Mens Health Blog. Medical Blog

Depending on what newspapers and magazines you read, you might have seen headlines like those above. Certain parts of the press seem obsessed with the idea that taking HRT is about nothing more than having the looks and sexuality of a TV star. Every year, dozens of interviews are conducted with television and screen personalities who are now in their fifties and sixties ‘and look twenty years younger’.

In some ways, this can be a thoroughly good thing. For too many centuries, the older woman has been neglected, and treated as almost invisible. As far as The Real World is concerned, she just doesn’t exist. Newspapers and magazines seldom feature older women in their own right; if they are mentioned at all it is usually as the wife or mother of a man who is making the news. Books end when the beautiful heroine marries the hero; sometimes the story extends to the years of bringing up children, but how many novels can you think of in which the principal character is a woman of 50 or 60? It has been said that ‘Sensitive treatment of the ageing woman … is not a dominant theme in Anglo-American literature.’ Too true! Once you are past child-bearing years it is almost as if you move, in one swift step, to being an unimportant old crone.

Now all this is changing, and HRT can take some of the credit. Suddenly many older women look and feel younger. They don’t mind giving their age, because it provokes the response, ‘Goodness, are you really? You don’t look a day over 45,’ and that makes them feel good. Well, it would, wouldn’t it? Being more energetic, more confident and still looking youngish, they are visible once more, and that has got to be a good thing. Good for the individual woman and her own self-esteem, and good for womankind in general.

However, this book will not be plugging hormone replacement as an elixir for eternal youth. You will not read in these pages that you, too, can be a sex-kitten forever. If your husband is glancing sideways at younger women, your elderly parents are driving you mad, and your daughter looks how you would like to look, HRT will not magically put your world to rights. It may help mend a breaking marriage, or increase your sex drive, or make you feel 10 years younger, or it may not do any of these things. But it will make you feel better able to cope with what the world is throwing at you, and give you a better feeling about yourself.

One of the problems of the ‘sex kitten’ image is that it actually puts many women off taking HRT. Or they become reluctant to tell their friends they are on it in case they get comments like, ‘Oh, is your husband going off with someone else?’, as if the only reason a woman takes HRT is to keep her husband in her bed. And many doctors wonder if a woman is enquiring about taking it just so that she can remain ‘youthful’. Yes, there are reasons why it can help you maintain a satisfying sex life for many years but, as you will have read so far, it has many other advantages, too, and to concentrate on the Eternal Youth image is to trivialise HRT and to diminish women.

‘After I am waxed old shall I have pleasure, my lord being old also?’ Sarah (wife of Abraham) in Genesis 18:12.

“I finally plucked up courage to see my doctor. He seemed surprised that a woman of my age (I’m 53 and happily married) should be reluctant to stop having sexual intercourse. He made me feel a freak, the female equivalent of a Dirty Old Man”.

The menopause is thought of by many (especially by men and by younger women) as ‘the beginning of the end’, a time of decline and degeneration, especially sexually. But it needn’t be like that. The end of fertility doesn’t mean the end of sexuality, let alone the end of femininity. With 30 years or so left, that’s just as well! The woman reaching the menopause now is unlikely to view this time as the end of her sexual years, and nor should her doctor, nor society in general. If she has sexual difficulties, they should not be pushed aside.

Many men and women are reluctant to talk to their GPs about sexual problems, as he is quite likely to dismiss it as an unimportant matter in older people. The average young doctor might be quite surprised that a couple in their sixties should still be having an enjoyable sex life, and wanting to continue for many more years. Even couples in their fifties are often considered ‘over the hill as far as all that sort of thing is concerned’.

As you have read at various points in this book, one of the symptoms of the menopause is vaginal dryness. Reduced levels of oestrogen diminish the sexual response and cause the cervix to secrete less mucus, so the vagina becomes dry, intercourse is more painful, and you get less pleasure from it.

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Information about recovery after hysterectomy is sometimes neglected in discussions between women and their doctors. Compared with the decision to have the operation and the demands of surgery, recovery may seem straightforward. Often, however, this does not prove to be the case.

The process of recovery from hysterectomy is extremely variable as illustrated by the experiences of Rosa and Denise, neither of whom had any postoperative complications. The day after her hysterectomy Rosa helped make beds in the hospital ward and, five days later, she was ready to leave. Within a few days she was doing all the housework and three weeks after surgery she was swimming and cycling. In contrast Denise was unable to leave her bed for fourteen days after her hysterectomy. She convalesced slowly at home and finally returned to work thirteen weeks after surgery. The variation in the physical recovery of Rosa and Denise demonstrates why it is difficult for a surgeon to provide a fixed schedule for post-operative recovery.

To do so might put the brakes on the recovery of some women and unduly tax the capabilities of others.

Women recover from hysterectomy at different rates for many reasons. These include the nature and severity of the problem for which the operation was carried out, the type of operation performed and the extent to which it interfered with various organs of the body, the skill of the surgeon, the general physical and psychological health of the woman pre-operatively and the effect of anaesthetic agents on her.

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Every morning when we wake up and open our eyes we see the sun shining through the window. The light/dark cycle appears to be very important in the resetting of our circadian rhythm. When we open our eyes in the morning, the light stimulates the light-sensitive part of our eyes, the retina. The retinae from both eyes convey the light message along the optic nerves to a central point called the optic chiasma, which is in the middle of the brain stem adjacent to the hypothalamus. Half of this light message crosses the optic chiasma and is relayed to the rear part of the cerebral cortex. Scientists now believe that part of the light message is also relayed to a group of nerve cells in the hypothalamus adjacent to the optic chiasma. This area is called the suprachiasmatic nucleus (SCN) in the hypothalamus and is the site of master control of the circadian rhythm. In animals destruction of the SCN abolishes the circadian rhythm.

It is thought that the SCN possesses an endogenous oscillating mechanism which in free running conditions in man is 25 hours. The SCN is the master oscillator, and it is believed that there are other suboscillators which control hormone rhythm, body temperature rhythm, etc. Hence in cases of jet lag or shift work, the phase maps of the different suboscillators are thrown out of phase with each other. By resetting the master oscillator, the SCN, the circadian rhythm, and the suboscillators are put back into place.

Chronobiologists have recently studied the SCN in detail, both in animals and in man. They have found that if a strong light message is received in the SCN at an hour different to normal sunrise, the SCN is reset into a new circadian rhythm after a few days. Chronobiologists call the light signal the Zeitgeber, synchronizer, or time giver, and the resetting process the entrainment.

The Zeitgeber for crabs that are flown from one coast to the other in the USA is the light/dark cycle of the new location. The Zeitgeber for Dr Charles Czeisler to entrain his jet lag patient to a new circadian rhythm is artificial bright light Dr Thomas Wehr of the National Institute of Mental Health in the USA has been using light treatment and sleep deprivation to treat certain kinds of depressive illness. It is believed that, by adjusting the master oscillator, its suboscillator that modulates mood and depression will also be adjusted and lead to recovery from the depressive illness.

At present, in Australia and New Zealand, a great deal of research is being conducted on the chemistry of the biological clock. Melatonin, a chemical secreted from the pineal gland situated at the base of the brain, has been shown to be closely related to the circadian rhythm. During the night, the SCN relays impulses to the pineal gland and melatonin is secreted into the blood. In the day, sunlight has an inhibitory effect on the SCN, and this stops the pineal gland from releasing melatonin. The concentration of melatonin in the blood hence becomes a good marker of the circadian rhythm.

Melatonin comes from the word melanin, which means skin pigment. In some lower animals, skin colour changes according to the amount of sunlight. At night, there is more melatonin and this contracts the melanophores of the skin, making the skin pale in colour, whereas in the day, with plenty of sunlight, the skin becomes darker. This skin colour change is controlled by the light/dark – , of the circadian rhythm through melatonin.

However, in man, the exact role of melatonin is stillunknown. It has been suggested that there is a melatonin stimulates the SCN to secrete even more melatonin and a rise in melatonin concentration speeds up the resetting of the biological clock. A group of volunteers were asked to travel from New Zealand to London and back, and were given melatonin capsules to take for a few nights on arrival at their new destination. It appears that this increase in the concentration of melatonin at night speeded up the resetting of their biological clock to the new local time. They felt more alert in the day and their sleep pattern was reset much sooner than if they had not taken melatonin capsules. A new company, called Circadian Technologies, has recently been set up in Melbourne. It plans to produce melatonin capsules on a commercial scale. Of course, this has yet to be approved by the Food and Drug Administration in the USA. Perhaps, one day, overseas travellers will regularly be taking melatonin capsules to minimise their jet lag. Or there may be coin-operated bright light machines available at all major airports to entrain the travellers’ biological clock to the new local time.

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Ideas can be accepted into the mind by two distinct mechanisms. We can scrutinize an idea that is offered to us, and examine it logically and critically. If we find it a good idea we accept it by this intellectual process of evaluation. On the other hand, many ideas are accepted into the mind quite uncritically and without any intellectual evaluation. We see this most commonly in children and in adults who are very relaxed, fatigued, or alcoholic. In this process the acceptance of the idea depends much more on our feeling toward the person who offers the idea than on the merits of the idea itself. The process by which ideas are accepted uncritically in this way is technically known as suggestion. It is important to remember that the uncritical acceptance of ideas in this fashion does not result from the evaluing mechanism working in less degree, but results from the activity of suggestion, which is quite a different mechanism of the mind. However, if the alert critical faculties of the intellect come into play, they always put a stop to suggestion, and the idea is subjected to the intellectual process of evaluation.

If we consider this matter from the biological point of view, we see that the critical method of accepting ideas is a recent evolutionary development, whereas the uncritical method based on our feeling for the other person is a biologically primitive process which has been practically superseded by this more recent development of our ability to evaluate things critically.

The important fact from our point of view is that this primitive process of suggestion functions very much more effectively when we have regressed a little toward a more primitive mode of mental functioning. This of course is exactly what we do in the regression of our mental exercises. So while we are regressed like this, we can use the process of suggestion to influence the working of our mind in a way that would be quite impossible if we were in our normal alert waking state.

In the matter of anxiety and general nervous tension our mind is quite impervious to the logical reasoned approach of the intellect, but on the other hand it is quite amenable to the process of suggestion when in this relaxed and regressed condition. In our exercises we ourselves present the ideas to our mind, so in this case the process is known as autosuggestion.

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My first question to Dr. Essen concerned the meaning of the term biological medicine. The concept of biological medicine is very exactly defined by Dr. Essen in Vidi Nova, a special publication for biological medicine issued by him, which deals with the practical results of applied biological methods. As the foremost representative of biological medicine in Sweden and the leading spirit behind the new and growing movement of progressive doctors following the principles of biological medicine in their practice, Dr. Essen was indeed a man well qualified to answer my question: “What is biological medicine?”

“May I, instead of using dry, scientific definitions, illuminate this with a concrete example,” said Dr. Essen. “A doctor is treating a case of infectious disease by the conventional methods. The determining factor for a successful result of this kind of treatment is to identify the kind of bacteria considered responsible for the infection in question. When the intruder is identified, the patient is given a specific chemical or antibiotic drug, which, as a rule, accomplishes the immediate results: the bacteria are destroyed and the patient is free from symptoms.

“After a while, it may happen that the same patient will turn up with a new infection. The diagnosis shows that either it is a question of the same kind of bacteria, which this time, however, is already immune to the specific drug, or there are new bacteria involved. Accordingly, new and more potent drugs are prescribed, which bring about immediate results, as far as the fighting bacteria is concerned. But in spite of the “success” of the treatment, the patient’s resistance to infection seems to progressively weaken and various complications set in. Now, perhaps, such potent drugs as cortisone—pain-killer and symptom-remover—and other highly toxic synthetic drugs enter the picture. The body, already weakened by the disease, must now, in addition, cope with the toxic and damaging side effects of the poisonous drugs.

Then, one day, we stand by the deathbed surprised and shocked. The patient had received all the correct treatments in accordance with medical science’s conventional practices and regulations. The laboratory tests proved that we made no errors! Bacteria samples showed that the bacteria, which our treatment was aimed at, were ‘successfully’ eradicated. As far as the direct cause of the symptoms was concerned (the bacteria) our treatment was a complete success. The only problem was the patient died! We succeeded in killing the bacteria, but we failed to save the host organism, where our war on bacteria was so successful It also could be said that the treatment was successful, but unfortunately, as a result of the treatment and resultant complications, the patient died. Or, The operation was successful but the patient didn’t survive.’

“Now, actually, this kind of a result is not so surprising, is it?” continued Dr. Essen. “After all, what did we treat? Our treatment was directed at micro-organisms which we considered pathogenic or disease-causing. In the meantime, the biological environment for this micro-organism, the host organism, the living, delicate, sensitive, and easily damaged human body, has actually been completely neglected. The man hardly comes into the picture at all. What we actually treat today are diseases, not the diseased people. The sick body, however, is subject to very different biological laws than those which could be applied in primitive germ war with chemical and antibiotic germ-killers.

“A parallel to this can be seen in today’s damage and destruction of life and natural environments as a result of man’s indiscriminate use of insecticides and other poisonous chemicals. Is there any intelligent human being who is so naive as to assume that these poisons will be less devastating to the human body, with its endlessly more intricate and delicate living mechanism? The biological laws of life are quite different from the laws which regulate chemical reactions observed in laboratory tubes. When we fail to see the difference between the two, catastrophic conditions will be the result, and we have to accept the consequences of our unwise actions.”

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It is difficult, if not impossible to provide an overall prognosis for epilepsy in children, because of the differing ages of onset, different epilepsy syndromes, differing causes of epilepsy, and the varying response to treatment.

However, certain factors are known to be associated with a poor outcome, with seizures unresponsive or only partly responsive to treatment. These factors include:

• epilepsy that starts before the age of two or three years;

• seizure types that include myoclonic (jerk) or atonic (drop) seizures;

• seizures that are initially difficult to control;

• the need for more than one anti-epileptic drug to obtain control of the seizures;

• the association of other neurological problems, such as moderate or severe learning difficulties, or a physical handicap such as cerebral palsy; and

• if a cause has been identified (e.g. abnormal development of the

brain, as in tuberous sclerosis, or following meningitis or encephalitis.

There are other factors which indicate a good prognosis. These include:

• epilepsy that starts after 5 but before 13 years of age;

• seizure types that include typical absence (petit mal) seizures or tonic-clonic (grand mal) seizures;

• ready control of seizures, using just one anti-epileptic drug;

• a lack of other associated neurological problems;

• the absence of an identified cause; and

• the presence of a strong family history of epilepsy.

Many of the epilepsies in children can be classified into epilepsy syndromes. One of the purposes of this classification is to give some guidance on the prognosis or outcome. Syndromes that have a poor prognosis include the West syndrome (the seizure type in which is infantile spasms or myoclonic seizures) and the Lennox-Gastaut syndrome (seizure types include atonic, tonic, and myoclonic seizures). Seizures in both these syndromes start before the age of 3 years (rarely between 3 and 7 years in Lennox-Gastaut syndrome), and this in itself carries an unfavourable prognosis. Syndromes that have a good outcome include typical absence epilepsy (petit mal) and some partial epilepsies (for example, benign partial epilepsy with centro-temporal (rolandic) spikes). In typical absence epilepsy, between 70 and 75 per cent of children will stop having absence seizures by the age of 14-16 years and the anti-epileptic medication can be withdrawn. The remaining 25-30 per cent may need to continue taking medication into adult life, perhaps even for the rest of their life. The children that are likely to fall into this group are those in whom absences began after the age of 11 or 12 years, were associated with generalized tonic-clonic (grand mal) seizures, and in whom the seizures were difficult to control.

Benign partial epilepsy with centro-temporal (rolandic) spikes is, as the name suggests, really benign. All the children with this epilepsy syndrome will have stopped having seizures by 14-16 years of age, and medication can be withdrawn with no risk of relapse (recurrence) of seizures.

Some syndromes have an intermediate outlook. One of these is juvenile myoclonic epilepsy which usually starts between 10 and 16 years of age. The seizures (myoclonic and generalized tonic-clonic) are usually easily controlled by one drug (sodium valproate), but if the medication is withdrawn, the seizures may recur. Many (but not all) patients who have this type of epilepsy will have to take the treatment for the rest of their lives.

Overall, approximately 30-40 per cent of children will ‘outgrow’ their epilepsy before they become an adult. This means that the anti-epileptic medication can be withdrawn. Over 70 per cent of children with typical absence epilepsy will probably be able to have their medication withdrawn after they have been seizure-free for between two and three years. In contrast, over 90 per cent of children with Lennox-Gastaut syndrome will probably need to take anti-epileptic drugs for most of their lives.

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These problems are all very similar. Tennis players absorb the shock of the ball on their racquets at the elbow, golfers get it in the wrist, and skiers absorb the shocks from their poles in their arms and shoulders.

Their knees also get a good workout. Football, hockey, and soccer players get knocked about all over.

Athletes and former athletes are among our most numerous and most contented users of CMO. Often their problems don’t show up for years, but when they do they can be crippling. CMO functions very well in reversing arthritic problems caused by sports injuries. Athletes are always amazed at the relief they get with CMO.

We’ve said before that arthritis starts long before any symptoms appear. It starts the moment macrophages are called upon to clean up the debris of damaged cartilage. It may take years, even dozens of years, before the destruction of cartilage reaches the point where it is felt as a painful symptom.

We feel quite certain these impact related arthritic problems could be nipped in the bud if CMO were used as a preventive. Taken occasionally during an athlete’s active phases CMO could alter the arthritic process very early on so as to prevent arthritis from ever developing. Unfortunately, it will take a twenty or thirty year study to confirm that theory.

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Precautions

•     An infant is temporarily immune to each of the three types of polio for four to six months after birth only if the mother is immune (because she’s had the disease or been vaccinated against it). The child needs a full series of vaccinations by mouth to achieve long-lasting immunity.

•     Anyone who has received injections of the original, dead vaccine (Salk) must have boosters or two full series of the Sabin vaccine to guarantee immunity.

•     Polio virus still exists in this country, and polio is epidemic in many other countries of the world. Since it is not possible to avoid it, immunization is essential.

Medical treatment

Your doctor’s diagnosis will be made on the basis of a physical examination and the results of a spinal tap. A child with a suspected or known case of polio will be isolated. A child who is not immunized and has been exposed to the disease will be given gamma globulin to prevent or lessen the severity of the disease. A child who has contracted polio will be given aspirin, paracetamol, other pain killers, and hot packs to reduce the pain. If polio causes paralysis, the child may need an artificial respirator, a tracheotomy (an opening into the windpipe through the neck), prolonged physical therapy, braces, or orthopedic surgery.

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AIDS may not yet be completely manageable, but it’s completely preventable. And there’s still plenty of incentive to prevent it.

For example, even while incidence in the United States is decreasing, worldwide rates of AIDS infection are soaring. While the rates for homosexual men are dropping, they’re still high. And while the rates for heterosexual men are still low, they’re rising. Any way you look at it, there’s a problem out there.

Solve it by doing the right things. Let’s assume that you, a health-minded individual, are not in the habit of shooting illegal drugs into your veins with used needles. There’s pan of your AIDS risk taken care of. Virtually all the rest is from unprotected sexual relations. Protect your sex and you won’t get AIDS, says Dr. Kassler.

Unprotected sex is dangerous because HIV can be transmitted through semen and vaginal secretions as well as blood. But if neither of you has HIV, then there’s nothing to transmit. “If you’re in a mutually monogamous relationship with somebody who is uninfected, that’s safe sex,” Dr. Kassler says. “You can do whatever you want.”

That’s simple enough, but it begs a question: How do you know? The sad fact is that you don’t—unless you’ve both been recently tested or have been monogamous together long enough for any infections from previous relationships to declare themselves. Anybody can have HIV, and you can’t tell just by looking at a person.

So protecting yourself against HIV and AIDS comes down to what you do and whom you do it with. “Limiting the number of people you have sex with helps,” Dr. Kassler says. “However, choosing your partners wisely comes first.”

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Coeliac Disease

This digestive disorder, which is not just a female disorder, is an intolerance to gluten which is found in grains such as wheat, rye, barley and oats. Before diagnosis the intolerance causes malabsorption and can therefore leave you deficient in vital nutrients. Many deficiencies have been noted in sufferers of coeliac disease, including folic acid, vitamins A, D, E, Ê and the  vitamins, zinc (essential for fertility) and selenium. It is known that women with coeliac disease can be sub-fertile and this is yet another indication that having the correct levels of vitamins and minerals can play an important role in increasing fertility.

Natural Treatment

If you have been diagnosed with coeliac disease you first need to remove gluten from your diet. You will probably have been given dietary advice with the diagnosis which means that you will have to eliminate wheat, rye, barley and oats and substitute other foods like rice cakes, gluten-free bread and also pasta made without gluten such as corn and millet pastas. Then you need a nutritional assessment (see Useful Addresses) to ascertain which supplements are required to correct any deficiencies. Remember that any food supplements (e.g. multivitamin and mineral for pregnancy) must be gluten-free.

Polycystic Ovary Syndrome

There is a difference between having polycystic ovaries and having polycystic ovary syndrome. When ovaries are seen on an ultrasound scan, they can look polycystic, which means that a number of partially developed follicles can be seen. Of course, follicles have to be present for eggs to develop adequately, and so that ovulation can occur. However, with polycystic ovaries, the ovaries are larger than normal and the undeveloped follicles resemble a bunch of grapes. This is very common and does not necessarily present a problem. It is only when the polycystic ovaries lead to a hormonal imbalance that a woman is said to have polycystic ovary syndrome (PCOS) where she will probably not be ovulating and can be overweight and have excess body hair, skin problems and mood swings. The hormone imbalance is produced by having high levels of LH (luteinising hormone) and a higher than normal level of free testosterone, particularly in overweight sufferers.

Just before ovulation in a normal menstrual cycle, LH levels rise dramatically. This is called the LH surge and causes an egg to be released from a follicle. If LH is high during the whole of the follicular phase (the phase before ovulation), then the LH surge does not take place and an egg is not released. High levels of LH have been implicated in both infertility and miscarriage.161 Doctors have not yet found out why high levels of LH may cause infertility or miscarriage, but research is continuing.

In summary, a woman with PCOS can have:

• high levels of LH

• high estrogen

• higher than normal male hormones (androgens)

• Low progesterone

Diagnosis

This is usually made by ultrasound or a laparoscopy, where a narrow tube with a telescopic lens is inserted into the abdomen via a small incision below the navel. These investigations are conducted together with hormone blood tests.

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