Attitudes to physical beauty still seem harsher for women in their middle years than for men of the same age. We are so geared to youth, and youth is so tied up with femininity and sexuality, that once you reach menopause you may be viewed as ‘past it’.

The environmentalist and anti-nuclear campaigner Dr Helen Caldicott, whose marriage of twenty-six years broke up on the eve of her fiftieth birthday, says blinkered attitudes do not help. ‘In the eyes of some men, older women . . . have lost almost all value when they reach menopause because their hormones are no longer at the level they were before.’ Dr Caldicott has achieved a new beginning and a sense of liberation and independence since moving out of the family home, to settle first on the north-east coast of New South Wales and then in Gippsland, Victoria. ‘Doing it released me and made me understand the strength I had.’

Women actors complain that few challenging roles are available once they reach about forty-five. While men such as Sean Connery, Sam Neill and Robert Redford still play romantic leads into and beyond their fifties, women are rarely seen in such parts. Genevieve Picot, who played the role of the obsessive Celia in Proof and is deputy federal president of the Actors Equity section of the Media, Entertainment & Arts Alliance, says she is frustrated about being considered ‘old’ in the industry. ‘The irony and the disappointment for me is that as a performer I’m feeling much more confident and my skills are so much better than they were ten or fifteen years ago, yet I just don’t have the opportunity to use them very much.’

There are signs of change, however, the most obvious place being on television, where presenters and commentators are increasingly likely to include women over forty who do not necessarily look like stunners.

The highly regarded SBS newsreader Mary Kostakidis believes women themselves must make the first move. She refuses to dye her greying hair because she sees no point in camouflaging the maturity and complexity that come with midlife and beyond. ‘As a younger woman I was often attracted to older men because of these sorts of qualities. And now that I’ve arrived there myself, I’m not about to cover up the fact.’

She says that women presenters on Australian television are still largely ornamental. ‘It’s boring. We are an ageing population, and decision-makers who cannot accept this and act accordingly are behind the times. In many cultures older women assume positions of great status and respect. Australian women also have pride in their years. The time must come when they are no longer discarded for no other reason than their age. If not — if our institutions don’t reflect our values — our democracy is a farce.’

Women throughout Australia are, like Mary, Helen and Genevieve, asking questions, getting information, and deciding what is important for them at midlife and beyond.

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Who would have believed, a generation ago, the current popularity of ‘alternative’ therapies and the challenge they have thrown down to orthodox medicine? There was little to indicate in the 1970s that the so-called fringe therapies like naturopathy, homeopathy, traditional Chinese medicine and herbal medicine would attract a vast pool of clients who alternated between orthodox and less conventional practitioners with breezy savoir-faire.

Equally unexpected were the greening of the Western diet and the enthusiastic adoption of power walking, jogging, aerobics and weight training by women of all ages. Many older women took to the challenge with gusto, viewing their increased involvement in physical activity as an antidote to the lack of strenuous exercise in their lives. When the 1991 Bulletin/Qantas Businesswoman of the Year, Sara Henderson, was writing her bestselling autobiography From Strength to

Strength and its sequel (still to be published at the time of writing), she felt the need to restructure her writing days to include short time-outs for exercise.

‘I’d played sport till I was forty-five, mainly tennis and squash. And there was a lot of physical activity at Bullo, down in the yards, working gates, building fences, lifting cases of beer in and out of the store. [Sara and her daughters own and run Bullo River, a remote Northern Territory cattle station.] To keep in nick when I’m writing twelve hours a day, I take a few minutes off every hour or so and do a couple of hundred skips. In the evenings I walk some kilometres along the airstrip with the dogs and, before going to bed, I do weights for my upper body for twenty minutes or so.’

Sara went through a fairly straightforward menopause when she was fifty. There were several months of irregular and heavy bleeding, followed by a return to normal periods, then irregularity again and so on, the whole process taking about three years and coinciding with the deaths of her husband, mother and son-in-law. Sara has not had HRT, says that people comment on how well she looks, and remarks on how well she feels. She enjoys a balanced diet mainly of fresh meat, vegetables and fish, does not smoke, and since the age of forty-five has drunk alcohol on special occasions only.

Whether women choose HRT or not, they should be aware of the range of lifestyle changes and alternative or complementary therapies capable of lessening menopausal symptoms and enhancing long-term health.

A common criticism of alternative therapies is the lack of solid scientific evidence about their effectiveness and safety, a problem compounded by the lack of quality control in the manufacture of some substances. As with HRT, uncertainties about effects should be considered carefully in assessing the benefits and risks.

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‘The fact is that women are relatively protected, in terms of their cardiovascular status, by having oestrogens. It’s relative because it’s true as long as they have oestrogens. After the menopause, however, the incidence of heart disease rises rapidly, parallel to that in men; and as everybody knows, women live on average seven years longer. While men may have a head start, women have a higher chance of living widowed and with serious cardiovascular disease.’

Another unpalatable reality is that the causes and the most effective prevention *and treatment strategies for heart disease in women are still being learned, whereas they are well established for men with heart disease. This discrepancy relates to the male focus of much heart disease research, a fact that concerns health authorities in many countries. ‘Women die of heart disease almost as often as men do, but later in their lives,’ says Judith Dwyer, who chairs the Women’s Health Committee of Australia’s major health watchdog, the National Health and Medical Research Council. ‘It is surely inexcusable to base clinical advice on data that is good for the gander but may be worse than useless for the goose, even if that data is easier to gather.’

Judith Dwyer says the exclusion of women as participants in heart research is longstanding and ingrained in the system that governs trials of new pharmaceuticals. ‘Drug companies in Australia are almost required to use only healthy, young male volunteers when testing new formulations,’ she says. ‘It seems to me to be perfectly possible to develop methods of avoiding many of the perceived problems, such as the danger of liability in the case of pregnancy in women.’ In a bid to overcome the problem, a new approach has been devised to redress this kind of imbalance in Australian heart research.

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It is a hormone that contributes to feelings of wellbeing and to the maintenance of a woman’s so-called ‘secondary sexual characteristics’ such as distribution of hair, type of voice, and libido. Although testosterone is usually thought of solely as a male sex hormone (also known as an androgen), this is incorrect. It is more accurately described as ‘the third female sex hormone’. Women are already producing testosterone during childhood and continue to do so for the rest of their lives.

TESTOSTERONE AS PART OF HRT If you have had your ovaries removed surgically, you may become aware of lethargy and loss of libido. The addition of testosterone to HRT, or perhaps testosterone on its own, may prove helpful in your case.

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Rheumatoid arthritis is characterized by painful, swollen joints that feel warm to the touch and are often stiff. The stiffness and pain are usually worse in the morning. Various blood tests are used to confirm the diagnosis – they look for certain factors in the blood that are characteristic of rheumatoid arthritis.

Inflammation is the cause of the problem, and the part to be affected first is the synovial membrane, although the inflammation later spreads to other parts of the joint. The synovial membrane has an important role to play in the joint, because it produces the fluid that lubricates the joint. The synovium, which surround the joint, is filled with this fluid. In rheumatoid arthritis the synovial membrane is invaded by large numbers of immune cells which cause the inflammation.

The presence of all these immune cells suggests that there is an infection in the membrane, and early theories about rheumatoid arthritis invoked some bacteria or virus. But despite many years of searching, no infectious agent has been found. An alternative theory suggests that the body is mounting an immune reaction against its own proteins – in other words, that rheumatoid arthritis is an autoimmune disease. Some recent discoveries tend to support this idea. A third theory suggests that there is an overgrowth of cells in the synovial membrane which attracts the attention of the immune system – this idea is currently being tested.

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Fortunately, there are still some people left who resist being infected by discontent but know how to remain cheerful in spite of difficulties. I remember a very sick farmer’s wife who suffered from multiple sclerosis and had been paralysed for fourteen years. When she achieved a slight improvement with great effort and was able again to use her arms and eat without help from other people, she was so happy and grateful for the fact that she could cope so well with her still deplorable condition. Whenever I had to face some unpleasant jolt such as cannot be avoided on our bumpy earth my mind always returned to this lady and her quiet contentment.

Especially when we are tired we tend to look at the present, future and past with a negative spirit, but this does not contribute to a contented attitude by any means, nor will it provide the basis for restful relaxation and refreshing sleep. Therefore, we would do better to think of all the positive things that have happened to us and are still going on every day; in other words, we should count our blessings. This attitude will allow a pleasant sense of gratitude to enter our heart and will help to restore the mind and body to a state of well-being. We must admit that every person has sufficient grounds to feel upset, to worry and feel unhappy. However, if you place these negative factors on one side of the scales, then the same quantity of active, positive factors should be placed on the other side in order to balance them. So when you feel depressed and beset by problems, think about all the valuable things you have, the good you have been able to do in your life, your successes, the many gifts nature offers you day by day. All these encouraging memories and experiences are able to fill your heart with gratitude so that life’s burdens, all your complaints, appear small indeed.

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So, if one values life, the heart muscle ought to be well cared for. This brings to mind some words of ancient wisdom: ‘More than all else that is to be guarded, safeguard your heart, for out of it come the sources of life.’ Even though these words have a deep symbolic meaning, they indicate nevertheless that our heart is an organ that demands our whole attention, for if the heart fails what else remains but death? When the liver or the kidneys fail the patient is able to stay alive for a little while, but when the heart suddenly stops beating the person will drop as if struck by lightening and death follows instantly. Anyone who has witnessed a case of heart failure is extraordinarily affected by the tragedy -the sudden transformation from life to death. The pathologist will probably say that the heart muscles had been starved of blood for many years and were therefore terribly changed. The information that nicotine had been responsible for the fatal damage is then, unfortunately, no longer of any use. It is too late. Fortunately, it need not come to this, because the mere fact that the effects of nicotine poisoning become apparent long before the possible fatal consequences should make the addict decide to give up the habit before it is too late. Or would it not be better to give up smoking long before disturbances arise?

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It is appropriate to consider this question, since many people hold mistaken views about salt. We were taught in school that a person requires 7 kg (about 14 lb) of salt a year in order to stay alive. It is true that man and beast cannot do without it, although it is also acknowledged that certain diseases demand a low-salt or even a salt-free diet. This apparent contradiction resolves itself when we realise that our salt requirement need not necessarily be obtained from the crystalline kind of salt known as common or table salt, but can equally well come from our food. Cases in point are the inhabitants of the Asiatic steppes and the Indians living at the headwaters of the Amazon River. They have never heard of salt, nor do they have a word for it, but as they could not survive without it, it is obvious that they must cover their requirement by means of their food.

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Bread has always played an important part in our nutrition. It is still on our table today and every day as a staple food. The age-old request ‘Give us this day our daily bread’ illustrates to what extent we depend upon it. We may have an abundance of other foods, but bread remains the foundation of our diet. How much we disliked having it rationed during the war years. Things have changed since then, although the need for good and wholesome bread is as great as ever.    

We know from the history of ancient Rome that their legionaries were issued a certain quantity of wheat every day. Wheat grain can be stored almost indefinitely without losing any of its value, but this is not the case with flour. As soon as the external sheath has been broken and the grain has been milled, the oxygen in the air begins to take effect, and the longer the flour is kept, the more it will lose of its value. The enzymes are probably the first to suffer from such exposure. These are active elements in the grain, for example diastase, which comes to life during the process of germination and changes the starch of the grain into maltose, then dextrose.

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Every year, come autumn and winter in my garden in the Engadine, the little clusters of scarlet barberries between the leafless thorny branches of the berberis shrubs just beg to be harvested. A little earlier it would have been the ripe redcurrants, shining in the autumn sun. So when I am there, I pick some of these berries most days and enjoy their acidic flavour which is due to ascorbic acid, or vitamin C. These berries are, in fact, a natural food for the nerves. Before long, even the slopes facing south become covered in thick snow, and the birds will be daily guests on the shrubs, feasting on the beautiful red, oblong berries in order to obtain their requirements of sugar, minerals and vitamins. The red fruits of the Rosa canina (wild rose), the rose hips, will still be peeping through the snow. When these hips are ripe they are deliciously sweet. Because of their vitamin Ñ content they, too, are a wonderful food for the nerves. No wonder that rose hip puree and barberry puree are a perfect source of vitamins during the bleak winter months. They should be on every table because they fill an important gap in our nutrition, since practically all other foods lose some of their vitamin content during their months of storage. Wild fruits, in the form of fruit puree or conserve, prevent vitamin Ñ deficiency while being tasty and pleasant food. But not only barberries and rose hips are rich in vitamin C, even richer are the berries of sea buckthorn, which grows abundantly in the lower Inn valley, the Tessin and the Maggia valley in my native Switzerland. Their orangy-red colour, bright amongst the olive-green leaves, can be spotted on slopes and along brooks and rivers — a delight to the eyes of every nature lover.

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