As you may have read on our Weight Loss with Semaglutide page, we believe that Semaglutide and Mounjaro (tirzepatide) can be safe and highly effective tools for long-term weight loss and weight management. Most patients who have traditionally struggled with weight loss, when put on a GLP-1 (Semaglutide)  or GLP-1+GIP (Mounjaro or Zepbound ®), recognize substantial weight loss, especially when combined with a healthy diet and a regular exercise regime.   When used responsibly, these medications can be profound for patients who battle weight and metabolic dysfunction and can allow a patient to take control of their health trajectory.

Research shows that 40 percent of men in their forties have reported some changes in erectile function - and the incidence and the decline in quality of erections increases with age. Because it’s such a widespread challenge, erectile dysfunction (ED) treatments are proliferating at an accelerated rate. Men are being barraged with solutions, from pills to penis pumps, to address ED, some more evidence-based than others.

I recently listened to a Huberman Lab podcast that discussed weight loss concepts that you don’t typically hear about. Andrew Huberman, Ph.D., a neuroscientist and Professor at the Stanford University School of Medicine, reviews a number of unique, evidence-based hacks for weight loss. Because we are all inundated with information about the “best” ways to lose weight - keto, intermittent fasting, pills, exercise regimes, etc.

In part one of this series about menopausal weight gain, we discussed the reasons why women tend to put on weight during perimenopause and menopause. Now let’s discuss what to do about it. Many of the variables that impact weight gain during this phase of life can be modified by focusing on what you eat, how you move your body and determining if medications and/or hormone therapy might be right for you.

According to Menopause.org, “...there is no scientific evidence that menopause or hormone therapy is responsible for midlife weight gain….Age and lifestyle are the main culprits.” WTF? If you ask any woman in America aged 48-52 - they might just disagree. In fact the majority of my patients are experiencing an unexplainable 10–25 pound weight gain around the age of perimenopause (40-51 on average) and menopause (52+ on average) - despite an increasingly strict focus on diet and exercise.

Unlike your bathroom scale, body composition analysis can tell you what percentage of your total body weight comes from fat, muscle, and bone - providing a much more accurate measurement of your overall health and fitness levels. You may have heard of BMI - which measures your weight against your height. But this can be very deceiving - for instance, people with more muscle mass can show up in the “obese” category on the BMI scale.

Cold exposure therapy is a brief to extended exposure to cold temperatures via different forms including cold showers, ice baths, cold plunges, etc. There are many well-documented benefits to cold-exposure therapy including a boosted immune system, enhanced mental clarity, anti-depressive benefits, building mental toughness, improved metabolism and metabolic detox.

As we discussed in our first blog of this series, losing weight and keeping it off can be challenging. Ideally, we like to start by focusing our patients on lifestyle changes - specifically diet and exercise. While there is no one-size-fits-all approach to nutrition, in our experience, a plant or whole foods-heavy diet with at least some consciousness around carbohydrates and varying degrees of intermittent fasting can be the most effective for weight loss.

According to a 2018 CDC report, 56% of women and 42% of men in the U.S. tried to lose weight within the previous 12 months. And research suggests that approximately 80% of people who shed a significant portion of their body fat will not maintain that degree of weight loss for 12 months - and most dieters regain, on average, more than half of what they lose within two years.

Pelvic floor physical therapy is a treatment applied to the pelvic floor muscles. This is a subspecialty of a physical therapist and most pelvic floor PTs have special training allowing them to work on the pelvic floor. The pelvic floor, a group of muscles running from the pubic bone to the tailbone, serves a number of purposes including supporting the pelvic organs, controlling the bladder and bowels, and allowing for healthy sexual arousal and orgasm.

Many women - and men - may have heard about Kegel exercises. But so many of our patients wonder what exactly they are and how, precisely, to do them. Kegels can be an excellent exercise to help improve your urinary health as well as your sex life - so learning about what they are and how best to perform them can really contribute to your wellbeing.

Dr. Kass takes a comprehensive approach to treating urinary incontinence, evaluating possible contributory factors such as medications and medical conditions before recommending specific treatment.

While the number of men undergoing prostatectomies may be declining, the percentage of men experiencing urinary incontinence and ED following the procedure is significant.

Multiple causal factors may contribute to Erectile Dysfunction (ED). Peyronie’s disease, or Peyronie disease, is also a common affliction, affecting up to 23% of the worldwide male population between the ages of 40 and 70 years.* In many cases, Peyronie’s disease leads to ED.

Premature ejaculation (PE), which is also known as early or rapid ejaculation, is defined according to three essential criteria: (1) loss of control; (2) brief ejaculatory latency (reaching ejaculation in two minutes or less); and (3) psychological distress in the patient and/or partner. PE is a fairly common issue in men, with the Mayo Clinic stating that as many as one-third of men report that they experience this problem at some time in their lives.

I can’t tell you how many women come to me with stories of being discounted by their OB-GYNs or primary care practitioners. Many women’s primary providers (OB-GYNs and family medicine) are failing women suffering through menopause - telling them “This is normal and it will pass” or offering them inadequate treatments like antidepressants. And so many women feel like they are losing control over their bodies and wellbeing.

If you have struggled to find the help you need to address menopausal symptoms, you are not alone. Despite the discomfort women experience during menopause, and treatment options that can improve one’s quality of life and perhaps prevent several chronic diseases, very few women are successfully treated. Today, American women can spend a third or more of their lives struggling with menopausal symptoms and related conditions, many without a clear understanding of what to expect, how to respond, and what treatment is possible.

According to an article in AARP, nearly 6,000 women reach menopause every day in America. The North American Menopause Society (NAMS) reports that approximately 75 percent of women experience some kind of menopausal distress. And sadly, for close to 20 percent of these women, night sweats and hot flashes are severe enough to interfere with nearly every significant aspect of their lives: work, relationships and sleep.

For the majority of my female patients, vaginal rejuvenation is all about enhancing genital urinary health, function, and feeling. While some are looking to enhance aesthetics, I have found that more women turn to me for vaginal rejuvenation because they are having some level of dysfunction that is compromising their quality of life or relationships and they’re looking for a solution. And these conditions are more common than many imagine. For instance, more than 30% of women are affected by urinary incontinence, and half of postmenopausal women are affected by vaginal dryness and discomfort with sex.

Shockwave therapy has been employed in the medical field since the 1980s - used to treat everything from breaking up kidney stones to addressing conditions like joint pain, bursitis, and tendinitis. More recently, physicians and scientists have had encouraging results using this kind of therapy to treat erectile dysfunction (ED).