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Vicky Romanski, FNP-BC, APNP

Vicky Romanski, FNP-BC, APNP

Vicky Romanski, FNP-BC, APNP, is a functional medicine Nurse Practitioner at Wise Woman Wellness, LLC. Romanski combines the best of conventional, functional and integrative medicine to help women with female, thyroid and adrenal hormone issues to live healthier, more abundant, joy-filled lives. She is also the Wise Woman Wellness Men’s Vitality Program Director and helps men eliminate their uncomfortable hormone imbalance symptoms and increase energy and longevity. Wise Woman Wellness is an innovative wellness and hormone care center located at 1480 Swan Rd, De Pere. Please contact her at 920-339-5252 or via the internet at www.wisewomanwellness.com

Thursday, 31 May 2018 02:02

Men’s health, hormones and aging

In June, we celebrate Father’s Day and we acknowledge the special men in our lives. It’s a great time to consider men’s health and making sure they stick around for a very long time.

Men’s health has often been referred to as the “silent health crisis” because most men don’t visit the doctor; at least, not as often as women. In fact, most men take better care of their cars than they do themselves. There are plenty of excuses: “I don’t have a doctor,” “There’s nothing wrong with me,” “I’m just getting old,” “It costs too much.” Does this sound familiar? If the men in your life think that wellness is expensive, they should consider the cost of illness.

There are many health conditions, such as high blood pressure, high cholesterol and high blood sugar, that are, in fact, silent. Often, the symptoms are not easily recognizable or significant until it causes a big problem like a heart attack, a stroke or death. Discovering a smaller issue through preventative care can be a lot easier to deal with than be sidelined by a big one. Imagine the loss of work and being away from your family and your life. Along the same lines, doctor visits tend to be less expensive than a hospital stay. Creating a wellness plan with a health care professional, especially one who practices functional medicine, can not only increase the length of your life, but also increase the quality of life.

Andropause, also known as male menopause, testosterone deficiency or low T, has been found to contribute to many of the silent health issues affecting men. Declining testosterone levels in men are inevitable as they age. It begins around age 40. Levels continue to drop by 1-2 percent yearly after age 40; however, most men do not begin to notice until their 50s. The symptoms that typically motivate a man to “do something about it” are usually the obvious, annoying symptoms like erectile dysfunction, loss of libido or declining strength and energy. The reality is that these symptoms can be an indication of something much bigger and life threatening. For instance, erectile dysfunction has been directly linked to blood flow issues caused by high cholesterol and high blood pressure. Inadequate blood flow in one area of the body is a good indication it is going on in the rest of the body.

Treating andropause is essentially about preventative medicine during the aging process. The goal of hormone experts who practice responsible hormone management is to achieve an optimal level for each individual male. Restoring their hormone levels to the levels they had when they were in their mid-30s. It isn’t about bulking up or becoming the next Mr. Universe, it’s about protecting the various systems in the body (bones, heart and circulatory, muscles) that are directly affected by declining hormones, which occur naturally as we age. If we begin to take this into account, we will not only improve the quality of life of the men in our lives, but it can be cost savings in the long run. The savings overall could be tremendous and experienced in our health/wellness, relationships, our finances (individual/societal) and our lives in general.

Testosterone replacement therapy, when done correctly with careful monitoring and follow-up labs, can make a world of difference. If you or someone you know is experiencing signs/symptoms of low testosterone — be proactive, get tested and start making changes today. 

Weight loss is one of the major concerns we hear from new patients. It is almost always listed among the various symptoms that bring frustrated women to our doors. The over-simplified equation of “eat less, exercise more” is not working for them and their resolve is dwindling. There has to be more to the equation — and there is!

The “eat less, exercise more” philosophy is not without merit, but it doesn’t paint the entire picture and without the rest of the picture, weight loss efforts can fail and send women to the “Why bother?” camp. There are many things that can sabotage weight loss efforts and correcting them can help the exercise and nutritional changes you make work more effectively for you.

Disrupted sleep

It is critical for the body to be given the appropriate amount of downtime. Sleep allows the body to restore itself and it is also a vital part of our circadian rhythm, which signals our body to release specific hormones at determined times. These hormones play a role in our feelings of being full or hungry and in resisting certain cravings. A 2016 study at the University of Chicago confirmed the connection between sleep-deprivation and appetite. “We found that sleep restriction boosts a signal that may increase the hedonic aspect of food intake, the pleasure and satisfaction gained from eating,” said Erin Hanlon, a University of Chicago research associate in endocrinology, diabetes and metabolism. “Sleep restriction seems to augment the endocannabinoid system, the same system targeted by the active ingredient of marijuana, to enhance the desire for food intake.”

Imbalanced hormones

Hormones are our chemical messengers. They carry the instructions to each and every one of our cells on what, how and when they should be functioning. This hormonal balance is often compared to a symphony because they all work together and throwing off just one of these hormones impacts the rest of them. Major hormones like insulin, cortisol and adrenaline are significant players in weight loss or gain. Unbalanced hormones can undermine any efforts toward losing weight.

Inefficient metabolism

Metabolism is your body’s ability to break down food and convert it to energy. Metabolism is regulated by the thyroid. It is important to have a balanced, healthy thyroid in order to maintain a healthy weight. Testing your thyroid function should be performed at the cellular level to provide an accurate picture of the available thyroid hormone in the cells, where thyroid function occurs. A normal TSH blood test result does not necessarily mean one’s thyroid function is normal but often is all that is looked at in the conventional medical setting. This is why reflex testing is used along with symptom mapping and lab tests to develop an accurate picture of thyroid function in patients.

Leaky gut

Leaky gut is hyper-permeability of the lining in the small intestine. This permeability allows undigested food particles, toxic waste products and other unwanted substances to leak through the intestine and enter the blood stream and other parts of the body. The body tags them as foreign substances to be destroyed and launches an autoimmune response. This causes inflammation and disease and becomes a vicious cycle. Systemic inflammation interrupts metabolic function and messages sent to the brain for fullness and hunger.

Nutrient deficiency

It is no great secret that our bodies require the proper nutrients to survive and thrive. However, the typical American diet does not supply us with an adequate amount of these nutrients. The grocery stores are stocked with processed foods that are quick and easy, and void of the ideal nutritional values our bodies need. And food that does provide the nutrition we need is less potent because years of industrial farming practices has stripped the soil of many nutrients. In general, if you are not supplementing your diet with pharmaceutical grade vitamins and nutrients, you are most likely not getting the right nutrients and this will affect weight gain. Lacking nutrients can cause slow metabolism, fatigue, poor sleep and cravings for unhealthy, high caloric foods. This becomes a vicious cycle. Proper nutrition is key. The following nutrients have been identified as important to maintaining a healthy weight, yet deficient in most adult diets: magnesium, B vitamins, vitamin A, vitamin C, vitamin D, vitamin E and omega-3s.

Monday, 26 March 2018 20:21

Erectile dysfunction and heart disease

If you’ve ever paid close enough attention to the commercials for the “little blue pill,” you will hear a disclaimer that, “Erectile dysfunction may be a sign of a serious heart disease,” followed by the advice to see your health care practitioner to make sure your heart is healthy enough for sexual activity. This is an important warning that should get a little more attention than five seconds at the end of a commercial.

Erectile dysfunction can be an early warning sign of heart disease or other circulatory problems

Erectile dysfunction (ED) is characterized as the inability to get or keep an erection firm enough to have sexual intercourse. An erection is achieved when arteries in the penis relax and open up to let more blood flow in, while at the same time, the veins close up and trap the blood inside the penis. The penis must be able to store blood in order to achieve and maintain an erection. Vascular disease restricts blood flow to different areas of the body and can cause ED. There are other possible causes of ED, including relationship problems, anxiety, diabetes, kidney disease, neurological disease, certain medications, injuries, and chronic illness. However, according to the Cleveland Clinic, vascular diseases, which include atherosclerosis (hardening of the arteries), hypertension (high blood pressure) and high cholesterol, accounts for 70 percent of physical-related causes of ED. Atherosclerosis alone accounts for 50 to 60 percent of ED cases in men over age 60.

While scientists continue to work on demonstrating the direct cause and effect relationship between low testosterone and hardening of the arteries (atherosclerosis), it has been concluded in many recent studies that low testosterone is considered a marker for cardiovascular risk. In a recent article published on nebido.com, the author summarizes several studies on low testosterone and its association with cardiovascular disease. Of particular interest is a study published in the Journal of Sexual Medicine, which concluded that low testosterone levels are associated with harmful elevations in nine of 10 cardiovascular biomarkers.

Testosterone Replacement Therapy to Reduce Cardiovascular Risk

Early studies of testosterone replacement therapy suggested a link between testosterone therapy and an increased risk in heart disease. However, more recent studies have indicated the opposite and the previous studies have been found to be faulty. In an April 2017 article published in the Jama Internal Medicine Journal, the findings of the Kaiser Permanente study concluded that, “When use in androgen-deficient men with documented low morning testosterone levels, TRT was not associated with an increased risk of cardiovascular outcomes. During long-term follow-up the risk of cardiovascular outcomes was lower in testosterone-treated men.”

According to Dr. Neal Rouzier, Director of The Preventative Medicine Clinic of the Desert and specialist in bioidentical hormone replacement therapy, “Having good testosterone in your system decreases incidents of heart attacks, strokes, Alzheimer’s, diabetes, high blood pressure. It has a beneficial effect in protecting against cardiovascular disease in every study. It decreases the instance of heart attacks because of its effect on blood vessels. It has a beneficial effect of improving your good cholesterol and lowering your bad cholesterol. It has a beneficial effect of improving all of the good lipoproteins and reducing all the bad lipoproteins.”

Testosterone replacement therapy, when done correctly with careful monitoring and follow up labs, can make a world of difference. If you or someone you know is experiencing signs/symptoms of low testosterone, be proactive, get tested and start making changes today.


“Heart Disease & Erectile Dysfunction.” http://cle.clinic/2DvZxgD. Cleveland Clinic.

“Low Testosterone is Associated with Elevated Cardiovascular Disease Biomarkers.” http://bit.ly/2FJQxXe. Nebido Research News.

“Low Plasma Testosterone is Associated with Elevated Cardiovascular Disease Biomarkers.” Journal of Sexual Medicine. Pastuszak et al.

“Association of Testosterone Replacement with Cardiovascular Outcomes Among Men with Androgen Deficiency.” JAMA Intern Med. T Craig Cheetham et al.

Wednesday, 28 February 2018 14:15

The importance of testosterone for men

Testosterone levels for men declines as they age — it is inevitable. It begins around the age of 40 and levels continue to drop by 1-2 percent yearly after age 40. Most men do not begin to notice until their 50s when the negative symptoms of low testosterone, or low T, become too uncomfortable to ignore.

Low testosterone is also referred to as hypogonadism, testosterone deficiency syndrome, or andropause: the male menopause. Symptoms of andropause are often missed due to the gradual onset. Development of symptoms can progress over 10-15 years! Symptoms can include: fatigue, reduced energy, difficulty concentrating, sleep disturbances, moodiness/irritability, depression, declining libido, weaker erections, impaired sexual function, decreased muscle mass/strength, which in turn can lead to increased body fat, osteoporosis, increase in LDL (“bad”) cholesterol, impaired fasting glucose levels, and increased cardiovascular risks. The occurrence of low T has been found to be concurrent in a number of chronic health conditions:

  • Obesity and/or larger waist circumferences – 52 percent
  • Diabetes – 50 percent
  • Hypertension – 42 percent
  • Hyperlipidemia (elevated cholesterol/lipids) – 40 percent
  • Erectile dysfunction – 19 percent

Testosterone deficiency is projected to be associated with the development of approximately 1.3 million new cases of cardiovascular disease and 1.1 million new cases of diabetes. Correcting low T may help reverse insulin resistance and help keep arteries more flexible, allowing for essential dilation/constriction with blood flow. Keeping this in mind, it would indicate that testosterone replacement therapy is important for men.

Yet, there still remains significant controversy regarding its use, since there have been studies indicating increased risk of prostate cancer and cardiovascular events with testosterone use. This in turn prompted the FDA (2015) to issue warnings to physicians and patients. However, the (2016) Registry of Hypogonadism in Men (RHYME) study asserts testosterone use does not cause an increased risk of adverse cardiovascular events. Additionally, the following medical groups are in agreement: The European Association of Urology, International Society for Sexual Medicine, European Menopause & Andropause Society, Canadian Men’s Health Foundation, the American Association of Clinical Endocrinologists, and American College of Endocrinology, and furthermore Debruyne et al. research revealed that, “testosterone treatment is not associated with increased risk of prostate cancer…” British Journal of Urology, International (2017).

It is evident that testosterone is important for men. So what can be done to restore optimal testosterone levels? There is plenty to be done and it is not just about a prescription either! It starts with you taking charge of your future by increasing your knowledge, making changes toward a healthier lifestyle and having balanced hormones to allow for a happier, healthier life.

How to start

  • Begin to eliminate bad habits related to sleep, diet and exercise
  • Get your cholesterol checked
  • Control your blood pressure/cholesterol if they are high
  • Don’t smoke
  • Increase physical activity to at least 30 minutes daily, most days of the week
  • Eat a healthy diet with more fruits/vegetables and less saturated/trans fats
  • Find a provider who specializes in male hormones — get your hormones tested!
  • Consider starting a wellness program to include:
    • Lifestyle/nutritional guidance
    • Supplement recommendations
    • Sexual health consultation
    • Thyroid care
    • Hormonal replacement (if needed)
  • Start on high-quality, pharmaceutical grade supplements to start feeling better faster
  • Drug store/big retail chain brands do not guarantee quality ingredients. These often contain fillers or binders that may cause additional health issues

Testosterone replacement therapy, when done correctly with careful monitoring and follow-up labs, can make a world of difference. If you or someone you know is experiencing signs/symptoms of low testosterone, be proactive, get tested and start making changes today.

Wednesday, 31 January 2018 04:04

Hormones that affect our libido

Our delicate hormone balance is often referred to as a symphony. When each hormone plays its part correctly, the music is beautiful and life is good, but when one of the instruments falls out of tune the music can quickly fall apart. Each hormone relies on and is affected by the other hormones at play in the body. A symptom that might seem to be caused by a female hormone imbalance might actually be caused by the adrenals or thyroid. This is why testing, along with symptom charting and patient history, is critical when diagnosing hormone imbalances.

All hormones need to be balanced in order to achieve optimal health and wellness. When our hormones fall out of balance it can lead to a wide range of symptoms varying in degrees of unpleasantness. So, we can safely say that all hormones can eventually lead to a loss of libido because when you don’t feel good and don’t feel like yourself, it’s difficult to get excited about sex. However, for this article we are going to look at a few hormones that seem to have a more direct cause and effect relationship with the libido.

Testosterone

This is not just a male hormone. Women also have testosterone in their system and it helps to drive desire and fantasy, and provide energy for sex. Women’s testosterone levels start to decline with age — same as men. With that decline, women can experience a lower sex drive and a decrease in sensitivity in the vagina and clitoris, which can also affect libido.

Estrogen

This is considered by many as the primary female hormone. It helps regulate menstrual cycles and it controls the development of female sex organs. Estrogen levels begin to decrease dramatically as a woman approaches menopause. Low levels of estrogen can cause vaginal dryness, which can lead to painful sex. It also causes mood swings and unstable sleep patterns, which can have negative effects on the libido. Estrogen dominance can also cause low sex drive, irritability, anxiety and sleeplessness. Estrogen really needs to be balanced with the right amount of progesterone.

Progesterone

Progesterone is often called the “feel good” hormone. It is needed to keep estrogen in check and prevent estrogen dominance. However, too much progesterone can negatively affect the libido and actually prevent a woman from achieving orgasm.

Thyroid and adrenals

Hypothyroidism, or low thyroid, causes body systems to slow down. Metabolism slows and causes other organs and glands to slow down. Reproductive organs and the adrenal glands, which produce hormones that convert into sex hormones, produce lower levels of these hormones resulting in a lower sex drive. On top of the hormone imbalance, there is also the issue of fatigue that is associated with hypothyroidism, which also affects libido.

High levels of cortisol, released by the adrenals during extended periods of stress, can also rob your body of estrogen, progesterone and testosterone. These sex hormones are essential to a healthy libido and the stress of a lower sex drive can lead to a vicious cycle here if hormones are not brought back into balance.

This list helps to demonstrate the hormone symphony and how each hormone plays a critical role in that interwoven composition. Each cell in our body requires hormones to function properly. When our hormones are out of balance many systems in our body are affected and libido is often one of those systems. There is no reason we can’t enjoy a happy, healthy sex life long after menopause.

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