Depression is already a known risk factor for cardiovascular disease but it seems that taking antidepressants may significantly increase the risk of stroke for women who are postmenopausal.  The study is based on data from the well respected Women’s Health Initiative which was responsible for proving that hormone replacement therapy significantly increased the risk of heart attack, stroke, cancer and death in postmenopausal women.

This latest study took place over six years and involved over 136,000 women between the ages of 50 and 79. The study found that those taking antidepressants were 45 percent more likely to suffer from a stroke during that period than women not taking the drugs, and 32 percent more likely to die from any cause.  The risk of stroke for a postmenopausal woman taking an antidepressant was roughly one in 200 in each given year and the increased stroke risk from antidepressants remained the same regardless of which drug class women were taking – whether selective serotonin reuptake inhibitors (SSRIs) or tricyclics.  However SSRIs appeared to pose a higher risk for a hemorrhagic stroke caused by brain bleeding.

The Stroke Association are currently funding further studies to look into the links between depression and the risk of stroke.  If you want to reduce your own risk then simple steps to take are lifestyle changes such as reducing your blood pressure, giving up smoking, reducing alcohol intake, improving your diet and getting plenty of exercise.

Girls are most likely to have their first migraine headache in their teens and it usually occurs with the start of menstruation. This time of hormonal upheaval can be a factor in many conditions, but it does seem that the decline in the blood level of estrogen during the onset of menstruation is a trigger. It may be that it is the fluctuating levels of estrogen, rather than the estrogen itself, that are at the root of this condition. Our central nervous system is highly sensitive in responding to hormonal fluctuation and it is an entirely normal reaction.

Once out of the teenage years, there is a marked increase in the number of women suffering migraines, mostly after the age of 40. The good news is that it does seem to diminish once menopause starts, so that is one potential blessing!

Many women as part of their PMS symptoms do suffer from headaches, but they usually cease when the period starts. Migraines related to menstruation tend to happen 2 days before and 2 days after the period’s onset and the first day is when they are most likely.

A headache is a headache, but migraine is unmistakable because of its distinct symptoms. The pain is intense and often on one side of the head only and you will be highly sensitive to light and sound. Nausea is common and any movement makes it worse with many experiencing disturbance to the vision – seeing flashing lights or an aura around objects.

Some things can make it worse, the contraceptive pill for instance has been linked to an increase in migraines but some women have found that it has improved them – that hormone fluctuation may have been balanced out by the pill. If you are on the pill and suffering, talk to your doctor about the dosage of estrogen you are receiving as the migraine risk is linked to that, and not the the progestin the pills contain.

What can help?

There is no permanent cure for migraines, though there are things that can help. First identify if you have a specific trigger that brings on your migraine and avoid it. The most common are: stress, sleep disturbances, fasting, hormones, bright or flickering lights, odours, cigarette smoke, alcohol, aged cheeses, chocolate, monosodium glutamate, nitrites, aspartame, and caffeine.

Natural help can include the mineral magnesium, the herb feverfew and 5-HTP. The latter is a compound produced in the body from the amino acid tryptophan to make the neurotransmitter serotonin and the hormone melatonin in the body. Therapies that many have found relief with include acupuncture, chiropractic and biofeedback. 

However, all hormones, although natural, are powerful substances and to quote my good friend Dame Dr Shirley Bond ‘should not be taken as a preventive, but for a specific and needed purpose.’  She is backed up by a recently published assessment by the American Medical Association (AMA) of the risks and benefits of growth hormone, testosterone, estrogen and DHEA for anti-ageing.

One leading medical authority in the USA who has criticised the use of anti-ageing hormones is Dr. Thomas T. Perls, an associate professor of medicine at Boston University School of Medicine.   In an editorial appearing in the Future Medicine journal Ageing Health, he applauds the courage and example displayed by the AMA and particularly takes drug companies to task for their use of the words ‘all natural’ relating to drugs that are exactly the same as hormones prescribed by endocrinologists for specific diseases.

The AMA’s review of the risks and benefits of these hormones in relation to anti-ageing concludes that the risks of these hormones out-weigh the little or no benefits.

Specific problems with testosterone

By the late 1940s testosterone was being touted as an anti-ageing wonder drug and it has specific, and good, medical uses.  For women it has prescribed for low sex drive and depression and the side effects most commonly reported are acne and weight gain – due to changes in bone and muscle.  However there is a theoretical risk that testosterone therapy may increase the risk of breast or gynaecological cancers, and further research is needed on this link.   In 2006 it was reported that women taking a combination pill including estrogen and methyltestosterone (a synthetic testosterone) were at considerably heightened risk of breast cancer. This drug was withdrawn.

For men the risk of testosterone therapy can be problems in urinating and the development of fatty tissue in the breast area.

Whatever you feel about the ageing process it might be wise to discuss any such hormone therapy with your doctor and ask about both the success rate, and the risks.

The key here of course is ’some extra pounds’ and in fact keeping an eye on your weight from as early as age 20 can help protect you against breast cancer. This finding comes from a National Cancer Institute (NCI) study in the USA of 72,007 postmenopausal women who were enrolled in the NCI’s Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial.

Their conclusions are startling. When they analysed all the data they concluded that a 30-pound gain over the period from age 20 to menopause for a five-foot, four-inch woman nearly doubled the risk of developing breast cancer after menopause had begun.

Of course other factors such as family history, whether menstruation commenced early (another high risk factor) and if a woman has had children or not were taken into consideration.   However, a simple weight gain of only 2 pounds a year over the period were found to be as significant as any of the traditional risk factors.

This extra weight was revealed to be as significant as family history of the disease, the age at which a woman begins to menstruate (the earlier, the higher the risk), or whether or not she has had children and the age at which she gave birth.

However, you have to keep a sense of proportion because double the risk means that instead of one in a hundred women it could be two, but of course none of us wants to be that second woman.  Keeping a healthy eye on your weight from your twenties onwards obviously makes sense and the two key factors are a good diet that includes plenty of omega-3 fatty acids and regular exercise.

This finding was reported at the American Stroke Association’s International Stroke Conference 2010 and the warning bell is for women having more than 7 grams a day of trans fats, mostly found in processed, baked and fried foods.

Ischemic strokes are caused by blockages in blood vessels in or leading to the brain and the researchers reported positive associations between total fat intake and ischemic stroke incidence and between trans fat intake and ischemic stroke incidence. We know from previous studies shows that different types of fat have different effects on the incidence of coronary heart disease (CHD), with trans fat being identified as a risk factor but those were small scale studies. This one involved 87,230 post-menopausal women ages 50 to 79 who participated in the Women’s Health Initiative (WHI) Observational Study, by answering a food frequency questionnaire when they entered the study and were then followed for an average of 7.6 years.

During that time, 1,049 ischemic strokes occurred and the researchers looked for links between dietary fat intake of all types (saturated fat, monounsaturated fat, polyunsaturated fat and trans fat) and ischemic strokes and covered all health variables including physical activity, drug use, smoking, alcohol and hormone therapy. The top 25% of women had an average total fat intake of 86 grams a day and the lowest 25% consumed just 26 grams a day. With a 40% risk of stroke at the top end of fat intake it makes sense to monitor fat intake, and particularly trans fats to keep their levels down.

If you are not sure of how much fat a day you take in, there is a handy way to determine it and the example below is based on the average amount that a woman needs which is a total of 2,000 calories a day, but you can be more accurate by exactly working out your daily calorie intake.
1. Take the number of calories you eat each day and multiply it by 30 percent (.30). For example: 2,000 calories x .30 = 600 calories from fat
2. Divide your answer by 9 because there are 9 calories in each gram of fat. This will give you the number of grams of fat per day that should be your goal.
600 ÷ 9 = 65 grams

You can use a calculator if you need to!

It involved almost 58,000 women in France over a 12 year period and adds to a growing body of evidence suggesting a link between some female hormones and asthma. French and Mexican researchers found that compared with women who had never used any form of HRT, those who did use it were 21 percent more likely to develop asthma, but the risk was most significant in those using estrogen alone.

Among these women, the overall risk of asthma was 54 percent higher than for women who had never used any form of HRT, the scientists from the Gustave Roussy Institute in France and the Instituto Nacional de Salud Publica in Mexico wrote in a study in the British Medical Journal’s Thorax publication.

“There is now a large body of evidence suggesting a link between female hormones, including the use of HRT, the development of asthma and its severity,” Leanne Metcalf, director of research at the advocacy group Asthma UK, said in a commentary on the study.”However this is the first large-scale and long-term study to suggest that it is estrogen-only HRT which significantly increases the risk.”

Experts say asthma is more common in young women after they have started having periods, and hospital admissions for asthma are more common among women than men. Hormones play a part too, as the severity of asthma also varies throughout the menstrual cycle and during pregnancy, but the incidence tends, in general, to fall after menopause.

So what caused that drop of 50 per cent in taking HRT? It seems this is what John Lee described as women ‘voting with their bodies’ rather than the medical profession prescribing less.

A study undertaken in 2009 at Stanford University in California found that women who take HRT for more than five years double their risk of suffering breast cancer for every 12 months they spend taking it. Breast cancer is the most common form of the disease diagnosed in women in Britain and one in nine women will develop the disease at some form in their life. More than 45,000 cases are diagnosed every year and about 15,000 women die from the cancer, although survival rates have increased significantly in recent years.

However, the good news is that within a year of stopping HRT the risk of developing breast cancer was almost back to normal. This was not a small scale study either, unlike the original research on HRT, as more than 57,0000 women were studied which enabled the research team to say conclusively that there was very strong evidence that HRT causes breast cancer.

Cancer, wherever it occurs, brings a whole maelstrom of emotions and feelings along with the physical effects and depression is certainly one of them. If a woman with breast cancer takes Paroxetine, the generic name of an SSRI drug now commonly prescribed for depression, there is a serious risk to consider.

Paroxetine may be given under the trade names of Seroxat or Paxil and if taken at the same time as Tamoxifen has an increased risk of death according to a study published on the British Medical Journal website. Why the increased risk? Because paroxetine itself does not cause or influences the course of breast cancer but it impairs the effectiveness of Tamoxifen.

Whatever the advisability or not of taking Tamoxifen, the reality is that in order to work, it must be converted into an active metabolite (endoxifen) by the liver and antidepressants can interfere with this process. Because it is common for women with breast cancer to be on antidepressants for long periods of time, and although many antidepressants have little or no impact on tamoxifen’s metabolism, paroxetine is a potent inhibitor of the metabolic step that converts tamoxifen to endoxifen.

This latest research was carried out by Dr Catherine Kelly and colleagues at the Institute for Clinical Evaluative Sciences (ICES) in Toronto and they concluded that Paroxetine, but not other SSRIs, in combination with Tamoxifen, was associated with an increased long-term risk of breast cancer death. The researchers estimate that treatment with paroxetine for 41 percent of the total time on Tamoxifen will result in one additional breast cancer death at five years for every 20 women so treated. One of the study’s authors, David Juurlink a scientist at ICES, went further and stated that “these results highlight a drug interaction that is extremely common, widely underappreciated and potentially life-threatening, yet uniformly avoidable.”

This means that the choice of antidepressant can significantly influence survival in women taking Tamoxifen for breast cancer, so needs to be thoroughly discussed with your doctor or cancer team. Any women currently taking this potentially lethal duo also needs to discuss withdrawal of the antidepressant as it should not be abruptly withdrawn to minimise side effects.

Organic matcha from specialty company Teapigs comes from the renowned Nishio region in Japan, where the tea leaves are grown under cover for the last few weeks to produce the maximum amount of amino acids and the chlorophyll that gives it the green colour. The leaves are then dried and very slowly ground by a granite stone to a very fine powder, which is then packed and sealed immediately to lock in all the nutrients. Just a quarter teaspoon of this bright green powder gives you the same health benefits as equivalent of15 cups of regular green tea and contains 70 times the antioxidants of orange juice, 90 times the beta carotene of spinach plus vitamins A, B and C.

What more can you want? The thing I particularly like about green tea is that it is both energising and calming and because matcha is a fine powder that you mix with hot or cold liquid there is no waste as you have the whole leaf in powder form. Matcha can be drunk like any normal green tea – with hot water – though I prefer to start the day with it on an empty stomach and mix it with juice or a smoothie. It feels odd to be glugging down a green liquid, but the result is worth it. When I am packing for a stint as a speaker on a cruise ship, it’s the first thing into the case!

If you have had an overindulgent Christmas and New Year followed by this debilitating cold weather then that can really impact your health. A simple way to remedy that is to use matcha in a smoothie recipe for breakfast to set you up for the day. This delicious recipe was devised at Jamie Oliver’s Fifteen Restaurant in London

In a blender put the following:

2g (approx 1/2 teaspoon) matcha

1/2 apple

1/4 stick celery

2 sprigs mint

1/2 banana

1/2 pear

Blend and drink- delicious

Food scientists Dr. Susanne and Steve Talcott undertook a study at Texam A&M University on five varieties of mangos that are most common in the USA. Kent, Francine, Ataulfo, Tommy/Atkins and Haden, in case you are interested, and they specifically tested polyphenol extracts from the fruit on colon, breast, lung, leukaemia and prostate cancer cells.

Polyphenols are natural substances in plants that are antioxidants with the potential to protect the body from disease and this research focused on polyphenolic compounds in mangos known as gallotannins, a class of natural bioactive compounds believed to help prevent or block the growth of cancer cells.

The results are encouraging as the mango extract demonstrated some cancer fighting ability when tested on lung, leukaemia and prostate cancer cells, but really were impressive when tested on the most common breast and colon cancers where they were found cause cancer cells to undergo apoptosis, or programmed cell death.

The researchers documented that the division process cancer cells go through was interrupted by mango extract. This is crucial information, for cells that may be on the verge of mutating or being damaged, mango polyphenolics could prevent this and so prevent cancer.

The scientists have conducted additional research on the colon cancer cell lines because mangos contain small molecules that are readily absorbed in the colon as well as larger molecules that are not absorbed and remain present longer in the colon. That could potentially make eating mangos a potent way to help prevent colon cancer.

Time to add mangos to one of your five a day?