International Women’s Day 2019 – 5 Facets of Women’s Health

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This week, I found myself reflecting on how awesome it is that we have an annual day to celebrate us ladies. Don’t get me wrong, I’m all for gender equality and power to the dudes out there too, but every year International Women’s Day makes me smile ear to ear. I also have several gal pals who have been major rocks for me as friends over the last year in particular, and some epic friends who have been, particularly over the past year, setting up and grafting to build their own businesses, chasing their dreams, and not being afraid to own every part of who they are. You can’t get much more inspiring than that, and it definitely boosts my confidence to continue my slightly less traditional route as a doctor. So for this week’s Friday Focus, I decided to share 5 simple ways us ladies out there can look after an optimise our physical and mental health. Let’s have a closer look!

Nutrition and Nourishment

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Anyone who has followed my blog and social media for a while now will know I’m a big advocate for greater awareness among the population in general about the importance of a healthy diet. I’m gonna keep this one simple – it isn’t about foods that are ‘good’ or ‘bad’, and labelling aspects of our diet in this black and white way of thinking doesn’t foster a healthy relationship with food. Focus on what you can gain from a healthy dietary pattern. In developed countries, the ‘food pyramid’ or ‘plate’ has many critics, but the fact of the matter is that many of us don’t stick to the healthy dietary guidelines proposed by our national and international nutritional bodies, which are based on sound evidence and science – doing that alone consistently would be fantastic for our health! Of course, as you guys know I’m a doctor, not a dietitian or nutritionist, so this section isn’t prescriptive nor it is exhaustive, just broad brushstrokes!

  • Aim to meet your 5 to 7 servings of fruits and vegetables per day (aim for more vegetables than fruit in this ratio) everyday, to provide a tasty wide range of micro-nutrients and fibre
  • Boost your intake of whole-grains to help that fibre intake too (having an adequate fibre intake has well-established benefits for our metabolic and digestive health in particular!)
  • If you’re an omnivore (i.e. you eat meat), go for lean cuts of white and red meat, and aim for two servings of fish per week (one of which should be oily fish, such as salmon or mackerel)
  • Try to include plant sources of protein in the diet, like chickpeas, lentils, beans, nuts and seeds – these are full of fibre and other micro-nutrients, and make great meat alternatives to protein!
  • Don’t fear dairy. Despite the absolute craze around plant-based milks (and don’t get me wrong, I’m not bashing them per se, and consume a mix of dairy milk, soy and oat milk myself) and the myths that have been spread among the media about dairy, there are MANY well-established health benefits to consuming it. It’s a fantastic source of calcium and protein in particular in the Irish diet, and unfortunately many people who have drastically cut down on their intake (whether for environmental/animal welfare reasons or just to follow a trend) haven’t considered where the replacement for those nutrients will come from. Check out this awesome article by dietitian and friend of mine Maeve Hanan here all about myth-busting dairy!
  • Also – don’t fear fat! Focus on getting those heart and brain-loving mono- and poly-unsaturated fat sources into your diet – for example, omega 3 fatty acids (a type of polyunsaturated fat) from oily fish, a mix of mono and polyunsaturated fats from raw mixed nuts, monounsaturated fats from extra virgin olive oil and avocado!
  • Finally – moderation, not deprivation. I didn’t call my blog ‘The Irish Balance’ for nothing!

Enjoy Your Exercise

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I get asked A LOT about different types of physical activity, which to pick over the other, how to get started with a new type, etc. Physical activity has an absolute WEALTH of health benefits for us – physical, mental and emotional. If we could wrap those up into a pill, we would all be taking it gladly everyday! It’s so important for us ladies (and the men!) to stay active throughout life, to keep us fit and functionally independent right up to the age of 100 and beyond! Here’s my take home tip for exercise:

  • Find the type that you ENJOY. Even if that takes a few tries until you get there! Personally, I love a mix of strength training at the gym, walking (an occasional run too!), yoga, and I’ve discovered a new love of Reformer Pilates (I’ve tried two classes and really enjoyed both!). I also plan to get back into swimming next week! Did I figure that mix out overnight? Of course not! For example, I only found a love of yoga a year ago, but was hooked straight away. Don’t be afraid to try new things if you haven’t found a form of exercise you love yet – and don’t force yourself into the kind that you dislike! If possible, find yourself a balance of aerobic and resistance type training to optimise your cardiovascular fitness, and keep your muscles and bones strong with age. Have a peek at my most recent exercise article here!

Sort Out Your Stress

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Okay, so I know I have chatted about stress a LOT on my blog – you’ll find my most recent article full of my stress-busting tips right hereJokes aside – it is just as important to manage your stress as it is to look after your diet and exercise. In this crazy 24/7 society that we live in, one where technology is literally ‘king’ and we are always hyper-connected to our phones, it’s easy to see how we can become a little bit overwhelmed. Between our busy work and home lives (not to mention keeping up with friends and hobbies!), it can seem almost impossible to find a way to slow down the pace of life and check in with how we are doing, and how we are talking to ourselves. You’ll find a whole range of stress management tips I’ve found helpful in the article I’ve linked above, but my personal go to tools are – taking a walk (even ten minutes!), doing ten minutes of meditation with my Calm app, breathing techniques like Box Breathing, talking a problem out with a friend (or my mom – can I get a hell yeah for the mothers out there!) and finally just making a list of tasks I’m stressing over, and scheduling when I’ll do them can be really helpful I find! Find the ways that work best for you, but do make time to figure out what those are. Here’s a favourite quote of mine to illustrate what I mean – I even have it on a mug!

Peace. It does not mean to be in a place where there is no noise, trouble or hard work. It means to be in the midst of those things and still be calm in your heart.’ 

Remember the Risky Behaviours

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This point is 3-fold so I’ll keep it short and sweet, and bullet-point it. Do let me know if you’d like to see further blog posts expanding these further!

  • Smoking. I do have a blog post coming on this topic soon, but in short – if you are a smoker (and yes, ‘social smoking’ counts), PLEASE think about seeking help to quit. The direct and indirect damage smoking does to the health of the smoker and those around them (via second-hand smoke, or ‘environmental tobacco smoke’) are no joke. Nearly 6000 deaths in Ireland every year are attributable to smoking, and one in every two long-term smokers die of tobacco-related disease (Health Service Executive, 2018). The most recent smoking prevalence estimate in Ireland is 18.8% of the population, which is a downward trend, albeit a slow one. If you are keen to quit (and if you’re not, please at least start to consider it), speak with your GP for advice, and check out Quit.ie for those based in Ireland!
  • Alcohol. Many of you reading this will be from Ireland and the U.K. I know, and I do have a full article on alcohol in Ireland right here. The maximum limit of alcohol intake per week (i.e. our low-risk guidelines) for women is 11 standard drinks (or 110g pure alcohol) per week, spread out over the course of the week with a minimum of 2-3 alcohol-free days. A standard drink is half a pint, one measure of spirits, or a 100ml glass of wine. Binge-drinking, the levels of which are quite high in Ireland (second highest in the world, actually!), is defined by the World Health Organisation as consuming six or more standard drinks in one go. Alcohol affects our physical and mental health, and can compromise our safety (for example, through people engaging in drunk-driving, or getting into fights, or having accidents while inebriated). Keep yourself safe, and be aware of those guidelines. The Irish website Ask About Alcohol a massive amount of very informative content on it, and also has a drinks calculator to allow you to get an insight into where your current consumption falls according to guidelines.

Healthcare ‘Down There’

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Finally, I’m going to make 3 (and a bonus!) key points on this topic, and all are equally important – sexual health, menstrual health, and getting savvy about your cervical smear:

  • Sexual Health. Ask yourself the following: Am I sexually active? If so, do I use barrier protection (e.g. a condom)? Have I ever had a check for a sexually transmitted infection (STI)? Sexual health is a rather neglected aspect of our overall health and well-being, which is in part due to quite a lot of stigma and poor education around the various STIs out there – HIV, Genital Herpes, Genital Warts, Chlamydia, Syphilis and Gonorrhoea to name but a few. Importantly, in Ireland we are seeing a major rise in certain STIs, particularly Chlamydia and Gonorrhoea, which are both often clinically silent (i.e. you don’t notice any symptoms or signs) when initially contracted, but can spread and lead to a condition called pelvic inflammatory disease later on, and increase the risk of infertility. The Irish website resource Sexual Well-being is fully of really helpful and easy to understand information on the various different types of STIs, how to prevent them, what good sexual health is, and what to do to get an STI screen in Ireland. Most STIs are passed between sexual partners through unprotected oral, anal or vaginal sex. So the take home points here are – use a condom every time you have sex, and if you or your partner show any signs of infection, cuts or sores on the genital area, avoid sex (including oral) until you have been tested (+/- treated if required). Similarly, if you or your partner are diagnosed with an STI, it’s essential to avoid having sex again until after you have been treated and cleared of infection. Having an STI test is a great idea when you have a new partner (both of you!) – remember, many STIs can be asymptomatic initially, but still passed on. This is a topic I want to write on on for the blog (with additional emphasis on unplanned pregnancy which is also a key aspect of sexual health), so keep an eye out for that!
  • Monitor Your Menstrual Cycle. Okay ladies, we all know about T.O.M. – time of the month, our ‘period’, whatever nickname you have for it! Our period (when blood leaves the womb through the vagina) happens approximately every 28 days (although this can be a range between 24 and 35 (HSE, 2018). The menstrual cycle occurs as a result of hormonal cycles and communication between your brain and your ovaries (a simplified explaination!) I won’t get into the nitty gritty science further than that right now (do let me know if you’d like to see more posts on the topic!), but my point is this. If you have noticed irregularities in your menstrual cycle (not compared to your friend or sister, compared to what was your normal), whether that is the frequency (i.e. how often), nature (i.e. duration/pain/’heaviness’ or absence/loss of your cycle (called amenorrhoea), make it your mission to check in with your GP to discuss it. The menstrual cycle is a natural part of being female, and while it can be a total pain in the butt sometimes, it is a sign of our reproductive health, so if things have gone awry (or absent entirely), you need to get it checked out.
  • Get your cervix checked. Depending on what country you are from, the ages at which cervical screening is done may vary, but in Ireland its for women between the age of 25 and 60 via a smear test performed every 3 years for those ages 25 to 44, and every 5 years for those aged 45 to 60. DO NOT SKIP YOUR SMEAR. There is a lot of fear and confusion about smear tests in my experience, but it’s so SO important to attend for your smear when called. Cervical screening aims to detect pre-cancerous changes in a woman’s cervix (the neck of the womb). Cervical cancer can take 10-15 years to develop, making it a very preventable disease, which is one of the main reasons we screen for it. There are approximately 300 new cases of cervical cancer in Ireland every year. If you’re afraid or nervous to go for your smear – please don’t be! It’s a very quickly performed test – less than 5 minutes. The doctor or nurse performing the smear test will use an instrument called a speculum to open the vagina, which allows them to see the cervix. A small specialised brush is used to get a small sample of cells from the cervix. It can feel a bit odd and some find it uncomfortable, but not painful – and the more you relax, the less likely that is. Your results will be sent to a laboratory for testing, and then sent back to your GP/clinic within a few weeks, and if abnormal changes are seen, you’ll be called to your GP/clinic to discuss this, and maybe referred on for another test called a colposcopy to have a closer look at the cervix. Have a look at the Irish Health Service Executive website on cervical screening here for more information for those based in Ireland.

Bonus on the Breast

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On the topic of screening, I couldn’t finish this article without mentioning the other key aspect of female health – checking our breasts! In Ireland, we have the screening programme Breast Check which is currently being extended, and by 2021 will invite all women aged 50-69 for a free mammogram every 2 years (originally it was 50 to 64).  A mammogram is essentially an x-ray of the breast. This age bracket was chosen because in Ireland, over 70% of cases of breast cancer occur in women over 50, and the risk of breast cancer increases with age, and this age bracket is what is recommended nationally and internationally. Below the age of menopause, the breast tissue is quite dense so spotting small cancers is a lot harder on mammogram (Health Service Executive, 2018). Similarly to cervical cancer, we screen for breast cancer because by detecting disease earlier, when it is asymptomatic, research has shown screening reduces the number of deaths due to breast cancer due to early pick-up and treatment. Additionally the Irish Cancer Society (linked) recommends us ladies be ‘breast aware’ and get into the habit of looking at and feeling our breasts from time to time, so that we know what’s our ‘normal’, and therefore might notice when something is ‘abnormal’, such as breast size, shape, nipple changes, skin changes, lumps/thickening or pain in the breast, as well as swellings in the armpit.

So if you’re in the above-mentioned age bracket and in Ireland, make sure your keeping up to date with your screens, and if you’re not in Ireland, check out your country’s screening programme and guidelines, and similarly for cervical screening too!

And that folks, is a wrap! I hope you found this post helpful, and as always I would love to hear any feedback you guys have, and of course any tips you ladies stick to for a healthy lifestyle too! You know where to find me – @theirishbalance on Instagram/Twitter/Facebook!

Ciara 🙂 x

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