Posts from May 8th, 2009.

GENERAL HAIR CARE

Hair conditioner is usually a cream to be used as a rinse after the hair has been washed, its basic ingredient being an antistatic compound that forms a residual film on the hair. Shampooing decreases the hair’s normal oily film, resulting in a dry and dull appearance. This may lead to static electricity, making the hair unmanageable; in this state the hair is more prone to tangling, and combing may result in breakages. Conditioners help to control these problems by making the hair more manageable, and leave it feeling soft and glossy. Egg or beer conditioners simply leave a layer of sugar or protein on the hair which may appear to provide more ‘body and manageability’. Protein conditioners, like other protein-containing products for the hair or akin, are not absorbed. They therefore do not change hair structure, affect hair growth, or in any way permanently after the hair. Although hair consists of a protein known as keratin, the hair above the skin is dead tissue that cannot be fed or revitalized. Furthermore the protein derivatives used are derived from animal tissue, not human hair, and are hence incompatible. Protein conditioners have the same effect as any other conditioner, namely to coat the hair shaft with a film that tends to temporarily make the hair appear thicker and improve its appearance and manageability. It does nothing to strengthen the hair or restore its structure, and its affect is only temporary.

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THE G.I. FACTOR: SNACKS – KEEPING YOUR ENERGY LEVELS UP BETWEEN MEALS

The fine art of grazing! Hands up all those who thought that sensible eating meant keeping to three meals a day? Traditionally, there has been a belief that sensible eating meant sticking to three square meals a day. Perhaps this stems from images of an erratic eater. You know the one, the person who skips breakfast making up for it with snacks during the day and then feasting before sleeping at night—certainly not the ideal pattern! New evidence suggests that the people who graze properly, eating small amounts of food throughout the day at frequent intervals, may actually be doing themselves a favour.

A recent study which compared people eating a diet of three meals a day with those who had three meals and three snacks showed that snacking stimulated the body to use up more energy for metabolism compared to concentrating the same amount of food into three meals. It’s as if the more fuel you give your body the more it will burn. Frequent small meals stimulate the metabolic rate.

The problem with grazing is that most snacks turn out to be high fat foods like cakes, chocolate, snack bars, crisps or pastries. Another criticism of grazing has been that for people who eat too much, increasing the number of times that they face food is tempting disaster. Overeating is less likely to occur if the foods eaten are carbohydrate rich and have a low G.I. factor. Using these foods, you will feel satisfied before you have overconsumed!

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COPING WITH ENDOMETRIOSIS: SHIRLEY’S STORY

‘The worst case of endometriosis I have ever seen’. These were the first words I remember hearing through the haze after an anaesthetic.

I tried repeating the word to myself — ENDOMETRIOSIS. I drifted back to sleep, happy that at last a name had been given to the cause of my debilitating period pain.

The doctor’s voice roused me once again: ‘You’ll probably never have children’.

I wondered who the doctor was talking to. I knew it was not me because I had not even tried to get pregnant.

The truth dawned the next day when once again the doctor described the severity of the endometriosis and repeated that pregnancy looked very doubtful.

He told me that I was to take 400 milligrams of Danazol a day for three months and then he would perform major surgery including the removal of my diseased ovary.

As the endometriosis was so extensive, he felt the Danazol would only marginally improve my condition and he could not guarantee the success of surgery.

I was devastated. One day I was in hospital with a suspected ovarian cyst. The next I was told I had a disease that I could not even pronounce, I had to take male hormones, I had little prospect of ever having a baby and I was to have major surgery in the near future.

I knew very little about Danazol as it was then a relatively new drug in Australia and I asked my doctor about any side effects. He tried to assure me that I need not worry about little details and that he would look after me. I did not feel at all reassured.

The week after being diagnosed as having endometriosis, my husband’s firm transferred him interstate. I was in turmoil, life was caving in around me.

Once settled in our new home, I decided to seek a second opinion. The news about the endometriosis had been so shattering I did not want to believe it. I wanted to hear something positive, something encouraging.

My new doctor had received a letter from my first doctor giving details of the disease. The new doctor asked me if I had any questions. Did I have any questions!

For the next half an hour he quietly explained in detail all I wanted to know, including drawing some diagrams so that I understood more clearly. He felt it was essential that I knew all the possible side effects of Danazol.

After I had exhausted my list of questions, he told me that he wanted to change the dosage of my treatment. I was to increase the dosage of Danazol to 600 milligrams daily and take it for six months. He hoped he would not have to perform major surgery. At the end of six months I had a laparoscopy to see how effective the Danazol had been. Much to my doctor’s surprise there was no visible endometriosis. There were certainly signs where the disease had been, but everything appeared normal.

My doctor suggested I continue taking Danazol for another three months just to make absolutely sure the endometriosis had been completely eradicated.

A few weeks after finishing the Danazol tablets I discovered to my delight that I was pregnant.

I often wonder how my story would have ended if I had not decided to have a second opinion. Would the smaller dosage of Danazol have cleared my endometriosis? Would the major surgery have eradicated the endometriosis? Would I have been left with painful adhesions? Would I have lost an ovary? Would I ever have become pregnant?

Of course, I do not know the answers to these questions but I am grateful I decided to seek a second opinion as the outcome was more than I ever hoped for.

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HORMONAL TREATMENT OF ENDOMETRIOSIS: GNRH AGONISTS

GnRH agonists, also known as LHRH agonists, are a group of drugs that have been developed over the last two decades. Since the mid 1980s they have been used in clinical trials in Australia and overseas for the treatment of endometriosis. They have also been used to treat a range of other conditions including anovulation (absence of ovulation) and fibroids.

The GnRH agonists are modified versions of a naturally occurring hormone, gonadotropin releasing hormone (usually abbreviated to GnRH), which helps to control the menstrual cycle.

Initially, it was drought that the GnRH agonists would not be suitable for the treatment of endometriosis as it was assumed that they would stimulate the production of oestrogen. However, it was discovered that prolonged use of the GnRH agonists actually suppressed the production of oestrogen and caused the oestrogen levels in most women to decrease to the levels found in women following the menopause. Consequently, researchers began to investigate their use for the treatment of endometriosis.

How GnRH agonists work

The GnRH agonists eradicate endometrial implants by suppressing ovulation and oestrogen secretion. The resulting low levels of oestrogen in the body mean that the endometrial implants are no longer stimulated to grow and breakdown each month so they gradually degenerate and waste away.

Most women stop ovulating and menstruating during treatment and resume ovulation and menstruation again within one to two months of completing their treatment.

Dosages of GnRH agonists generally used

Since 1971 more than 2,000 GnRH agonists have been developed by various pharmaceutical companies. Some of them are still being developed and tested while others have been released for use in some countries. At present none of them are available in Australia for the treatment of endometriosis, except under special circumstances.

Some of the more well known GnRH agonists are Buserelin (Superfact), Naferelin (Synarel), Leuprolide (Lupron), and Goserelin (Zoladex).

None of the current GnRH agonists are effective when taken by mouth because they are broken down in the digestive system. Other methods of administering the drugs have been developed, including nasal sprays, daily injections and monthly injections.

Side effects GnRH agonists

The side effects experienced by most women are usually a result of low oestrogen levels. The majority of women experience hot flushes and some also experience other menopausal-type symptoms, including vaginal dryness, decreased libido, headaches and depression. The side effects usually disappear soon after the cessation of treatment.

The GnRH agonists appear to have no adverse effects on the levels of fats and cholesterol in the blood.

One possible long-term side effect of GnRH agonist therapy is osteoporosis (loss of bone density). In trials conducted so far some women have shown a decrease in the density of the bones in their spines; it appears that this effect is reversed and the bone density usually returns to normal within six months of ceasing treatment.

At present it seems that this loss of bone density is not likely to be a significant long-term problem if the treatment lasts only six to nine months but considerable further research is needed before the complete picture is known.

How effective are the GnRH agonists

The results of the clinical trials indicate that the GnRH agonists are effective in eradicating endometriosis and relieving its symptoms but, like all the other hormonal drugs, they have no significant effect on adhesions or endometriomas and they are not a permanent cure. Overall, the GnRH agonists appear to be as effective as Danazol. When they have been approved for use in Australia they will probably assume an important place in the hormonal treatment of endometriosis.

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THE FEMALE REPRODUCTIVE ORGANS: UTERUS (WOMB)

The female reproductive organs consist of the uterus, fallopian, tubes, ovaries, cervix, vagina, vulva, clitoris and labia.

Uterus (womb)-The uterus is a hollow muscular organ which is about the size and shape of a flattened pear. It lies between the bladder and the lower end of the bowel and is approximately 7.5 centimetres in length and weighs about 40 grams.

The upper part of the uterus can move forwards and backwards to some degree within the pelvis. Usually, it is tilted forwards so that it lies against the back of the bladder. In this position it is said to be anteverted. However, it may be tilted backwards and when it lies in this position it is said to be retroverted.

The uterus is made up of three layers. The outer layer is known as the peritoneum. The middle layer consists of a thick layer of muscle known as the myometrium. The inner layer which forms the lining is known as the endometrium. When this endometrium is found outside the uterus it is known as endometriosis.

The main function of the uterus is to protect and nourish the growing foetus during pregnancy.

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