Good News

Dr Anne Nixon, a very experienced doctor in integrative medicine, and in using natural hormones, will be joining me here in April, on a part time basis.. She is available for new patients, and others who have trouble in getting appointments with myself.

Dr Anne Nixon

Dr Anne Nixon MBBAO Bch (Ireland) FRACGP

Dr Anne Nixon has worked in general practice for 41 years having come to Australia from Ireland in 1976. She completed her medical degree with honours in University College Dublin, Ireland with a Bachelor of medicine and obstetrics. She completed her internship and registrarship at the Mackay Base hospital and became a Fellow of the Royal Australian college of General Practitioners in 1992. In 1994 she built Pioneer Medical Centre in Mackay and worked in all aspects of General and preventative medicine with six other GPS for the next 40 years.

She is experienced in children’s health, ante natal care, gynaecology, women’s health, insertion and removal of contraceptive implants and pap smears. She is also experienced in skin cancer screening performing excisions and diathermy.

Her special interest is in natural hormone balance in both women and men and has 25 years’ experience in treating menopause in both sexes. She also does Skype menopause consultations all over Australia. She is one of the few doctors in Brisbane with experience in natural HRT and compounded hormones.

She also does coal board and dive Medicals. She has worked for some time in Africa and in Papua New Guinea. Dr Anne is passionate about all aspects of patient care and treats medicine in a holistic way with emphasis on nutrition, mental health and preventative care.  In 2016 she moved to Brisbane to be close to family and grandchildren and looks forward to bringing years of experience to Family Drs Plus in a part time capacity.

Why women get PMS and why some are more affected

Health Check: why women get PMS and why some are more affected

November 19, 2018 1.52pm AEDT Up to 80% of women experience PMS.

Author

  1. Jayashri Kulkarni Professor of Psychiatry, Monash University

Disclosure statement

Jayashri Kulkarni has received grant support for research from: The Stanley Medical Research Institute (Washington,USA),The National Health and Medical Research Council of Australia, Jansen-Cilag, Neurosciences Australia, and the Department of Human Services (Victoria, Australia). She has received honoraria as a speaker for Servier, Jansen-Cilag, Lundbeck, pharmaceuticals and was a past advisory board member for Janssen-Cilag. This article received no funding or support from any source

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Women have been menstruating throughout history. So it’s curious the earliest documented record of what we now know to be premenstrual syndrome (PMS) appeared pretty late in the game. In 1931, psychoanalyst Karen Horney described increased tension, irritability, depression and anxiety in the week preceding menstruation in one of her patients.

Now it’s generally accepted up to 80% of women in their reproductive years experience some PMS. The condition includes symptoms such as fatigue, poor coordination, feeling out of control, feeling worthless and guilty, headache, anxiety, tension, aches, irritability, mood swings, weight gain, food cravings, no interest in usual activities, cramps, feeling sad or depressed, breast tenderness, sleep problems, and difficulty concentrating.

Premenstrual syndrome is different to premenstrual dysphoric disorder (PMDD), which is rarer (only 3-5% of women of reproductive age experience it) and is listed in the diagnostic manual of mental disorders. People who experience PMDD have severe depression which is often accompanied by suicidal thoughts. Their onset and offset usually coincide with the premenstrual cycle. Unlike PMS, the severely depressed mood of PMDD usually comes on suddenly.

Reproductive hormones – oestrogen, progesterone and testosterone – are also potent brain hormones. They influence the brain chemicals responsible for our thoughts, behaviours and emotions. Their amounts fluctuate throughout the menstrual cycle, so the connection between them and mental health is clear. And we are learning more about why some women may be more affected than others.


Read more: Chemical messengers: how hormones affect our mood


Brain chemicals and PMS

There is no single clear theory yet to explain exactly which hormones trigger particular chemicals or why only some women experience PMDD or PMS.

But we know some women are susceptible to mood changes due to small fluctuations in reproductive hormones. In these vulnerable women, small changes in oestrogen and progesterone levels lead to shifts in central brain chemicals (GABA, serotonin and dopamine) that then affects mood and behaviour.

At the same time, many of the physical PMS symptoms such as breast tenderness, bloating, headaches and constipation are a direct effect of reproductive hormones. So both mind and body are affected.

Hormonal changes before menstruation affect both the body and mind. from shutterstock.com

Oestrogen appears to be a “protective” hormone, which can improve psychotic symptoms (such as those common in schizophrenia) as well as depression. Oestrogen directly influences the neurotransmitters serotonin and dopamine to achieve this positive effect.

So depression and other adverse mental symptoms can appear or worsen during phases when oestrogen is low. This happens during the four to seven days before menstruation, and during the transition into menopause.


Read more: Menopausal mood swings can signal more serious mental illness


Progesterones can have the opposite effect. Many women who take a progesterone-only contraceptive pill (the mini-pill) experience depression. There are certain types of progesterone in the combined oral contraceptive pill that can be very depressive.

What about the more severe symptoms?

Recent work suggests PMDD is the result of brain neurochemicals responding in unusual ways to fluctuations in brain oestrogen, progesterone and testosterone, as well as the hormones released by the pituitary gland that determine the levels and fluctuations of these reproductive hormones.

Other studies about the cause of PMDD reveal that a breakdown product of progesterone – called allopregnanolone (ALLO) – is a critical stimulator of a receptor on a part of the GABA transmitter. When stimulated, the GABA system can alleviate anxiety. Benzodiazepine drugs like diazepam (Valium) stimulate the GABA system and help to calm down agitation.


Read more: Weekly Dose: Valium, the ‘safer choice’ that led to dependence and addiction


In this way, ALLO works as an “anti-anxiety” hormone. Just like oestrogen, progesterone levels (and its metabolite ALLO levels) fall in the premenstrual phase.

Women who have PMDD are often agitated, anxious and depressed during the premenstrual phase. A newer theory is that their brain chemistry isn’t reacting normally to ALLO, so they become anxious. This is important to explore further and already new drugs that impact ALLO are being developed and tested.

PMDD is complex, like many mental health conditions, and there is an interplay between psychological and social issues as well as hormonal and neurochemical factors. Tertiary education, supportive relationships, fewer socioeconomic struggles and good physical health appear to be helpful, but do not mitigate PMDD completely. Overall, PMDD appears to be biologically driven.

How can we treat it?

Understanding the body-mind connections in both PMS and PMDD is critical for developing effective management strategies for the many women who suffer from significant depression and other issues every month.

Management options need to consider all aspects of the woman’s life including her work, relationships, past traumas, current physical health and daily demands. Many women experiencing PMDD require hormone treatment and other strategies such as antidepressant medication to help them improve their quality of life.


Read more: Biology is partly to blame for high rates of mental illness in women – the rest is social


It’s a good idea for women experiencing PMDD or PMS to keep a diary of their cycles and moods. Women can be reassured their observations connecting hormones and moods are valid. It is important women with PMS/PMDD seek help from health professionals who will explore specific targeted treatments with them. Above all, it is important to recognise the links between hormones and mental health.

Don’t have time to exercise? Here’s a regimen everyone can squeeze in

Don’t have time to exercise? Here’s a regimen everyone can squeeze in

February 21, 2019 3.25pm AEDT

Author

  1. Emmanuel Stamatakis Professor of Physical Activity, Lifestyle, and Population Health, University of Sydney

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Emmanuel Stamatakis receives funding relevant to this article from the National Health and Medical Research Council (Australia), PAL Technologies (Scotland), and The Human Animal Bond Research Institute (US).

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For those of us who are time poor, high intensity exercise can be incorporated into our daily routines. Shutterstock

Have you recently carried heavy shopping bags up a few flights of stairs? Or run the last 100 metres to the station to catch your train? If you have, you may have unknowingly been doing a style of exercise called high-intensity incidental physical activity.

Our paper, published today in the British Journal of Sports Medicine, shows this type of regular, incidental activity that gets you huffing and puffing is likely to produce health benefits, even if you do it in 30-second bursts, spread over the day.

In fact, incorporating more high intensity activity into our daily routines – whether that’s by vacuuming the carpet with vigour or walking uphill to buy your lunch – could be the key to helping all of us get some high quality exercise each day. And that includes people who are overweight and unfit.


Read more: Health Check: high-intensity micro workouts vs traditional regimes


What is high intensity exercise?

Until recently, most health authorities prescribed activity lasting for at least ten continuous minutes, although there was no credible scientific evidence behind this.

This recommendation was recently refuted by the 2018 US Physical Activity Guidelines Advisory Report. The new guidelines state any movement matters for health, no matter how long it lasts.

This appreciation for short episodes of physical activity aligns with the core principles of high intensity interval training (HIIT). HIIT in a hugely popular regimen involving repeated short sessions, from six seconds to four minutes, with rests from 30 seconds to four minutes in-between.

Among a range of different regimens, we consistently see that any type of high intensity interval training, irrespective of the number of repetitions, boosts fitness rapidly and improves cardiovascular health and fitness.

That’s because when we regularly repeat even short bursts of strenuous exercise, we instruct our bodies to adapt (in other words, to get fitter) so we’re able to respond better to the physical demands of life (or the next time we exercise strenuously).


Read more: Yes, your kids can run all day – they’ve got muscles like endurance athletes


The same principle is at play with incidental physical activities. Even brief sessions of 20 seconds of stair-climbing (60 steps) repeated three times a day on three days per week over six weeks can lead to measurable improvements in cardiorespiratory fitness. This type of fitness indicates how well the lungs, heart, and circulatory systems are working, and the higher it is the lower the risk for future heart disease is.

In fact, research suggests physical activity intensity may be more important for the long-term health of middle-aged and older people than total duration.

Achievable for everyone

The main reasons people don’t do enough exercise tend to include the cost, lack of time, skills, and motivation.

Exercise regimens like high intensity interval training are safe and effective ways to boost fitness, but they’re often impractical. People with chronic conditions and most middle aged and older people, for example, will likely require supervision by a fitness professional.

Walking to and from the supermarket is a good option if it’s not too far. From shutterstock.com

Aside from the practicalities, some people may find back-to-back bouts of very high exertion overwhelming and unpleasant.

But there are plenty of free and accessible ways to incorporate incidental physical activity into our routines, including:

  • replacing short car trips with fast walking, or cycling if it’s safe
  • walking up the stairs at a fast pace instead of using the lift
  • leaving the car at the edge of the shopping centre car park and carrying the shopping for 100m
  • doing three or four “walking sprints” during longer stretches of walking by stepping up your pace for 100-200 metres (until you feel your heart rate is increasing and you find yourself out of breath to the point that you find it hard to speak)
  • vigorous walking at a pace of about 130-140 steps per minute
  • looking for opportunities to walk uphill
  • taking your dog to an off-leash area and jogging for 30-90 seconds alongside the pup.

Read more: Four common myths about exercise and weight loss


This type of incidental activity can make it easier to achieve the recommended 30 minutes of physical activity a day. It can also help boost fitness and make strenuous activity feel easier – even for those of us who are the least fit.

A good start to Monday.

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Seven myths and truths about healthy skin

Seven myths and truths about healthy skin

February 20, 2019 3.07am AEDT Shutterstock

Author

  1. Sara J Brown Professor of Molecular & Genetic Dermatology, Wellcome Trust Senior Research Fellow, University of Dundee

Disclosure statement

Sara J Brown receives research funding from the Wellcome Trust, the Tayside Dermatological Research Charity and the British Skin Foundation and is a medical adviser for Eczema Outreach Support.

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Skin is our largest organ and something we may take for granted when it’s healthy. As an academic dermatologist I frequently hear misleading “facts” that seem to be stubbornly enduring. Here are some of the most commonly shared myths that can be cleared up immediately, and some truths you can rely on.

Skin constantly renews itself

TRUE The skin provides a dynamic barrier between your body’s internal environment and the outside world. Cells called keratinocytes in the epidermis (the outer layer of skin) are constantly dividing to produce a supply of cells that move up through this layer and are shed from its surface. Skin is a rich source of stem cells with the capacity to divide and renew themselves.

A good skincare regime starts with removing dirt from skin. Shutterstock

Drink two litres of water a day for healthy skin

FALSE The amount of water you drink does not directly affect your skin. Water is supplied to the skin by blood flowing through the dermis, the inner layer of skin; water is lost from the epidermis, especially in a dry environment.

Shutterstock

Water is needed to maintain skin hydration and when you become seriously dehydrated your skin appears dull and is less elastic. In a healthy person the internal organs – kidneys, heart and blood vessels – control the amount of water reaching the skin. There is no fixed volume of water that you need to drink, it simply depends on the amounts you are using and losing.

Stress can make skin unhealthy

TRUE There are many health issues in modern life that we blame on stress, but several skin conditions have been shown in scientific studies (see below), to be worsened by life events, possibly via stress hormones including cortisol (a steroid hormone made in the adrenal glands). Notable examples are alopecia areata, an auto-immune condition where the body’s immunity begins to attack the hair follicles, causing hair to fall out; psoriasis, another auto-immune condition that causes skin thickening, scaling and inflammation; and eczema, itchy red skin inflammation often occurring alongside asthma, hay fever and other allergies. Unfortunately a flare up of these skin conditions is exactly what you don’t need when you are feeling stressed or under pressure.

Eating chocolate causes acne

FALSE Acne vulgaris, the common “teenage” acne which can actually persist into your 30s and 40s, occurs as a result of the interaction between hormonal effects on grease glands in the skin, plus the skin’s immune response to blocked pores and microbes living on the skin.

Eating a high fat diet is unhealthy for many reasons, but it doesn’t cause acne. In fact some tablets prescribed for severe acne such as oral isotretinoin are better absorbed when pills are swallowed with a fatty meal – and that could include chocolate.

Washing powder causes eczema

FALSE Eczema is a condition where the skin is dry, itchy and red. It is caused by a combination of genetic factors (how your skin is made) and environmental effects, leading to inflammation. Soap, detergents and washing powders can irritate the skin and contribute to dryness because they remove oil from the skin (just as washing-up liquid removes grease from your dishes). Biological washing powders contain enzymes – proteins that break down fats and other proteins to remove stains – and these can irritate sensitive skin, so they may worsen eczema. It is important that any washing power is thoroughly rinsed out of clothing before it is worn, to avoid skin irritation.

White marks on nails = calcium deficiency

FALSE Nails are manufactured in the nail matrix, an area under the skin at the top edge of your nail. If the matrix is traumatised, bumped or bitten, an irregularity in the developing nail occurs and air can become trapped. This appears as a white mark as the nail grows out. Calcium is important for healthy nails (as well as bones and teeth) but these white marks are not a sign of deficiency.

Sunshine is good for you

TRUE & FALSE Many people have experienced the feel-good factor of a sunny day, but there are good and bad effects of sunlight. Light from the sun includes a mixture of different wavelengths of light: some are visible to the human eye, some are shorter than the colours we can see – these are called ultraviolet (UV) – and some are longer, the infrared. Different wavelengths have different effects on skin.

UVB is used by skin to manufacture vitamin D which is essential for bone health. Without sun exposure this vitamin must be obtained from the diet. Dermatologists use specific wavelengths of UVA and UVB in carefully controlled doses to reduce skin inflammation, a valuable treatment for some skin conditions.

But when the skin is exposed to too much UV it can damage the skin cells’ DNA, leading to uncontrolled growth – the basis of cancer. As a simple rule, unless you have a disease or treatment that suppresses your immune system, sunshine is good for you in moderation, but always avoid getting sunburned.

Keep it simple

The basic principles of keeping skin healthy are mainly common sense. You should wash your skin regularly to remove dirt, but not so much that you remove the essential moisture and water-proofing substances. Use a moisturiser if your skin feels tight or dry – a greasy ointment works best unless you have acne-prone skin, in which case you should use a non-greasy water-based cream. Avoid stress if possible, eat a healthy diet and drink water when you feel thirsty. And finally, protect your skin from too much sun with a hat and clothing or sunscreen.

HRT should be considered as first line therapy for perimenopausal depression

I have been away for the last 2 weeks celebrating 50 years of marriage. Our 4 children 4 spouses, 6 grandchildren were all there for the occasion. My son came from Tokyo to be with us, so it was wonderful to see them all and our friends and relatives. I am back to work next Monday,

BJOG: An International Journal of Obstetrics & Gynaecology banner

BJOG Debate: HRT should be considered as first line therapy for perimenopausal depression Free Access

HRT should be considered as first line therapy for perimenopausal depression: FOR: Estrogens are the first line treatment for perimenopausal women

John Studd First published: 21 April 2016 https://doi.org/10.1111/1471-0528.13922 Cited by: 2Sections

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Perimenopausal women with depression (PMD) suffer the many symptoms of the menopausal transition before the cessation of periods, together with anxiety, poor concentration and loss of libido. These women often have a continuum of depression from an early age with a history of hormone‐related depression of premenstrual depression (PMS) and a history of postnatal depression (PND). The PND then becomes cyclical with the return of periods, becoming worse with age until the mid‐forties. These women are then denied hormone therapy because they are not post‐menopausal. This pattern of depression in women is best called reproductive depression (RD) and cannot be diagnosed or excluded by blood tests because the hormone levels will usually be in the premenopausal range (Studd & Nappi. Gynecol Endocrinol 2012;28:42–5).

Transdermal estrogens are safer than oral estrogens in that they do not carry any extra risk of thrombosis and also have been reported as more effective in the treatment of depression. This should be by patches or gels giving a reasonably high dose using estrogen patches of 100 mcg twice weekly (Soares et al. Arch Gen Psychiatry 2001;58:529–34). A similar dose of gels should be used. There is often a loss of libido and loss of energy at the same time and these women will benefit from transdermal testosterone. Although it is unlicensed in women, it can be achieved by testosterone gel, Testim or Testogel using approximately one‐tenth of the licensed male dose (Studd. Climacteric 2011;14:637–42). Those women with a uterus have to have cyclical progestogen but as these women are progesterone‐intolerant it is justifiable to use a shortened course of Norethisterone, Provera or Utrogestan for 7–10 days each month.

Not all women will have the depression removed by hormone therapy and there will be a case for the use of antidepressants in a few women, but I believe this is second line treatment for these patients who do not respond to the more logical transdermal estrogens. I have tried to arrange a lecture for years at the RCPsych but I am informed that there is no interest in this treatment among senior psychiatrists. Is it a territorial issue? Possibly. Is it a safety objection? This is unlikely as transdermal estradiol is safer than long‐term antidepressants (Smoller et al. Arch Int Med 2009;169:2128‐39). Essentially, the problem is the failure to recognise the hormonal component of perimenopausal depression. This failure leads to an interesting catalogue of explanations: treatment resistant depression (wrong treatment); borderline personality disorder (a familiar DSM V diagnosis); bipolar disorder (it is cyclical after all!); premorbid history of depression (depression also occurred before the current PMD; it was PMS or PND—usually both). Most psychiatrists are not effective when treating depression in women. I hope Michael Craig will be able to instruct them. I have failed.

Disclosures of interests

None declared. Completed disclosure of interests form available to view online as supporting information.

Stem Cell therapy – Beware.

Beware the stem cell clinics mimicking trappings of science

Clinical Ethics Research

If you sign up to a clinical trial, you may think whatever treatment you’re getting has been signed off on by an ethics board and has at least passed some safety and efficacy tests. 

But when it comes to stem cell treatments, you may be being misled. 

In Australia, and worldwide, stem cell treatments have been marketed as a cure for everything from autism to dementia, and websites adopt the language and trappings of science to lead patients into thinking the approach is part of mainstream medicine. 

Some clinics are going so far as to register seemingly legitimate trials on the US government-run database, ClinicalTrials.gov, to recruit customers then charging them thousands of dollars for the service. 

Ironically, the public clinical trial registry was created in 1997 to increase transparency around research, in part by declaring the scope of a trial at the outset in order to prevent modifying the outcomes afterwards. But it is often also used by patients and clinicians to find trials they may be eligible for. 

It turns out this free and relatively unmonitored database can also be a good way of advertising unproven and potentially dangerous treatments under the guise of legitimate clinical research. 

Unlike legitimate research however, these trials demand money for the therapy and often never publish clinical data in peer-reviewed journals, instead choosing to only publicise positive anecdotes.

One of these clinics with registered trials on the government database was behind the high profile cases where three of its patients went blind or had severe vision loss after having stem cell therapy for age-related macular degeneration. 

Clinical trials are just one of the “tokens of legitimacy” that Canadian health law expert Professor Timothy Caulfield says clinics use to portray themselves as being part of the medical establishment and exploit the trust customers have in science and scientific institutions. 

Others include renting space in, or near, universities and hospitals to increase their appearance of legitimacy. 

“The other thing these clinics are doing is using predatory journals to make it look like they’re publishing in this space,” the Canada Research Chair in Health Law and Policy explained. 

“So when you have a website that has a clinical trial registered on it and that looks like they have publications, it becomes really difficult to tease out the real stuff from the fake stuff.” 

Even crowdfunding campaigns are contributing to misrepresentation, according to a study published in the journal, Regenerative Medicine, last week. 

Across 78 different campaigns, which raised around half a million dollars for stem cell treatments, campaigners commonly described the treatment as being part of a clinical trial, sometimes even calling them “government-approved clinical trials”. 

Campaigners often believed their participation would contribute to the scientific literature and benefit thousands of future patients, the authors reported. 

These shoddy practices were under the magnifying glass at the EuroScience Open Forum in Toulouse last week, where experts revealed the tactics clinics are using to manipulate customers into believing the treatments have more mainstream acceptance in the medical community than they really do. 

Hyping up the possibility for cure and downplaying or omitting the risks is commonplace both in the media and in the industry itself.

Professor Ana Iltis, at the US center for Bioethics, Health and Society at Wake Forest University, said one way to describe this was that “stem cell clinics are providing incomplete, slanted and sometimes even false information to get people who are in need of treatment to agree to do something that puts them at physical risk and that costs them a great deal of money”.

“It involves an unfair taking advantage of their need and lack of knowledge, and deceives them for the clinic’s gain.” 

Hair dye is toxic – could natural alternatives be made to work?

Hair dye is toxic – could natural alternatives be made to work?

January 8, 2019 2.20pm SAST Symonenko Viktoriia/Shutterstock

Author

  1. Madeleine Bussemaker Lecturer in Chemical Engineering, University of Surrey

Disclosure statement

Madeleine Bussemaker receives funding from Food Waste Net (BBSRC grant BB/L013819/1) and the Plants to Products Network (BBSRC grant BB/L013797/1).

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University of Surrey provides funding as a founding partner of The Conversation UK.

The Conversation is funded by the National Research Foundation, eight universities, including the Cape Peninsula University of Technology, Rhodes University, Stellenbosch University and the Universities of Cape Town, Johannesburg, Kwa-Zulu Natal, Pretoria, and South Africa. It is hosted by the Universities of the Witwatersrand and Western Cape, the African Population and Health Research Centre and the Nigerian Academy of Science. The Bill & Melinda Gates Foundation is a Strategic Partner. moreRepublish this article

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Do you really know what you’re putting on your hair? Many hair dyes you can buy in the shops or hairdresser contain toxic chemicals that can cause skin problems or even increase the chances of DNA mutations (a potential cause of cancer). As a result (and to save money), many people are turning to supposed natural alternatives, with the internet showcasing a plethora of home-made and plant-based concoctions. Yet very few of these provide much evidence that they colour hair.

My colleagues and I recently conducted research to see if ultrasound, which is used to encourage fabrics to absorb dyes, could also help natural hair colours to be more effective. But while the results were positive, we also found that the treatment – and some of the natural dyes themselves – can also cause hair damage.

Hair dyes work by filling strands of hair with coloured chemicals, which enter through the hair’s pores. In permanent dyes, two types of molecule go through these holes and then react to form a bigger type of molecule that is too large to come out again. Semi-permanent dyes, meanwhile, only penetrate the outer layers of the hair and use chemicals that like to stick to the keratin protein in hair. In both cases, alkaline solutions such as ammonia can help to swell the hair, open up the hair cuticles and widen the pores to improve penetration and enhance the colour.

A huge range of natural products are recommended online for covering grey hairs, creating highlights or even changing the entire hair colour. Suggested substances include coffee, tea, beetroot, carrots, onion skins, nigella seeds and a tasty concoction of vinegar and soy sauce. Since these are all things we eat, they are inherently non-toxic, but most articles that recommend them suggest reapplying every week or fortnight and provide little evidence they actually work.

A common suggestion for highlighting is to use lemon juice, honey and sunlight. The sun’s ultraviolet rays damage hair melanin which results in a yellowed colour, and the small amount of citric acid in lemon juice can speed up this reaction. But the acid can also shrink the shaft of each strand, leaving hair thinner, and strips the hair of essential oils and moisture.

You can also buy hair dyes that use naturally derived ingredients. If you don’t mind having purple hair, one natural ingredient that has been shown to work is blackcurrant extract. However, the most common ingredients in natural dyes are henna or indigo, with henna’s use dating back to the ancient Egyptians. When mixed with indigo, henna can create a range of shades from brown to black. These colour extracts work in a similar manner to temporary dyes and are adsorbed onto the surface of the hair. But like other plant-based dyes, henna treatments are limited by their messiness and the need to frequently reapply them.

Henna hair dye is natural but limited. fotolotos/Shutterstock

To see if we could improve the hair dyeing properties of natural hair dyes, my colleagues and I recently tested the effects of ultrasound on samples of goat hair. Much to the relief of the university ethics review board, this didn’t involve taking a goat to the local hairdresser. Samples of light-coloured goat hair provide a consistent source for testing and it has similar properties to human hair.

We already know that ultrasound can improve the performance of natural dyes on wool, silk and cotton. It creates a pressure wave in liquids that grows and collapses tiny bubbles, creating microturbulence that, depending on the ultrasound’s characteristics, can help the liquid’s molecules move around faster. Under certain conditions, ultrasound can also open up the pores of natural materials. Our results showed that, with the right settings, ultrasound could halve the typical two-hour dyeing time of henna-based dyes.

Hair damage

But we also took magnified images of the hair using a scanning electron microscope before and after different treatments. These showed that, when ultrasound was applied for long enough, it changed the hair structure, creating a different shape hair follicle that has previously been seen in ectodermal dysplasia patients.

In some cases, there was also some surface damage to the hair, most likely from erosion caused by the ultrasonic bubbles collapsing near or on the hair surface. The images also showed that henna-based dye can damage the outer layer or cuticle of hair, which is typically linked to dry and damaged hair.

Overall, ultrasound under the right conditions was able to create a more intense colour that was more resistant to washing than using the henna dye on its own, and without damaging the hair. But before you go sticking your head in an ultrasonic bath, we need to work out all safety implications. Our next step will be to look at how ultrasound can be used in the best way to enhance different dyeing formulations without damaging hair and how this can be used in the real world.

So far, it doesn’t look like there are any natural hair dyes without their downsides. But there is definitely room for new products that don’t involve smearing smelly, sticky food into your hair.

Impact of screening mammography on mortality from breast cancer before age 60 in women 40 to 49 years of age.

Curr Oncol. 2014 Oct;21(5):217-21. doi: 10.3747/co.21.2067.

Impact of screening mammography on mortality from breast cancer before age 60 in women 40 to 49 years of age.

Author information

1
Dalla Lana School of Public Health, University of Toronto, Toronto, ON. ; Women’s College Research Institute, Women’s College Hospital, Toronto, ON.
2
Women’s College Research Institute, Women’s College Hospital, Toronto, ON.
3
Dalla Lana School of Public Health, University of Toronto, Toronto, ON.

Abstract

BACKGROUND:

Whether screening mammography programs should include women in their 40s is controversial. In Canada, screening of women aged 40-49 years has not been shown to reduce mortality from breast cancer. Given that screening mammography reduces mean tumour size and that tumour size is inversely associated with survival, the lack of benefit seen with screening is puzzling and suggests a possible adverse effect on mortality of mammography or subsequent treatment (or both) that counterbalances the expected benefit derived from downstaging.

METHODS:

We followed 50,436 women 40-49 years of age until age 60 for mortality from breast cancer. Of those women, one half had been randomly assigned to annual mammography and one half to no mammography. The impact of mammography on breast cancer mortality was estimated using a left-censored Cox proportional hazards model.

RESULTS:

Of 256 deaths from breast cancer recorded in the study cohort, 134 occurred in women allocated to mammography, and 122 occurred in those receiving usual care and not allocated to mammography. The cumulative risk of death from breast cancer to age 60 was 0.53% for women assigned to mammography and 0.48% for women not so assigned. The hazard ratio for breast cancer-specific death associated with 1 or more screening mammograms before age 50 was 1.10 (95% confidence interval: 0.86 to 1.40).

CONCLUSIONS:

Mammography in women 40-49 years of age is associated with a small but nonsignificant increase in the risk of dying of breast cancer before age 60. Caution should be exercised when recommending mammographic screening to women before age 50.

I Need to Know: ‘is it normal to get sore down there after sex?’

I Need to Know: ‘is it normal to get sore down there after sex?’

February 18, 2019 6.00am AEDT Sex should never hurt. http://www.shutterstock.com

Author

  1. Melissa Kang Associate professor, University of Technology Sydney

Disclosure statement

Melissa Kang 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.

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University of Technology Sydney

I Need to Know is an ongoing series for teens in search of reliable, confidential advice about life’s tricky questions. If you’re a teen, send us your questions about sex, drugs, health and relationships, and we’ll ask an expert to answer it for you.


Hi! I only recently have gotten a boyfriend and have started having regular sex. After 2 or more days, it starts to get a bit sore down there. Is that normal? I just assumed it was pain from friction, but I don’t know if that’s right and I’ve never sought help because it’s a bit embarrassing!

Sandra, 17, in Sydney

Key points

  • Sex should never hurt
  • if it does, tell the person to stop
  • get checked out by a GP or sexual health clinic to make sure it’s not something that needs to be treated – better safe than sorry.

Hi, and thanks for your question! You’re not alone in finding that sex isn’t always straightforward. By sex, I assume you mean intercourse. What I’m not sure about is where you mean by “down there”. In a woman’s body, down there is lots of places!


The Conversation, CC BY-ND

To start with, sex shouldn’t hurt, and if it does, a good tip is to say “stop”, no matter what! The aftermath of sex also shouldn’t hurt – whether it’s two minutes, two hours or two days later.

Even very vigorous intercourse where there’s lots of friction should not actually hurt. It can happen if there’s not enough natural (or artificial) lubrication or if there’s some muscle tension in the vagina. Both of these can be signs of not being fully aroused (turned on) beforehand or during sex, or being a bit anxious about having sex.


Read more: Female sexual dysfunction or not knowing how to ask for what feels good?


A new partner or relationship can bring some anxiety for each person. It can affect the way a woman’s body (or a man’s) gets aroused and how comfortable sex feels. Good communication with your partner about what feels good is really helpful.

If you have background worry about sexually transmitted infections (STIs) or pregnancy, that can definitely affect enjoyment of sex. Getting armed with knowledge and equipment to prevent any unwanted consequences of sex should be a routine part of getting into a relationship for both parties.

The cause of your pain also depends on where it is – is it at the opening of the vagina, or other parts of the vulva? Is it related to peeing, and is it always in the same place?

Inflammation (redness and soreness) can cause pain – this could be from inside the vagina such as with a thrush infection (which is not sexually transmitted) or from the skin in the vulva (which could be from dermatitis or a skin condition).

Some STIs cause pain in the genital area, for example herpes (caused by the cold sore virus), but you would be likely to notice the sores as well. A common STI such as chlamydia often has no symptoms, but could cause pain higher up in the pelvic area or when you wee. A condition known as vulvodynia causes chronic pain, not just from having sex – it can also be triggered by the conditions mentioned above.


Read more: Health Check: what controls our sex drive? When and why do we feel like sex?


You deserve to be enjoying a happy and healthy sex life, and not feeling embarrassed about one of the most natural experiences in the world – even if it’s not always going right. It’s important you do get personal advice, since this could be something that needs treatment. It would be good to have a doctor or sexual health clinic check up, and this can all be done completely confidentially.