MATERIALISTS

 It is nice to forget about our day-to-day problems and dive into a good movie or a novel. I managed to watch this movie with my toddler, trying to bribe her with chocolates and snacks. I had watched the trailer with Pedro Pascal and Dakota Johnson, and I knew I wanted to watch the full movie. The story really touched me, because I had experience with a matchmaking company in my late thirties. It was not easy admitting I failed to meet my soulmate spontaneously, and now the time is running out, and I need the help of matchmakers. It was weird going for photoshoots, and having to fill out forms, and elaborate on what kind of match I wanted. I did not mind about a much older match, or the hairline, or their income. I really could not tolerate a guy who was shorter than me! I was brutally rejected because of my religion, then we decided that since I am not a practicing and strict Muslim girl,  we could put spirituality on the forms. After a couple of bad dates, the matchmakers suggested we consider the pool of divorced men. That is also a big no-no for me! especially divorced men with children…Anyway, I got bored with the matchmakers and went back to online dating and found my husband. 

Back to the movie tackling the challenges of the match-making business, where they have to find that handsome, rich, and tall guy in the dating pool. It was funny when Pedro Pascal bumped into Dakota Johnson; she called him a unicorn in the dating world.  Lucy (Dakota Johnson) is a successful but increasingly cynical high-end matchmaker. Her razor-sharp instincts have led to nine marriages, yet her personal life is stalled. The catalyst for her crisis is a messy love triangle: on one side is John (Chris Evans), her broke, artistically ambitious ex-boyfriend, representing messy, genuine history and emotional depth. On the other is Harry (Pedro Pascal), the 'unicorn'—a suave, impossibly wealthy hedge fund manager who seems to check every box on the market's list of desirable traits.

Pedro Pascal’s performance as Harry is a masterstroke of charming menace. He embodies the perfect catch: handsome, generous, and sophisticated, he offers Lucy the lifestyle of her dreams—a penthouse, silk sheets, and freedom from financial anxiety. Pascal plays Harry with an effortless, seductive polish that makes it genuinely challenging for the audience to root against him, even when the film begins to reveal the transactional nature of their connection. His character is the physical manifestation of material value, forcing Lucy (and the viewer) to confront whether calculated security can ever truly replace spontaneous love.

Song cleverly uses this triangle to expose the transactional nature of dating, turning human connection into a set of quantifiable assets. The film's strength lies in its refusal to paint a clear villain or hero; Harry is genuinely kind, and John is genuinely struggling. The real conflict is internal—Lucy’s struggle to reconcile the idealistic passion of her past with the financial pragmatism of her present career.

Ultimately, Materialists is a brilliant and honest deconstruction of the genre. It's less concerned with providing a swooning, fairy-tale ending and more interested in the painful, adult compromises that underpin long-term relationships. The perfect relationship with Harry did not work out because, ultimately, love was not on the table, and Lucy drifted towards her struggling ex-boyfriend, where she found more comfort and freedom with him, and she knew they would be fine, because now she earns enough to look after things. 

MENTAL HEALTH

 Last week, we received the shocking news that one of my husband’s close friends had taken his life. All his friends and family members were devastated. I had met him briefly just before we immigrated to Ireland. He was moving between houses and staying with his sister. His bike was parked by my parents’ house for months. My dad was furious to get him to move the bike. His friends found him in his house when it was too late, with a note. 

I know this is a blog about women and women’s health, but today we want to dedicate this post to men and their well-being. We know that most men do not do well with life crises, especially going through a divorce, or loss, or a separation. They tend to keep their struggles to themselves, not to cry or talk to friends or family, because it is a sign of weakness. They often resist seeing a therapist. The easiest way out seems to be drifting to alcohol and substances, which makes matters worse. The studies show that 1 in 8 men experience mental health issues, and men are three times more likely to die by suicide than women. Only 1 in 4 men seek help for mental health concerns. 

As a health care worker, I fight for our patients’ well-being to make sure they recover from their physical ailments. Mental issues in women may be neglected in the process, especially if we are dealing with chronic illnesses such as polycystic ovary syndrome, which presents with irregular menstruation, weight gain, or infertility. Endometriosis is another condition that causes a lot of mental health problems due to chronic pelvic pain and fertility struggles. 

It is important to talk about mental health and break the stigma. Mental health is not a weakness;, it is a human issue. Suppressing emotions can lead to more anxiety and depression. Seeking help is a sign of strength not weakness. We should encourage open conversation about mental health, support friends and loved ones struggling, and create a culture where men feel comfortable discussing their mental health. 

GENITOURINARY SYNDROME OF MENOPAUSE

 Genitourinary Syndrome of Menopause (GSM) is a term used to define a compilation of signs and symptoms arising from decreased estrogenic stimulation of the vulvovaginal and lower urinary tract. The main signs and symptoms of GSM include burning, irritation, vulvovaginal dryness, dyspareunia, and urinary symptoms such as urgency, dysuria, or recurrent urinary tract infection. Labial atrophy, vaginal introitus narrowing, and clitoral atrophy may also be observed.

The Topic of sexual intercourse should not be something that we shy away from when consulting women in the 60s or even 80s. most women in this age category are very sexually active and suffer from vaginal dryness, dyspareunia. It should not be that way. They deserve to enjoy that aspect of life like younger women. 

Each symptom alone may indicate a specific diagnosis; however, in women undergoing menopause or perimenopause, it is important to consider the overall pattern of symptoms and rule out other potential causes of these symptoms. Isolated urinary symptoms should prompt a targeted evaluation of the urinary tract, including urinalysis with dipstick, urine culture, and ultrasound, to identify causes such as polyps or bladder cancer. Sexual symptoms, including reduced libido or dyspareunia, require assessment of the patient’s emotional and relational well-being, along with screening for depression or intimate partner violence. Similarly, genital symptoms appearing alone may reflect various gynecologic conditions, including infections, pelvic organ prolapse, and vulvar lichen sclerosus.

Using non-hormonal treatment for GSM, such as lubricants, may not be sufficient. Local hormonal treatment can then be considered the treatment of choice. Options include vaginal estrogen in the form of suppositories, rings, or creams, which restore vaginal pH, epithelial integrity, and microbiota balance. Dehydroepiandrosterone suppositories are also effective for vulvovaginitis and dyspareunia.

Systemic hormonal treatment may be required in selected cases. Tibolone has beneficial effects on the vagina and bladder. Ospemifene is particularly indicated for the treatment of severe dyspareunia and vaginal dryness.

CO₂ laser treatment is a nonhormonal alternative that has shown effectiveness, particularly for vaginal dryness and urinary symptoms. Treatment restores vaginal epithelium, microbiota, and pelvic vascularization.

In conclusion, GSM affects most postmenopausal women but remains undertreated despite the availability of effective treatments. General practitioners play a key role in the detection of this condition, and early management can improve symptoms and quality of life.

MY FIRST DAY IN IRELAND

 There are those moments in life that we will probably never forget: the first day of school, the first day of university, the day I had my baby, or the day I had a miscarriage. It was September 9, 2025. The plane was about to land. The flight from Doha to Dublin was about 6 hours from midnight to early morning. Aryana slept for most of the flight; she had neither eaten nor had a nappy change. I dragged myself to brush my teeth and freshen up. The good thing about flying with children is that the flight attendants serve the children first, and when they don't eat the food, which is mostly the case, we tired adults end up eating it. 

After a short wait, it was time for us to exit the plane. The line at the passport check was quite long. We presented our visas and my work permit, took some photos, and entered the other side of the airport. I almost cried when I saw that I had to climb down another escalator with a child and my heavy hand luggage. My mother-in-law was bragging to me about how she always travels light with only one handbag on the last day. I was not impressed with that comment!I am immigrating with my husband and child, for goodness' sake!

waited with our eight big bags, my husband’s snowboard, and my Persian carpet for an Uber van to drop us at our hotel in Dublin. It was my husband’s idea to have a stop at Dublin, eat, shower, and then drive to Sligo to our new home the following day. We had another round of breakfast, and we waited to check into our room at 2pm. We had a good shower, baby had a very pleasant bath with her bucket and favourite toys. While daddy and baby had a nap, I decided to do some admin on my computer. My husband woke up and ordered some takeaway food. We ate, Aryana was watching some TV, and I passed out. I could not remember anything until the next morning. According to my husband, Aryana continued to watch the kids' channel, and while I was fast asleep, he managed to slip out of the hotel room to have a couple of drinks in the Pub across the road. It is not easy to leave your family, your home, and your job and end up in a country you have never been to. Thanks to the internet these days. you are able to look at YouTube and watch videos of places you have never been. With Google Maps, we can navigate the streets, and with FaceTime and WhatsApp, we can stay in touch with our loved ones. 

THE BOOKS I READ IN SEPTEMBER

 It has been a crazy month, with the family relocating to Ireland. During the busy times of settling with family, going to work, and doing a million admin tasks, I came across a beautiful public library in Sligo City, as I was walking from my Hospital to the Antenatal Clinic. The public libraries in Ireland are very big with a great supply of new and classic books. We can join for free, take up to 12 books per card, my toddler can even have her own library card, and there is no fine for late return of books. I took one novel for myself and three children’s books for my toddler. 

The first book I picked was by Fern Britton, The Beach Cabin. It was the easiest read I had ever had. It was printed specifically for people with dyslexia. It was a contemporary story tackling problems of modern families, when teenagers are always grumpy and hard to impress, on their iPad all the time, and are picky with family dinners. While all these things are happening to the kids, the parents are having their own personal and career challenges. In the middle of all this, the father decides to bring the family to a beachside vacation, and a lot happens. 

I read a book about a balanced lifestyle in the modern world. It was short, and I read it mainly on the bus commuting to work. I did not take a picture of the cover or record the author's name, and the book is back at the library. It started with basic family values and appreciation, and inner peace, to later work on other interpersonal relations. 

The third book, which I was very excited to see in the village library, was by Stanley Tucci, What I Ate in One Year. I follow him on social media, and I know he has cooking programmes here and there. I always enjoy his movies, even though he is usually playing a very influential supporting actor. He starts writing on the second of January 2023. His writing is simple and has a good sense of humour. He portrays his day-to-day life. The challenges of acting, rehearsals, and constant travelling. He also has young children. He tries to be a hands-on father, trying to prepare kids for school and make them breakfast and dinner. There are recipes that he shares in the book. He is originally Italian and his favourite dish is pasta! There are many other Italian dishes that I didn't know and had to look up. I was impressed that he still incorporated regular Pilates and yoga with his instructors to try and stay fit. He stays in the UK, and I was impressed that he is a Harry Styles fan; they dine together whenever he is not busy or on tour. It was a very interesting read, even though I am not a fan of Italian food, but it is interesting to have a glimpse of the celebrity lifestyle. 

MY BIRTHDAY MONTH

 It is September! It is my birthday month. I am turning forty this year. It is a great milestone. I am surely getting older and wiser. becoming a mature woman. It has been quite a busy year for me. Receiving a job offer in Ireland in May changed many things. Between having a full-time job as an OBGYN, we had to start renewing our passports and apply for a new passport for my daughter. Apply for ACLS and BLS courses, which require a lot of preparation and a dedicated full weekend of hands-on training. By the end of June, I had received my work permit, and the online Visa application was done, and we were waiting. By mid-August, we had our Visas and we had to book our tickets, organise accommodation abroad, pack our bags, and move as soon as possible. 

While the full-time stressful job is going from 7:30 to 5pm, along with the baby drop off and pick ups from school. I was going through a huge emotional turmoil with my own family. My work family still did not know about my plans. My colleagues and my Boss found out about everything at the beginning of August. By mid-August  I was submitting my resignation letter and sorting out a million things with the human resources department. Long story short, tickets were booked for the 8th of September. and I started packing bags and shipment boxes. I had to look at all the sentimental items in the house and decide what needs to be packed and what goes to the box, and what needs to be donated. 

All this happened, and still, friends and family made my 40th birthday special. My best friend took me to Mount Grace for a lovely Spa day. It was an amazing drive and a relaxing day. We got together with my family and the in-laws at the end of August and had a beautiful farewell lunch. and I got very beautiful gifts. My colleagues got together at work and threw a farewell party at which made me cry. We spend more time with our work colleagues than we do with our families. The last day of work was the 31st of August and everything went smoothly. My packing was finalised, the house furniture was sold, and some last-minute paperwork was done. Looking at the empty house made me feel sad, but it is a sign for a new beginning. I am looking forward to my new adventure! 

DAYDREAM

 It is a random Saturday, and I am at work in the hospital, going through the handover and a big antenatal ward round that takes the whole day. I would probably not be at work, and then my imagination started going wild, wondering where I actually want to be! I would definitely need a Spa day, probably on my own. I definitely do not want any family members or friends with me. I want to relax, have a fancy massage, then swim in the heated pool. After swimming, I want to relax in the steam room. After the relaxation is over, there comes one of the real joys of life, which is food. I would like a green salad, grilled prawns, some sushi, and fruit to eat. I love my tea, preferably some black tea. I want to sit and sip on my tea and read my new book, and get lost in the story without worry,  rushing, or interruptions. 

What I like about Spa days is that they give a brief break between the day-to-day hustle. They do not need extensive planning, packing, and travelling. I have a little baby and I do not want to be away from her for too long. So a little half-day break on my day off will be manageable. 

I love my little daydreams! They help me escape the brutal, non-stop working reality of life. They allow me to drift away and go to places and do the things I want to do. One of my favourite things to do is to travel back home to Grandma’s house. Imagine that it is around lunch time, when we usually just eat lunch and watch TV at the same time. I really don't care what grandma is watching, as long as we are together. It will feel good. It is September now, and extremely warm back home, but us Middle Easterners do not care; we should still have our tea. I miss the relaxing days of sitting with my grandma and listening to her stories. I miss her house and the old furniture. 

Even though we have circumstances in our lives where we can not change, we can change the way we think and drift away every now and then. 

MEMORIES OF MY CHILDHOOD

 I have been very nostalgic and sentimental recently. I am planning to move abroad. I sit and empty out the cupboards most nights, trying to figure out which items are going with me, which items to be sold, or to be donated. I came across a very special box which had very precious photos, some cassettes and CDs which I am keeping. My school uniform tie from Jeppe Girls was signed by my friends. Beautiful and tiny crochet baby boots! The baby boots really blew my mind. It humbles you knowing how tiny a baby is until it grows up. 

My first childhood memory goes back to around the time I was 5 years old. I had vague memories of Cyrus, my brother, when he was born. I remember Dad’s mother visiting us, and the house was full of visitors. It was quite disturbing. I remember trying to help my mother set the table or take the dishes to the kitchen to be washed. Up until now, I haven't liked guests, especially the ones who sleep over. I feel like they invade my space,  eat all my food, and make my house messy! I prefer to meet up with my friends in a restaurant. You will never find me trying to cook fancy food and set fancy cheeseboards to try and entertain people in my house in my adult life.             

Back in those days, we did not use disposable nappies. There were white cloths that had to be washed, disinfected, dried, folded, and stored in the cupboards. Another vague memory is when mom used to wash my brother's bump in the basin. He was definitely under six months. I went to school from the age of 3 years. I definitely was a very depressed child who had separation anxiety. I did not play with anyone; I hardly had friends. I would skip most of the school days. I was crying most of the days when I was in grade one in primary school. I remember Grandma was in charge of me during that time. Mom would drive me to primary school, and my brother to my old playschool. Grandma would help me with my homework, and most nights I would sleep in her bed, which was very fun. 

My brother grew up and became more fun. We would spend our days running around the house and the yard, screaming and shouting. We had a two-story house with a big basement. I remember I always enjoyed going to the basement area where my uncle used to study. Granny and Grandpa used to tell me I must not go there because there are rats there! One day, I went there all determined, shouted to keep the rats away,
and went to the basement, feeling very triumphant. My mom had to take us to the parks so we could play and have fun. I remember my first bike ride on the street. My dad was showing me how to keep the bike balanced, and I was very excited!

EXERCISE IN PREGNANCY

 This is a question I am often asked in obstetrics consultations regarding exercise in pregnancy. Most of the women we see take part in some sort of recreational physical activity, but only 15% of them exercise at the recommended level, which is 30 minutes of moderate activity every day of the week. 

Most women believe that pregnancy is the time to eat everything and gain as much weight as possible. Too much pregnancy weight gain can lead to problems such as Gestational Diabetes, large for gestational age babies, and a higher rate of caesarean section. We know that the woman's body changes during pregnancy, for example, her blood volume is increased by 40% and the stroke volume by 10%. There is decreased vascular resistance to enhance the placental perfusion. The growing uterus can shift the center of gravity and cause lumbar lordosis and back pain in 50% of pregnant women. The ligaments of the bony pelvis also become lax and can lead to severe discomfort. 

Moderate exercise can have multiple benefits for the mom and the baby. It can decrease the gestational weight gain and decrease the rates of pre-eclampsia, insulin resistance, and gestational diabetes. The guidelines suggest that overweight women should not gain more than 10% of their body weight in pregnancy. The recent trials have not found an increased risk of preterm birth or low birth weight in women who exercised in pregnancy. 

In summary, moderate exercise is encouraged in uncomplicated pregnancies. There is no evidence that moderate exercise can harm the mother and baby. We do not recommend exercise for women with chronic diseases such as severe anemia, cardiac disease, intrauterine growth restriction, or extreme morbid obesity. Forms of exercise such as horse riding, scuba diving, or skiing are also not recommended. I personally found moderate walking in the third trimester very helpful, although I was in so much pain and felt that my symphysis pubis in ripping apart. I tried to bounce on the gym balls as well, although I did not go to spontaneous labour and required induction of labour, but my labour progressed well, and I feel the exercise played an important part. 

FRECKLES

 I am back to reading fiction, and I am enjoying it. Back in the day, I used to enjoy novels from local authors, Jane Austen and Agatha Christi. In my late 20s, I decided to strictly read non-fiction books about politicians, famous people, etc. I think the last non-fiction book I read was Laura Bush’s memoir. I came across this book in the library, and the title suggested it must be a girly story. I finished it in less than two weeks! It was a beautiful and touching story about a girl who grew up in a boarding school from the age of five. She would spend time with her dad on weekends. They stayed in the rural parts of Ireland on Valentia Island.  Her mother left her after she gave birth. The book describes the girl's relationship with her dad beautifully. He has always been there for her and understood her. She had her freckles from her dad’s side. 

After finishing school, she moved to Dublin to pursue a career and to find her biological mother. Her struggles in Dublin are described in detail, and how she is shy and awkward around people. She comes across a guy who tells her she is the average of the five people she spends most of her time with. She is trying to find those people amongst influential celebrities, and starts writing to them. For sure, she knows her dad is at the top of the list of influential figures in her life. She even tries to find that popular girl from her school days that she always wanted to be friends with. At the end, she realizes she has enough friends and influential figures around her already who inspire her and love her. 

The moment of truth in the book is when she finally introduces herself to her biological mother, and it is quite a surprise. Another touching moment in the book is when she is in a hair salon, and her biological mother is doing her hair, and she is loving it! I enjoyed reading contemporary fiction where people post things on Instagram, send emails, and have smartphones. She is a hardworking girl trying to figure things out while trying to build her self-confidence and pay her bills. There is a lot of growth in her throughout the story, and her love for her father is as strong as ever. It is quite unique because he is the one who wanted her and raised her. 

HPV VACCINE

 It breaks my heart when I come across patients who have negative misconceptions about vaccination. We have come a long way in medicine when we used to have various infectious diseases wipe out a whole population, or leave thousands with multiple disabilities. The discovery of the Human Papillomavirus by Harold Zur Hausen as the causative agent for various cancers, such as the cervix, anus, and oropharyngeal, was a major scientific breakthrough. He won a Nobel Prize for this. Later on, we had the HPV vaccine coming around 2006, to prevent our youth from being infected with the virus, and decrease the rate of precancerous cervical lesions and other HPV related cancers. 

The HPV vaccine has been available in South Africa since 2009. There have been numerous international studies showing that the vaccine works. The number of women diagnosed with precancerous lesions has declined after the introduction of the HPV vaccines. What we need to do as health care providers is to educate young women, to get vaccinated before they become sexually active, around the age of 9. HPV is a sexually transmitted disease, and boys also need to be vaccinated. Due to financial constraints, the governments are funding women to be vaccinated. 

The rise of vaccine misinformation in conventional and social media has contributed to growing distrust in vaccines in general, including the HPV vaccine. All related health care workers, such as paediatricians, Obstetricians and gynaecologists, and public health experts must respond with evidence-based messaging that emphasizes cancer prevention. Social media sends controversial messages that the HPV vaccine causes infertility, autoimmune disorders, or promotes early sexual activity.