How to Use Topical Estrogen Cream For Aging Skin
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Dr. Sam Ellis, dermatologist, explains:
Tackling the cause
Estrogen is important for very many aspects of health beyond the sexual aspects. When it comes to skin, a drop in estrogen (usually because of menopause) leads to changes like collagen loss, dryness, reduced elasticity, and slower wound healing. Applying estrogen creams to the skin can reverse these changes.
If your estrogen levels are already within normal pre-menopausal female ranges, by the way, there isn’t so much science to indicate its benefit when used topically. If you are already on systemic HRT (i.e., you take estrogen already to raise your blood estrogen levels and affect your body in its entirety), you may or may not gain extra benefits from the topical cream, depending on factors such as your estrogen dose, your route of administration, your cardiovascular health, and other factors.
For those with lower estrogen and not currently on HRT, you may be wondering: can topical estrogen cream affect systemic estrogen levels? And the answer is that it mostly depends on the dose. In other words: it’s definitely possible, but for most people it’s unlikely.
As ever, if thinking of taking up any hormonal treatment, do consult an endocrinologist and/or gynecologist, and if you have an increased breast cancer risk (for example genetically or prior history), then an oncologist too, just to be safe.
That sounds like a lot of scary things, but mostly it’s just to be on the safe side. The dose of estrogen is very low in topical creams, and even then, only a tiny amount is used per day.
For more on all of this, enjoy:
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Want to learn more?
You might also like to read:
- “Why Does It Hurt When I Have Sex?” (And What To Do About It) ← because topical estrogen is not just for your face! Yes, you can use it down there too and it’s commonly prescribed for exactly this use.
- Hormones & Health, Beyond The Obvious
- The Hormone Therapy That Reduces Breast Cancer Risk & More
Take care!
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Dr. Patrick Walsh’s Guide to Surviving Prostate Cancer – by Dr. Patrick Walsh & Janet Farrar Worthington
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Prostate cancer is not glamorous or fun, and neither is this book.
Nevertheless, it’s a disease that affects 12% of men in general, and 60% of men aged 60+, with that percentage climbing every year after that.
So, if you have a prostate or love someone who has one, this book is worthwhile reading—yes, even as a preventative.
Like many cancers, prostate cancer is easy to treat if caught very early, becomes harder to treat as it goes, and almost impossible to cure if it gets as far as metastasis (i.e., it spread). Like all cancers, it’s better off avoided entirely if possible.
This book covers all the stages:
- How to avoid it
- How to check for it
- How to “nip it in the bud”
- Why some might want to delay treatment (!)
- What options are available afterwards
This latter is quite extensive, and covers not just surgery, but radiation, thermo- or cryoablation, and hormone therapy.
And as for surgery, not just “remove the tumor”, but other options like radical prostatectomy, and even orchiectomy. Not many men will choose to have their testicles removed to stop them from feeding the prostate, but the point is that this book is comprehensive.
It’s asking whenever possible “is there another option?” and exploring all options, with information and without judgment, at each stage.
The writing style (likely co-author Worthington’s influence; she is an award-winning science-writer) is very “for the layman”, and that’s really helpful in demystifying a lot of what can be quite opaque in the field of oncology.
Bottom line: absolutely not an enjoyable read, but a potentially lifesaving one, especially given the odds we mentioned up top.
Click here to check out Dr. Patrick Walsh’s Guide To Surviving Prostate Cancer, and be prepared!
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For many who are suffering with prolonged grief, the holidays can be a time to reflect and find meaning in loss
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The holiday season is meant to be filled with joy, connection and celebration of rituals. Many people, however, are starkly reminded of their grief this time of year and of whom – or what – they have lost.
The added stress of the holiday season doesn’t help. Studies show that the holidays negatively affect many people’s mental health.
While COVID-19-related stressors may have lessened, the grief from change and loss that so many endured during the pandemic persists. This can cause difficult emotions to resurface when they are least expected.
I am a licensed therapist and trauma-sensitive yoga instructor. For the last 12 years, I’ve helped clients and families manage grief, depression, anxiety and complex trauma. This includes many health care workers and first responders who have recounted endless stories to me about how the pandemic increased burnout and affected their mental health and quality of life.
I developed an online program that research shows has improved their well-being. And I’ve observed firsthand how much grief and sadness can intensify during the holidays.
Post-pandemic holidays and prolonged grief
During the pandemic, family dynamics, close relationships and social connections were strained, mental health problems increased or worsened, and most people’s holiday traditions and routines were upended.
Those who lost a loved one during the pandemic may not have been able to practice rituals such as holding a memorial service, further delaying the grieving process. As a result, holiday traditions may feel more painful now for some. Time off from school or work can also trigger more intense feelings of grief and contribute to feelings of loneliness, isolation or depression.
Sometimes feelings of grief are so persistent and severe that they interfere with daily life. For the past several decades, researchers and clinicians have been grappling with how to clearly define and treat complicated grief that does not abate over time.
In March 2022, a new entry to describe complicated grief was added to the Diagnostic and Statistical Manual of Mental Disorders, or DSM, which classifies a spectrum of mental health disorders and problems to better understand people’s symptoms and experiences in order to treat them.
This newly defined condition is called prolonged grief disorder. About 10% of bereaved adults are at risk, and those rates appear to have increased in the aftermath of the pandemic.
People with prolonged grief disorder experience intense emotions, longing for the deceased, or troublesome preoccupation with memories of their loved one. Some also find it difficult to reengage socially and may feel emotionally numb. They commonly avoid reminders of their loved one and may experience a loss of identity and feel bleak about their future. These symptoms persist nearly every day for at least a month. Prolonged grief disorder can be diagnosed at least one year after a significant loss for adults and at least six months after a loss for children.
I am no stranger to complicated grief: A close friend of mine died by suicide when I was in college, and I was one of the last people he spoke to before he ended his life. This upended my sense of predictability and control in my life and left me untangling the many existential themes that suicide loss survivors often face.
How grieving alters brain chemistry
Research suggests that grief not only has negative consequences for a person’s physical health, but for brain chemistry too.
The feeling of grief and intense yearning may disrupt the neural reward systems in the brain. When bereaved individuals seek connection to their lost loved one, they are craving the chemical reward they felt before their loss when they connected with that person. These reward-seeking behaviors tend to operate on a feedback loop, functioning similar to substance addiction, and could be why some people get stuck in the despair of their grief.
One study showed an increased activation of the amygdala when showing death-related images to people who are dealing with complicated grief, compared to adults who are not grieving a loss. The amygdala, which initiates our fight or flight response for survival, is also associated with managing distress when separated from a loved one. These changes in the brain might explain the great impact prolonged grief has on someone’s life and their ability to function.
Recognizing prolonged grief disorder
Experts have developed scales to help measure symptoms of prolonged grief disorder. If you identify with some of these signs for at least one year, it may be time to reach out to a mental health professional.
Grief is not linear and doesn’t follow a timeline. It is a dynamic, evolving process that is different for everyone. There is no wrong way to grieve, so be compassionate to yourself and don’t make judgments on what you should or shouldn’t be doing.
Increasing your social supports and engaging in meaningful activities are important first steps. It is critical to address any preexisting or co-occurring mental health concerns such as anxiety, depression or post-traumatic stress.
It can be easy to confuse grief with depression, as some symptoms do overlap, but there are critical differences.
If you are experiencing symptoms of depression for longer than a few weeks and it is affecting your everyday life, work and relationships, it may be time to talk with your primary care doctor or therapist.
A sixth stage of grief
I have found that naming the stage of grief that someone is experiencing helps diminish the power it might have over them, allowing them to mourn their loss.
For decades, most clinicians and researchers have recognized five stages of grief: denial/shock, anger, depression, bargaining and acceptance.
But “accepting” your grief doesn’t sit well for many. That is why a sixth stage of grief, called “finding meaning,” adds another perspective. Honoring a loss by reflecting on its meaning and the weight of its impact can help people discover ways to move forward. Recognizing how one’s life and identity are different while making space for your grief during the holidays might be one way to soften the despair.
When my friend died by suicide, I found a deeper appreciation for what he brought into my life, soaking up the moments he would have enjoyed, in honor of him. After many years, I was able to find meaning by spreading mental health awareness. I spoke as an expert presenter for suicide prevention organizations, wrote about suicide loss and became certified to teach my local community how to respond to someone experiencing signs of mental health distress or crisis through Mental Health First Aid courses. Finding meaning is different for everyone, though.
Sometimes, adding a routine or holiday tradition can ease the pain and allow a new version of life, while still remembering your loved one. Take out that old recipe or visit your favorite restaurant you enjoyed together. You can choose to stay open to what life has to offer, while grieving and honoring your loss. This may offer new meaning to what – and who – is around you.
If you need emotional support or are in a mental health crisis, dial 988 or chat online with a crisis counselor.
Mandy Doria, Assistant Professor of Psychiatry, University of Colorado Anschutz Medical Campus
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Discipline is Destiny – by Ryan Holiday
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We’ve previously reviewed another of Holiday’s books, The Daily Stoic, and here is another excellent work from the same author.
We’re not a philosophy newsletter, but there are some things that make a big difference to physical and mental health, the habits we build, and the path we take in life for better or for worse.
Self-discipline is one of those things. A lot of the time, we know what we need to do, but knowing isn’t the problem. We need to actually do it! This applies to diet, exercise, sleep, and more.
Holiday gives us, in a casual easy-reading style, timeless principles to lock in strong discipline and good habits for life.
The book’s many small chapters, by the way, are excellent for reading a chapter-per-day as a healthy dose of motivation each morning, if you’re so inclined.
Bottom line: if you’ve noticed that one of the biggest barriers between you and your goals is actually doing the necessary things in a disciplined fashion, then this book will help you become more efficient, and actually get there.
Click here to check out Discipline is Destiny, and upgrade yours!
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From immunotherapy to mRNA vaccines – the latest science on melanoma treatment explained
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More than 16,000 Australians will be diagnosed with melanoma each year. Most of these will be caught early, and can be cured by surgery.
However, for patients with advanced or metastatic melanoma, which has spread from the skin to other organs, the outlook was bleak until the advent of targeted therapies (that attack specific cancer traits) and immune therapies (that leverage the immune system). Over the past decade, these treatments have seen a significant climb in the number of advanced melanoma patients surviving for at least five years after diagnosis, from less than 10% in 2011 to around 50% in 2021.
While this is great news, there are still many melanoma patients who cannot be treated effectively with current therapies. Researchers have developed two exciting new therapies that are being evaluated in clinical trials for advanced melanoma patients. Both involve the use of immunotherapy at different times and in different ways.
The first results from these trials are now being shared publicly, offering insight into the future of melanoma treatment.
Svitlana Hulko/Shutterstock Immunotherapy before surgery
Immunotherapy works by boosting the power of a patient’s immune system to help kill cancer cells. One type of immunotherapy uses something called “immune checkpoint inhibitors”.
Immune cells carry “immune checkpoint” proteins, which control their activity. Cancer cells can interact with these checkpoints to turn off immune cells and hide from the immune system. Immune checkpoint inhibitors block this interaction and help keep the immune system activated to fight the cancer.
Results from an ongoing phase 3 trial using immune checkpoint inhibitors were recently published in the New England Journal of Medicine.
This trial used two types of immune checkpoint inhibitors: nivolumab, which blocks an immune checkpoint called PD-1, and ipilimumab, which blocks CTLA-4.
More than 16,000 Australians are diagnosed with melanoma each year. Delovely Pics/Shutterstock Some 423 patients (including many from Australia) were enrolled in the trial, and participants were randomly assigned to one of two groups.
The first group had surgery to remove their melanoma, and were then given immunotherapy (nivolumab) to help kill any remaining cancer cells. Giving a systemic (whole body) therapy such as immunotherapy after surgery is a standard way of treating melanoma. The second group received immunotherapy first (nivolumab plus ipilimumab) and then underwent surgery. This is a new approach to treating these cancers.
Based on previous observations, the researchers had predicted that giving patients immunotherapy while the whole tumour was still present would activate the tumour-fighting abilities of the patient’s immune system much better than giving it once the tumour had been removed.
Sure enough, 12 months after starting therapy, 83.7% of patients who received immunotherapy before surgery remained cancer-free, compared to 57.2% in the control group who received immunotherapy after surgery.
Based on these results, Australian of the year Georgina Long – who co-led the trial with Christian Blank from The Netherlands Cancer Institute – has suggested this method of immunotherapy before surgery should be considered a new standard of treatment for higher risk stage 3 melanoma. She also said a similar strategy should be evaluated for other cancers.
The promising results of this phase 3 trial suggest we might see this combination treatment being used in Australian hospitals within the next few years.
mRNA vaccines
Another emerging form of melanoma therapy is the post-surgery combination of a different checkpoint inhibitor (pembrolizumab, which blocks PD-1), with a messenger RNA vaccine (mRNA-4157).
While checkpoint inhibitors like pembrolizumab have been around for more than a decade, mRNA vaccines like mRNA-4157 are a newer phenomenon. You might be familiar with mRNA vaccines though, as the biotechnology companies Pfizer-BioNTech and Moderna released COVID vaccines based on mRNA technology.
mRNA-4157 works basically the same way – the mRNA is injected into the patient and produces antigens, which are small proteins that train the body’s immune system to attack a disease (in this case, cancer, and for COVID, the virus).
However, mRNA-4157 is unique – literally. It’s a type of personalised medicine, where the mRNA is created specifically to match a patient’s cancer. First, the patient’s tumour is genetically sequenced to figure out what antigens will best help the immune system to recognise their cancer. Then a patient-specific version of mRNA-4157 is created that produces those antigens.
The latest results of a three-year, phase 2 clinical trial which combined pembrolizumab and mRNA-4157 were announced this past week. Overall, 2.5 years after starting the trial, 74.8% of patients treated with immunotherapy combined with mRNA-4157 post-surgery remained cancer-free, compared to 55.6% of those treated with immunotherapy alone. These were patients who were suffering from high-risk, late-stage forms of melanoma, who generally have poor outcomes.
It’s worth noting these results have not yet been published in peer-reviewed journals. They’re available as company announcements, and were also presented at some cancer conferences in the United States.
Based on the results of this trial, the combination of pembrolizumab and the vaccine progressed to a phase 3 trial in 2023, with the first patients being enrolled in Australia. But the final results of this trial are not expected until 2029.
It is hoped this mRNA-based anti-cancer vaccine will blaze a trail for vaccines targeting other types of cancer, not just melanoma, particularly in combination with checkpoint inhibitors to help stimulate the immune system.
Despite these ongoing advances in melanoma treatment, the best way to fight cancer is still prevention which, in the case of melanoma, means protecting yourself from UV exposure wherever possible.
Sarah Diepstraten, Senior Research Officer, Blood Cells and Blood Cancer Division, WEHI (Walter and Eliza Hall Institute of Medical Research) and John (Eddie) La Marca, Senior Research Officer, Blood Cells and Blood Cancer, WEHI (Walter and Eliza Hall Institute of Medical Research)
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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Accidentally Overweight – by Dr. Libby Weaver
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This book’s main premise is that for most people who become overweight especially in midlife or later, if there wasn’t an obvious lifestyle change to precipitate this (e.g. started living on fast food for some reason), then in most cases, what’s needed is not drastic action, so much as some metabolic tweaks to correct things that have gone off-piste a little in our physiology.
The book covers nine factors that make an impact, and how each can be managed. They are:
- Insulin
- Stress hormones
- Calories
- Thyroid function
- Nervous system
- Emotions
- Sex hormones
- Liver function
- Gut bacteria
Some will be obvious, but as Dr. Weaver explains, are relative trivial compared to the others; “calories” in one such example of this “yes, it’s a factor, but very overrated” category.
Others are things that most people don’t think too much about, like liver function. And yet, it is indeed very much critical, and a major player in metabolism and adiposity.
The style is on the very light end of pop-science, but she does bring her professional knowledge to bear on topic (her doctorate is a PhD in biochemistry, so a lot of explanations come from that angle).
Bottom line: if you’ve found yourself “accidentally overweight”, and would like to tip the scales back in the other direction without doing anything extreme, then this book provides the tweaks that no amount of cardio or restrictive dieting will.
Click here to check out Accidentally Overweight, and re-adjust it back the other way!
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How to Prevent Dementia – by Dr. Richard Restak
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We’ve written about this topic here, we know. But there’s a lot more we can do to be on guard against, and pre-emptively strengthen ourselves against, dementia.
The author, a neurologist, takes us on a detailed exploration of dementia in general, with a strong focus on Alzheimer’s in particular, as that accounts for more than half of all dementia cases.
But what if you can’t avoid it? It could be that with the wrong genes and some other factor(s) outside of your control, it will get you if something else doesn’t get you first.
Rather than scaremongering, Dr. Restak tackles this head-on too, and discusses how symptoms can be managed, to make the illness less anxiety-inducing, and look to maintain quality of life as much as possible.
The style of the book is… it reads a lot like an essay compilation. Good essays, then organized and arranged in a sensible order for reading, but distinct self-contained pieces. There are ten or eleven chapters (depending on how we count them), each divided into few or many sections. All this makes for:
- A very “read a bit now and a bit later and a bit the next day” book, if you like
- A feeling of a very quick pace, if you prefer to sit down and read it in one go
Either way, it’s a very informative read.
Bottom line: if you’d like to better understand the many-headed beast that is dementia, this book gives a far more comprehensive overview than we could here, and also explains the prophylactic interventions available.
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