Vol. 176 September 1, 2017 Sexual Anatomy, Gender Identity, and Orientation

September 1, 2017

“Sexual orientation means ‘who you go to bed with’.
Gender identification means ‘who you go to bed as’.”

 -Norman Spack, MD, Pediatric Endocrinologist,
Chief of Gender Management Service, Childrens Medical Center, Boston

Discussion about transgender people is back on the front page since President Trump tweeted his wish, and then ordered the Defense Department, to ban the enlisting of transgender persons and to ban transgender soldiers from continuing to serve in our armed forces. The ACLU notes that there are currently about 8000 transgender U.S. soldiers.

The appearance of your genitals at birth, if anatomically correct, tells everyone in the delivery room what you are; “sexual anatomy”. “It’s a boy, or it’s a girl” are the first three words an infant “hears”. In the first decade of life we begin to think of ourself as a boy or as a girl; “gender identification”. In our second decade, as we approach and go through puberty, we begin to realize that we are attracted to boys or girls, or both; “sexual orientation“. These three terms are often confused and intermixed in our discussion. which can make rational, unemotional consideration of new policy, laws, and societal changes very difficult.

When do children begin to identify themselves as a boy or a girl? (1)
Studies show that it can be as early as third grade. (7-9 yo.) By then, most children associate themselves with one or the other sexes and understand that it is permanent; “girls grow up to be women and boys grow up to be men.”

What about “cross-gender” play which is very common at young ages?
By age 2 years all children know sex stereotypes (“women are associated with lipstick”,”boys don’t wear pink tutus”) ). It is remarkable that transgender children understand and accept the same stereotypes as their peers. Studies show that “cross-gender” play (“boys wearing dresses”, “girls excelling as tom-boys”) is very common in pre-school children, is normal, and is temporary in most children. 

Where are all these transgender children?
Everywhere. Since 2007 when Childrens Hospital started its Gender Management Service as part of their Sexual Disorders and Dysfunctions Clinic, they have treated about 200 transgender children, 95% of whom came from within 150 miles of Boston.

What causes transgender identification, nature or nurture?
Both probably. No one really knows. One twin study revealed that of 23
identical same-sex twin pairs, one twin in 9 of the pairs was identified as transgender. No twin in the 21 fraternal same-sex twin pairs were transgender. The suspected genetic basis of this is completely unknown. In 1895 an article in Scientific American expressed concern that riding bicycles threatened women’s health. In 1948 only 32% of adults believed women should wear slacks in public. (1)

What is the “treatment”? (2)
The Dutch taught us that the best time to change a person’s gender is before the onset of puberty (10-12 yo. in girls and 12-14 yo. in boys).

Dr. Spack and others thought that was a pretty young age for the patients (and their families) to make such a life-changing and permanent decision. Therefore, the U.S. standard of care is to delay puberty to buy some time.

At age 12 years after extensive psychometric testing of gender identification by a multi-specialty team, treatment with appropriate sex hormones that block progression of puberty of the “birth gender” is started. This puberty “blockage” is reversible and is continued for years.

At age 16 after the repeat of extensive psychometric testing of gender identification, the decision to move on to irreversible body-changing sex hormone treatment is considered. . If the decision is to NOT GO on with the change, that hormonal treatment is stopped and normal puberty appropriate to the “birth gender” occurs. If the decision is to proceed with a change, treatment with different sex hormones appropriate to the “affirmed gender” is started. The goal is to achieve the physical appearance of the “affirmed gender”. This treatment is usually very successful (“girls develop normal sized breast and have normal heights”).

After age 18 years and years of hormonal therapy, surgical reconstruction of genitalia can be considered. (Male-to-female surgery is much easier and can be successful enough to “fool a gynecologist”.)

Are there any barriers to treatment?
Yes. Very expensive (about $1000 a month for several years of hormonal treatment), misunderstanding about the reversibility of early treatment, and continued classification in the DSM-V (Diagnostic and Statistical Manual of Mental Disorders) of “Gender Identification Disorder” as one of a dozen “Sexual Disorders and Dysfunctions” (which exempts the treatment from most insurance plans). Note: Homosexuality was removed in 1973 from the DSM-III as a mental health disorder as it is NOT amenable to psychiatric therapy. Neither is transgender identity. There is no evidence that people can be talked out of, or therapized away from, their transgender identity.

What if the transgender child is not treated?
In the scheme of things the number of transgender children is limited. But, of the 100 patients seen by the Gender Management Service by 2012, 20% had performed self-mutilation and 10% had attempted suicide. Other studies have documented a much higher-than-average suicide rate in persons with gender identity issues.

So, gender identity can trump anatomy,
and sexual orientation can be completely unrelated to either.

This can get a bit confusing, but have no fear, it may even get harder to keep track of the players without a scorecard.
N
ew research is focussing on “nonbinary” children. These children  see themselves as in the middle of the spectrum and neither male nor female.

Refrences:
1. Scientific American, “Everybody has a stake in the new science of sex and gender”, September 2017
2. TED talk, Norman Spack, MD

 

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Vol. 170 May 1, 2017 Spring Fever: “Up” or “Down”

May 1, 2017

“In the spring a young man’s fancy lightly turns to thoughts of love” … or chronobiology.
– apologies to Lord Alford Tennyson.

 

Spring Fever has at least two meanings; an increase in energy and a brightening of mood when “your thoughts turn to love” OR  lassitude, fatigue, and even depression which slows you down and saps your energy. Neither actually raises your temperature, but it is called “fever” none the less, and there is no medical diagnostic code for it either. Since there are two diametrically opposed definitions of spring fever, it is not surprising that there are two different explanations of its cause.

Both theories relate it to the effect of increased daylight on our pineal body deep in the hypothalamus of our brain. The pineal body is sometimes called “the third eye” and is an element of the 6th Charka. In lower species the pineal structure is actually light-sensitive and is, in fact, a real third eye. In humans  the pineal body is an endocrine gland associated with melanin production and a regulator of our circadian rhythm.  (Boy, that is an eyeful of sentences for someone who is not a biology major. Sorry)

Multiple poets herald the positive side of spring fever as we emerge from the winter greyness and short days into the spring sunshine and blooming flowers. The negative viewpoint of spring fever, sometimes called “spring depression”, relate the feelings of lassitude to seasonal allergies, “reverse seasonal affect disorder” and point to the springtime peak in suicide rates as support for their view.

Both theories use what we do know about springtime hormonal shifts to explain their drastically different conclusions. Both consider the changes as caused by increased daylight. According to the “negative” theorists the reservoir of serotonin, the “happy hormone”,  becomes “exhausted” in the long nights and short days of winter and melatonin, the “sleep hormone”, dominates. In the spring, increasing daylight increases the production of endorphins, testosterone, and estrogen and melatonin decreases. “The changeover puts a heavy strain on the body resulting in a feeling of tiredness”.  According to the “positive” theorists those same changes in “sex hormones” cause the increased energy and interests of the poet’s spring fever. Much of what is written about spring fever in Wikipedia is done “without citation” which means it is opinion rather than fact. We actually don’t know enough to label one or the other theories as “alternative fact”.

All agree that spring fever does have something to do with the increased amount of daylight. So, the timing of spring fever varies with your distance from the equator. The further North you are the later the onset. According to one reporter in Germany up to 50-75% of people suffer from Fruhjarsmudigkeit , “Spring fatigue“, from mid-March to mid-April. Germany seems to be the center of study of this phenomenon described as “mild jet lag”, another state of temporary fatigue related to disturbance of circadian rhythms. Of course in Australia, spring fever occurs from the start of September to the end of November.

Fox News suggests that spring fever is the result of 3 factors: 1) increased daylight, 2) more exercise as we spend more time outdoors, and 3) the “reappearance of the female form” as winter clothes are shed.

“With days getting longer, weather getting warmer and women getting, well, ‘nakeder’,
it’s no surprise that spring impacts male mood and excitement. Whether the so-called spring fever
is a real biological phenomenon or not, it is clear that in the end,
it all essentially boils down to hormones.”
– published March 13, 2011, Fox News “We Report, You Decide”


Vol. 135 November 1, 2015 “He, She, or It?”

November 2, 2015

Hub thumbnail 2015

People tend to confuse sexuality and identity, and often want to conflate these things, but being transgender has nothing to do with sexuality.

— Norman Spack, Director Emeritus and Founder of the GeMS Program, Boston Children’s Hospital

Last week one of our five-man book-and-lunch club started our monthly gathering with, “Before we start can you tell me if an infant with unclear genitalia is called transgender?” It quickly became clear during the ensuing conversation that most of us not only knew someone with gender identity issues, but also that we (all over 60 y.o) had blurry, often overlapping, and quite different understandings of gender definitions and terms.  I suspected that we might not be the only ones confused, and thought that researching a blog on the subject might be clarifying for me and others.

What’s the difference between“transsexual”  and “transgender”?
“Transsexual” was coined by a German surgeon in the 1930’s for people (usually males) who wished to have sexual reassignment surgery (SRS) and change from male to female (M2F, MTF). “Transgender” was coined in the 1960’s, was much more about who the person thought they should be rather than about sexual orientation, and was not usually associated with the desire for SRS. In 1979 Christine Jorgensen rejected “transsexual” and insisted on “transgender” (even though he/she underwent SRS). Transgender seems to be the most PC term today, and transsexual, still implying an interest in SRS, is considered to be a subset of transgender. There is a World Professional Association for Transgender Health  as well as a blue/pink/white striped Transgender Pride flag that “will always be correct, no matter which way you fly it.”Screen Shot 2015-11-01 at 5.17.07 PM

A over-simplified, and not always correct, way to remember the differences is:
“Transsexual usually implies sexual orientation, ‘who you go to bed WITH’.
Transgender usually implies gender orientation, “who you go to bed AS?’ ” (1)

An excellent illustration of the complex interplay of these two terms is the Amazon Prime video “Transparent” for which Jeff Tambour won a 2015 Emmy for Lead Actor (a term, by the way, that is now often used for both male and female). In the series of 12 episodes we met several transgender characters, some of whom appeared to have had SRS and hormone therapy and some who have not.

What’s the difference between cross-dressers, drag queens, and transvestites?
Transvestites  are people who like to dress and act like those of the opposite sex. In the 1970‘s “cross dressers” was coined by such people who disliked the implications of fetishism or homosexuality in being called “transvestite”. Cross dressers can be private and have any kind of sexual orientation (J. Edgar Hoover?). Drag queens are theatrical cross dressers who are mostly male homosexuals with great pride in their flamboyant entertainment value.

Is a hermaphrodite the same as an infant with ambiguous genitalia?
Rarely an infant may be born with genitalia that appears to be neither clearly male or female (now called “intersex”). It is important for physicians and family to quickly forge ahead in checking chromosomes, internal anatomy, external physical appearance, parental wishes, and other factors to decide quickly which sex the child shall be raised as. Surgically, it is much easier to create a functional female than a male, but many factors are involved. Even rarer is the hermaphrodite who is born with both male and female genitalia. Unlike lesser species, these human hermaphrodites can not self-impregnate, but can apparently have a future career in adult porn.

In recent years our recognition of and services for gender identity confusion in children has increased. In 2007 Boston Childrens Hospital started a Disorders of Sexual Development and Gender Management Service (GeMS). Since then that multi-disciplinary team of 12 professionals have evaluated and treated over 160 pre-pubertal teen agers for gender identity confusion; 75% of whom lived within 150 miles of Boston. (1)  GeMS considers gender identity confusion as potentially life-threatening because of the higher than expected suicide rate among those adolescents not treated. Evaluations are initiated in “gender non-conforming” children  as soon as 10 or 11 years of age. Puberty is delayed by hormonal therapy, and later the child’s gender appearance can be changed to match the child’s mental gender identity through hormones and surgery.

Even a cursory review of these terms, what they used to mean and what they mean today, suggests many PC/sensitivity potholes dotting the road of their practical use. One Boston suburb middle school teacher started the first day of school this fall with a request to her class to indicate “by which pronoun each wished to be called”.  In addition to the grammatically traditional gender neutral terms like “it”, “one”, and “they”, invented gender neutral pronouns exist and include “zhe” and “zher” and “zhem”. (2000). The medical term “gender identity disorder”, disliked by many because it implies a disease condition, is being replaced with “gender dysphoria”.

References: 1. Norman Spack, MD TED talk


Vol. 131 September 1, 2015 Current, Recurrent Controversies

September 1, 2015

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“Anachron’s Law:
There is no myth which is so irrational that no one will believe it.
Anachron’s Corollary:
There is no truth which is so obvious that everyone will accept it.”
George Hammond

“How Much Is That Pill In The Window?”:
It costs either $2.6 BILLION or $1.4 BILLION to develop a new drug depending on which report you believe… the Tufts Center for the Study of Drug Development (supported in large part by drug companies) or Jeffery Avorn, MD of the Division of Pharmacoepidemiology and Pharmoeconomics of Harvard Medical School. The discrepancy is important since the high price of drugs is becoming a hot topic in this pre-election year. Read this NEJM article to get a glimpse of the smoke and mirrors used in such calculations (how to calculate capital costs?, what is a “self-originated” drug?, how much of R&D costs are covered by public tax money (NIH grants)?, what are R&D and what are marketing costs?, etc.). (1)

  • 80% of new compounds fail to meet expectations and are abandoned during development. This, of course, raises the calculated cost of developing the successful ones.
  • Both reports agree that the time required for new drug approval by the FDA has decreased to the point where it as fast as, or faster than other countries.

“Gadar” is faulty :
Ten years of research has not appreciably advanced our understanding of what makes people gay according to a “state-of-the-art” review of research into sexual orientation held every five years in a remote location. This year’s conference was held at the University of Lethbridge in Western Canada. The sharp dichotomy between nature (genetics) versus nurture (cultural) causes, the focus of numerous “twin studies” in many countries over many years, has been significantly blurred. The search for the “gay gene” has been tempered by the realization that at least 150 genes are involved in determining “something as simple as your height.” (2)

A new concept, the “environment of the womb”, has recently received greater research interest, but data remains inconclusive. The “environment of the womb” swirls with all sorts of different, and changing, levels of hormones and proteins for 9 months, and researchers  continue to look for its effects on the fetus – “epigenetics”. “Genes are the ingredients of grandma’s apple pie. Epigenetics is the recipe of how she actually makes it.” (2)

The scarce support of sexual orientation research is due in large part to societal controversies  (hence the remote locations for conferences to reduce easy access for “Spotlight Investigative Teams” roaming for hot topics). I wonder if such research is even worth it at all. Any research conclusion will likely be ignored by those people with the strongest negative opinions about sexual orientation because many have clearly shown no acceptance of scientific evidence about anything.

“Low-T” is another manufactured diagnosis:
Despite the lack of scientific evidence showing any benefits, 2.2 million men were prescribed testosterone in 2013 for “age-related hypogonadism”, a brand new diagnosis limited to aging men and apparently coined in response to a demand for testosterone prescriptions. Most of the men are 40 to 64 years old, and one-third of them had never had their actual testosterone blood level checked prior to the prescription. The authors of this report suggest that direct-to-consumer marketing for the improvement of “low-T symptoms” is a major reason for this wide-spread, increasing usage. The FDA has identified a “weak signal” that testosterone usage has adverse cardiac effects, and is concerned … so they have… “recommended some drug label revisions”. (3)

“Lingering Lyme”:
The CDC notes that one in five patients treated for Lyme disease may develop a persistent syndrome of fatigue and other symptoms known as “post-treatment Lyme syndrome”, and no one knows what causes it. It is NOT cured by continuous long-term antibiotics. There is new laboratory animal evidence that some of the organisms causing Lyme go into a “dormant state” when under antibiotic attack. They are NOT resistant to the antibiotic. The cell metabolism function that is attacked by the antibiotic just shuts down temporarily when the antibiotic is present, and so the organism survives. The researchers found that reintroducing the same antibiotic in the lab animal after a time off antibiotics subsequently killed these “persister” organisms. This is a new direction of inquiry in Lyme disease, but not everyone believes in “persisters” and “pulsed antibiotics”. They won’t believe, and shouldn’t, until all four of Koch’s postulates  for establishing a link between a disease and an organism are met. (4)

“Water, Water Everywhere…but not needed”:
The persistent myth that 8 glasses of water will keep you healthy was apparently initiated by readers of a 1945 Food and Nutrition Board recommendation that people need 2.5 liters of water a day. BUT, the readers ignored the next sentence that read “most of that quantity is contained in prepared food” … like fruits, vegetables, juice, coffee, tea, and even beer. Prospective studies have failed to find any benefit on skin elasticity, kidney function, “healthy appearance”, disease-free state, or mortality in those healthy people who increase their water intake. A recent study using a urine osmolality of 800 mOsm/kg (a measure of concentration) as the “normal” value in children concluded that more than half of 4,000 symptom-free, healthy children were “dehydrated”! It would seem that we should throw that particular “normal” standard out the window … or at least into the crapper. (5) Water is good for you, but, let’s face it, you really don’t need take a water bottle with you in the car when you go to pick up the mail.

References:
1. “The $2.6 Billion Pill – Methodologic and Policy Considerations”, Jeffery Avorn, MD, NEJM 372;20, May 14, 2015 .
2. “What Makes People Gay?- Revisited” , Neil Swidey, Boston Globe Magazine, August 23, 2015,
3. “Testosterone and ‘Age-Related Hypogonadism’ – FDA Concerns”, NEJM 378;8, Aug 20, 2015
4. “Lingering Lyme”, Scientific American, Sept. 2015, pg.17
5. “The Persistent Health Myth of 8 Glasses of Water A Day”, Aaron J. Carroll, MD, NY Times, Aug. 25, 2015, pg. A3


Vol. 107 February 14, 2015 The “Science” of Love

February 13, 2014

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“IT’S THE BRAIN, STUPID CUPID!”

February is the month of romance in pagan and Christian religions. February 14 was considered  to be the beginning of bird mating season in Great Britain. The Catholic Church designated February 14 as the feast day of St. Valentine but no longer celebrates it as a holiday. There are at least three different stories of why Valentine was designated a saint. About 1 billion St.Valentine Day cards are purchased each year; 85% by women. (Christmas cards top the charts at 2.6 billion).  Valentine cards inundate us with the symbol of love, the heart.

The earliest artistic depictions of the heart were in the shape of an inverted pine cone, apex pointing up. For a variety of speculative reasons this image was inverted to the one familiar to us today.big heart    If you believe that this image mimics the rounded buttocks of a forward-bending woman, then you will also agree that Cupid’s phallic arrow is correctly aimed.

Theories also abound as to why the heart was considered the source of love. Perhaps the easiest one to accept is that the heart quickens when we are “in love”. It certainly does so when we are making love. It may be the only aerobic exercise that many get.

Today, science tells us that the heart is not the source of love. It is the brain, the source of the chemicals and hormones surging and ebbing which apparently govern our emotions. There are three phase of love. Testosterone and estrogen fuel the first phase, lust. Their levels are controlled by the hypothalamus area of the brain, influenced in large part by our individual genetic make-up.

Dopamine, and its close associate serotonin, fuels the second phase of love, attraction. Dopamine increases our “wanting”, our “desires”, and reaches its highest blood levels during orgasm or after cocaine ingestion.

The third phase of love, attachment, depends on oxytocin, the so-called “cuddle hormone”. Oxytocin promotes  commitment and long-term relationships. It enhances mother-child bonding during breast feeding. It’s effects do diminish over time.  Marital counselors often counsel troubled couples whose surges of dopamine and oxytocin may have become less frequent to try more sex . Maybe this diagram of oxytocin should replace the heart as the symbol of true love.

Oxytocin-neurophysin     Somehow I can’t see Hallmark going for this in a big way.

Vasopressin, which is released after sex , also promotes attachment. Science knows this from the “voles experiment”.  Male vole are apparently known for multiple sex acts with the same partner out of proportion to the need to advance the species. They have less sex with, and decrease their  protection of, their partner when given an antagonist to vasopressin. 

There is no single “libido hormone”.  Testosterone and estrogen, the “lust” chemicals, are the most closely associated with libido. Viagra is merely a selectively acting vasodilator. (It was originally developed to help patients with restrictive lung disease or angina; arguably the most famous “unintended discovery” since penicillin; at least to certain stockholders.)  It does not arouse anybody. What does?

According to most psychologists, our brains do. We unconsciously build a list of attractive attributes of a potential mate, called, of course, a “love map”. When we encounter someone who has one or two of those attractive traits, we seek more encounters. If what we learn about the person matches more and more of our love map, the chemicals take over and guide our subsequent actions. (Could explain the “3-dates-before-sex rule” accepted by many today as a culture norm.)

Despite the millions spent on perfumes and colognes, there is little to indicate that smell is an important element in our love map. Smell, the detection of pheromones, is very important in the reproductive cycle of the rest of the animal kingdom, but not apparently for us. Legend has it that when Napoleon Bonaparte wrote Josephine to arrange a love tryst, he said, “I’m coming home — please don’t wash.” Recent research on the scientific basis of love suggests that the famous general may have been onto something that guaranteed his success in the bedroom as well as on the battlefield.

The intriguing “smelly T-shirt” experiment , first done in 1995 and repeated with the same result in 2005, is one of the few suggestions that smell might have a role in love.  Young woman were asked to smell T-shirts worn for two nights by young men and indicate which ones they found “pleasing”. Most of the women favored the T-shirts worn by men who had DIFFERENT immune genetic profiles than they did. This was interpreted as of positive evolutionary value because the presence of different immunological genes in the offspring would broaden their protection from disease organisms.  Many other efforts to come up with a “sniff test” for the perfect mate have not been successful.  (Eat your heart out Axe Peace super bowl 2014 commercial .) 

Despite all this scientific hodgepodge, deep down we all probably don’t want to believe that the mystery of human love can be explained by genetic maps and certain chemical blood levels. To quote one of the world’s most famous scientific skeptics, Alfred Einstein, when asked if he ever thought of trying to have “the perfect child”  with Marilyn Monroe, he said: “I would be afraid that the child might have my looks and her brains.”

Einstein might have had the last word on the relationship between science and love when he said, “Gravity is not responsible for people falling in love.”

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Vol. 91 June 1, 2013 Sunscreen Sense, Testosterone Hype

May 31, 2013

hub_2“IF YOU BUY SUNSCREEN WITH A SPF OVER 40 YOU ARE PAYING FOR BETTER MARKETING,
NOT MORE PROTECTION ”.

This year Consumer Reports (1) states that the according to their tests the maximum effective SPF is now 40. Paying for anything above that is wasted money. Two years ago Consumer Reports tests showed that any sunscreen with a SPF (Sun Protection Factor) over 30 gave no more protection than a 30. They also recommended that year-old sunscreen might have lost some of its effectiveness, so new sunscreen should be bought each year. New FDA regulations require the sunscreen to be labeled with a three-year expiration date. To be sure Consumer Reports recommends tossing out any leftovers after two years. New FDA regulations also now outlaw the term “sunblock”.

SPF refers only to protection against UVB rays. Those rays cause sunburn . “UVB for Burn” The UVA rays cause aging. “UVA for Aging”. Both kinds of rays can cause skin cancer. Only sunscreen labeled as “broad spectrum” can screen both types of rays.

Several manufacturers are now using nano-particles of zinc oxide in their sunscreens. Zinc oxide (the white goo lifeguards put on their noses) is a very effective sun block, but the FDA is cautious about the use of nano-particles because they are small enough to be absorbed through the skin. In fact, pharmaceutical companies are spending millions on R&D on nano-particle delivery patches for lots of drugs currently requiring injections.

The FDA is also cautious about the use of aerosol sprays of sunscreen. The fumes are easily inhaled and long-term studies of effects on lungs are not complete. Consumer Reports recommends spraying the sunscreen on your hands and then applying it; a literal obliteration of the spray’s alleged convenience. Certainly avoid using aerosol sprays on children.

If all else fails and you get sunburned, ”A plain yogurt mask for 30 minutes will take away the discomfort. Fat-free doesn’t work as well.” (2)…another small blow to nutritional political correctness.

“VITAMIN T” – MORE RISKS THAN BENEFITS

The number of testosterone prescriptions and the money spent for testosterone have both nearly doubled in the past two years. The advertising costs for two testosterone drugs went from $14 million in 2010 to $107 million in 2012 helping the U.S. sales of them to reach almost $2.5 billion (yes, that is a “b”). All for a drug “whose benefits are overblown and whose risks are underappreciated”. (1) The American Urological Association has added testosterone therapy to its list of overused and potentially dangerous medical treatments.

$570 a month does NOT apparently buy you a better libido, better performance, or better sexual satisfaction. It CAN buy a man a higher risk of heart attacks and other cardiac events, more rapid growth of prostate cancer, reduced sperm counts. blood clots in the legs, and increased sleep apnea.

The level of testosterone in blood normally decreases with age. Unless a man has loss of libido AND is extremely fatigued, depressed, with facial and pubic hair loss, and decreased bone and muscle mass, testosterone therapy will not make a difference. Those symptoms add up to the specific diagnosis of hypogonadism, not mid-life crisis.

References:
1. Consumer Reports Magazine July 2013
2. Boston Globe, Style, pg. 14 G , May 30, 2013


Vol. 39 February 15, 2011 Ten Really Fun Facts

February 11, 2011

Satchel Page’s advice for living a long time was right. “Don’t look back. Something may be gaining on you.”

There is a significant association between gait speed and 10-year survival for participants older than 75. If a person can’t walk 20 feet in 10 seconds the risk for early mortality is high. (1)

Grandma was  wrong about cranberry juice.

311 college-aged women drank cranberry juice or a placebo twice a day for six months after being treated for a urinary tract infection (UTI). Recurrence rates of UTIs were the same in both groups. In fact, the women who drank the cranberry juice had twice as many recurrences with E. Coli, the bacteria that cranberry juice is supposed to be most effective against. (2) Cranberry juice contains over 200 active compounds, so “the little berry that defies” science will continue to do so for a while.

Grandpa is still going strong down under.

31% of 2800 Australian men aged 75-95 reported having sex at least once in the past 12 months and 43% reported having sex “less often than desired.”  “A lack of a partner” was cited as the reason by 21%. (3)

French men drink the Irish under the table … and into the ground!

91% of French men surveyed consumed alcohol once weekly while only 61% of Irish men did so. Average DAILY alcohol consumption in French men was 33 grams while Irish men consumed only 22 grams daily. In 10 years of follow-up the Irish men had TWICE the number of adverse coronary events (heart attack or death due to cardiac disease) than the French. You might say that the Irish are just poor losers…or perhaps that wine is better for your heart than beer and whiskey. (4)

Some Super Bowl losses are more permanent than others.

The 1980 Los Angles Ram Super Bowl loss was associated with a 15% increase of cardiac deaths in Los Angeles in the 14 days after the game. The increase was highest in women and those over age 65. In 1984 the Los Angles Raiders won the Super Bowl and cardiac deaths dropped by 1% (5)

Sometimes “progress” can be relative.

The odds of getting killed in an automobile accident in New York City today is about the same as getting killed in a horse accident in 1900 (about 1 in 20,000 – 25,000) (6)

Baseball players CAN see better than umpires.

“On average, a baseball players’ vision is 20/12 which means a baseball player can see from 20 feet what a normal person can see at 12 feet. Normal vision is 20/20, of course. The best the human eye can see is 20/8, so 20/12 is halfway to the best human vision possible.” Major League Baseball did not respond to an offer to evaluate umpires’ vision. (7)

It’s about the same ON or OFF the job.

Percentage of unemployed Americans who take a nap each day: 39%     Percentage of employed Americans who do: 31% (8)

Sperm and the Proton Channel.

“A recent study directly measured whole-cell electrical activities in human sperm using patch-clamp methods and found that the proton channel HV1, which is sensitive to both the membrane potential and the pH gradient, is the predominant mechanism used by sperm to achieve intracellular alkalinization which is necessary for motility and interaction with the egg coat.” (9) I can’t find either the Proton Channel or HV1 on my TV. I wonder if the Australian grandpas get it?

But what about Rock and Roll?

“Adolescents who were enrolled in a school-based drug prevention program were less likely to engage in unprotected sex or sex with multiple partners 7 years later.” (10)

References:

1. JAMA 2011 Jan 5; 305:50, Studenski
2. Clin Inf Dis 2011 Jan 1; 52:23, Barbosa-Cesnik
3.Gen Med Jour Watch, vol. 31, 5,  p.26
4. BMJ 2010 nov 23; 341:c6077, Ruidavets
5. Clin Card, Feb. 2011; 34;2 102-107, Kloner
6. Harper’s Index, Dec. 2010, p.11 and 68
7. Interview with Dr. Daniel Laby, opthalmologist to the Red Sox, Boston Globe G, Feb. 22, 2010, p.3
8. Harper’s Index, Aug 2009, p.13 and 63
9. New Eng J Med 362:20, May 2010 p.1935
10. J Adolesc Health  2009 Aug; 45:111, Ellickson


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