Antidepressants Blog

The maddening itch of vaginal inflammation may be caused by three different microscopic organisms. One is the yeast-like fungus Candida. As you might guess, Candida is biologically related to moulds in cheese; yeasts in beer, wine, vinegar and bread; yeast-based  vitamins; and mushrooms.

Most of the time, Candida lives compatibly in the intestines and vagina along with other microorganisms that keep Candida in check. Under certain circumstances, though, Candida can overrun its fellow organisms, causing infection and inflammation (candidiasis). The vagina is especially prone to Candida infections for a number of reasons. Mainly, the fungus thrives in the warm, moist climate of the vagina. And Candida from the intestinal tract can easily find their way to the vagina from the nearby rectum, multiplying the chances for infection.

Candida infections are a special problem for people with allergies to yeasts and moulds. Their bodies react to an overgrowth of Candida as they would to any other yeast or mould. Nystatin and other anti-fungal medicines – in tablets or suppositories – can help kill off the fungus. But in allergic people, the itching and inflammation may not go away until all forms of fungus, dietary and internal, are kept under control.

One tactic is to adopt a low-mould diet, says a gynaecologist we spoke to from Sulphur Springs, Arkansas. ‘Eating moulds or yeasts overloads the system, and the infection flares up.’

The low-mould diet is most effective when combined with yoghurt therapy. Yoghurt contains Lactobacillus acidophilus, a special bacteria that suppresses Candida.

‘Candida vaginitis can be controlled by applying yoghurt [live cultures] to the vagina,’ we were told. ‘Eating yoghurt, too, helps by controlling Candida growth in the intestines.’

Chemical irritants aggravate vaginitis of any kind. Women plagued by vaginal inflammation should avoid using deodorant soaps, perfumed sprays, bubble baths and colored or perfumed toilet paper in the vaginal area.

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Coping with an allergy can make anyone cranky. A stuffy nose or itchy skin can leave you tense and tired.

But irritability can also be a direct allergic reaction to foods, chemicals and other inhalants. Their effect on the nervous system can leave you restless, emotional, tense, sullen and tired despite having had enough sleep. Allergists call allergy-induced irritability the ‘tension-fatigue syndrome’.

An irritable person may be described by others as argumentative, easily hurt, excitable, hard to please, highly-strung, hot tempered, jittery, jumpy, moody, nervous, over-sensitive or temperamental. If any of those labels apply to you, you may be allergic. An irritable, allergic child may be hostile, hyperactive and subject to fits of crying.

‘Although the most frequent cause of this problem is a food, such as food colouring, sugar, milk, chocolate, eggs or corn, it is also possible that other common allergenic substances can be at fault (pollens, dust, moulds, perfume odours),’ says Dr Doris J. Rapp, an allergist in Buffalo, New York.

Staying away from those allergens that spark tension can make life more pleasant for the allergic person – and everyone around him. For example, Dr Rapp tells of an eleven-year-old youngster named Sean who was irritable, clumsy, restless and hostile. Sean fought constantly with his family and schoolmates. Within one week of eating a diet free of common allergenic foods, Sean was much easier to get along with.

‘As foods were re-added to his diet, it was found that . . . food colours and sugar caused irritability, hostility and violent behaviour,’ says Dr Rapp. When Sean avoided those foods, he led a peaceful life. Several months later he tried to eat a normal diet. His teachers reported a dramatic return of irritable behaviour. Back on his allergy-free diet again, Sean calmed down and played happily with others.

Sean’s story shows how rearranging one’s diet to omit allergens can make a person less edgy and argumentative.

‘The allergic tension-fatigue syndrome should be considered in every patient who for no obvious reason is subject to [hyperactivity], irritability, weakness or sluggishness,’ says Frederic Speer, M.D., in his book Allergy of the Nervous System. ‘This is especially true if other causes have been ruled out. Certainly no patient should be classified as [neurotic] until allergy has been considered.’

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Diarrhoea is one of the most common symptoms of food allergy, especially in children. In allergic people, the bowel tends to react to certain foods as though they were laxatives, unpredictably flushing out loose stools throughout the day.

But being caught off-guard is only part of the problem. Prolonged diarrhoea – lasting more than a week – leaves the body dangerously weak and dehydrated from loss of fluid and minerals like potassium. With too little water and nutrients, your muscles and nerves don’t work. In children, diarrhoea is especially risky – their bodies are too small to deal with drastic losses of water and minerals. As a result, uncontrolled diarrhoea can leave children as limp as a ragdoll. Or they can have convulsions.

Diarrhoea has several possible causes other than allergy. But if your doctor has ruled out infection or disease, you should consider food allergy. In children, milk is to blame for one out of three cases of diarrhoea caused by food allergy. For them, diarrhoea is nature’s way of rejecting a food that it regards as harmful.

‘Because cow’s milk is not a natural food for an infant, the body often tries to reject it with allergic reactivity, especially when a family tendency to allergy exists,’ says Dr Albert Rowe, Jr, co-author of the book Food Allergy. Dr Rowe mentions one study which found that out of 140 children allergic to cow’s milk, 24 per cent – about one out of four – had diarrhoea.

In infants, breast milk nearly always relieves allergy to cow’s milk, especially if the nursing mother also avoids cow’s milk. When the child gets older, he or she may eventually be able to tolerate milk. It may take six months, or it may take twelve years. Trial and error is the only way to tell.

After milk, fruit and sugar are frequent causes of allergic diarrhoea. Apparently, some people cannot tolerate fructose, the sugar found in honey and sweet fruits such as plums, apples and grapes. In still others, any kind of sugar causes diarrhoea. Two Swedish doctors report the cases of four people who had suffered diarrhoea, abdominal pain and bloating for up to six weeks at a time. Between these episodes, they had milder discomfort. ‘All had noticed an aggravation of symptoms whenever they had eaten fruits, or food containing appreciable amounts of cane sugar,’ say the researchers. ‘All patients were free from symptoms on a fructose-free diet’. (Acta Medica Scandinavica)

And based on a study of several young children with diarrhoea, doctors at Adelaide Children’s Hospital in South Australia suggest that children with chronic diarrhoea should eat a sucrose-free diet for at least two months. If sugar is the problem, the diarrhoea will go away (Lancet).

In still other children, both milk and sugar must be avoided in order for diarrhoea to let up. One group of pediatricians studied seventy-five children (all younger than one year) treated for diarrhoea and other related problems. After several days on a milk-free, soya-based diet formula, some of the children were gradually given cow’s milk again, while the others received a soya formula free of milk and sugar. The children drinking cow’s milk continued to have diarrhoea indefinitely, while the children on milk-free and sugar-free formula got better fairly soon (Lancet).

Occasionally, wheat and other cereals will cause diarrhoea. To test for any of those foods, the diet must be tried for at least one week and often longer, since it takes several days after food is eaten for it to be completely eliminated from the body.

Sometimes food causes diarrhoea during the pollen season, but not during the rest of the year. For example, a child may be able to drink milk or eat cereal all year round with no diarrhoea, but will suffer several weeks of loose bowels when trees and grasses are pollinating in spring or summer.

Parents of children with diarrhoea should not hesitate to see a doctor, because of the immediate threat to health and the possibility of infection or disease.

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If you’ve ever craved a chocolate bar, you know how an alcoholic feels about his or her next drink. That preoccupation with alcohol, along with the compulsion to continue drinking once he or she’s started, is what separates an alcoholic from a social drinker. Alcoholics also tend to drink large amounts every day, and to start early in the day. Others drink in binges. Either way, an alcoholic responds to alcohol quite differently from the way most of us do.

Why some people become alcoholics and others do not is one of the unsolved mysteries of medicine. Heredity takes its share of the blame – although some of the biggest drinkers have parents who are strict teetotalers, and some abstainers have parents who are alcoholics.

In other words, in spite of their attraction to alcoholic beverages, problem drinkers may actually be allergic to the stuff. They may either be allergic to the alcohol itself, or to the grains, corn, fruits, yeast or sugar from which alcoholic beverages are made.

And alcoholics do tend to have more food allergies than other people. A research team at Deaconess Hospital in St Louis, Missouri, tested seventy-five drinkers for allergy to seventy foods. Compared with non-drinkers, alcoholics were nearly twice as susceptible to food allergies (Modem Medicine).

Alcohol may also aggravate food allergies indirectly by interfering with the complete digestion of food proteins in the stomach, leading to bowel troubles, gas and diarrhoea, among other discomforts.

We’re not saying that alcoholism is always caused by allergy. After all, alcoholism is a complex problem. But if you’ve reached a point where you know you’re drinking too much, too often, understanding your compulsion could be the first step towards controlling it. If you are indeed allergic to foods from which alcohol is made, eliminating them could help you beat the problem once and for all.

Incidentally, doctors have noticed that people who drink a lot seem to suffer more than their share of stubborn skin problems. If you drink heavily and have a skin rash that you can’t get rid of, it might clear up if you stay away from alcohol.

Because depression and anxiety can lead to alcoholism, people with drinking problems should also read the entries on those topics in this section.

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Frustrated with the limitations of traditional immunotherapy, a few doctors (most of them known as clinical ecologists) are trying to revive a system of allergy testing and immunotherapy developed several years ago and collectively known as serial dilution titration and neutralization therapy. This variation of standard immunotherapy still involves lots of time in a doctor’s surgery, considerable expense and allergy injections. In some ways, however, it may make up for a few of the shortcomings of traditional immunotherapy.

Serial dilution testing: what they can and cannot tell, is done on the skin (although a few doctors use drops of the test extracts which can be placed under the tongue in people who are not fond of needles). Doctors test for several common allergens, plus any others to which the individual seems to be particularly sensitive. In that respect, the test is similar to standard tests. However, the individual is not necessarily tested with one absolute amount of each test extract, but possibly with a series of up to fifteen or twenty increasing dilutions, one every ten minutes or so. The size of any weal and the nature of symptoms are noted. Doctors experienced with serial testing use the dose which does not produce symptoms – the ‘endpoint’ – as a guideline for choosing the optimal dose for this therapy. Again, the dose that is too small to produce a reaction yet large enough to prevent reactions is considered optimal. Doctors feel that, in this way, they can get a better picture of not only what a person is allergic to, but also how he or she reacts as an individual. What’s more, they claim that the treatment dose can be used to neutralize, or turn off, a reaction. The therapeutic dose usually turns out to be much smaller than that employed in standard immunotherapy, and takes only one or two testing sessions to achieve. That compares with a period of about six months of such experimentation to reach maintenance doses in standard therapy. Once the correct treatment dose is arrived at, doctors using neutralization claim that some people gain immediate relief.

One big difference between the two therapies is that some doctors using neutralization send patients home with premixed doses of extract to help them tolerate foods and inhalants to which they are allergic. That’s rare with standard therapy except for carrying emergency vials of adrenaline to be used in case of a severe bee sting reaction or other serious symptoms.

Another major difference is that neutralization is used to treat sensitivities to car exhaust, tobacco smoke, formaldehyde and other hard-to-avoid chemicals, although shots for those do not work nearly as well as injections for conventional allergens.

‘People always ask us for injections against air pollution,’ says Constantine J. Falliers, a traditional allergist and editor of the Journal of Asthma. ‘Well, we have no such thing.’

Many doctors using neutralization feel that, unlike conventional therapy, it can be successfully used to treat food allergy, holding out hope to the many people who are allergic to wheat, yeast or other ubiquitous dietary items.

Standard immunotherapy and neutralization seem to work in approximately eight out of ten people on whom the particular method is used, and both are relatively safe – they’re used without reservation on the young, the old, the pregnant -and even in people who are suffering a cold or the flu. For the individual who’s endured years of standard immunotherapy without relief of symptoms, neutralization certainly holds promise.

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Sexual assault, in its various forms, affects many people’s lives. It is a subject most of us would rather ignore, because it is unpleasant. Ignoring it will not make it go away, so perhaps learning more about it, and doing something about it will help to decrease its incidence and effects.

What is it? Assault is an act of violence by one person against another. There are endless possible ways this may happen. An assault may vary from a threat, to a rape or a near-fatal bashing. Assault is a crime, and is punishable by law.

Sexual assault has many forms. It can happen to anyone, of any age (including children), and does not necessarily involve sexual intercourse. Any sexual contact which is unwanted, or which occurs without the consent of a participant constitutes sexual assault. It is behaviour of a sexual nature which makes the victim feel uncomfortable or afraid.

Incest is when the sexual assault involves two members of the same family, most commonly assault by a father on his daughter.

There are many different experiences which can be called sexual assault, so it is not easy to define. The Centre Against Sexual Assault (CASA) in Melbourne has created a working definition, in which the unwanted behaviours may include:

• touching, fondling, kissing

• being made to look at, or pose for pornographic photographs

• being masturbated or being forced to masturbate another person

• voyeurism

• exhibitionism

• oral/genital contact

• penetration of the victim’s vagina, mouth and/or anus with a penis or object (also called rape).

So the term sexual assault includes many criminal acts. There are several legal terms for the actual type of assault (like rape, aggravated rape, indecent assault, gross indecency, incest, etc.). The crime a person may be charged for, and the maximum penalty for the crime may vary in different states and countries.

Some other forms of sexual assault, such as sexual harassment in the workplace or at school, also constitute unwanted behaviour of a sexual nature. This may take the form of ‘off jokes, suggestive comments, sexual propositions, or unwanted physical contact, for example. Sexual harassment is illegal in Australia. Employers are obliged to ensure that their staff are not subject to sexual harassment, and are advised to set up channels through which people can make complaints and take action. If these channels are not available or are insufficient, any person who is being, or has been, sexually harassed can take the matter to the Commission for Equal Opportunity.

Some people are more familiar with the term sexual abuse. Abuse is defined as ‘misuse, perversion, unjust practice, violation or maltreatment’. Sexual assault is abuse. A person’s emotional and physical state are abused in sexual assault.

Most sexual assault is committed against women. Most offenders are men. Social theories have been proposed to explain this, and it may be that the traditional roles and power balances of men and women in society play a large part in why sexual assault exists and is so prevalent. Understanding the reasons behind sexual assault may be useful in working towards decreasing, and eventually preventing, the high level of sexual assault in our society.

Boys and men can also be the victims of sexual assault. Again, it usually involves an unequal distribution of power (for example, an adult assaulting a child), and can be an act of aggression and hostility. Being a victim of sexual assault is just as much a violation and abuse when the victim is male as when the victim is female.

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How effective is male hormonal contraception?

In trials of men using this method, 80 percent of men had no sperm in their semen and the rest had such low numbers of sperm that it would be very unlikely for their partners to fall pregnant And there were very few side effects in men who were using this method.

Why would I want to choose male hormonal contraception?

Men who want or need to take responsibility for contraception and who don’t like using condoms may choose to use male hormonal contraception. It might also be a good choice for a man who is considering a vasectomy but is not ready to make such a permanent decision.

How do you use male hormonal contraception?

At present male hormonal contraception is only available by joining a clinical trial. Trials have been run in Australia as well as the United Kingdom and the United States. Men are given either a dose of injectable progestogen every three months or they take a higher dose progestogen-only pill by mouth every day. They have to take these pills at the same time every day for it to be effective. It may be a few years before male hormonal contraception is widely available.

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How does the IUD work as emergency contraception? If you have an IUD inserted it causes changes in the lining of the uterus. If an egg is fertilised and makes its way to the uterus it cannot implant in the lining and grow there.

Insertion of a Copper IUD within five days of unprotected sex is very effective at preventing pregnancy, with less than a 1 percent failure rate. It has to be a Copper IUD to be effective, because hormonal IUDs take too long to work to be useful for emergency contraception.

How do you use the IUD for emergency contraception? You just have the IUD inserted no more than five days after you have had unprotected sex. The only difference is that in this case you have an IUD inserted because you think you are at risk of becoming pregnant and you want to reduce that risk. You can of course choose to have the IUD removed after the next period, though few people actually decide to do this having gone to the trouble and expense of having the IUD inserted in the first place.

What does it cost? A Copper IUD costs from between $82 and $90 and can be bought at a chemist or a Family Planning Centre. You may also need to pay some medical costs for the doctor to insert the device so check the costs before deciding to go ahead with the insertion.

Things to think about if you are considering emergency contraception. Do you need to use more reliable contraception? If you think you do, the Copper IUD may be a good idea if it is suitable for you, because it will act as emergency contraception and then stay in place for up to ten years.

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Is there anything else that may be a problem if I want to use a Copper IUD?

There are some things you should talk over with your doctor if you are considering a Copper IUD because they may need to be sorted out before you can have the IUD inserted.

Tell your doctor if you have not had any children but you want to have children in the future. Tell your doctor if your periods are very painful or they last a long time, or both. Periods tend to be heavier and longer when a woman is wearing an IUD, so you may want to think again if your periods are heavy and long already. If you have had an ectopic pregnancy, which is a pregnancy in one of your Fallopian tubes this is also something that needs to be discussed before you decide on a Copper IUD.

If you are anaemic, that is you don’t have enough iron in your blood, or you have fibroids or other conditions that change the shape of your uterus or cervix you will need to discuss these too. It is also important to consider the risk if you have a medical condition that could affect your recovery if you got an internal infection. For example, if you have rheumatic heart disease, or you are being treated with steroids or other medications which prevent your immune system from working properly.

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Q. Does spermicide have any side effects?

A. Very few people are allergic to spermicide, but those who are usually feel itchy or sore. It is best to go to a doctor to be checked if the symptoms don’t stop in a few hours because you might have an infection rather than an allergy.

Q. If I use spermicide with my diaphragm, and my partner comes and then we start again should I put an applicator of spermicide in before he comes again?

A. No, it isn’t necessary.

Q. I have heard that you can also get spermicides in foams and creams and in tablets that you put in your vagina. Where can you get them?

A. You can only get these types of spermicides overseas, although they used to be available in Australia. Now, you can only buy spermicide gel in Australia.

Some things to think about if you are considering spermicide

• Remember that spermicide by itself can be unreliable. When it is used by itself it must be inserted very close to the opening in your cervix for it to work best and even if you manage to put it there, your body heat makes it melt and it can run out of your vagina easily.

• You have to remember to have it with you if you think you may have sex when you are not at home.

• If spermicide is the only contraception you are prepared to use, it is better to use it than to use nothing at all, just as long as you are aware of the risk. You should really consider what you would do if you had an unplanned pregnancy, so you could be prepared if it happened.

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