* Serious menstrual bleeding or pain: this is the reason for half the hysterectomies performed in the UK. However, most women with heavy bleeding have no detectable disease in the pelvic area, and their symptoms may be caused by hormonal imbalances, thyroid problems or fibroids. Sometimes, there is no obvious cause at all.

* Fibroids: these are non-cancerous fibrous, muscular growths inside or around the womb. Around 20 per cent of women over 30 have at least one fibroid, but may be totally unaware of it. The problem fibroids are those that start to grow under the lining of the womb, causing excessive menstrual bleeding, continuous cramping pain or urinary problems.

* Prolapsed womb: this is where the womb or parts of the vaginal wall drop down through the vagina.

* Endometriosis: the reason for 30 per cent of hysterectomies, in this mysterious disorder, bits of the same tissue as in the womb lining are found elsewhere in the pelvis, but behave as if they are still in the womb.

What does the operation involve?
There are three main types of hysterectomy:

* Radical: the womb, upper vagina, fallopian tubes and ovaries are removed, triggering an immediate menopause; ovaries may be left in place to avoid this happening

* Total: only the womb and cervix are removed; this is the most common type of operation

* Sub-total: only the womb is removed; keeping the cervix is believed to maintain sexual sensation.
These operations are performed either through an incision in the abdomen or via the vagina.

What are the downsides of hysterectomy?
The most obvious major disadvantage is irreversible infertility: childbearing becomes impossible.

In addition, there are problems with the operation itself. Despite being an ‘everyday’ operation, it is not risk-free – one in 1000 women die from it. It also has a ‘high risk’ of infections, affecting one in every three operations (Minerva Ginecol, 1991; 43: 435-41). Nearly 40 per cent of women lose so much blood that they require transfusions, and 16 per cent end up with damage to other organs, such as the bladder, and intestinal disorders, severe bruising or pneumonia. This adds up to more than half the women having ‘major complications’ after hysterectomy (Obstet Gynecol, 1993; 81: 206-10).

The operation can also be done using a laparoscope inserted through the abdomen or the vagina. However, such ‘keyhole surgery’ can result in more complications, particularly when done via the abdomen (BMJ, 2004; 328: 129).

Radical hysterectomy has even more problems, including fistula formation (an abnormal connection between organs or through the skin to outside the body), sepsis, and damage to the nerves supplying the bladder and colon. Other complications include a ‘dropped bladder’ (prolapse), urinary leakage, chronic pain and fatigue, depression and pain during sex. Longer term, hysterectomy also increases the risk of heart attack, heart disease and osteoporosis.

Moreover, hysterectomy doesn’t guarantee a cure – in 63 per cent of hysterectomies for endometriosis, the problem recurs. When women with heavy periods are operated upon, about half turn out to have had a normal uterus (Royal College of Obstetricians and Gynaecologists, The Initial Management of Menorrhagia: Evidence-Based Guidelines, No 1, London: RCOG, 1998).

Is hysterectomy really necessary?
In his groundbreaking 1979 book Confessions of a Medical Heretic, Illinois physician Dr Robert Mendelsohn was the first to question the routine use of the operation. Analysing the data from US hospitals, he contended that nearly 60 per cent of hysterectomies were unjustified. Hysterectomy was recommended as a solution to virtually any major gynaecological problem and routinely performed after the menopause to remove a body part that supposedly no longer had a function.

More recently, gynaecologists at the University of California at Los Angeles, one of the premier US medical research establishments, found that 70 per cent of hysterectomies are ‘inappropriate’ due to ‘lack of adequate diagnostic evaluation’ – in other words, surgery was the only route offered rather than an exploration of less invasive alternatives (see boxes, below and on p 11) (Obstet Gynecol, 2000; 95: 199-205).

Part of the problem is that doctors seem to disagree as to when a hysterectomy is truly warranted: some actively persuade their female patients to submit to one while others believe it should only be used as a last resort (Am Fam Physician, 1997; 55: 827-34).

* Transcervical resection of the endometrium (TCRE), where only the lining is removed, works less than half the time (Br J Obstet Gynaecol, 1997; 104: 601-7)

* Endometrial ablation, where the womb lining is removed by laser, also has only a 50 per cent success rate (Br J Obstet Gynaecol, 1997; 104: 601-7), and can cause perforation of the uterus, ovarian and fallopian abscesses, and swelling of the lungs and brain (Br J Obstet Gynaecol, 1994; 101: 470-3).

Endometriosis
* Keyhole surgery or hormonal drug therapy: symptoms often return (Lancet, 1992; 31 October), and can lead to artificial menopause, plus irreversible masculinisation (such as increased body hair and a deeper voice).

Fibroids
* Keyhole surgery is complicated and fails in 20 per cent of cases

* Bilateral uterine arterial embolisation, which involves cutting off the blood supply to the fibroid under local anaesthesia.

Prolapsed womb
* A ring-shaped pessary is inserted into the vagina to support the womb.

Prickly heat (and itchy skin, thrush etc.) may be a symptom of Candida overgrowth. Try an anti-Candida diet, so cut out sugars, simple carbohydrates, and remove fruit – and especially bananas – for a while. . .

With hayfever season upon us (certainly for us in the West), the Bowen technique may help relieve symptoms, says one reader, who is presumably a Bowen practitioner. . .

Threadworms can be treated by eating only halal or kosher meat as any microbes are drained out with the blood.

This happened to one 47 year old woman, even though she had a hysterectomy to treat the endometriosis.

She was put on a course of HRT but soon complained of kidney pains. Doctors discovered that the right kidney was obstructed, caused by a reoccurrence of endometriosis.

!ABMJ, 1996; 312: 1221-2.

Nutritional and vitamin therapy particularly with Vitamins A, C, E, B6 with B-Complex, calcium and magnesium zinc, selenium, evening primrose oil and chlorophyll. However, you should see a qualified nutritional or dietary therapist for individual prescription. Contact The International Federation of Clinical Nutritionists, Research House, PO Box 131, Fraser Road, Greenford, Middlesex UB6 7DX. Tel. 081 810 5644. Or the Society for the Promotion of Nutritional Therapy (SPNT), First Floor, The Enterprise Centre, StationParade, Eastbourne BN21 1BE. Tel. 0323 430203. In America, contact the American Association of Nutritional Consultants, Suite B-117, 1641 E. Sunset Road, Las Vegas, NV 89119. Tel: (702) 361-1132.

Complementary therapies which claim successful treatment of endometriosis, and may also help deal with the side effects of conventional treatment, include homeopathy, acupuncture, naturopathy and both medical and Chinese herbalism.

In a recent study a traditional Chinese herbal medicine called keishi bukuryo gan, which is used in the treatment of gynecological disorders such as heavy, painful or irregular bleeding and infertility, was shown to suppress development of adenomyosis in mice (Planta Medica, August 1993). Relatively high doses were needed, but there are no side effects with complementary medicine.

The National Endometriosis Society publish a useful information leaflet entitled “Endometriosis and Complementary Therapies” (35 Belgrave Square, London SW1X 8QB, tel: 071 235 4137).

Check that your hormones are functioning properly. Alternative columnist Harald Gaier recommends that women with endometriosis have a hormone profile, eg luteinizing hormone, follicle stimulating hormone, prolactin, progesterone, estrogen etc., done through their GP, to check that hormonal activity is in balance. If anything is found to be out of synch, he recommends regulation by herbal remedies as the least invasive form of therapy.

Investigate food allergy. You must also work with a qualified therapist to try an elimination diet, cutting out one thing at a time, eg, wheat products, dairy products, meat etc., for a few days to see if it relieves any of your symptoms. If there’s no change, reintroduce into your diet.

Try to avoid things like alcohol, sugar, allergenic foods and processed foods which have a lot of chemical components, as these are all dietary inhibitors of immune function.

For symptomatic relief of pain and discomfort, try sitz bath therapy. Alternate between sitting in a hot bath (105-150 degrees) for three minutes, then in a cold bath (55-80 degrees) for 30 seconds.

Endometriosis is the second most common gynaecological disorder requiring hospital treatment, and an increasing number of women are being diagnosed as having the condition. This may, however, be due to technical advancement in diagnostic techniques, particularly laparoscopy, rather than an increasing incidence of the disease itself.

No one knows what causes endometriosis, or how to cure it, and yet medical science continues to throw powerful hormonal drugs with physically and psychologically damaging side effects at it, or perform varying degrees of surgery despite the fact that the problem usually returns when treatment is discontinued. “A single form of therapy with consistent results for all patients is lacking,” said the Department of Obstetrics and Gynaecology, University of Tennessee, Memphis (Obstetrics & Gynaecology Clinics of North America, December 1993).

Endometriosis occurs when tissue similar to that of the endometrium (lining of the womb) is found in other parts of the body, usually on the ovaries, tubes and peritoneum. However, deposits have been found all over the body even, in rare instances, on the eye. Adenomyosis is another form of endometriosis found in the muscle of the uterus.

The tissue behaves in the same way as the womb lining, bleeding every time menstruation occurs, causing inflammation and often forming fibrous adhesions which may make organs stick to one another. Infertility may result if the reproductive organs, particularly the fallopian tubes, become inflamed and scarred. However, according to one report, “controlled studies offer strong evidence that endometriosis per se is not a direct cause of infertility” (Annals of Medicine, April 1990).

The most common symptoms are painful ovulation, painful periods and painful intercourse, although there are many others including bloating, heavy or irregular bleeding, constipation and/or diarrhea, constant tiredness, insomnia and depression.

Various theories exist as to what causes endometriosis. The most popular is that, during monthly menstruation, the endometrium not only flows from the womb down the vagina but also back along the fallopian tubes and out over the ovaries, tubes, womb and peritoneum. Sometimes some of this endometrium sticks to the structures in the pelvis and grows as new tissue. This may be normal, to a certain degree, in most women.

An increasing number of women who have not experienced any of the previously mentioned symptoms only discover they have endometrial deposits when undergoing exploratory operations for infertility or other gynecological and abdominal operations. Also the extent of visually diagnosed disease does not necessarily equate with severity of symptoms ie, a woman diagnosed as having mild endometriosis may complain of extreme symptoms, while another with many more endometrial “patches” and adhesions may not experience any symptoms.

This has led Eric J Thomas, Professor of Obstetrics and Gynaecology at the University of Southampton, Princess Anne Hospital, to argue that the presence of ectopic endometrium may, therefore, be normal and should be considered a disease state only if associated with symptoms or signs of progression and tissue damage (British Medical Journal, 16 January 1993).

In three studies following the natural course of the disease without medical treatment, he notes the disease progressed in about half the patients and in the other half either remained the same, improved or disappeared. Increased disease was not necessarily symptomatic. Professor Thomas concluded that “endometriosis should not, therefore, be treated just because it is there”.

Why then are some women more susceptible to endometriosis?

One of the most recent theories is that it may be due to individual immune deficiency caused by, among other things, immuno suppressive drugs, toxic overload from other drugs or environmental pollutants.

There is strong evidence linking endometriosis with immune system damage caused by the environmental pollutant dioxin. Research done by the US Endometriosis Protection Agency indicates a close association between dioxin levels in the body and the severity and incidence of endometriosis.

Dioxins are unintentional by products of chemical manufacturing processes involving chlorine, such as plastic, PVC, many solvents such as drycleaning fluid, pesticides and wood preservatives, disinfectants and drugs. They are produced when the waste containing these chlorine chemicals is burnt or incinerated. They then become airborne, fall on grass and plants and are eaten by animals such as cows, which become dioxin concentrators. Animal fat, such as meat and dairy produce, is the major source of dioxins for humans, and surveys of breastmilk suggest that UK dioxin levels are among the highest in the world.

It is well known that dioxins attack the immune system, and the US Environmental Protection Agency (EPA) has stated that immune system effects are likely at the levels of dioxins some of us already have in our bodies: “Some more highly exposed members of the population may be at risk. . . of decreased sperm counts, higher probability of experiencing endometriosis in women, reduced ability to withstand immunological challenge and others.”

An experiment carried out on rhesus monkeys exposed to the most toxic dioxin, TCDD, concluded that “the incidence of endometriosis was directly correlated with dioxin exposure and the severity of disease was dependent upon the dose administered” (Fundamental & Applied Toxicology, November 1993).

Until the use of chlorine is reduced, the only way in which we can cut dioxins intake is by eating fewer foods containing animal fat.

Drugs administered to women for conditions other than endometriosis may also lead to an immune deficiency.

A 76 year old woman who had, for several years, been taking tamoxifen (see WDDTY vol 3, no 11) an increasingly questionable drug used in the prevention and treatment of breast cancer, died from neutropenia, a blood disease linked to immune deficiency (The Lancet, 20 August 1994).

Symptoms of endometriosis usually disappear after the menopause (either naturally or medically induced), but hormone replacement therapy, in which there is little control over the amount of estrogen released into the bloodstream, has been shown to reactivate symptoms in post menopausal women (Australian & New Zealand Journal of Obstetrics & Gynaecology, November 1992).

The anti estrogen drug clomiphene citrate (Clomid), which is used to treat infertility, may also cause endometriosis, which is somewhat ironic considering that endometriosis is also being touted as a cause of infertility. In a letter to the BMJ (24 February, 1990) John M Svigos reported that in a study group of infertile women with no previous evidence of endometriosis, 57 per cent were found to have the disease following treatment with clomiphene citrate, compared to 7 per cent in the control group.

Psychotherapeutic and gastroenteric drugs have also been shown to cause adenomyosis in mice (Life Sciences 49 (3) 201-6, 1991).

The link between endometriosis and infertility is a moot one. Professor Thomas states that “none of the published randomized trials have shown that medical treatment improves fertility”, and suggests that “endometriosis should be considered to be coincidental unless it has caused tubal and ovarian damage that requires repair”.

Most current drug therapy for endometriosis suppresses ovulation, inducing either pseudo pregnancy (through the contraceptive pill or other progestogens) or, more commonly, pseudo menopause. It is therefore not a suitable treatment if a woman is infertile and wishes to conceive. If she does conceive while on hormone therapy, there is a chance of infant abnormality. Progestogens are also not a good idea as suppression of ovulation can continue for a long time after treatment has ended.

A quantitative overview of commonly used treatments for endometriosis associated infertility concluded that “ovulation suppression is an ineffective treatment” (Fertility & Sterility, May 1993).

Hormone treatment has proved quite effective in temporarily suppressing some of the worse symptoms of endometriosis, but the symptoms usually return once treatment stops (The Lancet, 31 October, 1992).

Even relief from symptoms has to be weighed up against the side effects associated with these drugs. These include hot flushes, depression, changes in breast size, dry vagina, sweating, mood changes, loss of libido, headaches, nausea, muscle pains and a reduction in bone density (which increases the risk of osteoporosis).

Danazol one of the most commonly used drugs and gestrinone, both induce a post menopausal state with the possibility of these sorts of side effects. But they are also both androgens which are similar to male reproductive hormones. Male hormonal side effects such as greasy skin, acne, hirsutism and voice changes (the latter non reversible) can cause additional distress.

Surgery may be offered to women with advanced endometriosis whose symptoms are extreme or who are infertile. The British Journal of Clinical Practice (Symposium Supplement, Autumn 1991) took the view that the only lasting cure for endometriosis was radical surgery with removal of both ovaries.

As for infertility, Prof Thomas points out that there have been no scientific studies of the experiences of surgical treatment of endometriosis on future fertility. Surgery itself can cause adhesions, which could further contribute to the problem.

Conservative surgery involves trying to conserve or improve reproductive capacity while removing endometrial patches and adhesions and repairing any damaged organs.

Radical surgery means a hysterectomy and removal of ovaries. This usually brings on the menopause, which is often more severe than natural menopause because its onset is sudden rather than gradual. Women who go through the menopause much earlier than normal also have an increased risk of osteoporosis and possibly even heart disease and hardening of the arteries. If the ovaries are removed, HRT may be recommended, which could of course reactivate the endometriosis.

A recently developed alternative to conventional hysterectomy is endometrial ablation (removal of the lining of the womb to stop heavy bleeding, using laser, radiofrequency electromagnetic energy or electrocoagulation). This technique is popular in the US and UK. However, a report in JAMA (8 September 1993) highlights four cases of hyponatremia (potentialy life threatening lack of sodium in the blood, possibly leading to convulsions and coma) following endometrial ablation, in which one woman died. The report concluded: “Menstruant women are at high risk for death or permanent brain damage from even modest postoperative hyponatremia. . ..

Endometrial ablation is becoming a more popular procedure, and unless appropriate safeguards are taken, more such cases will likely follow.”

Surgery is usually performed using either laparotomy the traditional method of performing abdominal or pelvic surgery through an abdominal incision or laparoscopy, which is minimally invasive endoscopic surgery mainly used for the diagnosis of endometriosis.

Few gynecologists are well trained in laparoscopic surgery, The Royal College of Obstetricians and Gynecologists admits in its Information Pamphlet on Endometriosis, which was published in 1994. “Some surgeons have become skilled in destroying the endometriosis with either the laser or cautery during a laparoscopy. A few surgeons are also able to remove endometriotic cysts and divide fibrous adhesions at laparoscopy. There is no doubt that the number of surgeons with these skills will increase over the next few years”.

Microsurgery and laser surgery are also being used by some surgeons. As the British Journal of Clinical Practice concluded: “Although their effectiveness remains to be confirmed in controlled clinical trials, they appear to produce good results and are safe in experienced hands”.

On the other hand, fibroids – or leiomyomas, in medical-speak – are painless and only make their presence known indirectly through shorter cycles, heavy menstrual bleeding or discomfort, an inability to conceive and a tendency to miscarry.

Medicine has nothing to offer for either condition other than drugs to relieve pain (in the case of endometriosis) or surgery (in the case of fibroids) to remove the entire womb or just the fibroids themselves. But neither offers a permanent cure; even after surgery, the fibroids often return. Natural medicine, however, has a range of remedies that can remove much of the discomfort of these two bugbears of womanhood.

Herbals and homoeopathy
The extract of the fruit of Vitex agnus castus (EAC), taken over a period of seven or eight months, has been shown to have a beneficial effect on heavy periods, persistent acyclical bleeding, endometriotic and pelvic pain, uterine fibroids of all varieties and menstrual dysfunction due to deficiency of progesterone (Hippokrates, 1954; 25: 717).

The effectiveness of agnus castus in treating these conditions has been scientifically validated by a number of laboratory and clinical studies (Deutsche Med Wochenschr, 1954; 79: 1271). This remarkable herb has been shown to reduce the production of follicle-stimulating hormone (FSH) in the anterior lobe of the pituitary gland and to gently increase secretion of luteinising hormone (LH) and prolactin – an effect that increases with the size of the dose.

EAC is not a female ‘plant sex hormone’ and doesn’t replace LH, but acts through central nervous system pathways to regulate the production of ovarian hormones.

Excessive bleeding, frequent periods, acyclical haemorrhages and similar menstrual disorders caused by ovarian cysts can all be brought under control by about 30 drops of EAC in water, taken once daily – with effects that have been confirmed by ultrasound (Deutsche Med Wochenschr, 1955; 80: 936). By promoting LH secretion, EAC also contributes to progesterone synthesis (Selecta, 1977; 19: 3688), making EAC of immense value in the treatment of endometriosis.

Based on my own clinical experience, many types of fibroids cease to grow and may actually shrink, as confirmed by ultrasound, during EAC treatment for six months or more.

Nevertheless, I’ve had no success with EAC in the treatment of subserous fibroids – those that lie under the outer membrane of the uterus. For this variety of fibroids, a better treatment possibility is the traditional Chinese herbal remedy keishi-bukuryo-gan (KBG; see below).

Experiments have shown that there are four homoeopathic remedies that can help with ovarian cysts and the symptoms they cause:

* Chlorpromazinum (no menstrual periods, excessive milk, cystic inflammation of the ovaries, inflammation of the cervix) (Br Homeop J, 1965; 2: 102-4)

* Cobaltum nitricum (frequent, irregular uterine bleeding, loss of libido) (Mezger J, Gesichtete Homoeopathische Arzneimittellehre, 4th edn, Heidelberg: Haug Verlag, 1977)

* Hedera helix (late, shorter and less copious menses, pain in fallopian tubes and left ovary) (Stephenson J, Hahnemannian Provings 1924-1959: A Materia Medica and Repertory, Bombay: Roy Publishing House, 1963)

* Nepenthe distillatoria (stinging, needle-like, flashing ovarian pain, loss of libido or sexual response) (Cahiers Biothér, 1966; 10: 1-32).

In addition, both Parathyroidinum and Cobaltum nitricum have been scientifically proven to work on fibroids (Allg Homoeop Zeitung, 1958; 203: 419-35; Arch Homéopath Normandie, 1962; 25: 30-53; Cahiers Biothér, 1971; 29: 1-14).

In Oriental medicine, fibroids are generally believed to correspond to ‘Stagnation of Damp Phlegm, Qi or Blood’. Causes are thought to be emotional stagnation, overconsumption of cow’s milk products, sexual intercourse at too early an age (before 18, when the body’s energies are considered to be immature) or emotional imbalance as a teenager (Gascoigne S, The Manual of Conventional Medicine for Alternative Practitioners, vol II, Dorking: Jigme Press, 1994: 415).

KBG – also known as kuei-chih-fu-ling-wan – is a traditional Chinese herbal mixture of five plants (Cinnamomum cassiae, Paeonia lactiflora, Prunus persica, Poria and Paeonia suffruticosa) that is often used to treat heavy or irregular periods and sterility. It acts as an antagonist (blocker) of LH-rf (luteinising hormone-releasing factor) and as a weak antioestrogen.

A later study by the same group of researchers investigated the effects of KBG on 110 premenopausal patients with uterine fibroids. Period problems such as irregular cycles and heavy bleeding were all improved in more than 90 per cent of cases. In 60 per cent of the women, the fibroids themselves had shrunk (Am J Chin Med, 1992; 20: 313-7).

Acupuncture
Acupuncture has shown success in the treatment of ovarian cysts in a number of animals, including mares, cows, sows and bitches (Klide AM, Kung SH, Veterinary Acupuncture, University of Pennsylvania Press, 1982: 218). However, although promising, these results may not necessarily apply to humans.

Harald Gaier is a registered homoeopath, naturopath and osteopath.

Many medical scientists claim that the Pill protects against endometriosis and ovarian cancer. However, in her book Sexual Chemistry Dr Ellen Grant convincingly argues that the contraceptive pill may well be responsible for the development of endometriosis, in some cases.”Although most contraceptive pills shrivel the womb lining, the blood vessels distort and dilate, which may encourage spread of endometrial tissue backwards through the veins,” she said. “When the Pill is given up, the misplaced tissue thickens and bleeds more profusely causing more monthly pain which eventually leads to the diagnosis.”

In the same way, she postulates, use of tampons, the long contraceptive cap (left in place longer than the conventional diaphragm) and having sexual intercourse during menstruation could also cause endometriosis.

While there are likely to be many factors in the development of endometriosis, evidence compiled at the University of Kansas Medical Center in Kansas City shows that women with endometriosis often have high levels of cytokines – proteins released during an immune response. In particular, they found that the cytokine tumour necrosis factor (TNF)-alpha was very common in women with endometriosis.

The research is still in its infancy, but the researchers note that disturbed levels of other cytokines, cell apoptosis, and T- and B-cell abnormalities are also common, all consistent with an autoimmune disease (Fertil Steril, 2001; 76: 223-31).

Recent alarms have been raised by worldwide pollution with these chemicals, which include: the pesticide DDT, banned in the U.S. in 1972 but still sold by U.S. corporations to other countries and still found in our own soil and water; the herbicide dioxin; and PCBs, which have been widely used in making electronic equipment, plastic, inks, adhesives, rubber and carbonless duplicating paper. Food, milk and water everywhere contain organochlorines.

The Trouble with Fish

Organochlorine contamination may have seriously affected the safety of seafood. Although fatty fish are an excellent source of essential fatty acids, most pollutants tend to accumulate in fatty tissue, so that fatty fish are no longer safe to eat on a regular basis, especially if they come from lakes or rivers.

Solution: The safest fish to eat are low-fat fish caught off-shore, such as cod, haddock, pollock, flounder and yellowfin tuna. Many fish farms are found in agricultural areas where drifting pesticide sprays and agricultural runoff can be a serious problem, so, if you eat fish from farms, you must know your source.

Problems with Breastfeeding

In the ultimate environmental horror story, organochlorine contaminants have been found to either mimic or block the effects of human sex hormones. Hormonal effects of organochlorines have been blamed for increased rates of spontaneous abortion, toxemia of pregnancy, endometriosis, breast cancer and testicular cancer. If male fertility really is declining, as some scientists assert, organochlorines may be to blame. The high levels of organochlorines found in human milk raise frightening questions about the safety of breast-feeding.

Solution: I urge my patients not to lose weight while breast-feeding, but to eat heartily. Weight loss releases organochlorines stored in body fat, which travel into the blood and from there into breast milk. Weight loss should take place after weaning, not before. Because organochlorines appear to be most toxic to infants in the womb–but the effects of this toxicity are not apparent until adulthood–the extent of the organochlorine catastrophe will not be evident for at least another generation.

Hazards of Chloricated Water

Chlorination of municipal water supplies dramatically reduced the death rate from typhoid fever, a bacterial infection which is spread through drinking water. But chlorine reacts with organic matter dissolved in water to form cancer-promoting organochlorines like the trihalomethanes (THMs), of which the best known is chloroform. Drinking chlorinated water increases the risk of developing cancer of the rectum or the bladder, the risk increasing the more water is drunk.

Solution: filter your tapwater through activated charcoal, which removes the vast bulk of chlorinated compounds. Charcoal filters also remove other chlorinated contaminants of tap water, like trichloroethylene (TCE), a degreaser which enters municipal water supplies after being dumped in the soil.

Pestcides


Over a billion pounds a year of pesticides are still used every year in the United States alone. Environmentalists, farm workers, federal agencies and food growers continue to disagree about what constitutes “safe” levels of the twenty thousand registered pesticides. Since many of the most toxic agents remain in the environment for decades, and are most harmful to the young, their full impact has not yet been realized.

Solution: The obvious solution is to buy food that is organically grown in compliance with the standards of a state certifying organization. If these are not available, or to expensive, follow the advice of the Environmental Working Group, a research and advocacy organization in Washington, D.C., which has rated forty-two fruits and vegetables for pesticide contamination, based upon a study of fifteen thousand samples conducted by the FDA during 1992 and 1993. They used seven rating criteria, including the percentage of each crop with detectable pesticide residues and the known toxicity of each type of residue. The group calculated that fifty per cent of food pesticide exposure occurs through consumption of twelve foods. The vegetables with the greatest contamination were bell peppers, spinach, celery, green beans, and cucumbers. They recommended substituting less contaminated vegetables for these. The safer vegetables included green peas, broccoli, asparagus, romaine lettuce, carrots, radishes, brussel sprouts, and potatoes.

According to this same report, the commercial fruit most highly contaminated with pesticides were strawberries, cherries, peaches, Mexican cantaloupe, apples, apricots, and Chilean grapes. Less contaminated fruits included nectarines, blueberries, raspberries, blackberries, oranges, grapefruit, tangerines, watermelon, and seasonal domestic cantaloupe or grapes.