Also known as ‘change of life’, menopause is the ending of the menstrual or reproductive cycle in women. It most commonly takes place in women between the ages of 45 and 55. Some stop menstruating suddenly, others experience irregular periods for several years before menstruation ceases altogether.

While menopause is a natural stage of life, there are many problems commonly associated with it, mostly the result of diminishing levels of the female hormone, oestrogen. Some women are troubled by hot flushes, excessive bleeding, vaginal dryness, nervous disorders and depression during the transitional period.

Because the adrenal glands take over some of the functions of the ovaries at this time and produce oestrogen, the proper function of these glands is important for keeping the uncomfortable symptoms to a mimimum. Vitamins B5, C and E, as well as zinc, all boost adrenal activity. The group of compounds known as bioflavonoids may also help during this time to ease both physical and emotional discomfort. Related to Vitamin C, they assist with its absorption and proper functioning in the body. One good source is the pith of citrus fruits but they are also found in vegetables, particularly onions, and in ordinary tea.

All women should exercise regularly and eat a high proportion of raw foods. For hot flushing, take the herb dong quai which possesses the ability to balance hormone levels. This herb is being used by Western women as an alternative to hormone replacement therapy.

Recent research indicates that dong quai, a rich source of both Vitamins E and B12 may also be helpful in the treatment of anaemia and in controlling cholesterol buildup in blood vessels. A naturopath can advise you on the correct dose for your needs.

Avoid the common trap of resorting to tranquillisers to combat depression. Instead try lifestyle changes to lift your mood or learn relaxation techniques to ease anxiety. Active women appear to suffer much less from depression around this time of life. The inclusion of oats in the diet can also help alleviate mild depression.

One of the greatest risks associated with menopause is the gradual loss of bone mass. This condition is known as osteoporosis and can result in fragile bones which fracture easily. Throughout adult life, women should take care to keep their calcium intake high and calcium supplements taken during and after menopause may help.

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Cat scratch fever is caused by a minor scratch or bite from a kitten or young cat. It is caused by a germ – probably a virus – although the cat is not ill. The puncture wound or scratch does not heal in the time expected. One to two weeks later, the wound is still red, sometimes with a small amount of pus. One to six weeks after the incident, the lymph nodes near the wound become swollen, tender, and red. The child has a low-grade fever (37.8°C, oral; 38.3°C, rectal). Eventually the lymph glands may break down and discharge pus through the skin.

Signs and symptoms

The signs of cat scratch fever are a minor cat scratch or bite that hasn’t healed; large, tender lymph nodes; and a low-grade fever. There may be pus in the wound. If you don’t know that your child has been scratched by a cat, it may be difficult to tell cat scratch fever from a wound infected with staph or tuberculosis germs.

Home care

Scrub all cat scratches and bites immediately with soap and water for ten minutes. Then apply an antiseptic. If the wound becomes infected, see your doctor.

Precautions

• Unsupervised play between cats and young children is dangerous to both the child and the cat.

• Do not allow children to tease or torment cats or any other animals.

Medical treatment

Your doctor will rule out other illnesses by blood tests and cultures. Treatment with broad-spectrum antibiotics is occasionally helpful. Cat scratch fever may require surgical incision and drainage or the complete removal of a lymph gland.

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Medical science has proved that “Only the Lonely” is a more accurate selection than “Only the Good Die Young” if we’re trying to pick the true hits on the Grim Reaper’s jukebox.

The lonely, the disenfranchised, the disconnected, those who feel their lives have no purpose-studies show that these are the folks at greatest risk for coming down with a bad case of premature death or life-threatening disease, says Dean Ornish, M.D., president and director of the Preventive Medicine Research Institute in Sausalito, California, and author of Dr. Dean Ornish ’s Program for Reversing Heart Disease.

Amazingly, in a study directed by psychologist Sheldon Cohen, Ph.D., professor of psychology at Carnegie Mellon University in Pittsburgh, people with the most diverse types of social contacts and networks were the least likely to be susceptible to a cold virus intentionally squirted up their noses.

Why does social interaction seem to have a life-lengthening and health-promoting effect?

“Bottom line: Nobody knows,” Dr. Ornish says. What is known, he says, is that “it is the quality, not the quantity of relationships” that matters.

So no one knows for sure why mingling and sharing thoughts and feelings with others is healing. Theories abound. Dr. Cohen and his research cohorts at Carnegie Mellon believe that having a wide range of social environments is distracting-and that’s good. “For example,” Dr. Cohen says, “someone whose only social role is worker will find problems at work more distressing than someone who works, has a family, and belongs to social groups.”

Whether we call it distress or just stress, it truly is a killer, Dr. Ornish says. Much of his program for heart attack patients is devoted to helping them learn to reduce stressful responses. “We know that when people are under stress, their immune systems are impaired and their cardiovascular system is more prone to heart attacks or sudden cardiac death,” he says.

In Dr. Cohen’s study that we mentioned earlier, participants’ blood levels of norepinephrine and epinephrine were measured regularly. These two hormones are released when we are under acute stress. Dr. Cohen’s researchers squirted the common cold virus up the nostrils of all the test participants. Those who became infected were those who had the highest levels of the stress-indicating hormones and were those with the fewest types of social contact. At this point in medical research, however, it is too early to say that we gain the health effects of positive interaction with others because our brains instruct our glands to exude some protective chemicals-or our brains emit specific electrical impulses-that strengthen our immune systems, Dr. Ornish says.

Dr. Ornish and colleagues have implemented and studied the effects of programs “that increase the sense of connection and community, and we have found that the patients initially think that this is the part of the program that will be least helpful. And yet when they have gone through the program, they find that it is the most powerful and meaningful part.” That’s because the peer interaction encourages people to stick with positive helpful behaviors, such as healthy diets, ceasing smoking, and other goals the programs set forth for the patients, Dr. Ornish says.

“People who feel lonely and isolated are more likely to smoke, abuse other drugs or alcohol, eat too much, work too hard, or watch too much television as ways of numbing, distracting, or killing the emotional pain that they feel. I think the real epidemic in our society is this emotional or psychological or spiritual heart disease-this sense of loneliness, isolation, and alienation that’s so common when people feel that sense of disconnection,” says Dr. Ornish. People in the throes of that epidemic are more likely to engage in behaviors that increase their risk of premature death or disease, he says.

So how does one get connected? First, says Dr. Ornish, realize that there is a difference between being alone and being lonely.

“It’s not how many people you call every week or how many people live in your household,” says Dr. Ornish. “It’s not so much the number of social contacts you have but the perception of whether you feel loved and cared for and nurtured by them. Someone could be alone by choice-in a monastery, for example-and they can also feel that sense of interconnection with something spiritual.

“It doesn’t necessarily have to be another person,” adds Dr. Ornish. “Some studies show that even having a plant to take care of, or a pet, prolongs life. Anything that takes us outside of the belief that we are separate and only separate, I think, is healing. The word healing even comes from the root ‘to make whole.’”

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Money spent on screening obviously has to come from somewhere and often it is diverted from curative services. This is all very well for those whose diseases are picked up early and successfully treated but what about those who are not treated for diseases only identified later? This raises all kinds of moral dilemmas for the medical profession and for society as a whole.

Next, it is worth considering the emotional, social and occupational harm done to people who think they are healthy but who are subsequently labelled ‘ill’ as a result of a screening procedure. Labelling someone with a disease has profound effects on his or her life. This would not be so bad if doctors could be sure of their labels but they often cannot because such labels are difficult to apply. Doctors disagree profoundly, for example, over significant levels of raised blood pressure, cholesterol and many other apparently straightforward parameters of body function. This means that one doctor will expend time and his or her patient’s emotions investigating further a laboratory result which another would consider ‘normal’. And none of this takes into account the false positives and false negatives that occur in any screening programme and which cause worry and complacency respectively. So it can be clearly seen from all this that simply detecting disease early is not necessarily enough. A World Health Organisation Report, recognizing this as a real problem, says the following about screening programmes:

1.    They must lead to an improvement in end results in those in whom a diagnosis is made (or in those around them in the community).

2.     The therapy for the condition must have a favourable effect on its normal course-not simply bringing forward the date of the diagnosis but improving survival or function (or both).

3.     There must be sufficient health services to ensure that diagnosis raised at screening can be properly confirmed and to provide meaningful medical care for the person.

4.     People who have been diagnosed as having an abnormality must be prepared to go along with medical advice about what to do about it, or the whole procedure is a waste of time.

5.     The long-term beneficial results must outweigh the long-term disadvantages.

6.      The procedure must be cost-effective.

7.     The problems produced by the disease that is being screened for must be large enough to make it worth while doing all the above. Clearly an extremely effective and cheap screening method for a trivial condition, however common, would be difficult to justify.

Having now injected a note of caution into the subject of health screening, we can ask what is worth doing in a preventive health context. Opinions vary, as you would expect, but there is little doubt that it is worth screening for the following seventeen conditions:

1.    Abnormalities of growth and development in children.

2.    Hearing loss.

3.    Visual problems (acuity, squint, glaucoma).

4.    Scoliosis (curvature of the spine).

5.    Cardiovascular risk factors: hypertension, hyperlipidemia (high blood fats), diabetes, sedentary lifestyles, smoking and obesity.

6.    Cancer (cervical, breast, large bowel, testicular).

7.    Anaemia.

8.    Kidney disease.

9.    Sexually transmitted diseases (syphilis and gonorrhea).

10.    Menopause problems.

11.    Alcohol and drug abuse.

12.    Various diseases of the chest other than lung cancer.

13.    Various conduction and rate abnormalities of the heart.

14.    Sickle cell trait in the black population.

15.    Rubella immunity in females.

16.    Phenylketonuria in newborn babies.

17.    Hypothyroidism in newborn babies.

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