How to Enjoy Healthy Holidays Without Being A Total Killjoy

The holidays can present a mixed bag. Most of us look forward to Christmas lights, trimming the tree, and holiday parties with friends and family. But for all of the pros, there are also plenty of seasonal cons: the holidays are hectic, nerve-wracking, and exhausting. Racing from store to store collecting all the trappings is rarely as festive in real life as it looks on paper. Especially for women – who are more likely to be responsible for much of the planning, decorating, cooking, hosting, and gifting that make the season merry and bright. While it’s wonderful to spend time with those you love, getting to your destination can be taxing – particularly if you must travel during hours when you’d typically be sleeping.

And if you’re trying to make healthy choices, the holidays are a minefield. Still, you want your loved ones to enjoy the yuletide cheer unfettered by your unique concerns. I mean, just because you’ve gone gluten-free that doesn’t mean your kids have to miss out on Grandma’s famous Christmas cookies. So, how do you strike the right balance? I’ve got you covered.

Arm yourself with these tips to help you enjoy a healthy holiday without being a total killjoy:


Travel like Santa: It’s all about logistics

Unfortunately, most of us don’t own physics-defying sleds pulled by flying reindeer. A girl can dream though, right? Maybe next year if I’m very good, Santa will leave one under my tree. Until then, we can only aspire to travel like Santa. But holiday traffic, long lines at the airport, last-minute shopping, and often unrealistic expectations from others can distress even the most centered among us. You get anxious, even panicky, sending your body into an intense stress response. The hormones released, such as cortisol and adrenaline, heighten your anxiety while suppressing your immune system at a time when you need to protect your health the most. Stressful times require serious countermeasures. Planning is key – plan ahead to protect your physical and mental health.

So, how can you trip up travel stressors?

  • Do your homework – Make sure you know the best route to the airport or your final destination. Find out whether your hotel has a gym so you can de-stress with some exercise during your stay. Follow the weather reports so you’re prepared for the unexpected.
  • Pack your own food – This way you don’t have to rely on the over-processed options lining gas station aisles and airport guest shops. Restaurant food is often packed with extra butter, salt, and preservatives. Make sure your hotel has healthy food options on the menu.
  • Press pause – Things like overbooked flights and last-minute changes of plans can be stressful. If you encounter them, slow down for a few minutes, take some deep breaths, and try to clear your head. Walk it off if possible – around the block or the airport terminal. I find that a brisk walk can help put things in perspective.
  • Laugh a little – The benefits of laughter include lowering blood pressure, improving your immune system performance and reducing stress hormones. Interestingly, these positive effects are similar to having sex – I talk more about that here. Over the holidays, try to remember what truly matters: friends, fellowship, family. Surround yourself with people who make you smile.

Laugh a lot! When you laugh, your body releases endorphins which can make a happy holiday even happier.

Holiday weight gain? Sleep it off.

Only 40% of people are getting the recommended amount of sleep (7-9 hours) per night – and that’s when everything is going according to plan. Over the holidays, your sleep schedule can really go haywire as most of us spend more time celebrating and less time logging some serious zzzzs. Just one night of bad sleep can make you hungrier and inclined to eat more. Not only can short-term sleep loss lead to increased caloric consumption, but multiple studies have suggested a link between chronic sleep deprivation and increased obesity risk over time. According to the CDC, people that get less than 7 hours of sleep a night are 24% more likely to be obese. And, the American Sleep Association says as much as 5% of the overall proportion of obesity in adults may be attributable to sleep deprivation.

How do you get a good night’s sleep when you’re waiting for the pitter-patter of reindeer feet?

  • Make sleep a priority – Insufficient sleep is linked to a broad array of chronic diseases and conditions, including type 2 diabetes, cardiovascular disease, obesity, and depression. Visits to the emergency room spike on Thanksgiving and Christmas days, in some areas, by as much as 12% and many of these patients present with injury or illnesses resulting from too little sleep.
  • Do not drive drowsy – We hear much about drunk driving but a surprising number of auto accidents each year are caused by over-tired drivers. According two the CDC, an estimated 1 in 25 adults report having fallen asleep at the wheel in the last month. Over the holidays, these numbers are surely higher and, oftentimes, complicated by excessive alcohol consumption. So get the sleep you need and – if you don’t – surrender your keys to someone who has.
  • Unwind before bed – Stay away from devices and limit screen time. Save searches for last-minute gifts on Amazon for daylight hours.
  • Soak before you sleep – Try taking a warm bath before bed. There’s nothing I like more than lighting a lavender-scented candle and unwinding with an Epsom salt bath. After your soak, retire to a room that is dark and cool for optimal sleep.
  • Sleep and depression – Not getting enough sleep isn’t just bad for you physically but it can profoundly affect your mental health. The holidays are prime times for sleep disruption: you’re away from home, in an unfamiliar bed, and often not in control of your nightly routine. Sleep disturbance is one of the key symptoms of major depression so strive to maintain your personal bedtime rituals while you’re on the road.

Eat, drink, and be merry…within reason

For many, the holidays are a time where you grant yourself a free pass to indulge – the problems arise when you overindulge. Now, I’m not suggesting that you deprive yourself of your favorite seasonal delicacies. Each year when I am making stuffing, I forgo my typical healthy breakfast and indulge in a slice of pumpkin pie…I challenge anyone to stop me. However, taking a mindful approach to food and drink around the holidays is wise. Focus more on the fellowship and less on the food and you’ll have fewer regrets. You may actually get to know someone new or learn more about a distant cousin. Then when the parties are over, get back to your normal healthy routine as soon as possible.

How does one feast in moderation? One. Bite. At. A. Time.

  • Drink plenty of water – whenever possible, choose water over other beverage options. I always travel with my green tea bags since they’re caffeine-free and potent with antioxidants to oppose some of our inevitable poor holiday choices.
  • Watch your alcohol – it’s natural to want to celebrate during this festive time of year. Unfortunately, some revelers may drink to excess and, for many, this can lead to bad choices and even depression. The “holiday blues” are very real and can have dire consequences. Limit your alcohol intake and take in the good cheer instead.
  • Eat your own healthy food before heading out to holiday parties – if you’re already sated, you’re less likely to be tempted to overdo it. If you overindulge at all, let it be on charity and the love you share with your family and friends.
  • Contribute a healthy dish – bring along your signature fall vegetable casserole or a colorful salad. Every year I bake sweet potatoes with cinnamon and nutmeg. Why drown a perfect vegetable in syrup and marshmallows?
  • Pack your supplements in advance – I double my probiotic dosage to boost my immune system, aid digestion, and to combat Seasonal Affective Disorder (SAD). Don’t forget your daily dose of D. During fall and winter months when sunlight is scarce and we spend less time outdoors, Vitamin D is especially crucial. Learn more about this multitasking nutrient here.
  • Live a little – if you love your mom’s cornbread stuffing then, by all means, have a serving. Treat it like the once-a-year special exception that it is.

Baby, it’s cold outside. Take advantage of it! The holidays are the best time of the year for snow angels.

Workout your bod and your mood

When you’re at home, you’ve got your exercise routine down pat – that’s the goal, anyway. But, over the holidays, you’re not always in control of your schedule and subjected to unexpected delays and complications. As our to-do lists grow ever longer, many of us exercise less and less. The last thing you want is more stress and, for many of us, trying to maintain our usual workout program does just that. At the same time, staying active gives you the necessary energy and peace of mind to mitigate both stress and offset some of those extra calories you’re eating. Most important, exercise is an all-natural means to keep depressive symptoms at bay during a time when many struggle the most from mental health concerns.

How do you  stay active and stay in the holiday spirit at the same time?

  • Keep your eyes open – Wherever your travels take you, stay on the lookout for walking, running, or hiking trails nearby.
  • Bring a workout plan with you – Pack resistance bands or, if you have a laptop, bring your favorite yoga DVD so you can spend some downtime on your mat. When I travel, I pack my portable OYO double flex and squeeze in a workout when I find a spare minute. And no, I am not a paid spokesperson; I simply love this piece of equipment. And I’m in good company: the OYO was engineered for astronauts to maintain muscle mass while in space.
  • Wear running shoes whenever possible – You never know when you’ll find a 15-20-minute window for a walk. You want to be ready at all times. After dinner is a perfect time for an excursion and it will give you a chance to catch up with family and friends.
  • Organize team sports – Like football, soccer, or basketball so you can get the whole family moving.
  • Volunteer to help with household chores – Things like raking leaves, carrying suitcases, or entertaining nieces and nephews who are hopped up on sugary treats allow you to burn calories and lend a helping hand at the same time.
  • Put on your dancing shoes – If there’s a dance floor at the company Christmas party, get your butt out there and shake it. Dancing burns up to 8 calories per minute…so get out on the floor and move. You’ll burn calories and steer clear of the buffet at the same time.
  • Get over yourself – So what if you can’t get in your daily 5-mile run while you’re visiting your in-laws? Don’t let it ruin your stay. Simply get back to your routine as soon as you get home.

Serenity now. Serenity now…Strategies for hosting and guesting

Whether you’re the party thrower or the party guest, holiday entertaining requires you to be flexible, resourceful, and above all gracious. Once again, planning is essential for avoiding stress and putting together a special night for your loved ones. But no matter how well you’ve thought it through, be prepared for things not to go as planned. That’s half the fun – just roll with it.

How do you entertain without feeling drained?

  • Have a backup plan – Always have a plan B. No matter what the occasion. Call in advance to see if any of your guests have dietary restrictions or allergies. So many people today are lactose intolerant and gluten-free; so save yourself some undue stress by preparing (or purchasing) an assortment of dishes to accommodate their needs.
  • Delegate, delegate, delegate – You don’t have to be a hero. Most people actually like to feel useful. Make sure to spread the responsibilities around whether it’s sending someone to pick up celebratory libations or letting the kids arrange a makeshift centerpiece from the pine cones they found in the yard.
  • It’s ok not to be perfect – If someone arrives with an unexpected guest, simply pull up a folding chair and make room for that exchange student who’s far from home. American holidays are a wonderful cultural experience for all of us to share. If you must surrender your own Christmas china for a paper plate, you’ll represent the embodiment of grace and the spirt of giving.
  • De-stress with aromatherapy – My holiday go-to’s are cinnamon, nutmeg, bergamot, and frankincense. Besides simply smelling amazing, essential oils are calming and have a multitude of health benefits. Essential oils can even provide support for your thyroid. For the millions of Americans with thyroid disorders the holidays can be especially stressful. If you’re concerned that you’re suffering from an undiagnosed thyroid problem, here’s a post that may help you get the help you need.
  • Give yourself a break – If you’re not feeling social, it’s ok to sit out an event. Just make sure you call your host and cancel and maybe send a nice gift. You know your limits. It’s up to you to honor them.

Now, you’re armed with the tools for a stress-free holiday season. Get out there and share your cheer as you ring in the new year!

How Money, Media, and Mental Health are Making Millennial Life Less Sexy

More than fifty years after the sexual revolution, sex in America is in a free fall – especially among young adults who historically are the most sexually active. The children of Boomers – who revolutionized American sexuality during the 1960s – are having far less sex than their parents. Millennials are not only doing it less but they are losing their virginity later than their parents and those from the X generation. The share of Americans who say they never once had sex in the past year is rising, and—most surprising—young adults top this list.

Some have called these trends a “sexual counter-revolution,” arguing that “whereas the 1960s saw a freeing up of attitudes towards sex, pushing at boundaries, this counter-swing is turning sexual freedom into sexual fear, and nearly all sexual opportunities into a legalistic minefield.” Children have always rebelled against their parents but typically they do so by upping the stakes. Today, especially younger millennials, are countering the freedom and liberality of Boomers with a new more puritanical and cautious approach to sex.

Casualties of the “sexual counter-revolution”

This decline in sexual behavior among millennials is the result of a nexus of factors from social media to social anxiety. I recently attended an Anti-Aging Academy of America (A4M) conference where I was shocked to learn that 33% of millennials are infertile – this figure applies to men and women and has proven to be multifactorial. However, I see some psychosocial and health ramifications that are as clear as day:

  • less and later marriage – later marriage means greater difficulty conceiving
  • lower birth rates – in the U.S., the birth rate is lower than it’s been in 30 years
  • lower libidos – largely the result of the hypothyroid epidemic
  • difficult pregnancies and more miscarriages – older parents have a harder time conceiving
  • increased number of people suffering from hormonal imbalances
  • lower testosterone which leads to lower sperm count. If you’re looking for solutions for low testosterone, you can read more here.
  • erectile dysfunction – yes, even among millennial males, 25% experience intermittent ED. To learn how we can treat ED, go here.
  • infertility in women and men
  • more mental health issues – anti-depressant and anti-anxiety prescriptions are at an all-time high
  • greater social isolation – largely the result of technology and social media

These trends are apparent among both young adult men and women. So, all that talk you hear about “Netflix and chilling”? It may be just that – talk. Young men and women appear to be doing lots of binge-watching and less and less “chilling.”

But it’s not all doom and gloom. Some positive developments of less sex are also evident–from fewer unplanned pregnancies to broadening the public discourse around issues of consent, sexual harassment, and rape, along with an unprecedented acceptance of LGBTQ community.  

Wait. What? Millennials aren’t hooking up like mad?

Yep. You read that right. Despite a lot of buzz about “hookup culture,” from 2004-2012, young adults didn’t have any more sex than their counterparts in 1988-1996. They were, however, less likely to be in a steady relationship with the people they slept with. American adults, on average, are having sex about nine fewer times per year in the 2010s compared to adults in the late 1990s. That’s a 14% decline in sexual frequency.

According to analysis of the General Social Survey, other 18- to 30-year-olds aren’t doing it at all. From 2002 to 2004, 12 percent of them reported having no sex in the preceding year. A decade later, during the two years from 2014 to 2016, that number rose to 18 percent. Time magazine puts the figure at one in three 20-somethings who have never had sex at all. Rather than focusing on sleeping around, it appears that many in their 20s are focused on getting ahead. Explanations for this phenomenon abound – experts blame everything, including:

  • more time spent on smartphones and other devices
  • the millennial trend of living with their parents
  • anxiety about the future and anxiety in general
  • fear of missing out (FOMO) magnified by social media

While millennials may not be doing it in record numbers, they are doing their Sex Ed homework online.

There is also the possibility that millennial conceptions of what constitutes “having sex” may be skewing the results. Anecdotally, in my practice, I’ve seen a rise in oral sexual behavior especially among young adult patients. Even so, these numbers indicate an undeniable cooling off of sexual conduct.

The most cautious generation

If Boomers are the sexiest generation, millennials are the most cautious by a landslide. Hovered over by ever-present helicopter parents, millennials were raised to be risk-averse. From birth, they wore helmets and fastened seatbelts. But risk-taking plays a major part in sexual experimentation. Millennials had unprecedented access to information about sexual behavior via the internet, including potentially alarming data facts about unplanned pregnancies and sexually transmitted diseases (STDs). Such access made an already anxious and serious generation more so. No generation before has had so much awareness about sexuality and so little real-life experience.

Millennials grew up in the shadow of HIV and informed about STDs, explains Jeffrey Arnett a research professor at Clark University and author of Adolescence and Emerging Adulthood. “When the Boomers were in their heyday, that didn’t exist and it seemed like free love was a good idea.” He also notes that millennials are much more likely to use condoms than Boomers ever were. I have seen this positive pattern in my practice, as well.

Millennials may view their parents’ comparatively fast and loose behavior as a cautionary tale. This is a lesson that they apply when making many of their life choices. These cautious millennials are not just having less sexual partners than Boomers, they are also limiting all sorts of risky behaviors:

  • they drink less – what once a rite of passage is now considered reckless
  • they smoke less – the popularity of vaping may change this
  • teenage pregnancy has dipped dramatically – and condom use is up
  • they commit less crimes – the crime rate is half now than it was 20 years ago

Money and marriage: Are millennials choosing salaries over sex?

Some posit that sharing a roof with their parents is among the limiting factors when it comes to millennials and sex. There’s likely something to this. For the first time in more than a century, young adults are more likely to live at home with parents than to be married or live with a partner. Married people have greater access to sex – and indeed engage in more sex, more often – than single people. Since millennials tend to marry later, a decrease in sexual participation makes sense.

Studies show that globally millennials are logging in some serious hours. Many are virtually married to their careers. The pressure on this generation has taken its toll so much so that those who are employed feel they must work crazy hours for job security or moving up the corporate ladder. The emphasis on preparing first for college and now for careers has come at the expense of romantic relationships and age-appropriate sexual experimentation – the very behaviors that typically lead to marriage.

Millennials have an historically low marriage rate. And, obviously, since married people are less likely to be virgins than the non-married, it follows that a decline in marriage means an increase in virginity.

Multiple monetary factors are at play when it comes to declining marriage rates:

  • More and more women choose to enroll in college and join the workforce before having children or getting married: the average age of first marriage for females in the U.S. has climbed to 27, compared to 23 in 1990, according to Pew statistics.
  • Millennial males remain less likely to hold down a job than the generation before them, even as women their age work at higher rates.
  • Student loan debt is through the roof, hitting the $1 trillion mark six years ago and many millennials can barely keep their heads above water.
  • Some millennials may simply be more selective than past generations – this is not necessarily a bad thing. With increased economic participation, women are much more active in the mate selection process than in the past.
  • Their Boomer parents were known not only for free love but also for high divorce rates. Divorce is rarely cheap and is often the result of financial friction.

Postponing marriage until you’ve got serious bank sounds smart. But it may impact your ability to conceive.

Many elements are involved in making relationships work – and money plays a fundamental part. However, putting off marriage until your financial house in order may impact your chance of having children. Later marriage is correlated to women having babies later in life, which means that those who experience difficulty conceiving – and this number is higher than you think – look into fertility treatments later, too.

Screen time vs. sexy time: New media and sexuality

Technology influences all of us in a modern world – but millennials were the first generation to grow up with new media pervading every aspect of their daily lives. It is no coincidence that the current dip in millennial sexual activity corresponds with the rise of new technology. The proliferation of smartphones and increased screen time undermine the development of non-virtual relationships, resulting in a sort of sexual disconnect that we’ve not seen in prior generations. New technology encourages millennials to devote more time to social media, video games, pornography and other virtual distractions, and less time with their human peers in person. Less flesh-and-blood encounters mean less sex.

The concomitant rise of social media also contributes to the decline in sexual intimacy among millennials. According to the Pew Research Institute, 88% of 18- to 29-year-olds are on some kind of social media network daily, if not several platforms. A majority report visiting Instagram every day, and 38% report visiting the app multiple times per day. Scientists have found that simply getting a “like” of one’s social media postings triggers a dopamine bump—which simulates an addiction cycle similar to drugs.

During their spare time, many millennials are choosing their screens over sex and selecting their devices over dating.

Social media and self-esteem

Social media also takes a toll on millennials’ self-esteem. Seeing peers portrayed with flawless bodies, accomplishing enviable personal and professional milestones, and advertising their seemingly perfect love lives, increases feelings of insecurity as it amps up competitiveness and the pressure to succeed. Social media rewards such displays with digital applause while propelling the less secure online toward mental health issues, body dysmorphic disorders, and social isolation.

People continually immersed in an electronic world don’t experience as much human contact of any kind as those who, in previous generations, found their stimulation face-to-face. Last year, a study found that, contrary to popular belief, older populations aren’t necessarily at the highest risk of feeling lonely. In fact, loneliness is greatest among teenagers and young adults. Social isolation often dovetails with low self-esteem, particularly among young adults.

Dating apps and sexual appetites

Meanwhile, finding sex outside of relationships has never been easier. Dating apps allow men and women to hookup with multiple partners – in shifts throughout the day, if they desire. Because these apps are accessible via smartphones, people can now keep illicit liaisons secret from their partners in ways not imaginable before. Extramarital sex is more widely accepted among millennials than any age group. In a recent study, compared to older generations, millennials reported the lowest disapproval of infidelity at 75 percent.

For millennial singles, online dating leaves much to be desired as well. Researcher Jean Twenge, a millennials-expert tells the Washington Post that the prominence of online dating contributes dramatically to their slumping rates of sexual activity. “It ends up putting a lot of importance on physical appearance” which “leaves out a large section of the population,” says Twenge. “For a lot of folks who are of average appearance, marriage and stable relationships was where they were having sex … [and dating apps may be] leaving some people with fewer choices and they might be more reluctant to search for partners at all.”

This superficial component of dating apps leaves many feeling left out and less likely to risk the emotional damage that comes with rejection. Many millennials would rather be safe and solo than suffer the consequences of “catching feelings.”

Many single millennials would rather be safe and solo than risk rejection or the possibility of “catching feelings.”

Porn and performance. Yes, they’re related.

Pornography is pervasive – there is no doubt about it. And its consumption is on the rise, especially among millennial males, but women are picking up steam. A research team led by Brigham Young University economist Joseph Price looked at shifting attitudes and behaviors surrounding porn from 1973 to 2012. Their research, published in the Journal of Sex Research, finds “porn viewership has increased substantially among young adults.” Popular adult site, Pornhub, saw its viewership grow from 10 million daily visits in 2009 to 25 million in 2012 to 75 million in 2017. That’s a significant leap by any standards.

Rising pornography consumption represents a serious factor in declining millennial sexual behavior. Young men particularly dedicate a significant amount of screen time and attention to virtual sex rather than the real thing. Twenge accounts for such devotion to porn like this: “Why risk rejection, sexually transmitted diseases, relationship arguments or having to meet up with someone when you can watch porn in the privacy of your own bedroom and do things your way?” I’ve got more on the increase in “self-love,” below. Keep reading for that.

But, excessive porn viewing affects more than the mental wellbeing of millennials – it also affects physical performance. Sexual perfectionism is an emerging problem that is firmly rooted in watching porn. Young men and women expect real-world sex to be seamless…just like it appears to be in the pornography that they’ve watched since they were teens. But, in reality, sex is messy and unpredictable. Sexual perfectionism can lead to all types of sexual dysfunction in men and in women – from the inability to orgasm (anorgasmia) to erectile dysfunction.

I’m not in the mood: Millennial sexuality and mental health

It’s not hard to imagine how the challenges of 21st-century life would spawn an epidemic of anxiety among this generation. A survey published earlier this year by the American Psychiatry Association found that millennials are by far the most anxious generation. Women tend to be more anxious than men, and people of color scored 11 points higher on the anxiety scale than Caucasians. Millennials are reporting these and other mental health conditions at higher rates than any generation before. This awareness may not necessarily mean that they are suffering any more than their older counterparts, but they are considerably more vocal – and less judgmental – regarding mental health.

Also referred to as the “anxious generation,” millennials grew up with the constant exposure to the internet and social media. For all of the benefits of technology, life in a digital world is complicated and many millennials feel overwhelmed. Constantly. Higher educational demands and pressure to earn hefty incomes also lead to an inflated quest for perfection. Given the amount of time they spend online, millennials cannot resist the urge to compare their personal and professional achievements to everyone else’s. This practice leads to low self-esteem, insecurity, and a host of other unhealthy mental habits.

Specifically, a dramatic increase in perfectionism – even when it comes to sex. Perfectionism often manifests as a fear of failure – or not performing constantly at your best. Fear of failure in the bedroom is very real. I talked about sexual perfectionism above and I hear these concerns from my patients almost daily. Taking pharmaceuticals is not always the solution and, in some instances, may even compound problems.

One in six Americans are on antidepressants, and the rate is even higher among millennials. Many medications used to treat anxiety and depression decrease libido and sexual activity.

If that’s not depressing, I don’t know what is. For those of us in the medical profession, now is the time to start having different conversations with our patients.

Millennials are doing their Sex Ed homework

While millennials may not be hitting the sheets en masse, they are, nevertheless, highly informed about sexuality. Since most millennials grew up with smartphones and access to the internet close at hand, the way they learned about sex is vastly different than past generations. Whereas Boomers may have had their first intimate encounter with a Playboy magazine or even National Geographic, many millennials found early thrills online.

Sure, both generations likely heard some version of “The Talk” from their parents, but millennials had the advantage of consulting Google for any follow-up questions rather than press their parents for embarrassing details. Millennials are also a more open and less judgmental group who have grown up with important issues like LGBTQ rights, consent, and sex positivity as part of the national conversation.

Self-love is the ultimate in safe sex. And the most “cautious generation” is practicing more than most.

And “self-love” is broadly accepted. The stigma surrounding masturbation has never been less pronounced. Across all generations, millennials masturbate the most often. A recent study comparing the “self-love” practices between the generations found:

  • Millennials masturbate an average of 18 times per month
  • Gen Xers get after it about 13 times per month
  • Boomers loosen their own belts about 7 times monthly

Most millennials have no qualms about discussing masturbation and routinely enlist the help of sex toys. Some even identify as “solosexual,” meaning that they engage exclusively in solo sex rather than sex with partners.

Say what you will about the millennials but at least the “cautious generation” is practicing safe sex. And lots of it.

The Sexy Sixties: Boomers and the Second Sexual Revolution

25 Oct 2018 Blog

Nearly 80 million Americans came of age during the social and sexual revolution of 1960s and ’70s. The era was characterized by rebellion against parents, society, and conformity in general. About a third of the members of this free-loving generation are now single — either divorced, widowed, or never married in the first place. While many Baby Boomers are now parents of the decidedly less sexy millennials and even grandparents, their interest in sex shows no sign of slowing down. The dating app reports that 50-plus is the fastest-growing demographic on the site. And a survey from, an online dating site for older adults, found that 87% of 50- to 70-year-old single users say that physical attraction is a requirement for a potential partner.

According to recent research in the Archives of Sexual Behavior, the average American adult has sex about 60 times per year, so a little more than once a week. For the 2015 and 2016 studies, researchers analyzed polled data on adult sexual habits from the General Social Survey. And who’s having the most? Compared to subsequent generations, Boomers have the most sexual partners over their lifetime. Boomers average 11 partners – compared with millennials who have a projected average of 8. And the X Generation comes in second with an average of 10 partners. I see patients in my practice everyday confirming that Boomers are trending up while, surprisingly, younger generations are trending down in terms of sexual interest.

The Boomers, who launched the sexual revolution in the ’60s, are now well into their 60s. For them, the revolution rages on.

Which is the sexiest generation of them all?

Hands down this distinction belongs to Boomers, who, as they age, continue to push the boundaries of sexuality. It is no surprise that the same generation of women who first benefited from the introduction of the birth control pill in 1965 are now demanding fresh solutions to keep enjoying sex. A movement is afoot – one that challenges long-held assumptions about aging and sexuality, asserting that adults in their 60s and beyond can have healthy and happy sex lives.

When the Food and Drug Administration approved Viagra in 1998 to treat erectile dysfunction, it changed the sexual landscape for older men, adding years to their sexual health. Urologists for men were dedicated to male sexual health and proactively finding solutions to maintain their vitality. Meanwhile, for decades, women with age-related sexual concerns were left high and dry with limited options and few physicians who would listen. My female patients have been tragically underserved by conventional medicine; however, with the emergence of laser medicine, I am thrilled to offer my patients science-proven solutions to meet all of their sexual wellness needs.

Unlike their Viagra-popping partners, Boomer women have been left high and dry…I’m thrilled for you, honey. Really.

Boomer women demand solutions for sexual wellness

Not only did gynecologists fail to rise to the occasion for their female patients, but the findings of the 2005 Women’s Health Initiative (WHI) set women’s health back irreparably by concluding that Hormone Replacement Therapy (HRT) was not safe for women. I see the repercussions of this inaccurate interpretation negatively affecting the lives of my patients on a daily basis. I have been treating women for over 25 years and I am astonished by the myths my patients believe. But more so by how misinformed many of my colleagues are on the role that testosterone therapy plays in preserving women’s libido and sexuality, maintaining bone and brain health, and preventing Type 2 diabetes, heart disease, and breast cancer. Yes, I said that human-identical testosterone therapy prevents breast cancer in women. Longevity cannot realistically be achieved without balanced hormones.

In my clinic, one of the first treatments I recommend to my Boomer women is hormone replacement with BioTE pellet therapy. With the return of the libido, women cannot wait to reclaim their sexuality. Each woman suffers from a unique combination of the many common sexual problems that accompany aging along with structural changes resulting from childbirth – things like incontinence, vaginal laxity and dryness, inability to orgasm, pain during intercourse, embarrassing hemorrhoids, and concern with the appearance of their external genitalia. Propelled by a growing market of women like these demanding solutions, the industry has finally realized the vast nature of this opportunity. Over the past decade, explosive technology – especially in the field of lasers – has emerged to serve the diversity of women’s sexuality.

This is an exciting and rewarding time for older women – and men, too – when it comes their sexual health.

Benefits of the bedroom

Of course, sex is lots of fun – that’s because during arousal, the brain releases powerful “feel-good” chemicals. But, sex also has many positive physiological and emotional benefits so it plays a major role in our overall health. People who have more sex report higher self-esteem, life satisfaction, and quality of life. They make better parents and happier employees. Other benefits of spending more time in the bedroom include:

  • boosts your immunity
  • regulates blood pressure
  • reduces stress and improves mood
  • improves sleep 
  • increased longevity

People with healthy sex lives possess greater confidence in and out of the bedroom. But, for Boomers, the pros of more sex come with new responsibilities and consequences.

Doctors don’t talk to patients about sexual health. Here’s why they should:

More often than not, healthcare professionals don’t ask about their patients’ intimate lives. This is especially true for older individuals, about whom physicians may have preconceived notions that they are not sexually active. Sexuality should be part of a physician’s review of systems – no matter what a patient’s age. Intimacy should be an essential component of the patient-doctor conversation. I ask all of my patients about their sexual health. Questions like:

Are you with a new partner? Perhaps more than one? Are you using protection? Would you like an STD screening? Are you satisfied with your performance and do you achieve orgasm? And, equally important, are you satisfied with your partner’s performance?

Boomers are used to giving “the talk” to their children. Many need to learn to take their own advice.

Why should Boomers talk about sex now?

With the increase in older people dating, high numbers of Boomers are now having unprotected sex. As a result, the increase of sexually transmitted infections (STIs) for older people is startling. In a report by Global News about sexually active seniors, they shared the following alarming statistics:

Recent studies have shown that in the U.S. STDs in the 50 to 70 age group have increased 38 percent from 2014 to 2017…. People over 50 years old made up 21 percent of new HIV diagnoses.

So, why is this happening? Well, it’s multi-factorial. Boomers are not using protection for a broad range of reasons.

  • No longer a fear of pregnancy – when Boomers started having sex, pregnancy was likely the first and only issue they considered. Now that this no longer a concern, older people do not realize that protection is necessary.
  • Unaware of symptoms – sexually transmitted infections (STIs) often can be present without any visible symptoms. Someone can be infected and not even know it. 
  • Not in the habit – many older people had previous long-term sexual relationships where protection was not necessary. Boomers carry these same assumptions from prior relationships into new sexual encounters without considering the consequences.

Sexual avoidance is a thing too

As we grow older, both women and men experience a drop in vital sex hormones, which is usually accompanied by a drop in sexual desire and performance. To make matters worse, as our sex hormone levels decline, we experience a whole host of other unwanted conditions. We have trouble maintaining our weight, difficulty sleeping at night, decreased muscle strength, and lack of energy and fatigue. It’s no wonder that many of us become less interested in sex as we age. HRT is the cornerstone of my sexual wellness philosophy – it’s so critical, that I dedicated a microsite to the topic. You can learn more about hormone pellet therapy here.

For many Boomers, not having sex – even avoiding it altogether – is also not uncommon. Some of the reasons are physical but, oftentimes, they are physiological or psychosocial. Changing bodies and changing priorities are among the many stumbling blocks Boomers face in their ongoing pursuit of love. Boomers represent one of the most stressed-out demographics today. Most are still working full time but many are also tasked with care for aging parents and increasingly helping to financially support adult children. Some simply don’t have the time, or emotional headspace, for romance. For others, the cause could be medical.

Why are Boomers avoiding sex?

Although Boomers are bucking the trend, historically in old age, people tend to have less sex. Some of this is because older people lose their partners and don’t necessarily start dating again. But being in poor health, or taking certain medications, can also make people less interested in sex. Among those who are not actively seeking sex, some Boomers are attempting to avoid it. Women more commonly avoid sex than men – in fact, up to 40% of women avoid sex some time in their lives. However, men too have their motivations for opting out of sex.

These are some of the reasons Boomers are looking for excuses:

  • Pain during sex for women
  • Incontinence and the embarrassment that comes with it – 80% of women experience incontinence during their lifetime.
  • Low libido among women and men
  • Inability to orgasm – 10% of women never climax
  • Metabolic conditions like diabetes and obesity
  • Many medications such as antidepressants and anti-anxiety drugs reduce libido
  • Low levels of testosterone for men – men lose 20% of their testosterone per decade
  • Dissatisfaction with their partner
  • Erectile dysfunction for men – 60% of men over 60 experience ED
  • Lack of opportunity is cited by men

Fortunately, we now have a plethora of solutions for many of these concerns. The second sexual revolution for Boomers could not have come at a better time.

Laser Love: New science so you stay sexy

A number of revolutionary and noninvasive treatments are available to address the complexity of issues impeding sexual performance and desire. You just have to know where to look. At HealthWellnessMD, we offer an array of non-surgical solutions for your most intimate concerns. We perform all of these procedures in the comfort and privacy of our medical spa with little to no downtime.

  • Vaginal Rejuvenation with the FemiLift

The FemiLift is for every woman. Every woman who suffers from incontinence, every woman who wants less discomfort during sex and greater sensation, every woman of every age who wants to feel rejuvenated. This minimally invasive laser stimulates collagen production and increased blood flow to the vaginal walls. The FemiLift has the dual effect of both improving urinary leakage and increasing your sexual sensation, lubrication, and overall intimacy.

  • Internal and external Vaginal Rejuvenation with Votiva 

Votiva uses radiofrequency (RF) to tighten pelvic muscles and treat the effects of vaginal laxity such as urinary incontinence and loss of sensitivity. This safe and comfortable treatment addresses both internal and external vaginal health issues without surgery. If you suffer from low blood flow or sensitivity, pain with intercourse, or decreased libido, Votiva may be perfect for you. Votiva can also address age-related loss of elasticity and wrinkled appearance of the labia and vulva.

  • Male performance enhancement with GAINSWave

Many men equate a healthy sex life with their ability to have a strong and long-lasting erection. They spend billions each year on temporary male enhancement treatments such as Viagra and Cialis despite the numerous and alarming side effects. Any man who wants to take back his sexuality naturally—without risky medication—can benefit from this gentle and pain-free therapy. The GAINSWave™system uses pulsating acoustic waves to increase blood flow to the penis resulting in a firmer, more resilient erection. Using acoustic waves increases the number of blood vessels, removes micro-plaques, and promotes soft tissue growth within the penis, so it stays firmer longer, while also increasing sensitivity. Greater blood flow means stronger erections and optimal sensation.

  • The O-Shot® for Women

The O-Shot®, or Orgasm- Shot, procedure is a very specific method of using blood-derived growth factors from your own platelet-rich plasma (PRP), to rejuvenate and regenerate the vagina. The O-Shot® helps relieve urinary incontinence, sexual problems, and increases sexual pleasure. For many patients, The O-Shot® improves lubrication and arousal from clitoral stimulation and may decrease pain for women who experience pain during intercourse.

  • The P-Shot® for Men

This groundbreaking new treatment uses platelet-rich plasma (PRP) from the patient’s own body to rejuvenate damaged and aged tissue. The P-Shot® entails safe, pain-free injections of a patient’s own PRP to rejuvenate the penis and stimulate new tissue growth, resulting in improved erections that are larger, firmer, and more frequent. Because the PRP comes from your own body, it is a natural and effective treatment for erectile dysfunction as well as Peyronie’s Disease. And because most men see almost instantaneous results, you can enjoy sexual relations on the day of the procedure.

  • Vaginal Revision with Laser Labiaplasty

Labiaplasty is the fastest-growing type of cosmetic surgery today. We offer a nonsurgical alternative for the many women who experience discomfort or limit activities, such as riding bikes or going to the beach, because of their pronounced labia. We can also help women who are embarrassed because they lack labial symmetry. I want all women to know that you can have perfectly symmetrical labia without going under the knife. After my in-office laser labiaplasty, you go home the same day, with little downtime, no stitches, and the symmetrical appearance you’ve always desired.

  • Hemorrhoids with Laser Hemorrhoid Removal 

Hemorrhoids are not only uncomfortable, they can be embarrassing and interfere with your desire for sexual intimacy. With the rise in oral sexual activity, this condition can be especially awkward. As many as 80% of American suffer from hemorrhoids and most are unaware of a simple and minimally invasive technique to eliminate them. Using our CO laser, we permanently remove external hemorrhoids. This laser vaporizes the content of the hemorrhoid as well as the remaining skin sack. So, you can enjoy your sexuality with confidence again.

Your sexual health and wellness is too important to ignore. With such advances in laser technology, there is no reason for Boomers to lack confidence in the bedroom due to medical, performance, or cosmetic concerns. You can feel great about your appearance and enjoy an active and fulfilling sexual life.

Taking it to the sheets: The second Sexual Revolution

Boomers are once again challenging the status quo – this time, they are upending assumptions about aging and sexuality. During the ‘6os, they were taking it to the streets. Now more than fifty years later, they are revolutionizing the way the medical establishment approaches sexuality and longevity. While there will never be another Summer of Love, with all of these science-backed solutions for sexual health, Boomers can come pretty darn close. Future generations say thank you.


6 Things Your Doctors Don’t Get About Your Thyroid Diagnosis

25 Sep 2018 Blog

Do you struggle with exhaustion, weight gain, infertility, constipation, and brain fog? Maybe you’ve got thinning hair, depression, or cold hands? And have you been to see your doctor – perhaps more than one – only to be told that there’s nothing wrong? Or worse, to have your symptoms written off as a natural component of aging, as “woman problems” (if you’re a woman), perhaps told stress was to blame, or even made to feel as if it’s all in your head.

Regrettably, this scenario is far too common in conventional medicine. And, as I explain to my patients every day, it’s often an undiagnosed thyroid condition that’s behind your symptoms. I want you to know that you’re not crazy and that this is not okay. As a functional physician, I know that thyroid problems can strike people as young as their 20s, they can affect men as well as women, and that the symptoms you are describing are all too real. At least 27 million Americans have some form of hypothyroidism (an underachieve thyroid), the most common form of thyroid dysfunction. Furthermore, it is estimated that 60% of those with thyroid dysfunction don’t know they have it. You may be one of them.

Does this sound familiar?

Let me share a story about that may resonate with you.

Troy is a successful businessman in his late fifties who travels extensively for work. He owns a ranch in the northwest where he retreats to fish, hike, and reconnect with his family. When I met Troy, he couldn’t remember the last time he had visited the ranch. He complained of low energy, weight gain, brain fog, dry skin, and decreased libido. What’s worse, he had been suffering from these symptoms for many years – so many, in fact, that he had begun to accept this state as his new normal. Troy had already seen 4 doctors before our appointment. All of them assured him that his concerns were simply a natural part of the aging process; each doctor said that his labs were in the normal range. To address his symptoms, Troy had been prescribed a shocking array of medications: anti-depressants, anti-anxiety medications, ED meds, statins, and sleep aids.

Troy rightly wondered, how can I be fine when I feel this terrible?

After listening to Troy’s symptoms and hearing the hopelessness in his voice, I was determined to find a solution. So, I took a complete medical history, asked him about the medications he was taking as well as any supplements. In addition, I enquired about his quality of life. I wanted to know: Are you exercising? What activities do you enjoy? And, how about relationships and intimacy? Troy told me he no longer exercised – he was too tired. He didn’t really have much joy in his life. Even a trip to his ranch seemed exhausting. And intimacy? Only a few years earlier, he still enjoyed a vibrant sex life and the stamina of a youthful man. Now? Sex had lost much of its luster.

I ordered a comprehensive metabolic panel, and a complete thyroid panel as well as an assessment of essential micronutrients. At Troy’s follow-up, we saw that most of his thyroid labs were indeed in the low “normal” range but that’s not always good enough. What is “normal” for one person can be sub-optimal for another. In Troy’s case, we compared his current labs to his results from the age of 50. I saw a significant fall in his Free T3, the active thyroid hormone; his levels were far from optimal. His testosterone had also fallen to the low 200s – I like to see my male patients maintain T-levels of 900-1100. When your thyroid levels drop, your sex hormones fall right along with them. These declines explain Troy’s low energy, low sex drive, and poor quality of life. He had been suffering from functional hypothyroidism for many years without treatment. Troy’s thyroid dysfunction had not been detected sooner because his physicians were treating his lab results and not treating him as an individual.

Unfortunately, I see patients daily – men and women, young and old – who tell me similar stories. This is a real shame as the solution is actually relatively simple. I placed Troy on desiccated thyroid hormone, in his case NP-Throid, along with nutraceuticals to support his thyroid. Once we optimized his thyroid, not only did his thyroid function improve but his testosterone levels returned to normal on their own, so he required no testosterone replacement therapy. Three months later, Troy called me from his ranch to thank me. He had stopped taking all of the meds prescribed by his other doctors and he felt better than he had in years. He was energized and sleeping well and once again fly-fishing with his family. Best of all, Troy and his wife had rekindled their flame – it was like they were on a second honeymoon.

A Functional Thyroid Is Essential – It is Your Master Hormone

Show me a person with a happy body and a great attitude and I can almost guarantee that he or she has a healthy thyroid. Most of us do not appreciate the degree to which our overall body function is dependent on our thyroid. The hormones produced by the thyroid gland create power for every cell in your body. Every cell in the body has a thyroid receptor because every cell requires thyroid hormone to properly function. Your thyroid is the key that turns on each and every cell and determines the speed at which the cell’s DNA can do what it’s genetically programmed to do.

Although the thyroid’s primary role is the secretion of thyroid hormone and the regulation of weight, thyroid hormone affects every cell in your body. It turns your food into energy. Without precisely the right amount of thyroid hormone, your organs cannot perform at optimal levels and your cells cannot produce properly. But, that’s not all. The thyroid gland is critical for the production of sex hormones, as well. So, if your thyroid is out of whack, your testosterone and estrogen levels will follow suit. This is exactly what happened to my patient Troy. Once you’ve gone down this slippery slope, your quality of life has long been on the decline.

6 Things Your Doctors Don’t Get About Your Thyroid Diagnosis

If Troy had been tested properly for thyroid dysfunction and received appropriate treatment earlier, he would have gotten better within months instead of slogging through his days for years on end. The fact that he had hypothyroidism that was left undiscovered absolutely infuriates me. What’s more, his case is the norm not the exception. Patients will walk into their doctors’ offices complaining of fatigue, weight gain, and depression, and their doctors will write prescriptions for anti-depressants and sleeping pills and send them out with instructions to exercise more, instead of recognizing the underlying thyroid problems. Many conventional physicians end up prescribing diet pills and ADD medications rather than diving in to find the root of the disease causing these symptoms.

I always remind myself that my patients do not want to feel bad; and, I am obliged to uncover the source of the problem. I want my patients to love their lives not simply tolerate them – and an untreated thyroid problem is one sure way to be miserable. If you suspect you have a thyroid problem, or, if you’ve gotten a diagnosis but you’re not seeing any real improvements, here are 6 things I want you to keep in mind:

1. They don’t run a complete panel

TSH, or thyroid stimulating-hormone, is typically the first and only test ordered when a patient with thyroid symptoms is evaluated by a physician. The problem is that, in isolation, your TSH levels reveal little about your thyroid health. Using only TSH to screen for hypothyroidism misses 80% of cases. Let that sink in; that’s most of the time. The TSH screen misses far too many diagnoses, leaving patients needlessly suffering. As a functional physician, I know that TSH represents only one-fourth of the picture. It is imperative to always test for all the functional thyroid studies, which include: TSH, Total T4, Free T3, and TPO (Thyroid Peroxidase). If I had looked solely at Troy’s TSH levels, he would not be fly-fishing at his ranch anytime soon.

2. They overlook an important marker

As many as 80% of people diagnosed with hypothyroidism actually suffer from Hashimoto’s, an autoimmune condition where your immune system attacks your own tissue. Despite what your conventional doctor may tell you, Hashimoto’s isn’t actually a problem of your thyroid; it’s a problem of your immune system. If you have Hashimoto’s, your immune system is malfunctioning and attacking your thyroid, causing it to underproduce its hormones and slowing down all of your metabolic processes. And, in these instances, you can have symptoms for years and have no idea.

Patients get all kinds of inaccurate “diagnoses” for a broad range of diseases – from autoimmune conditions to major psychiatric disorders. But, in reality, Hashimoto’s may be to blame. Hashimoto’s is a leading cause of hypothyroidism, yet mainstream medicine fails to test patients for thyroid antibodies that indicate the diagnosis. Every patient who presents with thyroid symptoms should have their TPO (Thyroid Peroxidase) levels screened. This simple blood test is all you need for a diagnosis.

What’s wrong with this picture? TPO, the only test for Hashimoto’s, is missing.

3. They don’t augment with iodine

Iodine is a relatively rare element but it’s found in abundance in the ocean. Unless you live on the east or the west coasts, you are likely iodine deficient – end, even if you do, chances are still good. In fact, 72 % of the world’s population is deficient in iodine. Why should you care? This micronutrient is essential to every cell in the body and is necessary for the production of all hormones, including thyroid. Iodine is one of the building blocks of your thyroid hormones. Similarly, every hormone and every cell in your body require micronutrients for optimal function. If you want to learn about the supplements you need to keep all of your hormones happy, you can read more here. For now, if you’ve been diagnosed with hypothyroidism and your physician does not recommend iodine supplementation, you may notice no improvement whatsoever even if you’re taking thyroid hormone.

4. They don’t focus on the right thing

Optimizing your thyroid is increasingly significant as we age. In order for you to feel well, you must convert T4 to T3. The older you get, the harder it is for your body to convert T4 to T3. Why is this important? Since T3 is the most active useable form of thyroid hormone that can be used in the cells of the body, Free T3 is critically important. Unfortunately, most mainstream doctors do NOT test for Free T3 levels. Over time, the amount of thyroid hormone decreases as a result of a decreased production by the gland. Additionally, age-related loss of effectiveness at receptor sites causes low thyroid symptoms in spite of “normal” blood levels. The only successful treatment for thyroid disorders is prescribing T3 and T4 combination-thyroid hormone along with key nutrients to support the thyroid. If your physician isn’t recommending this course of action, then find a new one.

5. They rely on old ranges

Even if your doctor does order a complete thyroid panel, they’re usually relying on “normal” reference ranges that are too broad and often inaccurate. It’s very important to know that your thyroid levels can be “normal,” just like Troy’s, and you can still have thyroid symptoms. That’s why I use optimal reference ranges when evaluating your thyroid labs.

  • Broad reference ranges– Ranges were created using people who go to the doctor (i.e. sick people), not healthy ones. So, the reference ranges are far too broad to catch minor variations in thyroid health.
  • Non-standardized reference range– Not only is the reference range too broad, but it can vary from state to state, lab top lab, and even doctor to doctor. This mans it’s possible that you can have a thyroid disorder in one state, but not another. That’s not good science and it’s definitely not good medicine.

So, even though your doctor tells you that your thyroid labs are just fine, if you’re still experiencing symptoms, get a second opinion—and a third, if necessary.

6. They miss the big picture

Everyday life in our modern world robs you of important nutrients that are essential for healthy thyroid function. And it’s key to screen for micronutrient levels because they play a major role in optimizing thyroid function. This is why I assessed Troy’s essential micronutrient levels at our first appointment. When you take medications, when you eat certain foods, when you’re exposed to certain chemicals found in everyday products, your thyroid is compromised. The culprits are nefarious and pervasive and include things like soy, gluten, dairy, and refined sugars, as well as the chloride in your water, fluoride in your toothpaste and mouthwash, and bromides in bread, make-up, and hair color. All of these bad actors also affect your gut health. This matters because there is a direct correlation between your gut, your microbiome, and thyroid function. About 20% of the conversion from T4 to T3 (the active form) happens in the gut. If you have an unhealthy microbiome, you’ll lose that 20%. Plus, your overall nutrient absorption will diminish and many of the nutrients that play a pivotal role in thyroid function will also be low.

How can you be sure you’re getting the best thyroid care?

You walk into the doctor’s office with telltale physical signs of hypothyroidism, including swelling of your face, signs of fatigue, thinning of your eyebrows and hair, pale dry skin, red irritated dry eyes, cold hands and feet, dulled reflexes, hoarseness of voice, and over 200 more obvious symptoms. Your doctor has no idea your physical symptoms are due to hypothyroidism. You are a walking talking billboard for hypothyroidism, but your doctor does not notice. To top it off, not only does the typical conventional physician not run a full thyroid blood panel, but many fail to fully investigate the patient’s medical history, symptoms, family history and conduct a thorough physical exam. I do not believe that patients are to blame for this.

Physicians should get up to speed and stop practicing medicine like it’s forty years ago. In their defense, I will point out that it typically takes 20-30 years for mainstream medicine to incorporate new medical research. However, it is crucial that physicians stay abreast of new science such as longevity science and precision medicine.

Patients: you have to be your own best advocates. Research your physician before your appointment – look for doctors who practice functional medicine because they understand thyroid physiology. And come armed with this list of 6 things that most doctors don’t get about your thyroid diagnosis. Now that you get them, you will be in a better position to get the best care.


7 Supplements to Keep Your Hormones Happy

13 Aug 2018 Blog

Not a day goes by that I don’t hear some form of this question from patients: “Which supplements should I really be taking?” With so much conflicting information about supplements in the news and online, it’s no wonder people are confused. And, at the risk of confusing you even further, you should know that I never recommend “supplements”; however, I do recommend supplementing with nutraceuticals. What are nutraceuticals? Glad you asked. Nutraceuticals is a broad umbrella term used to describe a potent medical-grade product derived from food sources with health benefits in addition to the basic nutritional value found in foods.

As an expert in functional nutrition and hormonal health, I emphasize that a nutrient-rich diet is the foundation of overall wellness. Furthermore, I know that when your hormones are properly balanced, the rest of your body runs smoothly. So, how can you optimize your nutrition and your hormonal health at the same time? You must first and foremost eat a nourishing diet. But, it’s not that simple – I wish it were. Although eating a micronutrient-rich diet of foods is the ideal, supplementing with medical-grade nutraceuticals is the reality for long-term hormonal health and well-being. Keeping your hormones happy will also enhance your healthspan and longevity.

How do I get started on the path to hormonal happiness?

Before you begin any nutraceutical regimen, you’ll want to have blood work done to see where you stand. Your doctor should run a full metabolic panel, along with an assessment of micronutrients to determine if you have any deficiencies. Honestly, I’d be surprised if you didn’t. I have never seen a patient with pristine labs. Almost all Americans are deficient in the essential nutrients required for optimal hormone function. Hormonal imbalances cause physical and psychological symptoms. Many times, they are misdiagnosed or simply ignored. Current clinical research and literature has redefined optimal levels of all sorts of nutrients which conflict with the ranges reported by most labs.

Why should you care? You can’t treat what you don’t know.

Why should I care about hormone balance?

Statistics reveal about 80% of women suffer from some kind of hormonal imbalance during their lifetime, which manifest as physical and mental health challenges due to low estrogen and progesterone levels – the female sex hormones. Most women think that testosterone is exclusively a male hormone. They are dead wrong. Testosterone in women maintains lean muscle mass, protects the brain from dementia, lowers the risk of heart disease, and builds far better bones than estrogen. However, hormonal imbalance is hardly a woman’s issue. Men are equally susceptible to a range of hormonal imbalances caused by testosterone that is too low or inadequate estrogen. In men, estrogen is protective against heart disease and stroke and protects the brain against Alzheimer’s. However, sex hormones are not the only chemical culprits in this story.

Most of us associate hormones primarily with sex. But, we’re really not giving these chemical messengers enough credit. Hormones are more multi-faceted and more complex than that. Your hormones determine how well you respond to stress, how well you sleep, what kind of mood you’re in, and how your thyroid functions. The endocrine system is responsible for the production and regulation of all the hormones in your body. If one or more is even slightly imbalanced, it can cause widespread major health problems.

When your hormones are happy, you’ll be amazed how your world is transformed.

What causes hormonal imbalances?

Hormonal issues typically occur when the endocrine system produces too much or too little of certain hormones. As a result, the body becomes less efficient at processing dietary nutrients, such as protein or vitamins. This malfunction triggers a chain reaction, leading to serious conditions like diabetes, ovarian dysfunction, hypothyroidism, cardiovascular disease, and loss of libido. These conditions occur in men and in women and at any life stage. As far I’m concerned, the decline or loss of sexual desire is as significant as major disease when it comes to our longevity and quality of life.

Each of these health conditions has a variety of causes, from genetics to poor eating, and stress. Sleep deprivation, for example, lowers testosterone and raises cortisol levels – one of the stress hormones. Chemicals or toxins in foods and the environment can disrupt your hormones. Other possible causes of hormonal disorders include obesity, menopause, and pregnancy.  There’s no such thing as low testosterone in the absence of hypothyroidism – many men can even reverse low-T by taking thyroid hormone. Even though you may not have full control over these factors, you can prevent and manage hormonal imbalances. Simple lifestyle changes, such as eating whole foods, getting better quality sleep, and incorporating movement into your day can all contribute to hormonal balance. But, for many, such modifications are not enough.

Nutritional support for optimal hormonal health

In my practice, I encourage all of my patients to optimize their hormones for longevity as well as to improve their quality of life. This means evaluating and treating any thyroid dysfunction and hormonal imbalances. To optimize testosterone and estrogen levels, I employ bioidentical hormone replacement with pellet therapy. And, for thyroid problems, I prescribe thyroid hormone. However, for these interventions to succeed, patients need nutritional support and should supplement with medical-grade nutraceuticals. Hormones always need co-factors to work. Typically, these are vitamins and minerals that help hormones achieve their maximal effects in the cell.

7 Supplements your hormones can’t live without:

I’m going to assume that most of you take a medical-grade multivitamin with your breakfast or dinner. If you don’t, you should. But, you’re going to need more than a multi to keep your endocrine system firing on all cylinders. If you could only make 7 changes to your diet via supplementation for your hormones to function optimally, here’s where I would begin:

  • Vitamin D:  In many ways, D behaves more like a hormone than a vitamin. Your D-level is the number 1 indicator of morbidity (disease) and mortality (death). D supports thyroid function and weight-control. And the nutrient is vital to the prevention of clinical depression and Seasonal Affective Disorder (SAD).
  • Iodine:  For thyroid support, take Iodine. You need Iodine to produce your thyroid hormone and it is also decreases disease in all reproductive tissue – for men and women. In addition, Iodine detoxes you at the cellular level.
  • Probiotics:  You probably know that probiotics are great for your gut health. A healthy microbiome is critical for the absorption of nutrients in your food as well as your nutraceuticals. What you may not know is that a healthy gut makes serotonin, your feel-good hormone, and that probiotics are protective of neurologic tissue. A healthy gut means a healthy brain.
  • DIM:  Diindolylmethane restores your hormone levels in more than one way. First, it alters the production of harmful estrogen metabolytes. Second, it is the most potent anti-inflammatory available, reducing plaque formation that causes cardiovascular diseases. This compound has been proven to promote hypertrophy, or muscle-building, as well as fat loss by suppressing estrogen production. Moreover, it boosts your energy and stamina, increases libido, and lifts your mood.
  • B-Complex:  People with B vitamin deficiencies frequently experience depression, anxiety, and mood swings. B vitamins are essential for the nervous system to work properly and, during pregnancy, they prevent brain and spine defects in the fetus. Further, B vitamins promote healthy metabolism and reduce the risk of stroke.
  • Ashwagandha:  This herbal supplement benefits your adrenals as well as your thyroid function because it promotes the scavenging of free radicals that cause cellular damage. Ashwagandha can be used to support a sluggish or overactive thyroid and can also help overcome adrenal fatigue. Your adrenals can become overtaxed when you experience too much emotional, physical, or mental stress, leading to the disruption of hormones like adrenaline, cortisol, and progesterone. Ashwagandha helps you respond better to such stressors.
  • Omegas:  Omegas make it easier for hormones to reach their destination while also repairing hormone receptor sites. For your heart and brain to function at their best, Omegas are essential.

Once your hormones are in balance, you’ll find it easier to maintain your weight, your skin will look younger, your energy will go up, and you’ll enjoy a more restful sleep. The icing on the cake? Your sex drive and satisfaction will soar and success in your relationships and in life will follow suit.




How I’ve Helped Thousands of Men Feel Like Tarzan Again

If you’re anything like the typical 21st-century American male over 40, I’m guessing you haven’t felt the urge to swing from vine to vine like the “lord of the jungle” recently. When is the last time you dazzled your Jane-equivalent with your stamina and sexual prowess? Been awhile? Know that you’re not alone. Erectile dysfunction affects 18 million men in America. Clinical studies show that performance issues occur in 40% of men at age 40, 50% at 50, and nearly 70% at age 70. Intermittent performance issues are increasingly occurring in younger men, as well, with up to 1 in 4 men under 25 experiencing sexual dysfunction.

What if I told you that I’ve helped thousands of men just like you feel like Tarzan again? All without pills, pumps, or side effects. It’s called the GAINSWave and, if you are among the 52% of men who experience erectile dysfunction, then this treatment may provide a long-term solution. Even for men who consider themselves problem-free, but would still like a boost in the bedroom, the GAINSWave represents a safe and healthy alternative.

Spontaneity Gone?

Satisfying one’s lover is essential to a successful relationship. Part of that satisfaction means being ready when your partner is. For men who miss the spontaneity of younger years, I want you to know that you don’t have to suffer in silence as these symptoms chip away at your desire for intimacy. You no longer have to struggle sexually or fear for the potential failure of your relationship. Furthermore, no matter what your age, I want you to know that you can enjoy a healthy and active sex life again, or for the first time.

Not only can you, but you should. A vibrant sexuality is critical for your wellbeing and for longevity. The benefits of an active sex life are multifold—ranging from better immune function and better sleep quality to a 50% reduction in heart attacks. So, embrace your inner Tarzan for a longer, more fulfilling life.

Many men equate a strong and long-lasting erection with their personal sexual health and wellness. Sometimes, however, external forces get in the way: stress, age, and lifestyle factors can interfere with intimacy. Certain medications may also be responsible for ED (even in younger men). This means many men resort to temporary male enhancements from the drugstore or from healthcare providers. But quick fixes like the “little blue pill” make spontaneity difficult and risk a long list of side effects.

Bio-hacking Your Inner Tarzan

When my male patients first come to see me they are typically defeated, but, still hopeful that I can help. Each one of them asks me the same thing: Why is this happening to me? I explain that, as men age, the blood vessels in the penis collapse due to deterioration or plaque blockage. In the same manner that we develop coronary artery disease from the formation of plaques, the penile artery also forms micro-plaques as a result of decreased blood flow. Adequate blood flow is essential for a strong and lasting erection–the greater the volume, the better.

We now have non-invasive technology for the improvement or possible resolution of much male sexual dysfunction. I approach the treatment of sexual health the same way that I treat all of my patients’ concerns—from the approach of Functional Medicine. This means I first look for the root cause and tailor a treatment to your individual needs. So, initially, together we will address any physiological or emotional impediments to intimacy. Next, I will evaluate your blood work for any vitamin or thyroid deficiencies. Now, thyroid testing is key for a number of reasons. Many men may not be aware that if their thyroid is not functioning properly, they will have low-T, or low testosterone.

If you’re concerned about your testosterone levels, make sure that your physician runs a thorough thyroid function panel that includes your free T3 levels. This number is very important and very misunderstood by most conventional physicians. Your free T3 is your master hormone—it is the key that ignites every cell in your body. So, if you’ve got low testosterone, the first thing I want to look at are your free T3 levels. Once we’ve optimized your thyroid, your testosterone numbers will improve as will your sexual health and pleasure. Plus, you’ll feel and look better in your loincloth.

Me Tarzan. You Jane. Have would you like a tour of my treehouse?

A Better Way to Boost Your Performance with the GAINSWave

I’ve helped literally thousands of men boost their performance using with the GAINSWave.  This noninvasive and pain-free treatment utilizes acoustic sound waves to restore and increase blood flow. The technology has been around for decades, but, only recently has it been used to treat erectile dysfunction and enhance male sexual performance. I’ve been using the  GAINSWave at my Dallas, Texas, clinic for almost 3 years. I’ll admit, at first I was a little dubious. But the results have proved me wrong. My patients are so thrilled with their outcomes that they are referring their friends for the Tarzan treatment.

The device that generates the acoustic waves is applied directly to the penis with the use of a sliding gel. The GAINSWave’s pulsating waves increase blood flow to the penis, which allows for a firmer, more resilient erection. Acoustic sound waves encourage the growth of new blood vessels, as well, while offering additional support to the pelvic floor through an increase in both oxygen and nutrients. This treatment also promotes soft tissue growth with the release of stem cells and growth factor which rejuvenates the tissue of the entire pelvic floor. So the penis stays firmer longer and you experience optimal sensation. Any man who wants to take back his sexuality naturally–and turn his back on prescriptions for good–can benefit from the safe and healthy therapy.

Why wait until you have a problem when you can prevent now?

Many ED sufferers are searching for a treatment when a better approach is early prevention. Most men don’t realize that their testosterone begins falling at the young age of 30. The role of testosterone in achieving erection is to signal to the blood vessels in the penis that it’s time to engorge and engage. In order to perform at your peak sexually, all of the testosterone receptors in the pelvic floor must be saturated.

Men who are passionate cyclists should know that all of that time in the saddle may cause long-term harm. Those precious blood vessels in the penis do not tolerate prolonged or chronic compression. For your overall sexual health and wellness, consider spending less time on the bike and more time in the bedroom.

There are at least 5 components that contribute to maintaining peak sexual performance:

  • Your head has must be in the game
  • Your thyroid must be optimized
  • Your testosterone levels must be optimized
  • Your blood vessels must be in great shape
  • Your exercise routine must be consistent

Does the GAINSWave work for everyone?

I’ve seen amazing benefits from the GAINSWave in my own patients – as many as 90% report marked improvement and enhanced performance. And, for the up to 23% of men between the ages of 40 and 70 who suffer form Peyronie’s disease, this treatment has proven highly successful. Of course, those with a severe degree of heart disease, diabetes, and advanced age may require more treatments and see milder change. Although every man is different, for best results, we typically recommend between 6 and 12 treatments and then a touch-up every year following.

Okay, perhaps you won’t have an occasion to swing from vines any time soon. But, with the GAINSWave, you may be tempted to swing from the bedroom chandeliers.


8 Ways Fasting Will Change Your Life

Can what and when you eat determine how long you will live? How about how healthy your life will be? According to Dr. Valter Longo’s book, The Longevity Diet: Discover the New Science Behind Stem Cell Activation and Regeneration to Slow Aging, Fight Disease, and Optimize Weight, the answer is a resounding yes. Longo is the director of the Longevity Institute at USC in Los Angeles, and of the Program on Longevity and Cancer in Milan. He has spent the past 25 years researching aging, nutrition, and disease in cultures across the globe in search of a simple formula for healthy aging through nutrition. The ProLon fasting-mimicking diet, or FMD, represents the culmination of his life’s work.

Fasting has many clinically proven benefits, including promoting regenerative changes – such as stem cell rejuvenation – as well as positively affecting a wide range of markers that contribute to aging. However, fasting has proven to be challenging for most people. The ProLon is a 5-day plant-based diet plan that properly nourishes you as it tricks the body into believing it is in a fasting state. You see, you don’t have to starve yourself for days on end to reap the benefits of fasting. Your body simply has to think you are.

With the ProLon FMD, your body gets all the benefits of the stem cell-based rejuvenation of a 5-day fast and you get to eat what they call “real food.” And, no costly supplements are required. The pre-packaged soup mixes, bars, and energy drinks contain all of the necessary macro and micronutrients to fortify your fast. However, because supplementation is increasingly necessary in our modern world, I dedicated an entire microsite to the medical-grade nutraceuticals that I recommend to my non-fasting patients. If you’re as confused as most of us about which vitamins matter most, you can learn more here.

The Fasting-mimicking Challenge – What to expect on Day One:

A few weeks ago, in an effort to optimize our health span, my team and I put the diet from the smart people at ProLon to the test. Some of us fared better than others but we stuck it out and completed the fast. I’ll be honest, the first day was a little rough for us all – primarily, because we didn’t know what to expect. Day 1 is critical though, as your body transitions into burning fat and the beginning of cellular optimization. Once you make it through the first day though, you begin to notice real change – in the way you feel, look, and even think. As with any diet, the ProLon is best when conducted under a doctor’s supervision.


8 Ways Fasting Will Change Your Life:

1. You will lose weight

The ProLon is the fastest way to lose fat – especially dangerous belly fat – while, at the same time, protecting lean body mass. Based on $38 million of funding and decades of research, the FMD is the only diet patented to eliminate dangerous visceral fat. The fat that accumulates around the abdominal organs, our visceral fat, is strongly correlated with scores of serious disease risks, including heart disease, cancer, and dementia. By Day 2 of the FMD, your body is switching to fat burning mode. And it’s not just any fat that’s going down; but, the bad kind around your midsection. Even people of normal weight can harbor harmful amounts of this hidden fat beneath the abdominal wall. Periodic fasting is the only proven diet to attack visceral fat.

2. Your energy will skyrocket

During periodic fasting, many people report feeling energized and on the top of their game – as was the case with me and my team. Because you are burning fat rather than the fuel reserves stored in your muscles, your muscles perform better and your energy levels soar. Remember, even though you may feel great during these five fasting days, you should not exercise. No matter how jazzed you feel. This energy surge is not limited to the fasting days: my team and I are all still performing at higher levels.

3. You will sleep like a baby

Lots of activities feel better on an empty stomach – sex, exercise, and sleep are the big ones. Because the FMD initiates stem cell regeneration, a higher percentage of your cells are performing in an optimal manner while you’re fasting; this translates into better sleep patterns. When your brain and body cells are performing at their best, you achieve more restorative sleep. Who doesn’t want that?

4. Your skin will look amazing

As you progress along the fast, stem cell-based regeneration continues and the body is rejuvenated from within. As you eliminate toxins from your body, you can see the benefits in your skin and even your hair. Why? We store the majority of our toxins in fat cells. Periodic fasting detoxes the skin as it purges the toxins from the underlying supporting fat cells. Anecdotally, my team and I noticed an improvement in the appearance of subcutaneous fat and a reduction of cellulite, as well. We were thrilled by this unexpected boon.

5. You will have better sex

Like sleep, sex is better on an empty stomach. Plus, once you lose that visceral fat around your midsection, you’ll be  more confident in your naked skin. Your core will not only look better, it will also function better. No matter who’s on top, that extra core strength will intensify your performance. And that extra energy that I mentioned? It makes all the difference – in and out of the bedroom.

6. Your risk of disease will drop dramatically

Periodic fasting prevents a myriad of diseases. But, that’s not all. It initiates the improvement of chronic disease by lowering blood pressure and cholesterol, controlling glucose, and decreasing rates of all kinds of cancer. Furthermore, fasting lowers markers of inflammation for overall wellness while preventing age-related muscle and bone loss. Periodic fasting even builds your resistance to Alzheimer’s. In my opinion, there is nothing better you can do to promote disease-free longevity than incorporating periodic fasting into your lifestyle.

7. You will have a clear head

Ever experienced brain fog after eating sugary starch foods? Fasting fixes this, too. While fasting, your mental performance is enhanced and you’ll notice greater focus and clarity. In addition, through the process of fasting, you develop a better understanding of your body and an ability to recognize both when you are truly hungry and when you reach fullness. Often, when we think we’re hungry, we’re actually thirsty – the ProLon is incredibly hydrating so you rarely get such mixed messages. Fasting puts you on the road to achieving that elusive mind-body connection – and, this time, you will stay on it.

8. You will live longer

You have probably heard lots about how stem cells can prolong your life. What you may not know, however, is that, as people age, stem cells lose their ability to regenerate. This age-related loss of stem cell function can be reversed by a 24-hour fast, according to a recent study by biologists from MIT. Because the ProLon enables a 5-day fast, you get 5 times the benefit. Meanwhile, the FMD activates stem cell-based renewal as well as the clean up of aging and damaged cells. These cellular processes hold amazing anti-aging benefits that extend your lifespan along with your quality of life.

How often should you do the diet?

The benefits last well after the 5 fasting days end. Stem cell-based rejuvenation continues for 2-3 days once you complete the ProLon FMD and return to your regular healthy meal plan. How often you repeat the cycle depends on a few factors, including your body weight, baseline markers and health measurements, and the evaluation and recommendations of your health care provider:

  • High risk individuals: 3-12 times a year depending on condition
  • Low risk or healthy individuals: 2-4 times a year

Here in my office, a smaller group of us just completed our second cycle of the ProLon. This time around, we found the fast more than doable. The energy elevation and mental focus improvements were exponential during cycle 2 and the additional weight loss delighted us all. What we did not anticipate was a marked decrease in anxiety and simultaneous increase in our ability to handle the stressors of our fast-paced workplace.

Would I recommend the ProLon FMD to my patients?

I would and I do. Longevity science is the future – I want them to be there.




How to Live Longer Through Better Sex

30 Jun 2018 Blog

A few weeks ago, I had the pleasure of chatting with Katie Wells – you may know her as Wellness Mama – for her The Healthy Moms podcast. For those of you who aren’t familiar with Katie’s mission, she is doing some great work on behalf of moms everywhere who want healthier, more holistic lives for themselves and their families. We had a great talk and I’ve been eager for you all to hear it for yourselves. Now, you finally can. Katie recently released podcast episode 168: A Proactive Approach to Aging and Sexual Health and Wellness With HealthWellnessMD. Since it aired, I’ve been overwhelmed by the response from her vast and vocal community of listeners.

Initially, we had planned to discuss the GAINSWave and other natural remedies for erectile dysfunction. Many of the Healthy Moms’ listeners write Katie with questions about non-pharmaceutical options for ED for their husbands so this was to be the focus of the podcast. But, the two of us had so much to talk about that our conversation ran the gamut. Katie and I covered a broad range of subjects – from longevity and anti-aging science to thyroid optimization and the importance of testosterone replacement as we age. And, in addition to the GAINSWave, I introduced Katie to the newly-developed FemiWave – both technologies use shockwave therapy to treat sexual dysfunction and enhance sexual pleasure in men and women, respectively.

First things first. What’s this about shockwave therapy for sexual health?

My patients have been hearing about the benefits of shockwave therapy for pelvic floor health for some time now. I was the first Dallas, Texas provider of the GAINSWave to treat male sexual concerns and improve performance. The GAINSWave uses shockwave therapy to increase blood flow to the penis resulting in a firmer, more resilient erection. We’ve done thousands of these treatment here at HealthWellnessMD and they are not only well-tolerated but my patients are eager to come back due to the their progress. And, in the podcast, I really break down the science. For now, all you need to know is that any man who wants to take back his sexuality naturally—without risky medication—can benefit from this gentle and pain-free therapy.

We also discuss the FemiWave and, as a gynecologist, I’m especially excited about this innovation for women. Like the GAINSWave, the FemiWave utilizes shockwave therapy for pelvic floor health. I have been conducting clinical trials of the FemiWave with impressive results. Preliminary findings indicate an increase in sexual sensation, enhanced sensitivity, and improved lubrication. I’m also seeing an unexpected benefit – a dramatic improvement in female incontinence. Such a large percentage of women let this condition get in the way of living their optimal lives. I’m thrilled to be on the forefront of this alternative solution. But, I’ve said enough. It’s all in the podcast.

Ready to listen?

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The Ultimate Mother’s Day Spa Special

If you want your Mother to have surgical results without the knife

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Vitamin D Update – Benefits Beyond Bone Health

The majority of modern Americans, particularly those of us who live and work in urban environments like Dallas, need more Vitamin D than we currently take in—especially during cold weather months when sunlight is scarce. More than a billion people worldwide suffer from D-deficiencies; alarmingly, most have no clue.

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