THE INS & OUTS OF WOMEN’S HEALTH: PART 2

By Dr Orly Zuker, Chiropractor

(B.Appl Sci; Comp Med, Clin Chiro; Masters, B.Nursing)

To most people, health is a paramount value and a life long journey. There is no price we can pay for good health, however if our health is lost we are often required to outlay a significant amount of money, time and energy in order to preserve or reclaim our health. People do often have varying ideals and ideas about health, with some people immediately turning to medicine and often choosing a ‘bandaid’ approach and others prefer a more 'drug-free', holistic and natural approach.

Either way, the ‘great Australian dream’ has it that houses, cars and winning Tattslotto are our ‘most’ important values, however without our health we can not enjoy any of these material rewards.

When it comes to woman’s health in the second half of our life, it is essential to take good care of yourself so that you may age gracefully, free of disease and with great levels of health and energy. Always do your best to eat well, exercise regularly, take supplements where necessary, look after your spine and posture, have adequate sleep and maintain healthy mental and emotional health.

TAKING CARE OF YOURSELF IN THE LATER YEARS

Dealing With Menopause:

Menopause is a biological change of life, where the menstrual cycle ceases and a woman becomes biologically infertile. Over the years various theories have existed in an attempt to explain menopause, leading to what is commonly referred to as ‘the medicalisation of menopause’, with women being treated as if they were sick and treated with medicines.

In an attempt to understand the cause and effect of these biological changes experienced during menopause, three models of menopause were developed in the 1980s.

1. The Biological Model, predominately focused on the physiological cessation of ovarian function, and reduced oestrogen levels that causes hot flushes, night sweats, vaginal dryness and mood changes that many women experience during this change of life.

2. The Psychological Model, takes into account and respects the emotional changes that occur as a result of altered hormone levels.

3. The Environmental Model, focuses on the elements external to the human body that may have an impact on body function, for example; chemical stress and toxin exposure (oestrogen mimicking plastics and chemicals), food (phytoestrogens such as soy), sleep patterns, air quality and exercise.

Interesting, there are some cultures around the world (specifically in the East) where women transition through to their elder years without any sign of menopause (other than the cessation of menstruation). On the other hand women in the west commonly experience a multitude of challenging and uncomfortable side effects relating to menopause.

In an attempt to understand this cultural difference, scientists have studied the diets and lifestyle of various cultures, finding an association between a diet high in fish (omega fats) and soy (isoflavonoids) and a lower incidence of menopausal symptoms. Although this understanding is giving women hope and a positive outlook in coping with menopause, it is not recommended to overhaul your diet and lifestyle. Rather implement such dietary changes years before the onset of menopause and know that epigenetics (the study of genetics that is based on our environment, lifestyle and the health choices of our ancestors) may also play a role in your experience of menopause.

Hormone Replacement Therapy (HRT):

It is well known that oestrogen has protective benefits when it comes to bone density and bone health in general. The only issue with something like HRT however is that it is a laboratory produced drug, which comes with dangerous side effects. Science has discovered a link between long term HRT use and increased risk of stroke, heart attack, uterine cancer, ovarian cancer and breast cancer. More specifically, a number of studies have found that women who used oestrogen-only replacement therapy for 10 years plus had a significantly increased risk of ovarian cancer, whereas short-term oestrogen/ progesterone replacement appeared to pose no increased risk.

There is no doubt that HRT is exceptionally effective in reducing menopausal symptoms, yet for those women concerned with the apparent risks, making a natural choice, may in fact be a better choice...

Natural Alternatives to HRT:

There are a number of HRT alternatives that may not be as effective initially, but over time have been found to relieve the symptoms for many menopausal women. Wild yam, Chaste Tree, Red Clover, Black Cohosh, Phytoestrogens/ Isoflavones and Vitamin E have all been found to be helpful in naturally managing menopause, Keep in mind that these preparations are not necessarily a miracle cure and are most effective when used before symptoms become overbearing.

1. Remifemin is a herbal preparation that predominantly contains Black Cohosh extract. Multiple scientific case reports have shown Remifemin to be an effective natural intervention for menopause symptoms.

2. Promensil is a herbal preparation that predominantly contains Red Clover. The phytoestrogens found in this product are the key biologically active ingredient that mimics the oestrogen in the body, reducing the symptoms of menopause.

3. Many women report that Wild Yam based creams that contain plant derived Phytoestrogens are effective in also minimising symptoms of menopause, specifically in the area of hot flushes.

PREVENTATIVE HEALTH  & SCREENING PROCEDURES

Mammography:

Mammmography was first invented in 1966 to detect cancerous tumours of the breast. In the 1970s significant safety concerns were raised. Mammography uses ionizing radiation that is emitted directly into the breast tissue being screened. During this procedure the breast is basically placed in a vice, squashed flat, causing trauma to the breast tissue and then radiated. This process and the radiation exposure has raised much concern in respects to the evolution of breast cancer.

Since its development the machines have seen many developments, with modern machines supposedly using less radiation. Over the past 30 years scientists have discovered that the high levels of radiation that the machine emits may be implicated in the increase prevalence of breast cancer today. Some theories of breast cancer also look at the fact that the procedure may cause a spread of undetected cancer through the blood and lymphatic system as a result of small blood vessels being ruptured during the breast flattening procedure. In addition, the breast tissue of younger or pre/ peri-menopausal women is significantly denser and mostly glandular, making mammography less accurate with more false-positive readings and or mis-diagnosis. In addition, research is now illustrating that mammography is in fact not an early diagnosis tool as breast tumours must in general be present for at least five to seven years before they may be diagnosed accurately with mammography. In saying this, ultrasound may be a more accurate and safer option of breast screening.

Dr. John Gofman, an authority on the health effects of ionizing radiation, “estimates that 75 percent of breast cancer could be prevented by avoiding or minimizing exposure to the ionizing radiation”, which includes mammography to x-rays. It is important to note that most studies have focused on cumulative risks where women have multiple mammogram procedures over their lifetime.

When it comes to making our individual health care choices, public mass media and governmental campaigns may not be so helpful. Often such campaigns use coercion and manipulative techniques to convince women to choose a particular intervention, instilling fear in people. What all women must know is that mammography is not necessarily the best and certainly not the only option used in detecting breast cancer and that other safer options do exist today that are not necessarily profit or fear driven.

Thermography:

Digital Infrared Thermal Imaging (DITI) or Thermography is revolutionary technology used to screen the body by scanning the it (or a specific tissue) for abnormal heat patterns..
The procedure is painless, radiation-free and that is non-invasive. It is able to show cancerous change in tissue as early as 2 years after initial development.

Over the past 1.5 decades, breast thermography has been shown to have outstanding results, having a sensitivity and specificity of 90%. Research supports that DITI is a valuable adjunct to mammography and ultrasound, especially in women with denser breast tissue.

The simple breast self exam (BSE) is of course also available in the comfort of your own bathroom where you may regularly assess your breast for tissue change. Alternatively, your trusted GP is also available if you do not feel confident of your palpation skills or self examination technique. 

KEEPING HEALTHY & FIT DURING MENOPAUSE

Osteoporosis & Bone Health:

“Strong women, strong bones” is a common saying amongst health care workers. This is simply because when we exercise with weight bearing activities, muscles contract, and the bone for which each muscle attaches to undergoes remineralisation and nutrition exchange. Bones that undergo loading through regular exercise will in most cases never experience osteoporotic changes. 
Eating a diet high in bioavailable calcium and having adequate daily vitamin D levels are also essential.  Foods that are high in bioavailable calcium include; broccoli, green leafy vegetables, sesame, carrot, papaya, nuts, legumes and believe it or not, but oranges also contain calcium. Try to vary your diet and don’t rely on dairy as your main source of calcium as many people have undiagnosed lactose intolerance and will therefore not absorb the calcium appropriately. In addition, dairy in general only has highly absorbable and bioavailable nutrition for baby cows, not humans and it is through the process of heating/ pasteurisation that calcium and other minerals are destroyed. In some cases calcium supplementation may be required if osteopaenia (low bone density) has already become evident.

Exercise, Fitness, Cardiovascular Health & Weight Management:

Cardiovascular disease is the leading cause of death in Australia, so keeping fit and healthy is more important now than ever. Exercising regularly, reducing unhealthy fats in the diet, ceasing smoking and managing weight are all positive steps towards ensuring a healthy heart.

In attempting to loss weight, the first steps are:

- Eat smaller meals (stop eating the moment you feel full)
- Avoid meal replacement shakes
- Eat a minimum of 3 small-medium meals a day (skipping meals is a trap to losing weight as it slows metabolism and interrupts hormone function)
- Consume healthy fats (from coconut, olive, fish, nuts and seeds).

- Drink plenty of filtered water each day (minimum 1.5-2.5L; this will fill your stomach and hydrate your cells and organs)
- Try to avoid drinking with your meals however as doing this will cause a dilution of the hydrochloric acid in the stomach and affect digestion. As a rule of thumb, try to drink minimum 30 minutes before or after your meal.

The topic of women’s health is complicated and includes a collection of broad topics and areas. Everybody’s health status is varied and based on our lifestyle we all express health differently. Regardless, whether we are young or old taking great care of yourself today is more important than fixing your health in the future. Enjoy and cherish every moment and good luck on your journey of health. 

References

Price, EH etal. (1999). Risks of hormone replacement therapy. The Lancet. Vol 354 (9186). Pg. 1302-1303

Epstein, SS etal. (2001). Dangers and Unreliability of Mammography: Breast Examination is a Safe, Effective, and Practical Alternative. Internat Journ Heal Serv. Vol 31(3). Pg. 605-615.

Gotzsche, PC & Olsen, O. (2000). Is screening for breast cancer with mammography justifiable? Lancet Vol 355 (9198). Pg. 129-134.

Bell, SE. (1987). Changing Ideas: medicalisation of menopause. Soc Sci Med. Vol 24 (6). Pg. 535-542.

Ng, EYK. (2009). A review of thermography as promising non-invasive detection modality for breast tumor. Internat Journ Therm Sci. Vol 48 (5). Pg. 849-859.

Arora, N etal. (2008). Effectiveness of a noninvasive digital infrared thermal imaging system in the detection of breast cancer. Amer Journ Surg. Vol 196 (4). Pg. 523- 526.

Saxena, T etal. (2010). Menopausal Hormone Therapy and Subsequent Risk of Specific Invasive Breast Cancer Subtypes in the California Teachers Study. Cancer Epidemiol Biomarkers Prev. Vol 19 (9). Pg. 2366 -2378.

Chlebowski, RT & Anderson, GL. (2011). The Influence of Time From Menopause and Mammography on Hormone Therapy- Related Breast Cancer Risk Assessment. JNCI Vol 103 (4). Pg.284-285

Grady, D etal. (1995). Hormone replacement therapy and endometrial cancer risk: A meta-analysis.  Obstet Gynec. Vol 85 (2). Pg. 304-313.