low testosterone causes - Carmel Monthly Magazine

June 2019 Total Performance Medical Center: Experts on Regenerative Treatments and Men and Women's Sexual Health Writer // Janelle Morrison Photography // Laura Arick and submitted The providers at Total Performance Medical Center of Carmel, Indiana, are dedicated to helping men who struggle with erectile dysfunction, premature ejaculation and testosterone therapy, and women seeking treatment for low libido and hormone replacement therapy. The center also offers anti-aging solutions for both men and women, such as Botox, PRP (platelet-rich plasma) treatment, micro facials and other treatments provided at their Carmel location. We met with Carmel resident Danielle Lammers, nurse practitioner and co-owner, to tour the center and find out more about the myriad of treatments that she and her dedicated staff provide for men and women alike. “The center opened just over 10 years ago under different owners,” Lammers explained. “At that time, it was solely a clinic for men’s health, and testosterone therapy and erectile disfunction (ED) were the two main focuses then.” Last September, the clinic came under new ownership. Lammers was brought into the fold by her silent partners in January. “We do have an M.D. on site,” Lammers mentioned. “If you’re a nurse practitioner in Indiana, you have to have a doctor collaborating with you. Our doctor here is Dr. Robert Clements. He reviews a lot of my charting if I have any questions.” Services Offered by TPMC “We still work with men’s testosterone and ED treatments, but we have also gotten into aesthetics, such as PRP facials, and we will soon offer Botox and bioidentical hormone pellet therapy—available for both men and women,” Lammers explained. Hormone Pellet Therapy Provides Convenient Alternative “The pellet looks like a little grain of rice and is inserted directly under your skin. It stays there for four to six months, and it slowly releases hormones based on lab levels. It helps with energy, libido, depression, brain fog and things like that. We will be offering that treatment in July. The product that we will use is called BioTE. It’s been available overseas for a long time but has been available in the U.S. for a couple of years.” Lammers said that hormone pellets are time-released and work off of cardiac output. So, when you’re sleeping, there’s not much being released, and if you’re exercising, more is released. It’s a bioidentical hormone, so it matches your body. It’s more natural than testosterone therapy or estrogen pills that women take. The pellet therapy evens you out, and the patients don’t need the injections. Women need to replace BioTE usually every four to five months, and men can last a little longer, usually six months. There are no known drug interactions, and it is safe with any other medications or birth control, per Lammers. She did mention that once a female patient is on BioTE, they will not have to take oral estrogen any longer. “Once the pellets inserted, we will take a blood test after six weeks to make sure that you’re where you need to be, and then you only have to do a blood test once a year after that,” Lammers said. “While there are hardly any side effects, the pellet is easy to remove should there be a need to remove it.” When asked at what age a man or woman might need or be interested in hormone therapy, Lammers replied, “Men or women can be candidates as early as 30 on up. We have a lot of patients here who are on testosterone injections, and those are usually once a week. Usually by the end of the week, your levels start to go down and the symptoms come back—the fatigue and other related symptoms. Symptoms that are specific to men are things like loss of muscle mass, body fat increase, fatigue and mood swings.” TPMC Only Group Offering BioTE Hormone Pellets in Carmel The cost of BioTE provided at Total Performance Medical Center will be around $400–$500 for women and $650–$700 for men, and that includes the lab testing. Most patients will get the pellets twice a year. Currently, Total Performance Medical Center is the only group offering BioTE hormone replacement pellets in Carmel. Lammers mentioned that none of the treatments provided by the center are billed through insurance, though the office staff is happy to provide the necessary paperwork for patients to submit to their insurance providers. Testosterone injections are many times covered under one’s insurance policy. When asked what most of the feedback provided by users of BioTE has been, Lammers stated, “Anyone that I’ve ever talked to that has pellet treatment, within a few weeks they feel completely better. In addition to BioTE and testosterone injections, we also have patients on testosterone cream, and that is less effective than the shots because it works on how much is absorbed into the skin, and there’s no way to really tell how much of that you are actually getting.” TPMC Now Offers Platelet Rich Plasma (PRP) for Facials The center offers PRP treatments and facials at the practice. “PRP has only become available within the last couple of years but is an effective regeneration treatment with numerous applications, including erectile dysfunction, hair loss, and scars or wrinkles on the skin” Lammers said You may have read about or have seen the “vampire facials” depicted rather poorly on TV. Lammers set the record straight on the proper procedure and benefits of a PRP facial. “The PRP facial or ‘vampire facials’ that you see on TV that look red or bloody is an inaccurate portrayal,” Lammers emphasized. “I don’t know why they look like that because when you spin down the plasma, it’s gold. It’s not bloody-looking at all. The procedure for the facial begins with using lidocaine on the face to ensure that it is numb. Then, we draw a small amount of blood of which the platelet rich plasma (PRP) is extracted from. Using a microneedling device, small “micro punctures” are made on the face. Lastly, the PRP is massaged into the face. This helps to promote collagen production, which in turn helps reduce acne scarring, age spots, and wrinkles. Afterwards, your face will be red for a day or so, but it will give you a nice, healthy glow.” When asked what the desired results of a PRP facial are, she replied, “It does help to get rid of wrinkles and fine lines, but it works best to get rid of scars and age spots and those kinds of things. We can also inject the PRP directly into the wrinkles, and it helps regenerate the cells. We will also be offering Botox, which is the most effective way to get rid of wrinkles. Botox works within a few days, and PRP is not an instant ‘fix.’ You can do both treatments, though.” The PRP procedure is also helpful in erectile dysfunction in patients who are no longer responding to ED medications, or desire to stop medications. In PRP for ED procedure, the PRP is injected directly into the penis. This is a very effective treatment and one of our main treatments we do here. TPMC Offers ReGenED Along With PRP for ED The center also offers ReGenED. The painless, pulsating soundwaves of the ReGenED procedure opens up old blood vessels and stimulates the formation of new vessels, in a process known as neovascularization. This results in improved blood flow, which helps any man—not just those with ED—to achieve stronger and more sustainable erections. James Earl Jones, medical assistant at Total Performance Medical Center “A lot of men with ED have blockage from diabetes cholesterol. ReGenED is painless for the most part and breaks up those blockages. A lot of men choose to do both procedures, so the ReGenED breaks up the blockages and then the PRP helps regenerate lost cells or damaged nerves. We still offer more traditional ED treatments as well.” Symptoms of the center’s patients (specific to men) include things such as decreased libido, lack of energy, decrease in strength, endurance or both, decreased nocturnal erections, mood swings, depression and recent deterioration in work performance. According to Lammers, she uses the same range for every male patient, and the dose does not vary by the man’s age. For women, the symptoms are similar to men’s and include things like fatigue, working out but feeling like you’re gaining weight rather than losing it, feeling “out of it” and having “brain fog,” where you know the words you’re trying to utter but can’t seem to remember them right then and there. What Can Patients of TPMC Expect from Their First Visit? “Patients will fill out a questionnaire, and then we draw your blood,” Lammers stated. “We usually get the results in a couple of days. For testosterone injections, we get the results within a couple of days, and then you come back in and get the injection, and then you come in once a week after that. For patients who are comfortable with it, after several weeks, we can give you the syringes and you can do it yourself. But a lot of people find it easier just to come in once a week and do it here.” The center also offers a free Doppler ultrasound screening to see a male patient’s blood flow and to see if he has any blockage that may be causing the ED. “If they want Trimix, we offer that as well,” Lammers said. “Trimix is injected into the edge of the penis up by the belly, and you do that before having sexual intercourse to achieve an erection. A test dose is prepared here to make sure it works, and then we can give you medicine while you are here to reverse it. A proper dose is based upon the patient’s desired results. The patients are also sent home with the medicine to reverse it as well.” Trimix versus Oral Treatment for ED “Patients will ask why they should consider taking injections if you can just ingest the medicine,” Lammers stated. “Trimix doesn’t have the side effects, as Viagra, Cialis, Levitra can cause headaches and other side effects. You’re not taking Trimix orally, so it’s not absorbed systemically but rather directly into the penis, so that’s why you don’t have the side effects. We can ship Trimix to patients that live farther away or out of state. We have patients that winter in Florida or elsewhere, and we ship it to them.” Don’t wait another day to feel good again. Get back to living your best life and make the call to Total Performance Medical Center now to set up an appointment and start feeling like a younger you today! The center is open Monday through Saturday, closed Tuesdays and Sundays. Visit the center online at totalperformancemedical.com. Total Performance Medical Center10385 Commerce Drive Suite 120Carmel, IN 46032 Office: (317) 454-7700 Email: hello@totalperformancemedical.com

Total Performance Medical Center: Experts on Regenerative Treatments and Men and Women’s Sexual Health

Total Performance Medical Center: Experts on Regenerative Treatments and Men and Women’s Sexual Health