Additives are synthetic drugs which give color and flavor to food. These have practically replaced the safe natural colors and flavors used previously and their number today ranges around four thousand.

An additive should not be condemned without knowing its exact composition, function, and level of safety usage. In products produced by reputable firms, each additive serves a purpose and is carefully screened for its suitability and its safety under predictable patterns of consumption.

The symptoms that an additive may cause are hyperactivity and psychoneurotic behavior (such as headaches, hostility, slow learning, restlessness, and reduced attention span). All such symptoms have been attributed in the past to allergies, to wrong family upbringing, or to both. We know now that most of these symptoms are caused by additives contained in canned foods.

Besides psychoneurotic behavior, other allergy-similar reactions to food additives are rhinitis, nasal polyps, cough, laryngeal edema, hoarseness, and asthma; pruritis, writing on the skin, localized skin lesions, hives, angioedema; enlarged tongue, flatulence, and acid eructation; constipation; mouth chancres; pain in the joints with edema.

The treatment of symptoms caused by additives rests on psychotherapy, tranquilizers, and a diet called the salicylate-free diet. This diet was originally designed for the management of the aspirin-sensitive child. It has now been expanded to include all foods containing additives because flavors and colors which constitute 80 percent of all food additives are based on salicylates and tartrazine, which is a remote relative of aspirin.

The following are foods and products that should be avoided in the salicylate-free diet.

Foods Containing Natural Salicylates

almonds     nectarines

apples     oranges

apricots     peaches

blackberries     plums or prunes

cherries     raspberries

currants     strawberries

gooseberries     cucumbers and pickles

grapes or raisins     tomatoes

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There are also a number of drug treatments your partner can be offered if problems are found with the quantity or quality of his semen.

hCG and hMG

These two drugs (the same ones as those mentioned above) can be used either separately or together for men who are deficient in LH and FSH, which in turn causes problems with sperm production. Men with a lack of GnRH can benefit from this treatment or the use of pulsing GnRH. It is interesting that many of these men (and women with a lack of GnRH) may have lost their sense of smell, which can also indicate a deficiency of zinc, a vital nutrient for fertility.

Bromocriptine

Men can also have high levels of prolactin which can cause loss of libido and impotence. This drug lowers prolactin, just as it does in women.

Clomiphene or tamoxifen

These are both anti-oestrogens which have been given to men where no hormone imbalances have been found but the sperm count is low. However, these drugs do not have product licenses for male infertility. And the Royal College of Obstetricians and Gynecologists states that the use of these drugs has been shown to be ineffective in treating male infertility.

Testosterone

This is another hormone which is of questionable value in fertility treatment. It is often given where there is no hormone imbalance but there is a problem with the sperm count. Proper development of sperm is dependent on high levels of testosterone and the amount that would need to be taken orally to get the required effect could have a destructive effect on the liver. Also, giving testosterone creates a vicious circle by decreasing levels of FSH and LH, causing further problems with sperm production. The Royal College of Obstetricians and Gynecologists, reviewing the papers on the use of testosterone, felt that there was no evidence for effectiveness and even if it had a placebo effect the dangers of using it were too great.

Corticosteroids

These are sometimes used for men who have anti-sperm antibodies. But there is no real evidence for the effectiveness of this treatment. The side-effects can include weight gain, dyspepsia, facial flushing, bloating, skin rashes, irritability and insomnia.

Case History

Jennifer was 34 and had been trying to conceive for the ten years since she had been married, but her husband had been told that he had a low sperm count. Two varicoceles were diagnosed and operated on but this did not improve his sperm count. Four years previously he had been diagnosed with testicular cancer and one testicle had been removed, followed by radiotherapy and chemotherapy. Some sperm had been frozen before treatment. Jennifer had tried two ICSI treatments but they had been unsuccessful. She contacted me in August 1997 on her own, as the couple lived abroad and she was going back straight away. Her nutritional analysis showed very low levels of magnesium and high levels of copper (common after fertility treatment). I gave her a programme of supplements and suggested changes in her diet which she followed for the four months of the Preconception Plan. At the end of December the same year I received a fax from her telling me she was five weeks pregnant. She now has a lovely baby girl.

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What is it?

A sexual assault, usually involving intercourse, on a woman against her will. It is an increasingly common crime in large cities everywhere and in the US it is at epidemic proportions. Any figures as to exactly how often it happens are purely speculative because experts in the field estimate that between 75 and 90 per cent of all rapes go unreported. Most rapes occur at the hands of someone known to the woman and the assault itself often occurs in circumstances which make establishing that the woman really was unwilling very difficult. For example, the claim of a woman that she was raped when hitchhiking alone may be countered by a claim by the car driver that she led him on. A woman may lead a man on sexually and then think better of it before intercourse has taken place-her change of heart does not always get through to the man.

Unfortunately, many rape victims have further unpleasant experiences after the rape itself in the hands of the police: intensive, often sceptical, questioning, disbelief, humiliating gynecological examinations, and so on. For these, and many other reasons, most women do not choose to pursue the charge of rape to the bitter end.

What causes it?

• Most rapists are immature, often violent in other ways and dislike women in general. They have often been intimidated or humiliated by women. Some can only become sexually aroused if the sex act is violent and can’t enjoy or even have sex with a compliant woman.

• Alcohol and rape often go together-partly because an immature man such as this may only be able to bring himself to do anything at all sexually when fortified with alcohol. A US study found that half of all convicted rapists had taken alcohol before committing the crime and that 35 per cent of them were actual alcoholics.

Prevention

• Keep away from lonely areas, especially at night. Go with someone else or wait until someone else comes by and walk a little behind them.

• Avoid areas where there are known to be street gangs.

• Take taxis late at night if at all possible.

• If you think someone is following you run into the middle of the road and stop a car.

• Never get into your parked car at night without first looking in the back seat.

• Park under a light at night.

• Put locks on your doors and windows at home. Never open the front door without using a safety chain.

• Always ask to see the identity cards of workers who come to the house unless you know them.

• If attacked, scream-this can immediately put off many (but not all) rapists. If he does not desist, pull your knee up into his groin and dig him in the eyes with your fingers.

• If the rapist is armed take it quietly and don’t do anything heroic-a combination of a weapon and a few drinks can be lethal. Once you have decided on this passive role talk to your attacker. Some rapists, once they have the realization forced on them that their victim is a person, can’t go any further and run away. Many women have talked a rapist out of the attack at this stage but it may be difficult to remain calm enough for this.

Be careful not to fuel your attacker’s ardor by mentioning the suffering he is causing you-this will usually make matters worse. Try to memorize things about him-his speech, clothes, appearance, and so on-so that you can describe him to the police. If he rapes you act as lifeless as possible and certainly don’t show any emotions or this could make him more violent.

• If you feel that someone you know is likely to rape you contact a local rape crisis centre to discuss it and get their advice. The address can be found in the telephone book. They are also very helpful when it comes to coping with the aftermath of a rape whether or not you report it to the police. If you are raped, contact a centre as soon as you possibly can after the rape occurs.

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As a result of the tests carried out your doctor will advise you 3 to the best course for a desired pregnancy.

If all is normal with your partner’s semen analysis it may ¹ suggested that you are failing to ovulate and that a course of fertility drugs such as Clomiphene (Clomid) be taken to induce or increase egg production.

You will be told to start taking Clomid on either day 2 or day 5 (depending on the length of your cycle).

If a pregnancy still has not occurred after several months you may be advised to try a combination of Clomid with ultrasound scans and injections of HCG (human chorionic gonadotrophin)

The Clomid will encourage the production of an egg(s), the ultrasound scan will determine its maturity and the HCG injection will ensure it is released into the fallopian tube within 36 hours. You will be told to coincide intercourse during that 36 hours.

If these treatments are not successful you will need to consider your options. At this stage the options may include deciding to have no further treatment or to investigate your suitability for IVF (in vitro fertilisation) or GIFT (gamete intra fallopian transfer). However, before embarking on either of these programmes it should be noted that the success rates for full term pregnancies is 10% and 20% for IVF and GIFT respectively.

Maria’s story

As I sat and listened to his words my whole life flashed before me. My only ambitions in life were to get a job, get married and have children. I had achieved the first two ambitions but the third one had caused me great pain. Now as my doctor’s words echoed inside my head it seemed that it would be one goal that I would not reach. His voice came as if in a nightmare.

How could he say that I should have a complete hysterectomy?

My doctor’s words sounded so insensitive and heartless. After being through so much with him it now sounded like he just wanted to wash his hands of me. His face normally was pleasant but now it reminded me of a Dr Jekyil and Mr Hyde’s face. His good looks and charm had disappeared and were replaced by callousness.

As the tears blurred my vision, my body started trembling. Anger, resentment and despair overpowered my thoughts. I wanted to shout at him, abuse him, and scream that it was unfair.

After all that I had been through. The appointments accounted for hours spent waiting, sitting on uncomfortable chairs, reading magazines, looking at the clock and watching its hands move slowly, or staring at the uninspiring paintings on the walls. Then there were the tests, treatments and operations, all of which had been in vain, both mentally and physically.

I kept waiting for my husband to say something. He had always been a great support to me and now when I needed his support the most he was unable to help me.

The doctor was silent. I realized that this would be the last time that I would see him. There would be no more four hour trips travelling to Melbourne to his clinic. No more hours spent huddled with his other patients in the diminutive waiting room.

I was amazed at how quickly his attitude had changed.

He had always been so understanding and hopeful. I guess in retrospect I had intrinsically entrusted him to solve my problem.

Seeing him in a different light I noticed how negative his attitude was. I stared at his masked face and words failed me. It appeared that I had been down all the possible avenues and there would never be any children now.

There was not the usual eye contact or friendly goodbye as we parted. Walking past his receptionist’s desk I remember thinking how I would not be sorry to see the last of her. She had always been so moody and unhelpful. I paused for one moment as the next couple passed by in the corridor on their way to see the doctor. What future lies in store for them? Would they experience the same traumas and ordeals that we had – only to be left with heartbreak at the end?

The lift took longer than usual to reach the ground floor. I walked with my husband out of the building. We still had not spoken a word to each other. When we reached the footpath he put his arm around me and gave me a gentle hug which told me that he too was hurting inside.

Later, after accepting a life without children, we took a good look at our lives and reassessed our priorities; it was a painful process and required courage. We both needed a lot of support and luckily received it from friends and family – and each other.

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The role of women in society is changing very quickly and sexual attitudes have changed in parallel with this over the last thirty years. Earlier sexual experience results in more babies born to young girls which in turn increases the statistics for still-birth, prematurity and ‘poor quality’ births. Low-birth-weight babies are two to three times more likely to be born to such youngsters. The results of sexual promiscuity, with more than half of all married people admitting to having had an extramarital affair, and the considerable rise in premarital sexual activity have resulted in more VD, more cervical cancer and more unwanted pregnancies. At the most dramatic end of the scale AIDS kills hundreds of people a year in the West and genital herpes causes substantial sexual disability among millions.

About a third of all pregnancies in the UK have been calculated to be ‘unwanted’-at least at the time of conception. Young girls who get pregnant have a 20-50 per cent increased chance of having a low-birth-weight baby, which in turn can be associated with an increased mortality rate among the babies.

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