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Byline: Dr Sarah Brewer

Dr Sarah Brewer is here to solve your problems in The Max. Sarah graduated from Cambridge University as a doctor in 1983. She was a full-time GP for five years and now works in hospital medicine.

She writes on all aspects of health, and has written more than 25 popular health books.

Sarah is married to Richard and has a four-year old son, Saxon, and baby twins, Roman and Sapphire.

Write to her, in confidence, with any problem your family need solved, at The Max, Daily Record, One Central Quay, Glasgow G3 8DA.

FOR a woman whose family is complete and who wants a reliable yet reversible method of contraception, the intrauterine system (IUS) known as Mirena is an excellent option.

Mirena is a coil that releases a small dose of progestogen hormone (levonorgestrel) into the uterus and works for up to five years at a time.

It acts as a contraceptive by thickening cervical mucus so sperm cannot swim through, by thinning the womb lining (endometrium) and by interfering with the development of ovarian follicles, although it does not completely suppress ovulation.

Mirena is as effective a method of contraception as female sterilisation (failure rate equivalent to fewer than two women in every 1000 becoming pregnant per year), but is readily reversible.

Circulating levels of levon-orgestrel hormone are low and are equivalent to taking just one to two progestogen-only 'mini' pills per week. As a result, side-effects are low.

Mirena is also free from many side-effects associated with normal copper coils, as it does not seem to increase the risk of pelvic inflammatory disease or ectopic pregnancy.

When Mirena is inserted, your first three periods may be longer than normal and you may have some spotting between periods.

A few women may bleed for several weeks, although this is not usually heavy.

After this, periods become lighter and menstrual blood loss typically decreases by an average of 75 per cent, which could save many women from having to have a hysterectomy due to heavy, painful periods.

Around one in five women using IUS find their menstrual flow stops altogether after a year, so they experience a welcome lack of periods.

This is reversible if Mirena is removed and menstrual bleeding and fertility usually resume within 30 days.

Your GP or family planning clinic can advise whether Mirena is likely to suit you.Q I WANT to move my 16-month-old son on to sharing family meals, but we eat processed or ready meals containing high levels of salt. Are these alright for him?

A IDEALLY, children should - like everyone else - follow a low- salt diet.

Excess salt can cause fluid balance problems in young children and, in the long-term, high intakes of salt have been linked with developing high blood pressure.

Perhaps this is a good opportunity for the whole family to start eating less processed foods and more fresh foods.

When cooking, try not to add salt and only add it sparingly at the table. Use herbs and spices for extra flavour and your tastebuds will soon adapt.

Q MY son is now 13 and starting to develop a few facial spots. Is it possible to prevent acne from developing, or can it only be treated once it has appeared?

A ACNE affects four out of five teenagers, but is often mild and self- limiting. Early treatment with topical antibiotics and benzoyl peroxide solution at the first sign of symptoms will help to keep spots at bay and reduce the risk of scarring.

Prevention is less easy, but eating a healthy, wholefood diet full of fruit, vegetables and wholegrains is very important for good intakes of vitamins and minerals.

Evening primrose oil capsules are suitable for both males and females and help to keep skin healthy and reduce the risk of spots.

Naturopaths recommend avoiding drinking excess milk due to its high hormone content and organic dairy products may be better than non-organic in this respect.
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Title Annotation:Features
Publication:Daily Record (Glasgow, Scotland)
Date:Mar 21, 2001
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