Is DHEA available to enhance sexual function in women?

There is no doubt that DHEA can mimic the effects of estrogen in the body and is also known to enhance sexual function. The hormone can thicken vaginal wall lining and also increase lubrication. For post menopausal women, who tend to have painful intercourse, this can be a blessing.

At the moment, low dose DHEA is being evaluated for treatment of vaginal atrophy in post menopausal women. The initial studies indicate that not only does the hormone increase lubrication of the vagina, it also enhances the quality of orgasms. 

However, the evidence that DHEA is the “Sex Drug” like Viagra for women continues to be mixed. Women are complex creatures and decreased libido has multiple causes.

The only way to know if DHEA will boost your sex life is to try it out. If you take it, I suggest letting your healthcare provider know. Limit the duration of intake for 4-6 weeks at a time. No one knows what the long term effects of DHEA are. You certainly do not want to become a crazed nymphomanic for 6 weeks, only to find out that you got some type of cancer afterwards.

Tinnitus and Stress

Is tinnitus ever associated with trauma or stress?

 

Yes, there are a number of reports suggesting that tinnitus may be influenced by stress, depression or some type of head trauma. Some individuals who have the TMJ syndrome may also develop tinnitus. The most common disorder associated with tinnitus is meniere’ disease. With this condition, it is believed that there is either an abnormal ear pressure or abnormal fluid composition. A rare cause of tinnitus is a cancer known as acoustic neuroma. Other causes of tinnitus include high blood pressure, kinking of your blood vessels leading to the ear and abnormal development of blood vessels in the ear. In the majority of cases, no cause is ever found.

 

 

 

Tinnitus causes

My doctor says I have tinnitus. Can you tell me more about the disorder?

 

Tinnitus is a disorder of the inner ear. The condition presents with a noise or ringing in the ears and this sound is only perceived by the person. It is a common problem that affects close to 10-18 percent of the population. Tinnitus is not a disease by itself but is usually caused by another disorder like an ear injury, advanced age or some type of blood vessel disorder.

Tinnitus can be annoying but is not life threatening. Therefore, the first thing to do is not search for exotic cures that can be very expensive. In a few people, tinnitus can be helped. In some cases when the underlying disorder is treated, tinnitus can diminish. Besides drugs, other treatments for tinnitus include masking the noise with devices. Unfortunately, more than 50% of people remain unsatisfied with the treatment of tinnitus.

Cialis for men

Does cialis work in all men? I have taken some samples but found no benefit

Millions of men regularly buy cialis to treat erectile dysfunction. In fact even many normal men buy cialis to prolong their erection and have a satisfying sexual relationship. For some unknown reason cialis does not work in all men. At least 30 percent of men fail to get an erection with the blue pill. The reason for this is believed to be an interaction with the type of foods that one eats. In other cases, the reason is fake or counterfeit pills. Always buy your pharmaceutical products from a reliable pharmacy- many online overseas pharmacies sell fake products.

What liquid should I take viagra with?

Is there any special beverage that I can take with viagra?

Water is the best beverage. You may take it with tea or coffee but alcohol is not recommended. Alcohol prevents or delays absorption of viagra. In addition, too much alcohol will interfere with your ability to perform in bed.

Viagra with food

Do I always need to take Viagra with food?

Not necessary. However, some people do develop cramps when they take Viagra on an empty stomach. If you do take Viagra with food, avoid oily and fatty foods- since these foods delay the absorption of Viagra from the stomach. If you do not develop any abdominal cramps, you can take Viagra without food.

What is melasma?

Can you please tell me what is melasma? I am a 26 year old female who is 14 weeks pregnant.

Melasma is a skin disorder and is also known as ‘chloasma’ or ‘mask of pregnancy’. Melasma is associated with dark patches of skin which gradually develop on cheeks, forehead, nose, and upper lip. Melasma is more common in women and is associated with pregnancy and certain medications that contain hormones. Melasma seems to develop in about 60% of pregnant women but can also occur in men. Melasma is most common in Asians and in those with dark skin complexion.It is not a disease and in 99.99999% of cases, the condition resolves on its own. This means - please do not be a sucker and fall for the fradulent therapies that are being offered.

Treatment for melasma

I am a 31 year old female and have melasma. How does one treat this skin condition?

 

Melasma results in darkening of skin and thus, all treatments are geared towards lightening your skin. Current treatments for melasma include sunscreens, bleaching creams (e.g. hydroquinone), acne creams (e.g. azelaic acid), topical retinoids (e.g. tretinoin), and facial peels where an acid solution is used to remove outer layers of skin (e.g. glycolic acid peels or the blue peels). Some spas also incorporate a combination approach such as triple-combination cream (hydroquinone, tretinoin, and steroid). Some plastic surgeons also offer a variety of lasers to get rid of your melasma. As to which one is the best treatment is anyone’s guess. 

What you have to understand that in most cases, melasma disappears on its own. So it is impossible to tell if anyone of these remedies really work!  The only two things for sure are that 1) you will certainly be paying big bucks for anyone of these treatments and 2) one of these treatments will probably worsen your skin condition. Best advice- be patient and in most cases melasma disappears or lightens up on its own. It is not a life threatening disorder nor is it a disease that requires treatment. All the people who offer therapy for melasma can best be described as FRAUDS.

Laser for hair removal

My friend has recommended laser removal for unwanted hair. Is this a good idea?

Next to acne, unwanted hair is a major pain in the rear for most women. There are zillions of treatments hyped up to remove unwanted hair and one of them is laser. Today, hair is being removed by a variety of lasers including alexandrite, diode, neodymium, YAG, ruby lasers and intense pulsed light. Even though every Tom, Dick and Harry is now offering laser for hair removal, there are no decent studies to determine if it is an effective treatment. The few reports indicate that both alexandrite and diode lasers do reduce hair by 50% in some people and this partial hair-free period lasts anywhere from 3-6 months. The reports also indicate that there is little evidence that IPL, neodymium: YAG or ruby lasers do diddly squat. 

There is no evidence that any laser treatment can permanently remove hair. For those of you still interested in laser, do understand that lasers can cause pain, skin redness, discolor your skin and cause keloids- and some of these changes are permanent. And finally, lasers do not come cheap and there is no guarantee that the treatment will work.

Minocycline for acne

I have terrible acne and my doctor has prescribed me minocycline. Is this an effective drug?

Minocycline is a tetracycline antibiotic that is frequently used for treatment of moderate to severe acne vulgaris. Minocycline only needs to be taken once or twice a day and can be taken with food, but it is also more expensive than the other tetracyclines. Concerns have also been expressed over its safety and a few deaths have been reported. 

Even among skin doctors, the use of minocycline is questionable. So far there is not a single decent study that has shown that minocycline is better than other tetracyclines. Considering that the drug is expensive and has undesirable side effects, I personally would not recommend it. 

Final note: from my personal experience this drug is useless for acne. I do not recommend it. Instead ask your doctor for a retinoid like accutane

Lasers and acne scars

How effective is laser for acne scars? I am 27 and have terrible scars from acne.

In the last decade, many skin doctors and plastic surgeons have been offering laser treatment for acne scars. Unlike other treatment, laser resurfacing is more precise and can help smoothen out skin. However, the benefits of laser on acne scar are seen in less than 5% of individuals. In the majority of people with acne scars, the laser makes the scars uglier. Moreover laser also has complications some of which are permanent. If you have one or two small acne scars, then laser is fine but if you have lots of acne scars which are deep, laser is not a recommended treatment. 

There are some reports that the both the carbon dioxide and Erbium YAG laser may help. However, reports from patients indicate that both lasers suck big time and that this procedure is a rip off. And trust me, laser resurfacing for acne scars can cost as much as a down payment on a home. So the choice is simple- either you get your acne scars fixed and hopefully look good, or look like crap but still have a permanent place to stay which you can call home.

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Zomig for migraines

Can Zomig prevent migraines? 

Zomig also known as zolmitriptan is a drug used to treat migraines. The drug can help relieve the intense headache and symptoms of migraine like nausea and vomiting. Zomig can help people with migraine lead normal lives. It also helps people from seeking other drugs. Zomig is not a cure for migraines nor does it reduce the frequency of headaches. Zomig belongs to a class of drugs known as the triptans. Zomig is believed to work by blocking pain signals in the brain. Unfortunately Zomig does not work in all people with migraines and even when it works, the effectiveness disappears after a few months. The drug cannot be used to prevent migraine and only used to treat acute symptoms.

Tummy tuck surgery

Can tummy tuck be done under local anesthesia?

Tummy tuck involves removing a lot of your redundant skin and the fat pouch. Local anesthetic generally does not work when fat is removed. Most people need general anesthesia.

Complications after Tummy tuck surgery

Does the tummy tuck procedure have any major side effects I should know about?

After the abdominoplasty, you may experience numbness, bruising or an odd ache at the incision site. Once you go home you will have a firm elastic band placed around your abdomen to help promote healing. One has to avoid strenuous exercise for at least 6 weeks to prevent the wound from breaking down.  Of course you still have to select a good surgeon. While most cosmetic surgeons are good, there are enough bad ones to make your life miserable. So take your time in selecting a surgeon and never ever be rushed into this surgery-it is purely an elective procedure.

Masking sound for tinnitus

I have tinnitus and my doctor has recommended that I buy a masking sound device for treatment. Any suggestions?

 

It seems your doctor is either a musician or a salesperson. Tinnitus is a disorder where there is a perception of sound that is not related to the external environment. Subjective tinnitus is only heard by the sufferer and not by anyone else. At present, there is no single treatment that works in all patients. 

Now we have doctors turning into business people and recommending unproven therapies. Some years ago, sound therapy or masking devices were developed to treat tinnitus on the principle of distraction. This sound is played which is often sufficient to distract the individual from hearing noises produced from within the ear- or masking the tinnitus. Unfortunately, all good studies have shown that masking devices suck-meaning you pay a lot of money for a device which looks like a portable radio but the darn thing does not work for your disorder. 

As of today, the management of tinnitus remains difficult and requires multiple strategies. Go and see a decent ENT surgeon and stop visiting charlatans. Your doctor sounds like a crooked businessman.

Blocked bypass grafts after heart surgery

I had coronary bypass 1 month go and now my doctor says the grafts are blocked. What should I do next?

 

Well, the first thing you need is a damn good lawyer. 

Coronary bypass surgery is a routine procedure but if the grafts blocks within the first 3 months, then the surgeon is almost always at fault. The problems are most likely technical. 

You have to understand that there are many awful heart surgeons and this is evidenced by the number of patients who develop complications. The next thing you need to do is ask your doctor to perform an angiogram and determine which of the bypass grafts are blocked. In many cases, fresh bypass grafts may not be amenable to stenting or angioplasty because there is always a risk of a fresh clot breaking off. 

If you have symptoms, you may need to continue your medications. In many cases, when the first surgery is screwed up, you need another one. If you have no symptoms, then you may have the option of taking medications, but if you have symptoms, then another surgery may be required. Speak to your doctor and do not go back to the same surgeon. 

What causes tinnitus?

What causes tinnitus? I am a 33-year-old female and have just discovered that I have tinnitus.

 

In the majority of people, no cause of tinnitus is ever found. Rare causes of tinnitus include damage to the inner ear cells. It is believed that damage to the very fine hairs in the inner ear causes them to be supersensitive to noise and amplify the signals that you hear. Other causes of tinnitus include chronic ear infections, trauma to ear and injury to the auditory nerve.

Common reasons why people have tinnitus include advanced age, exposure to loud noises from heavy equipment, listening to loud music, ear wax and bone changes. Unfortunately even after these conditions are corrected, tinnitus may continue. The work up for tinnitus can be expensive and include numerous tests.

Antidepressant for tinnitus

I have had tinnitus for many years and my doctor has started me on an anti-depressant. Does this drug work for tinnitus?

Unfortunately, many doctors are lazy/clueless and do not bother to keep up with current literature. Tinnitus is ringing in the ears and is a very difficult disorder to treat. Tinnitus is characterized as perception of sound or noise in the absence of real acoustic stimulation. The disorder is often compared with chronic pain, and may be associated with depression or depressive symptoms that can significantly affect quality of life and ability to work. Antidepressant drugs have been used to treat tinnitus in patients with and without depressive symptoms for many years.

However, review of studies indicate that  there is no proof that antidepressants are effective for tinnitus. Fortunately, the studies showed that the doses of anti- depressants used did not cause any side effects. So for now, anti-depressants have no effect on tinnitus but if you have concomitant depression, then perhaps you may want to continue with the drug therapy.

Buying Viagra Online

How can one know if the Viagra being sold online is real or fake?

There is no way of knowing, unless you try the product. If it does not work, then the problem is either you or the drug.  Sometimes the product is real but the quality is poor. You should always buy Viagra from a pharmacy that follows strict guidelines and sells quality pharmaceutical products that are manufactured according to US regulations. I can tell you one thing-if you live in america, you should avoid online pharmacies from Canada, Russia and most of the Orient- most of them are scammers. Once you have given your credit card to them, the only thing you will get in return is depression and limp dick.

Cialis for bodybuilding

I have been thinking of taking cialis while doing muscle training. Do you think it will help?

Many men buy viagra to help improve exercise endurance and build their muscles. Viagra is a favorite pill among many bodybuilders and professional athletes. The drug works by opening up blood vessels and gradually improves exercise endurance and strength. Unfortunately, these effects of viagra are not seen in all men and often take months to develop.  However, I don’t see why cialis cannot do the same. 

Since many bodybuilders use anabolic steroids that causes a decrease in libido, Cialis may help restore the erections and sexual performance.  It is important for all athletes to know that many professional sporting organizations do screen for these pills in the urine and condone its use. Cialis, like Viagra, can improve one’s sex life increase exercise endurance and boost self-confidence.

Fake Viagra

Does fake Viagra really exist?

Trust me, fake products in the pharmaceutical industry are nothing new. Companies from India have been making fraudulent drugs for decades and now the Chinese have also gotten into this habit. What is worse is that some of these manufacturers also spike the fake pill with real drugs. For instance they may sell you a herb for weight loss, but in fact they spike it with a real drug like ephedrine.

The fact is that like all medications, there are numerous reports about fake and counterfeits pills on the market. Fake pills probably are the number one reason why not all men respond to Viagra bought online. 

While working in Africa and Asia as a surgeon, i brought back to america 100s of pills and discovered that nearly 60-70% were fakes. 

MRI for back pain

I have been having moderate back pain. Do I need an MRI?

The diagnosis of back pain is not difficult but not everyone needs expensive radiological tests. If the physical exam is normal, then in most cases no testing is needed. However, if there is back pain on standing, shooting pains down the leg, or if you have urinary retention, then the doctor may order a study. Plain x-rays are garbage and rarely contribute to treatment. Physicians who order plain x-rays are clueless and just increase the cost of health care.

MRI and bone scans are used to determine the cause of back pain. If there is suspicion that a nerve is pinched, then nerve-conducting studies may be ordered to determine the response of muscles. The ideal study is an MRI but less than 2% of patients need it – the test is also very expensive. If your doctor orders plain x-rays for back pain, then he/she can't be very bright and you can rest assured you will be referred to other more crappy colleagues who will just scam you with more bogus tests.

Back pain managed conservatively

I have back pain and have been thinking of treating myself at home. Is this okay?

Sure, treatment of back pain starts at home. Most people can get better with the use of over the counter pain meds and rest. A short period of bed rest is more than adequate. If the over the counter pain meds do not work, one can obtain prescription strength pain medications. In some cases, low doses of anti depressants can help both pain and sleep.  Once the pain has subsided, physical therapy can help strengthen the muscles and increase range of motion. Physical therapy may involve ultrasound, TENS, electrical stimulation and water therapy. Regular use of these techniques may help improve posture and ease back pain.

Some people with more severe back pain may benefit from injection of corticosteroids in the joint. The steroid can ease inflammation but take a few weeks to work. Not all people respond to these injections. The one thing i can tell you- the more you muck around with your back by going to healthcare professionals, the worse your back pain will become.