Mens Health Blog. Medical Blog

Nowadays, we think we know all there is to know about sex, having babies, contraception, and all that. Yet we seem to know so little about the menopause. Why don’t we talk about it more, compare notes, learn from each other? We do about most other things.

Talking about the menopause is something that most women have just never done. We talk about other aspects of our lives, but not this one. As a result, a conspiracy of shame and silence has drifted down the generations, expressed in such phrases as: ‘It’s her time of life’, ‘She’s going through the Change, poor old thing’, ‘Take no notice of her, she’s just having a hot flush’. Say no more, nudge nudge, wink wink.

Now, however, at last, compared with their predecessors, women reaching the menopause could be the lucky ones, the ones who know about it and are well informed. They can recognise hot flushes and other symptoms for what they are: the body’s response to a fall in the level of the female hormone oestrogen – simply that. They are not something shameful; nor do they mean we are suddenly old. After all, who wants to feel old at 50? It will be another 30 years before you need even to start worrying about that, so don t wish it on yourself now.

Part of the problem is that, until fairly recently, the majority of women didn’t live long enough to experience the menopause. Until reliable birth control became readily available, women who bore children tended to spend the majority of their married lives in a state of pregnancy or breast-feeding until their early forties. A combination of continuing pregnancies and the hazards of childbirth, as well as poor sanitation and inadequate health care, meant that, even at the start of the twentieth century, most women were dead by about fifty. So it is hardly surprising that so little was known about the menopause, let alone talked about.

Those who did survive to the menopause never made much of a fuss about it. They used a bit of self-medication, herbal remedies handed down through the generations, or exciting dietary supplements like ‘two sheep’s ovaries a day sandwiched between unleavened bread’, or ‘one tankard dairy of the urine of a she-goat’, and waited for it to pass.

Today, we often feel the menopause is just another illness to be treated by visits to the doctor and by medication. We hear the term ‘deficiency disease’, that is we are deficient in oestrogen. Yet most women still don’t really know what the menopause is, when it might happen, what to expect, and what can be done to ease their passage through it.

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Comments (0) May 08 2009

There are several sites for cancer that prompt women to consider a hysterectomy. Cancer of the cervix, also called cervical cancer, develops in cells that line the cervix. The abnormal changes usually occur over a period of years, although in some women the changes seem to happen much faster. Abnormalities of the cells of the cervix, thought to be precursors of cervical cancer, used to be called dysplasia; but nowadays the term cervical intraepithelial neoplasia (ON) is used.

Cervical cancer is diagnosed in about 1100 Australian women each year. Although most diagnoses are made in women aged over fifty-five, it seems that increasing numbers of women in their twenties and thirties are now being affected. Tell-tale signs include bleeding between periods in pre-menopausal women, bleeding after sexual intercourse or at any time after menopause, and a smelly vaginal discharge.

Screening for cervical cell abnormalities that could develop into cancer is available using the Pap smear technique. A small sample or biopsy of cells from the cervix is obtained using a special brush and a fine wooden spatula. The cells are smeared onto a piece of glass and then sent to a laboratory for examination. From the appearance of the cells, it is possible to identify cancer at a stage early enough to permit its complete removal and cure. Australian health authorities recommend a Pap smear every second year from the time women start to be sexually active.

Over 400000 women in the State of Victoria, Australia, had a Pap smear during 1990, but seven out of ten women considered to be most at risk of cervical cancer did not come forward for testing. Of every ten smears done, eight were completely normal or showed insignificant changes. Less than four in every 100 smears showed CIN changes and only one in every 2000 was suggestive of possible cancer. If the results of a Pap smear raise concerns or if a woman experiences any unusual bleeding or cervical discharge, the cervix is examined for suspicious-looking tissue using a magnifying instrument called a colposcopy. A biopsy is usually taken and the tissue sample removed from the cervix is sent to a laboratory for microscopic examination. If the examination indicates severe CIN or pre-invasive cancer, any areas of the cervix which look abnormal are treated by cryosurgery (which destroys tissue by freezing), diathermy (which achieves the same end using an electric current), or else by heat or by laser. Diathermy or electrocoagulation entails using an electric current to produce points, loops or small balls of heat that burn the tissue while also closing blood vessels. Lasers are high-density beams of light energy that can cut tissue precisely and, at the same time, close off blood vessels. All these techniques have a high cure rate, and they do not interfere with a woman’s sex life or prevent her from having children in the future. Occasionally, a procedure called conisation is performed in which a cone-shaped sample of tissue about a centimetre thick is removed from the cervix using a scalpel, diathermy or laser. Once again, it is rare for the technique to damage a woman’s sex life or impair her ability to have children. If, however, there is any evidence that the disease has spread inside or beyond the cervix, a hysterectomy should be discussed. Radiation therapy or chemotherapy may also be suggested in a bid to ensure the complete destruction of cancer cells.

Although scientists do not know the exact cause of cervical cancer, there appears to be an association with sexual activity. Research suggests that certain strains of the human papilloma virus (HPV), which may be transferred during sexual contact, are involved in the disease process.

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Comments (0) May 08 2009

In 1953, Dr Natheniel Kleitman, Professor of Physiology at the University of Chicago, made a major discovery about the nature of sleep. He was studying sleep in small babies, and made round-the-clock observations of them. He noticed recurrent rapid movement of the eyeballs beneath the eyelids of these babies. The eyeballs moved for a few minutes, then rested. This recurred nearly every boar. He then started to investigate if this also occurred in adults. He was joined by William Dement, a medical student at that time. They started the first electrical measurement of eyeball movement during sleep. They attached electrodes to the skin at the corners of the eyeballs to pick up potential changes when the eyeballs moved. This kind of eye movement recording is called an electro-oculogram or EOG. Dr William Dement is now the director of the Sleep Disorder Centre at Stanford University, California, and also the Professor of Psychiatry in its medical school. He remains a world authority on sleep.

Kleitman and Dement observed that, when a person is sleeping, there is rapid eye movement in both eyes and this recurs periodically about four to five times each night. If these people are awakened during one of these periods of rapid eye movement, 95 per cent report that they are dreaming, compared with 7 per cent at other times of awakening. The duration of the dreams they recall appear to correlate with the length of the period of the rapid eye movement. This rapid eye movement sleep is now abbreviated to REM sleep. REM is pronounced like the word ‘gem’.

During REM sleep, the person is dreaming, his mind is active, and his eyes are moving rapidly back and forth under closed eyelids. The EEG recording is very similar to that of the awake state, like a very irregular saw tooth, and nothing like that of the four stages of sleep described previously. Contrary to what we expect, when the person is dreaming his body is not moving at all, but is in complete relaxation—paralysed. Some people call this REM sleep the paradoxical sleep. This is because the mind is active and dreaming, but, paradoxically, the body is totally inactive and motionless. It is thought that this complete body rest during REM sleep is essential for the refreshing feeling the person feels in the morning. This is because no matter how tense a person is, during REM sleep his muscles are all relaxed It is also thought that this complete body paralysis during dreaming prevents the dreamer from acting out his dream physically when he is asleep. It looks like there is some form of jamming mechanism that disconnects the brain activity from the muscular system of the body.

Michael Long, in a 1985 edition of National Geographic, reported that, in Minneapolis, at the Hennepin County Medical Centre, a Dr Mahowald and a Dr Schenck interviewed over 30 people who somehow bypassed this jamming mechanism during REM sleep and acted out their dreams. This is of course extremely dangerous, but fortunately also extremely rare. During dreaming all sorts of fantasies, angers, and frustrations are acted out. Those people with no jamming mechanism can endanger not only themselves but also those sleeping beside them. It was reported that some of these violent dreamers beat their wives up repeatedly, smashed windows, punched holes in the walls, and displayed remarkable strength and agility. Fortunately most of us have this jamming mechanism which prevents us from acting out our dreams; otherwise our beds would look very different, with restraining belts to lock our bodies and limbs to the bed, to prevent us from running wild destroying things in the house when we are having a nightmare.

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Comments (0) May 08 2009

Man has evolved to what he is today through hundreds of thousands of years of insecurity. In fact, it would seem that we function best when we feel that we are not completely secure.

At work there is always insecurity. We may lose our job, or if we are self-employed, our business may fail. If this insecurity reaches a certain degree we become tense and anxious. The sensitive are among the first affected, and those who are less gifted, less competent, and less well trained soon feel the strain. The situation is always worse when aggression is aroused. Because of our insecurity, our aggression has to be controlled at work, and as a result is likely to be displaced on to our wife and children at home.

A conscientious worker in a large industrial concern had been promoted to works manager. He now found that he had lost the fellow-feeling and security of being one of the men, and in addition he had to face pressures from both top management and union leaders. He broke down with chronic tension, depression, and sleeplessness. Relaxation helped him, and he was able to carry on; but when last seen he was still unable to attain real ease of mind, as he had really been promoted into a job beyond his emotional capacity.

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Comments (0) Apr 29 2009

Anxiety is often one of the symptoms of depression and when it is part of an overall depressed picture, it appears that St John’s Wort will help the anxiety along with the other symptoms of depression. Some people, however, suffer from anxiety without exhibiting any symptoms of depression and so far there have been no research studies to determine whether these people will benefit from St John’s Wort. It would not be surprising if the herb did prove to be of some value in anxiety since many other antidepressants have been found to be helpful in the treatment of anxiety disorders. There certainly seems little harm in trying the herbal treatment for a month or two if you are anxious and determining for yourself whether it is helpful to you, but you may want to start with a low dosage and increase it slowly since anxious people may be more susceptible to the symptoms of restlessness reported by some people on St John’s Wort.

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Comments (0) Apr 29 2009

A common story is for parents to be woken by the stertorous breathing or grunting of a child in the next bedroom. They go to him, thinking usually that he is having a bad dream, and find him staring, unresponsive, convulsing, and perhaps blue. Few if any parents can cope calmly with such a scene. It is usual for the family doctor to be telephoned at once, and, if there is any delay in his arrival, for an ambulance to be summoned as well. Many parents subsequently confess that they thought their child was dying, so they are acting in an entirely rational way. Almost invariably, however, by the time the family doctor or ambulance has arrived, the seizure is over, the child is sleeping peacefully, and the adults are making tea. But they will not sleep again that night. Many—though not all—are immediately aware of the nature of what they have just seen.

Although the first seizure can occur anywhere and at any time, another common scenario is for the first seizure to occur in a young woman in the company of her friends or at work. In this case, the lack of ready access to the family doctor, whose name and telephone number is unlikely to be known to the bystanders, results in an ambulance being almost invariably called, and the unfortunate young woman being rushed off to hospital. She will recover consciousness either in the ambulance or in the Accident and Emergency Department of the hospital. To the confusion invariably consequent to the generalized seizure must be added the feeling of ‘What on earth has happened to me, and how have I finished up here on a stretcher with strangers peering at me?’ Obviously, therefore, although ambulance services are rather prickly on this point, a friend should accompany her to hospital—not only to provide moral support when recovery of consciousness occurs but also to give an accurate account of events to the hospital staff. In this case, the diagnosis of a tonic-clonic seizure is clear, but in others matters are not so straightforward. It is important to distinguish between an epileptic seizure and some other event which may initially seem to be one. Patients may speak in terms of a ‘black-out’, ‘funny turn’, or ‘blank spell’, and we have to do our best to analyse the cause.

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Comments (0) Apr 28 2009

Ms HM, Cambridgeshire, England. “I started taking the [CMO] at the beginning of October. By the end of the course I had improved quite a lot but still needed as many painkillers. Since Christmas it has taken another spurt. I was able to play snowballing and was able to build a snowman in the beautiful Christmas snowfall. Now after seven years of only being able to take showers, I can get in and out of the bath quite easily. I have not needed to take antiinflammatories for two months and am now able to cut down on the pain killers…..So many thanks.”

Mrs M K, Staffordshire, England. “I have suffered with arthritis for the last two years in my feet and legs – nothing too drastic but enough to curb a lot of my activities, particularly my love of gardening.”

“I had a course of Acupuncture last year for about six months, it did halt the pain only left me for a few days after each session. I was told it would need a lot of treatment. I was then told about your treatment and have taken a full course of tablets following a strict diet for recommended. Within a few days I could feel improvement and after the fall course felt more like my old self again. I am now back on my gardening. I am able to do a lot of things I was unable to do last year. I shall always be very grateful to the [CMO] treatment and to all of you that have helped me.”

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Comments (0) Apr 28 2009

Symptom

Yellowing of skin and whites of eyes.

Home care

Home treatment cannot be undertaken until an accurate diagnosis has been made.

Precaution

Jaundice caused by a drug will disappear when the child is taken off the particular medication. All other types of jaundice in children are potentially serious and require prompt medical attention.

Jaundice is a yellowing of the skin and the whites of the eyes due to the accumulation in the body of a substance called bilirubin, which is released when old red blood cells are replaced by new ones. Bilirubin is excreted by the liver into the intestine as bile. Jaundice develops when the red blood cells are rapidly destroyed (as in sickle cell and other forms of anaemia); when the liver cannot transform bilirubin into bile; or when bile cannot flow through the bile ducts into the intestine, for example, if the bile duct is blocked by stones, cysts, or a malformation.

Jaundice rarely occurs as a complication of a generalized infection, but it may be caused by some drugs and poisons. The usual cause of jaundice in children over one month of age is hepatitis, which damages the liver cells and interferes with the formation of bile.

Signs and symptoms

The yellow-gold-orange color of the skin and whites of the eyes suggests jaundice. When a child has jaundice, all of the body fluids are stained; the tears are yellow, and the urine is dark orange. However, the diagnosis can be exceedingly complex and depends upon laboratory tests.

Home care

Only after a clear diagnosis has been made can anything be done in the home.

Precaution

Jaundice caused by a certain medication will disappear when the child is taken off the medication. Other causes of jaundice in children are potentially serious and hard to diagnose. They all require a doctor’s attention.

Medical treatment

A child suspected of having jaundice will require laboratory tests to define the reason for the jaundice. Hospitalization is sometimes required.

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Comments (0) Apr 28 2009

•     After the age of 30 or so regular brushing of the teeth becomes more valuable in terms of what it can do to promote healthy gums than in the battle against tooth decay. Brush your teeth at least once a day with fluoride toothpaste, ensuring that you have a good-quality nylon brush. Always brush from gum to tooth and never scrub across the teeth. Work systematically around your mouth so that no area is missed. Don’t forget the inside surfaces of the teeth.

Now return to where you started and, using small circular motions with the brush at the junction of tooth and gum, work around your mouth from tooth to tooth ‘massaging’ the gums gently. If you notice that your teeth trap food between them (this is especially likely with meats) see your dentist to have this area looked at. A piece of food caught between two teeth even for a day or two can make your gum very sore and start up an infection.

•      If you do get a sore gum, don’t panic. Simply start the above routine and within days it should be better. In other words, thorough brushing can actually cure early gum disease, provided your technique is good.

•     Take more vitamin Ñ on a regular basis-1 g a day and double this when you have a sore area of gum. Animal research has proved that vitamin Ñ helps reduce the risk of gum disease, and experiments in Yugoslavia have found that the vitamin can reverse the kind of gum breakdown seen in gum disease. When the volunteers were given as little as 75 mg vitamin Ñ daily for six weeks the cells in the gums became observably healthier.

But vitamin Ñ alone may not be enough-calcium too may be vital. Certainly it is true that calcium deficiency can weaken the jawbone into which the teeth are set, but in addition this is now thought to make the bone more liable to infection. After the menopause women especially lose calcium in large amounts and many a woman first notices loose teeth at this time of life. Repeated pregnancies also cause a substantial loss of calcium into the fetuses. These plus slimming diets that involve eating no milk or dairy products can leave a lot of women calcium-deficient.

One US study used folate (the  vitamin) too with great success. After sixty days of gargling with folate-rich water the subjects’ gums were examined. They had soaked up folate ‘like a sponge’ and were much less inflamed than those of a control group who had been gargling with plain water for the same sixty days.

•     There is some evidence that gum problems are linked to emotions. Trench mouth, for example, is a very rampant type of gum disease. Sufferers have higher levels of the natural steroid Cortisol in their urine than normal. One study found that these patients had experienced more negative, unsettling life events in the previous year than had other people. They also demonstrably had higher levels of anxiety, depression and emotional disturbances. Clearly, preventing these life events is one way to combat at least this cause of gum disease.

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Comments (0) Apr 23 2009

Brenda is 51, married, with two children aged 14 and 19, and works as a nursing sister in an operating theatre at a large hospital.

A year ago she attended her first routine breast screening, and a week later received a letter asking her to return for a repeat mammogram. Brenda had had no breast problems, and was unable to feel a lump, but although the letter stated that the request did not mean that she had cancer, this was, of course, her overriding fear. She went immediately to talk to a surgeon at the hospital where she works, and he examined her breasts, finding no abnormality. Despite his reassurance, she found the next few days traumatic, and was unable to eat or sleep properly.

Brenda rang the breast screening clinic to cancel her appointment as she was sure there was nothing wrong, but was persuaded, rather unsympathetically in her opinion, not to do so.

At her second appointment, several mammograms were taken of both her breasts. She found the process uncomfortable, and felt that little was done to reassure or cheer her. After waiting a short time at the clinic while the X-rays were developed, she saw a doctor who explained that what had been detected on the original mammograms were tiny areas of calcification in her breasts which, on further examination, did not appear to be a cause for concern. The doctor thought they had probably been there for some time, and were likely to be quite a ‘normal’ aberration.

Brenda was very upset to discover that she had spent a week worrying about something that, as an experienced nurse herself, she would have been able to understand if it had been explained in the letter. She felt that the doctor was unsympathetic, and that the entire experience had been an unnecessarily distressing one.

Brenda was asked to return a year later for further mammograms and the doctor she saw immediately after these had been developed was very helpful and understanding. She explained to Brenda that the areas of calcification had not altered at all in the previous 12 months, and that she had nothing to worry about, but should return for further mammograms every 2 years.

Brenda’s relief at finding there was nothing wrong was tempered by her frustration about the difficult and anxious time she had had to spend. Although she appreciates that breast screening can play an important part in the early detection of breast disease, she does feel that there must be a better way of recalling women for further investigation.

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Comments (0) Apr 22 2009