SYMPTOMS OF ENDOMETRIOSIS: DYSMENORRHOEA AND DYSPAREUNIA

Posted by admin on April 22, 2009 under Women's Health | Be the First to Comment

Dysmenorrhoea

Dysmenorrhoea means painful periods. It is the most common symptom of endometriosis. In a recent survey of women with endometriosis by the Endometriosis Association, 81% of the women had experienced dysmenorrhoea.

According to medical textbooks there are two types of dysmenorrhoea: primary and secondary.

Primary dysmenorrhoea is said to be the ‘cramping’ type of dysmenorrhoea that typically affects teenagers. It usually begins a year or two after the onset of menstruation and tends to lessen by the age of 25, or after childbirth. The pain usually begins with the menstrual flow and lasts for only one or two days. It is often accompanied by nausea, vomiting, diarrhoea, dizziness and fainting. This type of dysmenorrhoea is generally believed by the medical profession to have no relationship to endometriosis.

Secondary dysmenorrhoea is the ‘grinding’ or ‘boring’ type of menstrual pain which is usually due to an underlying condition of the reproductive organs. According to the medical profession it typically appears in women who are in their 20s and 30s. This is the type of dysmenorrhoea that is generally believed to be associated with conditions such as pelvic inflammatory disease (PID), fibroids and endometriosis.

The pain of dysmenorrhoea due to endometriosis may be mild, moderate or severe and may be described as constant, deep inside, sharp, stabbing, knife-like, nagging, aching, burning, throbbing, dull, boring or cramping. It may be located in the centre or on one or both sides of the abdomen. The pain may radiate into the vulva, pubic bone, lower back, rectum, buttocks, groin or thighs. It may be more severe when using the bowels or passing urine, and may be accompanied by nausea, vomiting, and diarrhoea and/or constipation.

The pain may begin one to several days before the start of the period, gradually becoming more severe, particularly once the menstrual flow begins. The pain may last for the first one to two days or continue throughout the entire period. Usually the pain is most severe on the first or second day. It has been reported that the pain worsens and peaks at the end of the period although this pattern is not common.

It is not known precisely what causes the dysmenorrhoea associated with endometriosis but it is probably due to several reasons. One is that the bleeding from the endometrial implants causes irritation to the surrounding tissues. Another possibility is that the pressure resulting from the swelling of the implants and cysts causes pain in the immediate area in much the same way that a boil causes pain. It is also possible that the release by the endometrial implants of chemicals known as prostaglandins causes pain. Irritation to neighboring organs, such as the bowel or bladder, by the implants of endometriosis can also lead to pain in those organs.

Dyspareunia

Dyspareunia means painful sexual intercourse. It is another common, but often unacknowledged, symptom of endometriosis. In the survey conducted by the Endometriosis Association nearly half (48%) of the women with endometriosis had experienced dyspareunia.

Dyspareunia often causes much heartache for women with endometriosis and it can have devastating effects on their self-esteem and their sexual relationships.

Dyspareunia due to endometriosis may be felt during or after intercourse and may be so severe as to make intercourse impossible. The pain maybe described as sharp, stabbing, jabbing, or a deep aching. Intercourse may always cause pain or only when intercourse occurs at certain times of the month – for example, during menstruation or at ovulation. The pain may be felt only during deep penetration but it may also be felt during any form of intercourse, particularly if the uterus is rigidly fixed by adhesions in a retroverted position.

Dyspareunia is usually associated with endometriosis in the Pouch of Douglas, the utero-sacral ligaments and the rectovaginal septum. It may also be associated with cysts or implants on the ovaries, vagina or cervix.

If the endometriosis is located in the Pouch of Douglas, the utero-sacral ligaments or the recto-vaginal septum the pain may be due to stretching or jarring of the endometriosis on those tissues.

If cysts are located on the ovary the pain may be due to compression of those cysts, particularly if the ovary is rigidly held in position by adhesions. In addition, penetration may cause some implants to bleed slightly and this may cause pain for some time after intercourse.

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CHANGING YOUR LIFESTYLE: BREATHING

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Breathing is an activity to which most of us give little thought yet we are aware that when we are tense we breathe shallowly or sigh a lot. When a person is relaxed and happy his or her breathing is slow and rhythmic and healthy breathing involves the whole ribcage. When we are tense breathing becomes rigid, shallow and only the uppermost part of the chest will move. Many relaxation and meditation programmes involve breathing manoeuvres, mainly because thousands of years of experience have shown that breathing control can alter a person’s state of mind and vice versa. Learning to breathe properly can be a valuable part of stress control. This works because stretch receptors in the lungs feed back information to the brain and alter central functioning in a way which tunes up the rest of the brain. Teachers of the Alexander Technique claim to be able to abolish all kinds of physical and even some emotional complaints solely by altering body postures and improving breathing techniques.

Breathing is one vital function of the body over which we have conscious control, and because it can be so easily mastered to our benefit it is worth learning how to breathe more healthily. The main purpose of learning breathing exercises is to be able to use them in stressful and painful situations. You can also use them to help you to get to sleep. If you doubt that breathing exercises can be of help in tense and stressful situations just watch tense people and see how they sigh a lot, catch their breath, gasp or show laboured breathing. Panicky people over-breathe and can get tingling in their fingers and toes as a result.

There are many good breathing exercises and the reader should refer to a specialized book on the subject, but here I will just outline one-three-stage breathing.

•    Start by lying down on your back with your lower back touching the floor. You may have to bend your knees to achieve this.

•     Rest the palms of your hands on the upper part of your chest and breathe gently. Breathe out slowly and completely and repeat this cycle ten times. Your hands are simply registering the movement of this part of your chest.

•     Place your hands on your lower ribs on either side of the breast bone so that the fingertips almost touch when you breathe out. Watch and feel your fingertips being parted-one hand from the other-as you breathe in. Breathe in and try to separate your finger-tips as far as you can. Breathe out and try to get them to touch in the midline. Close your eyes, relax and repeat this ten times.

•     Place your hands on your tummy at the level of the navel. Repeat the slow breathing and see if you can make your tummy expand as you breathe in. This shows that the diaphragm is working fully. Your fingertips will move back and forth as they did on your chest but probably more so. Repeat this ten times.

•     With your hands on the floor breathe out completely and then expand your abdomen with your breathing. Then fill your lower chest-then your upper chest until all three areas seem ‘full of air’ (of course there is really no air in your tummy but it expands because of the diaphragm pushing down from the expanded lungs). Carry on until your whole respiratory system is full of air. This should take about 10-15 seconds.

•     Reverse the process to exhale. Expel air first from your upper chest, then your lower chest, then your abdomen. Expel the last of the air by contracting your abdominal muscles slightly. Pause for 2-3 seconds and then restart the whole cycle.

•     Repeat the cycle ten times.

The benefits of learning to breathe more deeply and fully include:

•     You will feel more relaxed while you do the exercises

•     You will be able to call on the: at times of stress and tension

•     You can use them to get to sleep

•     You can use them as a prelude t meditation or other relaxation exercises.

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FEED YOUT BODY RIGHT: SHE’S SLIMMER—AND SO ARE HER FAVORITE RECIPES

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Teresa Tomeo grew up in a traditional Italian family that loves traditional Italian meals. Huge plates of spaghetti, bowls of meatballs, and thickly buttered bread are staples at family gatherings. And it shows: Many of Teresa’s relatives are overweight.

But not Teresa—not anymore. Her secret? She learned to make slimmer versions of her favorite Italian dishes.

Teresa’s weight-loss odyssey began in 1985. Then age 25 and a successful news reporter for a Detroit radio station, she was trying hard to break into television news, with no success. Finally, a friend laid it on the line: At 190 pounds, Teresa was too fat for TV.

The remark stung, but Teresa knew that her friend was right.

She wasn’t about to let her weight stop her from realizing her career | goals. So she enrolled in a medically supervised weight-loss pro- ^ gram that included a written eating plan and weekly weigh-ins. j ^ Within 7 months, she lost 60 pounds.

Teresa was thrilled with her new, trim figure, and she vowed ! ^ not to let those pounds come back. So, armed with the nutrition knowledge that she had gleaned from her weight-loss program, she 1 “* began experimenting with her favorite Italian recipes, looking for ways to lighten them. She reduced the amount of olive oil in her tomato sauce to just a drizzle. And she took out the meat completely, replacing it with vegetables. She used vegetable purees to thicken sauces as well as soups. She topped salads with a squeeze of lemon.

By turning her kitchen into a laboratory and reinventing her recipe collection, Teresa has managed to maintain her weight at a healthy 130 pounds for 14 years. Along the way, she realized her dream of working in television news, landing a job with a Detroit TV station. She stayed there for 10 years before returning to radio, which she calls her real love, in 1998.

WINNING ACTION

Create low-fat versions of your favorite foods. As Teresa discovered, you don’t have to give up your favorite dishes when trying to slim down. Just look for ways to make them slimmer. There are many excellent cookbooks on the market that will show you how to take the fat out of traditional recipes. One of my favorites is Healthy Homestyle Cooking by Evelyn Tribole, which is available in paperback in bookstores. Her Deep-Dish Turkey Pot Pie is fabulous!

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APPENDICES: EMOLLIENTS AND RELATED TREATMENTS

Posted by admin on April 20, 2009 under Allergies | Be the First to Comment

An emollient is a substance that soothes the skin and restores water to it, thus damping down the symptoms of eczema. White soft paraffin, glycerin and lanolin are commonly used. Most emollients and similar preparations contain several different ingredients. Urea is sometimes added to the cream or ointment because it helps the skin to bind water, but it may sting slightly and has a urine-like smell. Emollients may be applied directly to the skin or added to the bath, and some can be used instead of soap.

Crepe bandages soaked in calamine lotion, or bandages soaked in saline, are also used in eczema, to relieve the itching and prevent scratching.

Drugs which reduce itching (antipruritics) such as crotamiton (Eurax) or antazoline (R.B.C.) may also be used. Non-steroidal anti-inflammatory drugs (see Section 7) such as bufexamac (Parfenac) are sometimes helpful.

Soothing treatments of this type are generally tried as a first step, where the eczema is not severe. They are free of side-effects, although a small minority of patients may become sensitized to lanolin, so that lanolin-containing creams cannot be used thereafter.

Trade names of emollients and other soothing treatments used for eczema

Alcoderm

Alpha Ken

Aquadrate

Aveeno

Balneum

Calmurid

Diprobase

Eczederm

Emulsiderm

Epogam

Eurax

Humiderm

Hydromol

Keri

Lacticare Lipobase Locobase Miol

Nutraplus

Oilatum Emollient

Parfenac

R.B.C.

Siopel

Sprilon

Sudocrem

Thovaline

Uitrabase

Unguentum

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FOOD ALLERGY AND INTOLERANCE: APPENDIX I

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Foods that may release sulphur dioxide

Sulphur (or sulfur) dioxide is a gas that can irritate the airways of asthmatics and provoke an asthma attack. Some preservatives give off this gas in small amounts, and it is inhaled during eating. There is no need to avoid these preservatives unless you are sure tfiey trigger off attacks.

Most dried fruits are treated with sulphur dioxide and give off the gas when chewed. This treatment does not have to be declared on the label. Dried fruit that has not been treated will usually be labelled ‘unsulphured’.

The following preservatives give off sulphur dioxide:

Sodium sulphite;

sodium hydrogen sulphite;

sodium metabisulphite;

potassium metabisulphite;

calcium sulphite.

These preservatives are widely used in wine, beer and cider, and, like other additives used in alcoholic drinks, do not have to be declared on the label. Homemade wine is no exception: Campden tablets, sold to wine-makers, contain potassium metabisulphite.

Fresh sausages may also contain these additives. Cod can be treated with sodium hydrogen sulphite to bleach and preserve it. Although sulphites are not allowed on meat, unscrupulous butchers occasionally add them to old meat to give it a ‘fresh’ red colour. In all these cases, the greater part of the sulphur dioxide will be driven off by the high temperatures used in cooking.

A fourth ‘hidden source’ of sulphur dioxide is restaurant, take-away and cafeteria food. French fries used in the catering trade have usually been dipped in a metabisulphite solution and give off significant amounts of sulphur dioxide. Prepared salads, avocado dip, shrimps, prawns and lobster are also likely to have been treated with these preservatives, and sometimes cause problems.

Fruit salad, glace cherries, fruit juices, fruit pie fillings, dried vegetables and soup, fruit squash, pickled onions, jam, fruit jellies and custard are other possible sources of sulphur dioxide in the catering trade. It is not worthwhile avoiding these foods unless you know they trigger off your asthma attacks.

Packaged foods often contain sulphites and metabisulphites, but these are easier to avoid as they are declared on the label. Look for the names given above, or for the appropriate ‘E numbers’. These are E220-E227.

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PREPARING FOR THE ELIMINATION DIET: SEEING YOUR DOCTOR

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The first, and most essential step, is to see your doctor, describe your symptoms fully, and ask for a medical check-up. As explained in Chapter Seven, many of the symptoms of food intolerance can be due to other causes, and some of these may be serious – your doctor can examine you for such problems. Should there be nothing obviously wrong, then the next logical step is to try an elimination diet. Explain to the doctor you want to do, and ask for advice. He or she may well have reservations about elimination diets, and you will be better prepared if you have read all or most of the book, and understand what is involved. If the doctor feels that you should not alter your diet for medical reasons, you must take this advice.

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MUNCHAUSEN-BY-PROXY AND MEADOW’S SYNDROME

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Baron von Munchausen was an eighteenth-century Hanoverian soldier who greatly exaggerated his prowess in war – and his battle-scars. ‘Munchausen’s syndrome’ is the name given to attention-seeking patients who feign illness or deliberately fabricate symptoms. There are instances, fortunately very rare, of mothers simulating illness in their children in order to get medical attention -this is known as ‘Munchausen-by-proxy’ or ‘Meadow’s syndrome’ after Professor Roy Meadows, who first described two cases in 1977. Doctors are far more aware of this possibility in children than they once were, and any parent attempting to fabricate symptoms is likely to be found out very quickly.

The question of Meadow’s syndrome in relation to food sensitivity is a difficult issue. Various doctors have described cases of children whose parents believe them to have food sensitivity, but where no consistent reaction to a food can be shown. If those parents seem over-anxious or over-protective, and have obvious emotional problems of their own, then they have often been labelled as ‘Meadow’s syndrome’.

Eleven such cases were reported in 1984, in an influential article that has coloured the outlook of many doctors, and led to the belief that Meadow’s syndrome is quite common in relation to food sensitivity. However, there were several important differences between the cases described in this article and Meadow’s syndrome proper. For one thing, the children involved all had genuine symptoms, and there was no suggestion that the parents had attempted to fabricate any symptoms. Unlike Meadow’s syndrome mothers, these women did not seem to relish their child’s hospital stay, nor were they willing to subject them to any investigation, however painful and unpleasant. Such differences are important and must raise serious doubts about the conclusions reached – was the label ‘Meadow’s syndrome’ really justified? These parents may have been disturbed or overwrought, but this does not necessarily mean that they were mistaken about their child’s illness. The elusive nature of the reactions seen in food intolerance makes it difficult to rule out this diagnosis without very thorough testing, and there seems to have been undue reliance on skin-prick tests in this study, despite the fact that these are unreliable indicators in most cases of food sensitivity. Despite the doubts over this study, the idea of ‘Meadow’s syndrome’ has become a popular one, especially among those doctors who are sceptical of food intolerance generally. This is unfortunate for parents, especially when such a diagnosis is made without proper testing for food sensitivity, and without any firm evidence of fabrication. There undoubtedly are cases of parents who exaggerate their child’s ills, and who are determined to blame them on some physical cause, when family tensions and emotional problems are actually the true source of the symptoms. But unless there is gross exaggeration or fabrication of symptoms, these should not be described as Meadow’s syndrome.

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FOOD ALLERGY: ALLERGEN AND ADJUVANTS

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An allergen is essentially the same thing as an antigen, except that it happens to cause an allergic reaction in a particular person. The proteins in cow’s milk, for example, are antigens to most of us, but for the child with cow’s-milk allergy they are allergens. The main difference between an antigen and an allergen is not in the molecule itself but in the way the individual’s immune system reacts to it.

Having said that, it does seem that some foods are more ‘allergenic’ – more likely to cause allergies – than others. Certain foods turn up again and again as the culprits in food allergy, while other commonly eaten foods are rarely en-

countered. Why this is so, no-one can say at present, but there are several possible explanations.

Perhaps these apparently more allergenic foods contain compounds with very unusual and distinctive chemical features that are ‘easily recognized’. Such compounds might induce IgE antibodies more readily than others, although it is far from certain that the structure of antigens can exert such an influence over the immune system. The whole question of how the body scrutinizes incoming antigens and regulates its response to them is still very poorly understood. As yet no-one can say what role the chemical make-up of antigens plays.

An alternative explanation is that such foods contain substances which stimulate an immune response, known collectively as adjuvants. Adjuvants are used in the laboratory as a way of inducing immune responses for research purposes. These adjuvants are mostly derived from bacteria, but there are also adjuvants found in some plants. The extent to which these occur in foods, and their potential for stimulating IgE rather than other types of antibody, is unknown.

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A SELECTION OF MEDICINAL HERBS – AN EFFECTIVE REMEDY FOR ASTHMA

Posted by admin on April 8, 2009 under Herbal | Be the First to Comment

Of all the available plant remedies for asthma the various butterbur preparations stand out as being the most effective. These are Peta-stites officinalis extract, Petadolor tablets and, for exceptionally stubborn conditions, Petaforce capsules. All these preparations are made from 100 per cent plant extract and are reliable antispasmodics. A senior consultant at a Kneipp sanatorium once related the case of an asthma attack that would have killed the patient if it had not been for the doctor’s help. The strongest chemical medicine, which the doctor had reluctantly administered before, was

not as effective as the Petasites preparations he then gave the patient. Moreover, it is gratifying to know that Petasites not only provides effective short-term relief but in time will bring about a cure.

The effect is not always the same with every patient, since there are various kinds of asthma. To back up the treatment, it is often necessary to prescribe a biological calcium preparation, for example Urticalcin. One asthmatic told us that such a treatment with Asthmasan had practically rid him of his problem, even though he used to suffer from almost unsupportable attacks every time there was an atmospheric depression, or fohn, in the air.

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FOOD FOR THOUGHT

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I am often surprised to see young girls strutting along in high-heeled shoes, or else in slipper-like shoes with thin soles and no heels at all. Both extremes are harmful and inappropriate; both force the body into an unnatural position, causing it to tire more quickly and suffer damage. The blood can become congested, leading to varicose veins.

There is a natural reason why walking barefoot does not cause any problems. You simply would not walk for long along a hard and even road surface, but over meadows, fields and forest ground, all of which are uneven surfaces that support the arch of the foot, for movement acts like a massage. Judging from the standpoint of zone therapy, you will happily realise that the whole body benefits as a result. It is for this reason that walking barefoot in warm weather when you are on holiday or when working in the garden is an effective and invigorating natural treatment.

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