YOUR HEALTH Dr James Le Fanu: 21 June
Medicine is not immune to the vagaries of fashion, with popular therapies suddenly going out of favour only to be subsequently rehabilitated – and none more contentiously in recent times than Hormone Replacement Therapy (HRT).
Twenty-five years ago HRT was widely perceived as almost equivalent to the elixir of life. In 1987 the indefatigable Tory MP Teresa Gorman described, in a speech in the Commons, how with the onset of the menopause ‘my wrist and ankles hurt, I became listless, irritable and forgetful’.
Luckily, she had discovered HRT and was now ‘a resurrected woman’. Many similarly glowing affidavits followed, evoking powerfully positive imagery as in: ‘I felt as if the fog had lifted from around my head and I could see the sun again.’
These psychological benefits, together with the abolition of hot flushes, the promise of stronger bones (and fewer fractures) and cleaner arteries (fewer heart attacks and strokes) and it seemed almost perverse not to want to take HRT. There was a small increased danger from breast cancer, but this was far outweighed by the advantages.
Yet five years later, in 2002, the elixir of life had turned into a poisoned chalice with two major clinical trials apparently demonstrating the risks to be substantially greater than previously supposed.
Put simply, for every 1,000 women taking HRT for 10 years, 30 would expect to have a significant adverse effect that they would not have experienced otherwise – including seven with heart attacks, eight with a stroke, and eight with breast cancer.
These findings caused a sensation – resulting in one million women in Britain opting to discontinue HRT. More recently, however, it has been suggested that they are excessively pessimistic.
‘Hormone replacement is very, very safe; certainly for women under the age of 60,’ observes gynaecologist Professor John Studd. ‘In fact, it is very important for them as it deals with their main symptoms.’ It is certainly preferable to taking the alternatives such as Prozac for depression or Fosamax to prevent osteoporosis.
THIS WEEk’S MEDICAL QUERY comes courtesy of a reader from Bristol who reports that this past winter both her and her husband have for the first time been troubled by fingernails in poor condition.
‘They are brittle, cheesy and often break before needing to be cut,’ she writes. Why should this be she wondered and might there be anything to prevent the same thing happening next year?
It is frequently observed that nails are more brittle in the winter months – usually attributed to the relatively low humidity of the air. This can be prevented by applying a moisturising cream and stopping the nails from being exposed to injurious chemicals, by for example, wearing waterproof gloves when washing up and doing household chores. Both gelatin capsules and omega 3 fatty acid supplements are said to strengthen them.
drjames@lady.co.uk
‘I used to suffer from very severe nasal congestion. Then, by chance, I had to go away for a week and to my surprise, the congestion cleared up. I tried to think about what I had eaten or drunk at the hotel where I was staying and how it was different from what I normally had at home. By a process of elimination it turned out, to my surprise, to be orange juice. The cure was instantaneous.’
Twenty-five years ago HRT was widely perceived as almost equivalent to the elixir of life. In 1987 the indefatigable Tory MP Teresa Gorman described, in a speech in the Commons, how with the onset of the menopause ‘my wrist and ankles hurt, I became listless, irritable and forgetful’.
Luckily, she had discovered HRT and was now ‘a resurrected woman’. Many similarly glowing affidavits followed, evoking powerfully positive imagery as in: ‘I felt as if the fog had lifted from around my head and I could see the sun again.’
These psychological benefits, together with the abolition of hot flushes, the promise of stronger bones (and fewer fractures) and cleaner arteries (fewer heart attacks and strokes) and it seemed almost perverse not to want to take HRT. There was a small increased danger from breast cancer, but this was far outweighed by the advantages.
Yet five years later, in 2002, the elixir of life had turned into a poisoned chalice with two major clinical trials apparently demonstrating the risks to be substantially greater than previously supposed.
Put simply, for every 1,000 women taking HRT for 10 years, 30 would expect to have a significant adverse effect that they would not have experienced otherwise – including seven with heart attacks, eight with a stroke, and eight with breast cancer.
These findings caused a sensation – resulting in one million women in Britain opting to discontinue HRT. More recently, however, it has been suggested that they are excessively pessimistic.
‘Hormone replacement is very, very safe; certainly for women under the age of 60,’ observes gynaecologist Professor John Studd. ‘In fact, it is very important for them as it deals with their main symptoms.’ It is certainly preferable to taking the alternatives such as Prozac for depression or Fosamax to prevent osteoporosis.
THIS WEEk’S MEDICAL QUERY comes courtesy of a reader from Bristol who reports that this past winter both her and her husband have for the first time been troubled by fingernails in poor condition.
‘They are brittle, cheesy and often break before needing to be cut,’ she writes. Why should this be she wondered and might there be anything to prevent the same thing happening next year?
It is frequently observed that nails are more brittle in the winter months – usually attributed to the relatively low humidity of the air. This can be prevented by applying a moisturising cream and stopping the nails from being exposed to injurious chemicals, by for example, wearing waterproof gloves when washing up and doing household chores. Both gelatin capsules and omega 3 fatty acid supplements are said to strengthen them.
drjames@lady.co.uk
AN INSTANT CURE
It is well-recognised that those troubled by catarrh and chronic sinusitis may benefit by cutting down on dairy food. This account from a Nottingham reader suggests that other factors may also be implicated.‘I used to suffer from very severe nasal congestion. Then, by chance, I had to go away for a week and to my surprise, the congestion cleared up. I tried to think about what I had eaten or drunk at the hotel where I was staying and how it was different from what I normally had at home. By a process of elimination it turned out, to my surprise, to be orange juice. The cure was instantaneous.’