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'Dry January made me see alcohol in a different light'

'Dry January made me see alcohol in a different light'

Joanna Munro describes herself as the typical mother who enjoys a well-earned glass of her favourite tipple at the end of a trying day.

As someone who drank no more than a couple of glasses of wine a day, Joanna, 45, was by no means a heavy drinker. But one day, she realised that "wine o'clock" had become more of a habit than a pleasure.

She gave up alcohol for a month for Dry January to prove to herself she was still in control but she tells how she soon started noticing unexpected health benefits.  

Pleasure or habit?

"Back in December, I was a typical example of the mother who reaches for her first glass of rosé while simultaneously burning dinner, tripping over the dog, emptying the washing machine and resolving conflicts between the kids. Then I realized that "wine o'clock" had become an automatic reflex that wasn’t so much a pleasure as a habit. 

"I didn’t find an answer to my question on the internet, but I did find Alcohol Concern’s website and a challenge called Dry January. I liked the idea – an opportunity to prove to myself that I had more self-control than a four-year-old who’d been left alone in a Cadbury’s warehouse. If I was hooked, I’d be clawing my way up the curtains in despair within days.

"So I signed up. Over the month, my resolve was considerably strengthened by Dry January’s Facebook page and the determination and solidarity of those taking part. The challenge worked a charm because people can encourage each other and be accountable to each other.

"The aim was simple on paper: give up alcohol for one month. As I’m an eternal optimist, I added an hour of exercise every day for good measure. I quickly worked out a circuit through my local village. When attempting abstinence for the first time in 12 years, sunshine and great countryside proved ideal to lift this trainee teetotaler’s spirits."

Health benefits

"The first week, I rode the virtuosity wave. I was a disdainful diva, even declining champagne on the beach to toast in the New Year. By the middle of the second week, however, the queen of self-control and restraint was glowering, Gollum-like, over her glass of Perrier and lime as hubby savoured his beer.

"After two weeks the cold turkey wore off, and the first benefits kicked in. I was in bed snoring shamelessly before 10 and was awake before the alarm at 6.15am. My skin was looking better. I had more energy, and was proud of myself for sticking at it.

"Although weight loss wasn’t a decisive factor for me, I lost 5lbs (2.3kg) in the first month and I have now lost nearly 10lbs and banished three inches (7.5cm) of muffin top from my waistline. Like many other people on Dry January’s page, my problem was the inexplicable desire to replace my evening dose of wine with snacks in front of the TV.

"Yet in the long run, less wine meant less nibbles. I realised how alcohol opened up my appetite and made me reach for those salty nibbles.

"Less nibbles meant less weight. Not exactly rocket science, but a winning equation nevertheless."

The NHS recommends:

  • Men should not regularly drink more than 3-4 units of alcohol a day
  • Women should not regularly drink more than 2-3 units a day
  • If you've had a heavy drinking session, avoid alcohol for 48 hours

"Regularly" means drinking this amount every day or most days of the week.

Hot flushes: how to cope

Hot flushes: how to cope

Hot flushes are the most common symptom of the menopause but there are a range of medical treatments and self-help techniques to beat the heat.

Not all women experience hot flushes going through the menopause, but most do. Three out of every four menopausal women have hot flushes. They’re characterised by a sudden feeling of heat which seems to come from nowhere and spreads through your body. They can include sweating, palpitations, and a red flush (blushing), and vary in severity from woman to woman.

Some women only have occasional hot flushes which don’t really bother them at all, while others report 20 hot flushes a day, that are uncomfortable, disruptive and embarrassing.

Hot flushes usually continue for several years after your last period. But they can carry on for many, many years – even into your 70s or 80s. They’re probably caused by hormone changes affecting the body’s temperature control.

Causes of hot flushes

Most women going through a natural menopause experience hot flushes. But there are other causes of hot flushes, including:

  • Breast cancer treatment – according to Cancer Research UK, seven out of 10 women who’ve had breast cancer treatment have hot flushes, and they tend to be more severe and frequent than those of women going through a natural menopause. This is because chemotherapy and tamoxifen tablets reduce oestrogen levels.
  • Prostate cancer treatment – men having treatment for prostate cancer can also have hot flushes, sometimes for years. Hormone treatment causes hot flushes in men by lowering the amount of testosterone in their body. Read advice for men with prostate cancer on how to tackle hot flushes.

What does a hot flush feel like?

Women often describe a hot flush as a creeping feeling of intense warmth that quickly spreads across your whole body and face ‘right up to your brow’ and which lasts for several minutes. Others say the warmth is similar to the sensation of being under a sun bed, feeling hot ‘like a furnace’ or as if someone had 'opened a little trap door in my stomach and put a hot coal in’.

Watch these videos where women describe what a hot flush feels like.

Hot flush triggers

Hot flushes can happen without warning throughout the day and night, but there are well-known triggers, including woolly jumpers, especially polo necks; feeling stressed; drinking alcohol or coffee; or eating spicy foods.

Treatments for hot flushes

Many women learn to live with menopause-related hot flushes, but if they’re really bothering you and interfering with your day-to-day life, talk to your doctor about treatments that may help.

The most effective is HRT which usually completely gets rid of hot flushes. But other medicines have been shown to help, including vitamin E supplements, some antidepressants, and a drug called gabapentin, which is usually used to treat seizures.

Note that doctors recommend that you don’t take HRT if you've had a hormone dependent cancer such as breast or prostate cancer.

Here’s more information on help for hot flushes from your GP.

Complementary therapies for hot flushes

Women often turn to complementary therapies as a ‘natural’ way to treat their hot flushes.

There have been small studies indicating that acupuncture, soy, black cohosh, red clover, pine bark supplement, folic acid, and evening primrose oil may help reduce hot flushes.

However, the research is patchy, the quality of the products can vary considerably, and the long-term safety of these therapies isn't yet known.

It’s important to let your doctor know before you take a complementary therapy because it may have side effects (for example liver damage has been reported with black cohosh) or mix badly with prescription medicines (red clover is unsuitable for women taking anticoagulants).

Be aware, too, that soy and red clover contain plant oestrogens so may be unsafe for women who have had breast cancer.

Read more about complementary therapies and whether they work.

Self help remedies for hot flushes

Try these everyday tips to ease the overheating:

  • cut out coffee, tea, and stop smoking
  • keep the room cool, use a fan – electric or handheld – if necessary
  • if you feel a flush coming on, spray your face with a cool water atomiser or use a cold gel pack (available from pharmacies)
  • wear loose layers of light cotton or silk clothes so you can easily take some clothes off if you overheat
  • have layers of sheets on the bed rather than a duvet so you can remove them as you need to and keep the bedroom cool
  • cut down on alcohol
  • sip cold or iced drinks
  • have a lukewarm shower or bath instead of a hot one
  • change the timing of your medicine. If tamoxifen is causing your hot flushes, Cancer Research UK suggests taking half your dose in the morning and half in the evening

Is a hot flush anything to worry about?

Hot flushes are generally a harmless symptom of the menopause. But very occasionally they may be a sign of a blood cancer or carcinoid (a type of neuroendocrine tumour).

See your doctor if, in addition to hot flushes, you've been unwell with, for example, fatigue, weakness, weight loss or diarrhoea.

Now read about the best foods to eat during the menopause.

Read other articles about the menopause.

Stopping smoking is good for your mental health

Stopping smoking is good for your mental health

Being smoke-free helps relieve stress, anxiety and depression and gives you a more positive outlook on life. These benefits apply to all smokers, not just those with pre-existing mental health problems.

We all know that stopping smoking improves your physical health. Here are 10 health benefits of stopping smoking. But did you know that stopping smoking is also proven to boost your mental health?

Although most smokers report that they want to stop, many continue because they’re convinced that smoking helps relieve stress and anxiety.

But it’s a complete myth that smoking helps you to relax. The reality is that smoking actually increases anxiety and tension. Smokers are more likely to develop depression or anxiety disorder over time than non-smokers. And cutting out cigarettes triggers a big improvement in mood.

It’s a myth that smoking improves mood

Why do smokers with and without mental health problems falsely believe smoking improves their mood?

Scientists think it’s because they confuse the ability of cigarettes to abolish nicotine withdrawal as a beneficial effect on their mental health.

Smokers tend to feel irritable, anxious and down when they haven’t smoked for a while and these unpleasant feelings are temporarily reversed when they light up a cigarette. That creates the impression that it’s the smoking that has improved their mood, when in fact it’s smoking that caused the psychological disturbances in the first place.

The mental health benefits of quitting smoking

Studies show that people's anxiety, depression and stress levels are lower after they stop smoking when compared with those who carry on smoking and that their quality of life and mood improves. Also, the improved levels of oxygen in the body means that ex-smokers can concentrate better.

Smokers with mental health problems

The psychological benefits of stopping smoking are just as striking in people who already have a mental health disorder as those without. Stopping smoking helps their mental health symptoms and can lead to reduced doses of anti-psychotic medicine.

This is welcome news because people with diagnosed mental health problems, including anxiety, depression or schizophrenia, are two to three times more likely to take up smoking and also tend to smoke more heavily than the general population.

It’s estimated that 30% of all smokers have a mental health problem and that two of every five cigarettes smoked in England are smoked by people with a mental health problem. Smokers living with a mental health problem also have a life expectancy eight years less than the general population, very likely as a result of the physical ravages of smoking, such as lung cancer.

Stopping smoking helps more than antidepressants

One theory as to why people with mental health problems are far more likely to smoke than the general population is that they perceive nicotine gives them immediate relief from the unpleasant symptoms of anxiety, depression or schizophrenia.

But the opposite is true. People with psychiatric problems are likely to feel much calmer and positive and have a better quality of life after giving up smoking. In fact, the beneficial effect of stopping smoking in people with psychiatric problems is greater than that of antidepressant therapy for mood and anxiety disorders.

Many people living with mental health problems have successfully quit smoking and report a wide range of benefits as a result. 

8 tips to stop smoking

If you want to stop smoking, contact your local NHS stop smoking services, these provide the best chance of stopping completely and forever.

Here are eight ways to boost your chances of stopping smoking. This advice applies to people with or without a mental health problem:

  1. See an NHS stop smoking adviser. It's free and will massively increase your chances of quitting. 
  2. Use either a nicotine patch, plus one of the faster acting nicotine replacement products (such as the nicotine nasal spray) or the prescription medicine, Champix, and make sure you use them for at least six to eight weeks. Stop smoking treatments may be especially helpful for people with mental health problems if they’re combined with talking treatments. Read more about stop smoking treatments.
  3. If you take antipsychotic medicines and want to stop smoking it's very important that you talk to your GP and/or psychiatrist before you stop as the dosage of your prescription drugs may need to be monitored and the amount you have to take could be reduced.
  4. It helps to avoid drinking alcohol or using psychoactive drugs when you stop smoking to boost your chances of success.
  5. According to the Mental Health Foundation, people with depression and other mental health conditions can find it particularly difficult to give up smoking and experience stronger withdrawal symptoms and craving. Here's some advice on how to cope with cravings.
  6. Because smoking is often used as a way of coping by people with mental health problems, it’s important to find other ways of dealing with stress. Use these 10 stressbusters.
  7. Don’t worry too much about putting on weight when you stop smoking. If you eat healthily and keep active you should be able to keep weight gain to a minimum. Read how to stop smoking without putting on weight.
  8. The Royal College of Psychiatrists has advice for people with mental illness on quitting smoking.

Now, read more articles about stopping smoking.

'How I beat osteoporosis'

'How I beat osteoporosis'

Judi Paxton, 62, talks about her shock at being diagnosed with osteoporosis.

"Four years ago I was working as an HR Director. I was stuck in the office day in, day out from eight in the morning till six or seven at night. I never saw daylight and I never took any exercise because I was so busy working all the time.

"But never in a million years did I think my lifestyle might be affecting my bone health.

First signs

"Then one day I was walking down the road with my husband when I twisted my ankle. I felt a snap and fell over. My husband took me to A&E and it turned out to be broken.

"I was referred to the local fracture liaison service for a DEXA (or DXA) scan, which measures the density of your bones. In our area, they do that for everyone over 50 who has a fracture. I thought it was a sensible thing to do, but I didn’t for a minute think there anything wrong with my bones.

"It took ages to get the appointment because the service was very busy. But finally, eight months after I broke my ankle, they did the scan. It was a bit like an X-ray really. I just lay there while they scanned different parts of my body.

Shock diagnosis

"Once they had finished they told me there and then that I had osteoporosis (when the bones become weak and fragile). When I heard that I was in shock.

"It never occurred to me that it was something that could happen to me. No one in my family had had osteoporosis, and I didn’t know that women are more at risk following the menopause.

"The staff at the clinic were very kind. They gave me some leaflets about osteoporosis and referred me to the physiotherapists.

"I really thought it was the end of my life as I knew it. I thought, “My bones are all fragile so I can’t do anything anymore. If I fall over I will break something.” It was a horrible feeling.

"When I went along to see the physios they measured me, checked my balance and generally looked me over. They also referred me for a series of 12 strengthening and balance exercise classes.

Reassuring news

"When I told one of the physios how worried I felt, she said, “You don’t need to be – if you do all the things we tell you, you can improve your bone density.”

"Once I heard that, I perked up no end. I hadn’t realised till then that you can actually improve your bone health. I thought, “Yes, I can do this.” From then on I felt very positive and started doing everything the physios told me.

"In the classes we did press ups against the wall to strengthen our wrists, shoulders and back. We used light weights and stretchy bands to strengthen our muscles, as well as stepping on and off a low step and some brisk walking.

"We also did balances while holding on to the back of a chair. All the time two physios watched over us all and took great care with us.

"Once the classes ended I was referred on to Vitality classes, which are run by the local authority with help from the NHS. These are special exercise classes for people who are a bit more fragile for some reason. That could be due to osteoporosis, arthritis, asthma or following a heart attack. Again, they were very good.

Healthy diet

"I started to eat as healthy a diet as possible. I had more milk and yoghurts to provide calcium for my bones. Instead of crisps I’d have handfuls of flavoured almonds, which are good for calcium too. I ate plenty of eggs and oily fish for vitamin D and got out into the daylight whenever I could. I also took tablets containing calcium and vitamin D twice a day.

"A year after my fall decided to give up work. I realised I needed to put my health first. It meant I could get on with taking exercise, being out in fresh air and generally getting fitter.

"Two years after being diagnosed with osteoporosis, I had another DEXA scan. My bone density had improved by 14 per cent. I was so pleased and excited.

"It just shows that it is totally possible to improve your bone health. I have done what I was told by the physios and have improved my bone health so much. I am not actually classed as having osteoporosis any more although I still have osteopaenia (lower bone density) in my spine.

Staying strong

"Now that I’m not working I spend a lot of time in the garden. It’s good because it gets you out into the daylight and it involves weight-bearing exercise.

I also go to three exercise classes a week – two Pilates classes and an easy circuit class. I make a point of talking to the instructors and asking for different exercises, particularly ones for my spine.

"As funny as it sounds, I was so fortunate to break my ankle. If I hadn’t gone for that DEXA scan my bones would just have got worse and worse. Thank goodness for the fracture liaison service.

"To anyone who finds themselves in my situation, I would say don’t despair. As long as you put the effort in – eating the right things, taking some exercise and getting out in daylight – you can improve matters. Being diagnosed with osteoporosis doesn’t have to be the end of the world."


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