Health News. Lots of resources and information

This very itchy skin infection is caused by a tiny (0.4 mm) mite called Sarcoptes
scabiti. The mite burrows into the surface layer of your skin. Its burrow is seen through the skin as a fine, red, wavy line. The adult female lives in the burrow for four to eight weeks, laying a couple of eggs along the tunnel each day. The eggs hatch onto the skin surface within 10 days and live there for another two weeks until they’re mature enough to burrow in, and so the infection goes on.

The most common places to find scabies tunnels are the wrists, between the fingers, armpits, breasts, penis, scrotum, thighs and buttocks. The itching is caused by an allergic reaction to faeces left by the mite along the tunnel. The itch is worse when your skin is warm after a hot bath or shower, and in bed. If you scratch too much you can tear the skin, which can then become infected by bacteria.

Scabies is caught from any sort of skin contact (including sex), and can also be picked up from clothes and bedclothes. It often spreads to all members of a household and among children who play together.

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Men at risk

Women may be at risk of catching a serious STD from husbands or steady partners who are bisexual, many of whom are very secretive about their homosexual activities. Some men deny their bisexuality, thinking that an occasional homosexual episode doesn’t count. Such encounters are potentially at high risk for STD.

If you suspect that your partner may be bisexual you must protect yourself by asking him about it, hoping that he’ll answer your questions truthfully. The same applies if you think your partner could be having sex with other women, and to partners who inject drugs and share injecting equipment.

Safer sex

These days we are plied with information about safer sex and how to avoid STD. Can sex ever be safe? I hope so! If you and your partner believe that you both carry minimal risk, the way should be reasonably clear.

On a recent plane trip I read an article called ‘Travel Safe’ in the airline magazine. It was about avoiding STD, and advised that everybody should use condoms for all sex when away from home. I thought this statement was rather ambiguous. Did it really mean all sex or only casual sex or sex with a new partner? What if you were travelling with your steady partner?

In Sydney I asked some AIDS educators what they thought it meant. They answered: ‘We now recommend condoms for all sex, even between steady partners’. I asked: ‘Should couples who’ve loved, trusted and been faithful to each other for years start using condoms?’. Yes,’ they replied, ‘you can’t trust anyone about matters of life and death such as AIDS.’

This advice seemed absurd to me. How would babies be conceived? And I don’t like to think that you can’t trust anyone, even your nearest and dearest. Perhaps I’m being unrealistic. I admit that you can’t be absolutely sure, but there must be times when a long-term trusting relationship counts for something. Here are the rules for safer sex.

• Ask new partners these questions.

a How many partners have they had? How often were condoms used? Have they had sex overseas, with other men, or injected drugs? If so, have they been tested for STDs, and when?

b Have they ever had any STD? If so, what, when, how did they get it, how was it treated?

с Have they ever had a transfusion of blood or blood products? Not all people who had transfusions in Australia during the risky years (1980-85) have been tested.

• Use condoms. Condoms used properly give good protection against the transfer of infections from semen and vaginal fluids as well as to and from skin of the penis and vagina (and against unwanted pregnancy). They don’t prevent transfer of infections from other parts of the genitals, which may be important for some STDs. But because of this don’t think they’re not worth using. Condoms are good for preventing most of the serious STDs: HIV, hepatitis, gonorrhoea and chlamydia, as well as many others.

Many people use condoms for the first three months of a new relationship. A round of negative STD tests by both partners after this period offers confidence that neither of you carry an infection if you both remain faithful.

• Sexual activities with a high risk of STD that should be avoided include:

a vaginal sex without a condom

b anal sex without a condom between men or between women and men. When the penis penetrates the anus there is a high chance of breaking skin and lining membranes, opening the way in for infection. Anal sex is thought to be about twice as risky as vaginal sex for transmitting HIV

с sex with casual ‘pick-ups’

d changing partners – the more you have, the greater the risk

e sexual intercourse with anyone who has a genital discharge or sore. The latter may not be due to STD (for example, it could be due to injury or some sort of dermatitis) but it’s wise to make sure before taking a chance.

• Avoid contact with anyone else’s genital secretions until you know they’re safe.

You have every right to refuse sex or insist on condoms and other safe sexual practices. Remember that there are many ways that you can both be sexually satisfied (by ‘heavy petting’ and mutual masturbation) without penis-in-vagina intercourse. But though the women’s movement has given many women the confidence to make their own decisions and take initiatives in many matters, there are lots who still find it hard to say ‘No’ to men about sex, suggest alternatives to intercourse, or stand up for their right to protect themselves against STDs. But it’s your responsibility to guard your health.

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If you have endometriosis, there is always a choice whether or not to have treatment and, if so, what type. You will decide with your doctor what to do, and your choice will be guided by your symptoms and whether you want to become pregnant.

The aim of treatment is to relieve symptoms and preserve or restore fertility. Medical treatments include pain relievers, hormonal treatment and surgery. There is no treatment suitable for every case, and no guaranteed cure.

In mild cases with few or no symptoms it may be appropriate to wait and see if the disease gets better or progresses. You’ll need regular checks, and if there’s no improvement you’ll probably accept more active treatment.

Another option is to relieve pain without treating the disease by taking pain relievers and/or anti-inflammatory drugs. This may be suitable if the pain is mild or if you’re near the menopause, after which symptoms usually subside. Other measures that help with any chronic pain, such as heat pads or a hot-water bottle, massage, yoga, meditation and acupuncture have brought relief to some sufferers.

The hormones used to treat endometriosis either prevent the production of oestrogen or counteract its effect. Without oestrogen, endometrial tissue doesn’t grow and the endometrial deposits outside the uterus become inactive and shrink.

Hormonal treatments used in Australia include danazol (Danocrine, Azol) and progestogens (Duphaston, Primolut N, Provera, Depo-Provera). Danazol is a weak male hormone that reduces the amount of oestrogen produced by the оvaries to postmenopausal amounts. Progestogens also reduce oestrogen production (though not as much as danazol does) and if taken continuously prevent breakdown of endometrial tissue. Sometimes the combined oral contraceptive Pill, taken continuously, is used to stop endometrial breakdown.

All hormonal treatments take six weeks to relieve symptoms used in courses of 3-12 months have side-effects: if hormonal treatment is suggested, you should be told what side-effects to expect. The condition can relapse after hormonal treatment is stopped.

Surgery may be needed to remove tissues affected by endometriosis: not only the deposits and cysts, but also adhesions within the pelvis and abdomen. It is often combined with hormonal treatment.

Some women try alternative therapies for endometriosis. These include a variety of diets, vitamin and supplements; naturopathy; homeopathy; osteopathy; herbal remedies. Many of
these therapies include counselling about self-esteem and lifestyle and can lead to new, beneficial attitudes to life and health, but I’ve heard no evidence that any alternative treatment (except some herbal extracts that contain hormones) сan influence the course of endometriosis.

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Can you catch thrash from sex or from other people?

It’s possible but not very likely. If your sexual partner has Candida in his penis or around his fingernails it could be transferred to your genitals or vagina, where it could grow and cause inflammation if the circumstances are right.

If you have had sex when Candida is building up in your vagina, your partner will be carrying an excessive amount of Candida on the skin of his penis, even if he has no symptoms. He should be treated at the same time as you; otherwise you’re likely to become reinfected.

It’s also possible to pick up someone else’s Candida from sharing towels, underwear or swimwear.

Symptoms of Candida vaginitis

Thrush causes redness and swelling of the vaginal lining and a white milky or lumpy discharge that can be maddeningly itchy. The discharge has no particular smell. The inflammation often extends to the genital skin, which becomes red, swollen and tender to touch. Small splits in the skin can develop, which sting badly when wet (by urine or washing). Sex and inserting tampons are usually painful.

How can Candida be diagnosed?

Very easily. The appearance of the discharge and the vaginal walls is usually enough to arouse suspicion, which can be confirmed by a simple on-the-spot examination of the discharge under a microscope. The budding threads of the fungus are unmistakable, but if any doubt remains, Candida can be cultured in the laboratory.

Is Candida ever misdiagnosed? Yes, if the diagnosis is made only on the symptoms and without identifying the fungus, mistakes may be made. Many women consult their doctors saying ‘I have thrush again’ and are given a prescription for antifungal medication without being examined, when their symptoms may be due to other causes. And women with candidiasis that affects mainly the genital skin may have little or no discharge; the main symptom will be burning on passing urine. If they are not examined, the problem may be diagnosed incorrectly as cystitis and treated with antibiotics, which makes the candidiasis worse.

For correct diagnosis, the fungus must be seen under the microscope.

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What are the symptoms?

Though some older women notice gradually
increasing joint and muscle aches and pains because their weakened bones are
less able to support the weight and movements of their bodies (and thus the onset of arthritis and tendon changes are hastened), it is a broken bone that most often gives the first clue that osteoporosis is advanced.

These fractures may happen as a result of a very slight injury or during normal daily activities such as bending, twisting, lifting a grandchild, being hugged and pen for no apparent reason. The bones of the spine, wrist, upper arm and hip are most likely to fracture.

The spinal vertebrae are at great risk because they contain a high proportion of the scaffold-like bone most weakened by osteoporosis. Fractures in the spine are often of the insidious ‘crush’ type where small areas of the vertebral cores collapse torn
time to time, resulting in curvature of the upper spinal – the dowager’s hump’ that used e considered inevitable in older women. Spinal fractures can also occur very suddenly causing severe pain radiating the trunk.

These spinal fractures can’t be straightened. The bone sets in the crashed position, leaving the spine permanently curved and resulting in loss of height, pain and disability due to distortion of posture.

Why is osteoporosis so much in the news today?

Osteoporosis is not new, but because there are many more older people (especially women) in the population now than there were 50 years ago, fractures due to osteoporosis have become an important problem of public health.

Let’s look at some statistics.

• In 1900 the average life expectancy for women was around 50 years of age: today it’s around 80 years. In women, most fractures due to osteoporosis occur after the age of 65; from then on the rate of these fractures doubles every five years.

• In the year 2000 there will be twice as many Australian women over the age of 80 as there were in 1985.

• In Australia, nine out of ten fractured hips occur in postmenopausal women.

• It is estimated that female hip fractures use around $400 million per year in health-care costs; other fractures due to osteoporosis cost a further $400 million.

• The number and cost of fractures from osteoporosis can be expected to double by the year 2020 due to the ageing of our population.

Can something be done to reduce the health problems resulting from osteoporosis? Yes! This is another reason for osteoporosis being so much in the news. It is now clear that fractures and other disabilities due to osteoporosis are mostly preventable.

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