INFERTILITY

Posted on September 10, 2012 by Cliff Bacchus, M.D.

Infertility

In my practice, one in ten couples suffers from infertility. Delaying marriage, and not getting pregnancy early enough may contribute to this medical problem. The main causes are:

Sperm disorders
Ovulatory dysfunction
Tubal dysfunction
Abnormal cervical dysfunction
Unidentified factors

We must examine the man and the woman — the earlier the better.

Emotional factors involved in infertility are:

Frustration
Stress
Feeling of inadequacy
Anger
Guilt
Resentment

The investigation and treatment is expensive. Counseling and psychological support are important. The treatment doesn’t always work. Further counseling might be necessary. If the couple wants, they can adopt.

Men must avoid high fever and excessive heat. High temperature destroys sperms. He might also be born without the ability to produce sperm. He might have an obstruction in the genital system. Abnormal dilation of certain veins in the testes raises the temperature, and results in no sperm. Men who have neurological dysfunction or prostatectomy would have retrograde ejaculation. He backfires. Semen does not come out.

We screen men and women with infertility for hormonal disorders.

We look for a history of mumps, infection of the testes, testicular injuries, toxin exposure from factories, and chronic medication use. A sperm count is a good evaluation from the man. Then, there is the immuno-bead test done in specialized clinics. Sometimes a testicular biopsy is necessary.

We treat varicocele (vein dilation) surgically. Clomifene increases sperm count. Artificial insemination might sometimes help the infertility.

We try to establish the cause of irregular periods or no periods before treatment. A woman may monitor her ovulation with the basal body temperature. The procedure is inaccurate. Pelvic ultrasound, serum progesterone (hormonal), and biopsy are more accurate. Bromocryptine is the drug of choice. Women with Polycystic Ovary Syndrome respond well to clomifene and progesterone. Your doctor works out the plan for you.

Salpingitis, or Pelvic Inflamatory Disease, in a woman may block the fallopian tubes. An operation called hysterosalpingogram establishes patency. A gynecologist does this. For abnormal cervical mucus, a postcoital test is necessary. In unexplained infertility, a trial of clomifene for several months may help.

Assisted reproductive techniques are now common: In vitro fertilization, gamite intrafallopian tube transfer (GIFT), and intracytoplasmic sperm injection.

Weather the infertility is primary (No babies), or secondary (one or more children), you will have to discuss the problem of infertility with your doctor. He is your best guide. We cure infertility. I’ve seen marriages wrecked because of male or female infertility. Take advantage of the opportunities, and enjoy the peace of mind and happiness you so deserve.

Part 2: Andropause and Age – You’re wrong!

Posted on September 1, 2012 by Cliff Bacchus, M.D.

Part 2: Andropause caused only by age?

You’re wrong!

It is true that men, like women, start to experience andropause with advancing age. Testosterone drops gradually. But new research shows that behavioral and lifestyle factors play a greater role than age. This means these factors cause testosterone to plummet, and decrease sex drive.

Confusing? It is.

Smokers, alcoholics, and drug abusers – recreational and prescription – may suffer from low testosterone. So do patients with chronic conditions: metabolic syndrome, which causes hypertension, diabetes and obesity. Stress, anxiety and depression may do the same bad job of lowering testosterone level. The result? Low sexual drive, or sexual neurasthenia.

A vicious cycle ensues with obesity. A slim body with a paunch is no exception. Fat cells suck up testosterone, and convert it to estrogen – the female hormone. Lower testosterone leads to more fat cells, which produces more estrogen. Again the result is low energy or impotence.

Having a great sense of humor is good. Laughing a lot is a boon. Dancing much, and exercising daily shoots up the male hormone. Maintaining a healthy and regular sex life increase testosterone. In other words, a man who keeps himself healthy and active, exercises regularly, always in a good mood, sleeps well and eats well, and lives stress-free, may not experience the signs and symptoms of andropause even though he might be fifty, sixty, seventy or eighty! In other words, you have a man who is potent.

I know of old vegans and men of faith – Christians, Muslims and Hindus – who are in their seventies, walk every day, farm every day, and are sexually active. So, is it mind over matter? Maybe. The mind influences the nervous system, which influences the hormonal systems. But lifestyle and behavioral factors play an integral role. It’s a matter of choice. Lose weight, feel great. Exercise often. If you have to drink, drink sensibly. Have at least six to eight hours sleep. Enjoy a healthy sex life. Remember testosterone peaks from 2 am to 6 am. It is the best time for sexual activity.

It’s a matter of choice. You choose the life you want, consciously.

Andropause

Posted on August 25, 2012 by Cliff Bacchus, M.D.

What is andropause?

It is the male equivalent of menopause. It comes with age. This results from the progressive lowering of the male hormones, testosterone and dehydroepiandrosterone. Symptoms include loss of libido and potency, nervousness, depression, impaired memory, difficulty concentrating, fatigue, and insomnia.

Alzheimer patients may become andropausal. Osteoporosis in men is due to andropause. I find that if a man complains of loss of energy and concentration, I think of andropause. If he is always negative, in his fifties, sixties or seventies, and are always pessimistic, complains often, and even cry for no reason, I think andropause. They can be happy. They can be sad. They can be cantankerous.

After age 30, testosterone declines 1% every year. Men who work in the pharmaceutical industry, in plastic factories, and in farms where they use pesticides have low testosterone. They soon show signs and symptoms of andropause. By age 55, 30% of men start to experience andropause. By 65, we may see full-blown andropause. Men with hypertension, diabetes and genetic disorders that produce hypogonadism, have an accelerated andropause.

The treatment is simple:

Dietary changes, to exclude foods too high in estrogen – for example, soy products. Reduce simple carbohydrates, and saturated fats, and avoid foods exposed to pesticides. Go organic!
Exercise help to increase testosterone. Do it daily.
Supplements like maca, horny goat weed, tribulis terrestris, sarsaprella, gingko biloba, wild green oats, ginseng, gotu cola, muira puama, saw palmetto, spirulina, nettles, wild yam, ginger, dandelion and royal jelly help. You may take them as a teas, simply drink the capsules.
If the man’s PSA is normal, I administer Testosterone injections with B-12 monthly.
Maintain a good sense of humor. Laugh often. Have faith in something or somebody. Do good and good will follow you – and may even reduce the signs and symptoms of andropause.

LOW LIBIDO

Posted on August 18, 2012 by Cliff Bacchus, M.D.

Low Libido

It’s something men do not want to talk about. Even in my practice, I find men coming in ostensibly for me to treat headache, backache, insomnia, fatigue, and chest pain. In reality, they might have an underlying low libido. My question is always, “How is your sex life?”

“I’m glad you asked, doctor. I’m still forty, but I don’t have the urge.” He would look away. “You know what I mean, Doc?”

Pride is a reason for a man’s evasion. Denial is everywhere. In low libido it is big – it is as big as his ego. The higher the ego, the more he denies the problem. If self-esteem is low, he tries to cover up with fake complaints, and whines. He looks pathetic.

Much depends on what he expects. If he thinks once a year is good enough, and his partner agrees, then he doesn’t have a problem. The problem arises when he thinks five times a week is not enough, and his partner thinks so, too.

Be wary of men who boast of their sex life. When they do this often, they most likely have low libido, and are covering it up.

Libido in a man starts to decline from ages 50 to 55, and gets worse by age 65. By age 70, his libido is at it’s lowest lever. Why? Because his testosterone lever decreases. Andropause, like menopause in women, steps in. If he accepts it, there is no problem. If he doesn’t, I begin treatment. With advancing age, metabolism decreases. Hormones dry up. Immunity does down. Men have to watch out for prostate problems. If his PSA is high (Test for prostate health), I avoid any intervention. If it is normal – 0.1 to 4.0 or less – I might consider starting him on injectable testosterone monthly, and add 1000 microgram of injectable B-12.

Natural products are available on the market: horny goat weed, maca, l-argenine, stinging nettle, sarsaparilla, tribulis terrestris, and a host of combination supplements available in health food stores. Prescription drugs like Viagra for erection are for just that – an erection. They do not address the underlying causes. Most of them do not give the emotional response you might want. The erection pills may have dangerous side effects. We must only use them under a doctor’s supervision. They may cause cardiovascular and neurological problems. I would suggest going with the natural supplement and foods unless a physician thinks differently.

Remember, sex begins in the head, and ends there.

SEX THERAPY

Posted on August 4, 2012 by Cliff Bacchus, M.D.

SEX THERAPY

What is sex therapy?

It is the treatment of sexual dysfunction. It treats the following ten conditions:

Nonconsummation: It’s the first act of sexual intercourse between two people that did not take place.
Premature ejaculation: This is when a man ejaculates earlier than he should. It happens just before the sexual act, or as soon as it starts.
Erectile Dysfunction: This is the inability to develop or maintain an erection during the sexual act.
Low libido: Low sex drive.
Sexual fetishism: It is the sexual arousal a man or woman receives from a physical object or from a specific situation.
Sex addiction: This is hypersexuality. It is sexual urge, behavior or thought that is extreme.
Painful sex.
Lack of sexual confidence.
Sexual assault.
Stress-related sexual problems.

The Catholic Church says a marriage is consummated when “spouses have performed between themselves in a human fashion a conjugal act which is suitable in itself for the procreation of offspring, to which marriage is ordered by the nature and by which the spouses become one flesh.” Some theologians think that intercourse with contraception does not consummate a marriage. English Law states that the refusal or inability to consummate the marriage can be grounds for the wedding to be void.

If a man ejaculates within two minutes after penetration, he has premature ejaculation. However, seventy-five percent of all the men I have seen within the past forty years, have had, at one time or the other, premature ejaculation within two minutes. The disorder may be genetic, physiological or psychological. There are two types of premature ejaculation: primary or puberty premature ejaculation and premature ejaculation later in life caused by stress, age or disease. The neurotransmitter serotonin (5HT) plays a central role in modulating ejaculation. And so, selective serotonin reuptake inhibitors (SSRI) which increases serotonin level in the synapse, seems effective in treating premature ejaculation. The Kegel exercise and desensitization creams help.

The most important organic causes I’ve found of erectile dysfunction are cardiovascular diseases, diabetes, neurological problems ( trauma from prostatectomy), hormonal insufficiency, drug side effects, and psychological reasons (guilt being a reason). Viagra is the first line treatment, but we have to be wary of the side effects – heart attack, blindness, headache, and dizziness. Potassium tablets, prostaglandin tablets, injections into the penis, penile prosthesis, a penile pump and vascular reconstructive surgery all help.

In low libido, testosterone for men and women works. At the same time, I address poor nutrition, smoking, and alcohol abuse.

More on the other sexual problems later.

HYPNOSIS

Posted on July 21, 2012 by Cliff Bacchus, M.D.

What is hypnosis?

It’s a mental state created by an induction. It involves the hypnotist and the subject. The hypnotic state might be self-imposed. This is self-hypnosis. Stage hypnosis is fake. A trained medical doctor or a psychotherapist performs clinical hypnosis. This therapy relieves or cures mental or physical conditions.

I’ve had great success combining clinical hypnosis with acupuncture.

During hypnosis, the patient is conscious. As the patient focuses on a particular object, mentally or physically, there is a decrease of peripheral awareness. There is physical relaxation and mental concentration. The patient responds to suggestions for conditions that ail him. The patient is in control. A therapist cannot cause the patient to do anything against his moral, spiritual or philosophical conviction.

Through suggestion, hypnosis relieves anxiety, arousal, negative behavior, uncontrollable behavior, and improves self-esteem. Some medical conditions respond well to hypnosis. Post-Traumatic Stress Disorder is one of them.

Unlike fake stage hypnosis, clinical hypnosis calls for the patient to be lying on a couch or a table. I lead him into muscular relaxation and optical fixation, and eye closure. I sometimes add the counting technique. It works wonderfully. Then, the verbal suggestion phase steps in to target the problem for relief and cure. Mental imagery is effective. Visualization of interesting and calming sceneries helps the induction. After the hypnosis, I spend time to bring the patient out of the hypnotic spell. I ensure the patient gets a good post-hypnotic suggestion to last for a few days, a few weeks, or a few years, or a lifetime.

It’s that simple, unless hypnotists are dealing with patients with Type A personalities – the leaders, the hyperactive, the aggressive, the testosterone macho men. I find it impossible to hypnotize them. In my assessment, I make sure patients are either Type B or Type C.

Hypnosis is self-hypnosis. The hypnotist only leads. We are speaking to their conscious mind. They take it to the deeper levels of their minds. Subliminal suggestions in the form of stories may bypass the conscious mind. Let the patients filter the suggestion through their conscious mind. That way, the patients are in control. Patients can learn the techniques, and do the tension-relaxation, induction and suggestion.

Clinical hypnotists are not miracle workers or magicians. We only lead.

MESOTHERAPY

Posted on June 24, 2012 by Cliff Bacchus, M.D.

Mesotherapy

Want to lose weight when nothing else works?

Want to get rid of cellulite?

Need to melt abdominal fat?

Do you want to grow back falling hair?

Do you need a facial rejuvenation?

If your answer is yes, this therapy is for you.

I’ve been practicing mesotherapy since 2005. It is a successful therapy, but I don’t find it successful for obese people. It works well for mild to moderate obesity with bulges here and there – abdomen and thigh. It is promising for premature baldness.

Mesotherapy is body sculpting. It uses tiny needles into the skin to melt fat. The patient does not feel the needles because I apply lidocaine gel before. The treatment targets specific areas of the body. For example, if you want to treat fat in the stomach, the needles go there. It is a nonsurgical cosmetic procedure. It uses pharmaceutical, homeopathic, and herbal medicine, and vitamins. The medicine targets adipose fat cells. It causes lipolysis. The fat melts away!

Dr. Michel Pistor, a French doctor, founded mesotherapy in 1948. The French press termed it mesotherapy. Mesos = middle. Therapeia = to treat medically. It became popular in France and Europe, and spread to South America. It’s popular in the United States.

Some of the more popular medicines used are phosphatidylcholine, aminophinine, l-carnitine, l-arginine, hyaluronidase, collagenase, alpha lipoeic acid, vitamin C, lidocaine, ginkgo biloba, vitamins and trace elements, and caffeine.

I’ve also used mesotherapy for tendinitis, cervico-bracialgia ( neck and shoulder pain), and arthritis.

Like any therapy, individual response varies. Observing hygiene, and taking a good medical history is important. The therapy should be in the hands of doctors qualified to do mesotherapy.

How long does a session take? Between thirty to ninety minutes. Depending on the severity of the case, a client might need monthly treatments. It is for all ages, but I’ve been getting middle age men and women, and women in their thirties coming in for minor tucks here and there.

How much does it cost? It varies with the area to treat. It might cost from $300 to $900.

Worth a try!

FACIAL REJUVINATION

Posted on June 16, 2012 by Cliff Bacchus, M.D.

FACIAL REJUVINATION

Do you want to look ten years younger?

Women look like celebrities after I do this procedure on them. It has different names: cosmetic acupuncture, facial rejuvenation, antiaging procedure, and nonsurgical face-lift.

What is facial rejuvenation? It’s an effective way to get rid of fine lines and wrinkles from the face. It revitalizes the skin, and gives a youthful look. It works by increasing circulation, and so stimulates the body’s collagen production.

I insert acupuncture needles into specific facial points, and leave them for half an hour. To crown it all, I do a facial massage with natural ingredients. The result? No more sagging skin. Good-bye to double chin. The wrinkles disappear. The skin tightens and becomes more elastic. Puffy eyes and dark circles go away.

Some women need only one treatment. Others require several treatments weekly. The younger you are, the fewer treatment you need.

Of course, lifestyle comes first. Eat in moderation, and avoid too much meat. I’m not saying be a vegan, but it helps. Avoid junk food. Avoid too much sun. Do not smoke. Drink in moderation if you must. Drink at least six glasses of water daily, and exercise. Eat a well-balanced diet, and because our foods may lack all the essential nutrients, take your vitamins, minerals, and herbs. I always recommend high doses of slow-released vitamin C and omega 3 for skin elasticity. Avoid stress as much as possible. It causes vaso-constriction, poor blood supply to the face, and reduces collagen production.

I detoxify my clients often. This would include colonic detox, lymphatic detox, and general organ detox. You may browse around health food stores for detox plans. Avoid artificial sweeteners and sodas. Milk is a mucus secretor. Unless you have to, avoid drinking milk. Milk is for cows! I tell my patients to avoid coffee, and drink more green tea.

I’ve had hundreds of success stories with facial rejuvenation. It’s noninvasive, and it has no side effect. It’s an outpatient procedure, and is based on 4,000-year-old Chinese acupuncture. So, when next time you look in the mirror, think about nonsurgical face-lift, and speak to a good acupuncturist in your neighborhood who specializes in facial rejuvenation. If he/she speaks English, tell him I sent you. If he doesn’t speak English, just bow low, and say, “Ni hao ma?”

LA Video

Posted on June 3, 2012 by Cliff Bacchus, M.D.

Copy and paste this video into your URL, and open.

This video interview was during a major book signing in Los Angeles – The Los Angeles Book festival. It is the second largest book show in the world.

.I would appreciate your comments.

OVERDIAGNOSIS

Posted on June 2, 2012 by Cliff Bacchus, M.D.

OVERDIAGNOSIS

Doctors, have you ever diagnosed a case that would never cause any signs, symptoms or death?
You are guilty of turning patients into hypochondriacs. You treat them with medication that would do their bodies harm. We already know how poisonous some of the prescription drugs are.
Cancer screening that leads to the pathological finding of cancer under a microscope is a good example. The findings might never lead to signs and symptoms of cancer in a patient’s lifetime. The patient lives a full, health life, dies, and the condition only shows up at autopsy. As a postscript, PSA is not a reliable yardstick for prostate cancer screening.
A patient of mine, age 91 died of natural causes. He was never a patient of mine, and had never seen a doctor for anything. I knew him from involvement in the community. He never had any urinary problems, debility or chronic fatigue. He ate well, and kept a normal weight. He was always cheerful, and worked hard in his farm. The autopsy showed cancer of the prostate. This smart gentleman avoided the rigors of over-diagnosis.
In cancer screening, it is easy to detect ‘sloth’ or slow-growing cancers. Some preclinical cancers will not turn into full-blown cancers. That’s over-diagnosis. At times, we miss the ‘rabbit’ or aggressive cancers. The ‘rabbit’ cancers are the ones we don’t want to miss.
Sometimes doctors misdiagnose with mammography. So does X-ray screening for lung cancer. Unnecessary treatment for cancer leads to the deadly exposure to chemotherapy and radiation. Calling someone a cancer patient, when there is no need to, may lead to a depressive reaction. Treatments are expensive, and if millions of Americans have no health insurance, where will they find the money for treatment that is the result of a doctor’s over-diagnosis? Would this be iatrogenic economic bankruptcy?