Happy new year everyone and yes, you read me right you can postpone your periods… I can imagine some smiles appearing on many faces (both females and males😉.
During the last holiday season, I found out that a lot of of my female friends were not very impressed that their periods usually occur during their holiday trips. It then occurred to me that so many females are unaware that they can actually prevent their periods from showing up when they don’t want it around for example, during travels, special anniversaries, exams etc.
Women not taking the combined oral contraceptive pill
This can be achieved by the use of prescription-only tablet Norethisterone 5mg three times daily starting 3 days before your next normal anticipated onset of menstruation. Your period will normally begin 2-3 days after stopping the norethisterone. Note that it can be taken for up to 3-4 weeks if necessary.
This should be used only on an occasional basis – for special events, rather than regular usage. It has to be prescribed by a doctor to make sure it is safe for you to have it because in a very limited number of people it may be unsafe to take these tablets for numerous reasons, or not advised at a particular time. These include women who are overweight, smokers, have liver disease, taking some other medications, or any other woman at risk of clotting – developing clots due to different reasons or medications or who have clotting disorders and some other relevant personal or family history.
This medication should only be taken on the advice of a doctor as these checks are not exhaustive and prescription is on individualised basis. Again, it is generally safe and widely prescribed for most women and I frequently prescribe it in my everyday practice. Medroxyprogesterone acetate 10mgs twice or thrice daily is the alternative medication for those for which norethisterone is unsafe.
Women taking the combined oral contraceptive pill
If you are taking a fixed-combined oral contraceptive pill you can simply start the next pack without the usual seven-day break. It is safe to take two packs back-to-back in this way if done occasionally. You still only need to have A seven-day break at the end of these two packets.
If you are taking a triphasic or biphasic type of pill then you will need to take the last phase of the pills from the second pack immediately after finishing the first pack. Alternatively, you can change to a fixed-dose pill.
You should see your doctor or pharmacist if you are not sure which pill you are taking. The pills most commonly used are fixed-dose. If it is triphasic or biphasic usually the colour of the pill or the packet will not be the same throughout the month.
So, no more period worries for those memorable or stressful times! 😊 For these medications, always consult your doctor and always read the information leaflet that comes with your medicine . Hope this helps and I am happy to answer your questions. Best Wishes, Dr Adeola.
The reports of suicide in the news in recent months has brought my attention back to mental health problems and I picked OCD (Obsessive Compulsive Disorder) as one of the common but less well-publicised mental health problems which is associated with an increased risk of suicide.
The worldwide prevalence of obsessive-compulsive disorder (OCD) is approximately 2% of the general population. It is thought that 1-3 in 100 people have some form of OCD behaviours or traits.
What is OCD?
A disorder is
defined as an illness that disrupts normal physical
or mental functions. Obsessive-compulsive disorder (OCD) is a common mental health problem.
Symptoms typically include recurring thoughts and repetitive actions in
response to the recurring thoughts.
What are Obsessions?
Obsessions are unpleasant thoughts, images or urges that keep coming
into your mind. Common obsessions include:
Fears about contamination with dirt, germs, viruses (for example, HIV), etc
Worries about doors being unlocked, fires left on, causing harm to someone, etc
Intrusive thoughts or images of swearing, blasphemy, sex, someone harmed, etc.
Fear of making a mistake or behaving badly.
A need for exactness in how you order or arrange things.
Obsessions can be about all sorts of things. Obsessive thoughts can make
you feel disgusted, anxious or depressed. You normally try to ignore or
suppress obsessive thoughts.
What are Compulsions?
Compulsions are thoughts or actions that you feel you must do or repeat. Usually, the compulsive act is in response to an obsession. A compulsion is a way of trying to deal with the distress or anxiety caused by an obsession.
For example, you may wash your hands
every few minutes in response to an obsessional fear about germs. Another
example is you may keep on checking that doors are locked, in response to the
obsession about doors being unlocked. Other compulsions include repeated
cleaning, counting, touching, saying words silently, arranging and organising –
but there are others.
The
Impact of OCD
In popular culture and frequently within the media OCD is mistakenly portrayed as a positive trait and personality quirk, but in reality – for those that suffer from Obsessive-Compulsive Disorder (OCD), it has a devastating impact on their life. The obsessions that you have with OCD can make you feel really anxious and distressed.
The severity of OCD can range from some life disruption to causing severe distress. You know that the obsessions and compulsions are excessive or unreasonable. However, you find it difficult or impossible to resist them.
OCD affects people in different ways. For example, some people spend hours carrying out compulsions and, as a consequence, cannot get on with normal activities.
Some people do their compulsions over and over again in secret (like rituals). Other people may seem to cope with normal activities but are distressed by their recurring obsessive thoughts. OCD can affect your work (or schoolwork in children), relationships, social life and quality of life.
OCD can be so severe that it can seriously impact
on some or all areas of a person’s life, sometimes disrupting or completely
ruining: Education, Employment, Career development, Relationships
with partners, parents, siblings and friends, Starting a family.
Also, some of the behaviours that people do to cope with OCD (including compulsions) can also have devastating effects, for example, Substance abuse (self-medicating with alcohol or other substances or harmful drugs)
Who gets OCD and why?
The cause of OCD is not
clear. Anyone at any age can develop OCD but it usually first develops
between the ages of 18 and 30. Up to 2 in 100 children are also thought to have
OCD. If you are concerned that you may have OCD, you should see your doctor and
explain your concerns. Is there any thought that keeps bothering you that you
would like to get rid of but cannot? Do these thoughts interfere to the extent
that you respond to them with some compulsory actions so much so that it
interferes with your daily activities by taking a long time to finish them or
not even being able to perform your daily activities or function?
A detailed assessment is
needed for OCD to be diagnosed. This may either be carried out by your doctor
or by a specialist mental health team. The assessment will look at any
obsessional thoughts and compulsions that you have and how they affect you and
your daily life. Children with OCD may be referred to a specialist mental
health team which is experienced in assessing and treating children with OCD.
What is the treatment for OCD?
The usual treatment for OCD is:
Cognitive behavioural therapy (CBT); or
Medication, usually with a selective serotonin reuptake inhibitor (SSRI) antidepressant medicine; or
A combination of CBT plus an SSRI antidepressant medicine.
Cognitive
behavioural therapy is a type of therapy that deals with your current thought
processes and/or behaviours and aims to change them by creating strategies to
overcome negative patterns, which may help you to manage OCD more effectively.
Recent studies suggest that people with OCD are 10 times more likely to die by suicide than the general population. Actively thinking about suicide (sometimes called suicidal ideation) also appears to be relatively common among people affected by OCD. This risk can be further heightened when an OCD sufferer develops depression because he or she is unable to relieve themselves of the disabling symptoms of OCD.
The take-home message is to seek help early when suffering from symptoms of OCD or indeed any mental health problems. We all have a role to play in reducing the suicide rates in our community. Being aware and supportive of people with mental health difficulties goes a long way to relieve their distress and prevent the rising rates of suicide.
Acknowledgements:
OCD UK, WHO, VeryWell mind, Time to change.org.uk, NHS Self Help
therapies. NHS Cognitive behavioural therapies.
Suicide Risk in Obsessive-Compulsive Disorder and Exploration of Risk Factors: A Systematic Review. (PMID:29929465)
SKIN TALK: IT’S SUMMER TIME, LOTS OF SUN AND LOTS OF FUN
I have heard several times that dark skinned people feel they are protected from skin cancer and as such would not bother to use sun cream or hats or protect their skin in whatever form from the sun. Whilst it is true that the melanin present in abundance in the dark skinned offers some protection against some forms of skin cancer, it is also known is that the most severe form of skin cancer that is likely to spread and therefore more difficult to treat and in essence cure is commoner in the dark skinned population. Therefore I found it imperative to discuss this topic both for the benefit of both fair and dark skinned people and to help dispel the belief that dark skinned individuals do not need extra sun protection for their skin. I hope you find my discussion on skin cancer below useful.
SKIN CANCER
Skin cancer is the most common cancer in the UK. Around 100,000 cases are diagnosed each year. The main cause of all types of skin cancer is ultraviolet (UV) light which comes from the sun or tanning beds. The main types of skin cancer are Melanoma, Basal cell carcinoma (BCC), Squamous cell carcinoma-SCC) Anyone can develop skin cancer but you’re particularly at risk if you have fair skin, lots of moles or freckles, red or fair hair, pale coloured eyes, used tanning beds, a family history of skin cancer or had skin cancer before, or take medication which affects your immune system. As against popular belief dark skinned people do get skin cancer and the most aggressive type of skin cancer are commoner in dark skinned people.
Get to know your skin
Getting to know your own skin will help you spot changes early and it’s important to know what’s normal. Moles and Freckles are common and most are harmless. Check your skin once a month and report any changes without delay to your doctor.
Moles:
Moles are small, coloured spots on the skin. Most people have them and they are usually nothing to worry about unless they change size, shape or colour. It is normal for:
Babies to be born with moles.
New moles to appear: especially in children and teenagers.
Moles to fade or disappear as you get older.
Moles to get slightly darker during pregnancy.
Normal Moles
Melanoma
Melanoma is the most dangerous form of skin cancer with around six people dying every day. Common places to develop melanomas in men are the back and chest, and in women on the legs and arms, but changes can appear anywhere. Any changes to moles should be checked by a doctor. The ABCDEguide is an easy way to remember some of the most common things to look for.
Other Types of skin cancer : BCC and SCC
These are some of the most common types of cancer in the world. They may first appear as:
A new, unexplained skin change which appears suddenly.
A spot or sore which continues to itch, hurt, scab, crust or bleed for more than four weeks or does not heal within four weeks.
Ulcerated areas or patches where the skin has broken down and does not heal within four weeks.
There are two main types of this cancer known as squamous cell carcinoma (SCC) and basal cell carcinoma (BCC). SCC is fast growing while BCC develops slowly. If you notice any of the below changes to your skin you should discuss it with a doctor.
Squamous cell carcinoma (SCC)
Basal cell carcinoma (BCC)
What to do if you notice changes like these
If you notice any changes in your skin like the above, go to your GP as soon as possible. Lots of GPs are now able to send a photo to a specialist dermatologist, which can make diagnosis (and any subsequent treatment) much quicker.
When should I use sun cream?
Check out the Global Solar UV Index. This is a measure of the UV radiation level at the Earth’s surface and indicates the potential for skin damage. The greater the UV index value the greater the harm to skin. You need to protect your skin when the UV index is 3 or more. If you visit the Met Office’s website, they have a UV forecast on their homepage that you can customise to your location.
What does SPF mean?
Sun Protection Factor (SPF) tells us the amount of protection sun creams offer against UVB radiation. It gives an idea of how much longer skin that’s covered with the sun cream takes to redden in response to UV, compared with unprotected skin.
What are UVA and UVB?
Both are types of ultraviolet radiation from the sun. UVB is the main cause of sunburn. UVA affects the elastin in the skin leading to wrinkles, leathery skin and brown pigmentation, and skin cancer.
The UVA seal (a logo with ‘UVA’ inside a circle) shows protection against UVA and meets the EU recommendation for sun creams to offer a UVA protection factor equivalent to at least a third of their SPF.
How much sun cream should I apply?
The World Health Organization (WHO) recommends 35ml for the total body – seven teaspoons (or a shot glass full): one for the face/head and neck, one for each arm and leg, and one each for your front and back. The hand on the left shows the average amount of sunscreen we typically apply in a single full-body application. The two hands is the amount we should be applying.
Look after your skin.
Best Wishes, Dr Adeola.
Acknowledgements:
Tenovus Cancer Care, Cancer Research UK, Patient.co.uk, www.nhs.uk
Stress is the feeling of being under too much mental or emotional pressure. Stress is a common experience in everyday life. We feel stress in response to situations that we find difficult or challenging. People have different ways of reacting to stress, so a situation that feels stressful to one person may be motivating to someone else.
Whilst a bit of stress can help to motivate us to reach our goals; too much stress can be bad for our bodies and minds. Feeling over-burdened at work, reacting to a major life event, and coping with a difficult situation we were not expecting are some examples of things people report as causing a high level of stress. Stressful life events do not necessarily have to be negative events. For example, events such as starting a new job, moving house and getting married can all be stressful. Overall these positive and negative pressures of life turn into stress when you feel unable to cope.
Telltale
signs of stress building up include:
Not being able to sleep properly with worries going through your mind.
Minor problems causing you to feel impatient or irritable.
Not being able to concentrate due to many things going through your mind.
Being unable to make decisions.
Drinking or smoking more.
Not enjoying food so much.
Being unable to relax and always feeling that something needs to be done.
Headaches and muscle tension in the neck and shoulders
Feeling tense. Sometimes ‘fight or flight’ hormones are released causing physical symptoms. These include:
Feeling sick (nauseated).
A ‘knot’ in the stomach
Feeling sweaty with a dry mouth.
A ‘thumping’ heart (palpitations).
Signs
and symptoms of stress overload
Cognitive symptoms:
Memory problems
Inability to
concentrate
Poor judgment
Seeing only the
negative
Anxious or racing
thoughts
Constant worrying
Emotional
symptoms:
Depression or general unhappiness
Anxiety and agitation
Moodiness, irritability, or anger
Feeling overwhelmed
Loneliness and isolation
Other mental or emotional health problems
Physical
symptoms:
Aches and pains
Diarrhea or
constipation
Nausea, dizziness
Chest pain, rapid
heart rate
Loss of sex drive
Frequent colds or flu
Behavioral
symptoms:
Eating more or less
Sleeping too much or
too little
Withdrawing from
others
Procrastinating or
neglecting responsibilities
Using alcohol,
cigarettes, or drugs to relax
Nervous habits (e.g.
nail biting, pacing)
Effects of
chronic stress
If
you tend to get stressed out frequently, like many of us in today’s demanding
world, your body may exist in a heightened state of stress most of the time.
And that can lead to serious health problems. Chronic stress disrupts nearly
every system in your body. It can suppress your immune system, upset your
digestive and reproductive systems, increase the risk of heart attack and
stroke, and speed up the aging process. It can even rewire the brain, leaving
you more vulnerable to anxiety, depression, and other mental health problems.
Health problems caused or exacerbated by stress
include:
Depression and anxiety
Pain of any kind
Sleep problems
Autoimmune diseases
Digestive problems
Skin conditions, such
as eczema
Heart disease
Weight problems
Reproductive issues
Thinking and memory
problems
Improving your ability to handle stress.
Realise when it is causing a problem and identify the causes: An important
step in tackling stress is to realise when it is a problem for you and make a
connection between the physical and emotional signs you are experiencing and
the pressures you are faced with.
Review your lifestyle: Are you taking on too much? Can you do some things
in a more leisurely way?
Eat Healthily: There is also a growing amount of evidence showing how food
can affect our mood.
Be aware of your smoking and drinking: If possible, try to cut right down
on smoking and drinking. They may seem to reduce tension, but in fact they can
make problems worse. Alcohol and caffeine can increase feelings of anxiety.
Exercise: well proven to reduce stress.
Take Time Out: To relax and do some self care.
Get some restful sleep: Relieves tiredness and helps you think clearly to
deal with stress.
Build supportive relationships: friends or family can offer help and
practical advice can support you in managing stress. Joining a club, enrolling
on a course, or volunteering can all be good ways of expanding your social
networks and encourage you to do something different.
Treatment
Some people find they have
times in their lives when stress becomes severe or difficult to cope with. See
a doctor if stress becomes worse.
Further treatments eg pyschological
therapies or medication may be appropriate.
Take away bite:
If you continue to feel
overwhelmed by stress, seeking professional help can support you in managing
effectively. Do not be afraid to seek professional help if you feel that you
are no longer able to manage things on your own. Many people feel reluctant to
seek help as they feel that it is an admission of failure. This is not the case
and it is important to get help as soon as possible so you can begin to feel
better. Remember stress is a risk factor for and can precipitate physical and
mental health problems so seek help when you feel stressed and are unable to
cope and/or function.
