She and her husband tried different types of stimulation, but nothing got her in the mood. "My lack of interest in sex was hard on my marriage. My husband wanted to be intimate, but I didn't. I missed that connection with him."

Amy is not alone in her experience. HSDD is a diagnosable medical condition that affects approximately 1 in 10 women in the U.S., with a profound impact on a woman's emotional state, her sense of self and her relationships.

"Trying to deal with the strain of low sexual desire was difficult. I talked to my husband about it and we looked for solutions together. Eventually, my doctor helped me enroll in a clinical trial for an HSDD investigational treatment."

"In the clinical trial, I received training on how to use an autoinjector to take the medicine at least 45 minutes before I anticipated sexual activity. I found the injection easy to use, it fit conveniently into my schedule and it put me in the driver's seat for when I wanted to take the medication. I felt empowered when my desire returned and started to look forward to being intimate with my husband again."

Following the clinical trial, Amy hoped she would one day have the choice of taking the medication again. In June 2019, the U.S. Food and Drug Administration (FDA) approved Vyleesi™ (bremelanotide injection) to treat hypoactive (low) sexual desire disorder (HSDD) in certain premenopausal women. Vyleesi is not indicated for the enhancement of sexual performance, but women will have another treatment option for HSDD when Vyleesi is available later this month.

In the clinical trials, the most common side effects were nausea, flushing, injection site reactions, headache and vomiting. Vyleesi should not be used by women with uncontrolled high blood pressure or heart disease.

AMAG Pharmaceuticals, the company launching Vyleesi, will offer co-pay assistance to help women access Vyleesi. Patients will be able to obtain their first four-pack of Vyleesi autoinjectors with a $0 co-pay, and refills for no more than $99. Under current government regulations, pharmaceutical companies cannot offer this type of program to patients insured by federal health care programs, including Medicare and Medicaid.

Amy says, "I am motivated to share my story because I want to encourage other women to talk to their healthcare providers about distressing low sexual desire and find out what treatment options are available. They should know they do not have to suffer in silence."

Women who may be experiencing symptoms are encouraged to visit Vyleesi.com and utilize a tool called the HSDD Symptom Checker. To verify diagnosis and to see if Vyleesi might be an appropriate treatment option for them, women are encouraged to speak with their healthcare provider (HCP). An open and honest conversation between a woman and her HCP is the first step to improving desire, reducing distress and getting back to a fulfilling sex life - something all women deserve.

IMPORTANT SAFETY INFORMATION

Do not use VYLEESI if you have uncontrolled hypertension, known heart disease or are taking oral naltrexone-containing products intended to treat opioid or alcohol addiction. Women who can become pregnant should use effective birth control during treatment with VYLEESI.

VYLEESI can cause serious side effects, including temporary increase in blood pressure and decrease in heart rate, severe nausea, and skin darkening that might be permanent.

The most common side effects of VYLEESI include nausea, flushing, injection site reactions, headache, and vomiting. But these are not all the possible side effects of VYLEESI; consult your healthcare professional for more information or visit Vyleesi.com for additional Important Safety Information.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Case in point: the flu pandemic of 1918, colloquially known as the Spanish flu, occurred during World War I and spread worldwide during 1918-1919. Published research suggests the final death toll may have been as high as 100 million.

Despite decades of developments in biology and virology at the cost of more than $80 billion, the U.S. is unprepared to handle a flu pandemic of a similar scale if one should occur, contends Dr. Steven Hatfill, a specialist physician and virologist with additional training in medical biochemistry, and experimental pathology.

After more than a decade of study, Dr. Hatfill and his team have published a book, Three Seconds Until Midnight, in which he revisits the challenges of the 1918 pandemic and highlights the limitations of the current public health system in the U.S. in the event of a serious pandemic on the scale of the 1918 event.

"There are worse viruses out there in nature than another 1918-type pandemic. They are simply waiting for the right conditions to jump into man," says Dr. Hatfill.

In addition, "the overwhelming majority of Americans assume that the CDC and public health authorities are capable of rapidly detecting when a new outbreak of infectious disease is occurring and that they will quickly respond with a vaccine, drugs, and other measures to contain the event. In reality, none of this is true with respect to a serious pandemic," he emphasizes.

In the book, Dr. Hatfill and his team point out how the U.S. has an insufficient public health workforce and lacks the "surge" medical capacity needed for a pandemic situation with mass casualties, and that no programs are currently in place to train personnel how to handle a pandemic.

Vaccine distribution is another problem, says Dr. Hatfill. Department of Health and Human Services (DHHS) documents show that in a pandemic on the scale of the 1918 event, a minimum of 123 to 125 million Americans will not receive any anti-viral drugs or vaccine until at or near the peak period of infection and death. Historically, the poor, socially disadvantaged urban communities will be hit the hardest.

Citizens are uninformed on how to care for family members at home if they contract a contagious and possibly lethal infection, and entire households can become ill, Dr. Hatfill says.

Dr. Hatfill's book outlines how the government can salvage its preparedness plan by considering more involvement by the military in a disaster response mode, similar to the role played by the Armed Forces after Hurricane Katrina in 2005.

The major problems in pandemic preparedness occur not with the federal government but with the local city authorities who continue to be unprepared to manage an outbreak of a serious lethal infectious disease on a 1918-type scale. This includes having rational methods to manage worker absenteeism, organizing alternate care sites, expanding mortuary capabilities and teaching non-pharmaceutical interventions to the public.

"We now live under population densities that are a new phenomenon in human civilization and we have no precedent to indicate if we are nearing a threshold or not". As a consequence, every individual alive today is participating in a great on-going global biological experiment," says Dr. Hatfill.

Three Seconds Until Midnight will be available for purchase online via Amazon or Kindle in approximately mid-October. For more information, visit www.ThreeSecondsUntilMidnight.com.

For many middle-class families, the ongoing out-of-pocket costs for asthma or COPD medications is a growing burden. When money runs low, some people will try to stretch the use of their inhalers for as long as possible; others try to get by without them at all, placing their health at risk.

Asthma affects about one in every 13 Americans, one-fourth of whom are under the age of 18. It is the third-leading cause of hospital stays for children. COPD is a group of progressive lung diseases that obstructs airflow. Some 16 million Americans suffer from COPD, 70 percent of whom are 45 and older.

While many patients and caregivers struggle with these complex conditions, the high-cost insurance premiums, along with steep deductibles, copays, and poor prescription coverage, can prove a significant barrier. This is compounded by the fact that 75 percent of patients are not taking their medication correctly. And the impact of nonadherence can mean a visit to the hospital.

Asthma and COPD require an arsenal of medications. And, it is not uncommon for people suffering from one of these conditions to be impacted by other chronic conditions.

Rather than point fingers at medication costs or insurance company profits, it is important to help people find solutions.

Copay assistance cards, also called copay coupons, can help take the financial sting out of the cost of medication. Go to www.legacyhealthendowment.org to obtain one, and look for the button, " Click for Asthma and COPD Recommendations."

Please remember to start with your local pharmacist. He or she is the most informed about prescription medications.

And if you are uninsured, there are programs that often cover close to 100 percent of your costs. Try this website, mat.org, offered by the pharmaceutical manufacturer's trade association.

Cost should never be a barrier to care.

Jeffrey Lewis is president and CEO of Legacy Health Endowment in Turlock Ca.

Mr. Lewis' email address is [email protected]

Founded in 2000 by the World Heart Federation, this specific day aims to increase awareness of heart disease and stroke worldwide. The American Heart Association, a global force for longer, healthier lives, is a founding member of the World Heart Federation and continues to work collaboratively to reduce premature deaths from noncommunicable diseases, such as heart disease.

This year's campaign, called "My Heart, Your Heart" is about celebrating and connecting like-minded people, and creating a sense of commitment around the common cause of heart health. It is a concept that encapsulates the values of World Heart Day through making a "Heart Promise" to improve your heart health by eating healthier, being more physically active and stopping smoking and/or vaping.

"World Heart Day is about what you can do to get, and keep, your heart healthy, and the American Heart Association is proud of the extensive work we do to provide the information to get you to optimal heart health," says Sidney Smith, M.D., volunteer medical expert and past president of the American Heart Association. "Through the areas of cardiovascular research, healthcare quality improvement and resuscitation science, the American Heart Association is committed to reducing deaths from cardiovascular disease."

Cardiovascular disease is the leading global cause of death, accounting for more than 17.6 million deaths per year, a number that is expected to grow to more than 23.6 million by 2030, according to a 2014 study. It accounts for approximately 1 of every 3 deaths and claims more lives each year than all forms of cancer combined. However, through making healthy behavior changes, it's possible to greatly reduce the risk of cardiovascular disease and stroke.

To learn more about World Heart Day and the World Heart Federation's campaign, visit www.worldheartday.org.

Courtney McCormick, Dietitian at Nutrisystem, offers five low-carb swaps to keep you healthy and happy through the holidays:

1. Try veggies when you're craving a crunch. We're all guilty of lingering too long at the chips and salsa bowl at a holiday party. If you're craving something crunchy such as a pretzel or chips, try carb-conscious snacks with a crunch - brussel sprouts chips, kale chips, veggies such as cucumber, zucchini, and carrots - they pair wonderfully with a healthier dip such as low-fat ranch or hummus.

2. Sub in cauliflower for your favorite comfort foods. Do you love mashed potatoes, rice, pizza, and tater tots? If you've been avoiding these foods as part of your healthy lifestyle, cauliflower is here to help. This versatile veggie has recently become popular as a substitute for some of our favorite comfort foods. Mashed and steamed cauliflower have a texture and taste that is surprisingly similar to mashed potatoes - add a bit of salted butter and enjoy! And if you're not ready to go all in on the cauliflower craze just yet, McCormick recommends swapping out at least half the potatoes for cauliflower.

3. Mix your own dressings and condiments. Have you taken a close look at the nutrition facts on your favorite cranberry sauce? You might be shocked by the carbs and added sugars in dressings, sauces, and condiments, even those that appear to be "healthier" options. The best way to avoid sneaky carbs in your condiments is to make them at home. That way, you can control the ingredients and ensure they taste great.

4. Bring the healthy alternative to the holiday party. Where everyone else is hauling sugary cookies and cakes, dare to bring the delicious low-carb snack! Get creative with the presentation - use edamame hummus, pita, and slices of red pepper to make perfectly festive "holiday trees."

5. Don't drink your carbs. You've probably heard the saying, "don't drink your calories," before, but you shouldn't drink your carbs either. Toss the fruit juices and sodas for seltzer, unsweetened tea, and the original favorite, water. Light beer, spiked seltzer, or dry wines are good low-carb alcohol options if you're celebrating.

For more great tips and tricks on how to make the most of your holidays with healthy alternatives, visit leaf.nutrisystem.com.

As an older adult, the reasons for exercise change: benefits include helping to control chronic conditions such as hypertension and diabetes, strengthening muscles to prevent falls, and improving flexibility to maintain activities of daily living.

An added benefit? Regular exercise can help boost your mood and improve your overall sense of well-being. And, you'll make new friends! (Of course, always talk to your doctor before starting any type of exercise program.)

Where to look for a new exercise program? Start with your local fitness or community center. The key is finding activities that you enjoy. Some tips to get started:

- Follow your interests. Like to dance? Swim? Maybe yoga or Tai-Chi sounds appealing. There are fitness classes for every taste and ability level.

- Follow your friends. Going to a fitness class with a friend improves your motivation and if you're going it alone - here's your chance to make new friends!

- Listen to your body. Exercise doesn't need to be painful to be beneficial. Start slow and progress over time.

- Set goals. How often do you want to exercise? How hard? Develop a three- to six-month plan so you can measure your success.

But wait, there's more: Older adults who participate in group exercise programs report improved quality of life from the social aspect of group fitness. The group creates a sense of community that helps keep you motivated.

Social isolation, which often leads to loneliness, is common among seniors, but taking a fitness class can forge a bond that keeps people coming back for exercise and extends to socializing outside of class.

In a recent study of adults aged 65 years and older, researchers surveyed 46,564 participants in the SilverSneakers fitness program between 2010 and 2016 to determine how exercise improved their quality of life.

"Even though regular physical activity is important, well-being is about more than just exercise," according to Julie Logue, Training Manager at Tivity Health. "Through SilverSneakers, you can explore all kinds of fitness programs, socialization and nutrition programs to help you live your best life. We empower members to live healthier, happier, longer."

Older adults with more frequent visits to fitness centers who participate in SilverSneakers exercise programs report significantly fewer days when they felt physically or mentally unwell and rated their physical and mental health higher than those who participated less frequently.

Curious about more ways to stay motivated to get and stay fit? During open enrollment for health insurance between Oct. 15 and Dec. 7, enroll in a plan that offers SilverSneakers, which provides members with access to more than 16,000 fitness and community locations nationwide.

To check your eligibility and find a health plan that includes SilverSneakers, call 888-423-4632 or visit silversneakers.com.

First, as a cardiovascular physician I want to reinforce that no one should stop or alter their aspirin regimen before speaking with their doctor or health care provider. And second, I will help sort through the news and the research on this topic.

There are two main categories of patients who take a daily low-dose aspirin for cardiovascular (CV) event prevention: patients who have not yet had serious cardiovascular problems but may be at risk of having these problems AND patients who have already experienced serious cardiovascular problems like a heart attack or clot-related stroke. What the updated guidelines tell us is that certain individuals in the first category (have not yet had an event, often called primary prevention) may not need to continue taking aspirin due to the increased risks of bleeding outweighing the cardio-protection benefit. Whether or not you are one of these individuals in this category depends on your own personal risk factors, which is why it is important to consult your doctor who can help you understand the benefits and risks and what is best for your health.

For people in the secondary category - those who have already experienced a cardiovascular event - aspirin can be a lifesaver. Not only is it proven to help prevent another heart attack or clot-related stroke, aspirin is also one of the most extensively studied drugs in history. This is why aspirin remains the cornerstone preventative therapy for secondary prevention. In the United States, aspirin's professional label is approved for secondary prevention of a CV event.

Some of the media coverage around the new guidance was not clear on this crucial distinction. For those who have already experienced a heart attack, or clot-related stroke there is evidence that discontinuing an aspirin regimen without a doctor's guidance can increase the risk of another heart attack by 63 percent and a clot-related stroke due to a blood clot by 40 percent.

Cardiovascular disease is the number one cause of death in the United States, affecting more than 92 million American adults and causing about 2,200 deaths per day. That's one life every forty seconds. Each year 790,000 Americans alone will suffer from a heart attack, while another 795,000 will have a stroke.

Many factors can contribute to a person's risk of cardiovascular disease, including high blood pressure, high cholesterol and smoking - and almost half of Americans (47 percent) have at least one of these risk factors.

Clinical studies and cardiovascular professional guidelines have continued to support the lifesaving benefits of aspirin. Studies have found that an aspirin regimen under the direction of a doctor can help reduce the chances of a second heart attack by 31 percent and a second clot-related stroke by 22 percent.

Importantly, even though aspirin is the gold standard of preventative therapy for those who have experienced a heart attack, clot-related stroke, chronic stable and unstable angina, a stent placement (PCI) or open heart surgery (CABG), it may not be for everyone. Anyone who has questions about starting or continuing an aspirin regimen should talk to their doctor.

Aspirin is not appropriate for everyone, so patients should talk to their doctor before they begin an aspirin regimen. For more information on safe and responsible use of OTC medicines, visit www.KnowYourOTCs.org.

Disclosure: Dr. Gurbel is compensated by Bayer to advise on cardiovascular health issues.

Dr. Gurbel is the Director of Cardiovascular Research at Sinai Hospital of Baltimore, MD and Director of the Sinai Center for Thrombosis Research and Drug Development. He is also Professor of Medicine at Johns Hopkins University School of Medicine and Adjunct Professor of Medicine at Duke University School of Medicine.

Doctors and patient groups say it doesn't have to stay this way.

"Lung cancer is the leading cause of cancer death in men and women. Finally, we have a screening exam that will make a major impact and change the face of lung cancer for the future to a survivable cancer, not a death sentence," says Ella Kazerooni, MD, MS, chair of the National Lung Cancer Roundtable and Professor of Radiology and Internal Medicine at the University of Michigan.

Screening older current and former smokers each year with low-dose computed tomography or "CAT" scans is a cost-effective system proven to significantly reduce lung cancer deaths.

CT lung cancer screening exams for high-risk individuals are recommended by the American Cancer Society, the American Lung Association, the National Lung Cancer Roundtable, The U.S. Preventive Services Task Force, GO2 Foundation for Lung Cancer and many other medical and scientific organizations.

"After decades of having little to offer adults at high risk for lung cancer, we've entered a new era where we now have evidence that lung cancer screening saves lives, and new targeted therapies and immunotherapy are offering new hope to patients diagnosed with advanced lung cancer," says Richard Wender, MD, Chief Cancer Control Officer at the American Cancer Society.

"CT lung cancer screening is a game changer. We finally have a weapon to fight back against this terrible disease - if patients who need this screening get tested," says Debra Dyer, MD, chair of the American College of Radiology Lung Cancer Screening 2.0 Committee.

"Most lung cancers are not diagnosed until it is too late. This screening provides critical early detection that saves lives," says Carolyn Aldigé, founder and chief executive officer of the Prevent Cancer Foundation.

Insurance companies cover these exams with no copay for people 55-80 years of age with a history of heavy smoking who are current or former smokers. Medicare ends coverage at age 77. If you were a heavy smoker, meet the age specifications and stopped tobacco use in the last 15 years, you are covered.

However, unlike breast and colon cancer screening, if you are covered by Medicare, your health care provider must discuss the risk and benefits of a lung cancer screening CT exam with you during a "shared-decision making visit" before ordering your first screening CT.

Lung cancer care advocates urge those who think lung cancer screening can help them or a loved one to have that conversation with their doctor.

"Lung cancer screening is a proven, valuable tool in finding the number-one cancer killer at its most treatable, and even curable, stage," says Laurie Fenton Ambrose, Co-Founder of the GO2 Foundation for Lung Cancer.

For more lung cancer screening information, visit NLCRT.org and RadiologyInfo.org

Source: National Lung Cancer Roundtable (NLCRT.org)

So when Gunnar started having difficulty hearing at work and home, he did what he preaches to his clients: he attacked the problem and got a pair of hearing aids. Now as a hearing loss advocate, Gunnar offers the following tips to get your hearing in shape this fall.

* Be "present" with your hearing: Being present with your hearing means being aware of how you hear throughout the day. If your family members are complaining the TV is too loud, or if you're the one complaining that everyone else is mumbling, you may have a hearing problem that needs to be corrected.

* Get your hearing checked: At least once a year, you go to the doctor for a physical, or to get your eyesight checked. But when was the last time you got your hearing checked? Even if you're not having issues right now, just go and get a baseline to compare it to in the future.

* Preserve your current hearing: Noise-induced hearing loss is a problem that is completely preventable. If you work around a lot of noise, you need to use protection. If you go to loud concerts or enjoy firing up the leaf blower or lawnmower on the weekend, use protection. Remember, once you lose your hearing, it doesn't come back.

* Don't brush off tinnitus: If you have an annoying ringing or buzzing in your ears, especially when it's quiet, it may be tinnitus. Tinnitus and hearing loss often go hand-in-hand, so don't brush it off as a minor annoyance. Go see a hearing care professional and have it checked out.

Consider invisible hearing aids: If you need hearing aids but are worried people will judge you if they see you wearing them, know that invisible hearing aids such as the Phonak Lyric exist. They are 100 percent invisible and can stay in your ears for months at a time. A recent study even showed that Lyric relieves tinnitus faster than regular hearing aids, thanks to 24-hour amplification.

Neauvia International Group recognizes this incongruity and aims to transform the way we practice beauty and solve skin care challenges by extending its premium energy-based devices into the United States.

In the hands of trained medical aesthetics professionals, Neauvia devices leverage sophisticated technology such as thermo-lifting and water peeling to deeply target your areas of concern. With years in the global skin care market, Neauvia's approach pairs this advanced technology with specially formulated skin care for remarkable results.

"Over a decade of Neauvia's international skin care success has taught us that a single product does not meet the overall demands of and desired outcomes for patients or providers," says Sean Wilson, President of newly launched Neauvia North America. Best-in-class treatments do, however. They also require training and certification. So, take time to research your local plastic surgeons, dermatologists, aestheticians and med spas because they offer you access to these revolutionary non-invasive treatments that are not available for home use, and to professionals qualified to use them. They'll work with you to customize an optimal treatment plan to achieve your desired results.

Often, using multiple technologies per session yields a marked difference. The Zaffiro treatment combines thermo-lift technology with the gentle exfoliation of water-resurfacing and specific solutions for your skin type and desired results. It delivers lifted, tightened and hydrated skin with less visible lines and wrinkles.

Energy-based devices strengthen and surpass home treatments. Let's say you love the fresh feeling and smooth, even texture of your skin after you do an at-home face scrub. Try adding a water-peeling facial like the Zaffiro treatment once a month for more deeply cleansed and revitalized skin.

Treatments can rejuvenate beyond your face and neck. Zaffiro's thermo-lift technology gradually heats the deep layers of the skin, stimulating collagen and prompting lifting and tightening effects. It can be applied to tighten the décolleté and upper arm skin, give the tummy and derriere a firm appearance and even help tighten up post-pregnancy belly skin.

Innovative energy-based devices can yield beautiful effects by working with the body's natural functions in a way that is safe, reliable, and non-invasive. They're less costly and require little to no downtime. This makes them an excellent way to fine tune your appearance and delay signs of aging without a lengthy recovery time. In fact, many of these innovative treatments provide results when done over a lunch hour! Dr. Joshua Weitz, MD, CEO of Dermatology Associates of Rochester sees them growing in appeal and use. "The non-invasive market is the future, and I anticipate Neauvia will be a guiding light in providing exceptional solutions," Weitz says.

A well-rounded skin routine ensures that your actions - daily, monthly, over time - compound for outstanding outcomes. Incorporating treatments using Neauvia energy-based devices is simple yet addresses the complexity of your skin and helps attain your best overall skin health and appearance.

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