Dear Miriam - Mirror.co.uk

Don't fall for those menopause myths

2009-07-02T23:33:32Z

There are so many myths and misconceptions about the menopause it's no wonder that women can get confused.

Referring to it as "the change" makes it sound like a sudden and terrifying event - but life is a series of gradual changes, of which the menopause is a natural part.

One of the scary things you may be told is that your memory will never be the same but this isn't strictly true.

A study from the University of California found that any forgetfulness is only temporary for most women and learning ability returns to normal after the menopause.

This is good news for the 60% of women who report memory problems. My brain was certainly affected by the menopause initially, becoming something of a black hole. I would forget what I was saying in the middle of a sentence - which is bad news on live television!

Hormone replacement therapy (HRT) helped but I also kept my mind active by engaging and challenging it every day. I even learned a new language.

You may be surprised at the amount of misinformation surrounding the menopause. It isn't always easy to cope but knowing the difference between fact and fiction can make it a whole lot easier.

TRUE OR FALSE?

All women will suffer unpleasant symptoms
Most women get one or two of the most common symptoms, including hot flushes and night sweats, but many sail through the menopause with no problems at all.

Branding of "the change" as some kind of nightmare leads women to fear and dread it unnecessarily.

In countries such as Japan, where age is revered and older women are respected, fewer physical and psychological symptoms are reported.

I feel negative attitudes towards the menopause and ageing in the West have an adverse effect on women here.

You'll put on weight
Women do tend to put on weight at the menopause but it's partly due to a slower metabolism as we age, which affects men, too.

Declining oestrogen levels can affect how fat is distributed, explaining why any weight gain is often round the waist. You may have to work harder but weight loss can still be achieved in the usual ways: a healthy diet and regular exercise.

Studies show as many women who don't take HRT gain weight as those who do. Some women get increased water retention/bloating but changing the dose or type can help with this.

Smoking leads to earlier menopause
Women who smoke are more likely to begin the menopause before 45, putting them at increased risk of heart disease and osteoporosis.

The average age for menopause in the UK is 51. The risk of early menopause is almost double for heavy smokers. Evidence shows you may not be affected if you quit before middle age but the earlier you stop the better.

Your sex life is over
This is only true if you want it to be - and research shows that most of us don't. A study this year suggested that more than 80% of menopausal women still want an active sex life.

Some even report increased sexual satisfaction after the menopause, which may be due to the higher testosterone-to-oestrogen ratio. Many women feel liberated from the fear of getting pregnant and relax more.

Dwindling oestrogen levels can cause vaginal dryness and discomfort during intercourse but there are safe and effective treatments for this, including water-based lubrication.

You'll start the menopause at the same age as your mum
Your mum's history can be a good indicator of what's in store and many women whose mothers have an early menopause seem to follow suit. Research from the Netherlands proves there is a genetic link and in future women could be tested for the risk of an early menopause, helping them to decide when to start a family.

The age you started periods could be significant - if you started young, you may finish later.

HRT is dangerous
Experts are divided on HRT health risks but scare stories have led thousands to stop treatment. It has been linked to a slightly increased risk of certain conditions such as stroke, ovarian cancer and breast cancer but, looking at the studies involved, the risks are very small in real terms.

Most experts agree that, if you have menopausal symptoms affecting your quality of life then the benefits of taking HRT (for five years or less) greatly outweigh risks, especially for under 60s.

I favour HRT delivered through your skin by patches and gels, as they need a smaller dose than tablets. By rubbing in gel, you can gauge the lowest dose needed to control your symptoms.

Don't listen to scare stories, evaluate your individual risk with your GP and discuss the options. There's no other treatment close to HRT for effectiveness and I personally decided to live with the perceived risks in exchange for getting my old vigour and active brain back.

It's all downhill now
This is absolute nonsense! I believe you can make what you want from your life during and after the menopause. It can be a time where you concentrate on yourself - freed from the demands of a young family - or establish new and exciting goals. Most women expect to carry on into their 80s so that's a good 30 years after the average menopause.

As long as you look after yourself, keep active mentally and physically, and have a healthy attitude to ageing, it can be a wonderful time for a woman.

Letter of the day: I can't leave now she's sick

2009-07-02T23:09:32Z

Dear Miriam,

I'd been seeing my girlfriend for about three weeks when she had a routine mammogram and a lump showed up. She's now been diagnosed with breast cancer and is receiving treatment.

I've being doing my best to support her but the anxiety has placed a strain on our relationship.

Instead of having fun and going out we've been spending much of our time in hospitals.

Lately, she's been calling me a good friend rather than her partner and I've noticed her pulling back and being distant emotionally.

She has an ex-husband who's back in touch and has visited her. I met him last week, which was a bit awkward, but he did seem genuinely concerned about her.

My girlfriend's told me they've talked about a reconciliation and she's seriously considering it. This has really upset me.

I wouldn't say I'm in love but I'm very fond of her. She says she's grateful for my friendship. If she does go back to him I'd be unhappy and yet I'd feel very guilty if I abandoned her when she's sick.

What can I do?

Frank

Dear Frank,

Illness can make relationships complicated. Both of you will have a mixture of feelings.

She probably doesn't want to burden you. She may feel she's dragging you into her problems and interfering with your life - you might be scared she won't get better.

What's not in doubt is that you have been a great friend. Many lesser people would have made a quick exit.

You should be very proud of being someone who doesn't ask to be excused when things get tough.

It never entered your head to ditch her and look for someone else and now she's considering doing just that. Of course, that's a huge blow but at least all your feelings, hopes and dreams are not yet tied up in her.

Maybe she realises this and wants to set you free? She has a much longer association with her ex. He knows most things about her and you're still only learning.

A few weeks or months doesn't even give you time to know someone, much less agree to make a serious commitment. A crisis like poor health can help people understand what's really important in life and it seems to have given your girlfriend and her ex a chance to re-evaluate their decision to separate.

All credit to her for being candid. She doesn't want to exploit your patience and kindness just to ensure she has someone there to take care of her and relieve her loneliness. So, as difficult as this must be for you, especially because you've steadfastly stood by her through her illness, accept that the old relationship has ended.

How will you feel if you cut and run on her? How will she feel? Do think twice about abandoning the friendship altogether.

Life is messy and none of us live it perfectly but that would seem cruel.

Use some of your strength of character to get over the hurdle that she's chosen another man. I expect she'll always be grateful to you for all the time you are there for her.

Should I ditch my sex buddy?

2009-07-02T23:06:32Z

Dear Miriam,

I'm 24 and in the middle of a situation I don't know how to handle.

Three months ago my boyfriend broke up with me, saying the relationship had gone stale after four years together. That night I went out clubbing to cheer myself up and met someone else.

We had sex in the car park and I got a buzz out of doing something really naughty and I'm still seeing him for sex.

I don't have any feelings of love for him and we don't have a relationship, just sex.

My boyfriend has asked if we can try again but it will mean no more hook-ups with my sex buddy. What should I do?

Jan

Dear Jan,

Now is a good time to get things straight with yourself. What do you want? A relationship or casual sex? Who matters more, your boyfriend or the sex buddy?

If you shilly-shally about ending things with your sex buddy, you'll be guilty of sabotaging a new beginning with your ex, so why put yourself through a reconciliation if you'll be calling your buddy more than your boyfriend?

If you decide to go back to your boyfriend, don't forget you could always put the experience you've had with your sex buddy to good use and teach your boyfriend some new tricks.

I fear she fancies her handyman ex-brother-in-law

2009-07-02T23:05:32Z

Dear Miriam,

For the past year, I've been seeing a 42-year-old divorcée. I've noticed she's still close to her ex-brother-in-law, who is also divorced and single.

She needs her living room decorating and I offered to do it but she said she's going to ask the brother-in-law and he can stay with her while he's there.

Other times, when we've made plans, she's cancelled them at the last minute if he's coming over. It seems clear that she doesn't want me around when he's with her.

This business with the decorating has made me think she's attracted to him. Am I being paranoid?

Pete

Dear Pete,

These two have a friendship which has lasted beyond her former marriage and she genuinely might be fond of him with no romantic intentions.

However, it does seem suspect that she keeps blowing you out for his sake. If the relationship with him was strictly platonic, she ought to want you around as well.

You have to talk to her and get her to open up about her true feelings.

This guessing game is working on your self-confidence. Explain that you don't expect her to devote all her time to you but it hurts when she ditches plans you've made together at the last minute. If she's not willing to schedule more of her life around you, it's time to wise up and move on.

Boyfriend's mum is my enemy

2009-07-02T23:04:32Z

Dear Miriam,

I'm 20 and have been seeing my boyfriend for seven months. His mother can't stand me and has a go at me whenever she gets the chance.

She let rip because we were kissing and hugging in front of her. I didn't start it, he did, but she made me feel like a slut.

Now I make sure I'm not too close to him when she's around.

She's accused me of being clingy and reckons he could do better.

This really hurt me as I'm not ugly, stupid or chavvy. I know she's trying to put him off me and I don't know what to do.

He's an only child. Can you help?

Gina

Dear Gina,

Mothers can be very protective when it comes to relationships and friends.

She may feel scared you'll take her son away.

You and his mum both love him - and he loves the two of you.

As frustrating as this situation is for you, don't force your boyfriend to choose between you.

Tell him how her sniping makes you feel and ask if he can talk to her about it. Just be sure not to insult his mum in any way.

Ultimately, you can only control what you do, not what she does. Keep showing her you're as wonderful as her son thinks you are.

I want widow to have his ring

2009-07-02T23:03:32Z

Dear Miriam,

Many years ago, I was in love with a man who gave me a beautiful diamond engagement ring. It originally belonged to his grandmother.

He was in the Army and went to fight in Korea. When he came home again, the spark between us had gone and we mutually agreed to end our relationship.

I offered to give him back the ring but he was adamant he wanted me to keep it and remember him fondly. I've recently discovered he died a few months ago, leaving a widow, three daughters and several grandchildren.

The ring has always been very special to me but I don't know if I should return it to his family. I feel guilty for keeping it.

What do you think?

Rose

Dear Rose,

Engagement rings are gifts and legally the ring belongs to you so you're under no obligation to return it to the family.

You might stir up some difficult emotions if you turn up out of the blue with something the family knew nothing about, and which represents a life before them. You could get a frosty reception.

However, if you're convinced they are being deprived of an heirloom, it would be a very generous gesture to offer it to them.

Tip of the day

2009-07-02T23:00:32Z

From the age of 10, a child may enjoy the responsibility of looking after a pet.

The rights and wrongs of drugs that are available over the pharamacist's counter...

2009-07-01T23:50:54Z

Men can now walk into Boots the chemist, answer a few questions from the pharmacist and buy the impotence pill Viagra.

It's just one of a growing number of medications that used to be prescription-only but can now be bought without seeing a doctor.

While I'm not in favour of just any drug becoming available over the counter, I do think the fact that certain treatments are now more accessible is a real benefit.

It's not only a plus for patients but over-the-counter treatments free up doctors' time - and I am in favour of cutting out unnecessary doctors' visits.

Most importantly, however, it's vital that any drug is only made available over the counter after careful consideration and rigorous checks...

(1) Has it been taken by huge numbers of people?

A drug must have been on the market long enough for us to get a full understanding of its side effects - and this can't be achieved just by clinical trials.

We only really know the true side effects when a drug is tried by millions of people in the general population. And, until we know every risk, no matter how rare, a drug must stay on prescription so its use can be controlled and any side effects reported.

(2) Do we know the safe dosage?

I was working for a pharmaceutical company when ibuprofen was licensed for use over the counter. Because it had been used by millions of people, we gathered enough information on it fairly quickly in terms of the maximum safe dose.

However, it still took around another 10 years before it was made available over the counter for children as, quite rightly, it takes a lot longer for a drug to be declared safe enough for use in kids.

(3) How does it interact with other drugs?

When drugs react badly with one another, they can cause serious harm.

And, when you think of the huge number of people taking various different combinations of prescription medicines, it's clear we must be certain how a drug interacts with all of these before it can be considered safe for over-the-counter use.

No prescription needed...

Here are some key drugs that have recently become available in your pharmacy - and why I think it made sense...

Viagra - Men can buy Viagra over the counter from this month as long as they have a 30-minute consultation with the pharmacist to ensure it's safe and appropriate.

I think this is sensible as both Viagra and impure imitations have long been widely available on the internet - the imitations putting people in serious danger. Going over the counter is a far safer way of controlling this drug's use.

Statins - I'm very much in favour of these cholesterol-lowering drugs being available to buy from the pharmacy.

Statins have been found to protect against serious conditions such as heart disease very successfully, reducing the risk of heart attack with very few side effects.
They've also been used by millions of patients worldwide so are now considered safe.

Migraine drug - Imigran Recovery (a version of the prescription drug sumatriptan) is the only over-the-counter treatment that treats the cause of migraine and can stop an attack in its tracks.

It was put through a raft of very strict safety tests - all of which it passed - and combines very few side effects with a high success rate.

Fat pill - Alli, the first weight-loss drug to be sold over the counter, is a lower-dose version of the prescription drug Xenical, which has been available from GPs for the past ten years.

Even though it's half as strong, it's 80% as effective at cutting the amount of fat you absorb and is virtually side-effect free.

Morning after pill - I agree with the morning-after pill being available over the counter as it prevents an extremely serious condition - unwanted pregnancy.

It's also a relatively low dose of hormones over a short period, so the likelihood of side effects is minimal. For me, the benefits outweigh the risks.

Drugs I wouldn't make over the counter

The following prescription-only medicines have been discussed as potential over-the-counter candidates but I don't think they should be. And here's why...

The Pill - Knowing the possible side effects of the Pill, including a higher risk of thrombosis in some women, I wouldn't like to see it available without prescription. A doctor needs to make an informed decision about whether an oral pill is the best form of contraception based on a patient's history.

Plus, women could fib about their age, smoking habits and even body weight - all of which can make the pill dangerous - far more easily to a pharmacist than to their own doctor.

Ritalin - A professor recently called for Ritalin - used to treat children with severe attention problems - to be made available to exam students over the counter, as it can improve concentration.

This may be so but it's a terrible idea to make it so easily available and open to abuse. Not only could parents of naughty kids decide to buy it and self-medicate them, Ritalin can also cause nasty side effects including heart palpitations, nausea, anxiety and insomnia.

Antibiotics - It's been mooted often that antibiotics should be available over the counter but I think this would be a disaster. Firstly, people would self-diagnose and take them pointlessly for colds and flu, which are viral, not bacterial. Secondly, people could overuse them or not finish courses - both of which can lead to antibiotic resistance.

Over-the-counter drugs that wouldn't pass today

Many common medications and substances wouldn't be licensed to be sold over the counter if they had to get through today's strict safety testing. For example...

Aspirin - The side effects of this drug, including gastric bleeding and the fact it thins the blood - which could trigger a stroke for people with high blood pressure - mean aspirin would never get approval today.

Alcohol and cigarettes - If they'd been subjected to the scrutiny today's drugs are put under, the potentially-fatal side effects of both substances would have ensured an outright ban.

Codeine - This ingredient in extra-strength over-the-counter painkillers is a member of the same family of drugs as morphine and very addictive in large doses, so the chances are it wouldn't be passed today.

Herbal products - If they were subject to the same rigorous testing as pharmaceutical products, many would fail on the grounds of impurity, ineffectiveness or dangerous interactions with prescription drugs.

Letter of the day: I'm a loser with this games addict

2009-07-01T23:32:36Z

Dear Miriam,

My boyfriend is obsessed with computer games. He often gets up at 5am to play one involving super-soldiers and aliens. When he comes in from work, the first thing he does is switch on the computer.

Sometimes he even forgets to eat. It's just as bad at weekends. We don't do anything together any more.

I feel there's no time or space for me in his life. Every time I bring this up, he tells me I'm being selfish and smothering him.

I get angry at his couldn't-care-less attitude and I hate the way he ignores me. He's hardly interested in sex any more - I might as well be invisible. I'm sick of nagging him and getting nowhere and I'm tired of all the arguments.

I've considered giving him an ultimatum - the computer or me - and I hate to admit it but I think he'd choose the computer!

What can I do?

Angie

Dear Angie,

In a healthy relationship, partners should make enough time for their own hobbies and activities - but your boyfriend's game-playing is taking over his life, not to mention yours.

He's an addict and you're being dragged into his addiction. As long as you're willing to hang around and watch him indulge, he won't change.

It's no different to him being an alcoholic or addicted to drugs. The addiction removes him from a life with you. He doesn't seem to have a problem taking the pleasure and happiness away from your relationship and expects you to walk on eggshells and not complain.

This is your relationship too, and you have every right to stand up for yourself. You'd be better off single because then you'd have the freedom to go out and have fun or find someone else who will treat you better.

You have three choices. You can continue to let him ignore and neglect you while he spends all his time in another world, leaving you feeling increasingly lonely and frustrated.

You can try to persuade him to seek help for the habit which is controlling his life. You know what he likes other than computer games, so try something he used to do to help pull him away.

Also let him know that you don't mind him playing but you want to do some things together, away from the computer and outside the home.

Or, if you're no longer attracted to the back of his head, you can stop being second best, cut your losses and leave. If you do go, he probably won't notice because he'll be too busy running amok in a galaxy far, far, away. Ultimately, if he wants you, the real world must win.

Love cheats need rat-like cunning

2009-07-01T23:27:36Z

Dear Miriam,

Why are so many men stupid enough to let their wives and girlfriends catch them cheating?

I've had several girlfriends over my 20-year marriage. I've had sex with some of them at home when my wife's been working on a night shift and she's never suspected a thing.

It doesn't take a genius to clear away the evidence so you're not found out. A colleague at work is in big trouble because he left a hotel receipt in his trouser pocket.

I've no sympathy for him. What would my wife gain if she stumbled on my secret life? It only takes a few simple precautions to protect our partners and ourselves.

Don't you agree?

Stevie

Dear Stevie,

Who do you think you are - a public relations man for Cheaters 'r' Us?

While it's true some relationships survive infidelity because wives turn a blind eye to all the clues, and some men, like you, are master con merchants, most people prefer not to have the wool pulled over their eyes.

What would your wife gain if she were to learn the truth? She would get a good look at you and be able to decide for herself if she wants to spend the rest of her life with an unscrupulous Lothario.

She's living a lie and doesn't know it. Maybe you have more to lose than she has and one day, when she does find out, she'll give you your marching orders.

Husband drives me up the wall

2009-07-01T23:25:36Z

Dear Miriam,

My man's driving me crazy. Habits I used to find endearing, like the way he twiddles with his hair, now irritate me.

My husband has never been tidy and I used to pick up after him without a word but now I'm on his back all the time telling him to clear up his own mess. I look at the hurt on his face when I've had yet another go and I feel nothing.

I don't know what's come over me. We've been married for two years and used to be so happy but now I feel I want to escape and be free. Have I fallen out of love with him?

This is killing me inside.

Beth

Dear Beth,

Everyone gets doubts in a relationship. Unfortunately, in real life, that feeling of being in love often fades. No, your love for that person doesn't suddenly vanish but the butterflies-in-the-stomach, sweaty- palmed, rapid-heartbeat feeling wanes. Sure, you're annoyed with him but the qualities you fell in love with in the first place are still likely to be there.

First, spend time each week on your own interests and friends. Being fulfilled outside your marriage will help you feel more content inside it. Next, gently voice your irritation to avoid letting it build to snapping point. Only if the relationship feels like a lot of hard work and you can't see it getting any better, is it time to end it.

Little girl's kept hidden

2009-07-01T23:22:36Z

Dear Miriam,

My eight-year-old granddaughter's a little sweetheart who wouldn't say boo to a goose but I feel she's in deep trouble at home and I want to help her.

Her mother, my ex daughter-in-law, has a new husband and he's very strange. He lives like a recluse and expects my granddaughter to stay mostly in her room out of the way. She's no longer allowed any friends to visit and seems very lonely and bored.

When I mentioned to her mother that she should be mixing with other children, she said her husband suffers badly from migraines and needs peace and quiet.

What do you think I should do?

Marie

Dear Marie,

Alas, children from broken relationships don't get to vote on their fate and some get a very raw deal. But you need to be very careful you don't alienate either the mother or stepdad as they might retaliate and keep you at arm's length in future.

It's vital you do nothing to threaten your relationship with your granddaughter. She needs you. See her as often as you can and perhaps have her stay at your house and invite her friends to visit so she can still see them outside school.

You can become her loving comfort blanket, someone she can confide in. And where's your son? Shouldn't he be more involved in his daughter's life?

Who cares about carers like us?

2009-07-01T23:20:36Z

Dear Miriam,

I'm in my late 70s and luckily I still have fairly good health.

My husband has Parkinson's disease and I work hard to keep him comfortable as well as doing the cooking, cleaning and gardening.

Family and friends always ask how he is, and I appreciate that, but they never ask how I'm managing or if I want help. I don't want sympathy but I wish people would spare a thought for carers like me.

Rosie

Dear Rosie,

Who cares for the carers? Unsung heroes and heroines like you, motivated by a strong sense of duty, are the backbone of society but you must feel emotionally and physically exhausted.

Caring for a dependent loved one is both demanding and stressful. I expect people don't mean to be insensitive or ignore your self sacrifice, they simply haven't experienced what you're going through and don't understand what it's like to be on call all day, every day.

Instead of putting a brave face on everything, you might feel better if you're more truthful about the strain you're under. Carers UK is the voice of carers.

It improves carers' lives by providing information and advice and you can call CarersLine on 0808 808 7777. Make use of support groups, family and friends so you can take regular breaks to do something enjoyable for yourself.

Tip of the day

2009-07-01T23:19:36Z

"From about the age of eight, a child can sleep over at a friend's house"

Letter of the day: I cheated on my true love

2009-06-30T18:28:24Z

Dear Miriam,

I'm 20 and I've been through a lot. Dad died when I was 13, mum couldn't cope and I was fostered. I went home again for a while when mum remarried but I didn't get on with my stepdad - he beat me and I had to leave.

My dad's cousin gave me a home but I always felt I wasn't really wanted. I'm now living with a friend and work in a supermarket.

Last year I got pregnant and had a miscarriage. It was just as well as I didn't want to keep the baby and my boyfriend dumped me as soon as I told him. Soon after I met someone else who is six years older than me and really cared about him. He made me feel secure and safe.

Then I did a stupid thing. I had sex with my ex. It only happened once but my ex bragged to some people and my new boyfriend found out. I felt so ashamed for being weak but he won't forgive me.

It's been five weeks since I've lost him and I would do anything for one more chance. I miss him so much. He means everything to me and I don't understand why I cheated.

Can you help me?

Denise

Dear Denise,

Your life's been a catalogue of tragedies and it doesn't seem fair that one person has had to cope with so much misfortune.

One way to work out why you cheated is to write down questions you would have asked him if he'd cheated on you. Think about what you'd want to know. When that's done, write down your answers. Writing will help you get things straight in your head. By identifying the reasons, you'll stand a better chance of moving forward, either with him or on your own. You may find you were deliberately trying to push him away so he would break up with you!

You've been abandoned throughout your life and it's likely that you subconsciously expected your boyfriend to leave and hurt you the way the other people you've loved have done - so you got in first and made it happen.

Because of your upbringing, no doubt you have worries about trust and probably feel you're not worthy of kindness and love because these have been in short supply.

Although this is untrue, years of letdowns and disappointments have conditioned you to believe this.

As far as letting your ex know how you feel, be honest with him. This is probably best done in a letter as you can write down all your thoughts and ideas without interruptions and distractions. Let him know how much you care about him, how much he means to you and how sorry you are.

Hopefully, with time, he'll see past all the anger and realise it was a mistake you regret and that you love him. If he's too hurt to take you back, this will still have been a good relationship for you and certainly won't be your last. Learn the lessons, take responsibility for your choices, then forgive yourself.