Tag: Women's issues

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Health

It's OK to Complain…especially when you're sick!

How are you?

Sometimes the polite answer to “How are you?” isn’t the one you should give – if it’s your doctor or a concerned family member who is asking. My mom, never one to complain, would always answer “Fine, thank you” whether she was feeling well or not. In later years, after the onset of rheumatoid arthritis when she really wasn’t feeling well at all, her answer changed to “Not too bad, thanks”. For her, I believe this probably led to a delay in treatment.

Many people will say they’re fine when they really aren’t – not wanting to be seen as a complainer – but there’s a way to say you’re not at your best without being whiny and to ask for help when you need it. Yesterday, at the milk cooler in the grocery store, an elderly woman asked if I might pass her a quart of milk – it was on the top shelf and I could see, from the way she was using the grocery cart for support, that she had some physical disabilities. Shoulder arthritis may have been one, balance might have been another. I was happy to help her out.

Staying composed

Our society values composure, especially in women. Being poised, regardless of the situation, is considered a virtue, a talent. At the opposite end of the spectrum, simply pouring out emotions with the goal of “purging” may not be the answer either. I think something between, expressing emotions or discussing problems with a trusted person, is a better plan especially when the goal is to work out a solution or at least a next step to take. Depending on the nature of the health problem, this person could be a sympathetic friend, family member or a healthcare professional.

Stress and muscles

Holding in emotions can actually affect your health. Hilary Jacobs Hendel, author of It’s Not Always Depression, describes how we change our breathing and contract certain muscles when we suppress emotions. Tension headaches are a result of spasms of muscles in the scalp, and many problems with back pain originate with muscle spasms along the spine or in the hip muscles. Dr. John Sarno, a rehab specialist physician in New York (now retired), has written extensively about the association between stress and back pain. He has noted that many of his patients would improve once they realized the likely origin of their back pain, especially when no structural cause could be found. He has suggested that the brain shunts blood away from an area of the body, creating pain and spasms, to distract us from the stress or emotion we want to suppress. Certainly an interesting explanation!

I’ve noticed that I carry my tension in my shoulders – usually I don’t even notice I’m tightening my shoulder muscles until they become achy and painful. The body systems that our subconscious brain chooses to block when we’re stressed vary from person to person, resulting in back or shoulder pain for some, headaches, or digestive problems for others. But even when the pain originates with an emotion, the pain is real and can be extreme.

And more…

Suppressing emotions can also cause other problems. Hendel says “Learning to be extremely composed meant we had to suppress natural, primal emotions, and blocking core emotions over time contributes to symptoms of anxiety, depression, and even addiction.” We can probably add cardiovascular disease, inflammatory diseases and maybe cancer and others to that list. Often, women choose composure and suppression of emotions rather than risk being labelled hysterical (note that “hyster” refers to anything concerning the uterus…). Generations ago, women’s emotions were thought to be associated with their hormonal cycle, hence the term “hysterical” – blame it all on the uterus! She notes that women in particular are at risk of feeling pressured not to express their pain, and observed in her 2001 study that women are more likely to have pain dismissed even by healthcare professionals as “emotional” or “psychogenic” (created by the mind) and, therefore, “not real.”

None of us are fine all the time. The harm to our health occurs when we keep up a stoic front, a “stiff upper lip”, and don’t seek the help we need for physical or emotional difficulties soon enough. The idea that you can and should distinguish between things you can control and those you cannot is a powerful way to cope when you really aren’t fine. Working on things you can change and getting help, when necessary, with those you cannot is a solid strategy to gain control of your life and help prevent stress-related illnesses.

References:

When Staying Composed Harms Your Health – Medium.com

It’s Not Always Depression – Hilary Jacobe Hendel

Healing Back Pain – Dr. John Sarno

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Health

Preventing Bladder Infections… Update!

I received a useful comment from a reader and have decided to pass her suggestion along. She tells me she has had good success in preventing bladder infections by taking d-mannose powder daily. This product was actually somewhat familiar to me from my study of natural medicines several years ago. I decided to do a little research to update my knowledge.

D-mannose is a simple sugar found naturally in apples, oranges, peaches and some berries, including blueberries and cranberries. It may actually be the d-mannose content of cranberries that gives it its ability to prevent bladder infections. Like cranberry, d-mannose works by preventing bacteria from sticking to the bladder walls and starting an infection.

I found a study that compared d-mannose 2 g daily mixed in 200 ml water, with nitrofurantoin 50 mg and no treatment. The effect of d-mannose in reducing recurrence of bladder infection was similar or slightly better than the effect of nitrofurantoin, and both were significantly better than taking no treatment at all. It should be noted that d-mannose only works to prevent infection from e-coli, the bacteria normally present in our anal area that causes an estimated 90% of bladder infections. So, although an infection caused by other types of bacteria could still occur, d-mannose can still make a significant difference in the infection rate.

Other studies, done in mice, suggest that d-mannose is safe to take long-term if taken in appropriate amounts, but excess may cause kidney damage. Side effects may include bloating or loose stools and, if this occurs, reducing the dose would likely reduce these effects.

Caution is recommended in women who are pregnant or breast-feeding — although it is thought by some experts to be safe, being a simple sugar, it has not been studied in these populations. It is also recommended to use caution if you have diabetes, as it may make it harder to control your blood sugar, since it is a sugar. However, as most d-mannose is absorbed more slowly than regular sugan and excreted intact through the urinary system relatively quickly, people with well-controlled diabetes generally do not have any problem, according to other sources. Checking your blood sugar more often when starting this therapy would be advised to alert you to any potential problems.

As an interesting sideline, studies also suggest d-mannose may act as a prebiotic, encouraging growth of “good” bacteria in the digestive system.

The recommended dose of d-mannose for prevention of urinary tract infections, as used in the study, is 2 g (or approximately one teaspoon) once daily in adults, and one half to 1 teaspoon for children, dissolved in a glass of water. Dr. Jonathan Wright, one of the first physicians to begin using d-mannose, claims 85 to 90% effectiveness from this treatment in his patients. D-mannose is available in health food stores and some pharmacies. He also discusses a high success rate in treating active infections with the same dose given every 2 to 3 hours, but cautions that another treatment should be considered if no improvement within 1 to 2 days. I noted that he used an equivalency of 1gram = 1 teaspoonful… Regardless of the actual equivalency, 1 teaspoonful appears to be the dose commonly recommended for adults. Your pharmacist could weigh a sample of the powder for you, if you want to calibrate your 5ml teaspoon from your set at home!

If you decide to stay with cranberry, it is probably best to choose a cranberry concentrate capsule with a high amount of cranberry content (and presumably more d-mannose) rather than the sweetened juice to avoid the increased intake of glucose (sugar) it contains. A price calculation I did several years ago also found high-dose capsules were less expensive than an equivalent amount of juice!

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Health

Preventing Bladder Infection…

I received a question from a reader asking what women can do to prevent bladder infections. Here is some information about these infections that are so common and some strategies to prevent them.

Bladder infections can affect both men and women, but are 10 to 50 times more common in women (depending on which reference you read!), probably due to the much shorter urethra we have. The actions you can take to prevent a bladder infection will likely also reduce your risk of a vaginal infection and, in men, prostate infection.

Generally, infections start in the urethra, travel up to the bladder and, if not treated, can continue to spread up the ureters to the kidneys, leading to a much more serious infection. The recommendations below are for preventing infection; if you have signs of infection – pain or irritation with urination, needing to go frequently or urgently, blood in the urine, pelvic pressure or lower abdomen discomfort – you should see your doctor right away for diagnosis and treatment.

Bacteria that are normal to have in the bowel can cause an infection if they move into the reproductive or urinary systems. So, one of the first preventive measures is to pay attention to how you wash your genital area, making sure you are moving bacteria away from your vagina and urethra and toward the rectum when you wash or wipe these areas. Basically, always wipe from front to back with a clean tissue or cloth.

Infectious organisms also like warmth and moisture, so wearing looser-fitting cotton underwear can help keep the area drier – boxer shorts for men may help but I haven’t seen this style for women yet! However, at least we can choose comfy 100% cotton undies and avoid synthetic “non-breathing” materials. Thong-style underwear may increase the chance of movement of bacteria from the rectal area to the vagina or urethra, and are also more likely to irritate these areas – might be best to avoid this style of undies if you have recurring problems with urinary tract infections (UTI).

Avoiding long baths can be helpful, as bath water can become contaminated with bacteria fairly quickly, and using tampons is advised to keep the bladder opening drier, limiting bacterial growth.

Avoiding long intervals between urinating can also be extremely effective, and make sure to completely empty the bladder each time. Try to urinate every 4 hours if you are prone to infections, even if you do not feel the need to go. Drinking more water is thought to be helpful to dilute the urine, encourage more frequent urination and flush any bacteria from the bladder before it can attach to the bladder wall and start an infection.

Sexual activity can increase the risk of infection because it tends to introduce bacteria to the urethra opening. Keep in mind that spermicidal jellies and creams also kill normal flora that help keep harmful bacteria in check. If an association between sexual activity and infection is identified, doctors will sometimes prescribe a dose of a mild antibiotic to be taken afterward. Urinating after sex can help to flush away bacteria before it has a chance to enter the urethra, too.

The tissues of both the urethra and vagina are dependent on estrogen for growth and, as women age, these tissues can become thinner, less healthy and more prone to infection. Sometimes doctors will prescribe estrogen in suppository or cream form to improve the health of this area directly. Only a low dose is needed (for example, 10 micrograms of estradiol is used as a suppository, as compared to 1000 micrograms as a common strength of the tablets given by mouth for menopause symptoms). Compounding pharmacists can also make a gel or cream using estriol, a very weak estrogen that is very effective in improving the health of the genital tissues. Estriol has little or no effect in stimulating the growth of breast or endometrium tissues and is therefore sometimes preferred for women who would benefit from a local estrogen effect but have increased concerns about reproductive cancers.

The normal human bacterial flora, a mixture of non-harmful bacteria that grow on and in our bodies, is increasingly recognized as an important defense to infection. And since antibiotics kill normal flora along with the infecting bacteria, they may actually set us up for recurrent infections. As well, bacterial resistance to antibiotics is a growing problem – they quickly learn how to survive our cures. We need to be careful to only use antibiotics when they are truly needed, and to finish the full treatment so none of the infectious organisms are left behind… the bacteria that are the slowest to be destroyed are those that have already begun to develop some resistance to the antibiotic being used.

Probiotics are products containing live, non-harmful organisms that are beneficial when given in adequate amounts. When taken by mouth or applied to an area of the body that needs protection, they tend to overgrow disease-causing organisms and create an environment that is resistant to infection.

Studies suggest that when taken by mouth or applied vaginally, probiotics can reduce recurrent urinary tract infections (UTIs). Although somewhat less effective at prevention than low dose daily antibiotic therapy, probiotic treatment does not cause the bacterial resistance that is seen with antibiotics. So, although more research needs to be done to find the ideal way to use probiotics, it’s worth discussing with your doctor if you have recurrent UTIs.

Lastly, cranberries and blueberries contain a substance that can help prevent bacteria from sticking to the bladder wall, an essential step in the beginning of an infection. Cranberry juice, however, contains a lot of sugar to counter its bitter taste, and this sugar can promote the infections you are trying to prevent. Cranberry concentrate capsules are an option without sugar, but you need to read and compare the labels carefully – all cranberry supplements are not created equal! Some may contain as little as 5mg of concentrate but be labeled as over 1000mg – the amount of fruit it was extracted from… very misleading! Also, cranberry, like grapefruit, can interact with other medications you may be taking. Be sure to check with your pharmacist before taking large amounts of cranberry if you take other medications!

In summary, actions that reduce the amount of bacteria that reach the urethral opening, prevent bacteria from sticking to the bladder wall and maintain a healthy bacterial flora (especially after a treatment with antibiotics) will all help to prevent recurrent urinary tract infection.