Author Archives: Dr Colin Holloway

Can beetroot really improve athletic performance?


Can beetroot really improve athletic performance?

Published: February 9, 2023 10.16am AEDT


  1. Evangeline MantziorisProgram Director of Nutrition and Food Sciences, Accredited Practising Dietitian, University of South Australia

Disclosure statement

Evangeline Mantzioris is affiliated with Alliance for Research in Nutrition, Exercise and Activity (ARENA) at the University of South Australia. Evangeline Mantzioris has received funding from the National Health and Medical Research Council, and has been appointed to the National Health and Medical Research Council Dietary Guideline Expert Committee.

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Beetroot is gaining popularity as a performance-enhancer for athletes and those wanting to gain a competitive advantage in running and cycling.

Some people juice beetroot, some eat it, others mix up a drink from the powdered form. But will it make a noticeable difference on how quickly we run a race or cycle up a hill?

Small benefits for some

A large systematic review in 2020 included 80 clinical trials, in which the included studies had participants randomly assigned to consume beetroot juice or not. It found consuming beetroot juice provided performance benefits for athletes.

In sports where every second or centimetre counts, this can be a significant improvement. In a 16.1 kilometre cycling time trial the gains linked to beetroot consumption were equivalent to 48 seconds.

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But when the authors analysed subgroups within these studies they found beetroot juice wasn’t effective for women or elite athletes – though this could be because there were too few study participants in these groups to draw conclusions.

Man runs
Beetroot juice may provide a small performance benefit. Ketut Subiyanto/Pexels

Another large systematic review in 2021 of 73 studies that looked at endurance athletes (who run, swim or cycle long distances) found similar results. Supplementation with beetroot (and other vegetables rich in nitrate) improved their time to exhaustion by an average of 25.3 seconds and the distance travelled by 163 metres.

This improvement was seen in recreational athletes, but not in elite athletes or sedentary people. This analysis didn’t look specifically at women.

What is it about beetroot?

Beetroots are rich in nitrate and anthocyanins. Both provide health benefits but it’s primarily the nitrates that give the performance benefits.

Once ingested, the nitrate is converted in the mouth by the local bacteria into nitrite. In the acidic conditions of the stomach, the nitrite is then converted to nitric oxide, which is absorbed into the bloodstream.

Nitric oxide dilates blood vessels, which delivers oxygen more quickly to the muscles, so energy can be burned to fuel the exercising muscles.

The result is that less energy is used for performance, which means it takes longer to tire.

Read more: Why nitrates and nitrites in processed meats are harmful – but those in vegetables aren’t

How can I use beetroot juice?

The Australian Institute of Sport (AIS) has assessed beetroot and classified it as a Group A supplement. This means there is strong scientific evidence for use in specific situations in sport.

The AIS advises beetroot supplementation can be beneficial for exercise, training and competitive events that lasts 4–30 minutes and in team sports with intermittent exercise.

For performance benefits, the AIS advises the beetroot product (be it juice, powder or food) should have between 350–600mg of inorganic nitrate in it. Check the label. There are several concentrated juices available on the market.

Beetroot contains about 250mg per 100g of nitrate, so you need to consume at least 200g of baked beetroot to get the same effect.

Roasted beetroot and garlic in a pan
You need to consume a large portion of beetroot to have the same effect. Shutterstock

To give the nitrates time to be converted to nitric oxide and absorbed into your bloodstream, you need to consume the product 2–3 hours before training or competition. You may get added benefits drinking beetroot juice for several days leading up to training or competition.

However, don’t use antibacterial products like mouthwashes, chewing gums or lollies. These will kill the bacteria in your mouth needed to convert the nitrate to nitrite.

Are there any downsides?

Your urine will turn red, and this will make it difficult to determine if you are dehydrated. Your poo may also turn red.

Some people may experience an upset stomach when consuming beetroot juice. So try drinking it while training to determine if you have any problems. You don’t want to find this out on competition day.

What about nitrate from the rest of your diet?

While it’s difficult to consume enough nitrate to boost your athletic performance directly from vegetables before an event, consuming five serves of vegetables a day will help keep the nitric oxide levels elevated in your blood.

Vegetables higher in nitrate include celery, rocket, spinach, endive, leek, parsley, kohlrabi, Chinese cabbage and celeriac. There isn’t clear evidence about the effect of cooking and storage on nitrate levels, so it’s probably best to eat them in the way you enjoy the most.

However, it’s best to avoid cured meats with added nitrate. The additive is used to stop the growth of bacteria and adds flavour and colour, but the resulting sodium nitrite can increase the risk of cancer.

While beetroot may give you a small performance boost, don’t forget to tailor the rest of your training as well. Ensure you have enough carbohydrates and protein, and that you drink enough water. You may need to consult an exercise scientist and an accredited practising sports dietitian to get the best outcome.

Devastating, horrific – the jab’s true effect on mothers-to-be

-From the beginning of the vaccination roll out, I witnessed hormonal changes in my patients, and mentioned my concerns to other doctors I know, including a specialist I have known for a long time, and trust. The reply I invariably got was “where is your evidence? ” and ” follow the science” A gynecologist/Obstetrician working at PA hospital was sacked because he publicly voiced these same concerns. A patient of mine told me on Tuesday that her pregnant daughter was made to have the Covid vaccine otherwise she could not receive obstetric care. Read the article below, and ask – where is the outrage? do we just accept this? Has anyone been held accountable for these terrible decisions?

Devastating, horrific – the jab’s true effect on mothers-to-be

BySally Beck

March 20, 2023

DR James Thorp is an expert in high-risk and maternal foetal medicine. He has watched in horror, but thankfully not in silence, over the last two years as stillbirths, miscarriages and menstrual abnormalities have increased to numbers not experienced by women in recent history.

He is convinced that the novel mRNA Covid vaccinations have caused these catastrophic events and describes administering the shots to pregnant women as an ‘egregious violation of ethics’. He added: ‘We have never ever broken the sacrosanct golden rule in pregnancy of not administering novel substances to pregnant women since we learned our lessons from the past. [Thalidomide and diethylstilbesterol (DES). For more detail, see my analysis here.] There was never any safety data for the Covid vaccines so I can only conclude that this was a fait accompli.’ (See my analysis here.)

The figures he presents, distilled from US government information provided by its Vaccine Adverse Event Reporting System (VAERS), are shocking.

In addition, a leaked email from one of the largest hospitals in California, dated September 2022 and shared with TCW, was sent to 200 nurses working in their neonatal wards. It confirmed the phenomenon. The subject line said: ‘DEMISE HANDLING’ and it stated that: ‘It seems as though the increase of demise patients [babies] that we are seeing is going to continue. There were 22 demises [stillbirths and foetal deaths] in August [2022], which ties [equals] the record number of demises in July 2021, and so far in September [2022] there have been 7 and it’s only the 8th day of the month.’

Registered nurse Michelle Gershman, who works in the neonatal ward and has had her $5,000 bonus withheld for voicing her concerns, said she had noticed the increase. She said: ‘We used to have one foetal demise per month. That rose to one or two per week.’

Her experience, and the experience of doctors working with pregnant women, is contrary to official ‘safe and effective’ observation and advice, but no one was free to speak out because of a gagging order imposed in September 2021 by the American Board of Obstetrics and Gynaecology (ACOG).

Seven months earlier, in February 2021, Dr Anthony Fauci, former chief medical adviser to the US President, stated publicly that he had seen no red flags in the 10,000 women who had received the experimental Covid jab.

At the beginning of the rollout, in December 2020, pregnant women who were healthcare workers or deemed to be at risk from Covid began receiving the shots. By May 2021, the vaccine was being recommended to all pregnant American women, despite the fact that none of the vaccine manufacturers had completed reproductive toxicology reports in animals, and none had started clinical trials in pregnant women.

Two months later, hospitals noticed a huge increase in miscarriage, stillbirth, preterm births, pregnancy complications and menstrual abnormalities.

Dr Thorp and six colleagues, including the heart specialist Dr Peter McCullough, a witness to the increase of heart problems in newborns, compared VAERS reports post Covid vaccination with adverse events reported in pregnant women who had received the flu vaccine. The results are devastating:

·       1192 x higher rate of severe menstrual abnormalities;

·       57 x higher rate of miscarriage;

·       38 x higher rate of foetal death and stillbirth;

·       15 other major pregnancy complications exceeding the regulator’s safety threshold.

One of the most distressing menstrual abnormalities was an increase in incidences of decidual casting, which according to Dr Thorp, may even have occurred in a newborn baby. The decidua is the thick tissue lining the uterus and women were shedding it intact. It is a painful, distressing experience characterised by huge clots or the decidua detaching in one piece. Fewer than 50 cases had been recorded in 100 years then suddenly, in a seven-month period in 2021, 292 experienced this ‘rare’ event (which thankfully has no long-term effects).

Miscarriage and stillbirths were recorded in Pfizer’s post-marketing documents which show that they had received reports of 274 pregnancy adverse events. More than a quarter, 27 per cent, were considered serious.

Pfizer’s carnage list included premature birth with neonatal death, spontaneous abortion with intrauterine death, and rupture of membranes. They reported 19 cases in the first trimester, one in the second and two in the third trimester.

Michelle Gershman also noticed a rise in pre-eclampsia, a potentially dangerous complication characterised by high blood pressure which can lead to seizures and in rare cases to fatal consequences.

Experts are arguing about whether or not these figures are accurate, but our Office for National Statistics show that stillbirth figures increased by 199 in 2021 compared with 2020 (the height of Covid infections). They also said that the stillbirth ‘rate was above the five-year average in seven months of 2021’. No official figures are yet available for 2022.

It was April 2021 when pregnant British women were given the ‘green light’ to receive the Pfizer or Moderna mRNA jabs at any stage in their pregnancy.

Gershman said she began checking the notes of women losing their babies, some as late as 36 or 37 weeks (full term is 40 weeks). A pattern emerged as she noticed many had received their jabs or boosters a week earlier. Few mothers joined the dots and vaccinated consultants did not consider Covid injections as causation, so no alarm was raised.

Dr Kimberly Biss did not ignore what she saw in her private practice. A certified obstetrician-gynaecologist in Florida for almost 30 years, she said: ‘Back in 2021 we saw a significant increase in miscarriage in babies under 20 weeks usually occurring in the first trimester. I started keeping track, when I compared my data, miscarriages were doubling each year. In 2020 women (data analysed and confirmed by scientist Dr Jessica Rose) experienced 4 per cent losses, 8 per cent losses in 2021, 15 per cent losses in 2022. Miscarriage rates in our practice are currently 25 per cent.

‘Clinically I’ve never had a 10-15 per cent miscarriage rate, we normally see around 4 per cent although textbooks will tell you that 10-15 per cent is normal.

‘Ironically 2020 was the year when Covid, the disease, was at its worst. We had Alpha slowly turning into Delta, but we weren’t seeing the mishaps until the following year after they started the injections.

‘The number of newly registered pregnant patients is also going down year on year which may be a reflection of infertility.’

Anecdotally, in the UK, midwives are seeing women who have suffered multiple miscarriages post-vaccination, thin umbilical cords, clots in umbilical cords, placentas delivered in ribbons – the placenta is normally dark red and spongy, delivered as a healthy-looking disc. They say babies are failing to thrive and that double the usual number are being admitted to intensive care.

In the US, Michelle Gershman says that the neonatal intensive care unit in the hospital where she works also has double the number of babies. ‘There are generally 40 to 50. In March, we have 80.’

For speaking out Dr Thorp, 69, has come under threat. This is despite the fact that he has 44 years obstetric experience, has published 200 peer-reviewed clinical research papers, seen around 25,000 high-risk pregnancies, has received awards for his research and has served on the board of directors for the Society for Maternal Foetal Medicine and as an examiner for the American Board of Obstetrics and Gynaecology, an organisation now chastising him.

On December 7, 2022, he testified in the Senate with Senator Ron Johnson and others about the devastation affecting pregnant mothers.

Recently, Dr Thorp has focused his research efforts on the Covid-19 pandemic and has published more than 15 peer-reviewed scientific publications and a book documenting the dangers of the vaccine in women of reproductive age and in pregnancy. Nevertheless, his heroic efforts are falling on deaf ears and pregnant women are suffering indescribable grief.

Below is a full analysis of pregnancy Yellow Card reports made to the MHRA in the UK.

Miscarriages: 842; Pregnancy conditions: 1,234; Stillbirths and foetal deaths: more than 25. Underreporting is approximately 10 per cent according to MHRA, so add a nought for more accurate numbers.

A request for comment on the above information was sent to the Royal College of Obstetricians and Gynaecologists. Their spokesperson responded: ‘I’m struggling to understand exactly what you’re asking for here but hope this link helps. We’ve published our position on covid-19 vaccines here.’

The MHRA and US Centers for Disease Control have not yet responded to requests for comment.

ACOG refused to comment but offer advice on informed consent. They say: ‘Respect for autonomy provides a strong moral foundation for informed consent, in which a patient, adequately informed about her medical condition and the available therapies, freely chooses specific treatments or nontreatment. Respect for patient autonomy, like all ethical principles, cannot be regarded as absolute. At times it may conflict with other principles or values and sometimes must yield to them.’



(Data published March 8, 2023)

Below represents reactions experienced, not exhaustively listed. 

People may have reported more than one type of reaction per report.

Pregnancy Conditions – 755 (Pfizer-mono) + <5 (Pfizer-bivalent) + 342 (AZ) + 113 (Moderna-mono) + 9 (Moderna-bivalent) + 15 (Unknown brand) = 1,234 

Miscarriages (Spontaneous Abortions) – 514 (Pfizer-mono) + <5 (Pfizer-bivalent) + 241 (AZ) + 72 (Moderna-mono) + 5 (Moderna-bivalent) + 10 (Unknown brand) = 842 

Stillbirths & Foetal Deaths – 19 (Pfizer-mono) + zero cases but recorded <5 (not zero) fatalities (Pfizer-bivalent) + 6 (AZ) + <5 (Moderna-mono) + zero cases but recorded <5 (not zero) fatalities (Moderna-bivalent) + < 5 cases but zero fatalities noted (Unknown brand) = greater than 25 

Congenital Disorders – 121 (Pfizer-mono) + <5 (Pfizer-bivalent) + 122 (AZ) + 17 (Moderna-mono) + <5 (Moderna-bivalent) + <5 (Unknown brand) = 260 

Injuries Category – Maternal & Foetal Vaccination Exposure During Pregnancy & Breastfeeding – 3,472 (Pfizer-mono) + 35 (Pfizer-bivalent) + 2,007 (AZ) + 928 (Moderna-mono) + 49 (Moderna-bivalent) + 19 (Unknown brand) = 6,510 

Reproductive & Breast Disorders (all ages/sex) – 31,798 (Pfizer-mono) + 146 (Pfizer-bivalent) + 21,015 (AZ) + 5,369 (Moderna-mono) + 91 (Moderna-bivalent) + <5 (Novavax) + 279 (Unknown brand) = 58,698 

Including breast signs and symptoms that include discharge, oedema, pain and swelling, vaginal haemorrhage, premature menopause, post-menopausal bleeding, menstruation with decreased or increased bleeding, uterine, ovarian, cervix, vaginal, vulva and fallopian tube cysts, inflammation, infections, neoplasms (abnormal tissue growth) and other disorders. 

Reproductive & Breast Disorders (10-39yrs – Female) – 20,320 (Pfizer-mono) + 44 (Pfizer-bivalent) + 6,887 (AZ) + 3,071 (Moderna-mono) + 40 (Moderna-bivalent) + <5 (Novavax) + 118 (Unknown brand) = 30,480  

Of which 25,204 reaction types were deemed *SERIOUS = 82.7% 

Reproductive & Breast Disorders (10-19yrs – Female) – 785 (Pfizer-mono) + 82 (AZ) + 69 (Moderna-mono) + 10 (Unknown brand) = 946  

Of which 766 reaction types were deemed *SERIOUS = 81% 

* MHRA definition of ‘serious’ – patient died, life-threatening, hospitalisation, congenital abnormality, persistent or significant disability or capacity, deemed medically significant by MHRA medical dictionary or reporter 

For full reports, see here. 

The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick

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The wellbeing ‘pandemic’ – how the global drive for wellness might be making us sick

Published: February 23, 2023 6.04am AEDT


  1. Steven James JacksonProfessor and Co-Director, New Zealand Centre for Sport Policy & Politics, University of Otago
  2. Marcelle DawsonAssociate Professor of Sociology, Gender Studies and Criminology, University of Otago
  3. Michael SamAssociate Professor of Physical Education, Sport and Exercise Sciences, University of Otago
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Are we in the midst of a wellbeing pandemic? The question may seem curious, even contradictory. But look around, the concept is everywhere and spreading: in the media, in government institutions and transnational organisations, in schools, in workplaces and in the marketplace.

To be clear, it’s not just wellbeing’s infectiousness in public discourse that makes it pandemic-like. It’s also the genuine malaise that can be caused by the term’s misuse and exploitation.

Do you sense, for example, that your wellbeing is increasingly being scrutinised by peers, managers and insurance companies? Are you noticing an increasing number of advertisements offering products and services that promise enhanced wellbeing through consumption? If so, you’re not alone.

But we also need to ask whether this obsession with wellbeing is having the opposite to the desired effect. To understand why, it’s important to look at the origins, politics and complexities of wellbeing, including its strategic deployment in the process of what we call “wellbeing washing”.

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The halo effect

While concerns about wellbeing can be traced to antiquity, the term has emerged as a central feature of contemporary social life. One explanation is that it is often conflated with concepts as diverse as happiness, quality of life, life satisfaction, human flourishing, mindfulness and “wellness”.

Wellbeing is flexible, in the sense that it can be easily inserted into a diverse range of contexts. But it’s also surrounded by a kind of halo, automatically bestowed with a positive meaning, similar to concepts such as motherhood, democracy, freedom and liberty.

To contest the value and importance of such things is to risk being labelled a troublemaker, a non-believer, unpatriotic or worse.

Read more: Wellbeing needs a rethink – and a global outlook is the way to start

These days, there are two main concepts of wellbeing. The first – subjective wellbeing – emphasises a holistic measure of an individual’s mental, physical and spiritual health. This perspective is perhaps best reflected in the World Health Organization’s WHO-5 Index, designed in 1998 to measure people’s subjective wellbeing according to five states: cheerfulness, calmness, vigour, restfulness and fulfilment.

Translated into more than 30 languages, the overall influence of the WHO-5 Index should not be underestimated; both governments and corporations have embraced it and implemented policy based on it.

But the validity of the index, and others like it, has been questioned. They’re prone to oversimplification and a tendency to marginalise alternative perspectives, including Indigenous approaches to physical and mental health.

Individual responsibility

The second perspective – objective wellbeing – was a response to rising social inequality. It focuses on offering an alternative to GDP as a measure of overall national prosperity.

One example of this is New Zealand’s Living Standards Framework, which is guided by four operating principles: distribution, resilience, productivity and sustainability. These new and purportedly more progressive measures of national economic and social outcomes signal societal change, optimism and hope.

The trouble with such initiatives, however, is that they remain rooted within a particular neoliberal paradigm in which individual behaviour is the linchpin for change, rather than the wider political and economic structures around us.

Read more: Beyond GDP: changing how we measure progress is key to tackling a world in crisis – three leading experts

Arguably, this translates into more monitoring and “disciplining” of personal actions and activities. Intentionally or not, many organisations interpret and use wellbeing principles and policies to reinforce existing structures and hierarchies.

Consider how the wellbeing agenda is playing out in your organisation or workplace, for example. Chances are you have seen the growth of new departments, work units or committees, policies and programs, wellness workshops – all supposedly linked to health and wellbeing.

You may even have noticed the creation of new roles: wellbeing coaches, teams or “champions”. If not, then “lurk with intent” and be on the lookout for the emergence of yoga and meditation offerings, nature walks and a range of other “funtivities” to support your wellbeing.

Wellbeing washing

The danger is that such initiatives now constitute another semi-obligatory work task, to the extent that non-participation could lead to stigmatisation. This only adds to stress and, indeed, unwellness.

Deployed poorly or cynically, such schemes represent aspects of “wellbeing washing”. It’s a strategic attempt to use language, imagery, policies and practices as part of an organisation’s “culture” to connote something positive and virtuous.

Read more: Pilates, fruit and Amazon’s zen booths: why workplace wellbeing efforts can fall short

In reality, it could also be designed to enhance productivity and reduce costs, minimise and manage reputational risk, and promote conformity, control and surveillance.

Ultimately, we argue that wellbeing now constitutes a “field of power”; not a neutral territory, but a place where parties advance their own interests, often at the expense of others. As such, it’s essential that scholars, policymakers and citizens explore, as one author put it, “what and whose values are represented, which accounts dominate, what is their impact and on whom”.

Because if wellbeing is becoming a pandemic, we may well need the “vaccine” of critical reflection

The Subversive Wisdom of ‘Old Wives’ Tales’

Letter of Recommendation

The Subversive Wisdom of ‘Old Wives’ Tales’

Women’s care has always depended on women’s sharing stories with one another.

An illustration showing a silhouette of a face against the backdrop of a starry sky. A second silhouette of a face overlaps it, pointing the other direction, with its lips close to the first face’s ear.
Credit…Illustration by Vartika Sharma

By Hillary Brenhouse

March 14, 2023

As a kid, I believed every last old wives’ tale. I was sure that if I read in the dark I would go blind. That if I swam in the lake after a generous lunch I might sink to the bottom. That if I swallowed my bubble gum, the kind that came with a tiny comic strip, the hardened pebble of it would ferment in my stomach for the next seven years, which was a whole lifetime to me then.

In pregnancy I was a child again, vulnerable to received wisdom, desperate for anyone or anything that might show me the way. Through all of it, women considered my belly — how low it hung, how it led the rest of my body around — and declared that I was having a boy. I couldn’t help picturing my young son, until the day, eight months ago, when my baby slid into the tub water and I held her up to the lousy bathroom light.

The imagined divide between “legitimate” knowledge and the stories of women is archaic, older even than the King James Bible, in which Paul advises Timothy to “refuse profane and old wives’ fables, and exercise thyself rather unto godliness.” But the phrase “old wives’ tales” became popular in America in the 19th century, when a nascent medical establishment decided it would dismantle and replace female lay-healing traditions. Midwives, many of them older Black and immigrant women, were the final holdouts in this takeover. They were so thoroughly disparaged by male obstetricians that midwifery was essentially outlawed in the United States.

The physicians condemned the midwives in the name of science. These “old wives,” who educated one another in the evidence of their experience and rarely wrote anything down, were accused of trading scraps of hearsay, a damning indictment. For what could possibly be less credible than a story told by a woman?

As long as I’ve had a body and been confused by it, which is to say forever, I have been guided by women’s stories. Not the fictions that are called old wives’ tales no matter their source, simply by virtue of being nonsense. I’m talking about actual old wives’ tales: women offering counsel based on their encounters with sex and birth and bodily ailments.

It’s necessary to our survival that we tell each other stories.

The first who comes to mind is Gabriella, the Jewish Hungarian aesthetician who waxed my bikini line for the first time, each of my legs draped over one of her soft thighs as she recited remedies for ingrown hairs, bunions, bags under the eyes. Women, drawing on their own lives, told me how to lessen the agonizing endometriosis pain that has been routinely waved away by my doctors. (Coriander essential oil and masturbation, but not together, please.) An older unlicensed midwife advised me during my third trimester, sharing details about the hundreds of labors she’d attended and plants that help to prevent hemorrhage.

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It’s hard to say what’s most fatal about the label “old wives’ tale.” Are we to mistrust the tale because it originated with an old wife, or because stories are inherently unreliable? The idea that first-person storytelling can’t act as a vehicle for authoritative knowledge is well worn. As Melissa Febos writes, “Resistance to the lived stories of women” is “founded on the false binary between the emotional (female) and the intellectual (male), and intended to subordinate the former.”

And yet women’s care has always depended on women’s sharing stories with one another. I’m reminded of it every time I find myself scrolling message boards into the night, searching not just for answers but to feel less alone. There they are, other women who didn’t feel quite right after the loop electrosurgical excision procedure, or LEEP, which removes abnormal tissue from the cervix. Other women wondering if their copper IUDs might actually be responsible for their strange conditions. Others with postpartum hemorrhoids, low libido, long Covid. Women are severely underrepresented in clinical trials and far more likely to have their symptoms dismissed as illusory. It’s necessary to our survival that we tell each other stories, extract their insights and suggest paths toward relief, even when these may lead nowhere.

But frequently they lead somewhere. Long before the development of modern scientific technology, many American midwives, acting on anecdote and observation, engaged in preventive care. Formally trained doctors, meanwhile, embraced rituals, like bloodletting, that were often ineffective when not murderous. As Barbara Ehrenreich and Deirdre English write in their foundational text “Witches, Midwives and Nurses,” these women healers “developed an extensive understanding of bones and muscles, herbs and drugs, while physicians were still deriving their prognoses from astrology and alchemists were trying to turn lead into gold.”

Perhaps the authors of the ill-founded old wives’ tales we swap were operating according to a different kind of wisdom, the kind we aren’t used to recognizing. Swallowing too much gum will indeed block your digestive tract. Reading in low light causes eye strain. It’s worth looking beyond the distinction between science and superstition, toward what else might count as knowledge.

I think about the lessons of my embodied experience as the hair that fell out several months after I gave birth begins to grow back in. Tiny new hairs have sprouted across my scalp — I look as though I were scribbled in a kindergarten class — and every day I stop myself from pulling out the white ones. I know it can’t be true, the story that says if you pluck a white strand, two will take its place. But I remember it, more than any sterile prescription slip I was ever handed. I remember it because it was told — vivid and fantastic and utterly terrifying — to be remembered. And then I avoid the futile work of fighting against my own aging, scribbled self, which is maybe just the remedy the tale intended.

Hillary Brenhouse is a writer based in Montreal and an editor at large of Guernica magazine.

Is menopause making me put on weight? No, but it’s complicated

Is menopause making me put on weight? No, but it’s complicated

Published: March 12, 2023 12.47pm AEDT


  1. Nick FullerCharles Perkins Centre Research Program Leader, University of Sydney

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Nick Fuller works for the University of Sydney and has received external funding for projects relating to the treatment of overweight and obesity. He is the author and founder of the Interval Weight Loss program.

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It’s a question people ask often: does menopause cause weight gain?

Women commonly put on weight as they enter menopause. Research shows women aged 46-57 gain an average of 2.1kg over five years.

But like many things related to weight, all is not what it seems, and the relationship between menopause and weight gain is not straightforward.

Here’s everything you need to know about menopausal weight gain and what you can do about it.

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What typically happens to women’s bodies during menopause?

Menopause marks the natural end of the reproductive stage of a woman’s life. It officially starts when a woman has not menstruated for 12 months, and most women reach menopause between the ages of 45 and 55, but it can happen much earlier or later.

The transition to menopause, however, typically starts four years prior, with perimenopause marking the time when a woman’s ovaries start slowing down, producing less oestrogen and progesterone. Eventually, these hormone levels fall to a point at which the ovaries stop releasing eggs and menstruation stops.

The symptoms associated with the menopausal transition are many and varied, and can include irregular periods, breast pain, vaginal dryness, hot flashes, night sweats, fatigue, difficulty sleeping, and changes in mood and libido.

Read more: How long does menopause last? 5 tips for navigating uncertain times

So does menopause cause weight gain?

The short answer is no. But it’s complicated.

When it comes to menopause and weight, it’s weight redistribution – not weight gain – that is actually a symptom. Research has confirmed menopause is linked to an increase in belly fat but not an increase in overall weight.

This is because the hormonal changes experienced during menopause only prompt a change in where the body stores fat, making women’s stomachs and waists more prone to weight gain. Research shows visceral fat (deep belly fat) increases by nearly 50% in postmenopausal women, compared with premenopausal women.

It’s also important to recognise some menopause symptoms may indirectly contribute to weight gain:

  • sleep issues can lead to sleep deprivation, disturbing the body’s appetite hormones, increasing feelings of hunger and triggering food cravings
  • some mood changes can activate the body’s stress responses, increasing the production of the hormone cortisol, promoting fat storage and triggering unhealthy food cravings. Mood can also impact the motivation to exercise
  • fatigue, breast pain and hot flushes can make physical activity challenging or uncomfortable, also impacting the ability to exercise.
Woman looking at laptop in bed
A lack of sleep can disturb the body’s appetite hormones. Shutterstock

The truth? Ageing is the real cause of menopausal weight gain

You read that right – the weight gain often associated with menopause is a byproduct of ageing.

As the body ages, it stops working as efficiently. It experiences an involuntary loss of muscle mass – referred to as sarcopenia – and fat levels begin to increase.

Because muscle mass helps determine the body’s metabolic rate (how much energy the body burns at rest), when we lose muscle, the body starts to burn fewer calories at rest.

Ageing also means dealing with other health issues that can make weight management more complex. For example, medications can impact how the body functions, and arthritis and general aches and pains can impact mobility and the ability to exercise.

In short – the body’s ageing process and changing physicality is the real reason women experience menopause weight gain.

Read more: ‘Brain fog’ during menopause is real – it can disrupt women’s work and spark dementia fears

It’s not just weight gain

While menopause doesn’t make you put on weight, it can increase a woman’s risk of other serious health conditions.

The redistributed weight that leads to more fat being carried in the belly can have long-term effects. Belly fat that lies deep within the abdominal cavity (visceral fat) is an especially unhealthy fat because it’s stored close to the organs. People with a high amount of visceral fat have a higher risk of stroke, type 2 diabetes and heart disease than people who hold body fat around their hips.

The reduction in the amount of oestrogen produced by the ovaries during menopause also increases a woman’s risk of heart disease and stroke. This is because oestrogen helps keep blood vessels dilated – relaxed and open – to help keep cholesterol down. Without it, bad cholesterol can start to build up in the arteries.

Lower oestrogen can also result in a loss of bone mass, putting women at greater risk of osteoporosis and more prone to bone fractures and breaks.

Woman on yoga mat
Mood changes and fatigue can affect exercise motivation. Shutterstock

The bottom line: can we prevent weight gain during menopause?

Menopause itself does not cause weight gain; it unfortunately just occurs during a stage of life when other factors are likely to. The good news is weight gain associated with ageing is not inevitable, and there are many things women can do to avoid weight gain and health risks as they age and experience menopause.

Start with these six steps:

  1. incorporate daily exercise into your routine, with a mixture of intensities and variety of exercises, including body-strengthening exercises twice a week
  2. stop dieting. Dieting drives up the weight your body will strive to return to (your “set point”), so you’ll end up heavier than before you began. You’ll also slow down your metabolism with each diet you follow
  3. curb your sugar cravings naturally. Every time you feel an urge to eat something sugary or fatty, reach for nature first – fruits, honey, nuts, seeds and avocado are a few suitable examples. These foods release the same feelgood chemicals in the brain as processed and fast food do, and leave us feeling full
  4. create positive habits to minimise comfort-eating. Instead of unwinding in the afternoon or evening on the couch, go for a walk, work on a hobby or try something new
  5. eat slowly and away from distractions to reduce the quantity of food consumed mindlessly. Use an oyster fork, a child’s fork or chopsticks to slow down your eating
  6. switch off your technology for a minimum of one hour before bed to improve sleep quality

Exercise is even more effective than counselling or medication for depression. But how much do you need?

Exercise is even more effective than counselling or medication for depression. But how much do you need?

Published: March 2, 2023 6.06am AEDT


  1. Ben SinghResearch fellow, University of South Australia
  2. Carol MaherProfessor, Medical Research Future Fund Emerging Leader, University of South Australia
  3. Jacinta BrinsleyPostdoctoral research fellow, University of South Australia

Disclosure statement

Ben Singh receives funding from the International Society of Behaviour Nutrition and Physical Activity.

Carol Maher receives funding from the Medical Research Future Fund, the National Health and Medical Research Council, the National Heart Foundation, the SA Department for Education, the SA Department for Innovation and Skills, Healthway, Hunter New England Local Health District, the Central Adelaide Local Health Network, and LeapForward.

Jacinta Brinsley does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.


University of South Australia provides funding as a member of The Conversation AU.

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The world is currently grappling with a mental health crisis, with millions of people reporting depression, anxiety, and other mental health conditions. According to recent estimates, nearly half of all Australians will experience a mental health disorder at some point in their lifetime.

Mental health disorders come at great cost to both the individual and society, with depression and anxiety being among the leading causes of health-related disease burden. The COVID pandemic is exacerbating the situation, with a significant rise in rates of psychological distress affecting one third of people.

While traditional treatments such as therapy and medication can be effective, our new research highlights the importance of exercise in managing these conditions.

Our recent study published in the British Journal of Sports Medicine reviewed more than 1,000 research trials examining the effects of physical activity on depression, anxiety, and psychological distress. It showed exercise is an effective way to treat mental health issues – and can be even more effective than medication or counselling.

Read more: Considering going off antidepressants? Here’s what to think about first

Harder, faster, stronger

We reviewed 97 review papers, which involved 1,039 trials and 128,119 participants. We found doing 150 minutes each week of various types of physical activity (such as brisk walking, lifting weights and yoga) significantly reduces depression, anxiety, and psychological distress, compared to usual care (such as medications).

The largest improvements (as self-reported by the participants) were seen in people with depression, HIV, kidney disease, in pregnant and postpartum women, and in healthy individuals, though clear benefits were seen for all populations.

We found the higher the intensity of exercise, the more beneficial it is. For example, walking at a brisk pace, instead of walking at usual pace. And exercising for six to 12 weeks has the greatest benefits, rather than shorter periods. Longer-term exercise is important for maintaining mental health improvements.

Read more: When it’s easier to get meds than therapy: how poverty makes it hard to escape mental illness

How much more effective?

When comparing the size of the benefits of exercise to other common treatments for mental health conditions from previous systematic reviews, our findings suggest exercise is around 1.5 times more effective than either medication or cognitive behaviour therapy.

Furthermore, exercise has additional benefits compared to medications, such as reduced cost, fewer side effects and offering bonus gains for physical health, such as healthier body weight, improved cardiovascular and bone health, and cognitive benefits.

people running up hill
Exercise is cheaper than medication, with fewer side effects. UnsplashCC BY

Why it works

Exercise is believed to impact mental health through multiple pathways, and with short and long-term effects. Immediately after exercise, endorphins and dopamine are released in the brain.

In the short term, this helps boost mood and buffer stress. Long term, the release of neurotransmitters in response to exercise promotes changes in the brain that help with mood and cognition, decrease inflammation, and boost immune function, which all influence our brain function and mental health.

Regular exercise can lead to improved sleep, which plays a critical role in depression and anxiety. It also has psychological benefits, such as increased self-esteem and a sense of accomplishment, all of which are beneficial for people struggling with depression.

Read more: Let’s dance! How dance classes can lift your mood and help boost your social life

Not such an ‘alternative’ treatment

The findings underscore the crucial role of exercise for managing depression, anxiety and psychological distress.

Some clinical guidelines already acknowledge the role of exercise – for example, the Australian and New Zealand Clinical Guidelines, suggest medication, psychotherapy and lifestyle changes such as exercise.

However, other leading bodies, such as the American Psychological Association Clinical Practice Guidelines, emphasise medication and psychotherapy alone, and list exercise as an “alternative” treatment – in the same category as treatments such as acupuncture. While the label “alternative” can mean many things when it comes to treatment, it tends to suggest it sits outside conventional medicine, or does not have a clear evidence base. Neither of these things are true in the case of exercise for mental health.

Even in Australia, medication and psychotherapy tend to be more commonly prescribed than exercise. This may be because exercise is hard to prescribe and monitor in clinical settings. And patients may be resistant because they feel low in energy or motivation.

Read more: Netflix psychiatrist Phil Stutz says 85% of early therapy gains are down to lifestyle changes. Is he right?

But don’t ‘go it alone’

It is important to note that while exercise can be an effective tool for managing mental health conditions, people with a mental health condition should work with a health professional to develop a comprehensive treatment plan – rather than going it alone with a new exercise regime.

A treatment plan may include a combination of lifestyle approaches, such as exercising regularly, eating a balanced diet, and socialising, alongside treatments such as psychotherapy and medication.

But exercise shouldn’t be viewed as a “nice to have” option. It is a powerful and accessible tool for managing mental health conditions – and the best part is, it’s free and comes with plenty of additional health benefits.

Prostate cancer treatment can wait for most men, study finds

Urogenital & Renal Cancers > Prostate Cancer

I have been promoting this watchful waiting approach for a long time. I am of the opinion that surgeons are just too keen on surgery and do not follow the cautious approach enough. (in other areas as well)

Prostate cancer treatment can wait for most men, study finds

Published March 13, 2023 | Originally published on MedicalXpress Breaking News-and-Events

Researchers have found long-term evidence that actively monitoring localized prostate cancer is a safe alternative to immediate surgery or radiation.

The results, released Saturday, are encouraging for men who want to avoid treatment-related sexual and incontinence problems, said Dr. Stacy Loeb, a prostate cancer specialist at NYU Langone Health who was not involved in the research.

The study directly compared the three approaches—surgery to remove tumors, radiation treatment and monitoring. Most prostate cancer grows slowly, so it takes many years to look at the disease’s outcomes.

“There was no difference in prostate cancer mortality at 15 years between the groups,” Loeb said. And prostate cancer survival for all three groups was high—97% regardless of treatment approach. “That’s also very good news.”

The results were published Saturday in the New England Journal of Medicine and presented at a European Association of Urology conference in Milan, Italy. Britain’s National Institute for Health and Care Research paid for the research.

Men diagnosed with localized prostate cancer shouldn’t panic or rush treatment decisions, said lead author Dr. Freddie Hamdy of the University of Oxford. Instead, they should “consider carefully the possible benefits and harms caused by the treatment options.”

A small number of men with high-risk or more advanced disease do need urgent treatments, he added.

Researchers followed more than 1,600 U.K. men who agreed to be randomly assigned to get surgery, radiation or active monitoring. The patients’ cancer was confined to the prostate, a walnut-sized gland that’s part of the reproductive system. Men in the monitoring group had regular blood tests and some went on to have surgery or radiation.

Death from prostate cancer occurred in 3.1% of the active-monitoring group, 2.2% in the surgery group, and 2.9% in the radiation group, differences considered statistically insignificant.

At 15 years, cancer had spread in 9.4% of the active-monitoring group, 4.7% of the surgery group and 5% of the radiation group. The study was started in 1999, and experts said today’s monitoring practices are better, with MRI imaging and gene tests guiding decisions.

“We have more ways now to help catch that the disease is progressing before it spreads,” Loeb said. In the U.S., about 60% of low-risk patients choose monitoring, now called active surveillance.

Hamdy said the researchers had seen the difference in cancer spread at 10 years and expected it to make a difference in survival at 15 years, “but it did not.” He said spread alone doesn’t predict prostatecancer death.

“This is a new and interesting finding, useful for men when they make decisions about treatments,” he said.

© 2023 The Associated Press. All rights reserved. This material may not be published, broadcast, rewritten or redistributed without permission.

3 Steps to Age Exuberantly


3 Steps to Age Exuberantly

An 86-year-old author has a few rules to live by even when the trials of getting older make it easy to complain.

A photo-illustration with an image of two hands of a senior woman open with palms facing up. She is holding a small garden she's cultivated with birds flying overhead. In the background is a cotton candy colored sky.
Jancee Dunn

By Jancee Dunn

Published Jan. 19, 2023Updated Jan. 23, 2023

A new book came across my desk recently, with an irresistible title: “The Swedish Art of Aging Exuberantly: Life Wisdom from Someone Who Will (Probably) Die Before You.” I was already familiar with the astringent humor of the author, Margareta Magnusson, having read her previous book, “The Gentle Art of Swedish Death Cleaning” — a surprise international best seller and a call to, as she put it, “not leave a mountain of crap behind for our loved ones to clean up after we die.”

I phoned Magnusson, who was an artist before becoming a published author and is now 86 years old, in Stockholm, to get some of her best advice on how to make life worth living, no matter your age.

Magnusson acknowledged that aging is hard. “You cannot stop the passing of time and how it affects your body, but you can work to keep a clear and positive mind,” she said. “You can be young upstairs in your head even if your joints creak.” Here are her top three tips.

Embrace kärt besvär

This Swedish phrase blends kärt, meaning “dear or cherished,” and besvär, which means “pain.” So, one kärt besvär might be paying your bills — an annoying obligation, but you’re still grateful that you have the money to pay. Or, it could be taking care of someone who is sick, which I’ve been doing this week with my flu-addled daughter. When I’m frazzled by her endless requests for streaming service passwords and mugs of tea, delivered via text message, I remind myself that I’m glad I’m strong enough to take care of her.

As you get older, it’s easy to be frustrated and complain, Magnusson said. But kärt besvär helps her to live with joy. “There seems to be no other choice than to see every nuisance as something that I must find a way to cherish,” she said.

What I think Magnusson’s getting at is the idea that it’s OK to lean into your emotions — whatever they might be. Laura Carstensen, a psychologist at the Stanford Center on Longevity, who has studied the emotional changes that occur with age, said, “We find that older people are more likely to report a kind of mosaic of emotions than younger people do.” While younger people tend to be “all positive or all negative,” she said, older people are more able to experience joy “with a tear in the eye,” she added.

Surround yourself with the young

This is Magnussen’s simple definition of happiness: being around young people. Not only do they supply fresh ideas and perspectives, she said, but hearing about their plans and prospects “is a way to stay in tune with the young person you yourself were at some point.”

Spending time with younger people can also benefit your brain, said Vonetta Dotson, a professor of psychology and gerontology at Georgia State University and author of “Keep Your Wits About You: The Science of Brain Maintenance as You Age.”

There is research to suggest that as you age, especially if you’re starting to experience some cognitive decline, socializing with younger people who are mentally sharp can provide the type of stimulation that helps boost cognitive functioning, she explained.

Yet this blending of generations often doesn’t happen, Becca Levy, professor of epidemiology at the Yale School of Public Health and author of “Breaking The Age Code,” said. “Because, unfortunately, there’s quite a bit of age segregation in our culture.”

Break that barrier by keeping your door (and fridge) open for grandchildren, if you have them nearby. Make an 8-minute phone call to a younger relative. Volunteer to read to children at your library, or sign up for an organization like Big Brothers Big Sisters.

And, to keep young people around you, Magnusson writes, “Just ask them questions. Listen to them. Give them food. Don’t tell them about your bad knee again.”

Say “yes” whenever possible

One of the misconceptions about older people, according to Regina Koepp, clinical psychologist and founder of the Center for Mental Health and Aging in Burlington, Vt., is that “they’re rigid and they’ll never change,” she said. “That’s not true. Older people are not more rigid than younger people. Those are personality traits, not age traits.” Yet even older adults have internalized this narrative, Dr. Koepp said, “because they’ve heard it their whole life.”

To age exuberantly, you must actively recognize your “internalized ageism” and fight against it, Dr. Koepp said. Saying “yes” as often as you can, she added, “is in effect saying ‘yes’ to life — being curious and exploratory, being part of community.”

Magnusson told me that the older she gets, the more she can vividly recall the things she has said “yes” to, just when she was on the verge of saying no, and how those experiences have made her life richer. “I’ve found that having a closed mind ages me more quickly than anything else,” she said. Before she refuses something — a dinner, an art show, buying a leather jacket — she asks herself: “Is it that I can’t do it, or I won’t?”

“Give it a try, whatever it is,” she said. “Maybe you’ll go to a party and be the last to leave because you’re having such a good time.” I asked Magnusson when she last shut down a party. “A week ago,” she said.

I think I need therapy. Here are 5 types of psychotherapy to help with almost any mental health problem

Pexels/cottonbro studio

I think I need therapy. Here are 5 types of psychotherapy to help with almost any mental health problem

Published: March 9, 2023 6.07am AEDT


  1. John MalouffAssociate Professor, School of Behavioural, Cognitive and Social Sciences, University of New England

Disclosure statement

John Malouff does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.


University of New England provides funding as a member of The Conversation AU.

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CC BY NDWe believe in the free flow of information
Republish our articles for free, online or in print, under Creative Commons licence.

You have made a momentous decision: you will seek psychological treatment for your depression, anxiety, substance abuse, or other mental health issue.

Your mind then may turn to the question of what type of treatment would best suit you. To even ask this sophisticated question, you need to realise there are various types of psychological treatment. To make a wise choice, you must understand what each type of therapy provides.

Let’s look at several types of psychotherapy (also known as talking therapy) that have the potential to help with almost any mental health problem.

Read more: Think therapy is navel-gazing? Think again

1. Cognitive behaviour therapy

Cognitive behaviour therapy (CBT) is a common type of therapy where the therapist explores the thoughts and behaviours that relate to your therapy goal.

Let’s suppose you have been feeling depressed for months. Relevant thoughts might be that no one likes you and that you are worthless. Relevant behaviours might include staying in your home and avoiding contact with others.

The therapist would likely help you challenge the accuracy and usefulness of those thoughts and find replacement thoughts. The therapist might encourage you to do more for fun and to interact more with others.

Read more: Explainer: what is cognitive behaviour therapy?

2. Acceptance and commitment therapy

In acceptance and commitment therapy, you would instead be asked to accept your negative thoughts as yours (regardless of whether they are accurate) and also accept your negative emotions.

The therapist would encourage you to look at your thoughts and emotions as separate from you so you can examine them more objectively. Acceptance might reduce your negative feelings about yourself.

The therapist would explore your values and encourage you to commit to acting according to them. If you value kindness, for instance, the therapist might encourage you to show kindness to others.

3. Psychodynamic therapy

psychodynamic therapist would help you explore your childhood, searching for traumas and difficulties with your parents.

Woman writing in notebook
Some therapies look deep into your past. Kateryna Hliznitsova/Unsplash

If you felt unloved by your parents as a child, you would consider whether your parents provide a fair representation of the entire world.

You might consider to what extent you deserve love now as an adult. You might also gain insight into how your early experiences colour your current expectations, and affect your emotions and behaviour.

You might find yourself transferring to the therapist your feelings toward your parents and then realise that others are not your parents and you are no longer an unloved child.

4. Narrative therapy

In narrative therapy, you would explore the stories of your life, particularly the stories that seem to persist.

If you were an outsider in school, reluctant to join in social activities, you may think of yourself as a loner. As an adult, even though you engage fully and successfully in social interactions at work, you may continue to think of yourself as a loner.

In other words, the story you tell yourself remains unchanged despite your social success at work, and you feel depressed about being alone.

In becoming aware of the story of your life, you create distance from the story and you may find ways to change the story (the narrative). In essence, you rewrite the story in a realistic way to develop toward being the person you want to be.

Read more: Psychologists are starting to talk publicly about their own mental illnesses – and patients can benefit

5. Person-centred therapy

In person-centered therapy, sometimes called supportive counselling, the therapist would listen attentively, try hard to understand life as you experience it and try to understand and even feel your emotions.

The therapist would show caring and an interest in helping you, in the expectation that you can find your own way to overcome feeling depressed.

Supportive therapists listen attentively and try to understand and feel your emotions. Antoni Shkraba/Pexels

A mix of styles to suit you

You can ask potential therapists what type of therapy they provide. Many will say they are eclectic, meaning they try to choose methods to suit each client and specific problem. They may combine methods of different therapy types.

They may also use popular methods such as mindfulness training that do not fit any specific therapy type. Mindfulness training involves focusing on your breathing and being aware of the here and now.

You can request an eclectic therapist to provide a certain type of therapy or certain therapy methods. Once the therapist gets to know you, you can discuss your preferences and decide on the therapy methods to use.

Read more: Meditation and mindfulness offer an abundance of health benefits and may be as effective as medication for treating certain conditions

How can you decide which one?

You might wonder which type of therapy usually works best. The answer is unclear. Much depends on the specific client, the problem and the therapist.

Most types of therapy work moderately well for treating people with depression. Psychotherapy also appears to be reasonably effective for other types of psychological problems.

CBT has the strongest evidence for treating a broad range of psychological problems (including post-traumatic stress disorder). However, CBT has the most evidence in part because it is heavily studied (for example to treat specific phobias).

Acceptance and commitment therapy is also backed by substantial evidence, as is psychodynamic therapy.

The effects of narrative therapy and person-centred therapy have not been studied so much.

Some people, including those with depression or psychosis, can benefit by receiving psychotherapy and taking medication prescribed by a GP or psychiatrist.

If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14.

Doubling of Hormone Prescriptions Since 2020 Raises Fresh Vaccine Concerns

I knew that the vaccine affected women’s hormones very early on in the Covid epidemic, because my patients reported these hormonal symptoms which I knew could not be normal. I had many blogs on this last year, of which those below are just some of them. My colleagues would not believe me and thought I had an anti-vaccine bias – not true, but these effects could not be ignored and women needed to be warned about the possible consequences of having the vaccine, so that you could at least make in informed decision whether to have it or not. Now it appears I was right all along.;

Covid Vaccine and Women’s Hormones. 9th May 2022

Covid Vaccine effects periods. 17 July 2022.

Doubling of Hormone Prescriptions Since 2020 Raises Fresh Vaccine Concerns


7 MARCH 2023 7:00 AM

A short while back a friend mentioned in casual conversation that she’d been feeling fatigued for a while and had been referred by her GP to a consultant specialising in endocrine function. I suppose most people might have ignored this, but as it happened, when I got home I had a look at the data for the activity of hospital consultants in this field and had a bit of a surprise.

The field of endocrinology is all to do with the way hormones in the body work. The chart above suggests that something significant appears to have happened over the past three years. Intrigued, I popped over to the OpenPrescribing website to see if there had been any significant change in the prescription of drugs related to endocrine function. However, examination of these data didn’t highlight any particular problem for common endocrine disorders such as those associated with impairment of the function of the thyroid gland.

There did, however, appear to be a significant statistical signal for one set of endocrine disorders in the NHS prescription data. While hormones are responsible for regulating a huge number of biological processes in the body, arguably the most common interpretation of the word ‘hormone’ will be with sex hormones. We don’t have data for GP appointments specifically regarding dysregulation of sex hormones, but we can see what drugs they are prescribing – which for women will predominantly mean hormone replacement therapy associated with the menopause.

Female sex hormones

Note that the above data are specifically for prescriptions related to sex hormone dysregulation (principally HRT), and do not include contraceptive pills (which are also related to sex hormones but are included under a different code in the prescriptions medicines database).

This also matches up with an increase in prescriptions related to medications for vaginal and vulval conditions, which are also strongly (but not exclusively) related to the menopause.

Treatment for vaginal and vulval conditions

Has there been a significant rise in women suffering symptoms related to the menopause since the start of 2021? A document issued by the NHS last year on HRT activity in the NHS since 2015 suggests that there was indeed a significant rise in activity that occurred in spring 2021. Figure 2 from that document also indicates that this wasn’t simply more hormones being prescribed, but also that it was affecting substantially more women.

The NHS document suggests that approximately 500,000 additional women had at least one course of HRT over 2021-2022 compared with 2020-2021, an increase of around one third.

The odd thing is, there wasn’t any promotion of the NHS document on HRT in the press at the time – it suffered the usual fate of being hidden away in the metaphorical filing cabinet in the basement. This was doubly surprising as there has been considerable research that indicated the vaccines had an impact on menstrual cycles (see this paper for a review), and it is plausible that such dramatic changes might have some impact on the arrival and severity of the menopause.  There’s certainly been little outrage in the usual online forums on the potential for the vaccines to impact on female fertility. It is almost as if the Government wanted to make sure that no-one was aware of any changes in fertility that the vaccines might be responsible for. I accept that few women become pregnant when close to their menopause, but there is no doubt that the menopause marks the point where women naturally cease to be fertile, and it is also possible that something that changed the onset of the menopause in women in their late 40s might also impact on fertility of younger women (note that this is supposition – it would be useful if there were some research undertaken to investigate this potential effect, but none seems to have been undertaken despite the reduction in the number of births in the U.K. and other countries over the past 18 months).

It must be stated that we don’t have information on the age of the individuals being given sex hormones – it is implied that what we’re seeing is more women who reach the menopause are having sufficiently deleterious symptoms to want to take replacement hormones, but there is little evidence to confirm this. It is certainly possible that there has been an increase in the numbers of women reaching the menopause at a younger age, increasing overall prescription levels. As always, we desperately need more information to fully understand what is going on here.

Way back in 2021 I wrote about the strange and dramatic increase in Yellow Card reports on menstrual irregularities that occurred during April of that year. The most plausible explanation for this was that it followed an article on BBC Radio 4’s Woman’s Hour all about post-vaccination menstrual irregularities where the speakers suggested to listeners that they could make a Yellow Card report if they felt that they’d had side effects following their Covid vaccination. I applaud the Woman’s Hour team for highlighting this problem – physiological disorders relating to sexual function are all too often ‘hidden’ and unfortunately it usually takes this type of targeted encouragement in the media to get individuals to come forward and discuss their problems. Perhaps Emma Barnett might now like to revisit the story from way back then and investigate why there’s also been strange and dramatic increase in women taking HRT in the post-vaccine period. Oh, and while they’re there they could also investigate why this significant change in the health of such a large number of our population has been ignored by Government and why there has been no investigation into what might have caused it. They could also ask their audience to send in reports of the age at which they’re experiencing menopausal symptoms, because it looks like this information isn’t going to come from official sources any time soon.

For completeness, it wasn’t just women that saw changes during that year.  Data for males show a smaller, but still significant increase in the prescription of testosterone supplements over the same time period.

Testosterone for males

It should be noted that the menopause is a significant event for women and that HRT is very much a known treatment; however, men also suffer from increased sex hormone dysregulation with age, but this problem just isn’t discussed as much as the menopause and changes tend to be much more spread out over multiple years. Are there many more men than indicated in the chart above who might have sex hormone dysregulation and who thus might benefit from some medical intervention but who just don’t know how to interpret the signs? 

As an aside, I don’t like to rely too much on strange internet conspiracy theories but one possible link from the Covid vaccines to sex hormonal dysregulation came to light in a recent sting video featuring a Pfizer employee.  In this video the employee claims that he doesn’t understand why Pfizer’s Covid vaccine has had an impact on menstrual cycles and female sex hormones in general. While we should not place too much weight on a single undercover recording, it certainly creaks open a Pandora’s box in terms of who knew what and when…

Amanuensis is an ex-academic and senior Government scientist. He blogs at Bartram’s Folly – subscribe here