Scientists have discovered a novel use for a drug usually prescribed to treat infertility in women — repairing painful shoulder injuries in men.
They suggest that clomiphene citrate (a drug used routinely to stimulate egg production) could be given to speed up the healing process and increase movement within the joint. This is done by tricking the brain to produce more testosterone which is crucial for the healing process.
Shoulder pain is a common problem for one in three people.
Tears in the rotator cuff — a collection of tendons in the shoulder that stabilise the joint — are a major cause. They can be small tears (less than 1cm), or larger tears (more like 5cm). While the exact causes of this phenomenon are unknown, genetic susceptibility or degeneration may be one reason.
The only solution is surgery. Every year, more than 10,000 repairs to the rotator-cuff are performed in the UK.
Scientists have discovered a novel use for a drug usually prescribed to treat infertility in women — repairing painful shoulder injuries in men
However, up to 90 per cent of these procedures fail in the first 12 months (particularly for larger tears — for smaller tears 40 per cent fail), because the damage is too extensive or the edges of the tendon will not hold the stitches.
New therapy boosts natural healing.
Women receive clomiphene citrate as part of their fertility treatment. It reduces the natural oestrogen level.
This triggers the pituitary gland in the brain to secrete increased amounts of two hormones — follicle-stimulating hormone (FSH) and luteinising hormone — which in turn triggers ovulation and egg release.
Clomiphene citrate, however, triggers the release of testosterone in men, according to studies.
In 2006, The Journal of Sexual Medicine published a study that found the drug doubled testosterone in hypogonadism patients (men whose sex glands make very few or no sex hormones).
The role of testosterone in tissue healing is important. It transports nutrients and oxygen to the site of injury, aiding recovery.
It’s believed that increasing its levels could boost recovery. You can use testosterone as either a patch, gel or injection. It must be used regularly to ensure that it remains at its highest levels. Clomiphene citrate, however, allows your body to create enough testosterone to sustain high levels.
A U.S. trial, involving 90 men with rotator cuff tears, is underway at the University of Utah to assess the drug’s effect on recovery. For four weeks prior to surgery, the men will receive either the drug or a placebo each day. Then they’ll be monitored for six months.
The recovery and healing rate of the patient will be closely monitored using tests such as MRI scans. Also, pain and movement data will also be taken.
‘Clomiphene works within the body to trick it into thinking testosterone and oestrogen levels are low and motivate it to make more testosterone and oestrogen,’ say the researchers. ‘We believe that clomiphene treatment will reduce pain and improve functioning, enhance tendon healing and increase bone quality with rotator cuff repair in men.’
Roger Hackney, a consultant orthopaedic surgeon at Spire Leeds Hospital, said: ‘It will be interesting to see the results of this preliminary trial.
‘However, in the age group most commonly affected by cuff tears, there will be risks to inducing more testosterone such as a raised risk of prostate cancer.’
An injection of the patient’s own blood given during shoulder surgery cuts the risk of the procedure failing, according to a study. Nearly 60 patients with rotator cuff injuries given injections of platelet-rich plasma (PRP) — where a sample of their own blood is processed to isolate components involved in healing — were three times more likely to have successful surgery than a group not given PRP, reports the Orthopaedic Journal of Sports Medicine. It is believed that PRP can improve the repair of ligaments and muscle.
Remote Health
Patient care through long-distance diagnosis, monitoring, and improvement This week: Skin conditions
The NHS is experiencing a backlog of dermatology cases due to an app that takes high-definition pictures of skin lesions.
GPs can upload clear images to the Cinapsis digital referral app by attaching a special lens, called a dermatoscope, onto a smart phone. This allows specialists to view and diagnose the images.
Nearly 75% of primary care cases were reviewed within 48 hours in a pilot program that was implemented by nearly 90 GP offices across Suffolk and Norfolk. This is compared with a wait of roughly 50 weeks.
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MTHK Eye Spray was developed by ophthalmologists from Moorfields Eye Hospital, London. It relieves dryness by strengthening the natural oil layer of the eyes with moisturising vitamin B5 and vitamins E. This prevents water evaporation.
You can expect to be able to use it for as long as eight hours.
10ml, £15.99, mthk.com
These trousers showed Beyonce’s waist. Beyonce, who is 40 years old, works out five days a week and does interval training.
The secrets of an A-list body
Here’s how to achieve the star-like physiques. This week: Beyonce’s waist
Beyonce showed off her slim waist with these pants. Beyonce, who is 40 years old, works out five days a week and does interval training.
She dances nine hours per day on tour. ‘Dancing is what keeps me active,’ she has said.
Try the reverse lunge and rotation to tone your waist.
Stand straight up with your back straight, feet at shoulder width, and hands in front. Take a step backwards, with one leg. Bend your knees at 90 degrees. Keep both arms straight.
As one whole body, turn your body to the right. Then return to the center and do 15 reps to your right. You can continue to the left. You should do four sets each week.