Mens Health Blog. Medical Blog

- Instead of taking progestogen each month, is it safe to take it, say, every three to six months so that I don’t have so many withdrawal bleeds?

Researchers are now looking into this possibility. The available evidence suggests that, in some women taking oral oestrogen each day and progestogen for ten to fourteen days every second month, the endometrium is protected sufficiently for this to be a safe and convenient option. Further research is needed to determine which women are best suited for this approach, however. Women who have a very light monthly bleed or no bleed at all could turn out to be suitable. Until the research under way has been completed, it seems likely that most doctors will continue to prescribe some progestogen each month.

- I am taking oestrogen and progestogen, with five days at the end of each cycle when I don’t have any hormones. Is this approach widely used?

There doesn’t seem to be any justification for this once-popular approach as menopausal symptoms can return during the hormone ‘break’.

- I’ve had a hysterectomy. Is there any reason why I should take progestogen as part of HRT?

It was suggested at one stage that progestogen might protect the breast from cancer development, and this remains controversial. At the 8th Congress of the International Menopause Society in Stockholm in 1993 there was considerable discussion of whether oestrogen or progestogen, or both, stimulate breast cell growth. It may be that less stimulation occurs in women on low-dose oestrogen and progestogen throughout each cycle. It was suggested that even women without ovaries should be on this combination. Research is assessing this. Meanwhile women without a uterus usually receive oestrogen alone. This does not seem to increase breast cancer risk in the short term (less than five years).

- I am fed up with hot flushes and night sweats and am considering HRT, but I have fibroids. Should this affect my decision? HRT can be prescribed to women with fibroids. However, if fibroids are bulging into the cavity of the uterus heavy bleeding may occur, and this will need to be investigated and may need to be treated before HRT is prescribed.

- My vagina is dry and itchy and sex is often painful. I have started using a vaginal cream that contains oestrogen and wonder if I also need a lubricant?

You will find that your oestrogen-containing cream improves lubrication and reduces itchiness within a week or two. Until then, you may want to use a lubricant when having sex.

- Are hysterectomy rates going up?

After peaking in the late 1970s, rates of hysterectomy appear to have stabilised in Australia, with about 25 per cent of women having the procedure by the age of sixty-five. A NSW study found women aged from thirty-five to forty-nine years were most likely to have it, particularly in their late forties. Most of the operations were for benign disease such as endometriosis or fibroids.

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Comments (0) Apr 21 2009

About a quarter of women starting on HRT experience a small weight gain (up to 3 kg) during the first cycle and for a few months after. A smaller proportion put on considerable weight, part of which seems to be due to fluid retention. Some other women gain weight because of increased muscle mass — because they have discovered exercise in midlife. In older women who already have trouble moving freely, further weight can present problems because it makes regular activity more difficult.

Heather was sixty-eight when her doctor suggested she go onto HRT because of a personal and family history of heart disease. (She had already had coronary bypass surgery and her mother had died of a heart attack.) Heather’s weight shot up after starting on a twice-weekly oestrogen patch and daily progestogen tablets. The doctor reduced the dose of the patch but her weight increase continued, amounting to 13 kg over a ten-month period. In consultation with her doctor she embarked on a program of exercise and dieting aimed at getting her weight down and benefiting her heart. At the time of writing she was trying to decide whether HRT was worth the trouble. ‘I’m looking at the information and making up my mind whether to continue with HRT,’ Heather said.

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Comments (0) Apr 20 2009

women CONSIDER HRT for many different reasons, the most common being to relieve symptoms associated with the menopause. In addition, women at risk of fractures due to osteoporosis, or likely to develop heart and blood vessel disease, may have HRT recommended to them by their medical practitioners. The same advice is increasingly given to women with existing osteoporosis, or those with a diagnosed heart or blood vessel condition, the rationale being that HRT may prevent these problems getting any worse.

HRT and menopausal symptom control

Hot flushes and sweating often prompt menopausal women to seek medical assistance. Other common reasons for consultations include psychological symptoms like loss of concentration and ‘feeling blue’, general tiredness, irritability, vaginal dryness and pain with intercourse, loss of libido, urinary frequency and persistent urinary discomfort.

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Comments (0) Apr 20 2009

Research shows that when the ovaries stop releasing eggs at the menopause, and the lining of the uterus no longer changes in preparation for a possible pregnancy, most women continue to make measurable and useful amounts of active sex hormones. The major source of oestrogen is chemical conversions that take place in fat tissue, hence the amount of body fat has a good bit to do with oestrogen levels in postmenopausal women. The brain and the adrenal glands (two small organs near the kidneys) also continue to produce hormones that control the reproductive system at this stage of your life. Like body weight, your genetic make-up is an important factor in the output of these hormones.

Overall, we produce relatively smaller amounts of oestro-gens, progesterone and androgens (a class of hormones that includes testosterone) after menopause than before it, and the balance of the various hormones changes. Testosterone, for example, becomes a more dominant hormone, even though less is produced after menopause than beforehand. The altered hormone balance explains some of the rapid and not-so-rapid changes to the body associated with menopause.

These hormones act on chemical structures called hormone receptors in many parts of the body. Their influence extends to the ovaries, fallopian tubes, uterus, cervix, vagina, vulva, skin, heart, blood vessels, liver, joints, bone, breasts, brain and urethra (the passage from the bladder to the outside). Various forms of oestrogen affect tissues such as the vaginal lining and the blood vessels in quite different ways. For each of us, changes in our hormone balance will be different, and consequently the effects will vary from woman to woman. Thus the increased prominence of testosterone after menopause may cause an increase in facial hair, altered libido (interest in sex), and a change in the distribution of body fat that is quite apparent to some women but goes almost unnoticed by others.

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Comments (0) Apr 20 2009

Bowel function varies a great deal from one person to another, making it difficult to say exactly what diarrhoea is. For most people, one bowel movement a day seems to be the norm, but some people only go once every three or four days, while others go twice a day or more. An important question here is whether ‘average’ is the same thing as ‘normal and healthy’. One survey of 301 apparently healthy adults found that almost a third of them reported bowel symptoms of some sort (diarrhoea, constipation etc), although most had not consulted a doctor for their problem. This study can be interpreted in two ways. It either shows that everyone’s bowel function is different and there is no such thing as a normal pattern – or it shows that a large percentage of the population are suffering from minor bowel complaints. We would lean towards the latter view, and suggest that some of those people, at least, are sensitive to the food they eat.

In general, a healthy bowel pattern feels healthy, whether you go three times a day or twice a week. There is a regularity to the pattern – it is not erratic. The stools are fairly firm and well-formed and there is no particular urgency, nor any great difficulty in going. There is no sense of malaise or pain, either before or afterwards, and the movement feels complete – not as if you still have some faeces left to pass. In diarrhoea, soft, loose or semi-liquid stools are passed several times a day; there is usually a sense of urgency and, usually, some feeling of malaise. Diarrhoea is basically a means of ridding the body of toxins, harmful bacteria or other unwanted substances – it is a healthy reaction to infection, and should only be considered a problem when it serves no useful purpose. However, acute diarrhoea can lead to dehydration because so much water is lost, and this can be dangerous.

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Comments (0) Apr 20 2009

It used to be the custom in country homes to cover the mattress with a quilt for greater warmth and softness. But it is hard to understand how it was possible for the habit of sleeping on a soft foundation to creep in, especially in areas where the people are usually tougher. Soft beds that sag when you lie down are not healthy. And if there is a bolster and thick pillow as well, do not be surprised to find that the spine will adopt a distorted position. If the sleeping person could be X-rayed from the side, this would be seen quite clearly. That is why old beds in country homes, where great-grandmother had had difficulty in sleeping, are far from ideal for healthy sleep today.

A good bed must have a certain degree of firmness, because if it is too soft the blood vessels, in particular the veins, become congested and this impairs the circulation. Many people do not sleep properly on foam rubber, and those who suffer from rheumatism may find metal springs unfavourable to their condition.

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Comments (0) Apr 09 2009

The conclusion we must draw is that we should never go beyond what does us good. Brief spells of indirect sunlight are more beneficial and healing than the more common sunbathing. Moving around in the half-shade is a healthy exercise. People who suffer from high blood pressure and heart trouble should never expose themselves to intense heat or strong sunlight. Doing so could lead to sudden death.

When it is extremely hot you must be careful to avoid cooling down suddenly. Bathing in very cold water, for example in a mountain lake or a river with glacier water, can pose a great risk. Although I have mentioned the matter of drinking before, I would like to reiterate in this context that it is bad for us to drink water that is too cold. So, if you are on a mountain tour and nothing but cold water from a spring is at hand, add a little thirst-quenching Molkosan but no sugar and sip the water slowly while insalivating well. In this way you will avoid the chilling effect your body would otherwise experience and your thirst will be quenched much better than if you had taken a sweet soft drink. It is thus worthwhile putting a small bottle of Molkosan in your rucksack when going on a hike in the summer.

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Comments (0) Apr 09 2009

Milk is an ideal culture medium for all kinds of bacteria. If you leave unpasteurised fresh milk in a normally warm room in summer it will turn sour. The curdling is caused by lactic acid bacteria whose spores were either present in the milk or invaded it while it was in the kitchen. We do not recommend using milk that cannot turn sour because of chemical additives that make it stringy and go off if left outside the refrigerator.

There are various species of lactic bacteria, each one playing an important part in the preparation of special cheeses. Yogurt is made by inoculating the milk with lactic acid bacteria. Some of these bacteria should not be ingested constantly because they affect the intestinal flora. Thus yogurt is good for you if you eat it occasionally; if, however, you take it regularly all year round, its influence on the intestinal flora is one-sided and therefore detrimental. Some researchers claim that yogurt, if eaten every day over a long period of time, will cause the essential coliform bacteria in the intestines to degenerate. For this reason it is not recommended to eat yogurt continuously.

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Comments (0) Apr 09 2009

It is necessary to clarify certain questions connected with the various kinds of sugar, since many people are not sure of the difference between unrefined cane sugar and refined white sugar. In fact, it has been said that brown sugar (unrefined cane sugar) is treated with sulphur and is therefore no less detrimental to health than refined white sugar, which has been bleached and dyed for the purpose of preservation.

However, white sugar is dyed solely to enhance its whiteness, not to make it keep longer. This is done following the same principle as is applied in the manufacture of washing powder, to which is added ‘blueing agents’ to make the linen appear whiter than it actually is. Without this addition it would soon begin to look greyish. Sugar keeps indefinitely on its own and needs no preservative. If stored correctly, it will last a hundred years and still be sweet. It is ‘blued’ for eye-appeal and for no other reason.

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Comments (0) Apr 09 2009

Whole wheat also provides an ideal dish and should be prepared in the same way as rice. Instead of a risotto you would then get a ‘wheatotto’, so to speak. Other good carbohydrate foods containing nutritive salts are millet and buckwheat.

If you like soup, choose a vegetable soup, but only mildly seasoned. Meat soups are not particularly healthy for they promote the formation of uric acid in the system. Vegetable soups, on the other hand, are very beneficial for those who suffer from arthritis. Before you sit down to eat the soup, add some fresh herbs and raw vegetable juices. And if you do not like raw vegetables prepared as a salad, they too can be added to soup, finely chopped or grated. Finely chopped nettles, bear’s garlic (ramsons) and other herbs will improve both the nutritive value and the taste of the soup.

For those who like meat, beef or veal may be added to whatever dish they have chosen, but this should be considered as just a small addition to the main meal, for it is best to restrict oneself to a minimum of the protein-containing foods.

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Comments (0) Apr 09 2009