About Me

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Scottsdale, Arizona, United States
Angela M. DeRosa DO, MBA, CPE graduated from the Chicago College of Osteopathic Medicine in 1995. She went on to do an Internal Medicine Residency with a fast track emphasis in Women’s Health at Lutheran General Hospital. After her residency, she became the Director of Women’s Health Services and Education at Lutheran General Hospital. After two years of practice she started a full time career as the West Coast Senior Medical Director with Procter and Gamble Pharmaceuticals. There she worked on women's health product development, research and marketing. Seven years after starting this position, Dr. DeRosa decided to pursue other clinical endeavors. Dr. DeRosa is a nationally recognized internist and women’s health expert. Her clinical focus is on revitalizing the physician-patient relationship; striving to provide the highest quality of care to her patients in a warm compassionate environment.

Tuesday, December 3, 2013

The Difference Between Steroids and Testosterone Therapy

We've all read about bodybuilders using them, athletes who get caught "doping" or heard stories about "'roid rage" but there is a huge difference between "steroid use" and testosterone replacement therapy. Steroid use most often involves high doses of testosterone, human growth hormones (HGH) and other drugs to artificially enhance their strength, build muscles and increase endurance. Most doctors would never advocate this type of steroid use, as it can have serious short- and long-term health consequences.

Here's what you need to know: testosterone is a steroid hormone or androgen, and it's essential to core metabolic functions in both men and women - so it's not all just about sex. When functioning well, women's bodies make approximately 60% estrogen and 40% testosterone, and men's around 95% testosterone and 5% estrogen. As we age, testosterone levels decline, affecting mental clarity, glucose metabolism, fat burning, moods, libido, and for men, it can also begin to affect their ability to get or maintain an erection. Aging is not the only factor that can cause testosterone levels to drop. Medications like antidepressants and birth control pills and some health conditions can lower testosterone levels, so even young people can have imbalances.

There are many different ways to replace testosterone in the body, like gels, creams, patches, injectables, and pellets. While the delivery method will depend on a patient's individual needs, we consider bio-identical pellet therapy the gold standard. A small pellet (about the size of a grain of rice) is implanted under the skin. It allows for a more even, individualized dosage without the spikes and lows that come with gels, creams and patches, and there are fewer side effects. Each implant lasts 3-4 months for women, and 4-6 months for men.

Whether you're a man or a woman, hormone replacement therapy should always be done while under a doctor's care, so don't get caught up in the "As seen on TV" craze. If you think you have symptoms of low testosterone, get your levels properly tested by your doctor. If your levels are too low, you and your doctor can determine the right method of replacement for you.

Dr. Angela DeRosa is a nationally recognized expert in Internal Medicine and Hormonal Health. DeRosa Medical has offices in Scottsdale, Chandler, Glendale and Sedona. Call 480.619.4097 or visit DeRosaMedical.com.

Tuesday, November 19, 2013

Does Testosterone Really Lead to Heart Attacks in Men?

Testosterone Leads to Heart Attacks? 

Not so fast, says Dr. Angela DeRosa, DO, MBA, CPE. It was misunderstandings, misreporting of results and media hype that launched the panic over the WHI study on women and HRT in 2002, and the negative impact for women’s health has lasted to this day. 

This study linking testosterone to heart attacks makes the same mistakes and in my opinion they are committing reporting malpractice. Here is what men need to know…

According to Dr. DeRosa, an internal medicine doctor and hormonal health specialist, this is NOT a randomized controlled study. They do not match the patients properly, and they are not accounting for many variables that may already exist in this population comparison.The 26-29 percent increase quoted is a relative risk, NOT an absolute risk. 

In the original WHI study, the media reported that there was a 26 percent increase for risk of developing breast cancer when using hormone replacement therapy – specifically, this occurred in the Prempro trial. In reality, this number wasn’t statistically significant. Here’s why: the percentage was based on EIGHT more women having breast cancer in the Prempro arm. 

This study linking testosterone to heart attacks does the same thing. Once again, the media is looking at a small number of people that’s not statistically significant and making the larger number the report, and it’s again spreading fear and misinformation.

This testing was done on an older male population, which will naturally have a higher incidence of Coronary Artery Disease. As we age, plaque builds up in our arteries. For some people, it’s never a problem. For others, it advances to Coronary Artery Disease. The testosterone supplementation is not causing the condition: the groundwork has already been laid by years of lifestyle, usually poor diet, alcohol and tobacco use, or other variables.

Testosterone supplementation is usually prescribed for use in otherwise healthy males who are experiencing abnormal rates of testosterone decline. Catch it early, and we reduce the risk for developing heart disease, some cancers and other health conditions. 

This is a terrible leap to make these claims...once again. Let’s hope they don’t have the lasting negative impact irresponsible reporting and misinterpretations of data associated with the WHI 2002 study. If you’re still concerned, see your doctor.


Dr. Angela DeRosa, DO, MBA, CPE is a warrior for women, advocating for better understanding of women's health issues and the importance of hormonal balance to overall good health. She's warm and funny with just the right amount of wacky, but make no mistake, Dr. DeRosa knows her stuff. She has a gift for breaking down complex medical conditions into easily understandable terms. She uses media outlets to cut through misinformation and misconceptions and get to the heart of common health problems like thyroid disease, obesity, birth control, problems in the bedroom, romance killers, and menopause and how they impact our quality of life.
She is nicknamed Dr Hot Flash because she went through menopause in her early 30s and now devotes her work to help other women not feel so hopeless and scared about how they age. She holds quarterly events called "Hormonal Happy Hours" where women can attend and talk about sex, health, life in a comfortable and fun environment. www.derosamedical.com

Thursday, May 30, 2013

Lybrido: Myths & Misconceptions About "Female Viagra"

There's a lot of buzz these days about the new "female Viagra". The announcement of FDA trials for Lybrido/Lybridos raised hopes that the new drugs will be approved to help women’s sexual function and desire. In order to determine if these drugs will really help women, we need to better understand what actually drives women’s sexuality. First, some shocking news: sexual desire in men and women is very different. 

The low down: men do not usually suffer from a lack of desire (although with low T this can happen), they suffer from erectile disorders, or ED. In other words, plumbing issues from lack of blood flow to the penis. Drugs like Viagra and Cialis increase blood flow to the penis by causing vasodilation of the arteries in the penis. Contrary to popular belief, ED drugs do nothing to increase desire. 

In contrast, women usually have proper blood flow and do NOT get arousal disorders, which are characterized by the genitals not getting proper blood flow or feeling. This is not very common in women. Most often women (95%) have hypoactive desire disorders, or a lack of desire for sexual intimacy. This is usually due to very low levels of Testosterone in the body. Testosterone levels begin declining in most women during the 30s, as the ovaries slow down the production of testosterone. In order to properly address HSDD, one must replace Testosterone.

Serotonin and Dopamine also play instrumental parts in sexual desire. Dopamine is the “lust” hormone that creates the impulse of wanting to have sex – often described as feeling “horny”. Serotonin causes control and inhibition, which in turn will cause a drop in sexual desire. These two hormones work in conjunction to create a fine line balance between lust and control, so we don’t become nymphomaniacs, but still have the desire.

So let’s look at Lybrido and Lybridos. Lybrido has a coating of a small amount of Testosterone encasing a substance similar to Viagra. Lybridos has the Testosterone coating covering Buspar, (an anti-anxiety med) which temporarily lowers serotonin.

In theory, Lybridos would temporarily lower serotonin, while the T coating would temporarily increase desire. Lybrido alone does not alter these hormones, but does increase Testosterone. The Viagra like substance aids blood flow, but again this is not the most important issue for women.

These drugs do have some interesting promise. However, before we start giving drugs to women to treat the desire disorders, one needs to investigate the root cause. Desire is a much more complex issue for women than it is for men. 

We need to address psychological issues for low desire, including bad relationships, emotional traumas such as rape or sexual abuse, and medical issues like chronic illness or side effects of medication, etc. Treating women with Testosterone or any other drug will not work, if these issues are not identified and addressed first. 

Happily, most women can be treated with bio-identical testosterone alone and do not require these other components. We need to look at what we are trying to accomplish before determining the best course of treatment. Are we trying to create normal physiology or an unnatural balance in our bodies driving sexual desire? As a physician, I believe normal physiology is the most desirable outcome.

Monday, January 21, 2013

Trying to get pregnant? Why you can't always have it all...

Did you see my interview on infertility this morning on Good Morning Arizona

If you'd like to learn more about the challenges of getting pregnant, here are some things to know.
Each woman has a different story and the only way to know what is happening to YOU is to start by visiting your doctor. Keep these points in mind when you discuss your issues or concerns. 

Common medical irritants during pregnancy:
Many issues such gestational diabetes, increased BP and pre-eclampsia arise which are very serious, but most women just get garden variety medical “irritants”.

·         1st trimester
o   Fatigue
o   Breast tenderness
o   Nausea, morning sickness
o   headaches
·         2nd
o   Leg cramps
o   GERD, heartburn
o   Increase in gas/flatulence
o   Hemmorroids, constipation
o   Nose bleeds/bleeding gums
o   Carpal tunnel syndrome
·         3rd
o   Swelling of the legs
o   Shortness of breath
o   Insomnia
o   Frequent urination

·         Have to be cautious as to what medication/OTC one can take during pregnancy to help these things.
·         Fine to take during pregnancy: Tylenol, Antacids, Anti-gas, fiber/laxatives, preparation H, cough drops

Saturday, December 15, 2012

Heart Attacks During the Holidays

Did you know cardiac deaths are highest on December 25th, second highest on December 26th and 3rd on January 1st. Does that make your heart race a little? It should. Please slow down, take some time for yourself and know the risks and symptoms.

Risk factors include the obvious including smoking, high blood pressure, high lipids, diabetes, lack of exercise and increased age. Not so obvious factors: cold weather, emotional stress and over-indulgence. Plus at the holidays, people drink more, eat more, exercise less.
A big problem during the holidays is that people delay getting treatment in order to not disrupt the holidays and women are particularly guilty of this.
Women also may not present the same as men. The symptoms may not be so obvious. Men tend to get the "elephant on the chest, jaw pain, radiation down the arm. Then drop to the floor, clutching their chest.  Women may not be so obvious. Although the most common in both is chest pain or pressure.
Women can also experience any of the following:.
a.      Pain or discomfort in one or both arms, the back, neck, jaw or stomach.
b.      Shortness of breath with or without chest discomfort.
c.      Other signs such as breaking out in a cold sweat, nausea or light-headedness.
d.      Flu-like symptoms
e.      Uncharacteristic fatigue
f.      As with men, women's most common heart attack symptom is chest pain or discomfort. But women are somewhat more likely than men to experience some of the other common symptoms, particularly shortness of breath, nausea/vomiting and back or jaw pain.

 What you can do:
a.      Pile on the layers. Try to avoid exposure to very cold temperatures. Dress warmly.
b.      Take a load off. Steer clear of heart stressors, including too much physical exertion (especially snow shoveling), anger, and emotional stress.
c.      Make good choices. Avoid excess salt and alcohol.
d.      Get help. If you feel chest pain or other symptoms, call 911 for emergency help.

The stakes are high. So give yourself and your family a gift this season. Don't postpone a doctor appointment or treatment because you don't want to spoil the holiday merrymaking.

Saturday, November 24, 2012

Birth Control Pills Over the Counter? NO WAY!

OB-GYNs are saying birth control pills should be over the counter. I disagree strongly and hope you and anyone you know who is on the pill or considering it will read this and share with others. 

The  ACOG is making this suggestion based on pregnancy rates.  However, what makes me crazy is that OB/GYNs are surgeons and deliver babies.  They usually do not fully understand the differences of oral contraceptive pills (OCPs) and just give them out without understanding the effects on the rest of the body. They only think about the vagina, ovaries and uterus.

Oral birth control is great at preventing pregnancy, yes, but they have metabolic consequences especially the low estrogen OCPs.  They can lower free testosterone (because the ovary makes this and you just shut it down) which increases your risk for depression, low libido, weight gain, sugar problems and even diabetes. They affect your thyroid function..slowing it down.  The low estrogen pills also have a relative high ratio of progesterone, which makes women crabby and gain weight, but also puts women into ametabolic syndrome which is high sugars, high lipids, increased weight and higher risk for heart attack and stroke.  OB-GYN’s don’t think about these things….they just want the contraceptive effect and to stop women from having heavy periods.  This is a good thing, but you need to know what you are doing first.

You can balance these effects by using OCPs with good Estrogen levels especially lowering the progesterone effect….unless you have Polycystic ovary syndrome (PCOS) which is a whole other topic.  You often need to provide or add back testosterone to these women.

There are other options to oral birth control, which are better including: ortho evra patches, nuva-ring and IUD’s.  These avoid processing through the liver and does not increase clotting risk. They also free up some of the testosterone made by the adrenal glands. (10%)  Less chance of the weight gain, low libido, depression etc.

 If OCPs go over the counter, doctors cannot advise women properly about which contraception is uniquely best for that patient. Also, the annual well women exam which is where most young women get their birth control refill would be lost….they would not be compelled to come in as often and we lose an opportunity to provide health education and the needed examinations to ensure they are and stay healthy.

Wednesday, October 24, 2012


It is outrageous that we are still fighting the hormone fight on a badly designed study with flawed results. (WHI, 2002)
This “D” recommendation from another news story is coming from the organizations (USPTF) who gave a “D” recommendation about doing mammograms every other year after the age of 50.  
They are making a broad sweeping judgment based on only two medications (mind you I didn’t say bio-identical hormones which are NOT medications…they just replace what our bodies make. Meds treat illness)  Prempro and Premarin.  The 51 studies are largely based on follow up articles on the same WHI study being ruminated over. 
They are quoting inaccurate data because in 2009 even the WHI results were re-looked at with proper statistics and the Prempo arm showed neutral on breast cancer and a lowering of heart disease in women between the ages of 50-60. And the premarin arm showed a significant decrease in breast cancer by 23% and decrease in heart disease. 
Just last month the American College of Physicians (ACP) had an article in their journal about a large European study with over 1000 women at the appropriate age to start hormones (between 45-60) over 10 years a decrease of heart disease and heart failure/heart attack and NO increase in cancer. 
There are plenty of studies outside of the US that support using hormones for chronic illness protection.  However, this comes from hormones which are NON oral and bio-identical. 
Orals and synthetics DO cause increase clotting risk…..but even the worse of these DO NOT increase breast cancer. 
This study is OLD news and putting fuel on the fire to have women NEVER get hormones paid for by insurance companies.  It is complete gender bullsh*t! And it is hurting women.
Men get their erection drugs and hormones with NO questions asked…..what about women?  They have ZERO studies which are randomized placebo controlled studies and they get all preparations approved.  We have ONE BAD STUDY and millions of women on bio-identical now that have great data and we get NOTHING but terrible oral synthetic drugs approved or nothing at all.  We also have over 7000 women in placebo controlled randomized studies for our hormones and nothing!!


Sunday, September 9, 2012

VAGINA's 7000 vs PENIS' 0 ....and the vagina's are still losing

Now that I have your attention, let me bring some reality to this humor.  In 2012, did you know that we have over 7000 women in randomized placebo controlled studies to study new products/drugs for the treatments for sexual desire disorders in women (think low libido) as well as female pelvic dysfunction syndromes and to date the FDAhas not approved any of these in this country?  Testosterone helps with both of these medical problems and the only way we can get it for women is to compound it in a pharmacy or by using off label smaller amount of medications for men.  And to boot, many of the big pharma companies are trying to lobby the government to stop these pharmacies from doing so…..making these products unavailable to women.  This is outrageous!

Women in other countries have had access to approved products and we don’t.  Our country is light years behind other countries in women’s health issues and medications. And we are supposed to be the leaders in medicine. 
And what infuriates me even more…..did you know that men have numerous erectile dysfunction drugs (VIAGRA, CIALIS, LEVITRA) and tons of testosterone products in many forms (Testosterone cypionate injections, testim gel, androgel, testopel pellets…..to name a few) approved by the FDA.

And do you know how many randomized placebo controlled subjects in studies for these male products….Yup you guessed it ZERO.
So the reasoning behind the lack of female product approval.. .....They are worried the drugs will cause us adverse medical issues. Well none of the studies proved this.  The women showed only a small increase in acne and facial hair.  And most women did not discontinue the products due to this….as they felt much better. 

The male ED drugs can actually cause blindness, heart attacks and death.  Well at least they died blind and with an erection.
In a society where women are starting to outpace men in numbers in high leadership positions and having more with 6 figured salaries, we would think this would cause great alarm and a huge push to fix this.   The establishment has us off focus, because we still have to fight the fight on the birth control issue and who has the right to control our bodies……

Does anybody think we are in the 21st century?  It feels more like the middle ages.

Tuesday, August 21, 2012

STRIDES IN CANCER DETECTION - My thoughts on new gene biomarker

I came upon this video about a researcher from Mayo who discovered a gene biomarker for prostrate cancer detection and had to share this information with you!  This is very exciting news!  

I've known about the new marker Breast Test (BT test) that has identified a group of 5 inflammatory/tumor markers that can signal the presence of breast cancer...improving the detection of breast cancer in conjuntion with the usuall mammographic imaging, but men have not had any signficiant improvements in the detection of prostate cancer ...until now.  We have a glimmer of something to look forward to other than PSA levels.  PSA levels in the detection of prostate cancer in men has had its clinical challenges and most recently the US Preventive task force even stated that the PSA should not be used for routinue screening in men.

So, why has the PSA levels been challenging for doctors and patient?

To summarizie: 
The task force concluded from two large studies that over a period of 10 years, one prostate cancer death at most was saved from PSA screening for every 1,000 men screened.

The test finds many cancers that are not life-threatening, and treatment causes side effects from surgery and radiation such as impotence and urinary incontinence. The harms weighed against benefit aren't enough to justify the screen, the task force concluded.

But some doctors say the answer is to change the way that prostate cancer is handled in this country.

When a biopsy reveals cancer, 90% of men are treated -- even though most prostate cancers won’t threaten a man’s life.

However, the word CANCER evokes fear in even the most calm and reseasonable person.....no-one wants to know that they have a cancer brewing in their body.  But in fact, many of us die with cancers that are only found on autospy.  Not all cancers are going to kill us......or kill us quickly.

Which cancers to treat:  
Prostate cancer experts aren’t perfect about figuring out which cancers need treating and which can be carefully watched.
When a biopsy is taken, the cells are examined under the microscope and the cancer cells are given a so-called Gleason  score based on the shape of the cells. Gleasons of 8, 9 and 10 need to be treated, he says. Six or less, probably not.

Patients should do everything possible to get themselves to a center of excellence for treatment. Treatment side effects -- urinary incontinence, impotence and bowel problems -- are in the double digits across the U.S. but are “substantially” lower at centers of excellence,   There are good non surgical options that include high frequency ultrasound and proton therapy.

However, it is hopeful that with the advent of this new biomarker techology.....Mayo have found a way to better tell us which cancers we should aggressively pursue and which should we should.  However, I suspect this is a way off....this marker just may tell us if the cancer is present unlike PSA levels which cannot at this time.

Saturday, June 23, 2012

Testosterone is NOT the new Viagra......

"Doc, I need testosterone for my mojo." I hear this every day in my practice. Which in "guy speak" means erectile dysfunction. Although testosterone is great for libido and "mojo," people often mistake testosterone as a viagra-like substance to aid in "getting it up".

However, Testosterone and erectile dysfunction drugs work in totally different ways and one may not work without the other.  So here are the facts:

Testosterone is like the foundation of a home.  It is needed to prime all the organ systems to work properly including mental clarity, glucose metabolism, fat burning, mood and ability to deal with stupid, libido and, oh yeah, those erections! Testosterone primes the tissues in the penis to aid in engorgement of the blood in the penis, nervous system response to stimulation and ability and strength of the orgasm. 

Viagra, and other erectile disorder drugs on the other hand are a vasodilator....in other words it allows for the penis to be able to engorge with blood property so that an erection is possible.

If a man's libido is low or he has an inability to obtain an erection, one should start with testosterone first.   An erectile dysfunction drug should only be used if the testosterone did not fix the issue, as then blood flow is likely an issue.

Blood flow problems usually result from smoking, high cholesterol, high blood pressure, obesity and other things that cause damage to the arteries and veins.  And is usually occurs over years of damage.

In severe cases, even testosterone coupled with a drug like Viagra will not do the trick.  This is when penile injections (most men cringe at this thought but will do just about anything to "get it up") and pumps may be helpful.

Bottom line is......if you don't have your groove in the bedroom, talk to a doctor that specializes in testosterone replacement and has a good understanding that Viagra-like drugs are NOT the answer to everything.