re chinese herbalism well its not the only way to understand health/dis-ease but its pretty freaking amazing! its an ancient system with boatloads of empirical evidence to back it up...their ideas and herbal formulations have been tested on huge populations for millenia. their system of diagnostics reveals disharmonies in the body long before western doctors and medical testing can detect them. and the concepts behind chinese herbal formulations are the most sophisticated on the planet, no question...ask any major herb teacher/herbalist in the u.s. today for confirmation of this if you need it. there is a good reason why more and more american medical doctors visit china to study... tcm (traditional chinese medicine) can heal many diseases that western medicine can't touch. so while one is not necessarily better than the other, they sure are different. why? one reason is because the world views coming out of the east and west are about as different as you can get....the chinese look at every through the lens of energetics, in the west we are reductionists, materialists. there is no need to put one down when we have both available to us. integrated they form the most amazing system of medicine ever to appear on the planet. in general, for prevention and treatment of most disease, chinese medicine is far superior. in general, for trauma and emergency medicine, modern western medicine is far superior. there are exceptions obviously. for example the chinese have an herb capable of stopping bleeding from a gunshot/sword/arrow wound...chinese soldiers all carried it into battle millenia ago. even modern western medicine (forget western herbalism) has nothing that approaches this. i don't want to do without either system. herbalists michael and lesley tierra teach 'planetary herbalism' a synthesis of many systems as their philosophy is 'we don't care much where it comes from...let's cherry pick and use the best healing information and techniques available to us'. which seems so very sensible if your goal is to get the best results you can for your clients. this way of thinking is why i chose their program as my first formal training in herbalism. so while this client may not need to evaluated per tcm for us to 'understand'.... to say it would increase understanding enormously to anyone open to a new way of understanding, is no exaggeration. just my two cents: ) cheers, k

I'm almost 50 and also have had little or no libido for several months. As my testosterone levels were normal when I had my hormones tested recently I would be reluctant to take more and risk the hair problem!! I think it's more a question of estrogen levels (that was way down, even tho I'm still having periods). So, having had two unsuccessful goes at taking HRT over the past year - unpleasant bloatingn, weight gain etc - I'm about to have another try, this time with Bi-estrogen and a progesterone cream called Crinone 4% - there's lots of info on these newish options on the Net. I'm interested in hearing comments from anyone who has tried this combo. I live in Paris so now I have to find a Dr here who has heard of Bi-estrogens and Crinone. I asked my GP today who said "Just because it's on the Net Madame doesn't mean you can get it in France." Have to make an appointment with a gynae after Xmas and see if he's more enlightened! Life without libido is so boring!!

Hi Angie, Chronic pain is it's own brand of hell, isn't it? I have severe Crohn's disease (and, as an off shoot, a type of non-damaging arthritis and psoriasis). I understand the pain issue! You said you're disease was not progressive enough or not as of now to warrant biologics, but I wonder if it woudn't help. I take Remicade, started in Jan 2010, and though I still have some degree of pain, it wasn't enough to make me feel like just waking up was too much trouble. I had to stop Remicade back in Dec '12 due to lack of insurance--fast forwards to now, and I have pain constantly, no energy (fatigue seems like such a small word to describe how I feel), inflammation in my guts and elsewhere and sleep problems. Remember, inflammation causes fatigue, and as you probably know from experience, fatigue can muddy your cognition (I believe they call it brain fog), slow your body and generally produce a sinking malaise that threatens to take you down. Therefore, I wonder if a biologic might help with your overall pain levels? Maybe you could talk to your Rheumatologist about it? See if they have any recommendations. I feel like they would be better than a family physician in understanding how inflammation and chronic pain can affect your mental well-being. Also, when my pain is bad, my sleep is horrible. I think insomnia is the wrong word--let's just call it disordered sleeping (can't fall asleep till 5, 6 in the morning, get a migraine when I sleep past 11 am, and such nonsense). Maybe a biologic would at the very least reduce your inflammation to the point your cognition can rebound. ...(also, I understand low-low sex drive--makes one feel like a very pathetic person in a partnership. And, surprisingly, being on Remicade, for one reason or another, does help my sex drive--perhaps bc it's acting on the inflammation which is negating the inflammations usual cascade of horribleness?).

mdln, thank you for posting your information and experience. It is helpful. I appreciate your mentioning psychological therapy, especially CBT, as a non-drug treatment for depression. It is one I left off the list...my bad. My fear and experience may have led me to overstate the side effects of SSRIs, which are, as you say, supposed to be better than earlier generations of drugs. But then again, from the NIH However, questions about the safety and tolerability of SSRIs have emerged with their continued use. For example, in the original placebo-controlled clinical trials of fluoxetine in depressed patients, sexual dysfunction was reported in 1.9% of trial participants receiving fluoxetine. However, postmarketing clinical trials have reported rates of sexual dysfunction as high as 75%. Given that these drugs are viewed as relatively safe and efficacious heavily marketed by drug cos prescribed to larger populations including even preschoolers prescribed for use beyond depression prescribed for longer periods of time preferred by insurance cos as cheaper than therapy use of these drugs has skyrocketed. According to the CDC, antidepressant use has increased 400% from 1988 to 2008. Moreover, less than one third of those taking a single antidepressant have seen a mental health professional in the prior year. Add to that evidence that these drugs may not as effective as purported to be... Altogether, there were forty-two trials of the six drugs. Most of them were negative. Overall, placebos were 82 percent as effective as the drugs, as measured by the Hamilton Depression Scale (HAM-D), a widely used score of symptoms of depression. The average difference between drug and placebo was only 1.8 points on the HAM-D, a difference that, while statistically significant, was clinically meaningless. The results were much the same for all six drugs: they were all equally unimpressive. Yet because the positive studies were extensively publicized, while the negative ones were hidden, the public and the medical profession came to believe that these drugs were highly effective antidepressants. Moreover, ...he observed that even treatments that were not considered to be antidepressants -- "such as synthetic thyroid hormone, opiates, sedatives, stimulants, and some herbal remedies" -- were as effective as antidepressants in alleviating the symptoms of depression. Kirsch writes, “When administered as antidepressants, drugs that increase, decrease or have no effect on serotonin all relieve depression to about the same degree.” What all these “effective” drugs had in common was that they produced side effects... See The Epidemic of Mental Illness: Why? So, IMHO, what we have are drugs with potentially serious side effects, of questionable efficacy being prescribed for mental health conditions and other conditions by non mental health professionals at increasing rates for longer periods of time. Especially when there...