HRT: Benefits, Risks & Access

This assignment delves into the complex landscape surrounding Hormone Replacement Therapy (HRT) for women experiencing menopause. It examines the influence of a now-flawed 2002 US study that sparked widespread fear and limited HRT use. The text highlights the subsequent withdrawal of many HRT therapies by pharmaceutical companies, leaving fewer options available to women. Additionally, it discusses outdated warnings associated with HRT products and emphasizes the need for greater access to accurate information and appropriate treatment choices for menopausal women.

Nursing Degree
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It is well established that different types of media like newspaper, tv news and internet have
significant impact on the health outcome of the Australian people. Healthcare professionals
are aware of this fact that people are sensitive to media reports and make their perceptions
about the health based on the media coverage. Media has substantial power to set agendas,
frame stories and influence the public. Hence, healthcare professionals are considering these
facts while providing healthcare service to the people. Healthcare professionals have
challenging task to convince people to focus on healthy aspects of media reports and to
ignore unhealthy aspects of media reports. Swine influenza (H1N1) pandemic is the recent
example of media reports which creates havoc in the public. Reports of this pandemic could
have been presented in more ways incorporating preliminary preventive measures. Public
would have adopted these preventive measures more rapidly if it would have been displayed
in the mass media. It is difficult for the healthcare professionals to communicate this message
to everyone. Different types of media are being followed by Australian people. These include
free-to-air television, newspapers, radio and social media. Older people are more inclined
towards free-to-air television, radio and newspapers, while younger generation is more
inclined towards social media as compared to other three medias. It is estimated that
approximately 90 %, 70 %, 60 % and 75 % younger people below 40 age are following free-
to-air, radio, newspaper and social media respectively. Females (72 %) are more inclined
towards social media as compared to the males (59 %) (Antheunis et al., 2013). Males 70 %
are more inclined towards newspapers as compared to females 59 %. Males 33 % are more
inclined towards tv as compared to females 22 %. People living with partner 76 % without
children more prefer to read newspapers as compared to living alone 61 % or living with
children 67 %. Parents living with children (80 %) prefer to listen to radio as compared to the
living alone (71 %) or living without children (73 %). People in the high socioeconomic class
avail facilities of all types of media as compared to the people in the low socioeconomic
class. Scholars in the high schools and the universities get benefit of all types media as
compared to the average students. People with the attitude of negative thoughts and those are
negligent towards health-related issues, prefer to use social media (Coiera, 2006; Moran and
Keating, 2009).
Presence of specific class of people in the media also has influence on that class of people in
the society. In Australia, approximately 15 % older people above 65 age are there. However,
presence of older people in the media is very low. 4.7 % and 6.6 % people above age 65 are
present in advertisement and editorial media respectively in Australia. Hence, most of the
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reports related to the health issues are mainly focused on the younger generation. As a result,
older people are not getting accountable benefits in terms of health issues from the Australian
medias. Those people who are not constructive of their own lives can’t avail benefits of
media for improving their health. It has been observed that older people are not giving much
attention to the media for maintaining healthy life. However, people away from their families
are more reliant on the media for availing benefits for health-related issues (Wakefield et al.,
2010).
Focusing on specific class of people can have psychological influence on this class of people.
In media, most of the reports indicate that women and older people are being victimised due
to domestic and social issues. It can have psychological impact on the women and older
people. Hence, it may lead to depressive state and negative attribute towards health-related
issues. As a result, it is evident that women and older people happened to be sick in more
numbers. Older people also complained that negative media reports are responsible for
changing their perception about their health. Media reports stated that more money is
necessary for the treatment of older people. Hence, these people are keeping themselves away
from availing medical treatments (Delgado and Zhou, 2008; De Abreu et al., 2017).
It is evident that traditional media like radio and newspaper are insufficient in providing
scientifically accurate information related to the health. Few media persons and doctors also
agreed that these media failed to communicate health related issues in an effective manner.
Hence, it calls for research to improve applications of media in healthcare services. Most of
the medias present reports of health implications, however little work has been done to
improve its reach to all the people of different classes and different cultures. Most significant
obstacle for the effective implementation of media in health promotion is different goals and
values of journalists and healthcare professionals. Journalists and healthcare professionals
have different concepts of validity, objectivity and significance. Journalists prefer to be
anecdotal instead of following statistical evidence. Journalists prefer to display controversies
instead of agreement. Statistical significance and agreement are having significant role in
improving quality of health and positive medical reporting. Other barriers for the positive
medical reporting include lack of medical training for the journalists, time constraints
imposed by news production houses and commercial aspects in selecting news and stories
(Snow, 2008). News reporter’s job is to look critically in the health issue and write a story in
a balanced, factual and accurate manner. However, it would be difficult for the news reporter
to understand complexity of the medical research and present it to the public in simple
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language which is understandable for everyone. It can lead to the miscommunication and
negatively impact health of the people. These stories might exaggerate health issue, generate
false hopes and unnecessary fears among the people. Reporters need to understand medical
language, procedures and topics before translating this information to the public. However, it
is not true to all the media houses. Few media houses, producers and editors are concerned
about the pubic health and assist healthcare professional and healthcare organisations in
promotion of health. Media persons need to make their articles and stories interesting so that
it become appealing to the general public. Media houses should avoid story form the single
side. Media houses should take care that there should not be showcase of advertisements
which negatively impact health of the public. Australian Division of General Practice stated
that advertisement of unhealthy snacks containing high salt and sugar lead to rise in the
overweigh and obese people in Australia (Marinescu and Mitu, 2016).
Points need to be considered while incorporating news in print, online and tv media include
novelty of the medial treatment or medical procedure to the Australia, alternative options for
the treatment, evidence based validation of the treatment, benefit to risk ratio of the treatment
in absolute or relative terms, cost to harm ratio of the treatment, sources of the information,
and conflict of interest. Conflict of interest was the major issue during the swine flu pandemic
in Australia. Few media agencies were presenting news about vaccine companies with whom
they had conflict of interest instead of presenting news about companies possessing good
quality vaccine. ABC news channel running science programme ‘Catalyst’. In this
programme, two series were broadcasted on questioning link between the rise in cholesterol
level and risk of cardiovascular diseases. As a result, there was significant fall in the use of
cholesterol lowering drugs by the public. In reality, this is not the case. Cholesterol lowering
drugs like statins are developed after tremendous efforts by the scientific community and
these medications are best in the market for lowering cholesterol. This ABC broadcast made
significant negative impact on the health of many people because they chose to stay away
from these medications. Same type of case happened about the media reports of hormone
replacement therapy. Misleading reports by the media houses about the hormone replacement
therapy lead to the dramatic fall in the use of hormonal replacement therapy by menopausal
women. In few cases, health related news can increase sale of product like iodised salt. In a
program, it was presented that deficiency of iodine can cause brain damage in children. As a
result, people wish to provide more amount of iodine to their children. It leads to the dramatic
increase in the sale of iodised salt in Australia for a specific time. Even tough, such
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programmes presented for one or two days, it can impact public for the longer duration.
Hence, media persons should take precautions while presenting health news because it is easy
to scare people as compared to unscare them. Medical journals send their media releases
about the breakthrough research in the medical filed. In such cases, media houses should not
exaggerate the topic because breakthrough research needs validation. In such scenario, public
should not run behind such product or discovery without proper validation. These types of
exaggerated news might prove to be beneficial for the scientist, however, it might not be
immediately beneficial to the public. Media houses should clearly mention these points.
Australian Press Council (APC) warned against such news without scientific
validation (Kline, 2006; Martinson, 2005). Media houses should validate scientific basis
before presenting news related to the medical treatment. Presenting news without any proof
can have negative impact on the public health.
All types media can reach people with multilingual, multicultural and different
socioeconomic classes. Hence, these medias should be effectively used for the health
promotion of diverse cultures and socioeconomic classes. Newspaper and radio can reach to
people of all the cultures and all socio-economic classes. However, television may not reach
to the people with low socioeconomic background. Moreover, newspaper and radio can be
accessed at any places. Hence, these media can be utilized for the health promotion for 7 days
and 24 hours. Influence of media on the public can be determined by the status of the people
in the society. Social media and television should be utilised in the society of high-
socioeconomic class and radio and newspaper should be utilised in the society of low-
socioeconomic class (Hodgetts et al., 2008).
Mass media health promotion campaigns have important role in managing public health
issues. It can be done by influencing public behaviour. Mass media campaigns on health
issues and its causal factors for youth can prevent risky behaviour and improvement in health.
Mass media messages like health impacts of alcohol dinking and risks of drinking during
driving can lead to controlled drinking in youth. Showcasing detrimental effects of smoking
can reduce smoking in youth and consequently prevention of smoking associated diseases
(Chapman, 2007). World health organisation stated that accurate information is helpful in
changing behaviour of the public. Mass media proved to be most significant station for
providing accurate information to the public. According to the AMIA (Digital Industry
Association of Australia) approximately % of Australian youth are using internet and social
5

media. Hence, this mass media campaign would be helpful in improving health of the
Australian youth (Ventola, 2014; Naveena, 2015).
It has been observed that people of the aboriginal origin are having low life expectancy with
increased rates of chronic disease like diabetes, kidney diseases and asthma. It can be well
correlated with the media reports about people of aboriginal origin. According to report of
Public Health Advocacy Institute Western Australia (PHAIWA), in last 10 years, 74
% of the reports related to people of aboriginal origin were negative. Only 15 % news were
positive and 11 % news were neutral about Aboriginal people. Negative news broadcasted
about Aboriginal people include fall in employment rate of these people, 5 times more rate of
death in aboriginal youth as compared to other youth and approximately 25 % of total
prisoners in Australia are Aboriginal’s while their population is approximately 2.5 % of the
total population. Negative news also include alcohol, child abuse, petrol sniffing, violence,
suicide, deaths in custody and crime. In these news, Aboriginal people were portrayed as
drunks and violent perpetrators. This lead to the development of racist attitude in the
population. Racist attitude among the people have major impact on the health of the people.
These types of negative news about the Aboriginal people, lead to the physical and
psychological illness in these people. These news about Aboriginal people were mentioned in
the print media like The West Australian, The Australian, The Sunday Times and ABC
Online news service. In case of these Aboriginal people, it is not wise to give complete blame
to media. These media broadcasts might be in response to the comments by the advocates.
However, media could have presented these reports in a positive way which could have
brought positive changes in these people. Most of the media presented only half story and
didn’t presented scope for the future. Journalists should mention about the life, culture and
concerns of the Aboriginal people which would bring positive change in these people. Media
agencies should promote cultural diversity of the Aboriginal people (Wakefield et al., 2010).
In conclusion, media can be used as most effective channel for communicating health related
issues to the public. Public health professionals should utilise social media along with
traditional media because increasing number of people are moving towards social media.
There should be specialist reporters for healthcare sector with sound basic technical
knowledge, gatekeeping and thoughtful approach and investigative capability. Media should
be used strategically for public health communications. It would be helpful in minimizing
faults and maximizing benefits of media in public health communications.
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References:
Antheunis, M.L., Tates, K., and Nieboer, T.E. (2013). Patients' and health professionals' use
of social media in health care: motives, barriers and expectations. Patient Education
and Counseling, 92(3), 426-31.
Chapman, S. (2007). Public health advocacy and tobacco control: making smoking history.
Oxford: Wiley-Blackwell.
Coiera, E. (2006). Communication Systems in Healthcare. Clinical Biochemist Reviews,
27(2), 89–98.
Delgado, M., and Zhou, H. (2008). Youth-led Health Promotion in Urban Communities: A
Community Capacity-enhancement. Rowman & Littlefield Publishers.
De Abreu, B. S., Mihailidis, P., Lee, A.Y.L., Melki, J., and McDougall, J. (2017).
International Handbook of Media Literacy Education. Taylor & Francis.
Hodgetts, D., Chamberlain, K., Scammell, M., Karapu, R., Waimarie, N.L. (2008).
Constructing health news: possibilities for a civic-oriented journalism. Health, 12, 43-
66.
Kline, K.N. (2006). A decade of research on health content in the media: the focus on health
challenges and sociocultural context and attendant informational and ideological
problems. Journal of Health Communication, 11, 43-59.
Lee Ventola, C. (2014). Social Media and Health Care Professionals: Benefits, Risks, and
Best Practices. Pharmacy & Therapeutics, 39(7), 491-499.
Marinescu, V., and Mitu, B. (2016). The Power of the Media in Health Communication.
Routledge.
Martinson, B.E., and Hindman, D.B. (2005). Building a health promotion agenda in local
newspapers. Health Education Research, 20, 51-60.
Moran, A., and Keating, C. (2009). The A to Z of Australian Radio and Television. Scarecrow
Press.
Naveena, N. (2015). Importance of Mass Media in Communicating Health Messages: An
Analysis. IOSR Journal of Humanities and Social Science, 20(2), 36-41.
Snow, J. (2008). How the media are failing the health service. British Medical Journal, 337,
a572.
Wakefield, M. A., Loken, B., and Hornik, R. C. (2010). Use of mass media campaigns to
change health behaviour. Lancet, 376(9748), 1261–1271.
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Appendix A:
http://www.abc.net.au/local/stories/2009/06/05/2590223.htm5 June, 2009 9:58AM AEST
The latest on Australia's swine flu outbreak
By Ping Lo
Numbers of confirmed cases of swine flu continue to rise in Australia, with Queensland
recording the third-highest tally. Keep up to date with the latest information from the
ABC.
For comprehensive updates visit the ABC News Swine Influenza special site.
Queensland Health has also issued a number of press releases and general information
regarding the swine flu situation in Queensland.
*****
With one of the most recent cases of swine flu having just been identified in Blackwater,
Central Queensland, it's clear that virus - otherwise known as H1N1 - is not contained.
Confirmed cases of swine flu have been identified in all Australia's states and territories.
Currently, there are more than 870 confirmed cases of swine flu across Australia.
Victoria has been the hardest hit, with more than 750 confirmed cases of swine flu having
been recorded.
In New South Wales, 74 cases of swine flu have been confirmed, followed by Queensland's
current total of 31 confirmed cases.
Of Queensland's confirmed cases 15 relate to the Pacific Dawn cruise ship, on which cases
were identified by the time the ship docked in Sydney.
The Pacific Dawn continued north to Queensland where passengers were given the all-clear
to disembark in Brisbane last week, despite the reluctance of port operators to allow the ship
to dock.
In Queensland, some schools have been closed and swine flu clinics opened as the number of
confirmed cases continues to rise.
Opinion is divided among medical experts as to whether the steady increase in confirmed
cases is major cause for concern.
While some parts of Australia are still trying to contain the spread of the virus, for others the
response to swine flu is changing in response to the rise in confirmed case numbers.
9

http://www.abc.net.au/news/2017-04-06/flu-pandemic-plans-should-be-stepped-up-study-
says/8421304
Flu pandemic plans should be
stepped up as number of virus
strains jumps, researcher says
By medical reporter Sophie Scott
Posted 6 Apr 2017, 6:58am
PHOTO: Researchers said there is an increased
risk a bird flu strain could emerge. (Dave Hunt: AAP Image)
RELATED STORY: Avian influenza global spread raises concerns for next human pandemic
RELATED STORY: Australian eggs sent to South Korea as Avian influenza wipes out 30 million hens
RELATED STORY: Millions of unvaccinated adults increasing disease risk for all of us
MAP: Australia
A jump in the number of new flu strains means health authorities need to increase
preparations for a pandemic.
Key points:
 Increased risk pandemic-causing bird flu strain could emerge
 Measures need to focus on stopping viruses jumping from animal to humans
 Highest risk in low-income countries with rapid poultry commercialisation
Research from the University of New South Wales shows, in the past five years alone, four
novel subtypes and three novel variant strains of influenza have emerged in humans.
PhD student Dr Chau Bui from the National Health and Medical Research Council
(NHRMC) Centre for Research Excellence in Epidemic Response said there was an increased
risk a bird flu strain could emerge that could cause a human pandemic.
10

"Pandemic planning should incorporate interventions to prevent the species jump and
emergence of a human pandemic strain of influenza," she said.
"This urgency needs to be acknowledged by national and international pandemic planning
organisations."
The rate of novel flu strains emerging in humans has increased in recent years.
New strains of influenza A have emerged in humans 19 times since 1918.
Of these, six strains are able to be efficiently transmitted from human-to-human, 10 are
predominantly animal-to-human viruses, and three are predominantly animal-to-human swine
flu variants.
Do you know more about this story? Email [e-mail]
Dr Bui says health authorities preparing for a pandemic need to focus on preventing disease
in birds, particularly poultry.
Antibiotic resistance explained
Why your decisions matter in the fight against superbugs.
"We find there have been recent increases in the number of reports of avian influenza viruses
infecting humans, predominantly from mainland China," researchers said.
They recommend pandemic preparedness focus on preventing viruses that spread from
animals to humans, particularly in poultry populations.
"Low-income countries which are undergoing rapid commercialisation of their poultry sector
are at highest risk of harbouring avian influenza viruses and are unlikely to detect nor
adequately control the spread," researchers said.
The research was published in the Archives of Public Health.
11

http://www.abc.net.au/news/2015-06-15/patients-cut-back-on-statins-after-catalyst-story-
research/6545026
Australians cut back on or
stopped taking statins
following ABC Catalyst story,
researchers find
By medical reporter Sophie Scott
Updated 15 Jun 2015, 5:49am
Sorry, this video has expired
VIDEO: Study author Professor Emily Banks says 60,000 people reduced or stopped taking statin medications
after the Catalyst program aired (ABC News)
RELATED STORY: Patients stopping drugs because of ABC's Catalyst programs: Heart Foundation
RELATED STORY: ABC's Catalyst program 'breached impartiality standards'
MAP: Australia
More than 60,000 Australians cut back on or stopped taking cholesterol-lowering drugs
known as statins after a program questioning their effectiveness aired on Australian
TV, researchers have estimated.
University of Sydney researchers found an immediate impact after the science program
Catalyst aired on the ABC in October 2013.
Researchers looked at the Pharmaceutical Benefits Scheme medication records of 191,000
people and found 14,000 fewer people dispensing statins per week than expected.
Their work was published in the Medical Journal of Australia.
Researchers said an estimated 60,897 fewer people filled their statins prescriptions in the
eight months following the Catalyst broadcast.
Do you know more about this story? Email [e-mail]
They said this could result "in between 1,522 and 2,900 preventable, and potentially fatal,
heart attacks and strokes".
The Catalyst program examined the importance of cholesterol in cardiovascular disease and
the appropriate use of statin medication.
Cholesterol-lowering statins explained
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ABC Health & Wellbeing explains how statins work to lower the amount of cholesterol in
blood.
A spokesman for the ABC said the network acknowledged problems with the program Heart
of the Matter and removed it from iview.
"The ABC notes that the Medical Journal report acknowledges that the use and overuse of
statins is a legitimate public health policy issue," he said.
"As was stated in the program and restated on the Catalyst website, viewers should not make
any changes to their prescribed regimen of medications without seeking appropriate medical
advice."
Lead author Andrea Schaffer, from the University of Sydney's Faculty of Pharmacy, said
some patients at higher risk of cardiovascular disease, such as those taking medication for
diabetes, stopped taking statins.
"We found even in this group [who were dispensed diabetes medications], who were known
to be at high risk of cardiovascular disease, there was a reduction in statin use in this group,"
she said.
Debate over appropriate use of statins
The National Prescribing Service said evidence from a large review of clinical trials in people
at high risk had shown statin medicines could substantially lower the chance of having a
major cardiovascular event, on average by about 20 per cent.
What the research says about cholesterol and statins
The Health Report's Dr Norman Swan breaks down the conflicting claims on statins and
cholesterol.
13

They said statins could help prevent heart attacks and strokes in people who had already had
one and were at high risk of another.
But there has been debate about whether it is appropriate to use the medications in healthy
people with low risk of a heart attack or stroke.
The Royal Australian College of General Practitioners (RACGP) recently recommended
patients talk to their doctors about whether statins are appropriate.
The RACGP said doctors should not commence therapy for high cholesterol or high blood
pressure without assessing the absolute risk of a cardiovascular event like a heart attack or
stroke.
The American Heart Association said taking a statin was now recommended for:
 Anyone who has cardiovascular disease, including angina, a previous heart attack or
stroke, or other related condition
 Anyone with a very high level of harmful LDL cholesterol
 Anyone with diabetes between the ages of 40 and 75 years
 Anyone with a greater than 7.5 per cent chance of having a heart attack or stroke or
developing other forms of cardiovascular disease in the next 10 years.
Statins 'overused' in low-risk population
An analysis of Pharmaceutical Benefits Scheme data published earlier this year by Australian
Doctor showed no drop in statin prescribing rates.
The medical publication said dispensing of the top three statins held steady in the three
months after the Catalyst program was aired and rates increased slightly from 1.4 million in
November 2013 to 1.5 million in January 2014.
But some doctors strongly believe statins are being over-prescribed.
Harvard professor John Abramson has written a number of scientific papers raising concerns
about the overuse of the cholesterol-lowering drugs.
He raised queries about the latest research in the Medical Journal of Australia and said the
risk level of those who discontinued the statin medication was not known.
"By the article's own admission statins are overused in what the Australian guidelines call a
low risk population — less than 10 per cent five-year risk," he said.
"The article's assertion that the discontinuations could result in between 1,522 and 2,900
preventable, and potentially fatal, major vascular events is based on false premises."
14

Appendix B:
http://www.skynews.com.au/news/politics/federal/2017/05/31/
health-bodies-to-focus-on-indigenous-children.html
Health bodies to focus
on Indigenous children
Published: 4:10 pm, Wednesday, 31 May 2017
By Matt Cunningham
Northern Territory correspondant
Three peak health bodies have signed an agreement to work with the Australian Government
in a new push to close the gap for indigenous Australians.
Indigenous Health Minister Ken Wyatt has told Sky News the group will focus on improving
the health of indigenous children from the time they are in their mother's womb.
'I asked the colleges if they would walk with me in addressing the health issues that
Aboriginal and Torres Strait Islander people face and the enthusiasm, the level of
commitment and their desire to do it was manifested today in the signing,' he said.
At the top of the list is reducing rates of ear disease, early blindness, and issues relating to
alcohol consumption, including foetal alcohol spectrum disorder.
'That whole issue of a child in utero being affected by substance abuse, cigarette smoke or
alcohol impacts on them in their development,' Mr Wyatt said.
Health Minister Greg Hunt said the latest closing the gap report showed indigenous life
expectancy rates still fall 10 years short of non-indigenous Australians, while smoking rates
are four times the national average.
'If you ask me, our single biggest national failing over the last 40 years has been the
indigenous health levels,' he said.
15

One of the things discussed at the signing was the influence positive role models can have on
improving the lives of young indigenous people.
Adam Castricum from the Australiasian College of Sport and Exercise Physicians said having
proud sporting role models could play a big part in keeping Aboriginal people active and
healthy into adulthood.
'We know from the data that indigenous kids are more active than non-indigenous kids up
until the age of about 18,' he said.
'It's important that we take advantage of this desire to want to be active and keep it going
throughout their life so then it can improve their health outcomes and certainly keep them
away from chronic diseases like obesity and diabetes if we can keep them active.'
16

http://www.skynews.com.au/news/national/nsw/2017/06/14/cancer-holds-large-
health-burden--report.html
Cancer holds large
health burden: report
Published: 10:03 am, Wednesday, 14 June 2017
Cancer robs Australians of more years of life than any other disease, according to a new
analysis.
A report released Wednesday by the Australian Institute of Health and Welfare (AIHW)
shows while it's burden has lessened, cancer has the biggest impact on the nation's health,
accounting for one-fifth of the burden.
'This is calculated in terms of years of life lost due to early death from cancer, as well as the
years of healthy life lost due to living with the disease,' said AIHW spokesperson Michelle
Gourley.
While other conditions, such as cardiovascular disease, are more common and cause a greater
number of deaths, cancer results in more years of life lost due to deaths occurring in younger
age groups.
The report, based on 2011 data, shows five types of cancer accounted for almost half of the
cancer burden - lung, bowel, breast, prostate and pancreatic cancers.
'Overall, the burden from cancer lessened between 2003 and 2011--down by 10 per cent --
and this same pattern was seen across most individual cancer types,' Ms Gourley said.
However, this was not true for all population groups, with the cancer burden for Indigenous
Australians worsening since 2003.
Indigenous Australians experienced a cancer burden 1.7 times that of non- Indigenous
Australians.
The gap was particularly notable when it came to lung cancer, said Ms Gourley.
Indigenous males experienced 2.3 times the lung cancer burden of non-Indigenous males, and
for Indigenous females the rate was 2.6 times as high.
Australians in remote and lower socio-economic areas also experienced greater cancer burden
than other Australians.
17

In particular, people in the lowest socio-economic group experienced burden from lung
cancer at almost twice the rate of the highest socio-economic group.
Almost a quarter, 22 per cent, of the total cancer burden was attributed to tobacco use.
AAP
18

http://www.news.com.au/lifestyle/parenting/new-study-draws-link-between-low-iodine-in-
mothers-and-brain-damaged-children/news-story/95c46364f384fa51fdf4f5bc07ff3f1c
New study draws link between low
iodine in mothers and brain
damaged children
MUMS to be - who have low levels of iodine during their pregnancy -
may give birth to brain damaged children with lower IQs.
News Corp Australia NetworkMAY 22, 20139:06PM
MUMS to be - who have low levels of iodine during their pregnancy - may give birth to brain
damaged children with lower IQs.
A study of around 1000 UK mothers and their children has found even mild iodine deficiency
in pregnancy can lead to children who perform poorly at reading, comprehension and verbal
tasks.
The study published in The Lancet medical journal urges pregnant women to consume more
milk, eggs, dairy product, fish and iodised salt to boost their iodine levels.
And researchers say the research shows iodine deficiency during pregnancy "is an important
a public health issue that needs attention".
"Our results clearly show the importance of adequate iodine status during early pregnancy,
and emphasise the risk that iodine deficiency can pose to the developing infant, even in a
country classified as only mildly iodine deficient," one of the authors Professor Margaret
Rayman says.
Iodine is essential for producing the hormones made by the thyroid gland and has a direct
effect on fetal brain development.
The World Health Organisation consider iodine deficiency to be the single most important
preventable cause of brain damage worldwide but it is usually only considered an issue in
developing countries.
In 2009, after studies showed mild iodine deficiency in Australia, iodised salt has replaced
non-iodised salt in all bread sold in Australia
The UK researchers measured the iodine concentration in urine samples taken from pregnant
women during their first trimester.
The mental development of the women's children was assessed by measuring the child's IQ at
age 8, and reading ability at age 9.
19

After adjusting the results for parental education and breast-feeding, the researchers found
that children of women in the iodine-deficient group were significantly more likely to have
low scores of verbal IQ, reading accuracy, and reading comprehension.
The the lower the mother's concentration of iodine, the lower were the average scores for IQ
and reading ability in the children.
The WHO recommends an iodine intake of 250 micrograms per day in pregnancy.
20

http://www.abc.net.au/news/2012-07-28/calls-for-a-rethink-on-hormone-replacement-
therapy/4160906
Doctors call for hormone
replacement therapy rethink
AM
By Rebecca Barrett
Updated 28 Jul 2012, 7:09am
Doctors and specialists are calling for hormone replacement treatments (HRT) to be
more readily available for women who need them.
It has been 10 years since an alarming US study found HRT increased a woman's risk of
breast cancer, strokes and heart attack.
But a decade later, medical professionals agree that those findings were flawed.
Doctors say the pharmaceutical industry has withdrawn from sale half of all the available
therapies, while extreme product warnings are unnecessarily frightening and outdated.
But there is still confusion amongst women and GPs about the best treatment.
Gynaecologist Dr John Eden, head of the Sydney Menopause Centre at the Royal Hospital
for Women, says the 2002 Women's Health Initiative Study in the US changed the lives of
millions of women.
"It terrified women, there's no doubt about that, it was laced with fear," he said.
"Probably the most dramatic example is that before Women's Health Initiative (WHI) I would
hardly ever prescribe an anti-depressant, since WHI I've become an expert in anti-
depressants, and that's because I see there's a small group of women, probably around one-in-
eight, who have severe, intractable sweats and flushes day and night for the rest of their
lives."
Margaret Miller is one of those with severe symptoms.
"It was pretty uncomfortable. You're sitting in a meeting room, you might have 20 other
people in that meeting and all of sudden you start - it looked like your head started to leak
with water and it drips down your face; it is so embarrassing," she said.
The 56-year-old endured more than two years of this before turning to Hormone Replacement
Therapy.
She was aware of the WHI study linking HRT with a higher risk of breast cancer but nothing
else worked.
"I was the stage where I would have taken a cyanide tablet. I didn't care as long as it stopped
the sweats and this itching and this terrible feeling all the time that you weren't human," she
said
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Flawed study
The US study saw women abandon HRT in droves but a decade on doctors say many did so
unnecessarily, because the findings were flawed.
Dr Eden says the majority of participants were aged over 60, were not newly menopausal and
would not normally be treated.
In fact, for many women under 60, doctors say the benefits outweigh the risks.
Australasian Menopausal Society president Dr Jane Elliott says women should have had
easier access to HRT.
"I think a whole decade of women have missed out on the option of that treatment," she said.
"It's not for everyone, it's not a panacea, but it certainly should be something where women at
least feel they can consider it."
Dr Elliott says the options are now limited and the warnings on products are extreme.
"The problem is the actual number of TGA (Therapeutic Goods Administration) options has
decreased in Australia," she said.
"The number of PBS (Pharmaceutical Benefits Scheme) options has decreased in Australia
and there are what's called black box warnings on HRT preparations that women read.
They're really out date."
Dr Eden agrees.
"We've lost almost half of our hormone therapies over the last decade and the pharmaceutical
industry is quite open about it, they've withdrawn them because of business reasons, sales
have gone down and that means we've got fewer choices now," he said.
A spokeswoman for the Therapeutic Goods Administration says the extreme warnings on
HRT products are considered current.
She says the safety information would not change without a comprehensive review, which is
normally initiated by an application from the sponsor of the product.
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