process, go to auditions. An audition is a sample performance by an actor, singer, musician, dancer or other performing artist.

For actors, the audition piece is typically not from the show being considered; an actor wishing to be cast in Hamlet would not likely do a monologue from that play. However, most performers do have a range of audition pieces and select something appropriate; an actor auditioning for Hamlet would have a dramatic Shakespearean monologue ready, and not perform a monologue from an Oscar Wilde comedy, or a contemporary playwright, such as Tom Stoppard. The audition process is a big part of any actor's life - it should be taken seriously. To learn more about auditions go to auditions.

Erectile Dysfunction Pathophysiology

Penile erection is managed by two different mechanisms. The first one is the reflex erection, which is achieved by directly touching the penile shaft. The second is the psychogenic erection, which is achieved by erotic or emotional stimuli. The former uses the peripheral nerves and the lower parts of the spinal cord, whereas the latter uses the limbic system of the brain. In both conditions, an intact neural system is required for a successful and complete erection. Stimulation of penile shaft by the nervous system leads to the secretion of nitric oxide (NO), which causes the relaxation of smooth muscles of corpora cavernosa (the main erectile tissue of penis), and subsequently penile erection. Additionally, adequate levels of testosterone (produced by the testes) and an intact pituitary gland are required for the development of a healthy erectile system. As can be understood from the mechanisms of a normal erection, impotence may develop due to hormonal deficiency, disorders of the neural system, lack of adequate penile blood supply or psychological problems. Restriction of blood flow can arise from impaired endothelial function due to the usual causes associated with coronary artery disease, but can also be caused by prolonged exposure to bright light.