Herbal Health – information on herbal medicine

As a general guideline, the chances of developing breast cancer increase with the length of time you take HRT, and also the higher the dose of oestrogen. There appears to be no significant risk to women in the population at large who take it for less than five years, but the risk increases slightly between 5 and 10 years, and taking it for more than 15 years gives a higher risk still. (It is this long-term risk that has attracted media attention, though often the scare-mongering headlines are quite unjustified medically.) This can cause problems, because long-term oestrogen use is important for preventing osteoporosis, heart attack and stroke; and many women also feel so good on it that they would be very reluctant to give it up after just a few years.

Cancer is a very real fear for doctors and patients alike. Nobody wants to get it, but the risk needs to be put into perspective. Under the age of 50, deaths in women from breast cancer out-number deaths from coronary heart disease and stroke combined. However, after the age of 50,

this ratio is reversed, and far more women die from a heart attack or stroke than from breast cancer. Oestrogen reduces by 50 per cent your chances of having a heart attack or stroke.

The risks of developing breast cancer as a direct result of taking HRT are small when set against the protection it confers against osteoporosis and arterial disease, although it is important to say here that if you take progestogen in the therapy, then some of the protection against heart attack may be reduced. Progestogen’s effect on breast cancer is not clearly known; some researchers have concluded that it offers some protective effect, others that it may have a negative effect, and others still that it has no effect at all. More research is clearly needed here.

It is thought that oestrogens neither increase nor decrease the risk of cancer of the ovaries in post-menopausal women compared with those who do not take it; and oestrogen and progestogen appear to have no effect on the incidence of cancer of the cervix.

One important thing that has been noted is that, although there is a higher rate of breast cancer among women who take HRT than among those who don’t, their survival rate is also higher. In other words, if you develop breast cancer and are on HRT, you have a better chance of surviving than if you develop breast cancer and are not on HRT. This is possibly because regular screening of women on HRT picks up any breast problems in the very early stages, when treatment is more likely to be effective. Some studies have also suggested that tumours linked to oestrogen therapy might be less virulent and invasive than other types of tumours, and that these particular tumours respond to treatment better than tumours not linked to oestrogen therapy.

A tremendous amount of research is being carried out into all aspects of HRT and the menopause. Hopefully, the time will come when doctors will know more clearly which particular sub-group of women would be more at risk of developing breast cancer if they took HRT, so that they can leave it well alone, and the rest can take it with confidence and safety.

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The muscles around the pelvis are very important in supporting the bladder, urethra, vagina and rectum. Regular practice of pelvic muscle exercises can help to strengthen these muscles. The first step is to identify the correct muscles to exercise.

• To identify the muscles around the rectum, sit or stand comfortably and imagine you are trying to control diarrhoea by consciously tightening the ring of muscles around the anus (back passage). Hold this ‘squeeze’ for four seconds. Relax and repeat several times.

• Now go to the toilet and start passing urine. Try to stop the flow of urine in midstream. Once this is done recommence urinating until the bladder has emptied. The muscles used to stop or slow the flow of urine are the front pelvic muscles which help control the bladder.

• Some women find they can identify the correct pelvic muscles by inserting a finger into their vagina and then contracting the pelvic muscles to squeeze the finger. If there is no sensation of squeezing around the finger you may be exercising the wrong muscles. Note that you should not bear down as if trying to pass a bowel motion as this strengthens the wrong muscles. Do not despair if you do not seem to be making progress for several days; it may take a week or more to begin to identify the muscles that need to be exercised to strengthen and tone the pelvis.

The second step, having identified the target muscles, is to repeat the following series of exercises at least four times each day. Note that they should not be done while passing urine. With practice you will find that you can do them at any time — while waiting for a bus, watching television or setting the table.

1. While sitting or standing with thighs slightly apart, contract the muscles around the rectum followed by the front muscles around the vagina. Hold this contraction while counting to five slowly. Relax these muscles then repeat four more times. Try to be aware of the squeezing and lifting sensation in the pelvis that occurs when these exercises are done correctly.

2 While sitting or standing, tighten the muscles around the front and back passage together. Hold this contraction for just one second and relax. Repeat this exercise five times in quick succession. It is a good idea to return to the first step once every week or so, to check that you are using the correct muscles.

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So much for ordinary everyday stress, but what about extraordinary stress. This is like a hammer hitting an apple. We do not expect much of this stress in our lifetime, but when it comes, even if we are coconuts, we cannot help feeling the impact of the stress.

Loss of loved ones, loss of possessions, tragedies of any kind, or any events of similar magnitude are extraordinary and we are expected to feel the stress badly and most of us will be hurt. The normal biological and psychological reaction to stress as outlined earlier still applies, but is of much greater magnitude and lasts much longer. We call this grief reaction.

When we are hit with a stress hammer, there are two phases: the injury phase and the healing phase:

Injury phase. During the injury phase, we feel the pain. This pain can be in our head as headache or in our chest not unlike a heart attack. Of course, the pain is hurting most of all in the mind. It is a normal defence mechanism of the body to protect the psyche, and the immediate reaction is denial. What has happened is not true, we hope we are dreaming. There is a sense of disbelief: ‘Can somebody tell me this is not true’. This is a form of protection for us from the sudden shock of the extraordinary stress.

Healing phase. The healing phase starts when the body begins to react. We are angry at what has happened; we may be angry at ourselves or angry at the one we have lost. The biological reaction sets us on a chain of tension, anxiety, and depression all mixed up, until we feel exhausted. We are at battle stations all the time, but there is really no enemy. The enemy is ourselves. Some of us feel guilty and question whether there was anything we did wrong that may have led to this loss. We may cry and feel tired and exhausted. This may go on for days.

We need to let this energy out Hysterical crying and weeping is common. Sharing this locked up energy with someone is sometimes useful; just talking about it, airing our thoughts can be helpful. Some like taking long walks, some like rearranging and cleaning out their desks, or just doing something that may be purposeful but relaxing.

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