Is Herpes Forever, & Can It Be Treated?

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Dr. Christine Johnston explains:

Kiss and tell?

More than half of the global population (and most adults) carry a herpes simplex virus infection, yet up to about 90% of infected people don’t know they have it, because symptoms are absent or mild.

Meet the (herpesvirus) family: the term “herpesvirus” refers to a broader viral family, but the condition commonly called herpes is mainly caused by two related viruses, known to their friends as Herpes Simplex Virus Type 1 (HSV-1) and Herpes Simplex Virus Type 2 (HSV-2).

  • HSV-1 usually causes oral herpes with cold sores around your mouth
  • HSV-2 more commonly causes genital herpes, although either virus can infect oral, genital, finger, or eye tissues

Here’s what happens, step by step:

  • Infection: the virus enters through microscopic breaks in your skin or mucous membranes such as the mouth or genitals and hijacks cellular machinery to replicate.
  • Initial symptoms: most infections produce no symptoms, but some cause fluid-filled blisters that rupture into painful lesions, and severe initial infections can trigger fever, muscle aches, and headaches.
  • Immune response: your immune system tries to eliminate the virus like other viral infections, but herpes is difficult (almost impossible) to clear completely.
  • Nerve cell invasion: HSV infects nearby nerve cells and travels along axons to nerve clusters called “ganglia”. HSV-1 typically establishing latency in the trigeminal ganglion in the skull and HSV-2 in the sacral ganglia near the base of the spine.
  • Dormancy: in these ganglia the virus becomes dormant, shutting down replication so the immune system can’t detect or eliminate it.
  • Reactivation: the virus can periodically reactivate (sometimes triggered by illness, stress, or other unknown factors) traveling back down the nerve to your skin.

Transmission can be sneakily hit-and-miss, insofar as the virus spreads through direct contact when it is actively shedding from your skin or mucous membranes, even though many infected people remain unaware of their infection, due to its oft-asymptomatic nature.

How serious is it? Usually, not very. For most people, herpes causes sores during flare-ups, but doesn’t lead to serious long-term health problems.

Can we cure it? Not as yet, but antiviral drugs such as acyclovir and valacyclovir mimic components of viral DNA and inhibit viral replication, reducing symptoms and lowering HSV-2 transmission risk by about 50%.

The good news: over time, your immune system develops stronger control over the virus, so outbreaks and viral shedding usually become less frequent.

Looking forwards: scientists continue pursuing vaccines and cures, including approaches using gene editing technologies like CRISPR, but the virus’s ability to hide in nerve cells makes eradication challenging, to say the least.

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  • I lost weight and my period stopped. How are weight and menstruation linked?

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    You may have noticed that changes in weight are sometimes accompanied by changes in your period.

    But what does one really have to do with the other?

    Maintaining a healthy weight is key to regular menstruation. Here’s why – and when to talk to your doctor.

    The role of hormones

    The menstrual cycle – including when you bleed and ovulate – is regulated by a balance of hormones, particularly oestrogen.

    The ovaries are connected to the brain through a hormonal signalling system. This acts as a kind of “chain of command” of hormones controlling the menstrual cycle.

    The brain produces a key hormone, called the gonadotropin-releasing hormone, in the hypothalamus. It stimulates the release of other hormones which tell the ovaries to produce oestrogen and release a mature egg (ovulation).

    But the release of the gonadotropin-releasing hormone depends on oestrogen levels and how much energy is available to the body. Both of these are closely related to body weight.

    Oestrogen is primarily produced in the ovaries, but fat cells also produce oestrogen. This is why weight – and more specifically body fat – can affect menstruation.

    Woman in pyjamas lies on a bed holding a hot water bottle.
    Fat cells produce oestrogen, a hormone with a key role in the menstrual cycle. Halfpoint/Shutterstock

    Can being underweight affect my period?

    The body prioritises conserving energy. When reserves are low it stops anything non-essential, such as reproduction.

    This can happen when you are underweight, or suddenly lose weight. It can also happen to people who undertake intense exercise or have inadequate nutrition.

    The stress sends the hypothalamus into survival mode. As a result, the body lowers its production of the hormones important to ovulation, including oestrogen, and stops menstruation.

    Being chronically underweight means not having enough energy available to support reproduction, which can lead to menstrual irregularities including amenorrhea (no periods at all).

    This results in very low oestrogen levels and can cause potentially serious health risks, including infertility and bone loss.

    Missing periods is not always a cause for concern. But a chronic lack of energy availability can be, if not addressed. The two are linked, meaning understanding your period and being aware of any prolonged changes is important.

    How about being overweight?

    Higher body fat can elevate oestrogen levels.

    When you’re overweight your body stores extra energy in fat cells, which produce oestrogen and other hormones and can cause inflammation in the body. So, if you have a lot of fat cells, your body produces an excess of these hormones. This can affect normal functioning of the uterus lining (endometrium).

    Excess oestrogen and inflammation can interfere in the feedback system to the brain and stop ovulation. As a result, you may have irregular or missed periods.

    It can also lead to pain (dysmenorrhea) and heavier bleeding (menorrhagia).

    Being overweight can sometimes worsen premenstrual syndrome as well. One study found for every 1 kg increase in height (m²) in body mass index (BMI), the risk of premenstrual syndrome went up by 3%. Women with a BMI over 27.5 kg/m² had a much higher risk than those with a BMI under 20 kg/m².

    What else might be going on?

    Sometimes weight changes are linked to hormonal balances that indicate an underlying condition.

    For example, people with polycystic ovary syndrome may gain weight or find it hard to lose weight because they have a hormonal imbalance, including higher levels of testosterone.

    The syndrome is also associated with irregular periods and heavy bleeding. So, if you notice these symptoms, it’s a good idea to talk to your doctor.

    Similarly, weight changes and irregular periods in midlife might signal the start of perimenopause, the period before menopause (when your periods stop altogether).

    A woman in her forties gives her daughter a piggyback ride.
    Changes in weight and your period could be a sign of menopause approaching. Sabrina Bracher/Shutterstock

    When should I worry?

    Small changes in when your period comes or how long it lasts are usually harmless.

    Similarly, slight fluctuations in weight won’t usually have a significant impact on your period – or the changes may be so subtle you don’t notice them.

    But regular menstruation is an important marker of female health. Sometimes changes in flow, regularity or the pain you experience can indicate there’s something else going on.

    If you notice changes and they don’t feel right to you, speak to a health care provider.

    Mia Schaumberg, Associate Professor in Physiology, School of Health, University of the Sunshine Coast and Laura Pernoud, PhD Candidate in Women’s Health, School of Health, University of the Sunshine Coast

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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  • Natural Alternatives for Depression Treatment

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    Questions and Answers at 10almonds

    Have a question or a request? You can always hit “reply” to any of our emails, or use the feedback widget at the bottom!

    This newsletter has been growing a lot lately, and so have the questions/requests, and we love that! In cases where we’ve already covered something, we might link to what we wrote before, but will always be happy to revisit any of our topics again in the future too—there’s always more to say!

    As ever: if the question/request can be answered briefly, we’ll do it here in our Q&A Thursday edition. If not, we’ll make a main feature of it shortly afterwards!

    So, no question/request too big or small

    Natural alternatives to medication for depression?

    Great question! We did a mean feature a while back, but we definitely have much more to say! We’ll do another main feature soon, but in the meantime, here’s what we previously wrote:

    See: The Mental Health First-Aid That You’ll Hopefully Never Need

    ^This covers not just the obvious, but also why the most common advice is not helpful, and practical tips to actually make manageable steps back to wellness, on days when “literally just survive the day” is one’s default goal.

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  • Vibration Plates: Pros & Cons

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    Dr. Ruth Machin tells us what to watch out for:

    Good vibrations?

    Spoiler: she tested a vibration plate to fairly review it, but stopped within two days due to side effects and personal risk concerns.

    What vibration plates do: they deliver whole-body vibration via a standing platform, with frequency and magnitude determining muscular stimulation and force transmission.

    Why people use them. and how the science stacks up: often to increase bone density but meta-analyses show mixed and generally small effects on such, with possible modest benefits under specific settings and long cumulative use but limited real-world impact. That said, evidence is stronger for improving leg strength and reducing delayed-onset muscle soreness, although traditional resistance training remains more effective overall.

    Side effects and safety: short-term side effects like dizziness and pain are uncommon (Dr. Machin herself reports experiencing motion sickness), long-term safety data are limited, and extremely rare eye-related complications have been reported only in case studies.

    Bottom line from Dr. Machin: vibration plates can offer small benefits for muscle and possibly bone health, but they aren’t essential, aren’t a substitute for strength training, and warrant medical advice for people with bone or fracture risks.

    For more on all of this, enjoy:

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  • Is Your Estrogen HRT Going To Waste?

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    Taking HRT should not be a matter of just using it and hoping for the best. There are a lot of things that can affect absorption rates, so blind trust is not what’s needed here. Instead…

    Things to know about

    Firstly, know: transdermal estradiol (e.g. gel or patches) is almost always absorbed better than oral estradiol (i.e. pills); intramuscular estradiol (i.e. injection) is also better than pills, if (and only if) administered correctly.

    This video covers gel and patches, and discusses a recent study that included 1,058 women (perimenopausal and postmenopausal) using estrogen patches or gels, finding significant variability in blood estradiol levels, regardless of dose or delivery method. Even women on high-dose patches or gels could have low (sub-therapeutic) blood levels, and vice versa.

    Some numbers for serum estradiol levels before we continue:

    • 60–150 pg/mL: ideal range for bone loss prevention.
    • <54 pg/mL: considered sub-therapeutic by the study.
    • <20–30 pg/mL: levels consistent with untreated menopause.

    If you haven’t already, you might want to get your serum estradiol levels checked. A good protocol is to get a test every 3 months when starting, until levels appear stable and it’s established you’re now at the right dose. Then switch to 6-monthly, and then (if everything’s stable) annually.

    Now, factors found to affect absorption:

    • Formulation/brand differences affect absorption rate.
    • Biological factors: age, ethnicity, skin fat (adiposity), hydration, and blood flow, all affect absorption. Of the modifiable factors there: best absorption is seen in cases of lower adiposity, better hydration, and better blood flow.
    • Patch issues: skin reactions and/or poor adhesion reduce effectiveness.
    • Application site: inner arms (thin skin) may absorb better than thighs/belly.*
    • Timing: showering within an hour of applying gel can reduce absorption by up to 22%**.
    • Metabolism: some women metabolize estrogen quickly and eliminate it fast (lower blood levels). Others may retain it longer, showing higher levels.

    *however, if you do use your inner arms as an administration site, remember to avoid the crook of the elbow on the side you will get blood drawn from for blood tests, otherwise you’ll get an artificially elevated reading.

    **Showering (or similar) immediately before applying the gel can also be a problem if you use a product with surfactants (like most soaps and shower gels), including sodium lauryl sulfate. So, it can be good to wait for a while after using such products.

    For less on all of this (we normally say “for more on all of this”, but as it happens, this writer added some extra information above that wasn’t in the video), enjoy:

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    HRT Side Effects & Troubleshooting

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  • Parsnips vs Sweet Potato – Which is Healthier?

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    Our Verdict

    When comparing parsnips to sweet potato, we picked the sweet potato.

    Why?

    In terms of macros, there isn’t much between them: parsnips have very slightly more fiber and sweet potato very slightly more carbs and protein, but it’s close enough to fairly call it a tie, as we’re looking at average numbers, and the differences are within each other’s margins of variation (since exact figures will vary from plant to plant, soil to soil, etc).

    In the category of vitamins, parsnips have more of vitamins B9, E, and choline, while sweet potatoes have more of vitamins A, B1, B2, B3, B5, B6, B7, and K. Thus, a clear win for sweet potatoes in this round.

    When it comes to minerals, parsnips have more phosphorus and selenium, while sweet potatoes have more copper, iron, manganese, potassium, and zinc.

    Adding up the sections makes for an overall win for sweet potatoes, but by all means enjoy either or both; diversity is good!

    Want to learn more?

    You might like:

    Carb-Strong or Carb-Wrong? Should You Go Light Or Heavy On Carbs?

    Enjoy!

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  • The first night effect: why it’s hard to sleep when you’re somewhere new

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    It’s nighttime and you’re exhausted. But the hotel bed feels wrong. The mini fridge won’t stop making that low, irritating hum. The power outlet lights feel brighter than the sun. Outside, random car honks and noises make sleep feel like a distant possibility.

    Many of us struggle to sleep in new environments, even when we’re physically tired. But why? The short answer: a mix of biology and psychology.

    Vitaly Gariev/Unsplash

    Broken routines and missing sleep cues

    Your brain is wired for predictability, especially at night, during our most vulnerable behaviour: sleep.

    A combination of internal and external cues work together to create the right conditions for rest.

    Internally, your body signals that it’s time to sleep by decreasing core body temperature and increasing the sleep-promoting hormone melatonin. This makes you less alert.

    Externally, your environment needs to support these signals, not compete with it. At home, your typical pre-sleep wind-down habits and familiar surroundings tell your body it is safe to sleep.

    But sleeping somewhere new often disrupts these sights, sounds and sensations your body relies on.

    There may be different light levels (for example, from hotel room clocks or street lights), unfamiliar noises (such as elevators, traffic and neighbours) and different bedding (for instance, a firmer mattress or softer pillows).

    And you may be doing different activities, such as eating out late or working on a laptop on your bed.

    An alert brain in a new place

    From an evolutionary perspective, lighter sleep or more frequent awakenings when we’re somewhere new may be protective, allowing us to detect potential threats more quickly and respond to danger.

    This is known as the “first-night effect”. It means when we sleep somewhere new, our brains don’t fully switch off.

    Brain activity recordings have shown that during the first night in a new environment, the left side of the brain remains more responsive to unfamiliar sounds, even during deep sleep, compared to the second night. Once we become familiar with the space, this vigilance usually fades.

    But even when we start to get used to a new environment, other factors can still interfere with our sleep.

    Stress, travel and emotions

    Sleeping in a new environment can also be stressful.

    Your brain may be running through logistics and to-do lists, thinking about your early flight, or scenarios where you forget important belongings. Maybe you’re also experiencing jet lag.

    Emotions such as homesickness, excitement, anticipation or anxiety can disrupt sleep as well. Even positive stress – for example, feeling excited about a big trip – activates the same arousal systems in the brain as negative stress. The brain doesn’t distinguish why those systems are switched on.

    Unfortunately, a heightened arousal system and sleep are competitors. When your stress response is active, it directly interferes with the brain’s ability to disengage and transition into sleep, even when you’re physically exhausted.

    But some people actually sleep better away from home

    For some of us, being away from home can actually remove everyday distractions: there are no household responsibilities, no unfinished tasks competing for attention, and clearer boundaries between “work time” and “rest time”.

    The change of environment may also reduce bedtime rumination, which is often triggered by familiar home environments tied to stress, deadlines or to-do lists.

    Better sleep when we are away may be to do with the amount of sleep we usually get at home. Research shows that individuals who are not getting enough sleep at home are likely to get better sleep when travelling.

    If your sleep improves when you’re away, it might be an opportunity to consider how stimulating or busy your usual sleep environment has become – and what you can do to make it calmer.

    Tips for sweet dreams at home or away

    Reassure yourself. If you have a rough night of sleep in a new place it doesn’t mean something is “wrong” with you. It’s a normal, protective response from a brain that’s tuned to safety and familiarity. You might need a night or two to settle in.

    Choose sleep-friendly accommodation when you can. Many hotels are deliberately designed to support good sleep and these features, such as pillow menus, melatonin-rich foods on the room-service menu, or even a personal sleep butler, can make a real difference.

    Plan for a slower first day. If you know you’re sleeping somewhere new, expect that the first night might not be your best. Where possible, avoid scheduling demanding tasks the next morning and give yourself time to adjust.

    Pack your sleep routine in your suitcase. Just as parents might do for their small child, pack your sleep routine with you. If you have a particular pillow case or a sleep mask, or a certain scent that helps you sleep at home, try bringing these with you so your brain has some familiar cues in an unfamiliar environment.

    If you notice you sleep better away from home, take a look at your home sleep routine and environment. Keep your room cool and dark and make your bed comfortable with supportive pillows and fresh bedding. Establish a relaxing wind-down routine: dim lights and limit screens in the evening, and stick to consistent bed and wake times, even on weekends.

    Charlotte Gupta, Sleep Researcher, Appleton Institute, HealthWise Research Group, CQUniversity Australia and Dayna Easton, Postdoctoral Research Fellow, College of Medicine and Public Health, Flinders University

    This article is republished from The Conversation under a Creative Commons license. Read the original article.

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