Managing period pain

What is period pain?

Period pain is one of the most common health issues for women.

Period pain refers to pain in the lower abdomen which can occur just before or during a woman’s period, usually lasting for around two to three days. The severity of period pain varies between women; from a mild to severe pain which can interfere with normal day-to-day activities.

What causes period pain?

Period pain can occur when chemicals called prostaglandins are released from the lining of the uterus (womb). The release of prostaglandins causes the muscles in the uterus to contract which may cause pain in some women. Although it’s not entirely clear why some women experience stronger period pain than others, women with higher levels of prostaglandins may experience stronger cramps and pain.

Treatments

Anti-inflammatory medicines

Anti-inflammatory medicines can provide period pain relief for many women by stopping the body from producing prostaglandins. There are several OTC anti-inflammatory medicines that can be used to relieve period pain. Examples are:

• Ibuprofen
• Paracetamol
• Mefenamic acid
• Naproxen
• Piroxicam

Speak with your pharmacist which one is the best option for you. Some of these medicines are easily available from pharmacies.

Anti- inflammatory medicines may not be suitable for everyone

Anti-inflammatory medicines can also irritate the stomach and interact with other medicines. So not everyone can take them. If you have a history of the following medical conditions, it’s important that you talk with your doctor or pharmacist before starting anti-inflammatory medicines.

• Peptic ulcers
• Gastric Eosophagial Reflux Disease (GERD)
• Asthma
• Kidney, heart or any other health problems.

Paracetemol and other options

Pain relief medicines containing the active ingredient paracetemol (eg, Panadol) can be helpful for women experiencing mild period cramps. When taken as directed on the packet, paracetamol is generally well tolerated by most people.

Some women also benefit from non-medicine options such as heat packs, exercise, transcutaneous electrical nerve stimulation (TENS) or acupuncture.

Medicines containing codeine

Low-dose codeine medicines used to be available over the counter, but currently, all medicines containing codeine has been taken off the counter. 

OTC medicines containing low-dose codeine provide very little extra pain relief when compared to other OTC pain relief medicines. There are also serious risks associated with taking medicines containing codeine. Some people can become dependent on these medicines and develop withdrawal symptoms such as headaches and insomnia when they stop taking them.

If you are experiencing period pain that interferes with day-to-day activities, consider discussing alternative treatment options with your doctor. Some women find that the combined contraceptive pill (the pill), or other hormone treatments, can help with period pain, however, this is not suitable for everyone. Your doctor, pharmacist or healthcare professional can advise on what’s best for you.

Rarely, period pain can be caused by an underlying medical condition. If you are experiencing severe pain or have symptoms that are unusual or persist longer than expected, it’s important that you seek help from a doctor, or sexual health practitioner. This is because you may need tests to rule out other causes.

Experiencing sleep problems? How you can sleep right

While many people experience a bad night’s sleep from time to time, a sleeping problem may become an issue for you if it continues for several nights or weeks.  Thankfully, there are several techniques that can help you to sleep better — sleeping pills aren’t the only solution.

An unsuitable environment can affect sleep

Having trouble falling or staying asleep is common. It can leave you feeling sleepy and lacking energy during the day.

Getting a good night’s sleep is not about the number of hours of sleep you get. What matters most is the quality of sleep.

Having difficulty falling or staying asleep, or if you wake up too early in the morning, could suggest low quality sleep and your sleep is not as good as it could be. Insomnia is the medical term for this type of sleeping problem.

What can cause insomnia?

There are many of reasons why someone might be having trouble sleeping. These can vary from individuals, however some common reasons can include:

• Personal issues, such as grief or stress
• A noisy or disruptive environment
• Some medical conditions such as chronic pain or arthritis
• Psychiatric disorders
• Use of alcohol, caffeine or nicotine
• Some medicines 

How can you sleep better 

Behavioural therapies such as muscle relaxation, breathing exercises, meditation, counselling support (eg, cognitive therapy) and good sleep habits are the best ways to manage sleep problems in the long term.

These non-medicine therapies can take a few weeks to start working, but unlike sleeping pills they:

• often focus on fixing what has been causing the sleep problems
• let your body sleep as deeply as it needs to so you feel rested the next day
• don't cause the side effects, dependence and other possible harms of sleeping pills.

For natural sleep

Talk with your health professional about non-medicine therapies that might be best for your situation and where you can get further information and help. 

Regulate your sleep

• Try to go to sleep and wake up at the same times each day.
• Avoid naps during the day. If you do nap, keep it to 20 minutes.
• Avoid oversleeping.
• Avoid bright light in the evening.
• Seek out some bright light when you wake up each morning.
• Don't stay in bed worrying. If you're awake for more than 20 minutes — go to another room and do something that relaxes you, such as reading a book, listening to music or meditating.

Create a sleep-friendly environment

• Be as active as possible during the day, exercise and spend some time outdoors.
• Don't eat, work, watch television, read or discuss problems in bed.
• Avoid working on a computer, tablet or smartphone late in the evening.
• Reduce the amount of caffeine you have each day and avoid caffeinated drinks after lunchtime.
• Try to keep caffeine-containing drinks to a minimum in the evening .
• Avoid heavy meals and vigorous exercise within 3 hours of going to bed.
• Avoid smoking and drinking alcohol in the evening.
• Keep your TV, and brightly digital clocks out of the bedroom.

Prepare yourself for sleep

• Relax for 30 minutes before going to bed (eg, have a warm bath).
• Make sure your bedroom is not too hot or cold.
• Ensure you are comfortable and your bedroom is quiet and as dark as possible.

Treatment options

Treatment for sleep problems can get you back on track

If you have tried our tips and are still having problems with sleep, ask your healthcare professional about other treatment options including drug treatment. May be able to help find what will work for you and may also refer you to a sleep specialist.

Your doctor or specialist may recommend one or more of the following treatments:

• Cognitive therapy: this helps people who are excessively worried about their sleep and any consequences.
• Stimulus control: helps people who associate the bed or bedroom with frustration and worry.
• Sleep restriction: helps people who have difficulty staying asleep.
• Relaxation training: helps people who cannot sleep due to physical tension, an overactive mind or worry.

Using Medicines during pregnancy

Medicines should be used during pregnancy only when they’re needed. Many medicines can be taken while you are pregnant, but it’s important to check with your health professional first. Sometimes it’s possible to relieve symptoms without medicines.

At other times, it may be essential to continue using a medicine, such as when the medicine helps to manage a long-term condition like asthma, diabetes, depression, or seizures. Without the medicine, your health or your baby’s health could be put at risk.

There are some medicines that should be used with caution or avoided during pregnancy. You should always talk to your doctor, pharmacist or other health professional about using medicines when you are pregnant.

Medicines that cause harm during pregnancy in various ways:

• Some medicines are transported across the placenta and can interfere with the baby’s development.
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• Others can damage the placenta and affect the amount of nourishment and oxygen delivered to the baby.
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• Some can contract the uterus and increase the risk of miscarriage or bring on premature labour.
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• Others may have side effects like drowsiness that may affect the baby around the time of birth.

It’s important to ask questions as you plan your pregnancy, and to make sure you get the right information about medicines at all stages of your pregnancy. 

The use of any medicine during pregnancy requires careful consideration of both risks and benefits by your health care professional. 

Any decision about taking a medicine during pregnancy should always involve your health professional and you.

There are some medicines that should be used with caution or avoided during pregnancy. 

Remember that medicines don’t just come as prescription — they include over-the-counter and complementary medicines.

Complementary medicines (also known as ‘traditional’ or ‘alternative’ medicines) include vitamin, herbal, aromatherapy and homeopathic products. Many complementary medicines have not undergone the same level of research as prescription and over-the-counter medicines, so often less is known about their effectiveness, possible side effects and interactions both overall and during pregnancy.

Medications formulated for pregnancy

Some vitamin preparations are formulated specifically for use during pregnancy. This ensures correct recommended intake of certain vitamins and minerals (such as folic acid) and avoids excess intake of other vitamins. It is advisable to discuss with your healthcare professional about your specific nutritional needs during pregnancy.

If you have a chronic medical condition and need medicine to treat it, it is important to have your condition assessed while you are planning for, or during your pregnancy. Your doctor is the best person to assess your medical treatment. Sometimes changes are needed to ensure the health of both you and your growing baby. 

Sources of information such as Product information and Consumer Medicines information leaflets often don’t provide detailed information about use in pregnancy, so your health professionals are the best source of information to guide you about the use of medicines during pregnancy.

One Cigarette a Day Greatly Raises your Cardiovascular disease Risk

Smoking Even One Cigarette a Day Raises Cardiovascular Risk

For people who think that smoking only one or two cigarettes a day carries little cardiovascular risk, a powerful new study maintains the only way to reduce risk is to quit, full stop.

The investigators anticipated that smoking one cigarette a day would be associated with about 5% of the excess relative risk of smoking 20 cigarettes a day, but they found it actually accounts for 46% of excess Coronary Heart Disease risk in men and 31% of the risk in women. 

For the less commonly reported smoking-related outcome of stroke, the excess risk associated with just one cigarette per day was 41% for men and 34% for women.

There's been a big shift from people smoking 20 to 25 cigarettes a day to only smoking a few cigarettes a day with the assumption that's good enough for them. Their view is that smoking only a couple a day can't be harmful and that's probably not far off the truth for risk for cancer. For many smokers that's probably the first thing that comes to mind, but cardiovascular risk is the big one.

The main public health impact of this is that smokers have done well in reducing and there are various methods to help them quit and cut down, but the aim is to keep on searching for those methods, find one that suits them, and to cut down and then quit completely."

The unfortunate thing for cardiovascular disease is that the adverse effects seem to come through quite quickly after only 2 or 3 years of smoking and the impact is quite big. The good thing is that if you quit smoking, a lot of your risk goes away quite quickly as opposed to cancer, where it takes several years to mainly go away.

Recurrent Miscarriage: May be linked to the poor quality of sperm

Sperm Damage may provide clues to Recurrent Miscarriage.
Oxidative stress and DNA damage in sperm may contribute to repeated miscarriages in female partners.

There is strong understanding of female factors that can contribute to recurrent pregnancy loss, but male factors that may play a role is far less known. Recurrent pregnancy loss — at least three consecutive miscarriages (before 20 weeks' gestation) — occurs in about 1-2% of couples, and about half of cases are unexplained. A lot of women undergo many tests to determine the cause, but many cases have no identified cause. 

It is important to know the medical history of male partners, examine them, and maybe offer a further investigation so that it can be established where the problem is, and perhaps offer the couple better treatment.

The role of the sperm

The sperm plays an important role in the formation of the placenta, which is critical for survival of an unborn baby. Some known risk factors for male infertility include genitourinary infection, varicocele, scrotal heat, and obesity. Some of these conditions might contribute to reactive oxygen species in semen, which could then cause sperm DNA fragmentation and subsequent pregnancy loss.

Frances Hayes, MBBCh, clinical director of the reproductive endocrine unit at Massachusetts General Hospital, Boston therefore has a take-home message; "Don't neglect the male. Sometimes there may be need to screen both potential parents for balanced translocation in the chromosomes, but most of the focus is typically on the woman."

 

The early-stage study, from scientists at Imperial College London, investigated the sperm quality of 50 men whose partners had suffered three or more consecutive miscarriages.

The research, revealed that, compared to men whose partners had not experienced miscarriages, the sperm of those involved in the study had higher levels of DNA damage.

Until recently recurrent miscarriage was thought to be caused by health issues with the mother, such as infection or immune problems.

"However, this research adds to a growing body of evidence that suggests sperm health dictates the health of a pregnancy. For instance, previous research suggests sperm has an important role in the formation of the placenta, which is crucial for oxygen and nutrient supply to the fetus."

The research team is now investigating what may trigger high levels of these reactive oxygen species. It is possible there may be bacteria from previous infections lingering in the prostate gland, which makes semen. This may lead to permanently high levels of reactive oxygen species.

Obesity can lower sperm health as well -- possibly because high levels of body fat can trigger an increase in reactive oxygen species.

Dr Channa Jayasena, lead author of the research from Imperial's Department of Medicine concludes: "It has taken medicine a long time to realise sperm health has a role to play in miscarriage -- and that the cause doesn't lie solely with women. Now we realise both partners contribute to recurrent miscarriage, we can hopefully get a clearer picture of the problem and start to look for ways of ensuring more pregnancies result in a healthy baby."

 

WHEN DRUG ABUSE IS LEGAL

Drug abuse is no longer limited to illegal drugs like heroine or cocaine. One of the most dangerous and rising forms of drug abuse today is legal, over-the-counter (OTC) medicines.  They come from cough syrups and painkillers to sleep medicine and prescription tranquilisers; these socially accepted drugs are cheap, accessible and addictive – making them all the more dangerous.

How are they addictive?

Drug addiction is a complex disorder that is characterised by compulsive drug use. Every drug produces different physical effects, but the common result is that repeated use can alter the way the brain looks and functions.

Repeated abuse of drugs (even with some OTCs) floods the system with dopamine, which gives the user that euphoric rush. It is believe that the brain receptor cells change in conformation. When someone with a predisposition to addiction uses these drugs repeatedly, it causes the reward system to learn that drugs are essential to their survival and they should get it at any cost.

Dependence versus Addiction

Many people can use recreational or prescription drugs without ever experiencing negative consequences or addiction. Some others use of these substances quickly leads to abuse and then addiction. To tell when the line has been crossed is not easy as there is nothing to measure it, but some common behaviours indicating drug addiction include:

• Performing poorly at work

• Neglecting responsibilities to family and friends

. Loss interest in social activities

• Losing interest in sex.

Dependency is much more commonplace. Taking prescription medicine for more than a few weeks increases the chance of developing some physical dependence on the drug for the relief it brings, be it to pain or insomnia. People are usually stable on lower doses of the medicine. If they do stop suddenly, they will probably have some mild withdrawal symptoms. People that tend towards addiction usually abuse the drug with the intention of lessening their anxiety or getting high (escaping their feelings or reality). The pleasure of getting high and the fear of withdrawal instruct the brain to compulsively seek out the drug, at any cost, and to crave its continued use despite the negative consequences.

Some commonly abused prescription drugs

·          Sleep medicines: This helps people who suffer from insomnia (lack of sleep) but, when abused, addicts start to believe they need them to sleep.

·          Codeine and morphine: Painkillers are some of the most commonly abused OTC medicines. In small doses these drugs reduce pain, but in large doses they can cause a euphoric high and dangerous side effects like drowsiness and breathing problems.

·          Barbiturates or sedatives: High doses can cause breathing problems, especially if taken with alcohol.

Some available OTC drugs are especially popular with teenagers:

·          Diet or weight control pills: Youths are prone to “going on diets” and will often try anything which claims to make them thinner or prettier (especially ladies). The abuse of such pills often starts with them taking just to lose weight. In large doses, these pills can create false “energy”, a feeling that can be addictive in itself. The continued misuse can cause serious eating disorder.

·          Amphetamines: Most often this drug is abused by young people to increase energy and alertness, or to keep awake. High doses can cause a rise in body temperature, irregular heartbeat and sometimes cardiac arrest.

·          Dextromethorphan (DXM): Is a common ingredient in over-the-counter cold and cough medicines, which in large doses can cause hallucinations, vomiting, rapid heart rate, and brain damage.

·          Pseudoephedrine: A decongestant in many non-prescription cold medicines that helps to clear up stuffy noses. It may increase energy and causes toxicity at high doses.

The prevalence of prescription drug misuse is high and vary by age, gender, and other factors, but likely include ease of access. Misinformation about the addictive properties of prescription drugs and the perception that prescription drugs are less harmful than illicit drugs are other possible contributors to the problem.