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Research on Depression in the Workplace.

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Mental Health Matters Journal for Psychiatrists & GP's

MHM Volume 8 Issue1

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Literacy is a luxury that many of us take for granted. That is why SADAG created SPEAKING BOOKS and revolutionized the way healthcare information is delivered to low literacy communities.

The customizable 16-page book, read by local celebrity audio recordings, ensures that vital health and social messages can be seen, heard, read and understood by everyone across the world.

We started with books on Teen Suicide prevention , HIV, AIDS and Depression, Understanding Mental Health and have developed over 100+ titles, such as TB, Malaria, Polio, Vaccines for over 45 countries.

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Women all over South Africa assume that menopause implies having to go on HRT for the rest of their lives. Instead of passively complying to this point however, it is felt that women should be active in choosing HRT and an informed decision should be made on taking responsibility for our health.

The pharmaceutical industry has introduced a supposedly “safe” HRT which is a combination of synthetic progesterone and oestrogen. This treatment is to protect women from cardiovascular disease and osteoporosis, amongst other menopausal horrors.

Scepticism around the treatment of menopause have appeared from numerous doctors and researchers. For example, Dr Lynette ...... who is the senior Research Fellow at University of Melbourne’s Department of Surgery. She believes that HRT exacerbates the health problems and accelerates a woman’s ageing process.

Most often, advice given regarding menopause is incorrect and can be dangerous. Similarly Dr S West, Chief of Reproductive Endocrinology at St Vincent’s Hospital in New York, feels that the only appropriate reason for a hysterectomy is cancer of the reproductive organs. Whereas women are often told it is a necessary treatment for ovarian cysts, endometriosis and other common ailments.

Education is the key to a woman’s empowerment regarding menopause. Here are three fundamental facts that females should be aware of regarding their bodies:

· Oestrogen is produced for the first 10 days of a woman’s menstrual cycle in order to prepare the follicle for the release of one of the eggs. This hormone facilitates puberty and the development of the reproductive system.

· Progesterone levels begin to rise as ovulation occurs and oestrogen secretion reduces. Progesterone is responsible for the female libido and a soon as its level reduces in the body, the menstrual cycle begins anew.

· Menopause causes a decline in the amount of oestrogen and progesterone being produced by the ovaries while other hormone levels remain constant.

The natural design of a woman’s body is to produce progesterone and oestrogen, both in a delicate balance. These 2 hormones are closely related and one cannot be produced in surplus. The introduction of synthetic hormones can have hazardous effects in upsetting the balance. It should be considered that a females psychological well-being is inextricably linked to the monthly flow of hormones.

Women are told that because of this menopause is a deficiency disease. Focus remains on replacement therapy in order to prevent cancer, cardiovascular disease and osteoporosis. Although most doctors are well-meaning, they unfortunately tell their patients that HRT is the only alternative. However, due to the many side effects and complications of HRT, a woman must think very carefully about the HRT decision and also consult a number of sources before beginning treatment.

It is crucial to note the difference between natural progesterone and synthetic progestins such as Provera, Dyphasten and Primulut. Synthetic progestins are not exact replicas of progesterone as it is produced naturally by the body. Importantly, synthetic progestin tends to block the body’s ability to produce natural progesterone.

Women who are prone to depression and other anxiety disorders should then take extreme caution when beginning a course of HRT which contains synthetic progestins. Although progestin may help prevent endometrial cancer (cancer of the womb), it is often best to use it as a combined treatment, i.e. with oestrogen.

Some of the more common side of synthetic progestin treatment, when not combined with an oestrogen treatment, are as follows: headaches, fluid retention, agitation, insomnia and depression.

Pushing HRT onto all women who are experiencing menopause seems to be a popular trend on the part of medical practitioners. Despite HRT having a lot of merit in many cases, the over-enthusiasim for medication should be cautioned against. An informed and knowledgeable decision should be made by the patient, not only the doctor.


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