Will CBT work for me?

Have you been considering seeking counselling or therapy recently and wondering will CBT work for me? When people think about seeking counselling or therapy, it can feel confusing and challenging to know what type of counselling to seek; there are so many models and approaches.

Before we address the question will CBT work for me, it’s important to first establish that there are different types of counselling therapies being practiced, all of which ultimately aim to help the client overcome a range of emotional problems. However this means it’s not surprising the waters can become muddied when taking the first step towards seeking support through couselling.

Cognitive and Behaviour Therapies are among the counselling therapies and psychotherapies that people usually seek.  They are recommended by NICE (The National Institute for Health and Care Excellence) for anxiety disorders, depression and many emotional problems, because of the wealth of research that has demonstrated their effectiveness and efficacy.

The ideas that underpin each counselling model have a profound effect on the techniques we develop and the way we ‘do’ our work or the way we counsel.  The model a counsellor uses, their ‘therapeutic bias or preference’, will even affect what is considered important or relevant during sessions. But just because there are different types, it does not mean one particular therapy is more ‘authentically’ counselling than the other.

Many models of counselling

There are many different theories of counselling available to choose from, whether as a practitioner or a client. Some of the most well-known include:

  • Psychodynamic therapies, which includes Psychoanalysis, developed by Freud, are influenced by Freud’s ideas and direct the therapy to the past and childhood in order to make sense of their problems in adulthood.  Emphasis is given to negative experiences of early development and the role of early parenting in the formation of the self and the other.
  • Learning Theory Approaches, which include behavioural therapy which aims to eliminate unwanted and unhelpful behaviours as a way to solve problems.  It is active and goal focused.
  • Perceptual – Phenomenological Approaches which includes Transactional Analysis, Gestalt Therapy and Client Centred Therapy. Client or Person Centred is a non-directive form of talking therapy.  The therapist remains non-directive, does not offer suggestions or solutions.  It is not goal focused but rather focuses on the relationship between the client and the therapist. The idea is that the therapeutic relationship could lead to insights and lasting changes in clients.
  • Existential Therapy is philosophical and focuses on free will, self-determination and the search for meaning.  It emphasises the client’s capacity to make rational choices. It is non directive and the therapist does not offer suggestions or solutions.
  • Cognitive and Behaviour Therapy which includes Rational Emotive Behaviour Therapy or REBT, Cognitive Therapy (also known as CT and CBT), and Cognitive Behavioural Modification.  These are goal directed and state that our emotional disturbances arise from unhealthy unhelpful beliefs, attitudes and thinking and behaviours and that these can be changed so that we can free ourselves from being stuck in emotional pain.  They concentrate on present problems and the current mindsets and behaviours that are creating them.

All of these are counselling theories. ‘Cognitive Behavioural Therapy (CBT)’ is an umbrella term for several different theories that share common principles, just as ‘Psychodynamic Therapy’ is also an umbrella term.

will CBT work for me

Will CBT work for me? Informed choice is key

When deciding on what type of counselling to seek, it is important to make an informed choice. It is helpful to do some research, speak to your GP and perhaps talk to your friends about what they have found helpful and whether they managed to free themselves from their emotional suffering.  Prospective clients should ideally choose the model that they think best suits them, their strengths, experiences and ways of working.

But equally important is questioning perceived ideas or misconceptions about different models.  So, some non-CBT counsellors think that CBT counsellors don’t pay any attention to the therapeutic relationship (the working relationship between the client and the counsellor), which is completely untrue.  Of course, a CBT-counsellor will work hard to develop an open, trusting and relaxed working relationship. We are, after all, encouraging our clients to be frank and honest with their experiences and beliefs. How could we expect them to share these things if they did not trust us?

In Psychodynamic counselling, for example, the therapeutic alliance is viewed as the most significant condition or the central vehicle through which change occurs.  In contrast, a CBT counsellor sees the therapeutic alliance as significant and very important, whilst believing that change occurs when a client changes their mindset and their behaviour.  This process of change starts from understanding emotional responsibility, emotions, facing our past, present and future and developing skills of critical thinking and healthy behaviours. Without a therapeutic alliance effective change would be limited regardless of the counselling model used.

Even under the CBT ‘umbrella’ there can be differences. REBT, for example, can be described as philosophical CBT.  In REBT, the process of therapy is an active and directive one but collaborative.  The therapist and the client work as a team and focus on the client’s goal.  It is a transparent process where problems and priority problems are agreed, goals set, and emotions assessed.  Then the unhealthy beliefs that are at the heart of the client’s emotional problems are identified.  Once this happens, the client learns to turn the spotlight on these happiness sabotaging beliefs so they can be questioned to check if they are realistic and helpful.  Once this skill is learned, their healthy alternative beliefs are discussed and formulated.  Then the process moves onto how to strengthen the healthy versions and weaken the current unhealthy ones through cognitive and behavioural exercise and homework.   It’s like planting a seed for the healthy version and doing what’s needed so the seed can flower.  The weeds that need to be kept in check are the unhealthy beliefs. The client learns this philosophy of change is universal.  Once learned and applied to the initial problems, it can be universally applied to whatever we experience in life.  REBT is an active-directive existential and humanistic CBT model that leads to consistent mental health and resiliency.

Avy Joseph is the author of Cognitive Behaviour Therapy: Your Route out of Perfectionism, Self-Sabotage, and Other Everyday Habits with CBT (third edition published by Capstone, April 2022). He is an experienced CBT/REBT Therapist and Director of the College of Cognitive Behavioural Therapies. He is a registered and accredited therapist with the British Association for Behavioural and Cognitive Psychotherapies (BABCP).

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Benefits of yoga: Why you should add yoga into your everyday routine

We now live in a world where self-care, health and wellbeing are being prioritised, and actually, are actively encouraged – which is something that we haven’t seen until recent years. And one of the very best ways to practise self-care in our humble opinion is through yoga and meditation. Here, Victoria Cranmer, founder of health and wellbeing travel firm Mindful Escapes, shares her thoughts on the benefits of yoga and why yoga should be added to our everyday routine.

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There is a global increase in people battling burnout, and time is of the essence, therefore practising as little as 10 minutes of yoga as part of your daily routine can be a beneficial addition.

People have never been as busy as they are today. Whether it’s juggling work and business with family life or struggling to find the time to relax and unwind, people are continuing to battle the feeling of burnout.

Yoga enables and releases feelings of anxiety, stress, worry, self-doubt, fatigue and the feeling of burnout with each and every breath.

Much more than deep breathing and stretching, yoga is an act of healing – both physically and mentally.

benefits of yoga

Benefits of yoga

As a great source of healing, yoga has many benefits and can work to support everybody in an entirely unique and different way.

Whilst not medicinal, yoga is the ideal way to incorporate gentle movement to your day and improve mental and physical wellbeing.

Improves strength, balance and flexibility

The regular movements and breathing techniques of yoga can aid the improvement of your strength, balance and flexibility by increasing blood flow and warming up the muscles. As well as this, yoga can improve posture, which in turn, reduces back pain and enhances comfort.

Reduces aches and pains

For people with illnesses such as arthritis, or those that suffer from aches and pains, yoga makes for the perfect form of gentle exercise. The stretching and breathing of yoga eases pain and discomfort and is a great way to manage bodily aches and pains without medicinal intervention.

Reduces stress and benefits heart health

When practised regularly, yoga can help people to feel less stressed, thus reducing inflammation and contributing to a healthier heart.

benefits of yoga

Relaxes to aid sleep and boosts mood

With yoga comes a sense of calm and can therefore be a great way to end your day and wind down before going to bed. For a better night’s sleep, alter your exercises to encourage relaxation, but to kickstart your day, yoga can make for the perfect mood booster – simply select exercises that require a little more energy and that make you feel awake and raring to go.

The ultimate self-care tool

Yoga is the ideal way to take care of yourself. Whether it’s 10 minutes, 30 minutes or an hour – yoga can be practised in such a way that works around your day, providing you with some well-deserved ‘me time’ whilst supporting stress management and encouraging mindfulness.

Getting started

It’s important that people practise yoga in a way that suits them – after all, we all have entirely different needs.

Whilst you will receive maximum benefits from adding yoga to your everyday routine, some people prefer yoga retreats to fully immerse themselves and to create the ultimate experience.

A retreat can be the perfect way to prioritise yoga and its healing benefits in your busy life without any distractions from the outside world. For more information on yoga retreats and its benefits, visit: https://mindfulescapes.uk/

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Diagnosed with terminal breast cancer: How to live when life hands you lemons

I didn’t expect to be diagnosed with terminal breast cancer at 47. Whilst I knew there was a small possibility, I didn’t really expect my cancer would return along with an incurable diagnosis. But here we are.

If we know anything, it’s that life often throws us curve balls, this one being the biggest, shittiest one you could ever imagine. Being diagnosed with terminal breast cancer is unimaginable and something I still struggle to believe, even though I know it’s very real. As I walked out the hospital I remember telling myself and those I loved that I would beat this, that if anyone can I would. That I would defy the odds and live with this for a long time. This became my mantra and one I still tell myself most days.

As hard as it is to imagine, life goes on. Living with cancer is far from easy, but this diagnosis has driven me to try and live more vividly and fully than I had before. I may be diagnosed with terminal breast cancer but right now I’m well and not ready to go anywhere.

It takes an army to live your best life when life gives you lemons. Here’s some of the ways I cope:

Choose life

I got busy living. Embracing life, enjoying the little things. I love my adventures and intend to live big.

Belief

This work is never ending. I believe I can do anything I set my mind to. It applies more now than ever before. Facing my fears, choosing my beliefs and letting go of those that don’t serve me. All of this work is central to my determination and belief that I can thrive with stage 4 cancer.

Be informed

Do your own research, read books. Make sense of your cancer and take control based on what works for you.

Be my best advocate

I have had to trust myself and the decisions I make. To take charge. It’s documented that patients who direct their own treatment fare better than those that don’t.

A strong reason for living

Focusing on all the reasons I want to keep living, rather than the fear of dying. Looking forward. To the experiences and adventures I’m yet to have. My husband. My family. My friends. My business. Early on, I was so terrified, I couldn’t imagine life six months out. Eventually once the dust settles I just started focusing on living instead.

Avoid statistics

They are indicators not inevitabilities. There are exceptions to every rule. All we can do is walk our own journey, and be grateful and determined to defy the odds

Understand my disease

I spent a long time reading and researching different protocols so I kew my options. I have tried to understand what my body is trying to tell me. How to nourish myself, to appreciate, to let go. I try and take it as an opportunity to change the way I treat my body and the environment around me.

Focus on healing

I have also learnt that maybe this journey isn’t about finding a cure. A magic bullet. It’s about healing. The type of healing that never stops. Everything I do is about trying to heal my mind and body. There are so many options. The important thing is to trust the decisions you make and believe in yourself. My life has taken on a new normal, and whilst it doesn’t fit my old view of what my life would look like, it brings different joys and appreciations every day.

I’m only a year into my stage 4 diagnosis. As you can imagine, it’s been A LOT. It’s a process of continuous learning, about myself, my disease, my healing. My focus is on filling my life with love and adventures and creating something amazing as a legacy.

So when life gives you lemons, shake yourself off, take a deep breath and make shit happen.

Sara Cohen is founder of luxe sustainable womenswear brand www.hakinakina.com. Having already recovered from breast cancer once, she was in remission for several years, until last April when she found her cancer had returned and was by definition terminal. 5 years ago, having recently recovered from cancer she was looking for swimwear that suited her active lifestyle and offered the high level of protection she needed to cover up her radiation burns. She was left with minimal options; so when she moved to New Zealand she decided to take matters into her own hands.  Armed with a background in marketing and 5 years in women’s wear, she opened her own business and a line of swimwear to give women the freedom to play without compromising comfort, beauty or the environment. Find out more at hakinakina.com or connect on Instagram @hakinakina.active.

Feeling perimenopausal? Here’s how to decode your perimenopausal mindset

Remember when we thought we would have it all nailed in our forties? Remember when we walked into the kitchen and actually remembered what we walked into the kitchen for; and didn’t have to walk out and back in again seventy billion times to remember that all we wanted was just a cup of coffee? Feeling perimenopausal and wondering what has become of your life?

The advent of peri-menopause seems to come at the hardest time of our lives – often as we’re navigating children getting older but somehow needing us more. It’s a time when some of us are thinking of running our own business and then BANG here comes the brain fog, the anxiety, the overwhelm and all of the rage.

So what can we do about it?

Well we can try and rock in a corner, but then someone will probably ask us what’s for tea and whether we can give them a lift to their mates round the corner…

So we have no choice but to crack on and just push forward, even if we’re feeling perimenopausal, right?

You have a choice

Well we do have a choice if we’re feeling perimenopausal. We have a choice to make every day and it comes down to mindset (and in my case a sh!t load of HRT).

Navigating the murky world of feeling perimenopausal, and everything it entails, can become a daily battle and our best asset to learning to swim in the channel is to train our brains, take back control and work really blinking hard to master our mindset.

The key to mastering your mindset when you’re feeling perimenopausal, to rewiring the main frame, is practice and commitment. That’s the key. If we simply think about it, there’s no benefit. We have to act on it. We have to take action. And there is only one person that can do it. It’s the same person who takes all the laundry up the stairs rather than simply stretching across it… That’s right, it’s you. It’s me. It’s the mental mum rocking in the corner still wishing the bloody fairy would turn up with her magic wand and just do something for her.

Our mindset is the key to the door. It is the magic wand (in the absence of a housekeeper, cook and chauffeur). If we can manage and master our mindset then we take back control, and we can stem (some) of the overwhelm, fear and rage that is often part of  the Peri-Menopause Party happening in our head.

Step one

The first step is simply self-awareness. How often do you get up in the morning and check in with how you’re feeling, what your mood is and how you’re going to approach the day? How often do you give yourself that crucial five minutes in the morning that can then impact your mood for the rest of the day?

As you’re waking up and slurping on that vat-load of coffee each morning, ask yourself how you are feeling; and then here’s the magic, ask yourself how that is going to impact your day and what your triggers are going to be.

So if you’re feeling perimenopausal and knackered, and you acknowledge that you’re more tired than anyone who grew up watching Nightmare on Elm Street, you can understand that you are potentially going to be triggered, and therefore should pause and step away before you totally blow a gasket. (Although I’m not sure Mother Theresa would remain calm during a morning routine school run with a teenager.)

feeling perimenopausal

Step two

There’s power in choosing your mood, and not letting it choose you when you’re feeling perimenopausal. In the Manchester Mindset I don’t advocate all of the positive affirmation and some high fiving of the mirror to get the day started. I advocate a much more realistic approach. Understand how you are feeling, understand how you are going to react given your mood and pop in a moment to pause.

The power of the pause is the best thing we can gift ourselves (well other than a week on a beach in Thailand with Tom Hardy). By stopping, by pausing and by giving ourselves a chance to process, we stand a better chance of managing our mood and our reactions and triggers.

Our brains have something called the default mode network – it’s where all of our experiences are processed, and it only comes into play when we are in active rest.

Science is very clear on the amount of rest we need: it’s 42 per cent. That’s the percentage of time your body and brain need you to spend resting. And that is about 10 hours out of every 24. Yep – none of that ‘I only need four hours’ sleep malarkey’.

Ladies, we need to be in a state of rest for 10 hours out of 24 so that we can function and fly. It’s simple; if you consistently don’t take the 42 per cent, the 42 per cent will take you. It will sneak up on you, it will hunt you down and it will pull you under – so give yourself some time back to pause, to process, to rest.

Step three


Third, and finally, there is power in a good routine and a plan. There is freedom in routine and rituals, particularly when you’re feeling perimenopausal.

Find yourself a routine in the morning and stick to it – no I don’t mean get up at 5am for a HIIT workout. I mean get yourself a cup of coffee in peace before the shouting begins. A big benefit of a routine is that it signals to the brain that it’s an automatic response, which means the brain then has increased mental resources for other tasks. Eliminating the need to constantly make decisions about a particular set of activities reduces “cognitive load”. 

Creating predictability reduces stress, which in turn can give your brain more energy to concentrate on other tasks. 

In a nutshell, once you decide to do something, it frees up your brain power and you get more sh!t done. Find your routine and you will give yourself some headspace – which is what we all crave during these bonkers years.

Feeling perimenopausal

So here’s your checklist to navigate the perimenopause:

  • Check in with yourself,
  • Check in with your triggers
  • Gift yourself the power of the pause
  • Rest, find a routine and repeat
  • Drink the coffee

Oh – and have a bloody good shout and a swear when you need to. Because let’s face it, we’re perfectly imperfect.

Sarah Knight, founder of Mind The Gap Academy, for consideration for any profiling slots and any features surrounding motherhood and mindset. Sarah is full of practical tips about how to rewire the brain, establish new habits and shift mindset, as well as juggle the menopause, being a mum and running a business. 

With over 20 years experience in business, Sarah specialises in providing tailored training and coaching programmes to individuals and organisations through her academy, Mind the Gap, to help them mind the gap between running a business, managing a business and staying sane!

Sarah Knight is founder of Mind The Gap Academy. She specialising in providing tailored training and coaching programmes to individuals and organisations through her academy, Mind the Gap, to help them mind rewire the brain, establish new habits and shift mindset. You can follow Sarah at www.instagram.com/mindthegap.academy and learn more about Sarah’s latest online courses by heading to www.mindthegap.academy.

Beautiful lady photo created by 8photo, Flat lay photo created by freepik, week photo created by rawpixel.com

The power of breath: breathwork benefits & 3 techniques for beginners

I am a big believer in the power of breath, and have used breathwork for a whole host of things – combatting my anxiety, tackling my insomnia, getting a handle of big emotions, dealing with pain as well as my own particular health worries. I have very much felt the myriad of breathwork benefits first hand.

However, to many, the concept of breathwork might sound mysterious – after all, breathing is something we do every minute of our lives, without even thinking. But the reality is, most of the time, we are not breathing fully, or properly.

So what? You may ask. Well. Dr. Nerina Ramlakhan, author of Finding Inner Safety and wellbeing, sleep and energy expert, explains the problem here, “When we don’t breathe fully, we don’t inhabit our bodies fully. We become dissociated and numb. At some point in our lives we may have learnt that this was a helpful thing to do, that it would stop us feeling a pain or trauma at that time that we didn’t have the resources to deal with. Maybe we were young so learning how to not feel, to block out (in) uncomfortable feelings was preferable to feeling them.”

The good news is is that this is pretty easy to reverse, and if you are curious about breathwork benefits, then here is your chance to experience them right here, right now as we share three breathwork exercises taken from Dr Nerina’s book, so you can try along with us today, to experience what can be truly profound breathwork benefits.

Practice 1: Notice the Breath

Notice your breathing. What is it doing right now? Don’t try to change it, simply allow it to do what it has been doing all along until you paid attention to it.

Have you been holding your breath while reading or listening to my words? Are your shoulders tight? And what about your jaw?

Have you been gripping it? Is your breathing deep? Do you feel it in your belly or does it feel stuck in your chest, shallow and tight?

Go deeper.

If you find that your breathing is shallow and restricted in your chest, lie down comfortably. Don’t get into bed if you might be in danger of falling asleep! Using blankets and cushions, make yourself comfortable and warm.

Notice your breathing. Place your left hand on your chest and over your heart. Place your right hand on your belly. Allow your breathing to settle and deepen, feeling the weight of your hands on your body. Can you allow your breath to reach deeper into your belly?

Start to gently prolong your exhalation but don’t force it. Imagine you are breathing roots out through your lower body – belly, hips, legs, and feet. Don’t worry about your exhalation – it will take care of itself. Simply, gently making the exhalations longer OOOOUUUUUUTTTTTTT as if you are breathing roots out through your feet and deep into the earth.

Send those roots deep down into the earth. As you breathe out your roots of safety, repeat to yourself:

IT IS SAFE FOR ME TO BREATHE.

IT IS SAFE FOR ME TO BREATHE DEEPLY.

I AM SAFE.

I AM SAFE IN MY BODY.

I AM SAFE IN MY LIFE.

breathwork benefits

Practice 2: Take 5 a Day/Morning Practice

This simple practice is one that I do most days. On days that I don’t I might find myself rushing around, feeling ungrounded and even overwhelmed with everything I feel I have to do.

When you wake in the morning, avoid rushing to open your eyes. With your eyes closed, simply check in with your breathing. What is it doing right now?

Simply follow five exhalations. Doing this might make you want to breathe in a different way – your breath might deepen so you feel your belly expand. Alternatively, let it do whatever it wants to do. Simply follow it.

As you notice your breathing, ask yourself ‘How am I feeling right now?’ Just a simple check-in to start your day.

It would be good if you could repeat this exercise as you go about your day. Perhaps find three other times when you simply notice five exhalations at three other times in the day. Maybe before you have your lunch or while you make a cup of tea. And then, last thing in the day when you turn your light out, follow five exhalations to help you to slide effortlessly into velvety sleep.

This simple practice helps you to become acquainted with yourself and how you are feeling rather than being constantly caught up in the mental realm – always thinking, often over-thinking.

Breathe.

Come back into your body.

Come back to yourself.

breathwork benefits

Practice 3: Sigh it Out

This is a really effective practice for letting go of emotions or stuck energy as you go about your day. We tend to sigh spontaneously as we go about our day but if we bring intention to our sighing it becomes a powerful therapeutic practice in its own right.

When we sigh, it drops us into feelings of calm and contentment. Try it right now. Take a big, exaggerated breath in, hold it in for a second or two and then sigh it out through your mouth. Make a sound as you do so. Make a sound of relief as you sigh.

Try this again, this time exaggerating the exhalation and making it longer.

Imagine sending this exaggerated sigh out of the soles of your feet, as if you are breathing out roots, so this prolonged out-breath makes you feel safe, grounded, and connected to the earth.

Notice if you start to feel softening anywhere in your body. Maybe your shoulders drop and relax, or your eyes and jaw soften.

Have you tried breathwork before? Or is this your first time encountering the benefits of breathwork? Do let us know in a comment below.

This is an edited extract from Finding Inner Safety: The Key to Healing, Thriving and Overcoming Burnout, by Dr Nerina Ramlakhan (published by Capstone, April 2022)

Images by rawpixel.com

BRCA1 update: Removing my fallopian tubes to prevent ovarian cancer

I will forever remember Thursday 5th May 2022, the local elections..and the day that I signed the consent form for removing my fallopian tubes to prevent ovarian cancer. The day I effectively signed my fallopian tubes away to reduce my inherited risk of developing ovarian cancer.

After almost a year of fact finding, a rollercoaster of emotions and weighing up the best next step forward in light of my BRCA1 gene mutation diagnosis, I have finally taken the first step towards my cancer risk reduction.

With a heavy heart

I still have no idea whether this is the right thing to do, but this is my body, my mind, and my physical and mental health. It’s a big leap of faith. I am not going for the belt and braces gold standard approach of having both removing my fallopian tubes and ovaries, which is the best way of reducing the risk of developing ovarian cancer. I just can’t get my head round parting with my ovaries yet. The thinking about the removal of the fallopian tubes first is that according to current research, in many women with ovarian cancer it is believed that the disease may originate in the fallopian tubes.

Perhaps I am being cowardly but the thought of having my ovaries removed and being sent into surgical menopause and the will it or won’t it work of HRT frightens the life out of me at age 41. With the average age of menopause 50 I am just not ready to go there yet. I know everyone kept on saying if it was them, they would have both the fallopians and ovaries removed, but I am not everyone, I am ME.

Feeling frightened

I am also frightened that once they do go in there and go about removing my fallopian tubes, and take samples of the tissue from around that region that they will find cancer cells in there anyway (this happens in about 20% of cases), and I will have to have both my ovaries out and start cancer treatment. Or that ovarian cancer could develop before the later date of having my ovaries out, closer to the time or natural menopause.

I could drive myself crazy with these thoughts but have to take baby steps and trust that at least I am now in the system and what will be will be come my operation which is likely to be in November.

Taking comfort

I keep telling myself, at least I can take comfort in the fact that I am in excellent hands. The world class team running the Protector Study that I will be part of – running out of St Bart’s. I will never forget the warm yet firm handshake of Ranjit Manchanda, a Professor at Wolfson Institute of Preventive Medicine, Barts CRUK Cancer Centre, QMUL, and Consultant Gynaecological Oncologist at Barts and the Royal London Hospital – and that smile which told me I was in kind and extremely capable hands.

Still, I couldn’t hold back the tears as I agreed to all the risks and caveats involved in surgeries, the woulds and would not and signed the consent form for the removal of my fallopian tubes and my ovaries at a later date.

The secret is out

I am beyond relieved that my daughter now knows the secret I had until last week been keeping so close to my heart, waiting for the right time to unfold the truth.

There were tears as I tried to tell her that the upcoming preventative surgeries were for the best and would only start with a little one. She sobbed as I told her about the preventative double mascetomy which I would probably eventually have and asked whether she would be able to still cuddle me? Would my breasts still feel soft and squidy? I cried for the future loss of my good old friends which had fed my daughter in her infancy which were now a ticking timebomb.

Ultimately I know that my risk reducing journey is a marathon not a sprint, and I need to stay strong for the long haul and pray that my body will not renegade or submit to the worst case scenarios along the way as I countdown to receiving my operation date. I pray that time will be on my side, and that a positive outcome awaits.

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About the PROTECTOR study

PROTECTOR is a research study for women who are at an increased risk of developing ovarian cancer. Some women may have an increased risk due to:

  • Carrying an alteration in ovarian cancer causing genes such as BRCA1, BRCA2, RAD51C, RAD51D or BRIP1.
  • Having a strong family history of ovarian and breast cancer or ovarian cancer alone.

PROTECTOR aims to assess the impact on women of a new two-step surgery to prevent ovarian cancer. This involves initially just having your fallopian tubes (or ‘tubes’) removed to prevent ovarian cancer. This is followed by removing your ovaries in a second operation at a later date of your choosing or once you have reached menopause naturally (which on average is 51 years in the UK).

The study assesses women’s views and the impact of this two-step surgery to prevent ovarian cancer on sexual function, hormone levels, quality of life and overall satisfaction. Outcomes from this new approach are compared to the traditional approach of removal of both tubes and ovaries in the same operation. We will also compare this to the well-being of women who do not have surgery. Women are able to choose which arm of the study they wish to take part in: single operation removing both tubes and ovaries, two-step surgery, ‘controls’ (no surgery).

Approximately 30 hospitals across England, Wales, Scotland and Northern Ireland are recruiting participants for PROTECTOR. We aim to recruit 1,000 participants in total (333 in each study arm). If you would like to take part, please ask your GP to refer you to your nearest recruitment centre which can be found using this interactive map. Alternatively, you can contact the team for further details on how to take part.

Photo by cottonbro

5 ways to manage the menopause without HRT

The well-documented Hormonal Replacement Therapy (HRT) shortage has given many women reason to worry as this essential treatment helps to alleviate menopause symptoms such as hot flushes, low mood, anxiety and insomnia.

Whether you’re struggling with the perimenopause or menopause, we’re sharing five important ways to cope courtesy of Vitaminology – a health tech company reinventing how consumers discover and shop for vitamins helping them discover and compare the best supplements for them.

5 ways to cope and manage menopause without HRT

Adopting a healthy diet and lifestyle coupled with nutritional supplements or botanical therapies offer natural, yet effective strategies to help manage symptoms for many peri-menopausal or menopausal women. 

Eat a whole foods, balanced diet

… to help balance hormones. Avoid refined carbohydrates, sugars, processed foods and saturated fats. Opt for a wide variety of brightly coloured vegetables and fruits, whole grains, nuts and seeds, good quality lean protein and healthy fats. Remember that spicy foods as well as alcohol and caffeine are triggers for hot flushes and night sweats. Eating oily fish 2-3 times a week (think SMASH – salmon, mackerel, anchovies and herring and sardines) will also help to support hormone balance.

Exercising regularly

…has so many benefits including our ability to cope with the menopause. It supports a healthy weight, cardiovascular function, improved sleep and the ability to cope with stress. Regular exercise doesn’t have to mean hours in the gym (although weight-bearing exercise is known to be extremely beneficial for bone growth and repair, reducing the risk of osteoporosis) so find something that fits into your lifestyle such as a yoga class or a long walk every day.

menopause without HRT

Keep stress at bay

…and promote calm using self-help techniques such as deep breathing, gentle exercise (ie, walking, Pilates, Yoga, Tai chi), meditation or journaling. Complementary therapies such as acupuncture may also be beneficial when coping with the menopause. A calmer mind will help to achieve a calmer body.

Sleep well

When we sleep our body uses this time to rejuvenate, so good quality sleep is vital when battling menopause symptoms. Try good sleep hygiene techniques such as switching off devices an hour before bedtime, reading or listening to music before going to sleep, taking a hot Epsom salt bath (contains magnesium to help relax the muscles and mind) to help get a good night’s rest. It is super beneficial to go to bed and wake up at the same time each day, and sleep for 7-8 hours.

Consider supplementation

Sometimes in life, we need a little extra help – and this is no different when it comes to our health and wellbeing. There are number food supplements that can help with the perimenopause and menopause including multivitamins specifically formulated. In addition to these, a Vitamin B Complex will help to support energy, mood and brain function or try Vitamin E to relieve hot flushes and vaginal dryness.

Summary

Whether you are considering HRT or trying to find a suitable alternative, always discuss first with your GP who can advise you of the benefits and risks in your individual case. Consult with a registered Nutritional Therapist who can support you through the menopause with advice on diet, lifestyle and supplementation.

Food supplements should not be used as a substitute for a balanced diet or healthy lifestyle.

References:

  • Cagnacci A, Venier M. The Controversial History of Hormone Replacement Therapy. Medicina (Kaunas). 2019;55(9):602. Published 2019 Sep 18. doi:10.3390/medicina55090602
  • Chen MN, Lin CC, Liu CF. Efficacy of phytoestrogens for menopausal symptoms: a meta-analysis and systematic review. Climacteric. 2015;18(2):260-269. doi:10.3109/13697137.2014.966241
  • Dunneram Y, Greenwood DC, Cade JE. Diet, menopause and the risk of ovarian, endometrial and breast cancer. Proc Nutr Soc. 2019;78(3):438-448. doi:10.1017/S0029665118002884
  • Gava G, Orsili I, Alvisi S, Mancini I, Seracchioli R, Meriggiola MC. Cognition, Mood and Sleep in Menopausal Transition: The Role of Menopause Hormone Therapy. Medicina (Kaunas). 2019;55(10):668. Published 2019 Oct 1. doi:10.3390/medicina55100668
  • Hill DA, Crider M, Hill SR. Hormone Therapy and Other Treatments for Symptoms of Menopause. Am Fam Physician. 2016;94(11):884-889.
  • Johnson A, Roberts L, Elkins G. Complementary and Alternative Medicine for Menopause. J Evid Based Integr Med. 2019;24:2515690X19829380. doi:10.1177/2515690X19829380
  • Joseph E. Pizzorno, Michael T. Murray, Herb Joiner-Bey, 53 – Menopause, Editor(s): Joseph E. Pizzorno, Michael T. Murray, Herb Joiner-Bey, The Clinician’s Handbook of Natural Medicine (Third Edition), Churchill Livingstone, 2016, Pages 624-647,ISBN 9780702055140.
  • Ko SH, Kim HS. Menopause-Associated Lipid Metabolic Disorders and Foods Beneficial for Postmenopausal Women. Nutrients. 2020;12(1):202. Published 2020 Jan 13. doi:10.3390/nu12010202
  • Larmo PS, Yang B, Hyssälä J, Kallio HP, Erkkola R. Effects of sea buckthorn oil intake on vaginal atrophy in postmenopausal women: a randomized, double-blind, placebo-controlled study. Maturitas. 2014;79(3):316-321. doi:10.1016/j.maturitas.2014.07.010
  • Lobo RA, Pickar JH, Stevenson JC, Mack WJ, Hodis HN. Back to the future: Hormone replacement therapy as part of a prevention strategy for women at the onset of menopause. Atherosclerosis. 2016;254:282-290. doi:10.1016/j.atherosclerosis.2016.10.005
  • Rizzoli R, Bischoff-Ferrari H, Dawson-Hughes B, Weaver C. Nutrition and bone health in women after the menopause. Womens Health (Lond). 2014;10(6):599-608. doi:10.2217/whe.14.40

photos by wayhomestudio, valeria_aksakova, wirestock

Something wrong down there? What your vagina is trying to tell you

Let’s be straight. When you get the the feeling that there is something wrong down there, there usually is. If you get the feeling that your vagina is unhappy, there are a number of reasons why this might be, and one of them is Bacterial Vaginosis.

What your vagina it trying to tell you…

Bacterial Vaginosis (BV) is a confusing topic of conversation and 1 in 3 women will get it in their lifetime. Often mistaken for thrush, yet more women in the UK actually suffer from Bacterial Vaginosis (BV) than thrush[1]. They also suffer more often, typically 3-4 times per year and up to 72% of women will get recurrence of BV within 7 months. Yet very few people have heard of BV and typically treat symptoms as thrush.

In a nutshell, BV is misunderstood and mistreated. Let’s try and clear up some of the confusion and take a look at what it really is, how you can keep your vagina healthy and why heading straight out for antibiotics isn’t always the best solution.

What is BV?

So, what is BV? Bacterial Vaginosis is caused by a change in vaginal pH. Bacteria called lactobacilli keep the vagina acidic to prevent other harmful bacteria from growing there. With BV, the temporary shortage of lactobacilli allows bad bacteria to thrive, disrupting pH levels and causing unusual vaginal discharge. BV is a naturally occurring and common condition, it isn’t a sexually transmitted infection (STI) but it can be triggered by sexual intercourse.

The most common symptoms are:

  • Thin, watery, greyish-white discharge that has a fishy odour which gets stronger after sex or abnormally large amount of discharge
  • Occasional discomfort
  • Possible redness and irritation of skin around the vulva

Bear in mind that the symptoms can be very similar to thrush so it’s important to make the correct diagnosis. Experienced Consultant Obstetrician and Gynaecologist Dr. Shazia Malik on behalf of Balance Activ™, a leading women’s intimate healthcare brand, explains, “Unfortunately, the symptoms are very similar to thrush but the treatments should, yet often aren’t, very different. BV comes with the classic itchiness of a yeast infection, so it’s easy for customers to mistake it for thrush. There are some subtle, yet important differences. For example, the discharge associated with thrush tends to be white, thick and curd-like, whereas it is thin, watery and grey if you have BV. Another key difference is that the discharge from thrush is odourless, whereas with BV it has a strong, fishy odour, especially after sex.”

Remember the following about BV:

  • It isn’t caused by poor hygiene
  • It’s not an STI
  • It can still occur even in women who have never had sexual intercourse
  • Can only be treated with the right diagnosis

Something wrong down there? How to keep your vagina healthy and happy…

With so much confusion around what’s making your vagina unhappy, how do you keep it healthy and happy?

Here are five ways you can help:

  1. Avoid tight pants, thongs and underwear made from Lycra or nylon and instead opt for cotton pants that allow the area to breathe.
  2. Wash the intimate area with warm water or fragrance-free and pH neutral products. Remember the vagina is self-cleaning so douching isn’t good for it.
  3. During your period, change pads and tampons regularly to keep pH levels in check.
  4. If you’ve been to the gym, for a run or done any physical exercise, change out of your sports gear afterwards because sweat is the perfect breeding ground for bad bacteria.
  5. Finally, remember to use protection during sex and with new sexual partner as semen affects the vaginas pH.

Why antibiotics aren’t always the answer if there is something wrong down there…

Dr. Shazia Malik warns that although antibiotics are a therapy option for BV, Public Health England relaunched a national campaign in 2018 to support the government’s efforts to tackle antibiotic resistance[2]. She says, “Evidence also suggests that there’s a strong link between antibiotic use and these later causing thrush, as antibiotics may destroy the good bacteria.[3] Some women suffer from chronic (recurring) bacterial vaginosis; medicine can clear up the infection, but it returns again after a few weeks.[4]

“Treating BV with antibiotic tablets, gels or creams can have side effects and disrupt
the natural bacteria in the vagina but now women,  particularly those with recurring conditions, are increasingly favouring alternative and natural remedies, which are easily available over the counter.“

The unnecessary use of antibiotics can cause antibiotic resistance, a global concern predicted to cause 10 million deaths by 2050[5], so there has never been a better time to look for a natural alternative.

A natural alternative…

Balance Activ™ is a natural alternative to harsh antibiotics in the successful treatment of BV. Balance Activ™ gel and pessaries are safe and effective at restoring and maintaining the pH of the vagina and should start to work after just one dose.

Use Balance Activ™’s free symptom checker to understand more about your symptoms.

Balance Activ™ products are available nationwide from ASDA, Boots, Morrisons, Tesco, Superdrug and amazon.co.uk.

Do you ever get the feeling that something is wrong down there? Have you ever had VB? We hope this quick guide has helped you understand why that might be, what VB is and your options for treating it.


[1]Joesef MR, Schmid G. Bacterial Vaginosis. Clinical Evidence. 2005; 13: 1968-1978

[2] Public Health England. Keep antibiotics working. Accessed June 2019. https://antibioticguardian.com/ keep-antibiotics-working/

[3] Kim, J. and Park, Y. (2017). Probiotics in the Prevention and Treatment of Postmenopausal Vaginal Infections: Review Article. Journal of Menopausal Medicine, 23(3), p.139.

[4] https://familydoctor.org/condition/bacterial-vaginosis/

[5] O’Neill J. Review on Antimicrobial Resistance Antimicrobial Resistance: Tackling a crisis for the health and wealth of nations. London: Review on Antimicrobial Resistance; 2014. Available from: https://amr-review.org/sites/default/files/AMR%20Review%20Paper%20-%20Tackling%20a%20crisis%20for%20the%20health%20and%20wealth%20of%20nations_1.pdf [Google Scholar]

[6] Source  Andersch et al, 1986. Treatment of bacterial vaginosis with an acid cream: a comparison between the effect of lactate-gel and metronidazole. Gynecol Obstet Invest, 21:19-25

Photo by cottonbro from Pexels

What happens when you have a mammogram

I won’t lie. The first time I had a mammogram, I really didn’t know what to expect. But being at high risk of developing breast cancer in my lifetime due to the fact I have BRCA1 gene mutation, then well let’s just say I am going to become very familiar with mammograms! But apart from the fact I expected it was some kind of scan, I had little idea about what happens when you have a mammogram.

Mammograms save lives

The bottom line is that mammograms save lives with breast screening saving around 1,300 lives each year in the UK. Finding cancer early can make it more likely that treatment will be successful.

Having said that, it doesn’t distract from the fact that having a mammogram is not exactly the most pleasant of experiences in my personal opinion just because it does tend to be pretty uncomfortable as your breast tissues gets pulled and manipulated into certain “flatter” positions before it gets positioned into place ready for the scan.

That said I would rather take a mammogram every day of my life rather than having a malignancy undetected in my breasts. The alternative – not knowing the status of your breast tissue and any potential changes and what they may mean, is unthinkable to me.

Do not put your mammogram off

Whatever the pain and discomfort you feel, I want to lay down now how important it is NOT to let this deter you from having your routine mammogram and attending breast cancer screening. All women are invited for a routine mammogram in the UK from age 50 up. If you have an increased risk of breast cancer due to hereditary factors then you should be having a routine mammogram annually from the age of 30 of 40.

Worries about the procedure, along with COVID disruption saw a 44 per cent fall in the number of women screened for the disease nationally in 2020-21 according to NHS England, but mammograms and early diagnosis of cancer can rapidly improve the long-term prognosis and chances of recovery. 

If you are worried about having a mammogram, not sure what a mammogram is, or yet to have your first mammogram, here Kate Whittaker, Superintendent Mammographer, at King Edward VII’s Hospital explains all.

when you have a mammogram

I’ve been invited to attend a mammogram. Should I go and what should I expect?

When women turn 50, they will be contacted by the NHS Breast Screening Programme  Unit, inviting them for a mammogram. All patients registered as female will be contacted every three years, until they turn 71.

Mammograms are a straightforward, non-invasive short procedure, but increasingly women are missing appointments, or declining to attend their screening. Worries about the procedure, along with COVID disruption, saw a 44 per cent fall in the number of women screened for nationally in 2020-21 according to NHS England. But mammograms and early diagnosis of cancer can greatly improve a patient’s long-term prognosis and chances of recovery – so why should women attend them, and how can they prepare?

Before the appointment

As mentioned above, breast screening can save lives. Identifying and intervening early can dramatically improve the outcomes for breast cancer, but attending a mammogram is obviously a personal choice.

If you do decide to attend and feel nervous about the procedure, try to book an appointment at a time when you’re not going to be rushing around. If you feel comfortable doing so, ask a friend or loved one to take you to the appointment for moral support, and have something nice planned for afterwards that you can look forward to and distract from any worries.

When you have a mammogram, you’ll be asked to undress from the waist up, so try to wear something comfortable that’s easy to take on and off. You’ll always be imaged by a female mammographer, but if you have any queries or concerns, including mobility issues or special requirements, it’s best to contact the screening unit before your appointment. That will allow them to make any necessary changes to your appointment, such as duration or location, as some sites are remote and may not be accessible to disabled service users.

During the mammogram

When you’re ready, you’ll be invited into an x-ray room by the mammographer, who will explain the procedure and answer any questions. Your breast is imaged by gently placing it onto the x-ray machine and applying some compression. This only lasts a few seconds and releases the moment the x-ray has been taken. You’ll have four images taken in total, two on each breast. All you’ll need to do is take a few small steps in front of the machine and raise your arms when asked, to help with the breast positioning in the side images. The whole process is over very quickly, in around five minutes, but keeping still is really important to get an accurate x-ray.

Breast screening can be uncomfortable, or occasionally a little painful for some people, so talking through any concerns with the mammographer can be very useful, you can also tell them to stop at any point if you’re feeling discomfort.

Getting your results

Results will be sent to you by post and they generally take between two and four weeks. A copy will also be sent to your GP for your medical records.

Your results will either say ‘No sign of breast cancer’ or ‘Need further tests’. If you have no sign of breast cancer, you can wait for your next mammogram in three years time, unless you notice any breast changes, including any lumps in your chest or armpit, discharge from your nipple, or an unusual texture on the skin of your breast. Do a check once or twice a month, and contact your GP if you notice any changes or have any concerns about your breasts.

when you have a mammogram

If you need further imaging, don’t panic. Most people who need further tests will not be diagnosed with breast cancer. But if you are worried, you can discuss the appointment with a breast care nurse, who will be able to explain to you the result, and what next steps will be taken.

You’ll be offered an appointment in a screening assessment clinic where you’ll be offered an examination of your breast and sometimes more mammograms, an ultrasound, or sometimes a needle test. Results from these tests normally take around a week. All of this will help the Breast Unit team and your GP to best support you and offer any further investigations and treatment you may require, which, in some cases, can limit the need for invasive treatment, or surgery. So when you receive your next invitation, I’d urge you to come forward and attend your  mammogram, or if you notice any breast changes or symptoms in the meantime, speak to your GP to access support as early as possible, which may save.

We hope the above helps you overcome any fears you may have about attending a mammogram screening. Focus on the end game in that when you attend a mammogram, you are doing something amazing for your body and yourself, and empowering yourself with the knowledge you need about any risk factors, warning signs and potential treatment down the line. To find out more about assessing your breast cancer risk see this useful guide over at our friends Breast Cancer Now or speak to your GP.

Photos by cottonbro and Tara Winstead via pexels and National Cancer Institute on Unsplash

Let’s talk about… thrush… baby

This article includes PR samples

 I’ve suffered with thrush for as long as I can remember. Since having the kids its only got worse. I’m now on a maintenance plan through my GP. I manage my diet because I know that, for me, sugar is a massive trigger. I talked to Bupa’s expert, Dr Samantha Wild for some advice. Here’s what she had to say.

What is vaginal thrush?

Vaginal thrush is a yeast infection that can make you feel sore and itchy around your vulva and vagina.

It’s common – about three-quarters of women will have it at some point in their lives. Up to one in 20 women have repeated (recurrent) thrush infections. You can get thrush at any age, but it’s most common in women who are in their 20s and 30s. Men can also get thrush, including on the penis.

What are the most common symptoms of vaginal thrush?

You might not have any symptoms of thrush, and not realise you have it or need treatment. If you do get vaginal thrush symptoms, they may include feeling itchy and sore outside your vagina and a thick, white vaginal discharge. You may also experience soreness and discomfort when you have sex and when you go to the toilet.

What are the causes of vaginal thrush?

Vaginal thrush is caused by a type of yeast. Normally, this lives harmlessly in, or around your vagina, alongside healthy bacteria. But if it grows more than usual, this causes thrush.

There are several things that can cause you to develop thrush, including taking antibiotics, being pregnant, and having a weakened immune system. More research is needed, however there is a small amount of evidence that suggests some types of contraception, such as the combined contraceptive pill, may increase your risk of getting thrush.

Self-help advice:

Speak to a medical professional

thrush

Getting medical advice as soon as you notice a problem can help to get rid of your infection quickly and prevent complications. There’s no need to feel embarrassed about speaking to your doctor or pharmacist about any ‘unusual’ symptoms you’re experiencing – we’re here to help.

Often, you can get treatments for thrush over the counter, and you can get these from your local pharmacist. If your vaginal thrush symptoms get worse or you’re experiencing it regularly (more than four times each year), speak to your doctor. 

Avoid using perfumed products

If you have thrush, you might find it helps to stop using soap or perfumed shower and bath products around your genital area. Instead, it’s best to use water or non-perfumed moisturising cream – if you’re unsure what type to use, ask a pharmacist for advice. 

Other perfumed products such as feminine deodorants, biological washing powder and fabric conditioner may increase irritation and are best avoided.

Practice good hygiene

To prevent triggering a recurrent thrush infection, make sure you maintain a healthy lifestyle, keep your immune system strong, and practice good hygiene. You can do this by taking regular showers (and drying yourself properly), avoid wearing tight-fitted clothes, avoid douching (washing out your vagina with water or special douching fluid), and washing your hands frequently.

If you have thrush, it’s also best to avoid sexual activity until the infection has completely cleared up. Thrush isn’t a sexually transmitted infection but does share some similar symptoms with other infections; so, it’s a good idea to rule these out. Thrush symptoms can also be triggered after sex. 

Confide in your loved ones

It can be tough to deal with a recurrent health problem, particularly if you feel embarrassed. It can be a huge relief to speak to your close friends or family (whoever you’re most comfortable with) about how you’re feeling. If it’s causing you to experience a low mood, remember that your doctor is available and will support you, too.Alternatively, you can find support through reputable sources online, for example the NHS, Patient, and Bupa.

I hope this article has been helpful to you. I’ve found that taking a probiotic specifically designed to target the intimate areas has benefited me hugely and over the last couple of years I’ve had less infections which I believe is attributed to this. I use Optibac. Their product ‘For Women’ contains friendly bacteria strains especially found in the vaginal & urinary tracts, scientifically proven to reach the intimate area, and to complement the vaginal flora. It’s suitable for women of all ages and is backed by over 30 years of research.

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