By Hilary Diack

Back from a hedonistic summer? Here are some great tips from Mind Body Green on how to get on track again.

mindbodygreen.com/0-20780/5-habits-that-will-lead-to-healthy-sustainable-weight-loss

See, we always thought there must have been a link! Read on to learn more.

businessinsider.com/how-gut-bacteria-affect-the-brain-2015-7

A life-changing approach to home décor! Set the mood for happiness and health.

inhabitat.com/infographic-how-interior-color-choice-can-evoke-moods-in-your-home

Lavender, one of the most useful herbs we have. Learn more in this helpful article.

celestinevision.com/2015/04/health/17-uses-for-lavender-essential-oil

Even more on the wonders of essential oils and how they can assist in our wellbeing on every level.

healthy-holistic-living.com/complete-guide-to-essential-oils

Need that extra boost? Nature comes to the rescue with these potent helpers.

consciouslifenews.com/3-food-supplements-beyond-multivitamins/1181169

By Tabibi 24/7

Antibiotics are certainly one of the great advances in medicine, responsible for saving countless lives. However, misuse and overuse of these drugs have contributed to a phenomenon known as “antibiotic resistance”. This means that antibiotics that used to be standard treatments for bacterial infections become less effective or don’t work at all. Any bacterium that survives an antibiotic treatment can then multiply and pass on its resistant properties. Also, some bacteria can transfer their drug-resistant properties to other bacteria — as if passing along a cheat sheet to help each other survive. As antibiotic resistance grows to be a pressing public health concern worldwide, wise use of antibiotics became very important.

You can help reduce the development of antibiotic resistance through the following tips:

What to Do

• Ask your doctor if there are steps you can take to feel better and get relief from your symptoms without using antibiotics. Sometimes, symptomatic treatment is all you need. At other times, the safest prescription is to wait-and-see, where antibiotic prescribing is delayed until the need for it is justified.
• If an antibiotic is prescribed, follow directions for proper use. Failure to take an antibiotic as prescribed can contribute to antibiotic resistance.

-Complete the full course. It’s important to take all of the medication, even if you are feeling better.

-Do not skip doses. Antibiotics are most effective when they are taken regularly.

-Measure liquid doses carefully for your child. Use the dispenser in the package, a measuring cup or a graduated syringe. Using household utensils can lead to dosage errors.

• Ask your doctor about vaccines recommended for you and your family.

-Vaccines are an effective way of preventing infections that may require an antibiotic.

-Vaccines are also an important way of keeping diseases from spreading.

What Not to Do

• Never take an antibiotic for a viral infection like a cold or flu. Antibiotics do NOT cure viral infections such as:

-Colds

-Flu

-Most sore throats

-Most coughs and bronchitis (chest colds)

-Many sinus infections

-Many ear infections

• Never pressure your doctor to prescribe an antibiotic.
• Never skip doses or stop taking an antibiotic early.
• Do not save antibiotics. You might think that you can save an antibiotic for the next time you get sick, but an antibiotic is meant for your particular infection at the time. Never take leftover medicine.
• Do not take antibiotics prescribed for someone else. These may not be appropriate for your illness, may delay correct treatment, and may allow your condition to worsen.

*Consequences of antibiotic resistance:

For many years, the introduction of new antibiotics outpaced the development of antibiotic resistance. In recent years, however, the pace of drug resistance has contributed to an increasing number of health care problems.

The increasing number of drug-resistant infections results in:

• More-serious illness or disability
• More deaths from previously treatable illnesses
• Prolonged recovery
• More-frequent or longer hospitalization
• More doctor visits
• Less effective or more-invasive treatments
• More-expensive treatments

Finally, remember that antibiotics fight bacteria not viruses. Rushing for antibiotics can put you or your child at risk of undesirable effects and antibiotic-resistant infections.

Investigating Emotional and Binge Eating Disorders with Amira Khalil

By Hilary Diack

Suffering from an insatiable need for food? Nibbling when you are not really hungry? Just a few of the alarm signals that should get you thinking about your eating patterns. It is surprising how many people suffer from eating disorders, so Cairo West Magazine had an informative chat with Amira Khalil, certified in Counseling Psychology and Eating Disorders, and author of I Did it With Chocolate.

CWM: Is there a common root cause for eating disorders?

AK: Essentially, eating disorders are control issues; any eating disorder provides control over the life of the individual. For whatever reasons, the individual suffering from an eating disorder will most probably have control issues relating to earlier life and this might be due to any imbalance in the four childhood pillars: Unconditional love, Encouragement, Discipline and Self-Control. Those are the four pillars any child needs in his early life. If a child is not nurtured and where those four pillars are not balanced he might develop an eating disorder. For example, a child needs to know that he is loved unconditionally to feel valued and be able to depend on his parents whenever he needs reassurance, whether he is good or naughty. Also, the child needs encouragement and needs to feel that he is achieving something, demeaning and critical comments all the time will harm his self-esteem. Self-control also is an important example, not the kind of self-control that restricts behavior, rather the sense of control – feeling safe, unthreatened and having safe space around oneself. Abuse in childhood, either physical or psychological might damage the sense of self-control, hence eating disorders are often found in abused children.

An emotionally healthy person will have all pillars at the same level at a healthy rate; people with an eating disorder will not have this; eating disorders are a coping mechanism. The most important thing to understand here is that eating disorders in general have a purpose and are needed by their sufferers for many reasons. The cruelest thing to be done here is to attempt to remove the symptoms before addressing the cause. Eating disorders frequently show with other mental disorders, 50% of the people suffering from eating disorders have depression.

What is binge-eating?

Binge-eating is eating in a defined period of time (within a two-hour period) an amount of food that is definitely larger than what most people would eat in a similar period of time under similar circumstances. Excessive food consumption must be accompanied by a sense of lack of control to be considered an episode of binge eating. An indicator of loss of control is the inability to refrain from eating or to stop eating once started. Binge eating occurs, on average, once a week for three months.

In binge-eating disorders, there are several behavioral indicators of loss of control associated; at least three of them exist in a binge-eater:

1. Eating much more rapidly than normal.
2. Eating until feeling uncomfortably full.
3. Eating large amounts of food when not feeling physically hungry.
4. Eating alone because of feeling embarrassed by how much one is eating.
5. Feeling disgusted with oneself, depressed, or very guilty afterward.

How common is it, and does it affect particular age groups?

Eating disorders often develop during childhood and teenage years, but many people do not experience this during adulthood. It affects females a little bit more than males and is more prevalent among individuals seeking weight-loss treatment than in the general population.

What are the main triggers and causes for this?

It is difficult to specify a main cause for binge-eating. It is usually due to a host of contributing factors that lead to the disorder. It involves upbringing, social and cultural issues, brain and body chemistry, biological and psychological issues, and it also involves each person’s individual personality.

How can people counteract the compulsion to overeat?

Eating so much every once in a while is normal, so as eating for emotional reasons, from the moment we were born we are nurtured with food and rewarded with food. So emotional connections to food are sometimes normal.

What is not normal is compulsively overeating as a coping mechanism to cope with negative emotions; this is where eating could be out of control. People having this will think about food all the time, feel guilty, ashamed and depressed after eating. This is quite different however from what someone would feel after a big meal in an Eid family gathering for example.

If the problem is just emotional eating this is easy to counteract. Think before you eat. Am I really hungry? Do I really need to eat or do I just want to eat because I am bored, stressed or depressed?

• Moderation is the key. Don’t ban certain food and don’t resort to restricted diets as deprivation leads to overeating. All food is allowed but eat in moderation. Banning certain food will make you eat it in large amounts afterwards.
• Understand food. Learn about food; calories, fats and carbohydrates. Eating too much salty food will make you crave carbohydrates after it for example.
• Do something different. Be aware of your emotional eating episodes and once they are there just go for a walk, workout, read … etc do something that you like.

But if we are referring here to an eating disorder, it is vital to understand the emotional challenges and stressors a person is experiencing, and how they have become imprisoned by distortions of themselves in relationship to food, stress, weight and their own bodies. This is where we can begin the journey of healing for this disorder and/or compulsive behavior. The individual suffering from an eating disorder needs support to overcome it, counselors might help here.

What types of food are most likely to be turned to?

The type of food consumed during binges varies both across individuals and for a given individual. Binge-eating appears to be characterized more by an abnormality in the amount of food consumed than by a craving for a specific nutrient, unlike emotional eating where individuals crave sugar, carbohydrates and junk foods.

Can binge-eating also lead to bulimia?

Although there are similar characteristics between those with bulimia and binge-eating disorders, those who binge-eat do not purge. There are no compensatory mechanisms associated with the binge to get rid of calories, so individuals with binge-eating disorder are more likely to be overweight or obese, while patients with bulimia may be underweight, normal weight or overweight.

Dieting follows the development of binge-eating in many individuals with binge-eating disorders, unlike Bulimia Nervosa in which dysfunctional dieting usually precedes the onset to binge-eating.

Does stress play a role in eating disorders?

Yes, stress can have a powerful effect on our appetite and food cravings.  Sometimes stress shuts down the appetite but for some other people it does the opposite.  When stress becomes more than you can handle, you develop ways to cope, which may include binge eating or not eating at all.

That’s why it is very important to learn how to deal with stress and how to get out our negative energy, and most of all to unlearn the bad habits we’ve developed in dealing with stress. Poor diet contributes to stress, which in turn contributes to poor diet.

What are your top tips for avoiding emotional eating?

First of all let’s differentiate between emotional eating and binge-eating. Emotional eating is not a disorder, it is when a person turns to food for comfort and eats in response to feelings and not hunger, like depression, boredom, loneliness, stress, anxiety or frustration.

They generally just engage in that episode and that’s the end of it. They are looking to fill a void and food seems to serve that purpose. They may repeat this sort of behavior from time to time or even somewhat frequently, but this does not necessarily mean they suffer from a binge-eating disorder. If we ate for comfort by reaching out to low calorie food, we would be alright, but how many people turn to cucumbers when they are feeling stressed for example?

Learn how to handle your emotions.  Don’t reward yourself with food. Find your own thing; find something else to do when stressed or depressed to comfort you other than food. Have a customized life and don’t just follow the crowd.

Amira Khalil certified in Counseling Psychology & Eating Disorders, and author of I Did it With Chocolate.

Getting the Facts from Prof. Dr. Rashad Barsoum

By Hilary Diack

Diets and fitness regimes, supplements and surgery: tools we are increasingly using to feel and look the picture of health. Working behind the scenes of our daily lifestyle choices are our kidneys, often forgotten and taken for granted. To learn more about these vital little powerhouses and the critical role they play in our health, we visited eminent professor and kidney specialist, Dr. Rashad Barsoum at The Cairo Kidney Center in 6th Oct.

CWM: We have read that Egypt ranks 12th globally in mortality rates from kidney disease, why is that?

RB: In past years schistosomiasis had been responsible for many deaths, but with a massive government backed awareness campaign and effective use of the drug Praziquantel, which is considered to cure 70-80% of people infected with schistosomiasis, it is effectively under control. New cases have been reduced dramatically. Unfortunately this has been replaced by other threats to kidney health, diabetes and hypertension, illnesses linked to changes in our lifestyle and eating habits.

What are the most important points to remember when it comes to kidney health?

So long as you are basically in a normal state of good health the standard guidelines of drinking at least 8 glasses of water a day and keeping sodium consumption to a minimum apply. We must remember that sodium not only comes through table salt added to food, but is also a hidden component in many processed meats and convenience foods and snacks like potato chips. The amount of meat, fish, cheese and eggs consumed should be limited to small portions; the average adult really does not need to consume over 100gm per meal or snack. 15 gm of each portion would be protein, a total of 100gm of actual protein fulfils the daily needs. Vegetarians and vegans may choose to consume quality protein from alternative sources, this can be assimilated with the help of natural gut bacteria.

Are there specific foods that we need to eat to maintain our kidneys and avoid the formation of kidney stones?

So long as you are in general good health a balanced diet with a moderate level of animal protein and sodium is all that should be needed. Small amounts of naturally diuretic fruits, juices and vegetables can be included to boost urine production, but not in excess. For people with impaired kidney function a large amount of vegetables may result in too much potassium in the system, this can be avoided by boiling them first and draining off the water. If a problem exists, such as kidney stones it is important to carry out tests to ascertain which salts are evident, either calcium-oxalate (the most common cause of kidney stones, due to dietary factors, high doses of vitamin D, intestinal bypass surgery or several metabolic disorders which can increase the concentration of calcium or oxalate in urine), struvite (mainly from alkaline urine caused by a urinary tract infection or high magnesium excretion with high magnesium/plant-based diets), or urate (excess uric acid levels caused by a diet high in some types of seafood, organ meats and foods high in purines). Each has specific treatments and dietary adjustment requirements, so it is a mistake to either self-medicate or adjust the diet without identifying the cause. It is key to keep your water intake at the correct level to lubricate and flush the kidneys.

How can we treat kidney stones?

Anyone who has suffered from these can attest to how painful it can be. Smaller stones of less than 4mm can be flushed out through the urinary tract, but may require a painkiller to help. Stones too large to pass are sometimes treatable with ESWL (extracorporeal shock wave lithotripsy), where high-energy radiation or ultrasound is first applied to locate the stone, then shock waves used to break it down so it can be passed. For larger stones lodged in the urethra or kidney, minimally invasive surgery can be used, under general anaesthetic, or rarely, in more some cases, open surgery. Uric acid stones that build up through a dietary imbalance can usually be dealt with by alkalizing the urine with medication and drinking at least three liters of water per day. This usually dissolves them quickly.

What are the worst habits people can have that damage their kidneys?

Simply by neglecting to follow the simple commonsense guidelines for kidney health, or allowing diabetes or high blood pressure to go untreated. Excess protein consumption is another danger, especially with body-building and fitness fans. Whey protein is a good nutritional option, especially after workouts, but again, not in excess, and the body must be well hydrated.

Are there holistic remedies and herbal treatments that can help?

Traditional remedies like herbal teas can be a general tonic when used correctly by someone in normal health, but in the case of a real kidney problem the course of action should be to consult a specialist who has the knowledge to analyze and treat the condition. Medical treatments have advanced to the point where designer drugs are so carefully created they can target and deal with specific problem in one concentrated, focused dose.

Is the quality of drinking water in Egypt a factor in kidney disease?

Contrary to a lot of hype this is not a real factor. Of course, water should be clean and bacteria-free, if not this is more likely to impact the digestive system. Visible sediment is normally passed through the alimentary system, hopefully without creating gastric problems.

Are kidney problems more evident in urban or rural communities?

Both, for different reasons. Urban communities are more prone to problems through incorrect diet, hypertension and diabetes, but benefit from easier access to medical facilities, while rural communities are less likely to have these causes, they are more likely to develop urinary infections due to schistosomiasis . The problem for them lies in having less access to doctors and medical care.

So, how can kidneys fail?

Kidney failure can come as a secondary result of hypertension and diabetes, therefore it is essential to monitor your health regularly. High blood pressure causes artery damage, and the kidneys are packed with arteries as well as being supplied with dense blood vessels, with high volumes of blood flowing through them. The kidneys filter 25% of the blood volume every minute, 24/7. They reabsorb 99.9% of this filtrate. Hypertension hardens the blood vessels of the kidneys and disturbs the pressure gradients, leading to diminished perfusion and impaired filtration. This leads to dysregulation of fluid, so your body will retain more water and salt than it should, which can result in weight gain and ankle swelling. You may have protein in your urine. Also, waste materials will build up in your blood.

A nephrologist will recommend dietary adjustments and prescribe medication to support kidney function for as long as possible. Should that eventually cease to be effective the next step would be blood cleansing by dialysis, carried out regularly while the patient waits for a suitable replacement kidney. This can ideally be from a matched family member, as that lowers the chance of rejection by the patient’s body.

How many kidney transplants are carried out annually in Egypt?

Official figures range around 1400 transplants a year, but it is difficult to assess the full number. There is still a high demand for healthy kidneys for patients undergoing dialysis.

Where do transplant kidneys come from, and what guarantees are there that they are ethically sourced?

As mentioned, kidneys can be donated by family members (up to the 4th degree), who are a match in blood and tissue type. Alternatively they may receive from ‘emotionally’ motivated donors. Despite the law against accepting money directly for organ donation, unrelated paid donation is common in Egypt, mostly from Egyptian donors to Egyptian recipients. However the process is subject to stringent criteria set and audited by the Ministry of Health to avoid organ trading and trafficking as much as possible.  Being in the common interest of both the donor and the recipient the illegal practice of organ trading is likely to continue until an efficient deceased donor program is established in the country. There are serious efforts to do so in the near future, once more political and social stability has been secured.

Are there any local organizations supporting sufferers of kidney disease?

The Egyptian Kidney Foundation works as a branch of the Egyptian Society of Nephrology and Renal Transplantation and has detailed information on hospitals and centers providing kidney care and surgery. We are positive about the level of attention kidney care is receiving and look forward to even more progress in the field. And of course, The Cairo Kidney Center branches offer a full range of services for kidney care and treatment.

Nutrition for Active People with

Dr. Shady Labib

By Hilary Diack

There’s little doubt a change of lifestyle is upon us. Even the most couch-addicted have grudgingly gone to check out the facilities at the local gym. So, a change of pace could need a change in eating habits. Cairo West Magazine got the answers from Dr. Shady Labib, a certified nutritionist specializing in sports-nutrition and health coaching.

CWM: How do you assess your clients when tailoring a nutrition programme for them?

SL: Assessments are on top of my priority list when working with my clients. Some clients may find it a bit annoying when they are prompted to fill out long questionnaires, while they are booking an initial assessment and consultation session online with me. But here is the thing; we are all different and unique. We have different lifestyles; our body’s hormonal make up and daily stress levels are also different.

In order for a nutrition programme to be successful, all of these interpersonal factors are taken into consideration. The only way to do that is through a good assessment. So for example, a weight loss program for a 32 year-old mother of two that works part time, would be totally different from a program designed for a 26 year-old medical resident that works night shifts.

Usually the assessments I do come in many forms:

– Questionnaires online. (Asking you about your goals, your medical history, lifestyle factors, etc.)

– 3 day-dietary record. (You bring this to your first session)

– Interviewing at the first session. This is when I ask a few questions that will help me understand more about your background and your goals.

–Body assessments. (Skin fold measurements of body fat, girth measurements, weight and photos.)

What are the most common misconceptions when it comes to diet and fitness?

There are so many misconceptions when it comes to that field to the extent that I feel like I am more of a myth buster rather than a nutritionist! The major issue we are facing here is the way people gather information and data. They tend to believe anything they read or hear without even minimal questioning. Which could be a little bit disastrous when it comes to taking information for your health and wellbeing.

Here are the top four misconceptions I face:

1) Eat less and lose more. (This is true for a certain extent, but most of the time, it would yield to the opposite effect)

2) Stay away from fats. (Avocado and nuts will make me fat!)

3) If I eat at night I will gain weight.

4) “Hey what do you think about …. for fat loss?” (Put in the name of any supplements, tablets or herbs)

What do you consider to be the essentials of healthy eating when someone has an active fitness schedule?

People who exercise consistently require more attention to what they eat. Contrary to the “halo effect” (working out washes our food sins), when we workout, our bodies need more nutrients than average people.

When working with athletes, here are my top priorities:

1)  Getting the Big Two right. Macronutrients: carbohydrates, fats and proteins; and micro-nutrients: vitamins and minerals.

2) Placing systems and meal planning.

3) Peri-workout-nutrition, (the periods before, during, and after a workout can be exploited to help produce one’s desired goals), and supplements.

What is the best meal to have before a workout to give energy?

If your goal is to fuel your workout, then a mix of healthy complex carbohydrate like sweet potatoes, fruits, (it was believed that one should eat refined carbohydrate like sugars so it would hit the blood quickly, but this turned out to be wrong) and lean proteins (chicken breasts, red meat) 1-2 hours before the workout will give you the energy you need.

Of course, you should test it out and see what works for you, this is what I do with my clients. Some people won’t feel fine if they eat one hour before a workout and some people can’t eat certain foods before a workout. Again, we are all different and our bodies’ needs are different.

Do you recommend whey protein as a supplement? When is the best time of take it?

Whey protein is one of the natural proteins found in milk. It is very healthy and anyone -except people with renal and liver problems- could take it (there you go, another myth busted!). For an active person who works out, it is best to take it right after a workout. If not, it is beneficial to have it first thing in the morning. You could also use it on the go, if you can’t meet your protein requirement at any meal of the day. Just make sure to choose one with the least artificial ingredients.

Which vitamins/supplements would you recommend to aid in muscle growth (for men)?

All the supplements and vitamins in the world won’t yield anything, if not taken alongside a proper eating regiment. Food is the major player. Supplements are here to supplement. For men I would recommend safe supplements like, BCAA’s, Whey proteins, and Creatine.

Which vitamins/supplements would you recommend to aid in weight loss (for women)?

Again, the same concept: if you are not eating properly for fat loss first, you will not see any benefits.

Green tea extracts are helpful though.

How essential are proteins for promoting a healthy lifestyle?

Proteins are the most important macronutrients for healthy lifestyle and a healthy body. Everything in our bodies is made of proteins, our muscles, our immune system and our hormones. Proteins also help our metabolism, by something called the thermic effect of food. It takes up 30% of our energy consumption just to digest proteins and absorb it. Proteins will also help you be satiated.

How does one deal with sugar cravings?

This is something I get a lot in my practice. Usually sugar cravings are habits. They are not real.

Most of the time, they are our body’s way of handling our problems and stresses. We should first be mindful of this and we should understand what triggers it, in order to know how to handle it.

Aside from this, here are helpful tips to get over these cravings:

1) Clean your kitchen!!!! If chocolate is not there, you will probably not eat it. It is very hard to resist the urge of eating sweets if you are surrounded by triggers.

2) Go for the healthier alternative. Try a peanut butter/ banana smoothie before going for that chocolate and let me know what you think.

3) Watch the place you usually hang out, and take note of what the triggers are that set you off.

How does a person deal with too much water retention due to excessive exercising?

Drink more water and eat less salt. Too much exercising, especially in our country’s weather will not cause water retention.

What is the best post workout meal?

A mix of complex carbohydrates (potatoes, brown rice, quinoa, oats), lean proteins (chicken, red meat, fish, legumes (if vegetarian) and vegetables.

Dr. Shady Labib is a Precision Nutrition Certified Coach, a member of the General Syndicate for Sports with a specialty in nutrition, and also has his BChD in Oral and Dental Medicine from Cairo University.

Borrowing Exercises from Ballet

By Lydia Schoonderbeek

The quest for enjoyable ways of keeping in shape never end, and believing that every woman has a ballerina hidden somewhere inside her, Cairo West Magazine jumped at the opportunity to chat with Sabrina Dedeurwaerder, a qualified NYLA Barre Instructor now in Cairo.

What is Barre Fitness?

Barre fitness is one of the most effective fitness program for women. This ballet-inspired full-body workout uses your own body weight as resistance as well as some props such as a ballet barre, exercise ball and light weights. All major muscle groups are targeted through intense interval sets, performing low impact and small isometric movements, until muscles reach their point of fatigue. At this point, muscles are stretched for relief to create a slender figure with long, supple, feminine muscles without bulk.

How does Barre Fitness differ from other fitness programs?

One of the main elements of Barre Fitness is that it combines small dynamic movements with isometric exercises, rather than focusing on large compound movements like most other fitness programs do. Isometric exercises help isolate specific muscles to develop the optimum muscle contraction without shortening the muscle. This fires up your muscles quickly and reaches the many smaller muscles that women love to tone.

What are some of the benefits of Barre Fitness?

Before you know it, you will stand taller with an improved posture. Longer and leaner muscles, enhanced flexibility, reduced body fat and increased fitness levels are also part of the deal.

Is Barre Fitness a passing trend or is it here to stay?

It is definitely here to stay! The barre trend has been growing steadily in the U.S. for the past 10 years and has already started spreading across the ocean, especially in the UK and in the U.A.E. As soon as you start seeing the results on your body, you will become addicted to your barre class.

What does Barre Fitness work on most effectively?

Barre Fitness targets all problem areas by sculpting a cinched waistline, a lifted seat, strong and toned feminine abs, it provides high definition and length in arm and leg muscles.

How many calories can a person burn in a class?

About 300 to 600 calories can be burned in an hour-long class, depending on the person’s metabolism, weight and fitness level, amongst others factors. The leaner your muscles get, the faster your metabolism becomes and the more calories your body will burn.

Can Barre Fitness help weight loss?

It can help to lose weight. The weight might not vary greatly initially as you will lose body fat and gain lean muscle which is heavier than fat, but the muscle gain will tighten your figure in a visible way.

How often should a person take a Barre Fitness class?

Three to five classes per week would start providing visible results within 3 weeks.

Can a woman take a class if she is pregnant?

Pregnant women who were already working out prior to pregnancy can definitely keep on coming to class provided that their doctor authorises fitness practice.

How about if a person has an injury?

The class is low-impact and modifications can be provided to help people work out safely provided they get their doctor’s approval.

Sabrina Dedeurwaerder: After a successful career in banking in the City of London and having been a fitness enthusiast for many years, Sabrina embarked on a fitness career to share her passion for Barre Fitness by developing classes in Cairo.

By Francesca Sullivan

Is there such a thing as male menopause? This is a question still being debated amongst the medical community, though for some men going through middle-age, the answer might seem clear. Although the symptoms may not be as recognizable as those of women, a proportion of men over the age of fifty begin to experience declining energy levels, mood changes, lack of concentration, sexual problems and depression, which andrologists link to the lowering of testosterone.

Although some would argue that these problems are simply a result of unhealthy ageing (leading a lifestyle that includes lack of exercise, bad diet, weight gain, over use of alcohol or drugs, and the onset of conditions such as diabetes and hypertension), some doctors will prescribe controversial testosterone treatment to improve quality of life, and sexual function in particular.

Male hormone replacement therapy is gaining ground, especially in the US, where drug companies are allowed to push the issue with aggressive marketing direct to the public. But is it advisable or even safe? And are there other forms of therapy that can address such ageing issues?

Cairo West Magazine spoke with Professor Hussein Ghanem, professor at Cairo University Faculty of Medicine. An andrologist and a dermatologist specializing in non-surgical aesthetic procedures, Prof. Ghanem tells us how male menopause is being recognized and treated in Egypt.

CWM: Are many people aware of the existence of male menopause?

HG: Very few. The signs are less easy to recognize, and come on more gradually than in female menopause. From the age of forty there is an annual decrease of 1% in testosterone levels in men, so the effects often don’t really start to appear until the fifties and sixties. And usually when signs do crop up, they can be misleading. Men will start to seek help for different symptoms individually without realizing that there’s a link between them.

What are the first indications a man should look out for?

Physical changes range from decreased energy and general weakness and fatigue, to loss of libido and sexual function. Psychological and emotional changes may include unexplained anxiety and depression.

Are men generally open about this issue?

In my experience, men are willing to discuss it with a doctor that they trust. In general, men tend to pay less attention to health issues than women though. Men continue to live on average seven years less than women, and women pay better attention to health issues. For example, statistically they visit the doctor 150% more often than men, and while 17% of women do regular breast examinations, only 1.2 % of men have their PSA measured. With the global increase in life expectancy, it makes sense to pay better attention not only to the length of your life but also its quality.

Are there supplements or medications that can alleviate symptoms?

There are no supplements proven to be effective in this area. And testosterone must be taken under medical supervision. Although the subject is still being fiercely debated, there is some evidence to suggest that men at risk from prostate cancer will increase that risk with hormone replacement therapy. Before offering hormone treatment we would run tests for total testosterone levels as well as PSA over a period of several months.

It is important to look for lifestyle solutions such as giving up smoking, reducing stress, losing weight and getting more sleep. Lack of sleep is proven to dramatically reduce testosterone levels, while weight loss can improve those levels considerably.

Psychologically, there are other confidence boosting strategies men can consider, such as aesthetic procedures to look younger. The age at which some men start experiencing menopausal symptoms tends to be around the same age as patients who come seeking aesthetic non-surgical procedures, and undoubtedly  such procedures have been shown to have positive psychological effects.

Which kind of procedures are you referring to?

Botox, dermal fillers, fractional C02 laser therapy, PRP and thread lifts, are some examples. Although women make up a larger proportion of patients seeking these procedures, the numbers of men recognizing the positive potential of image enhancement is growing in Egypt. And it is especially relevant for those feeling the emotional effects of menopause. In my clinic I do not automatically suggest it to all patients, but I provide the relevant information to those I think would benefit psychologically.

Prof. Hussein Ghanem is a Professor at Cairo University and Consultant Dermatologist and Andrologist practising Anti-Aging & Esthetic Medicine at Dermahealth clinic in Cairo.