Whether your doctor is enthusiastic about HRT or not is quite closely linked to how long ago he qualified. Most older doctors hardly studied even the menopause at medical school, and HRT not at all. A survey in Brighton, Sussex, showed that of doctors who qualified in the 1950s, none prescribed HRT in a given year, those who qualified in the prescribed HRT in a given year, those who qualified in the 1960s were slightly more likely to, while those who qualified in the 1970s and 1980s were very likely to. So if your doctor is rather older than average and ‘doesn’t believe m HRT’, you might find a younger doctor more helpful; and, no matter what his age, if you do not feel he is sympathetic to your problems, ask whether you could see another doctor in the practice, or a Menopause Nurse. If you get no luck there, a local Menopause Clinic or Well Woman Clinic will be able to give you the information you want, and do a medical check-up. Help, information, advice and treatment is also available from The Amarant Trust. The aim of the Trust is to promote a greater understanding of the menopause and HRT. They run an HRT helpline for general enquiries, can send you a list of NHS and private Menopause Clinics, run specialist courses for GPs and nurses, and have their own private Menopause Clinics in London and Cheshire, where patients can receive assessment, information and treatment.

Most women nowadays are much better informed on medical matters than their mothers or grandmothers were, and they expect to be given as much information as possible. You do not have to be putty in your doctor’s hands; you don’t have to take (or not take) medicine just because he says so; you have every right to full information and then to make your own mind up. Fortunately, the ‘because-I-say-so, my dear, and-don’t-ask-so-many-questions’ type of doctor is becoming a dying breed, and GPs now expect their patients to want information about their condition and its treatment, including the options available and possible side-effects of different treatments. If you are unsure about anything, go along to your doctor with a list of questions written down on paper and then write his replies down, so you don’t forget anything. You may prefer to take somebody into the consulting and less intimidated, and you have the right to do this, and also to a second opinion.

As a result of the scares abut HRT in the 1970s, many doctors are uncertain how safe it is nowadays, and perhaps do not realise that cancer of the lining of the womb can virtually be ruled out for women starting HRT now as long as they take progestogen as well as oestrogen. They might also link safety concerns about the oral contraceptive with HRT, but as the dose is many times smaller, this is a largely unfounded fear. Although many doctors realise the benefits of long-term HRT for osteoporosis and heart attacks, they are also aware that there is an increased risk of breast cancer in women who take it long-term. It is interesting, though, that doctors involved in research projects with women who are taking HRT do seem to be enthusiastic about it; perhaps they feel it really does work, and, in most cases, has more advantages than disadvantages.

Finally, however well you are getting on with HRT, it is not a panacea for eternal good health, and any of us can develop serious diseases. There are some symptoms you should not ignore, whether or not you think they are connected with either the menopause or HRT:

• very heavy periods

• any bleeding or ‘spotting’ between periods

• any bleeding or ‘spotting’ after sexual intercourse

• any unexplained bleeding once the menopause has passed

• if you still haven’t reached the menopause by about the age of 54

• pain or swelling in the abdomen

• ‘indigestion’-type pain that persists for more than a day or two

• blood in the urine or stools

If you get any of these, see your doctor as soon as possible.

While a few GPs are still reluctant to take menopausal symptoms seriously (‘No one yet died of the menopause, my dear*), many are both enthusiastic and helpful. An increasedear’), many are both enthusiastic and helpful. An increasing number have set up Menopause Clinics within their practices, employing specialist Menopause Nurses, from whom women can receive advice, information and screening. Newly pregnant women see their GPs, and all women approaching the menopause should be encouraged to do so as well, not necessarily to be given HRT, but to discuss the menopause, their symptoms, and any treatment that may be advisable. Women who are well informed about this time of change will feel better able to cope with it, and will not be a burden to themselves or to their doctors.

*60\42\4*

A hysterectomy is often seen as a last resort by women who have uterine or menstrual symptoms that are making their lives, including their sex lives, a misery. Chronic pelvic pain and protracted menstrual bleeding, for example, may mean that prior to a hysterectomy a woman’s sexual needs and those of her partner are not being met. This can lead to unhappiness on all sides. A great deal of hope may be vested in the prospect of an improved relationship after hysterectomy, including an improved sexual relationship. If symptoms do not resolve quickly or new symptoms appear which continue to stymie efforts to reinstate a sexual relationship, feelings of depression may mount. Existing difficulties in a relationship may became more acute with outbursts of hostility and anger an increasingly frequent event. Short-circuiting this situation is not easy, but it may be achieved if partners can bring themselves to try pleasuring activities like massage, mechanical stimulation and mutual masturbation. In this way the very important communication that occurs via all the senses, and especially touch, can be developed.

Sexual interest, indicated by sexual arousal, sexual fantasising and masturbation, becomes apparent in females and males during the early teenage years. Then, as sexual interest matures in later adolescence, most individuals develop quite specific erotic fantasies. The ability of humans to create and respond to fantasies seems to play a major role in sexual motivation and in sexual receptivity. Strong and deliberate fantasising through erotic stories, pictures, readings and films may help stimulate this interest. Such strategies may help rekindle sexual interest.

Like most species, humans work up to sexual contact with foreplay that excites both partners. Birds coo, bow and strut. Primates spend hours grooming each other. In most mammals, delicate stimulation of sensitive body parts is an important component of stimulatory activity

preceding sex. Many couples find that taking the time to gently and lovingly play with the clitoris, penis, and the nipples, using the fingers, the tongue or a vibrator, can arouse intensely pleasurable sensations. If arousal takes a long time, accept this and continue the activity only as long as you are both enjoying the experience.

There is some evidence to suggest that techniques of sexual intimacy have changed in recent generations with increases in oral sex in marriage, more variation in foreplay and more experimentation with positions. Some women enjoy deep penile penetration and may achieve this by either the female-astride position, or the man-on-top position with her legs on his shoulders and pillows under her hips. Adequate vaginal lubrication is an important consideration and can be achieved using substances such as K-Y jelly or the new hormone-free Replens which lasts for several days and is not messy. Many women find that post-menopausal hormone therapy helps lubrication.

*74\198\4*

Ordinary stress is pressure exerted on us in our normal daily life. My car breaks down, my boss misunderstands me, I lose some money in my investment, 1 have an argument with my friend, I am going to sit an important examination tomorrow, and so on; these are normal events that we may have everyday. I am jealous, I am disappointed, I regret, I am frustrated, I feel guilty, I am frightened, and so on; these are feelings and reactions we can have in our everyday lives.

When we are under stress, a normal reacting mechanism in our body works to counteract the stress applied to us. Our body feels threatened, and we put ourselves on battle alert. We respond in two ways: with a biological reaction and with a psychological reaction. These two ways go hand in hand with each other, and both are protective mechanisms against the threat of imminent danger.

Psychological reaction. One of the things that makes us human is that we possess a unique psychological reaction to stress. We automatically protect our psyche; we deny what is going to happen. Denial of the existence of the stress is a normal common defence mechanism. A sense of disbelief is not uncommon. We feel anxious and sad at the same time. We are no longer sleepy, our brain is on full alert, unable to switch off, and is ready for the challenge. In fact we are wide awake. We magnify and exaggerate the stress, so that the stress in question

occupies every part of our mind. It is as if we are carrying a magnifying glass and examining the issue in detail all the time. So it is psychologically normal to exaggerate and to blow things out of all proportion when we are under stress. We will not let go until the issue is resolved.

The psychological reaction is useful as long as we do not suffer from it, but repeated exposure to stress can result in psychological illness, such as chronic insomnia, anxiety, panic attacks, agoraphobia, and even alcoholism. Were we all like coconuts, ordinary stress would have no effect on us. However, there are very few coconuts around. Psychologists have noticed that there are certain kinds of personalities that react excessively to stress. These are the perfectionists, who expect the real world to be perfect and strive for 100 per cent all of the time. If they feel that anything is not up to their expectation, they feel very stressed.

*76\174\4*

A patient used this expression and it seems to suit the situation very well. He had been married for three years; he was not impotent, but was unable to come to a climax. I had asked him not to have sex relations until he had mastered the exercises. One day he came in and announced that he was already getting “fringe benefits.” He said that he was much easier at his work, and added that his gait seemed easier as he walked. He was in fact a big, clumsy man with a rather awkward gait, His sexual difficulty cleared up completely.

Fringe benefits are not occasional incidents but are really the rule of the day. A patient who seeks help on account of tension in the home, finds that he is easier at his work and can do it more effectively. Many a wife has said that her husband is easier to live with, although this was not the cause of him coming to see me.

As our level of anxiety is reduced our sleep improves. This is a very constant finding of those who do the exercises.

Many people have told me how their golf has improved. When we are less tense we naturally swing more freely. Patients who ski have told me that their turns have improved because they are less tense and can balance better with more natural rhythm. I well remember the enthusiasm of a young stutterer about the improvement in his baseball.

One of the areas where anxiety is first felt is in sexual response. This is true for both men and women. Many patients have told me of improved sexual relationship when they have actually come for treatment of some quite different condition. Many of these people were in fact unaware that there had been anything wrong in their sexual response until they noticed this improvement. In more obvious cases, men who had habitually come to a climax very quickly found themselves no longer troubled with this difficulty. In the same way many women have reported more

satisfactory sexual experience as a fringe benefit when having treatment for some other reason.

We should not be surprised at this. In fact it is exactly what we should expect. Anxiety always tends to inhibit the smooth working of our body, so as we reduce the level of our anxiety we should expect fringe benefits of this nature.

I remember very clearly the case of a woman in her middle thirties who came to me to see if. I could help her with her stutter. Her speech difficulty was associated with a good deal of tension and anxiety. She had had considerable psychotherapy and speech therapy without significant effect. In order to find out the background of her tension, I asked her about her personal life. She was very much in love with her husband and he with her, but her sex life was a complete failure, and she had come to look upon it as a kind of nightmare.

I saw her six or eight times. Her speech returned to normal. On her final visit she explained that it was not only her speaking that had changed, but there had been a change all through her. When questioned further, she told me that she was now enjoying her intimate life with her husband in a way which she had not thought possible.

*98\57\2*

The term biological medicine, as used in this book, is a relatively new expression. Although it is used quite often in Europe, popularly and officially in scientific publications, the average American layman as well as the average physician are not too familiar with it.

The concept of biological medicine, on the other hand, is not new at all. It goes back as far as the very early history of the art of healing. It encompasses all the naturopathic, drugless therapies which were practiced for thousands of years, even before Hippocrates. During various periods of medical history and in different parts of the world these methods of healing were and are called by different names. In the United States, the school of healing nearest to the concept of biological medicine, would probably be called naturopathy, nature-cure method, natural hygiene, or drugless medicine. There are numerous naturopathic physicians, chiropractors, and drugless osteopathic physicians in this country who use in their practice methods of treatment very similar to those outlined in this book. Naturopathic physicians particularly would be very sympathetic towards biological therapies. There are also many medical doctors who are well informed on biological medicine and would find nothing objectionable in the programs outlined here.

How do you find these doctors?

Naturopathic physicians and chiropractors you can look up in the yellow pages of your telephone directory. For the biologically oriented medical doctors it would, perhaps, be better to ask the local chapter of the National Health Federation or ask in your favorite health food store for some names the owners might be familiar with. Because of the risk of pressure and malevolence from colleagues and medical organizations, the biologically oriented medical doctor would be reluctant to advertise his unorthodox affiliations or beliefs.

There are some clinics in the United States which use methods similar to those used in Swedish clinics, such as: Dr. Jensens in Escondido, California; Dr. Max Warmbrand’s Florida Spa in Orlando, Florida; Dr. H. Shelton’s Health School in San Antonio, Texas; the Pawling Health Manor, Hyde Park, New York; and a few others.

It is my sincere hope that this book will stimulate awareness of biological medicine among practitioners of the healing arts and governmental health agencies. I am hopefully looking forward to a not too distant future when awakened interest on the part of arthritics, physicians, and health organizations will motivate them to conduct objective experiments with biological therapies in some of the major hospitals in the United States or Canada under 100 per cent scientific control. When such an experimental clinic becomes a reality, then American arthritis sufferers will be able to obtain biological treatments, as described in this book, right here in their own country under professional medical supervision. The united action of millions of people and aroused public opinion can break the frustrating chain of hopelessness, complacency, indifference, and medical prejudice and make the dream of every arthritic to be free from this agonizing disease a reality.

For the sake of all sufferers of arthritis, I hope this will happen soon.

*57\176\2*

Until comparatively recently, the emphasis of neurologists and paediatricians has been on obtaining complete control of epilepsy. The child or person’s own feelings have not been taken into sufficient account, nor has the effect of epilepsy on aspects of their life such as choice of career, employment, social and leisure activities, and family life. The stigma which is associated with epilepsy, and the relatively poor medical understanding and management of epilepsy has contributed to patients with epilepsy experiencing a poor quality of life. This is now changing. Favourable factors are:

• an increased understanding about how epilepsy is caused;

• an increased medical awareness of the condition at all levels of undergraduate and postgraduate medical training;

• the development of more effective and safer drugs, and of surgical treatments leading to improved control of seizures;

• the development of clinics and facilities, both locally in general hospitals and nationally in major specialist centres;

• the appointment of specialist nurses in epilepsy whose role is to support and counsel patients of any age, and their families; and

• an expansion of local and national voluntary associations to provide advice and information to all patients and professionals who are involved with epilepsy.

The introduction of epilepsy clinics and specialist nurses in epilepsy are, in our view, as (if not more) important than the discovery of new anti-epileptic drugs in improving the quality of life of patients who have epilepsy.

*92\188\2*

Dietary experiments with monkeys have now clearly established that vitamin C helps to prevent inflammation and recession of the gums. Even when the vitamin C shortage is not severe enough to cause any other signs, normally harmless trauma leads to redness, swelling, bleeding and “pocket” formation of the gums around the roots of the teeth.

Of course, the Journal of the American Medical Association (246:730) points out, it has been known for hundreds of years that swollen, bleeding gums are major features of scurvy, the disease caused by a severe shortage of vitamin C. The importance of these new findings, however, is that unhealthy receding gums can result from such a minor shortage of vitamin C that it is hardly severe enough to be called a deficiency. The trouble is that once your gums have shrunk down to expose the roots of your teeth, no amount of supplementary vitamin or anything else can make them grow back again. Here is another good reason for taking extra vitamin C.

One must remember, however, that vitamin C is an acid (ascorbic acid) and is therefore capable of injuring the teeth, decalcifying, and eroding them when it stays in contact with them for any great length of time.

The Journal of the American Dental Association (107:253) reports the case of a 30-year-old woman that illustrates this danger very well. Several back teeth on one side of her mouth (the side on which she chewed) had become severely eroded and broken down, a condition that was readily understandable in view of her history of chewing three vitamin C tablets every day.

Chewable vitamin C, therefore, is best avoided by everyone except those who have a complete set of dentures, both lower and upper.

*207\143\2*

Signs and symptoms

It is difficult to be certain that an infant or toddler has a sore throat because the child cannot communicate, but swollen glands in the neck or difficulty swallowing are clues. Determining the cause of a sore throat depends on the results of a throat or other type of culture; on a complete blood count; and on the doctor’s skill in performing the physical examination, knowledge of the illnesses in the community, and professional judgment.

Home care

Older children may gargle with warm salt water to relieve a sore throat; all children should drink extra fluids and eat then-usual diet if they can. Give aspirin or paracetamol to reduce pain or fever and isolate the child from other children, particularly infants, until the cause of the problem is found.

Precautions

• Take the child to a doctor if a sore throat is accompanied by any of the following symptoms: moderately or severely swollen and tender neck glands; difficulty swallowing that cannot be relieved by aspirin or paracetamol; pus-like discharge from the eyes or nose; moderate or severe earache; tenderness over the sinuses; breathing difficulty; chest pain; reddish-purple rash or a rash resembling scarlet fever (fine, slightly raised red spots resembling coarse red sandpaper); stiff neck; weakness or exhaustion; confusion; or continual vomiting.

• If a sore throat and a fever continue to worsen after 24 to 36 hours, consult a doctor.

Medical treatment

Your doctor will conduct a complete physical examination and order a throat culture and, perhaps, other laboratory tests. Depending on the results of these tests, your doctor may treat a sore throat with antibiotics. Regardless of the treatment prescribed, you should report any new symptoms to your doctor. Also consult the doctor if there’s no improvement in the child’s condition after 48 hours.

*194/84/5*

This is a special kind of dust isolated from the inside of a house and recognized as early as 1922 as a potent and common cause of allergy. It is totally different from the dust found in the streets because it is composed of the emanations, the excretions, and the remains of the dead bodies of the common house mite. It may be obtained from a vacuum cleaner whose dust can be purified and used for testing and desensitization.

Precautions Against House Dust

An atopic child should have a room which he uses for sleeping purposes only; he should dress and undress and keep his clothing and books in another room. The bedroom must be made comfortable, pleasant, and colorful, and it must be kept free from dust by using the following precautions.

Cleaning. The room must be vacuumed daily, and it must be given a thorough cleaning once a week: the floor, the furniture, the tops of the doors, the window frames, the sills, etc., must all be cleaned with a damp cloth or oil mop. After the cleaning, the room must have its windows left open for half an hour, and then all doors and windows must be kept closed until the child is ready to occupy the room. If the child must be present in the house during cleaning time, he must wear a special mask over his mouth and nose. The best ones are made of polyethylene, which sticks to the skin, does not admit anything except air, and allows the child to talk freely. The dust clinging to it can be washed off later by dipping the mask in water.

Preparation of the bed. The mattress and springs must be cleaned and enclosed in a plastic casing (which may be bought in stores that specialize in allergy-free products). If a second bed must be used in the same room, it must be prepared in the same fashion.

Choice of the bedding material. The pillow must be made of sponge rubber, and the blankets of synthetic material (which is to be washed every four to six weeks). The bedspread must be of washable fabric that has been laundered previously. No mattress pad, quilts, comforters, or fuzzy woolen material is to be used on the bed.

The furnishings. They should be simple, not ornately carved, and should consist of a scrub-babble wooden chair, cotton curtains (instead of drapes), and roll-up window shades (instead of Venetian blinds). All toys present in the room must be made of wood, rubber, or iron (instead of stuffed toys which may contain dust, wool, and molds).

The heating. The temperature must be kept constantly at about 75°F by means of heated water and not heated air. However, if the room does have hot air heating, several layers of cheesecloth must be put on the heat outlets.

The following methods may be used to eliminate dust (as well as other inhalant allergens) from the air.

Filtration utilizes filters made from paper, glass wool, etc. The effectiveness of such a device is contingent upon the type of filter used, the rate of air exchange, and the size of the particle to be eliminated. If the size of the particle is a large one (such as that of a pollen grain which can measure from twenty to thirty microns), any simple filtering device fitted into the bedroom window will do. However, since most inhalant particles are less than five microns in size (particles of dust, fumes, smoke, mold spores, bacteria, and viruses), special material called Hepa is necessary to perform the filtration.

Electrostatic precipitation is achieved with plates charged with a high voltage and put in portable units for bedrooms, or in large units attached to the main ducts of the heating system. These plates attract inhalants and dust particles and precipitate them. The large units do their job well if radiant heat is used; however, with forced hot air heating, conventional filters have to be put in the heating ducts as well. The installation of such devices is becoming less costly each year, and the expense is tax deductible if they are installed with a doctor’s prescription.

*20/99/5*

We are going against nature with assisted conception techniques like IVF because the body is being asked to mature a great number of eggs in one cycle. (Normally only two at the most would ever be released at the same time.)

The question which is often asked, and rightly so, is: what are the long-term effects of taking these drugs on you and the baby that is conceived? And what are the effects if you have 12 attempts at IVF in an effort to conceive a child?

These questions are not easy to answer at the moment because the first baby born from IVF is only 21. In fact no drugs were used at all to achieve that first success. It was just done with the woman’s natural cycle, taking the one egg that was produced. The doctors had used drugs before with their other unsuccessful IVF patients but felt that this was hindering the success of the treatment.

At the moment it is not easy to say what the long-term effect on the ‘test tube babies’ will be, because they are still growing up. We do not yet know what effects the drugs will have on their fertility, for example.

It stands to reason that bombarding the ovaries with drugs like clomiphene is likely to have a long-term effect on the mother, however. The ovaries are being stimulated in a totally unnatural way and concerns have been expressed about the risk of ovarian cancer. At least one high-profile victim, the late fashion editor Liz Tilberis, believed that her disease was linked in some way to fertility treatments she had had years before.

Ovarian cancer is called the ‘silent disease’ because it is not usually detected until it is well advanced. There are two theories as to the natural cause of ovarian cancer. One is that each time a woman ovulates there is damage to the surface of the ovary which eventually triggers cancer. This is backed up by research which shows that women who ovulate less, such as those who have quite a few pregnancies and also breastfeed, have a lower rate of ovarian cancer. The other theory is that ovarian cancer is triggered by exposure to gonadotrophin hormones which are also used in IVF treatment.

The scientific results are not conclusive and more long-term research needs to be done. Some studies show that there is an increased risk of ovarian cancer for women who have undergone fertility treatment. Others show no risk.

It is wise to be cautious about any fertility treatments you are offered. They should be regarded as a last resort, once you have really tried the alternatives outlined in this book.

Fertility treatments may involve heavy doses of drugs as well as invasive medical procedures. They can be embarrassing and uncomfortable, and can certainly put a strain on your relationship with your partner. They are by no means an easy option, and that is something to think about and weigh up if you are concerned that following my Four-Month Preconception Plan is too demanding.

If you are in your twenties or early thirties you have enough time to complete the Four-Month Plan and wait a few months for the improvements in your health and fertility to become established. What have you got to lose?

If you are older you should start having tests earlier but, by following the Four-Month Plan, you will be in much better shape whatever choices you finally make.

*96/73/5*