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Brain connections

How to sleep better, worry less and feel happier

Author: Dr Giresh Kanji. Pp 175 ISBN978-0-473-46743-2

Review: Dr Sylvia Rosevear

Brain ConnectionsThis is a little book that with economy of effort one gets maximal scale. It has just been published and is on the top 10 best sellers list for non-fiction in New Zealand. It is an easy read for doctors or lay people on the complexity of the interaction of neurological and physiological principles and functions, that produce anxiety, depression and insomnia. The aim is to provide information to reduce the adverse effects of stress on our own health or our patients. It was written on a background of enquiry as a result of the author’s own childhood trauma. His intelligent research seeks to define, treat and annihilate the result of stress, to prescribe a life of vitality, energy and joy.

It is a book written by a well-qualified, musculo-skeletal pain specialist, (editor of the Australasian Musculoskeletal Medicine Journal) who gives solutions to common conditions in espousing the holistic with the commonly known, and common sense with scientific validity. There are 17 short chapters, sometimes just a page and a half, that elucidate information on anxiety, depression and insomnia. Chapters 18-30 are solution based.

It begins by introducing the concept of ‘stress’. The ‘stress response’ activates all the senses, including sight, sound, touch, and smell and keeps us alert and anxious by activating electricity in nearly every part of the brain. At least six stress chemicals are released in the brain, including adrenaline, noradrenaline, serotonin, histamine, corticotrophin-releasing hormone and acetylcholine. The stress response also prepares the whole body to ‘fight or flee’, releasing adrenaline, noradrenaline, and cortisol from the adrenal gland. He points out the stress response is activated by psychological stress, illness, viral infection, chronic pain, nightmares, smoking, alcohol and intense concentration.

He identifies an additional mechanism to reduce stress - reducing Gamma aminobutyric acid (GABA) levels– the neurotransmitter that shuts off electrical channels. Stress causes wakefulness because of increased electricity in the brain.

There is a chapter on the menopause as a stress because of the withdrawal of estrogen, aggravating insomnia, anxiety and depression, especially in those with a ‘wound up stress nervous system’. Mindfulness based stress reduction improves the quality of life, sleep quality, anxiety and stress at the menopause. Yoga, massage and regular exercise improve menopause-related insomnia.

He identifies the cause of ‘brain fog’ – the poor memory and concentration that accompany most stress related disorders that may be explained by a reduction in the size of the hippocampus. This reduction in volume of the hippocampus predisposes to poor memory, which may hasten the onset of dementia with age.

Unwinding the stress nervous system and restoring the neurons in the brain that act as an off switch can be achieved with mindfulness, exercise, sauna, meditation/breathing, yoga and Tai Chi performed for a minimum of 3-5 times per week. The stress nervous system is unwound by biofeedback for instance, slow breathing that stops the drive to release of stress hormones. Similarly, heat dilates blood vessels being a biofeedback to stop the release of stress chemicals that cause vasoconstriction. Staying in the moment calms the stress nervous system. Meditation calms the brain resulting in reduced electrical activity in the brain.

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The Women’s Health Book

The Women's Health BookA complete guide to health and wellbeing for women of all ages.

The Royal Women’s Hospital, Victoria

A William Heinemann book. Published by Random House, Australia 2014 800 pages.

The Royal Women’s Hospital in Melbourne is the largest health facility in Australia specializing in women’s health. The staff at “The Women’s”, many of whom have international reputations for their contribution to research and clinical practice, has put together a comprehensive volume of health advice for women. This guide is very accessible and well referenced and covers women’s health issues through all life stages. The aim of the writing group is to encourage women to share knowledge about health, educate others about important issues such as sexual violence and to advocate for gender equality in health.

The book is separated into four main areas dealing with adolescent health, young women, the midlife years and later years. There is a strong focus on healthy lifestyle and taking control of your health and, throughout the book, bullet points highlight the key issues. It discusses health screening and provides a clear table of what should be done and when. In doing so, it follows governmental screening advice and manages to steer clear of any controversy, such as that currently surrounding mammography.

A range of topical issues are discussed including body image, mental health, sexuality, contraception, pregnancy, abortion, menopause, use of complementary therapies, gynecological cancer and being a cancer carer.

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Change, Choice and Hormone Replacement Therapy

by Dr Barry G. Wren and Margaret Stephenson Meere

Rockpool Publishing; Summer Hill, 2013

Menopause: change, choice and HRTOver the last 11 years, menopause has experienced its own 'dark ages' much to the detriment of women who happened to be transitioning menopause or who were post-menopausal. Easy access to basic information about menopause and rational discussion of controversial issues were lacking. "Menopause: change, choice and HRT" has filled that void as an easy to read source of information about all aspects of menopause. It has been designed to be read in part or whole so that if the reader is seeking specific topic information, all pertinent information relating to that topic can be found in the chapter dedicated to that topic. This tended to lead to some repetition of information. However, when reading the book from cover to cover, this served to refresh the memory for readers who are less knowledgeable in this field.
The addition of a summary at the end of each chapter was a particularly useful inclusion which could easily substitute for reading the complete chapter if time is at a premium.

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Menopause Matters

Menopause Matters

Dr Julia Schlam Edelman MD FACOG

"Menopause Matters" by Dr. Julia Edelman, an American gynaecologist, is a comprehensive, scientifically based and well written guide providing information and practical advice to the woman approaching or arrived at the menopausal years. Topics addressed include lifestyle issues, menopausal symptoms, contraception for the perimenopausal women, psychological issues, heart and bone health, consideration of HRT, sexual function and more.The use of illustrative case stories, ability to convey complicated scientific findings in an accurate but simplified manner and the provision of lists for further reference at the end of each chapter enhances the consumer friendly nature of this book. I particularly like the emphasis on preventative health measures for midlife women and the "team approach" recommended for a woman and her doctor.

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Good oil or snake oil?: Treatment regimens for postmenopausal women’

Dr Barry G Wren AM,

This book is a wonderfully concise summary of the available treatments for the management of menopausal symptoms.  It also takes a fascinating look at menopause itself, in terms of how our understanding of menopause evolved over time, and how treatments were developed by various cultures for treatment of menopause-related symptoms.  Dr Wren takes the reader through the development of exogenous oestrogens and progestogens and puts HRT use into context, especially given the recent controversies surrounding HRT.   In the course of history synthetically produced sex steroid HRT has only really existed over the last 75 years or so, remarkable when we consider the controversy its use has been associated with over the past 10 years.  Dr Wren looks at the development of breast, ovarian and endometrial cancer, and the relationship of all of these to HRT.  He also looks at the effects of HRT on the cardiovascular system.  

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Where did my libido go?

By Dr Rosie King MBBS FAChSHM

This book is for any woman with a libido problem interfering with their relationship.

Dr Rosie King has assessed the different possible issues for women in this regard and managed to normalise the sexual difficulties which may be found in any relationship.  She gives clear guidelines as to ways that women may take control of the situation and work to make improvements with the assistance of the willing partner.

It is 309 pages long however she has condensed the information into a few pages of “key points” related to each chapter. This allows the reader to be directed to read the information relevant to them, more easily and then progress to the full chapter details if desired. The writing style is lucid, logical and humorous at times. She includes some relevant anatomy, physiology and behavioural information. She usefully includes anecdotal male and female libido stories to illustrate important points.

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Life Begins at Menopause?

A guide to the changes at midlife and menopause for women and their partners

Life Begins at Menopause? A guide to the changes at midlife and menopause for women and their partnersBy Dr Mandy Deeks PhD Psychologist

There are significant stages that a woman passes through in her life and menopause is a time when, by its very definition, the biological and reproductive function of a woman comes to an end. This ending brings with it consequences, in the context of a dynamic life journey, which can be either welcomed on the one hand or on the other, experienced with negative feelings. An acknowledgement and scrutiny of the complexity of the aspects of the menopause is welcomed as is consideration about how to understand and negotiate this journey with some success. This applies both physically and emotionally.

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Menopause a New Zealand Guide

Menopause a New Zealand GuideBeverley Lawton General Practitioner, researcher and a Past President of the Australasian Menopause Society is to be congratulated and thanked for her hard work and clarity in writing this concise and helpful book on menopause. Whilst its finer details are tailored specifically for New Zealanders, the topics she covers in the care of the menopausal woman have global interest, and her careful and timely summary of research data also pertain to world wide findings.

Whilst a woman with a secondary school education would be able to follow Lawton’s writing reasonably easily, health professionals, working both within and outside the realm of menopausal health, and women wanting more academic answers to questions would also be grateful for this book.

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Menopause for Dummies

Understanding the changes in your body, mind, spirit

Adapted for Australia & New Zealand by Dr Lily Stojanovska, Assoc Professor; Marcia L. Jones, PhD; Teresa Eichenwald, MD

Published by Wiley Publishers

Menopause for Dummies Menopause for Dummies is a very welcome addition to the stable of "For Dummies": popular books for beginners.

In picking up the familiar yellow and black jacket book typical of the "For Dummies" series, the reader is immediately struck by the front cover photo of an attractive older woman reflecting beauty, warmth, and a sense of wisdom and serenity. It also signals the intended primary readership demographic for this book, the menopausal woman.

The authors deserve to be commended for undertaking the challenge of dealing with the complex subject of menopause in the "For Dummies" format.  The end result is a book that can be read either cover to cover, or by selective chapters of interest within which are cross-references to thematically related material in other chapters.

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