Post-traumatic stress disorder (PTSD) isn’t confined to soldiers on the battlefield; it can happen to anyone after a traumatic event – including pregnancy loss.

After a miscarriage or ectopic pregnancy, one in 6 women can have PTSD nearly a year later, European researchers report.

Shocking, scary or dangerous experience

“Early pregnancy loss is associated with a significant level of psychological distress, and in particular, on the order of 20% will have PTSD that persists until at least nine months after the loss and probably longer,” said lead researcher Dr Tom Bourne.

PTSD is a psychiatric condition that can develop after a shocking, scary or dangerous experience. In many cases, PSTD will not respond to general counselling and will require specific treatment, said Bourne, a professor from Imperial College London and a consultant gynaecologist at Queen Charlotte’s and Chelsea Hospital in London.

His team studied more than 650 women who experienced a miscarriage – defined as loss of pregnancy before 12 weeks – or an ectopic pregnancy. That’s where the embryo starts to grow outside the womb and is unable to develop.

Those who suffered from PTSD continued to relive the feelings they had from losing their baby, and suffered intrusive or unwanted loss about their miscarriage. Some also had nightmares or flashbacks, and others avoided anything that would remind them of their loss.

For many women, pregnancy loss will be the most traumatic event in their life, Bourne said.

“There needs to be greater awareness of this issue and appropriate treatment provided. It is likely in the near future, women will be screened for PTSD at an interval after a pregnancy loss so appropriate treatment can be given,” Bourne said. “Given the number of women who suffer an early pregnancy loss each year – this represents a significant public health problem.”

Distress declined over time

In this study, questionnaires asked the women about their emotions and behaviour.

Researchers found that in the month after, 29% met criteria for PTSD, 24% had moderate to severe anxiety, and 11% suffered from moderate to severe depression.

Distress declined over time, but remained significant. After nine months, 18% suffered from PTSD, 17% had moderate to severe anxiety and 6% had moderate to severe depression.

The responses were compared with those from 171 women who had normal pregnancies. The level of psychological distress was significantly higher among those who had had a pregnancy loss, the researchers found.

Kate Rawson, a British actor and playwright, wrote a radio play based on her two miscarriages.

“After my first miscarriage I was numb. I did not know how to react or who to approach. I did not know if it was grief that I was feeling, or if that was even a valid response to have about losing something so ‘small’,” she said in an Imperial College London news release.

Trying again ‘full of anxiety’

Rawson’s second miscarriage was even more devastating, she said. Besides guilt “at what I could have done to cause it,” she said she also felt a deep sadness for herself, her husband and friends, who would have to console her again.

“I tried to ‘move on’ as advised. ‘Trying again’ was full of anxiety that got worse when I fell pregnant for the third time,” Rawson said.

“I struggled to keep perspective and flitted between wanting this baby more than anything else to wishing I would just bleed and get the awful thing over with and my life back,” she said. It was only after her baby was born, she said, that she realised the enormity of what she’d been through, and the need to process it.

“The loss of a baby is a painful experience to a family,” said Dr Lisa Waddell, deputy medical officer at the March of Dimes.

“We know that many women suffer in silence,” Waddell said. “These findings highlight the need to continue to evaluate ways to best support women before, during and after pregnancy,” she said. It’s important to ensure access to mental health services, social supports and clinical care, she added.

The report was published in the American Journal of Obstetrics and Gynecology.

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Breast cancer is the leading cancer affecting women in South Africa, according to CANSA. The National Cancer Registry indicates that one in 27 women is at risk of being diagnosed with the disease in their lifetime. 

But a new study casts a bright light on the fight to end this deadly disease. After looking at 200 000 people, scientists from the University of Cambridge identified 352 genetic mutations that increase an individual’s risk of developing the killer disease. The researchers, whose findings were published in Nature Genetics, believe that these mutations may impact as many as 190 genes.

According to the report, fewer than 40 genes had been previously recognised, making this breakthrough highly impressive.

Why this is good news

This new discovery paints a hopeful picture as it can help pinpoint which women are predisposed to developing breast cancer, and therefore allow them to be closely monitored. 

“This incredible haul of newly-discovered breast cancer genes provides us with many more genes to work on, most of which have not been studied before,” said Dr Alison Dunning from the University of Cambridge.

Dunning added that the large number of genes that are now known to play a role emphasise how complex the disease is, and that it will help researchers build a more detailed picture of how it arises and develops.

The human genome

The human genome contains between 20 000 and 25 000 genes, and while individuals actually share as much as 99.9% of the same hereditary material, 0.1% of our genetic variants make us unique. It’s also what makes us susceptible to certain diseases.

What makes studying these genes even more intricate is that there are no single genes that cause diseases such as breast cancer, but rather a combination of these genes acting together to increase one’s risk of developing the disease.  

Science writer Ed Yong from the Atlantic writes: “These genes continue to be mysterious because they sit in parts of the genome that are hard to analyse with modern techniques. So when geneticists search for variants in the genome that are associated with diseases or physical traits, they often gloss over these duplicated genes entirely.”

However, Yong also points out that newer techniques are starting to solve these problems, with the recent discovery a case in point. 

Living with breast cancer

According to the World Health Organization (WHO), cancer affects more than two million women each year with an estimated 627 000 breast cancer-related deaths recorded in 2018. The WHO also notes that the rates are increasing in almost every region across the world.

Although breast cancer often manifests as a lump in the breast, not all lumps are cancerous, as explained in a previous Health24 article. Risk factors for the disease include, among others, age, age at first pregnancy, genetic inheritance, early onset of menstruation, and menopause after age 55.

Here are some of the most common symptoms of the disease, once a tumour has formed:

• Unusual nipple discharge, sometimes stained with blood
• Rash or crusting on the nipples
• Lump or swelling in the lymph glands in the armpit
• Sharp pain in the breast
• Colour, shape and texture changes in the nipple

Breast lumps should never be ignored. If you notice a lump, it’s important to see your doctor right away.

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Compiled by Zakiyah Ebrahim

You made your resolution – this year was finally going to be the year you lost weight. But then your neighbour stopped by with a plate of cookies, and well, your resolve didn’t even last a day. Maybe next year?

But instead of looking at your resolutions as a sweeping year-long project, what if you concentrated on making healthy changes every Monday? That way, if you slip up and dive into that pile of cookies, another chance to get it right is just a few days away.

It’s called the Healthy Monday Reset, and the idea is to send you into the week with a fresh mindset.

Mindset change

“What we really want people to do is implement a mindset change. If you think about the New Year’s resolution, you pick one day a year to start changes and if you fall off the wagon, it’s another year,” explained Ron Hernandez, the managing director of The Monday Campaigns.

“But with Monday, you have 52 opportunities in a year. If you fall short one week, there’s always an opportunity right around the corner, so you don’t have to wait that long to make a change,” he said.

This, Hernandez added, is something you can really integrate: “‘Monday, I will make better choices.'”

A study conducted with Johns Hopkins Bloomberg School of Public Health found that people often describe Monday as the day they are seeking out health information.

“Monday becomes a cue, and if you start off the week well, you’re more likely to keep going through the rest of the week,” he said.

The Monday Campaigns recently surveyed nearly 1 000 adults with Data Decisions Group. Sixty percent of the group was white, 14% black and 18% Hispanic. The remaining 8% identified as “other”.

Only about one-quarter of respondents said they kept their resolutions all year long. Twenty percent made it just two weeks.

Some of the challenges they reported were staying on track, a lack of discipline, getting started and not seeing results fast enough.

Three-quarters of respondents said they thought refreshing their goals every Monday might help them maintain their resolutions.

Reflect and learn

Samantha Heller, a registered dietitian with NYU Langone Health in New York City, likes the idea of weekly goals. They’re more realistic, more achievable and less daunting than a year-long resolution, she said.

“You can use the Monday reset to reflect and learn. If my goal is to have vegetables every day for lunch, how did I do? If I managed three days, that’s good, but how can I plan so I’ll do better? People often make resolutions whether they’re prepared to do the work or not, but making a successful change takes thoughtful planning,” Heller said.

So, if you want to meet that vegetable every day for lunch goal, you have to plan time to shop, and then to prepare your lunches. “Learn to make a plan and set aside the time to reach your goal. You set aside time to get your hair done. Set aside time to achieve your goals,” Heller said.

And, if you didn’t reach your goal this week, look back at what works and then start fresh again on Monday. She said it’s important to be kind to yourself if you slip up.

“Change is difficult and there’s no quick fix. Start taking it step by step. You can’t walk on to a tennis court for the first time and start playing a Wimbledon-level match,” she explained.

“Use Mondays to reassess, learn and start doing something to be a happy, healthier person,” Heller added.

Exercise may do more than build body strength: New research shows it might also keep brain cells in shape.

According to the study, exercise helps maintain the brain’s gray matter, which is linked to various skills and thinking abilities. So, keeping your gray matter intact may help prevent thinking declines, the German researchers explained.

The report was published online in the Mayo Clinic Proceedings.

Improving cognitive function

“This [study] provides indirect evidence that aerobic exercise can have a positive impact on cognitive function in addition to physical conditioning,” said Dr. Ronald Petersen, a Mayo Clinic neurologist.

“Another important feature of the study is that these results may apply to older adults, as well. There is good evidence for the value of exercise in midlife, but it is encouraging that there can be positive effects on the brain in later life as well,” said Petersen, who co-authored an editorial that accompanied the report.

Exercise and brain scans

The German researchers, led by Katharina Wittfeld, followed more than 2 000 adults in northeastern Germany from 1997 through 2012. Over the study period, fitness was measured and participants underwent MRI brain scans.

Although the study found an association between exercise and brain health, it couldn’t prove a cause-and-effect relationship.

According to Mayo Clinic experts, moderate and regular exercise – about 150 minutes per week – is recommended. Good fitness also involves:

• Not smoking.
• Following healthy eating habits.
• Maintaining a healthy weight.
• Keeping a low blood pressure.
• Controlling cholesterol levels.
• Reducing blood sugar.

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