About Me

My photo
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