March is Endometriosis Awareness Month, yet we hear so little about a disorder that affects 200 million women around the world. Yes, on average, more than one in 10 women of reproductive age will be diagnosed with endometriosis during her lifetime. A whole-body disease that can affect any organ or tissue throughout the body, endometriosis is a condition where cells similar to the ones lining the womb are found elsewhere in the body, usually within the pelvic cavity.
Each month, these cells react to the menstrual cycle in the same way to those in the womb, building up and then breaking down and bleeding. Unlike the cells in the womb that leave the body as a period, this blood has no way to escape, which leads to inflammation, pain, and the formation of scar tissue (known as adhesions). A wide range of symptoms are presented, including pelvic pain, severe cramps during menstruation, heavy irregular periods, painful abdominal swelling, pain during sexual intercourse, fatigue and weakness, painful bladder and bowel movements, and gastrointestinal symptoms such as constipation, bloating, and diarrhoea.
Endometriosis is also one of the leading causes of infertility, with nearly 50% of infertile women suffering from the condition, occuring from puberty to menopause – although the impact may be felt for life. While the cause of endometriosis is still unknown, genetic, environmental, and anatomical causes may contribute to its development. Despite there being no way of preventing endometriosis, there are ways of managing both the condition and its symptoms.
Only the second doctor in the world to be certified as a Master Surgeon in Endometriosis Care, Dr. Charles Nagy from Medcare Women & Children Hospital in Dubai has noted an increase in endometriosis cases over the decades. “Diagnosis of endometriosis can often take many years, with the average time before accurate diagnosis is achieved anywhere between seven and 10 years,” he explains.
“While the causes of endometriosis are unknown, and there is currently no cure, there have been many theories that have tried to explain the disease – the most prevalent being the retrograde menstruation theory, where some of the cells of the lining of the womb spill into the abdomen during menstruation and stick to the ovaries, fallopian tubes, bowel, or bladder. Other factors include immunological dysfunction, metaplasia of normal cells of the peritoneum into endometriosis, and certain environmental toxins.”
While the cause of endometriosis is unknown, genetic, environmental, and anatomical causes may contribute to its development. Despite there being no way of preventing endometriosis, there are ways of managing both the condition and its symptoms, with some sufferers combining surgical and pain relief treatments with yoga to relieve pain symptoms.
“If untreated, endometriosis can lead to serious health complications, including bowel obstruction, permanent damage of the ovaries, bladder dysfunction, kidney failure, and infertility – and this is not taking into consideration the impact on quality of life and even a women’s career due to the chronic pain that accompanies it,” adds Dr. Nagy. “This is why it’s crucial that it be diagnosed and treated as quickly as possible by experienced doctors in a dedicated division that focuses on the management of endometriosis. Treatment can be either medical or surgical, depending on the woman’s age, fertility requirement, and severity and location of the disease, but one certainty is that this treatment will make a hugely positive impact on the quality of life that each woman manages to lead going forward.”
In a world where influencer fatigue is all too real, one woman by the name of Emma Armstrong – a.k.a. The Naked Doula – is using her platform to revolutionise birth and help pregnant women worldwide. The award-winning birth influencer has dedicated her life to educating women on how to have an empowered birth, turning tragedy into triumph.
“For me, being a birth influencer is helping women to find their power and influence their birth experience,” she explains. “I’ve always been a cheerleader for women, but when my mum passed away during my pregnancy, I was inspired. I took the grief and powered it into something truly special – and with that came my mission to inspire others globally!” Today, Emma not only conducts the Visual HypnoBirth Course that’s rooted in visual information to change the way women perceive childbirth, but she’s also the creator of fun yet informative flash cards designed to guide women from pregnancy to the early days of motherhood.
As for what she believes an empowered birth entails? Well, it starts with you. “Only you can empower yourself,” she asserts. “I don’t empower women – I give them the tools and motivation they need to find the power inside of them and relight a fire to feel confident and in control of their birth experience by making informed decisions.” As the realm of childbirth remains riddled with myths and misconceptions, Emma says she wishes that women would stop believing that they have to do what they’re told. “We often have no clue that we have the right to full body autonomy and can decline anything – we can make all the decisions about our bodies and birth!” Here, she shares seven of her top birthing hacks.
“Drinking from a straw whilst in labour instantly relaxes the masseter muscles, which you find on each side of your face. Once we are able to relax these muscles, its connection to our pelvic floor means this relaxes, too. In turn, you have a relaxed vagina and more elasticated perineum. It also means that, during contractions, our uterus has the space and room to do its job without restriction as our pelvic floor muscles are relaxed!”
“Extra-virgin olive oil is extremely beneficial in pregnancy and birth. I recommend women use this on their perineum whilst doing perineal massage as it doesn’t affect your vaginal microbiota – so basically, it won’t affect your pH levels or that wonder bacteria we need! Doing this regularly from 34 weeks decreases the chances of tearing in childbirth.”
“Dates, as mentioned in the Quran, were used at the birth of Jesus! Mary ate them to help ease the ‘pain of childbirth’ and there is definitely truth in this. If eaten from 34 weeks daily (x6 medjool), dates are linked to an easier labour. This is because they strengthen the uterus muscles, have a positive effect on the cervix, and have been shown to help women dilate quicker and with less discomfort, so they’re an all-round winner.”
“Singing is such a beautiful tool to use whilst in labour. There are a few benefits to this. The first is that as soon as we start singing, we activate the vagus nerve, allowing our brain to switch into a state of calm. Feel-good hormones are released and, generally, we feel amazing. It’s also been theorised that, as we sing and our voice box vibrates, the cervix/vagina has these same vibrations. The term ‘cervix’ comes from the Latin word for the neck. Also, the vagina and the throat are almost identical to each other in structure, so the more we sing, the more we dilate – in theory!”
“The phrase ‘Floppy Face Floppy Fanny’ was originally coined by American midwife Ina May Gaskin many years ago, when she shared how the face and bottom are connected. As I studied this, I found that it’s actually everything to do with the vagina – the face is connected to this area in so many ways, starting from when we’re embryos. With the word ‘fanny’ used for vagina in the UK, it made sense to create this mantra that women could chant during birth. Not only does it have an extremely powerful impact, but it’s literally changing the way we birth worldwide. In turn, it’s become a solid favourite in my community and something that I’m recognised for.”
“While the position at birth should always be instinctive, laying on your back goes against gravity. It also increases the chance of intervention tearing and overall loss of control. Instead, being upright or even laying on your side can bring your baby into the world a lot easier and with less need for intervention. KICO – a term I coined that means Knees In, Calves Out – is a technique where you’d bring your knees inwards and feet and calves out. If you can’t do this, then just bringing your knees parallel makes the difference. This way, the biomechanics of the pelvis means that the outlet space opens, giving the baby optimal room to turn and be born.”
“The environment is one of the most important things when it comes to birth, and we can influence this wherever we are! Start by thinking about the environmental factors of the womb that your baby is in warmth, trust, safe, familiar sounds, darkness with shades of red, hydration. Now think about how you can alter your environment to match this. Turn down the lights, wear an eye mask, listen to music that’s familiar to you, and take items that are of sentimental value or hold wonderful memories.”
Vitamin C seems to be everywhere these days, from multivitamin supplements and cosmetics to skincare routines – but what’s all the fuss about? Vitamin C, also known as L-ascorbic acid, is not made by the body, making it is an essential dietary component as well as a helpful skincare staple.
The Benefits of Vitamin C
Oral vitamin C is needed to make collagen, which is necessary for healthy connective tissue, cellular growth, repair, and wound healing to produce nerve-transmitting chemicals, neutralise cell-damaging free radicals, and support our immune system. It’s also needed for the absorption of minerals, such as iron from plant foods.
Severe vitamin C deficiency – now rare in the developed world – leads to a condition called scurvy, which is characterised by severe fatigue, connective tissue weakness, and bleeding. Smokers and those with suboptimal diets are at risk of this deficiency. There is also data to support vitamin C’s role in cancer prevention and treatment, cataract formation, eye degeneration, and heart disease prevention.
How to Get Vitamin C
Great sources of vitamin C include fresh fruits and vegetables such as citrus fruits, capsicum, and broccoli. Note that the cooking and prolonged storage of such foods can reduce their vitamin C content. Eating raw fruits and vegetables, and steaming rather than boiling vegetables, is also better for preserving their vitamin C content.
Dosing of oral vitamin C is personalised by age, gender, medical history, and current symptoms. What we do know is that the best way to get adequate vitamin C is through a healthy diet. The Institute of Functional Medicine advises more than nine portions daily for optimal health and well-being. Prolonged excessive oral vitamin C doses of 1 gram or more can contribute to kidney stone formation.
Vitamin C and Skincare
Skincare products feature vitamin C for a multitude of reasons. It offers some protection against UV light and pollution, supports skin brightening, evens out skin tone, and aids collagen formation (which in turn helps with wrinkles, fine lines, and creating firmer skin). Topical vitamin C is tolerated well by most people. However, minor skin irritation can occur with high potencies or those who have sensitive skin.
When choosing a vitamin C skincare product, always aim for potent subtypes that include L-ascorbic acid, ascorbyl palmitate, and magnesium ascorbyl phosphate. Ideally, the product should be in a slightly acidic water-free formulation – which makes serums a great choice. Starting with concentrations of 10% should be well tolerated by most individuals.
Meanwhile, combining vitamin C with other antioxidants can be a great way to see results. The formulation bottle should be opaque and airtight as vitamin C easily loses its antioxidant properties when exposed to heat, light, or air. Vitamin C undoubtedly possesses a powerhouse of supportive ingredients. For personalised medical advice, though, always speak to your family doctor.
Follow Dr. Preya Patel, a UK-trained Family Medicine Consultant and Functional Medicine Doctor, on Instagram.
Water is an essential element for optimal health, comprising 75% of body weight in infants and 55% in the elderly. According to Harvard Health, it assists in a variety of bodily functions. While there are countless health and wellness benefits of drinking water, several myths about water and how to drink it also persist.
Before we continue, it’s important to understand that the human body is a complex unit. It will also comfort and empower you to know you are well protected by the complexity of your body. It’s not as fragile as it’s made out to be by people who want to sell their services or products using fear-mongering as a marketing strategy, so here, we address five myths about drinking water.
MYTH 1: Water can dilute stomach acids.
An often-asked question is if drinking water can dilute stomach acids. To explain this a little more, let’s look at two scenarios. The first is drinking water on an empty stomach. Water is absorbed in about approximately five minutes, and there is no release of stomach acid when water alone passes through the stomach to the small intestine. So, in this case, there is no dilution of stomach acid happening simply because none was released in the first place.
The second scenario is when water is consumed with a meal. Water helps lubricate the food we swallow, especially when we are eating way too quickly with minimal chewing. The mix of food and water adds volume, which leads to the expanding of stomach walls and releasing of digestive juices simultaneously. The stomach releases stomach acid (also called hydrochloric acid or HCl for short), which creates a highly acidic environment in the stomach with an average pH level of 2. There are hardly any studies that seem to indicate that the presence of water leads to the dilution of such acids.
One study on 12 healthy subjects showed that drinking water (which has a neutral pH of 7) increased the stomach pH to ≥4 in less than one minute, and this alkalising effect of water disappeared in three minutes. Perhaps, this is how people got the idea that water dilutes stomach acid, but even though water can minimally and temporarily change the pH of our stomach acid, it is insignificant in the grand scheme of things as the contents of our stomach are constantly monitored to adjust to different components of our meals.
A related misconception is that water will ‘flush’ our meal out of our stomach. Yes, liquids do go through our stomach faster than solid food, but this doesn’t impact the solid parts of our meal. It just stays in our stomach until it’s digested enough to move along to the next part of our digestive tract.
MYTH 2: Drinking lots of water with meals helps with mindfulness.
When it comes to mindful eating, it’s best to avoid taking water with your meals as it can be a cue for us to ‘cheat’ on chewing our food, which helps to physically break down food and gives enough time for the mouth to mix food with saliva, thereby starting the digestion process. Drinking water with your meals may lead to a reduction in chewing as the water can aid in pushing the food down. While sipping on water (as needed) when eating your meal is fine, taking large gulps may not be a good practice for mindfulness.
MYTH 3: Drinking water with a meal can cause weight gain.
It’s standard for nutritionists to advise clients trying to gain weight to avoid water with meals to help them take in more calories, but that doesn’t mean having water with food directly causes weight gain. In fact, for those who are trying to lose weight, water with meals could be a positive habit that will help some to slow down the rate at which they eat as well as reduce their food portions, thereby helping them achieve a calorie deficit.
MYTH 4: Drinking water while eating can make you sick.
In most cases, drinking water with meals shouldn’t make people sick, but it may trigger reflux symptoms in those with GERD (gastroesophageal reflux disease). This can happen as the extra water can add volume to your stomach, and more volume leads to more pressure. This pressure can then allow acid to move back up the wrong way in some people.
Those who have gone through bariatric surgery are also asked to avoid having water and food at the same time because of the surgical changes to their digestive system. They often have to work on the timing and quantity of water they consume to avoid difficulties.
MYTH 5: Children’s stomachs are too small to drink water with their meals.
I still remember my mom telling me not to drink water with my meals. Years later, when I asked her why, she said it was to make sure I didn’t fill up my stomach with water, which could lead to food being wasted. Admittedly, children do have small stomachs that tend to get filled quickly, but again, this need not apply to all the children. If your child is able to eat enough whilst having water with their meals, then that’s absolutely fine.
Have you ever found yourself holding open the fridge door, peering in, and blankly looking at its meagre contents in the middle of the night? Your baby might have been up for what feels like a gazillion hours and you can actually count the minutes you’ve slept with both hands. Looking into the fridge, you might be starving or bored if your baby is finally sleeping – or even both! You might feel like you can’t be bothered to whip up anything healthy and nutritious.
Instead, you’re wishing and hoping that a giant tub of ice cream or a mouthwatering bar of chocolate would fall into your hands. And then you remember all those food delivery apps on your phone! At the click of a button, you can now satisfy all your cravings. Hello sugar high, and hello sugar crash! Ah, motherhood – where poor sleep leaves the nights long and the days even longer. Sleep deprivation is part and parcel of this journey, but what we often don’t realise is that with sleep deprivation can come strong food cravings. Thought you were over the cravings from when you were pregnant? Think again. Here are some ways that you can crush them.
Get Some Sleep!
When sleep deprived, our body creates a hormonal imbalance of Leptin and Ghrelin, which can affect the regulation of hunger cues and cause us to overeat or reach for foods that are a lot higher on the calorie count. And in some instances, it can even make us not want to eat much at all!
When we are tired – okay, exhausted – from being up all night, rocking and shh-ing the baby, reaching for that sugary ‘quick fix’ is generally what most mums find themselves doing when we have a minute to ourselves. Then, 12 months postpartum, we wonder why we look almost the same as we did the day we gave birth! I was on the same boat, too. So what can you do to stop yourself from reaching for the sugar rush?
The Sleep Foundation in Australia recommends that the average adult get eight hours and 15 minutes of sleep per night. Now, with a newborn, it is highly unlikely you’re going to be getting that, so if your baby is on a schedule, take a nap when they take their longest nap. If you aren’t quite there with a schedule yet and are a bit more relaxed about sleep times, observe your baby’s cues and choose one or two of those nap times to get some rest yourself.
The standard recommendation of the amount of water we should drink is between six to eight glasses per day. Active mums, those of us living in the Middle East or hotter climates, and those who are breastfeeding may need to up their intake of water by one or two glasses. Sometimes, our bodies will think we are hungry when we’re actually thirsty.
If water is not a regular go-to drink for you, then try some alternatives like super smoothies. Smoothies are a great way to keep hydrated, boost energy, and curb sugar cravings. To make it quick and easy, I usually add frozen fruit and baby spinach. I also freeze some bananas when they are looking a little too old. This is my go-to energy boost smoothie:
1 cup almond milk (or any milk of your preference)
1 cup of water
½ frozen banana
1 cup of berries (I often use blueberries, but you can also get a mixed bag)
1 tablespoon of honey
1 tablespoon of peanut butter
¼ cup oats
1 cup frozen baby spinach (optional)
Combine all ingredients in a blender.
Blend until it’s smooth.
A word of warning: the spinach can make the smoothie look more like a blended frog, but the honey helps cut through some of the bitterness and makes it taste better than it looks.
I know the last thing you probably want to think about when you are already using toothpicks to keep your eyes open is exercise, but doing a few minutes of gentle exercise can not only help perk you up, but also distract you from reaching for those sweets! Training was always very important for me, so I did this on a daily basis anyway, but when the sugar monsters called, I’d sometimes put on music and dance to distract myself. And once I was done, I’d be smiling, my cravings have subsided, or I’d have distracted myself enough that I didn’t feel like it anymore. All I’d have was simply drink water to quench my thirst.
Be Careful of What You Add to Your Cart
Always leave the treats for someone else to buy. Steer clear of the aisles stocked with chocolate, ice lollies, and ice cream, filling your trolley with wholesome fruits and vegetables instead. However, if you do fancy a sweet quick-fix for an energy boost, then I highly recommend the Slim Secrets Bare Bar Double Choc protein bar. They’re keto-friendly, packed with almond protein, and covered in mouthwatering chocolate.
Don’t Feel Guilty
Okay, so you haven’t done the food shopping yet and the only thing in the fridge is ice cream and chocolate, and your mouth is watering, so you grab the ‘not so healthy’ option. If that happens, that’s okay! Own it! We all need a little pleasure in our lives from time to time. This new mum business is tough stuff.
Just try not to eat the entire pack or tub, and remember that moderation is key. The more sugary food you eat, the higher the calorie content and the harder it is to get those extra kilos off later. Being a mother is one of the most challenging, yet rewarding things you will ever do. Love yourself and love your body. Fill it with good stuff and you will feel so much better.
Demystifying Vitamins with the Help of a Dietician
Edel Warke sets the record straight.
With vitamins promising everything from stress relief to smoother skin, improved immunity, and illness prevention, we’re collectively turning to supplements more than ever before. Heck, those brightly coloured Flintstones gummies have been approved for children as young as two years old. But do vitamins work? Do we all need to complement our everyday diets with them? And how is one supposed to choose? Enter: Edel Warke, Lead Dietitian at King’s College Hospital London in Dubai. Here, she separates fact from fiction across vitamins C, D, and B12 before delving into the subject of multivitamins. Take note!
Vitamin C is effective for preventing and/or fighting off colds.
“Vitamin C is an antioxidant, and has an important role in the immune system. Studies have shown that supplementing with vitamin C does not reduce the incidence of common colds in the general population. It has, however, been shown to reduce the severity and duration of colds.”
The best source of vitamin C is citrus fruits.
“Citrus fruits are an excellent source of vitamin C. It can also be found in kiwi, blackcurrant, mango, papaya, and sweet potato.”
75mg of vitamin C is recommended, but more will further develop immunity.
“The recommended amount differs across countries and is dependent on age and gender. Generally, 40-75mg per day is recommended, although people who smoke need slightly more. Having said that, taking high-dose supplements can lead to diarrhoea and kidney stones.”
Living in Dubai, most of us have a vitamin D deficiency.
“Many people in Dubai have a vitamin D deficiency despite the ample sunshine! Most likely, this is because we often cover up when we’re in the sun, wear sun protection to avoid burning our skin, or even stay indoors because it is so hot outside.”
Vitamin D cannot be absorbed through food.
“Vitamin D is present in some foods and can be absorbed, but it is very difficult to get enough from food. Some food sources include oily fish like salmon and egg yolks. It’s also added to breakfast cereals sometimes.”
Taking 1,000 IU of vitamin D daily eliminates the need for exposure to sunlight.
“The best way to check if you need a supplement is through a vitamin D blood test. Your doctor will then advise what dose of vitamin D supplement you need. This is important as some people will need more than others to ensure a good level of vitamin D, which is important for strong bones and a healthy immune system.”
Vitamin B12 helps boost energy levels.
“Vitamin B12 helps to release energy from food and is also involved in making red blood cells. If you have vitamin B12 deficiency anaemia, you are likely to have extreme tiredness and lethargy.”
Vegans and vegetarians tend to have a vitamin B12 deficiency.
“Vitamin B12 is only present in animal products like meat, fish, eggs, and dairy products, so people who limit animal foods are more likely to be deficient and therefore may require a supplement.”
Because it’s a water-soluble vitamin, getting too much can’t be dangerous.
“We don’t know what type of side effects could happen from taking too much vitamin B12. However, it may be dangerous. If you take a supplement, you should take 2mg or less per day as this is unlikely to cause any harm.”
A multivitamin can cover all your vitamin needs.
“Nutrients function better when they are consumed from whole foods rather than from supplements. By eating a healthy varied diet, it’s likely that you will get all the nutrients you need – unless you have dietary restrictions – with the exception being vitamin D. A multivitamin can be useful if micronutrient intake is low. However, my advice would be to focus on getting what you need from a balanced diet.”
Multivitamins are enough to prevent illness.
“It is unlikely that multivitamins will prevent illness. To support your immune function, focus on a healthy and balanced diet, drinking sufficient water, exercising regularly, sleeping well, and managing stress.”
Multivitamins are unnecessary if one’s diet is balanced.
“Correct. Any vitamin supplementation should be decided on an individual basis. For example, if you have a specific deficiency, are excluding major components from your diet (e.g. vegetarian/vegan), or fall into certain groups of the population (such as pregnant women and young children).”
Multivitamins are a must for picky eaters and/or those on restricted diets.
“This is when a multivitamin might be useful. However, make sure you stick to the dosage on the label, and check that the nutrients in the multivitamin do not overlap with any other supplements you’re taking. Those taking medications should check with their doctor before starting any new supplement, while a dietitian can check whether you’re getting enough of the essential nutrients in the diet and give individual advice of which supplements to take.”
Countless brands make multivitamins – but they’re all essentially the same.
“Many supplements contain similar amounts of vitamins and minerals. Although requirements vary with age and gender, some brands create more specific multivitamins depending on these factors, making it more specific to the individual.”
Here’s what you need to know about Cervical Cancer
Cervical cancer happens when cells change in the cervix, the part of the body that connects the uterus and vagina. This cancer can affect the deeper tissues of the cervix and could spread to other parts of the body (or metastasize), often affecting the lungs, liver, bladder, vagina, and rectum. Most cases of cervical cancer are caused by infection with the human papillomavirus (HPV), which is preventable with a vaccine.
Cervical cancer grows slowly, so there’s usually time to find and treat it before it causes serious problems. Thanks to improved screening through Pap tests and the cervical cancer vaccine, it kills fewer and fewer women each year. Women aged 35 to 44 are most likely to get it. More than 15% of new cases are in women over the age of 65, and especially those who haven’t been getting regular screenings.
What Is a Cervix?
The cervix is the lowermost part of the uterus. It forms a canal between the uterus and vagina, and is almost cylindrical in shape and measures about 2.5cm in length and diameter. It is divided into supravaginal part – the part lying above the vagina – and the vaginal part that lies within the vagina, with each measuring 1.25cm.
The cervix is made of two parts and is covered with two different types of cells. The endocervix is the opening of the cervix that leads into the uterus and is covered with glandular cells. The exocervix (or ectocervix) is the outer part of the cervix that can be seen by the doctor during a speculum exam. It is covered in squamous cells.
The place where these two cell types meet in the cervix is called the transformation zone. The exact location of the transformation zone changes as you get older and if you give birth. Most cervical cancers begin in the cells in the transformation zone.
What Are the Risk Factors of Cervical Cancer?
Almost all cervical cancers are caused by the human papillomavirus (HPV), a common virus that can be passed from one person to another during sex. There are many types of HPV. Some can cause changes on a woman’s cervix that can lead to cervical cancer over time, while other types can cause genital or skin warts.
HPV is so common that most people get it at some point in their lives, and it usually causes no symptoms, so you can’t even tell that you have it. For most women, HPV will go away on its own. However, if it does not, there is a chance that it may cause cervical cancer over time. Other things that can increase your risk of cervical cancer include:
Having HIV (the virus that causes AIDS) or another condition that makes it hard for your body to fight off health problems
The biggest symptom of cervical cancer is that there are no symptoms The symptoms that do show often occur late and include:
Post-coital bleeding (vaginal bleeding that occurs within 24 hours after sexual intercourse)
Bleeding between periods
Bleeding after sexual intercourse
Bleeding in post-menopausal women
Discomfort during sexual intercourse
Vaginal discharge with a strong odour
Vaginal discharge tinged with blood
What Should I Know About the PAP Test?
The Pap test and the HPV test can help prevent cervical cancer or find it early. The Pap test (or Pap smear) looks for pre-cancers or cell changes on the cervix that might become cervical cancer if they’re not treated appropriately. The HPV test looks for the virus (human papillomavirus) that can cause these cell changes.
Both tests can be done in a doctor’s office or clinic. During the Pap test, the doctor will use a plastic or metal instrument called a speculum to widen your vagina. This helps the doctor examine the vagina and the cervix, and collect a few cells and mucus from the cervix and the area around it, which are then sent to a laboratory. If you’re getting a Pap test, the cells will be checked to see if they look normal. And if you’re getting an HPV test, the cells will be tested for HPV.
How Is Cervical Cancer Treated?
Cervical cancer is treated in several ways, and it depends on the kind of cervical cancer and how far it has spread. Treatments include surgery such as a hysterectomy or cryosurgery, and chemotherapy or radiation therapy.
This treatment kills the cancer cells by freezing them. It may be used to treat pre-cancers or abnormal cells that can turn into cancer if not treated.
A hysterectomy takes out the uterus and cervix. It’s the most common way to treat cervical cancer and there are many ways to do this surgery. Sometimes, the ovaries are taken out at the same time. Nearby lymph nodes may also be taken out to see if they have cancer cells. Each type has its own risks.
This method uses special medicines to shrink or kill the cancer. The drugs can be pills you take, medicines given through your veins, or sometimes both.
Radiation uses high-energy rays (similar to X-rays) to kill the cancer. Radiation can be aimed at the cervix from a machine outside the body. This method is called External Beam Radiation. A radioactive source can also be put into the vagina near the cervix. This is called Brachytherapy.
What Is HPV?
Human papillomavirus (HPV) is a distinct group of viruses that spread through sexual contact. HPV is the main cause of cervical cancer and can also contribute to the development of vulvar, vaginal, anal, and oropharyngeal cancers. HPV vaccines help control the spread of the virus. This vaccine for cervical cancer, along with regular screening, can help us win over the cancer as well as protect us from many other infections.
How Is HPV Spread?
You can get HPV by having vaginal, anal, or oral sex with someone who has the virus. It is most commonly spread during vaginal or anal sex. It also spreads through close skin-to-skin touching during sex. A person with HPV can pass the infection to someone even when they have no signs or symptoms. If you are sexually active, you can get HPV, even if you have had sex with only one person. You also can develop symptoms years after having sex with someone who has the infection. This makes it hard to know when you first got it.
How Do I Know if I Have HPV?
There are HPV tests that can screen for cervical cancer. Healthcare providers only use these tests for screening women aged 30 years and older. HPV tests are not recommended to screen men, adolescents, or women under the age of 30. Women may find out they have HPV when they get an abnormal Pap test result (during cervical cancer screening). Others may only find out once they’ve developed more serious problems from HPV, such as cancers.
Which Vaccine Should You Take?
This vaccine stimulates an immune response that protects against nine strains of HPV.
This vaccine is a non-infectious vaccine that protects against four strains of HPV.
Who Needs the HPV Vaccination, and When ?
Across the world, HPV vaccination is recommended at ages 11 or 12, even though it can be given at the relatively young age of nine. The vaccination is highly recommended for all women up to the age of 26 – especially if they were not properly vaccinated against HPV earlier. Experts feel that it is extremely effective when administered before the first sexual intercourse.
What Is the Recommended Timing of HPV Shots?
The vaccine is given in a two- or three-dose schedule, depending on the age of the patient. For ages 9- 14, two doses at zero month and six months is recommended. For ages 15 to 45, three doses at zero month, one month, and six months are advised.
What Are the Side Effects of the HPV Vaccination?
Common side effects include:
bruising or itching at the site of the injection
a high temperature or feeling hot and shivery
pain in the arms, hands, fingers, legs, feet, or toes
Keeping up with your workouts when you’re fasting during Ramadan isn’t easy. It’s even harder when you’re not drinking water from sunrise to sunset as summer approaches. But there are ways to safely maintain your fitness routine – from making tweaks to the type of exercise you do, the duration of your workout, and when you exercise to managing food and water intake before and after your fast.
“We’ve introduced specific timings for our classes during Ramadan to help our clients manage their workouts in the safest and most effective way,” says Ivana Bruic, Co-Founder and Master Instructor of Storm Cycling in Mirdif. “We’ve introduced special classes at 5:30pm for those who want to exercise just before breaking their fast, and classes at 9:30pm and 10:30pm for clients who prefer to exercise after.”
Fitness experts agree that continuing to exercise during Ramadan is essential for both your physical and mental well-being, as sitting all day long or sleeping erratic hours can make you feel even more fatigued. But being more aware of your body’s needs whilst you’re fasting is vital to ensure your workout is safe and effective. So what should you be doing to make sure your health doesn’t suffer when you’re fasting?
Watch the Video: Staying Fit Whilst Fasting
Hydrate as Much as You Can, When You Can
Reduce your risk of dehydration by drinking as much water as possible between iftar and suhoor, especially if you plan to work out before you break your fast the following day. Aim for four or five large glasses of water before sunrise to ensure you’re hydrated for the day ahead.
Find Your Own Workout Time
“Each person has a different optimum time to get their workout in,” explains Ivana. “The idea is to maximise each person’s optimum time to get their workout in. So whether it suits you better to do a less-intense class just before you break your fast or a harder workout after iftar so your energy stores have been boosted, it’s totally your call.” If you’re a morning person and usually work out early anyway, a super-early morning workout before sunrise can boost your energy levels for the day ahead.
Switch Up Your Workouts
Following an intense cardio-based workout schedule while you’re fasting is significantly challenging, so changing your workout to one with fewer reps and more recovery time will help you manage your energy. If you love HIIT, swap to strength training, a slower and more controlled workout that won’t induce as much sweating and make you need to rehydrate as much.
Break Your Fast with the Right Foods
“Dates are the traditional food chosen to break a fast for a reason – they’re the perfect source of natural energy,” explains Ivana. “Rehydrating with lots of water is vital, and nut milk is also a great way to boost your energy levels. But if you’re planning to exercise after iftar, make sure you don’t eat heavily and allow two to three hours until you exercise in order to allow the food to digest properly.”
Make Suhoor a Smart Meal
Eating something comprised of complex carbohydrates – like porridge or oats with banana, dates, and nuts – will give slow-release energy throughout the day and keep rumbling tummies at bay.
Work, Rest, Pray
Waking up early to pray and going to bed late means that getting enough sleep can be difficult, so if you’re working out too, you’re going to need to build adequate recovery time into your schedule. It may not be something you’ll want to do after Ramadan, but naps are super-important for recovery whilst fasting.
Strategic napping – like a short nap after your first morning prayer and a workout three hours later or a nap a few hours before it’s time to break your fast – can really help energy levels. “You may feel really lightheaded during the first few days of fasting, so if you’re able to fit in a power nap or two in the daytime, you’ll feel more clear-headed and energised,” adds Ivana.
As we continue in the month of introspection and self-restraint, we’d be remiss not to explore the parallels between fasting and yoga. The former calls for both a strong mind and a strong body in order to endure 14-hour fasts, day after day, as temperatures inch towards 40ºC. The latter is a strength-based practice that has been proven to enhance brain function – a 2017 study in International Psychogeriatrics journal revealed that two groups of participants over the age of 55 showed significant improvement in memory through Kundalini yoga and memory enhancement training respectively. However, only the group that practised Kundalini yoga showed significant improvement in executive functioning and depressive symptoms.
And then there’s the matter of food consumption – or lack thereof. Renowned yogi and Isha Foundation founder Sadhguru says the body and brain work best when one’s stomach is empty, advising a minimum of five hours between meals, which echoes the practice of fasting in Ramadan. “In the yogic system, we say there must be a minimum of six to eight hours between one meal and the next. If that is not possible, at least a five-hour gap is a must.” From a spiritual perspective, fasting can help improve focus, making meditation – a key component of yoga – easier, deeper, and more fulfilling. With that in mind, The Gaggler tapped yoga teacher and meditation instructor Dina Ghandour for her insights on this synergy. Here’s what she had to say.
On the Correlation Between Yoga and Ramadan
“The correlation became much clearer to me as I became a more seasoned practitioner. You start to understand spirituality from a different perspective because you grow up with a certain idea of religion or faith, and then whether or not you stay connected to it is one thing. But if you get lost or are just going with it without knowing why, then you get into yoga and it’s like, ‘Oh, I get it now.’ It just puts all the puzzle pieces together and can help you better understand your faith. Ramadan, particularly, is a time of being quiet and more mindful, it’s more reverent and restrained in some ways –that’s why it’s such a perfect backdrop. It’s the perfect environment if you’re hoping to deepen your spiritual practice.”
On the Type of Yoga Best Suited to Ramadan
“Traditionally, yoga was taught as this whole science with a spiritual side, and it would be good to seek out a method that helps you move deeper into that space if you’re trying to deepen your spirituality this month. And maybe that’s just a meditation practice? Maybe it’s not yoga? You could simply meditate for a couple of minutes or half an hour every day. And if you want to incorporate the physical aspect, you can complement the introspective period with something a little bit slower, something restorative.
The style I teach is called Jivamukti, and the reason I love it is because it’s one of the first styles that specifically integrates the aspects of yoga that’ve been stripped away in favour of being hip and modern back into a classroom setting. Each of my classes has a spiritual teaching, and there’s always a meditation at the end. The bulk of it is still like a typical yoga class, we’re still flowing and moving to music in an uplifting environment. But it’s grounded in the spiritual side, which is one of the reasons I came to it.”
On the Best Asanas If You’re Fasting
“If you’re fasting, then opt for something a little slower, like restorative yoga. Yin yoga can actually be quite intense because you’re holding a pose deeply and the stretch can be quite intense. Restorative yoga, in contrast, is much softer – you’re supported by all these bolsters and sort of floating in air. As for specific asanas, twists and folds are really nice because they aid the digestion area of the body. Every time we twist, we’re sort of gently massaging the organs. There are so many different kinds of twists – standing twists and seated twists and lying down twists – and they all give the digestive system a little bit of extra support while it’s trying to break down food after not having eaten for a long time. Folds, meanwhile, are very calming.”
Watch The Video: In Practice with Dina Ghandour
On the Best Time of Day to Practise Yoga
“It’s always best practise on an empty stomach, so first thing in the morning is good, depending on how early you had suhoor and when you wake up. If you’ve had enough time to digest it, then that could be a really nice option. And if the session isn’t too draining, it will offer a little boost to energise you for the rest of the day. And then right before iftar is also great because you expend that last bit of energy through movement, knowing you’re going to be rehydrated soon.
The other really good thing about doing it before iftar is getting the body in that rest-relax-heal state, which happens with a practice that’s not too rigorous. We’re now learning that a couple of deep breaths before you start eating can help solve any digestive issues, and it’s sort of the same thing. We have this big nerve called the vagus nerve and, by taking a couple of deep breaths, we stimulate it. We give the body permission to rest a little. A lot of digestive issues stem from living in a state of high stress, so feeling rested and zen after yoga will help the body digest a big iftar afterwards.”
On How Meditation Fits Into the Picture
“Meditation is a tool that helps people move deeper into that space of awareness, so it can be really nice if people are used to praying – they can add it before or after their prayers, perhaps. They can use it like an affirmation or intention for whatever kind of behaviour they’re trying to omit or incorporate during the month of Ramadan. Meditation is a great way for people to slow down and move inward even deeper. I know Ramadan is a celebratory month, but if someone is not as interested in its social aspects, they’re likely to see meditation from a different perspective when they have that kind of a grounding.”
On Misconceptions Around Yoga in the Middle East
“It’s such a melting pot here in Dubai, so I haven’t dealt with a lot of negative stereotypes, but I know some think the chanting is strange. It feels a bit too cult-y for a lot of people because they’ve moved away from religion. And then there are people who are religious and therefore uncomfortable chanting something they don’t understand, something they assume is about other gods. That’s why it’s very important for me, as a teacher, to explain that chanting is about creating steadiness of the mind. It’s crucial that teachers share correct information and dispel these myths. It takes time, but people get into it. I was like that before I eventually started singing my heart out! Educating people and making them feel welcome – not intimidated – is key.”
Mercury Rising: Tips on Hydration Done Right in Ramadan
We tap four experts in the know.
Between rising temperatures and longer days, Ramadan will bring with it the challenge of adequately hydrating between iftar and suhoor. There’s also the added matter of giving your skin and hair a little extra TLC to offset the lack of food and water consumption during the day. With that in mind, The Gaggler tapped four experts from the fields of nutrition, fitness, skincare, and hair care for easy and practical tips to boost hydration – here’s what they had to say.
Farah Hillou, Nutritionist at The Chiron Clinic
Our conversation with Farah Hillou, Nutritionist at The Chiron Clinic starts with the basics, covering the best foods in general to hydrate the body. “The U.S. Dietary Reference Intakes (DRI) of water is 3.7 litres (15-16 cups) per day for men and 2.7 litres (11-12 cups) for women. These take into consideration fluids from water, beverages, and food,” she says. “As a general rule, we should aim to drink (in ounces) half of our body weight (in pounds). Additional fluids are needed depending on activity, season, and temperature. Up to 20 percent of our daily water intake comes from the food we eat, especially fruits, vegetables, and soups. Great hydrating foods include cucumber, lettuce, celery, radish, zucchini, watermelon, melon, grapefruit, and strawberry. These can be added to smoothies. Yoghurt is also a great option since it is about 80 percent water.”
In contrast, she says the likes of coffee, tea and soft drinks – all of which act as diuretics – should be avoided during Ramadan. “Caffeinated drinks can increase fluid loss from the body and raise risk of dehydration. If you desire some caffeine, go for green tea, which is considered to have strong antioxidant and anti-inflammatory properties as well.” Water aside, there are other beverages that can help hydrate the body, according to Farah. “Keep hydrated through water infused with lemon slices, berries, ginger, mint, star anise, or cinnamon in order to add a burst of flavour and health benefits, too! Coconut water may be another option as it contains some electrolytes. Herbal teas such as chamomile, ginger, fennel, or peppermint support hydration and can also aid in digestion. Milk and unsweetened dairy-free drinks, like almond milk, are good options as well.”
We ask her for a few outward signs of dehydration worth looking out for – chapped lips, for example. “Symptoms are usually not present during early dehydration, but become obvious when we are moderately dehydrated,” she explains. “Outward signs include dry skin and reduced urine output. We may also start to feel thirsty, dizzy, fatigued, and develop a headache. Moreover, we may experience muscle aches and joint pain. The lymphatic system, which is responsible for removal of waste and toxin build-up, is 90 percent water. Dehydration can thus affect its function. Remember that water provides lubrication for tissues, cartilage, and joints. Staying hydrated is essential to support kidney function, neurological function, circulation, muscle contraction, body temperature, and optimising digestion.” Farah also recommends breaking your fast with water, and consuming soup or broth followed by a colourful salad at iftar.
Aleksandra Macura, Personal Trainer and Clinical Dietitian at Enhance Fitness
But it’s not just what we eat and what we apply topically that matters – our workout routines call for a little adjustment as well. “The best time to train during Ramadan would be around two to three hours after breaking the fast,” says Aleksandra Macura, PT and Clinical Dietitian at Enhance Fitness. “This allows you to have a good meal, replenish your energy stores, optimise hydration, have enough time to digest the meal, and get into your workout with optimal energy levels – meaning you can maximise performance. A lot of people like to train right after breaking the fast with dates and milk or water, which can also be an option. However, your workout intensity level will need to be reduced in this case.”
As for how we should adjust our workout routines? “Sub-optimal hydration levels have a multitude of effects on our body and performance. Since dehydration greatly increases risk of injuries, we want to adjust workout intensity. This means lifting lighter weights and increasing rest intervals between exercises. A good reference can be reducing your workout intensity by 15 to 20 percent. You also want to be careful with exercises that include sudden changes of levels (burpees, inchworms), explosive moves (power jumps, sprints) and heavy overhead exercises. The golden rule is listen to your body!”
Aleksandra says Ramadan ought to be seen as a deload phase when it comes to training. “Allowing our body the time to recover will not only help us come back to where we left off, but can also make us come back stronger than before. Remember that we don’t get stronger from the act of intense training, we get stronger during recovery from intense training. Ramadan is not the time to break your personal best, but rather stay active at levels that feel good and allow yourself the time to recover.” She also (very rightfully) advises our readers to take mindset into consideration. “Since Ramadan is a religious and spiritual month, it is a great time to practice mindfulness and shift our focus inwards, which can in turn help us build healthier habits and make more conscious decisions.”
Rebecca Treston, Medical Aesthetician and Laser Specialist at Dubai London Clinic
“To ensure an angelic glow during the holy month, switch your regular face wash with a cleanser containing glycolic acid (normal-dry skin) or salicylic acid (oily skin). If your skin is sensitive, use a gentle cleanser daily and scrub once a week,” says Rebecca Treston, Medical Aesthetician and Laser Specialist at Dubai London Clinic. “Gentle exfoliation every day will stimulate your skin while removing any dead skin cells, imparting your skin with a healthy and radiant glow.” As for switching up the products used, she adds: “Opt for lightweight hydrating lotions or serums to let your skin breathe easy and avoid breakouts. Reapply a moisturising serum every time you wash your face to make sure your skin stays supple and hydrated. For your daily anti-aging skincare needs, look for products with vitamin C and A, as they are the true rockstar ingredients that can change your skin from drab to fab.”
Sticking with sunscreen, for obvious reasons, is essential. “UV rays from the sun are extremely damaging to skin. Not only do they promote pigmentation problems, but they also damage the skin’s collagen and elastin leading to premature ageing in the form of wrinkles and skin sagging, so invest in a broad-spectrum sunscreen,” she advises. And like Farah, she emphasises that you are what you eat. “This year, why not make a special effort and avoid oily/fast food, sugar, and refined carbohydrates? Your skin will thank you as you’ll avoid blemishes, breakouts, and lacklustre skin. Instead, eat fresh vegetables, proteins, and fruits. Eat as many nuts as you can – cashews and almonds are packed with healthy fibres, fatty acids, and proteins, thus effective in maintaining your skin glow. Fruits such as strawberries and blueberries are high in antioxidants, which are known for their positive effect on healthy skin.”
To eliminate any toxins from the skin, Rebecca advises drinking plenty of water between iftar and suhoor. “Perhaps you can make sure some of the meals you have are water-based, like soups,” she advises. And last but not least comes beauty sleep. “Get eight to ten hours every night if you want to avoid dark circles around the eyes and a tired look at the end of Ramadan. Our body goes through multiple changes in our circadian rhythm; different hormones for different purposes are secreted during day and night. Research has shown us that day sleep is not as beneficial as night sleep because the body only repairs and rejuvenates during night, with peak repair activity after midnight,” she explains. She also touches on how the body’s focus shifts this time of year. “The white blood cells in the body start to become more active during Ramadan, and the body repairs any damaged cells at this stage, so it’s a perfect time to optimise your body’s system of repair.”
Natalie Andrew, Top Stylist and Trainer at Trevor Sorbie
With hydration levels dropping during Ramadan, dry and limp hair often follow. An easy at-home hair hack to offset this? “Try to avoid washing hair every day, and steer clear of hot water as it only adds to dryness,” says Natalie Andrew. She also shares her insights on what we should and shouldn’t be using. “Replace your usual shampoo and conditioner with hydrating ones, so the hair doesn’t dry out. This is because your hair will get a lower amount of vitamins during Ramadan, and it is important to adjust your hair care routine accordingly. I also suggest using a nourishing night serum, like the 8H Magic Night Serum by Kérastase, before going to bed. It will nourish your hair while you sleep.”
Heating tools like dryers, curlers, and straighteners also contribute to dry and brittle hair, according to Natalie, so slow down on their use during this time. There are a couple of hydrating treatments on offer at Trevor Sorbie salon if you’re not the DIY type and looking to tend to your hair, with two in particular recommended by the expert in question. “The Naturaltech Nourishing treatment by Davines is perfect if you’re seeking a deeply moisturizing treatment, while the KeraStraight Smoothening and Hydrating treatment locks in strength and moisture for up to 30 days,” she says.
Between Kanye West’s erratic behaviour scrutinised by the media and misleading depictions in pop culture – Silver Linings Playbook and Law and Order: SVU included – it’s evident that we need to do better when it comes to understanding bipolar disorder. And that’s where World Bipolar Day comes in. Incidentally, March 30 was designated World Bipolar Day to reflect the birthday of artist Vincent Van Gogh, who was posthumously diagnosed with the mood disorder.
The vision of this annual celebration is to bring world awareness to the different types of bipolar disorder (bipolar I and bipolar II being the most common) and improve sensitivity towards the illness. Truly damaging, in this case, are the many widely believed myths that aren’t always true, thereby impacting the social inclusion of those with bipolar disorder. Here, Dr. Rasha Bassim, a Medical Director and Specialist Psychiatrist from Priory Wellbeing Centre in Dubai, tackles the five that persist.
Myth 1. Bipolar disorder is code for mood swings.
“Mood swings refer to changes in mood from high to low, or vice versa. It is normal for someone’s mood to change, depending on the situation, and for them to experience mood swings to a certain degree. However, extreme mood swings can be characteristic of several mental illnesses, especially when it affects daily life and causes problems in personal and professional relationships.
Bipolar disorder is one of several mental illnesses that manifests in mood swings, such as schizoaffective disorder, cyclothymia, and personality disorders. As a result, detailed and longitudinal history-taking, mental state examination, and psychometric assessments are mandatory for determining the specific mental disorder.”
Myth 2. Only adults are diagnosed with bipolar disorder.
“As a matter of fact, the average age-of-onset of bipolar disorder is about 25, but it can occur during teenage years or, more uncommonly, in childhood.”
Myth 3. The highs (mania) and lows (depression) come like clockwork.
“Not necessarily. The first episode is usually called the index episode. It could be mania or depression. They do not typically happen like clockwork – sometimes, they have no predicted pattern. Bipolar disorder does not just involve mania and/or depression; other clinical presentations like hypomania and mixed episodes can also be common.
Hypomania is a less severe form of mania, whereby patients can display heightened energy or activity level and a mood or behaviour that is usually unrecognisable by their friends and family. Mixed episodes are diagnosed when symptoms of mania and depression occur at the same time or in rapid sequence without recovery in between.”
Myth 4. Bipolar disorder cannot be cured.
“Medication is required to control the symptoms of bipolar disorder, but it is not the only treatment. Doctors also emphasise the importance of leading a healthy lifestyle, avoiding drugs and alcohol, cultivating good sleeping habits, exercising, and successfully managing stress levels in combination with the prescribed medication. While no cure exists for bipolar disorder, it is a treatable and manageable disorder with the help of psychotherapy and medications.
Mood-stabilising medications are usually the first choice in medication. They vary according to the overall clinical picture and type of bipolar disorder, as well as the individual’s medical profile. Bipolar disorder is much better controlled when treatment is continuous. Sometimes, however, mood changes can occur even when someone is being treated, but by immediately reporting to the physician, full-blown episodes may be averted as the treatment will be adjusted.”
Myth 5. People with bipolar disorder are unpredictable – and therefore unreliable.
“Left untreated, the symptoms can be devastating. But extremes are not norms. In fact, people diagnosed with bipolar disorder are exceptionally creative and can live extraordinary lives. Often, for example, they are high achievers in the arts and hold high-level professional roles in the community. Unfortunately, due to stigma and discrimination, the public rarely sees this reality as patients are often afraid to share that they live with bipolar disorder.”