Erasing Phobias; Industrial Nations' Infertility


Q: I have a fear of snakes that I cannot get a handle on. Not that I come across them very often, but they still creep me out. I've tried therapy and some anti-anxiety meds, but nothing seems to help. Any ideas? - Samantha G., Boulder, Colorado

A: Phobias are common and can range from mild aversions to life-altering anxieties. Overall, they affect about 19 million people in the U.S., and women are twice as likely as men to contend with phobias. Specifically, around 12 percent of women and 3 percent of men have a fear of spiders and snakes.

For years people have relied on a combination of cognitive behavioral therapy, desensitization therapy (gradual exposure to the object of fear), beta-blockers, antidepressants and sedatives to ease symptoms. And while many people find relief from their fears, no single approach works for everyone.

However, a new study has found that evoking a fear (of spiders) and two minutes later administering a 40-mg dose of the beta-blocker propranolol (40 mg twice a day is the standard initial dose for high blood pressure) is a very effective treatment. That treatment protocol cleared the phobia for a year (that's how long they followed the study participants).

How is this possible? Turns out that propranolol - which is used to control high blood pressure, help avoid a repeat heart attack and reduce migraine attacks - is also an amnesia-inducing drug. It does this if given before a memory becomes consolidated, and it blocks fears triggered by specific cues (like a spider or a snake). One of the researchers described the process of eradicating the phobia as "more like surgery than therapy." Another big plus: This may be effective in treating PTSD - an often-intractable and life-altering anxiety disorder that affects everyone from soldiers to hurricane victims. So ask your therapist or GP about trying this technique. And let us know what happens if you do try it.

Q: My son is only 28, and he and his wife are having a terrible time conceiving because of his poor sperm quality. He doesn't smoke, is not overweight and this problem doesn't run in the family. How can this have happened? - Becky, Boston

A: There can be all kinds of reasons, from genetics (which might not apply in your son's case) to unknown toxin exposure at work.

Abnormal sperm have a large or misshapen head or a crooked or double tail that prevents the sperm from being able to penetrate the egg. But abnormal shapes aren't the only reason for male infertility. It also can be associated with low semen volume, low sperm count and how lively the sperm are in their movement (called motility). Fortunately, in-vitro fertilization can be effective if, over time, conception doesn't occur.

But a disturbing new study out of Denmark and the U.S. offers another insight: The environment in industrialized countries is devastating to male fertility. Hormone disruptors such as BPAs in cash register receipts and flexible plastics, phthalates in household products, other common chemicals, plus our modern lifestyle (more sitting, being overweight, eating processed foods) are the causes. The researchers say that for men, adult reproductive problems "may start [before birth] in utero ... and [are] most often related to environmental exposures of the fetal testes ... However, environmental factors can also affect the adult endocrine system."

Whatever the trigger, the scientists also note that "we found such poor semen quality among young men aged 20 to 25. The average man had up to 90 percent abnormal sperm." So we would encourage your son to try to reduce his exposure to pesticides, plastics, receipts, BPA lining in canned foods and processed foods. He should increase his activity level, get seven to eight hours of quality sleep a night, take 600 mg of DHA omega-3 and a multivitamin daily, and be patient. Conception may happen, but if it doesn't, reproductive technology is amazingly effective.

© 2016 Michael Roizen, M.D. and Mehmet Oz, M.D.
Distributed by King Features Syndicate, Inc.

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