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Premenstrual Syndrome PMS or Premenstrual Dysphoric Disorder night sweat


Premenstrual Syndrome PMS or Premenstrual Dysphoric Disorder night sweat

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                                                                                                                                                            Premenstrual Syndrome (PMS)

                                                                                                                                       Health Scope
                                                                                                                    Permit #1
                                                                                                                  Lexington, KY                             or Premenstrual Dysphoric
Apex Research Institute
999 No. Tustin Avenue
                                                                                                                                                            Disorder (PMDD)?
Suite 120                                                                                                                                                                                                                                Health
                                                                                                                                                            by David D. Michie, PhD, Clinical Study Center
Santa Ana, CA 92705                                                                                                                                                                                                                  problems such
714-542-3008                                                                                                                                                We have all heard about PMS and use the         • bloating               as depression,
                                                                                                                                                            term frequently, but how does PMS differ        • decreased            anxiety and panic
                                                                                                                                                            from PMDD? PMS (premenstrual                      interest in           attacks are often
                                                                                                                                                            syndrome) refers to the variation of physical     usual               associated with PMS
                                                                                                                                                            symptoms and mood changes that appear             activities               and PMDD.
                                                                                                                                                            during the last one or two weeks of the         • marked lack of
                                                                                                                                                            menstrual period and disappear with the full      energy
                                                                                                                                                            flow of menses. On the other hand, PMDD         • problems with concentration
                                                                                                                                                            (premenstrual dysphoric disorder) actually      • sleeping too little or too much
                                                                                                                                                            describes a specific set of mood symptoms       • feeling overwhelmed
                                                                                                                                                            that are also present the week before menses
                                                                                                                                                            and remit a few days after the start of         There is evidence to support the theory that
                                                                                                                                                            menses. The mood symptoms associated            premenstrual symptoms are caused primarily
                                                                                                                                                            with PMDD interfere with social and role        by brain chemicals brought about by cyclical
                                                                                                                                                            functioning.                                    fluctuations in ovarian hormones. This is
                                                                                                                                                                                                            supported by the fact that PMS does not
                                                                                                                                                            It has been estimated that 80% of women         occur before menarche, during pregnancy or
                                                                                                                                                            have cyclical symptoms associated with          after menopause. Also, there are possible
                                                                                                                                                            their menses, but only about 3-5% have          genetic influences as well. Studies of
                                                                                                                                       Research Institute   symptoms so severe that they interfere with     identical twins indicate a higher incidence
                                                                                                                                                            work, school, usual activities or               of symptoms in identical twins versus non-
                                                                                                                                                            relationships. The symptoms associated with     identical twins.
                                                                                                                                                            PMS and PMDD appear to be age related,
Menopause and Insomnia                                                                                                                                      but there is some variability depending upon    Often PMS can be managed by simple
continued from page3                                                                                                                                        which article you read. On the average,         means such as:
                                                                                                                                                            these symptoms appear at about age 26 and       • dietary changes (low Carb diet)
Usually getting on the right combo of           • Try to breathe deeply and rhythmically. Try                                                               become worse over time. Other health            • discontinuation of caffeine containing
hormone replacement can banish insomnia,          this count…inhale, 2, 3; hold, 2, 3, exhale   HealthScope is published by Apex                            problems such as depression, anxiety and          products
since it will stabilize your hormone levels.      2, 3 and so on.                               Research Institute                                          panic attacks are often associated with PMS     • discontinuation of OTC medicines
Similarly, herbs, vitamins and phytoestrogens                                                   999 No. Tustin Avenue                                       and PMDD. Thus, it is often difficult to        • taking calcium supplements
that help with menopausal                       Over the Long Term                              Suite 120                                                   make a diagnosis of PMDD.
symptoms often can make a                                                                       Santa Ana, CA 92705                                                                                         Physicians have found that some classes of
                                                • Keep a regular schedule                                                                                   PMS is characterized by symptoms that are
difference. Disturbed sleep                                                                     714-542-3008                                                                                                medications may also be helpful in the
                                                   • Give yourself some "wind-down" time                                                                    more of a physical nature. Examples are:        management of PMS. These include
patterns typically level off after a                                                                                                                        • bloating
few years but since you probably                     before you go to bed.                      The information it contains is                                                                              antidepressants (Zoloft®, Prozac®, Paxil®
                                                                                                general in nature and should not                            • breast tenderness                             for examples), antianxiety agents (Xanax®
don’t want to wait a few years for a                    • Exercise every day BUT not before                                                                 • swelling of hands and feet
good night’s sleep, there are other                                                             be applied to self-diagnosis or                                                                             for example), drugs that block ovulation
                                                          bedtime.                              treatments for any medical condi-                           • general aches and pains                       (Lupron®, for example) and diuretics (water
things that can help.                                                                                                                                       • poor concentration
                                                                 • Avoid stimulants like        tion. Anyone who has, or suspects,                                                                          pills).
Here are some ideas on what                                                                     a medical problem should consult                            • sleep disturbances
                                                                   caffeine or nicotine for 4                                                               • appetite changes                              Many of the symptoms of PMDD are highly
you can do right now to help                                       hours before bedtime.        a qualified physician. Please con-
you sleep....and some ideas                                                                     tact our office if you wish to be                           • psychological discomfort                      linked to bloating and water retention. The
for long term improvement.                                 • Avoid certain hard-to-digest       removed from our mailing list.                                                                              FDA has approved a type of antidepressant
                                                             foods within 4 hours of bedtime.                                                                                                               known as a selective serotonin reuptake
Right Now                                                                                                                                                   In order to make a diagnosis of PMDD a          inhibitor (SSRI) for the treatment of
                                                                                                                                                            woman must have five (5) or more of the
• Drink chamomile tea. It’s calming and
                                                • Take a warm shower or bath 90 minutes
                                                  before bedtime.                               APEX                                                        following during most menstrual cycles in
                                                                                                                                                                                                            PMDD. Research into effective ways to
                                                                                                                                                                                                            manage PMDD center around hormone
                                                                                                                                                            the past year, and at least one of the          manipulation and the use of new generation
                                                • Try relaxation exercises every night before   Melvin J. Tonkon, MD, FACC,                                 characteristics marked with an * must be
• Try warm milk. It has the amino acid            you go to bed.                                                                                                                                            SSRI antidepressants.
                                                                                                FACP                                                        present:
  tryptophan which acts as a mild                                                               Director of Clinical Research
  tranquilizer.                                                                                                                                             • depressed mood*                               Women who are troubled by the symptoms

• Keep the bedroom cool. Cooler rooms help                                                      Cathy Fox                            Spring 2004            • anxiety or tension*
                                                                                                                                                            • irritability*
                                                                                                                                                                                                            of PMS and PMDD are encouraged to
                                                                                                                                                                                                            discuss these problems with their physician
  you to sleep.                                                                                 Administrator                                               • mood swings*                                  and to follow their recommendations.
                                                                                                                                                            • breast tenderness
Prostate Cancer
                                       Diabetes, Coronary Disease                                                                                       Apex Research Institute is seeking patients
By Terry D. Klein, MD, DABFP
Heartland Research Associates
                                       and Cholesterol                                                                                                  for the following studies.Compensation is                                                      May is:
                                                                                                                                                        available for some studies.
Bob Dole impacts us by his                                                                                                                                                                                                                             Asthma & Allergy Awareness Month
policy and by his pathology.           By Melvin J. Tonkon, MD, FACC, FACP, Director of Clinical Research – Apex Research Institute                                                                                                                    Better Sleep Month
Since with the news of his                                                                                                                              We always need volunteers so we can conduct studies to learn more about important new
                                                                                                                                                                                                                                                       Skin Cancer Awareness Month
                                       The diabetic population in the world is                   Many new techniques are currently being utilized       investigational or marketed drugs for diseases. When you volunteer to participate in one

                                                                                                                                                                                                                                                       June is:
having prostate cancer, we are
now talking about and                  approaching epidemic proportions. It is believed          in order to evaluate the success of aggressive         of our drug trials, you contribute to the development of medical therapies that can ulti-
understanding prostate cancer          that over 200 million people in the world or 2%           cholesterol lowering medication using the              mately help thousands of people. Please let us know if you would like to have your name
and related prostate disease           of the world’s population are Type II diabetics. In       intravascular ultrasound as described above. In        added to our mailing list. If you have a known chronic condition, it is very likely that you
much better than ever before.          the U.S. this number is at least 17 million. In the       addition newer techniques are looking at a             will be asked to participate in a study. Please contact our office if you wish to be removed
Prostate cancer is a killer that is                                                                                                                     from our mailing list.                                                                         Vision Research Month
                                       next 10 to 20 years the number of diabetic                reduction in intima-media thickness of the carotid                                                                                                    Headache Awareness Month
now receiving proper attention         patients in the world will more then double but           arteries as well as special computerized               We are currently enrolling individuals for these research studies:
and funding for history and            importantly in the U.S. by the year 2020, Type II         tomagraphy and magnetic resonance angiography
prevention.                                                                                                                                             Study                                                     Compensation up to:
                                       diabetes may account for 70 to 80 million people.         of the coronary arteries.
Over 221,000 new cases of              This significant increase in diabetes is directly                                                                Bipolar Disorder                                          Call for details                     Fruited Couscous
                                                                                                 Currently there are clinical trials on patients with   Pre-Menstrual Syndrome                                    Call for details
prostate cancer will be                related to obesity and inactivity. At the same time                                                              Weight Loss                                               Call for details                     & Chicken Salad
                                       cholesterol levels have dramatically                        extremely elevated cholesterol (familial
diagnosed this year and 29,000                                                                                                                          Hormone Replacement Therapy                               $1000 for completion
men will die. This is the second       increased in this patient population and                          hypercholesterolemia) with a new               Congestive Heart Failure                                  $900 for completion                  Salad:
most common internal cancer            the incidence of coronary heart                                      cholesterol lowering medication.            Asthma / COPD*                                            $760 for completion                  2 1/4 cups water
found in men, second only to           disease has reached epidemic                                           These studies involve a new statin        Coronary Artery Disease w/ Chest Pain –                                                        2 Tbsp chicken bouillon granules
lung cancer.                           proportions. Diabetics have a 2-4                                       that appears to dramatically lower       Oral Medication                                           $725 for completion
                                                                                                                                                        High Blood Pressure                                       $550 for completion                  1 3/4 cups couscous,
                                       fold increased risk of developing                                        LDL cholesterol and following the
Can we prevent prostate                                                                                                                                 Genetic High Cholesterol                                  $600 for completion                    uncooked
                                       coronary heart disease and                                                success with a reduction in IMT
cancer? Well, we certainly are                                                                                                                          Claudication (Leg Pain)                                   $525 for completion                  2 cups boneless skinless chicken breast,
                                       approximately 70% of the                                                  (intima-media thickness) of the
better at finding it earlier with                                                                                                                       Diarrhea Predominant IBS                                  $400 for completion                    cooked, cut into bite-sized pieces
                                       diabetic population will die of a                                         carotid arteries over a several year   Diabetes with High Blood Pressure*                        $400-430 for completion
the capability of utilizing PSA                                                                                                                                                                                                                        1 cup red bell pepper, chopped
                                       cardiac related event.                                                   period of time.                         Anemia*                                                   $336 for completion
testing (a blood test) along with                                                                                                                                                                                                                      1 carrot, chopped
                                                                                                                                                        Constipation                                              $300 for completion
digital rectal examination                                                                                     In addition many studies are being       Prostate Cancer Prevention                                $300 for completion
                                                                                                                                                                                                                                                       1/2 cup dried cranberries
                                       Over the years we have seen that
(DRE).                                                                                                       done with statins currently available      Heart Disease Prevention                                  $280 for completion                  1 green apple, chopped
                                       with the aggressive utilization of
                                                                                                        such as Crestor®, Lipitor®, Zocor®, with        Diabetes                                                  $225 for completion                  3 green onions, chopped
It seems increasingly that we          cholesterol lowering medications that we
                                                                                                 the addition of a new medication release               GERD (Heartburn)                                          $100 for completion                  1/4 cup parsley sprigs, finely minced
can, in fact, prevent prostate         have begun to reduce some of the ravages of                                                                      High Cholesterol                                          Pending
                                       coronary heart disease in this population. The            approximately a year ago called Zetia®. This new
cancer. Numerous clinical
research trials are now ongoing        number one risk factor in diabetics for developing        medication works to further reduce the cholesterol     We are also seeking volunteers for the following possible upcoming studies:                    Dressing:
in the study of prostate cancer        coronary heart disease is elevated LDL cholesterol        by blocking cholesterol absorption. Ongoing            Diabetes                                                     Alzheimer’s                       1/2 cup freshly squeezed lemon juice
prevention. Some very                  or bad cholesterol and low HDL or good                    studies are looking at the safety of the               Metabolic Syndrome                                           Migraine                          3 Tbsp olive oil
common agents have been                cholesterol. The next major risk factor is poor           combination of these medications as well as the        For more information on our research studies in Santa Ana, phone (714) 542-3008 x 306          1 clove garlic, minced
strongly associated with               glucose control as manifested by high hemoglobin          efficacy in lowering the cholesterol even further.     or e-mail                                                            1/2 tsp curry powder
prevention. Even diet (low             A1C of >7 followed by elevated blood pressure                                                                    * Denotes studies at the Riverside office                                                      1/4 tsp cumin
                                                                                                 From the latest meeting of the American College        For more information on our research studies in Riverside, phone (909) 680-0390 or email       1/4 tsp turmeric
animal fat and high fiber) has         and cigarette smoking. We have learned that in            of Cardiology doctors Eric Topol and Steve                                                                         1/4 tsp Tabasco sauce
shown a strong association with        diabetics the risk factors tend to cluster. That
prostate cancer prevention.
                                                                                                 Nessen at the Cleveland Clinic clearly stated that                                                                                                    1/4 tsp black pepper, freshly ground
                                       being the case, we see more diabetics with                the lower one gets the cholesterol (especially in a
Common arthritis medications           hypertension and hypercholesterolemia such that           diabetic patient) the better the patient’s prognosis
                                                                                                                                                                                                                                                               In a jar or small bowl, blend
that are used daily have found
great interest in the prevention
                                       we need to manage all of these risk factors in a
                                       diabetic patient.
                                                                                                 will be. There will be more plaque reduction seen,
                                                                                                 and a significant reduction in the risk of
                                                                                                                                                        Menopause and Insomnia                                                                                    together lemon juice, oil, garlic,
                                                                                                                                                                                                                                                                   curry powder, cumin, turmeric,
of prostate cancer as well as                                                                    cardiovascular morbidity and mortality.                by Donald E. Edger, MD
                                       Over the years several major trials have pointed to                                                                                                                                                                          Tabasco, and black pepper.
other cancers. Clinical
                                       the aggressive use of cholesterol lowering                Based on research that we have been involved           Central Kentucky Research Associates                                                                         Set aside. In a medium sauce
research investigators have
now focused their interest on
                                       medication, especially statins, in reducing               with for new cholesterol lowering therapies over                                                                                                                    pan, bring water to a boil, stir
clinical research trials to find the   cardiovascular risk. The Four S trial or the              the last 20 years we finally can say that we have      Not fun! Right when you could use sleep the most - due to all the physical                                  in chicken bouillon and add
practical truth as to our ability      Simvastatin Scandinavian Trial had nearly 300             strong evidence based medicine. This is especially     and emotional symptoms of menopause - you can’t sleep, tossing and turning                                 couscous. Mix couscous with
to prevent prostate cancer. In         diabetic patients in their database utilizing placebo     important for the diabetic population as we            and wishing that you’d fall asleep.                                                                       a fork; cover and remove from
the next few years, we will be         versus 20mg of Simvastatin or Zocor®. The                 continue to research medications to lower LDL                                                                                                                 heat. Let stand until broth is
                                       population on Zocor® had a reduction in                                                                          Insomnia is a typical menopausal symptom. It was generally believed that it was a                  absorbed, about 15 minutes. Fluff
given the results of large                                                                       levels even further. With the advent of safer and
                                       coronary artery events by over 40 percent and a                                                                  result of night sweats. You couldn’t sleep because night sweats were waking you up             couscous with a fork and transfer to a
research projects, related to                                                                    more powerful medications and even newer agents
not only prevention of diseases,       reduction in the need for revascularisations such                                                                and keeping you awake. Recent studies have found that you can have insomnia that               large bowl. Place bowl in refrigerator for
                                                                                                 currently in studies with a new drug to increase       isn’t related to sweats. It may be connected with the drop in the brain chemical
but also prevention of deaths.         as angioplasty or bypass surgery by nearly 50             HDL by blocking the enzyme that brakes down                                                                                                           about 5 minutes to cool. When cous-
                                       percent. In this study we did not even lower the                                                                 serotonin that occurs when your estrogen levels decline or it could occur due to               cous has cooled, mix in cooked chick-
Now, if you are interested in this                                                               HDL CETP, we feel that we can make a major             changes in hormones. With menopause comes insomnia. It’s usual for the frequency
                                       LDL as aggressively as we do today by the latest          impact in reducing cardiovascular morbidity and                                                                                                       en, red pepper, carrots, dried cranber-
very important men’s health            ATP 3 guidelines where a diabetic should have an                                                                 of insomnia to double from what you used to experience when you were                           ries, apple, green onions and parsley.
initiative, find a clinical research                                                             mortality. This reduction is especially critical in    premenopausal. Studies have shown that women usually begin to experience restless
                                       LDL cholesterol lower then 100. In fact the               the diabetic patient along with weight reduction                                                                                                      Add lemon dressing and toss well. Chill
study being conducted in your                                                                                                                           sleep as much as 5-7 years before menopause hits.
                                       Reversal trial looked at Provastatin® versus              and increasing their physical activity. Cholesterol                                                                                                   at least one hour before serving.
area and get involved.
                                       Lipitor® utilizing a new technique known as               is a major health care problem but physicians are      It winds up being a bit of a vicious circle. When you’re not getting enough sleep,
                                       intravascular ultrasound. The aggressive reduction        now armed with increased knowledge and newer           you wind up getting more stressed, moodier and more irritable - which, as we all               Nutrition Facts: Calories-283; Total Fat-7g;
                                       in LDL cholesterol of over 50 % was associated            medications to help combat this serious disease.       know, are symptoms we often get when our hormone levels are dropping. The                      % Calories from fat-23%; Protein-7g; Carbohydrate-
                                       with the significant reduction in the plaque
Health Scope                           burden in the wall of the arteries that had a
                                       dramatic reduction in cholesterol.
                                                                                                                                                        culprit is the lack of REM sleep - the deepest, most rejuvenating sleep. Without
                                                                                                                                                        good REM sleep, you get more stressed out...which makes you more prone to
                                                                                                                                                                                                                                                       46g; Cholesterol-trace; Sodium-389mg

            Spring 2004                                                                                                                                 insomnia...which makes you more stressed...and so on.               continued on page 4

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