АСТМА – ASTHMA

To avoid eating soya, you have to stop eating:

Soya flour

Soya milk

Soya beans

Tofu

Soya oil TVP

Soya sauce

Miso

Soya, in its various forms, is found commonly as an ingredient in processed foods (e.g. pies, bakery, prepared dishes). Read labels to see if any of the above products are mentioned. If a product contains vegetable oil of unspecified nature, it can often be soya oil. Avoid this. If it contains vegetable protein, this is invariably soya, and should be avoided.

Lecithin is sometimes derived from soya and sometimes from eggs; products containing this (e.g. ice cream and margarine) are best avoided to be absolutely sure.

Many breads now contain soya flour as well as wheat flour. You will not know this if you buy unlabelled bread from a local baker or wholefood shop. Check with them as to what ingredients they use. Avoid bread if you are not sure whether it contains soya or not.

If you are chemically sensitive, you may react to the water used to make up processed soya milks rather than soya itself .

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In intra-dermal tests, a higher dose of allergen extract is introduced just under the outer skin using a syringe. A similar weal and flare response within 10-15 minutes indicates a positive reaction. In addition, you may get a late skin reaction – a raised red swollen bump around the test site – about five or six hours later. Sometimes there may be a late skin reaction on the following day.

The infra-dermal test is much less commonly used in the UK than the skin-prick test. It can be painful, it has a slight risk of adverse reaction, and some people feel unwell on testing. It can, however, be useful in that it can detect positive reactions where skin-prick tests have previously been negative.

Patch tests are used to confirm a diagnosis of contact dermatitis – a delayed allergic skin reaction to something you have touched. Patch tests can be very useful in identifying specific things that you can then avoid. Small patches containing a range of common allergens, mostly chemicals, are attached to the skin, usually to the upper back. The sites of the tests are marked on the skin. The patches are left there for 48 hours, and then removed.

The sites are examined for reaction and then left unwashed for a further 48 hours, when the sites are examined once more. A raised red bump at the site of the allergen is an indication of positive reaction. False positives and false negatives can result, so once again patch tests are used mainly to corroborate a case history. You can use patch tests to test specific things you suspect – for instance, a fabric, a leaf or a chemical you use at work or school. You can also do a home version of the patch test for yourself.

Anti-histamine drugs block the release of histamine and can interfere with skin test results. Such drugs should not be taken for several days before testing.

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If you are exceptionally sensitive to resins, wear wool, pure silk or pure synthetics if possible. You can buy resin-free cotton clothes -usually called ‘formaldehyde-free’ – for babies, children and adults. Sources are given below.

You can also find certain kinds of cotton clothes that are much less highly treated than others. These are often well tolerated even if you are sensitive to resins. If you are unable to wear wool, silk or synthetics, and want to have a wider choice of cotton clothing, choose relatively untreated cotton clothing as follows:

Try
Avoid
Take care with
Cotton jersey
Cotton poplin
Brushed cotton
Cotton fleece
Cotton drill
Cotton lawns
Cotton corduroy
Denim
Cotton voiles
Cotton towelling
Easy-care

Knitted cotton sweaters
Permanent Press

Indian cottons
Sanforised

Third World cottons

Wash New Clothes

Resins wash out readily, but not all fabrics or clothes are washed during manufacture, and new clothes can have very high levels of fumes. You can reduce the level to tolerable amounts by washing new clothes before wearing them. If you add a dessertspoonful of sodium bicarbonate to the water, this also helps to neutralise the resins. You may have to wash new clothes several times before you can wear them, but, for virtually everyone, this is sufficient to avoid any major problems. Unless you are extremely sensitive washing clothes well will make resins tolerable.

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Synthetic and latex materials are conventionally described as non-allergenic and are often recommended by doctors in the belief that they do not cause allergy and that house dust mites do not thrive in synthetic materials. This advice is misleading. Synthetic and latex are useful as an alternative to wool and feathers, which commonly cause allergy, but people who are chemically sensitive often react to synthetics and latex (including plastic mattress covers as well as the bedding itself).

Synthetics and latex also harbour dust mites. To thrive, mites need warmth, moisture and human skin, bacteria or moulds as food. Bedclothes, pillows and mattresses of synthetics and latex provide these just as natural materials do. Some synthetic bedding can be washed and this helps in controlling dust mite allergy in that the mite’s faecal pellets (which are for most people the allergens) are washed out. But mites are not themselves killed by washing at the low temperatures necessary for virtually all synthetics. So they can survive the wash and continue producing faecal pellet allergens. Synthetic and latex bedding are therefore not an automatic choice for people with allergies and chemical sensitivity. They are a good choice if you are:

• allergic to wool, feathers, cotton or other natural fibres

• not chemically sensitive

Do not use a plastic or vinyl mattress cover even if you do not react to plastics. It prevents the mattress airing, keeps in damp and aggravates house dust mite problems. Use a small plastic sheet under the area that needs protection against bedwetting.

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If you want to keep a dog, some breeds are reported to be less troublesome than others. Allergy is very idiosyncratic, however, and these may not work for you, so take care. Many people with allergies say that dogs that require a lot of grooming are more likely to cause reactions than dogs that do not, because more hair is shed and more contact is necessary. Dogs that have shorter, wiry hair generally shed more dander than long-haired dogs, but dogs with soft, curly hair, such as small poodles’ are sometimes found to be less provocative.

If you are blind and have to keep a guide dog, it may be best to choose a type of dog that sheds less hair, or needs less grooming, such as curly-coated retrievers, or cross labradors.

Be careful with children and animals at school. Small mammals are often kept in schoolrooms and these may be responsible for your child’s reactions. School cats are also often allowed to roam out of school hours and can leave allergens to upset the exceptionally sensitive. Watch out for the ‘school run’ if your child travels regularly in a car in which dogs travel.

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• Learn all you can about erections and impotence problems by reading this book and talking to your doctor.

• Don’t give up on sexual pleasure even if your partner isn’t interested. Try to maintain physical contact with him, and give yourself pleasure by masturbating.

• Don’t let the problem control your life. Put energy into having some positive experiences. Don’t withdraw from friends, family and activities you enjoy.

• Take care of yourself. This is a difficult, stressful time for you, and you need extra amounts of support— which your partner, preoccupied with his own feelings, is probably unable to give. Talk to a close friend, or seek professional help with coping. Eat well and exercise to combat stress.

• Part of taking care of yourself is recognizing that most cases of impotence have nothing to do with the man’s attraction to his partner. Love may be strong, but it can’t open clogged blood vessels or overcome other physical conditions.

• Examine your attitudes towards erection. One woman said about her husband, «If I can’t give him an erection, I don’t want anything to do with him.» Her insecurity caused a lot of pain for herself and her husband. She was a victim of the myth that her partner’s erection would validate her worth as a woman.

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Lionel, for example, a 54-year-old, could not get an erection after he had surgery to correct severe back pain, because the operation damaged some crucial nerves. Lionel had a very strong relationship with his wife, Terry, and the couple adapted to this situation by expressing warmth and closeness in other ways. But they still felt something was lacking. For seven long years Lionel and Terry lived this way. Doctors told them it was very unlikely that Lionel’s body would heal itself. If Lionel wanted to have intercourse, he had two choices: a penile implant, or the shots.

After some discussion with his wife, Lionel decided to give the shots a try. After all, if the injections didn’t work, he could still have implant surgery. What did he have to lose?

Like some other patients with nerve damage, Lionel was extremely sensitive to the medication. The first injection of only a small dose of the drug brought him a very satisfactory erection— and brought a big smile to Terry’s face.

It took several office visits to determine the best amount of medication for Lionel, and to make sure he didn’t suffer any side effects. Then he and Terry were ready to try the shots at home. Terry was eager to learn the technique, so both of them learned how to give the injections. In fact, the couple later reported that giving the shot had become Terry’s job.

As long as Lionel keeps his regular checkup appointments to make sure the shots are working well for him and not causing any problems, he should be able to continue the shots for an indefinite period of time. But because the injections are so new, at this point we don’t know the possible long-term side effects and complications.

Will the shots provide a permanent solution for patients like Lionel? Right now, it’s just too soon to make such a prediction. As we pointed out earlier, repeated injections can cause scarring in the penis, and scar tissue will not expand like normal tissue. So it’s conceivable that scarring from long-term use of the shots could actually prevent a man from being able to get an erection.

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Once you decide that you need help with your sex life, you’ll have to choose among an array of doctors and other health professionals—an array that might seem confusing and even contradictory. There are urologists, endocrinologists, general practitioners, psychiatrists and numerous other therapists who may claim to have the answer to your problem.

And to add to the confusion, there are widely varying levels of competency within each specialty when it comes to dealing with impotence. Not all physicians are well informed about erection problems. And some doctors just aren’t comfortable discussing potency. Professionals can be vulnerable to the same distorted ideas, hang-ups and myths that plague the rest of us.

You need to find a health professional who is sensitive, well informed, capable, knowledgeable and interested in sexuality. He should also feel free to admit his ignorance where it exists, and should not be afraid to refer you to another specialist if it’s in your best interest. Finding a doctor like this is about as likely as finding an empty cab in a rainstorm, right? Wrong. There are real pros out there to help you. And it is your right to be treated by the best of them. You don’t have to settle for someone who doesn’t meet your standards. In the long run, your time and effort will pay off in sexual success. After all, 90 percent of men with potency problems can be successfully treated. You might as well take advantage of these odds by getting help from the best.

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The fact that erection is crucial to many men is supported by interviews with the wives and girlfriends of some men with potency problems. Many of these women are very specific about their partners’ changes in behavior and attitude. Typically, they found their husbands became depressed and very pessimistic when they couldn’t get or keep an erection. Some say this negative attitude extended to work and even to such things as trying out new restaurants. Sometimes, out of desperation, a man would tell his wife to get a boyfriend. And sometimes just the opposite happened. Some men became extremely jealous when their wives had innocent social contact with other men, even though such extreme possessiveness had never before been a problem in the relationship. It was very common for the man to withdraw, physically and emotionally. And some women report—with pain—that their man rejected them point-blank when they tried to hug, kiss or just touch him.

This behavior is an unnecessary tragedy. A man who sees his self-worth measured in his penis is selling himself short. He’s setting himself up for emotional trouble, because the odds are that sooner or later his erection will not come up to his expectations. For some this will be a momentary problem; for others it will develop into a chronic condition requiring professional treatment.

Not all men, of course, fall victim to such a restricted self-image that ties their penis to their self-worth. One man explains that he saw his erection problems as just another difficulty to be resolved, and he matter-of-factly compares his implant to the eyeglasses he wears. With this positive attitude, he accomplished his goal with much less anguish than many other men experience.

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It used to be that emotional connections were nurtured before a commitment led the way to marriage and sex. Today, to a large extent, just the opposite is true. Oftentimes, sex is at the starting gate of an encounter, with the possibility of an emotional connection growing from it. But there is an entire other world of intimacy, one that requires attention and nurturing. Doing so will provide the foundation for a stronger connection. Grounded in mutual affection and respect, it can then grow into a fully developed relationship.

Building—and maintaining—a long-lasting, satisfying partnership demands a commitment of time. But no matter how a relationship progresses, sex is a subject that a couple will have to return to over and over again. As part of the foundation of a solid bond between two people, it can function magnificently, bringing increased joy to and trust between the couple. As the sole pillar of a faltering marriage, it can be a weak link, at best. In between these two standards is an entire universe of experiences, unique to each couple.

With a new drug intervention at hand supplying the power to alter sexual compatibility, it’s time to look at how men and women are reacting to this development. To a large extent, they are at a psychological crossroads in their lives.

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Routine maintenance for the human body can help prevent many of life’s unpleasantries, and just as women have health concerns that should be addressed

in regular doctor visits, so do men. For men, those concerns include blood pressure, cholesterol levels, the health of their hearts, their activity levels, and as they reach middle-age and late-life years, specific tests to detect prostate cancer, colon/rectal cancer and heart disease.

In addition to an electrocardiogram or heart stress test, blood pressure monitoring, cholesterol blood test, immunization, and counseling and discussion, which all follow the same guidelines as women’s checkups described earlier in this chapter, men should also perform a monthly testicle self-examination for soreness, lumps and swelling. Starting at age 40, men should also have a digital rectal exam— a physical exam of the rectum and prostate to detect signs of cancer or prostate disease—every year.

Doctors recommend that men between the ages of 20 and 40 should perform a self-examination of their testicles about once a month to look for lumps or swellings that may indicate cancer. Self-examination (in addition to your doctor’s periodic examinations) is important because testicular cancer, which is the most common cancer in young men, is one of the most easily curable of all cancers if detected early. The best time to perform the examination is during or after a bath or shower when the scrotal skin is relaxed. Here’s what to look for:

1) A lump in either testicle.

2) Pain, swelling or tenderness of either testicle.

3) Ulceration of the scrotal skin.

Here are the steps involved in the self-examination procedure:

1) Standing in front of a mirror, look for obvious lumps or swelling of the scrotal sac.

2) Examine each testicle thoroughly and gently with the fingers of both hands by rolling the testicle between the thumbs and the fingers. Feel for any lump or abnormality in texture or contour. A normal testicle is oval and firm, but not hard, and has a regular surface.

3) Locate and identify the epididymis at the top and back of the testicles (the ropelike structure which collects the sperm). The structure may feel firm but should not be confused for an abnormal lump. Consult your doctor if it is tender or swollen.

Other danger signals to report immediately include a heavy feeling in the testicles, a dragging sensation in the groin, or a sudden accumulation of blood or fluid in the scrotal sac.

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Diabetes is a wide-spread disease that effects more than 11 million Americans. Diabetes comes in two forms — both with a major symptom of excessive urination. Diabetes Mellitus is by far the most common form and about 1/2 of all sufferers do not know that they are diabetic.

A diabetic person cannot make normal use of sugar. The kidneys discharge some of the excess sugar into the urine. Severe cases of diabetes also cause problems with the use of fats and proteins.

Diabetes cannot be cured. The serious form (Type I) requires that the patient take insulin. About 80% of diabetic cases are of Type II, these cases can often be controlled by diet alone. Diabetes can lead to blindness, kidney failure, nerve troubles, and circulatory problems.

Recent research has shown several ways for Type II diabetics to help control this disease and its effects. There are 3 major aspects for controlling diabetes: nutrition, exercise, and weight control. Some diabetics have eliminated many symptoms by following a careful plan worked out with their doctor.

The American Diabetes Association has determined what the best diet is for diabetics. Of course each person’s diet must be tailored to his or her particular lifestyle. No diet should be undertaken without consulting a doctor.

(1) The ADA recommends that a Type II person’s diet provide 50 to 60 percent of his or her calories from carbohydrates.

(2) Cut your fat intake. Try to use foods with polyunsaturated fats.

(3) Limit your intake of protein to 15-20 percent of your total calories.

(4) Eat high fiber food. These include vegetables, barley, oats, whole wheat products, fruit, and legumes.

(5) Cut your cholesterol by limiting your meat intake.

A diabetic should not make any drastic diet changes except under the supervision of a doctor. Make gradual changes, sudden changes could upset your body’s chemistry and cause major problems.

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Balloon angioplasty—surgery to open blocked arteries—is performed on over 280,000 Americans’ each year. While the operation, which brings about unrestricted blood flow by expanding the arteries, is highly successful, it may also damage the vessel walls. And, if the body tries to repair the injury, cells at the site multiply, often creating a new blockage. Recent research at the University Of Washington School Of Medicine may have discovered a way to prevent the new blockages from developing.

Earlier studies have suggested that a natural substance, platelet-derived growth «factor (PGDF), plays an important role in the development of new blockages in angioplasty-repaired arteries. In order to put that theory to a test, researchers first had to find an antibody to PGDF They obtained the antibody by injecting goats with PGDF taken from humans. The goats’ immune systems then produced antibodies against PGDF.

Armed with the PGDF antibody, scientists then performed angioplasty surgery on about 40 rats. The balloon was inflated in an artery, causing damage to the vessel walls—the same thing that happens in human angioplasty. Researchers then injected half of the rats with the goat-produced PGDF antibody. The other rats were injected with a different goat-produced antibody. The results showed a 41 percent reduction in arterial thickening at the angioplasty site in all the rats who had received the PGDF antibody. There was no such reduction in any of the rats who were injected with a different antibody.

Scientists believe that if the PGDF antibody can eventually be successfully applied to humans, they will be making a great step forward in preventing some cases of clogged arteries.

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This type of diet consists of calorie-controlled meals which are made up of a wide variety of low-fat foods. In order for a low-calorie diet to be effective it must provide at least 1,000 calories per day. It should also include a variety of nutrient-rich foods. It’s also essential that good eating habits continue after the initial weight-loss, otherwise the new weight will not be maintained. A low-calorie diet that meets all of the above requirements is highly recommended as a safe and effective means of proper weight control.

Many people think of low-calorie diets as bland and boring and because of that, fall back into old eating habits. Actually, a successful low-calorie diet doesn’t have to be unappetizing or extremely low in calories. The important thing is that you lose weight on the type of diet you will continue to follow, even after you reach your desired weight.

Several ways you can reduce your caloric intake and still enjoy mealtime:

1) Cut down on the serving sizes of (or eliminate altogether) these foods: Meats, including all meat with visible fat, bacon, sausage, salami, and lunch

meat.

Dairy products, including butter, whole milk, cream, most cheeses, and ice

cream.

Other foods, such as fried foods, potato chips, gravies or sauces, sweetened cereals, pastry, candy, chocolate, and beverages with added sugar. You should also limit your daily intake of alcohol to the equivalent of one ounce of 80- proof whisky—12 ounces of beer or 4 ounces of wine— or none at all.

2) Replace the above foods with small portions of the following:

Meat— lean beef, lamb and pork, skinless poultry (except duck or goose) and

liver.

Fish—oily fish such as mackerel, sardines, herring, and salmon or tuna canned in oil. Also nonoily fish, such as cod, haddock and shellfish.

Vegetables— legumes, such as beans (lima, pinto, kidney, navy and soy), and all other vegetables, including potatoes.

Dairy products— eggs, 2% or skim milk, plain low-fat yogurt, and low-fat cheese.

Other foods—Crackers, nuts, dried fruit, bread, unsweetened cereals, pasta, rice, and polyunsaturated soft margarine and vegetable oils.

If you fail to lose weight following the above menu suggestions, then try cutting down on the foods in the above group and increasing your intake of the following:

Meat— all poultry (except duck and goose) with skin removed, and liver.

Fish— nonoily fish such as tuna and salmon soaked in water, shellfish, haddock, and cod.

Vegetables— all vegetables

Dairy products— skim milk and plain low-fat yogurt.

Fruit— fresh fruit and unsweetened fruit juices.

Other foods— bran and whole-grain, pasta, cereals and bread.

Before you modify your menu to accommodate a low-calorie diet such as suggested above, consult your doctor for his or her recommendations.

*61\27\8*

Aspirin May Lead To A 20% Reduction In The Occurance Of Migraine Headaches

A five-year study has shown that minimal doses of aspirin—about 325 milligrams every other day—may lead to a 20% drop in the occurance of migraine headaches among acute migraine sufferers. This information does not mean that migraine sufferers should begin taking aspirin on their own, however. Even in low doses, aspirin is a powerful drug which can cause bleeding in the stomach and aggravate other conditions as well. However, with the guidance of a doctor, many migraine sufferers can try out this new way for alleviating headache pain.

What To Take For A Headache If You Take Aspirin For Arthritis

If you take aspirin for arthritis pain, you should take acetaminophen for headaches and other nonarthritis pain. If you take only aspirin for all those afflictions, you run the risk of overloading your system with anti- inflammatories.

Nasal Spray And Migraines

A new nasal-spray pain reliever, marketed by Mead Johnson Laboratories, offers relief for people who suffer from migraines and post-surgery pain. Stadol, the brand-name drug which has been available for about 15 years as an injectable pain reliever, is now available in a nasal inhaler. The new nasal spray can be administered at home by the patient.

According to Mead Johnson, the new nasal spray can be used when narcotics are not recommended. The drug Stadol is an analgesic and not a narcotic. It is not a federally controlled drug. Ask your doctor for more information about Stadol and the new nasal spray.

Sex And Headaches

The old joke «not tonight dear, I have a headache» isn’t all that funny to the many people who suffer from sex-induced headaches. However, according to a new Danish study, such «post-orgasm» headaches may be just a temporary problem, so be patient.

While headache specialists have long been aware of benign coital headache, or orgasmic cephalgia, knot much is known about why orgasms trigger headaches or the likelihood of recurrences. But the study, which involved 26 people who suffered sex-related headaches, suggests that the discomfort will eventually stop recurring as long as the person also does not suffer tension headaches or migraines.

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One issue that crops up from time to time is the question of the rights of the biological father when it comes to a decision about abortion. This is a difficult and emotive issue for anyone who finds themselves with an unplanned pregnancy, and many women think it’s better to avoid a confrontation altogether by acting on their decision without consulting the partner at all. This is particularly true of pregnancies that result from an extramarital affair or a relationship that is not likely to be longterm.

In other cases it depends very much on the relationship between the partners, and how much each person’s life is likely to change as a result of the decision. Far beyond the issue of who gets the morning sickness, the backache and the labor pains are the longer term questions: Who will have the responsibility for childcare? Who will cope with the reduced income? Who will have to compromise their career plans? As a rule of thumb, the right of each partner to make the decision will be reflected in the answers to these questions.

It’s not just your own contraceptive choices that force you to face your attitudes to sex. People say children grow up so fast that you turn around one day and they are adults, but it’s not until you witness your own child’s development at point-blank range that you realize the truth of this. The issue of a young person becoming sexually active can be a very confronting experience for a parent.

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Contrary to the opinion of some of the critics of pro-choice, abortion is not an ‘easy option’. The initial thought may be a reflex reaction to an extremely difficult situation, but it is rarely a decision that is taken lightly. Women will almost always go through doubts and second thoughts, like Angela. ‘When I was younger I always said to myself that if I ever got pregnant there was no way I would have an abortion. I had seen those films of little fetuses and what happens in an abortion and I couldn’t bear the thought. That was until I got pregnant the last time. I didn’t find out until just after my husband had left me (talk about the almost immaculate conception!) and I already had the other two kids to support on my own. Well, on top of all the hassles with divorce lawyers and custody agreements and so on, it was just unthinkable to have another child to bring up, especially because I wouldn’t be able to work for months; I couldn’t make ends meet as it was. Even though I knew it was the only solution for me, it was still one of the hardest decisions I ever had to make.’

All of the reputable abortion clinics have experienced counsellors to help women decide one way or the other. If the pregnancy is not too advanced, they will usually recommend you delay the decision until you have had time to work through the options.

Anyone who has not faced the dilemma of an unplanned and unwanted pregnancy will find it difficult to imagine what a hard choice it can be. Jane is forty and she had a dreadful time with her two pregnancies, spending three months of the last one in hospital with blood pressure problems. ‘I have no idea where we went wrong with the contraception. We thought we had taken all the right precautions. I agonized about what to do. I wouldn’t have minded another baby, but I just couldn’t bear the thought of going through all that again, not with two little ones at home. When I turned up at the clinic there was some sort of demonstration outside. Protesters were shouting at people going into the building and waving signs and some of them were holding up fetuses in glass jars. It was horrible. As if it wasn’t hard enough! I still sometimes wonder whether it would have been a boy or a girl, and what it would have looked like.’

*53\17\9*

There is a popular myth that if you have an unplanned pregnancy it is the result of irresponsible or illicit sexual activity, or a lack of planning. It’s estimated that in up to a half of terminations, the pregnancy was the result of misunderstanding of the contraceptive method or that method’s failure to work even when it was used properly. Having said that, there is a group of people who don’t make the practical link between heterosexual intercourse and pregnancy, even though they know their biology. The ‘it can’t happen to me’ syndrome is well at work here. There are other women who don’t take their fertility seriously until they have an unplanned pregnancy — the ‘I have done it without protection before and I didn’t get pregnant’ school of thought. It’s easy to be lulled into a false sense of security.

The trouble with withdrawal is that it doesn’t account for the estimated seventy percent of men who produce some fluid before they orgasm, the so-called ‘pre-ejaculate’, and the fact that this fluid can contain enough sperm to result in a pregnancy. Nor does it account for accidental loss of control in the heat of the moment.

*52\17\9*

There are other situations that you think are safe until you have the whole story. Like the fact that diaphragms don’t work in the bathroom drawer. Actually, diaphragms raise an interesting point. There are a lot of women who feel very uncomfortable about touching themselves in the genital area and many who are not familiar with their normal anatomy. Every so often someone asks me to check out a lump they discovered in their vagina, usually when a tampon has been inserted, and the concern» is that it might be something nasty like a cancer. What these women have discovered is their cervix, the bottom end of the uterus, which you can usually feel about a finger-length inside the vagina. Anyone wanting to use a diaphragm needs to know where the cervix is and what it feels like because you have to check that the diaphragm is covering the cervix for it to be effective. It takes a certain degree of familiarity with your body, and even then it can take a bit of practice to get it right.

Family planning experts say that more women need to know about the ‘morning after pill’, more accurately named the ‘panic pill’ because it can be taken up to three days after unprotected intercourse. There are objections in some quarters to this form of contraception, usually from people with a very punitive and judgmental approach to life. Their argument is that if you are not responsible enough to arrange your contraception before you have sex then you should have to suffer the consequences. Although it is not recommended as a routine form of contraception, if intercourse does happen without any contraceptive protection, or if a condom breaks, it is worth knowing about this method because it does reduce the risk of pregnancy. There is nothing exceptional about the ‘pill’ at all. It is simply a regular contraceptive pill which is normally taken once a day as a routine. In the case of a ‘panic’ or ‘morning after’ situation, you take several pills a day for a few days. Your doctor can tell you exactly what to do. It is a high dose, but only over a short time. Some women get nauseated though, so they may need to take something to help. A scare like that is usually enough to make you think about your contraception and adapt it to your needs.

*51\17\9*

Before any sort of sexual interaction with another person, it’s a good idea to find out all you can about sexually transmitted diseases so you can avoid them. Before heterosexual intercourse it is imperative that you know how pregnancy starts, so that if you choose not to have a baby you can avoid that too.

Sharing the responsibility for contraception and choosing what’s right for you and your partner is a part of sexual communication. Contraception means facing your sexuality together and talking honestly about what you want.

There is this myth that it is the responsibility of the woman not to get pregnant. Well, she can only ever be responsible for half of the genetic material that goes to make a pregnancy. This means men taking full responsibility for their own genetic material. One of the important things we need to learn is that, just as good sex takes two people giving each other mutual pleasure, reliable contraception takes two people to talk about the alternatives.

Contraceptive needs change according to your life situation and the state of your relationship. Choosing the type of contraception that suits you at any particular time depends on your age, the state of your relationship, and your future plans. Are you planning a baby in twelve months? Do you want children at all? How old is your partner? Do you have more than one partner?

You need to know how reliable the different forms of contraception are, and exactly how to use them. I am continually astounded at the number of women who take the Pill every day, yet could not tell anyone which one they are on. ‘Oh you know, the one in the gold pack with three different colored pills. I don’t know, I just take it.’

Knowing the pitfalls is part of understanding your contraception; being aware, for example, that if you miss just one Pill, especially near the beginning or the end of the pack, you can get pregnant. The same goes for vomiting it up or, in the case of diarrhea, not giving it time to be absorbed into your system. One interesting new method of contraception that overcomes a lot of these difficulties is the vaginal ring, or ‘the Pill you don’t have to take.’ It is a firm, rubbery ring about five centimeters in diameter that contains (I was going to say, ‘ … is impregnated with’) the same hormones that make up the oral contraceptive Pill. This is inserted into the vagina where it stays for three weeks out of every four and is then replaced. It constantly releases the hormones into the system. If it passes all the scientific tests they are doing, it should prove very popular because it is so easy.

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I worked part-time in an AIDS clinic for four years, so when I started to write this section on AIDS I thought, ‘That will be easy’. I was wrong. When I sat down, surrounded by references and with my head full of information and experiences, I didn’t know where to start, or what to include and what to leave out. So I asked one of my (adult) daughters what she would want to read about women and AIDS in the 1990s. Without hesitation she answered ‘What I and all my friends want to know is what’s happening. How bad is the epidemic? How many women are infected, how did they get infected and how can we prevent ourselves from ever getting infected?’. I’ll try to answer these questions, hoping that it’s also what you want to know.

The public has been provided with more information and education about HIV/AIDS and its prevention than about any other infection, so I won’t go into a lot of detail about it. Information leaflets about all aspects of HIV infection and AIDS are available free of charge at every hospital, doctor’s surgery and health clinic.

I’m sure that you all know that the human immunodeficiency virus (HIV) is transferred from one person to another through body fluids. Once inside the body, HIV invades and multiplies within lymphocytes and eventually destroys them. Lymphocytes are cells that are an essential part of our immune systems. When many lymphocytes are destroyed by HIV, we can no longer fight off infections and some other diseases, resulting in the illness known as AIDS (short for acquired immunodeficiency syndrome).

The HIV/AIDS epidemic

We have known about HIV/AIDS since 1981.

HIV is responsible for a worldwide epidemic that already has claimed many thousands of lives, and that is growing. So far there is no cure for the disease and no vaccine to prevent infection. The AIDS epidemic is very bad news.

AIDS is the most baffling infectious disease of our times. Though present-day research into this disease is more intense than for any other human illness, experts are still grappling with its mysteries and there is still some uncertainty and disagreement about how the epidemic started and why the infection behaves differently in certain groups of people.

One of the many extraordinary features of the HIV virus is that there can be a very long incubation period between infection and development of illness. A person may become infected and remain well for years – possibly up to 20 years. Whether all those infected will eventually develop AIDS is at present unknown.

It is believed that millions of people have been infected with HIV. If this is right, most don’t know that they’ve been infected and are the greatest worry in the spread of the infection and growth of the epidemic. Even when there are no symptoms the virus can be passed on.

Though the biggest ever public-health education campaign has been aimed at stopping the epidemic, there are still many misunderstandings about the infection and how it spreads. One of the barriers to acceptance of the realities of AIDS is that because so far it has been most often transmitted by gay sex or intravenous drug use, many people think ‘it can’t happen to us: it only affects other people who do things we don’t do (and don’t approve of)’.

The education campaign is beginning to break down this barrier. We now know that it is a myth that AIDS is a disease of homosexual and bisexual men who practice anal intercourse, even though in some countries, including Australia, it first appeared in this group. In some parts of Central Africa almost half of the young women and men are infected with HIV. In parts of Southeast Asia the same situation is rapidly developing. The World Health Organisation stresses that transmission through heterosexual intercourse is now the major risk worldwide.

How many Australian women are HIV-infected?

The total number of women carrying HIV is unknown. Of all Australians known to be infected with HIV, less than 1 in 25 are female. Of the cases of AIDS (not just HIV infection) reported so far in Australia, less than 1 in 33 have been female. Of those women infected for whom heterosexual transmission is likely, about nine out of ten had sexual partners known to be infected or at high risk of infection.

In Australia there is now virtually no risk of transmission from blood transfusion. The infection seems set to spread more rapidly now among intravenous drug users. At present, because it is uncommon among heterosexuals, the risk of heterosexual infection seems to be low in Australia, but authorities warn that this is no reason for complacency and that safe sexual hygiene should be practiced by all.

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Why are women prone to cystitis?

The anatomy of our lower urinary and genital systems makes us more liable to infections and other inflammations of the bladder and urethra.

The urethra is the tube through which urine passes from the bladder to the outside. Women’s urethras open onto an area where there are always plenty of bacteria, including those from the bowel and vagina. Some germs live in the lower end of the urethra all the time. These bacteria generally do no harm, but can cause inflammation if they get into the bladder in circumstances that make it easy for them to grow. And because women’s urethras are only about 4-6 cm long, germs don’t have far to travel to the bladder.

In contrast, men’s urethras are around 20 cm long and the skin of the tip of the penis is unlikely to harbour as many bacteria as the skin around women’s genitals. This is one reason why women are more prone than men to bladder infections. Also, after the menopause the linings of the urethra and bladder are more fragile and prone to infection.

Sex and cystitis

A woman’s urethra and bladder base are very close to the front wall of the vagina where they are liable to trauma from friction during intercourse, especially if the vulva and vagina aren’t sufficiently lubricated by sexual arousal before penetration.

Frictional trauma alone is enough to cause inflammation of the urethra. Some germs probably always get into the urethra and bladder during sex, but normal defences usually overcome these. However, if the tissues are also inflamed from frictional trauma, their defences will be down and infection is more likely to get a hold.

Some women are more prone than others to develop urinary symptoms associated with sex. Sometimes problems only happen when sex is repeated frequently over a short time (for example ‘honeymoon cystitis’).

Some unfortunate women develop bladder symptoms just about every time they have intercourse. They come to fear sex, knowing that it’s likely to bring on another attack. The fear inhibits their sexual arousal so that they’re less well lubricated and more likely to suffer mechanical trauma – the beginning of a vicious cycle of sex and bladder problems. This can play havoc with a relationship.

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Fibroids, also called fibromyomata, are benign (non-cancerous) tumours composed of fibrous and muscle tissue that grow in the wall of the uterus. At least one in five women are known to have them and probably many more have small fibroids that cause no problems and are never found.

You can have just one fibroid, but multiple tumours are much more common. They start when some of the fibrous and muscle cells start to grow and divide more quickly than the surrounding tissue, to form small pea-sized nodules within the wall of the uterus. Fibroids grow very slowly: they often stop growing before they reach the size of a golf ball but after growing for years may become as big as a baseball and very rarely, a football: there are some on record that weighed 10 kg! As fibroids grow they enlarge the uterus and distort its shape by bulging from its outer wall or into its cavity. If the uterus has become larger than a baseball you can usually feel a firm lump pushing up behind the pubic bone.

What causes fibroids?

We don’t know exactly, but their growth seems to depend on hormones, mainly oestrogen. Fibroids are rarely found in women under the age of 25 and they stop growing and shrink after the menopause.

What problems do fibroids cause?

Often none, but, depending on their size and position, they can cause any of the following.

• Large fibroids may press on the bladder, reducing its capacity and causing frequent need to pass small amounts of urine. Pressure on the rectum may make it hard to empty the bowel.

The Müllerian ducts can completely fail to join up, resulting in a double uterus, cervix and vagina. More common are partial abnormalities of joining, resulting in varying degrees of septate uterus. However, often the evidence of incomplete joining is no more than an indentation in the fundus and a heart-shaped uterine cavity. Uterine malformations often cause no symptoms and may be discovered by chance. However, they sometimes cause problems with menstruation or pregnancy.

Rarely one or both compartments of the uterus don’t open into the vagina. In this case the uterus will begin to fill with menstrual blood at puberty, and will eventually need removal or a surgical procedure to connect it with the vagina so that the menstrual flow can drain.

The increased endometrial surface area in uteruses with a well-developed septum can be a reason for heavier periods.

Infertility isn’t a problem as long as there is a functioning ovary, a tube that connects with the uterine cavity and a cervix opening into the part of the vaginal where ejaculation takes place.

Some women with these abnormalities of the uterine cavity have no problem will pregnancy or delivery, but in general there is a higher risk of problems than in women with a normal uterus. Some abnormalities can lead to increased risk of miscarriage, often between the fourth and sixth month of pregnancy. The reason may be that the placenta can’t develop properly in the distorted uterine cavity, or because there isn’t enough room for the foetus to grow.

A number of things are essential for a pregnancy to begin:

• there must be sufficient normal sperm in the semen

• sperm must be deposited in the vagina and move upwards through the cervix and uterus to the tube

• the woman must produce a healthy egg (ovum)

• the ovum must enter the fallopian tube and be moved along it

• one sperm must unite with the egg in the outer part of the tube

• the fertilised ovum must travel to the uterus and implant properly in its wall.

Anything interfering with any of these processes interferes with conception. Many things can break the conception chain.

Inadequate sperm production Often no cause for this can be found. Known causes include the testes not having descended into the scrotum; testicular disease that destroys the sperm-forming tissue; a mass of varicose veins, called a varicocele, in the scrotum, which keeps the temperature of the testis too high for sperm production; occupational factors such as working in a very hot environment or with certain other chemical or physical influences (a rare cause); some general health disorders, including a past history of mumps that has affected the testes; some treatments, particularly radiotherapy and chemotherapy for cancer. Excessive smoking and alcohol have been associated with reduced sperm count, and decreasing or stopping smoking and drinking may improve sperm production.

Disorders or disease of the spermatic ducts These ducts are the series of tubes that carry sperm from the testis to the ejaculate. Blockage of the duct system may result from scarring after previous infection, injury or surgery.

Irregular, infrequent ovum production This, or no ovulation, usually goes with a history of irregular, infrequent periods or no periods, though occasionally a woman may have regular menstruation without ovulating. This is basically a problem with the hormones that control ovulation.

Most couples decide to have a baby because it’s the right time and they have a strong desire for children. Some have clear plans about the number and spacing of the children they want. Others just take their chance, accepting each pregnancy as it happens. Some pregnancies result from forgetting to use or failure of contraception. Not all unplanned pregnancies are unwanted: on the contrary, many are greeted with as much joy as if they’d been carefully planned, though it may take longer to adjust to what’s ahead. In the past men have felt left out of child-bearing and child-care when these things were mostly considered ‘women’s business’. But it takes two to make a baby. One good outcome of the new balance in relationships between sexes has been that men now generally take more part than previously in family planning, pregnancy, childbirth and bringing up children. Many fathers now go along to antenatal checks, preparation-for-birth and parenthood classes, and are present during labour and can even participate (such as by cutting the cord) in delivery of the baby. This was unheard of 30 years ago, and would have been unacceptable to parents-to-be and their attendants. But some men still seem unsure about what’s expected of them. If you and your partner can share all your feelings – plans, joys, woes, hopes and fears – about child-bearing and parenting, it must strengthen and deepen your relationship. There are many facets to having children. Most of them are wonderful, both physically and emotionally. Some are not so good. No matter how carefully it was planned, it may be only when pregnancy is confirmed that you face up to the reality of the next nine months and the rest of your life as a parent. This can bring on mixed feelings, doubts and ‘cold feet’.

Can you cope – physically, emotionally, financially – with the changes and responsibilities ahead? How will a baby affect your relationship, your career, your other plans for the future. Will you be a good parent? Have you realistic expectations of what it means to have a family?

Everyone you know will tell you about their experiences with pregnancy, labour and new babies – all of them are different. Your own experience will be different again. You need to balance all the information and advice you’re given. Books, magazine articles, films and TV programmes produced by experienced professionals provide a reliable background for assessing ‘hearsay’.

Condoms for women

These have been developed during the past decade in response to a perceived need for better protection for women against sexually transmissible diseases, especially AIDS. By partly or completely covering the external genitals, female condoms could offer protection against transfer of genital skin infections such as herpes and warts. When these devices become available, women can take total responsibility for their protection if their partners are reluctant to use penile condoms. And, of course, any barrier that prevents genital transfer of bacteria and viruses will also pork as a contraceptive by preventing sperm from entering the cervix. A device called the Femidom is a transparent plastic pouch with a flexible ring inside the upper, closed end and a larger 5 at the open bottom end. You insert nth your fingers, pushing the upper ring behind the pubic bone. During intercourse, the device is kept in place by the outer ring, which tucks around (and covers) the vulva. The manufacturers report that in four years of testing on 1700 en in the USA, Femidom has proved resistant to slipping, tearing or penetration by bacteria, and its pregnancy-prevention rate is comparable to that of the diaphragm. Some unexpected comments during the North American trials include complaints about noise from the crackling of the plastic during use, and praise for increased sexual pleasure from stimulation of the clitoris by the outer ring. The Femidom isn’t yet available in Australia.

Also being tested is the ‘woman’s choice female condomme’ (a blatant tautology!) – a latex vaginal pouch inserted with an applicator – and what may possibly be the ultimate in contraception and disease prevention, the unisex condom garment’ – latex pants with attached crotch sheath that becomes a vaginal pouch or penis cover, depending on who wears it!

How to use condoms

Most condom packs include a sheet of instructions on ‘How to use’. However, because the instructions are in the outer box and not with the individual condom, and because the time of immediate need may not be ideal for going through a list of instructions, it may be useful to repeat the main points here.

• Remove the wrapping carefully, avoiding contact with sharp fingernails.

• Don’t unroll or test the condom before putting it on.

• Press the air out of the teat (or 1 cm at the tip if there is no teat) to make room for the semen.

• Roll the condom onto the erect penis before any genital contact.

• After intercourse withdraw the penis before it becomes too soft, holding the condom around its base so that it doesn’t slip off and so that the semen doesn’t spill.

• If you need additional lubricant, don’t use petroleum jelly (Vaseline), baby oil or any oil-based substance (which might affect the latex and increase risk of breaking): use a water-based lubricant or spermicidal jelly.

• If the condom breaks or comes off during use, consult a doctor or family planning clinic within 48 hours to see if ‘morning-after’ contraception would be advisable.

• Use condoms once only.

• Keep stored condoms in a cool place and check the expiry date before using.

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Perhaps the most common sexual worry for women is that they don’t reach orgasm from intercourse: as already mentioned, 5 to 80 per cent of women (depending on whose statistics are quoted) admit to this.

In the past women have been taught to think that the only ‘right’ or ‘good’ orgasm is one that results from penile thrusting in the vagina. Freud is responsible for this notion, which has now been disproved. An orgasm that follows any erotic stimulation, whether from a partner or masturbation, is just as ‘right’ as one resulting only from penile thrusting in the vagina. However, many men have learnt that women ‘should’ reach orgasm purely from penile thrusting, and feel inadequate (or that there’s something wrong with the woman!) if this doesn’t happen. Many women also want or prefer orgasm during intercourse. Why do so many women find it hard to achieve?

To start with, you must be sufficiently aroused before intercourse begins. Some couples neglect to make sure about this. The clitoris is believed to be the most powerful source of arousal. Then if during intercourse you don’t progress to the plateau stage so that the constricted lower vagina grips the penis, there may be insufficient tension on the clitoral hood and thus not enough stimulation from penile thrusting alone. Less commonly, a woman who reaches the plateau phase may not be able to grip the penis tightly enough because her pelvic-floor muscles have been severely damaged during childbirth.

This problem can be overcome by prolonging foreplay to ensure you’re highly aroused before penetration, and, if needed, by you or your partner providing additional stimulation during intercourse to the clitoris or wherever works best for you. Some women can manage just by finding a position that gives them more genital stimulation. Others do the trick by concentrating on erotic fantasies.

Most of us are shy and reticent about asking for what we want in sex, especially if we’ve been taught that it’s ‘bad’. It can be hard to ask your partner to wait before entry or to provide extra stimulation during intercourse, and so many of us (including our partners) feel so guilty about masturbation that we can’t bring ourselves to do it if anyone else is present, even a lover. Others feel bad about asking for a different position (particularly if it’s less satisfactory for the man) or fantasizing during sex with a partner.

You can’t expect your partner to know instinctively what stimulation gives you pleasure. Most men say that they would like some help and feedback from their partner rather than fumbling ‘in the dark’. You needn’t give verbal directions. You can direct your partner’s hand with yours to where, how and how much stimulation excites you best.

Most women can learn to reach orgasm from intercourse. It’s largely a matter of good communication and a sharing of the joys of sex – the problem is rarely physical. If you have no success from your own efforts, see a sexual therapist.

There’s another problem that can result from lack of orgasm. If you become aroused but don’t proceed to orgasm, resolution won’t be triggered and all the congestion and muscle tension won’t be released. This leaves you feeling uncomfortable, unsatisfied and restless – particularly maddening if your partner is snoring blissfully beside you. If this happens over and over, the build-up of congestion can lead to chronic pelvic discomfort or pain. The cure for this problem is for you or your partner to make sure that you go through the full sexual response cycle after arousal.

A small proportion of women say that they’ve never had an orgasm. Is this a danger to their health or relationships? Opinion remains divided. Some experts feel sure that there are women who are quite satisfied sexually without orgasm. Others state equally strongly that missing out on orgasm is harmful. My opinion is that lack of orgasm is only a problem if it worries you.

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Adolescents are generally under more stress than adults, and they have less experience behind them for coping with pressure. Some young people can take all this in their stride, but many have some pretty rough times.

You read a lot about stress these days, mostly telling you to avoid it. But you can’t avoid it, and not all stress is bad. For example, that nervous tension before an exam or sporting contest can drive you to do better than you would without it. Most of us need pressure to achieve what we want to do.

Bad stress is the constant, prolonged worry or pressure to do things we can’t handle. This builds up to anxiety, which can make you physically and emotionally ill. Anxiety causes the release of too much adrenalin, which can give you a pounding heartbeat, dry mouth, butterflies in the stomach, cold sweats and a panicky feeling that everything is closing in on you. Increased muscle tension can lead to headaches, abdominal pain and backaches. Prolonged anxiety can have more harmful effects when it suppresses the immune system, thus increasing susceptibility to infections and other illnesses, and an increased tendency to accidental injury (because your attention is on your worries and not on taking care).

During adolescence you become aware of the wider world you live in which, compared to the security of childhood, is full of uncertainty, conflict and competition. The media emphasize the bad news. Recession! Crime! Corruption! Disease! War! Riot! Disaster! Everything changes so fast. It’s no comfort that you’re about to enter this chaotic world.

Adolescents are also under pressure from conflicts about what they want and what the rest of the world wants of them. For example, you need to become independent but you also need the support and approval of your parents; the need to express yourself as an individual conflicts with pressure to be one of the gang; the need to compete with your friends may go against your need for them to like you.

Also, you’re getting mixed or confused messages about community values, personal integrity, sex roles and sexuality. Then there’s always the usual hassles with parents, teachers, friends and boyfriends. To top it off, there’s educational pressure and the need to make important decisions about your career. After training you might find your ambition sabotaged by unemployment.

Acupuncture arose from the ancient Chinese philosophy of Taoism. One of it teachings is that healthy life is a balance between two opposing but complementary forces, yin and yang, that influence everything in the world. Yin forces (also called female or negative) are passive am calming, and include moon, earth, darkness, coolness, moisture and stillness Yang forces (male or positive) are aggressive and stimulating, and include sun, sky light, heat, dryness and movement.

Another basic concept of acupuncture is belief in a life force or vital energy, called ch’i, that maintains a healthful balance in living things. Ch’i is believed to circulate in our bodies along precise pathways called meridians. Anything that disturbs the flow, amount or quality of ch’i in the meridians can result in ill health.

In acupuncture, needles are inserted through the skin to stimulate certain points along the meridians so that ch’i energy will be attracted to a deficient area, dispersed from an area of excess and released if the flow is blocked.

Acupuncturists diagnose the imbalances by taking a full health history, making observations (such as skin colour, voice, posture, tongue appearance) and by feeling the pulses.

Acupressure     This is based on the same principles but uses pressure instead of needles over the meridian points.

Shiatsu This Japanese technique uses vigorous massage over the vital points. Shiatsu wasn’t a therapy until the twentieth century: before this it was a home treatment for the relief of pain, muscle tension and fatigue, with the know-how being passed down through generations so that family members could help each other. Japanese children still give their parents Shiatsu to restore energy after a hard day’s work.

The use of plants for healing is as old as history, and herbalism is the parent of modem pharmacology. The majority of today’s drugs were previously used as plant extracts: for example aspirin from willow bark, narcotic analgesics from poppies, digitalis from foxglove. However, now that therapeutic plant chemicals have been isolated and their chemical structure identified, they are often synthesized by pharmaceutical companies because it is cheaper to do so and results in a purer product for more accurate dosage. Plants contain many powerful chemicals that are active in humans and other animals. Some plants contain multiple drugs, and some of these aren’t yet identified – a potential danger when whole plant extracts are used.