St Mary Cray Practice

St Mary Cray Practice NHS GP Practice, boundary applies, anyone living within the boundary can register to be a patient

07/03/2026

Strength training is highly beneficial, especially as we age.
We start to lose muscle and bone mass in our 30s.

Many women may be hesitant to use weights, worried about looking too bulky. It is difficult for women to look bulky and muscular.

If the aim is to look ‘toned’ - this is a combination of building muscle and losing body fat so the muscle is visible.

The best aim is to strength train in order to age well and maintain physical strength & mobility rather than change body shape.
Don’t be disheartened if the body shape doesn’t change, there are numerous benefits to having increased lean muscle mass. You will notice that you’re able to lift heavier. You may notice improved mental health, improved sleep, more energy. Exercising regularly may also make you more conscious of your nutrition as the 2 go hand in hand.
It all starts with small consistent changes.
🏋️‍♀️

02/03/2026

High BP - lifestyle changes (please continue take medication as prescribed)

👉🏽 Reduce salt
Do not cook with salt or add any to your food at the table, and cut down on processed foods, which contain a lot of salt.

👉🏽 Limit alcohol
If you drink alcohol, stick within the recommended guidelines of no more than 14 units per week and aim to have several alcohol-free days each week.

👉🏽Exercise:
⭐ Strength training twice a week or whatever you can

⭐ Try to do some moderate-intensity activity every day and build up to at least 150 minutes per week, in bouts of 10 minutes or more.

⭐Do not exercise with uncontrolled very high BP

👉🏽 Stress management
Mindfulness, yoga, breathing exercises, practicing gratitude

👉🏽 Sleep 7-9 hours
Consistently getting less than seven hours of sleep or having irregular sleep patterns increases the risk of developing hypertension.

👉🏽 DASH diet - (Dietary Approaches to Stop Hypertension)

⭐Wholegrains
⭐lean protein
⭐low fat diary
⭐Beetroot juice, celery, kale, banana, spinach, strawberries contain nitrates

Instead of focusing on one kind of fruit or vegetable, just try to make sure you eat at least five portions every day. By choosing a variety of different coloured fruit and vegetables, you’ll benefit from the wide range of nutrients they provide.

👉🏽 Caffeine:

Caffeine can raise blood pressure but its effect is usually short lived and lessens when you drink it regularly. That means a moderate intake, 4-5 cups a day, should not be a problem for most people. However, some people are more sensitive to caffeine than others and drinking too much caffeine may affect blood pressure

28/02/2026

Abusive relationships do not happen overnight.
It can happen slowly and many people can be unaware they are being abused or controlled until someone points it out to them and when reflecting back.

Key characteristics:

Isolation:
The abuser may isolate the victim from friends and family, limiting their support network.
Monitoring:
Victims may be monitored through technology or constant check-ins, restricting their freedom.
Control Over Daily Life:
Abusers often dictate aspects of the victim’s life, such as what they wear, where they go, and who they see.
Emotional Abuse:
This includes belittling, gaslighting, and making the victim feel worthless or dependent.

Signs of Coercive Control
Recognizing coercive control can be challenging. Common signs include:
Constant criticism or humiliation
Unreasonable demands for attention
Control over finances and access to resources
Threats of violence or self-harm if the victim does not comply

In the UK, coercive control became a criminal offense under the Serious Crime Act 2015. This law recognizes the serious impact of such behavior and allows for prosecution, with penalties of up to five years in prison.

https://womensaid.org.uk/information-support/what-is-domestic-abuse/coercive-control/

27/02/2026

Perimenopause can be thought of as 2 phases.

Early phase - can start from 40 years of age, or even late 30s. Periods are still regular but as progesterone levels start to decline, women may experience sleep disturbances, anxiety, mood changes and periods may become lighter or heavier or last longer.
Late phase - periods can start to become irregular and longer time between periods. May develop hot flushes/night sweats.

As oestrogen fluctuates, quite severely in some women, this can bring about a multitude of symptoms due to the fluctuations rather than deficiency.

HRT can cause side effects suggestive of excess oestrogen if started when women are still having regular periods, this is because they are still producing oestrogen but it is fluctuating, so sometimes the levels can be very high.
In some cases it may be more appropriate to block ovulation (using contraceptives) and replace with HRT to provide more balanced hormone levels.

If low mood, anxiety and sleep disturbances is due to perimenopause, HRT can help and antidepressants are not helpful.
If there are pre-existing mental health conditions like depression and anxiety, unrelated to perimenopause then HRT will not help.
HRT does not improve brainfog.

If the diagnosis is unclear and we suspect perimenopause (and other conditions have been ruled out), we can trial HRT to see if this is helpful. HRT can be very beneficial and the benefits far outweigh the minimal risks (if no major contraindications).
HRT is of most benefit when started earlier on in the menopause journey.
If the diagnosis is more certain (hot flushes, night sweats, irregular periods), HRT is first line in the management of perimenopause/menopause.

24/02/2026

1. Grip strength is a strong predictor of longevity, studies show that individuals with higher grip strength tend to have better overall health and a lower risk of chronic diseases. Weaker grip strength is assoc with increased mortality risk, making it an important indicator of aging and health status

2. VO2 max is the maximum rate of oxygen consumption during intense exercise, indicating your cardiovascular fitness level. A higher VO2 max generally means better physical fitness and a lower risk of cardiovascular diseases.

How to Improve VO2 Max
* Zone 2 training: Engage in long-duration, moderate-intensity activities like cycling, jogging, or rowing to enhance mitochondrial efficiency.
* High-intensity interval training (HIIT): Short bursts of intense exercise (e.g., 30 seconds of sprinting followed by 90 seconds of rest) can rapidly boost VO2 max.
* Regular aerobic workouts: Aim for at least 150–180 minutes of cardiovascular exercise per week

Thigh circumference
Studies found that people with big thighs had a lower risk of heart disease and premature death.
In round numbers, a thigh circumference (measured where the thigh meets the butt) of about 62 cm (about 24.4 inches) was most protective; bigger thighs provided little if any extra benefit, but progressively thinner thighs were linked to progressively higher risks.

The predictive value of thigh size held up even after the scientists accounted for other indicators of body composition, including waist circumference, BMI, height, and body fat percentage.

Thigh size remained a strong independent predictor even after researchers adjusted for risk factors such as smoking, exercise, alcohol use, systolic blood pressure, cholesterol and triglyceride levels, and (for women) menopause.
Also fat around lower body helps metabolism by reducing LDL, triglycerides and raising HDL and inc insulin sensitivity and lowering blood glucose.

https://www.health.harvard.edu/staying-healthy/big-thighs-may-be-wise

18/02/2026

For those observing Ramadan, a gentle cheeky reminder to try and resist those deep fried goodies……at least don’t have them everyday 😋

Don’t forget to drink plenty of water, prioritise protein, fibre and probiotics. Keep moving in any way you can


What is the evidence base for non hormonal treatment options for perimenopause/menopause?Many women will prefer to try n...
14/02/2026

What is the evidence base for non hormonal treatment options for perimenopause/menopause?

Many women will prefer to try non hormonal options and for some women, hormone treatment may be contraindicated.

None of these are as effective as oestrogen and will only treat symptom such as hot flushes, night sweats, some may help with sleep/mood.

Information taken from British Menopause Society resources and the recent Menopause course I attended

12/02/2026

The name of this chocolate bar changed in the 1990s, if you were old enough to have eaten it when it was a different name, it’s time for an NHS health check!

The NHS Health Check is a free check-up (for ages 40-74) of the health of your heart and blood vessels (cardiovascular health). It can tell you whether you’re at higher risk of getting certain health problems, such as:

heart disease
diabetes
kidney disease
stroke
During the check-up you’ll discuss how to reduce your risk of these conditions.

08/02/2026

Please only take supplements if advised to do so

A varied whole food diet should give your body all the nutrients it needs, however there will be times when supplements are required such as dietary restrictions or health conditions.

In the UK, vitamin D is required especially during the winter months; our body makes vitamin D from direct contact of the sun on our skin.

Iron: best taken on an empty stomach, combined with vitamin C (glass of OJ) can increase absorption.
Iron tablets should not be taken with dairy products, calcium supplements, caffeine, high-fiber foods, or antacids.
If unable to tolerate on an empty stomach, can be taken with a small amount of food.

B12 - best taken on empty stomach

Vitamin D - is fat soluble, take with a meal

Calcium carbonate- with a meal (needs stomach acid)

Omega 3 - is fat soluble, may be better absorbed with small fat containing meal/snack

Magnesium- with or without food, Mg glycinate in the evening if taking to help with sleep

Vitamin C - with or without food, doesn’t matter

Creatine - with carb or protein post workout or any time of the day, doesn’t matter, as long as taken daily, consistency is key

Correcting vitamin or micronutrient deficiencies can prevent chronic diseases

05/02/2026

Some facts about HPV.
There are over 200 types of HPV
14 types can potentially cause cancer
-cervical, vaginal, vulval, a**l, head and neck & pe**le cancer

HPV vaccine only protects against some types, hence cervical screening is still necessary

HPV does not cause symptoms, there is no treatment and usually the immune system will get rid of it within 2 years.
However, sometimes the virus stays dormant in the body without causing symptoms or being detected by the test.

The dormant virus can reactivate and when it is active it can be detected again on the test.
We are unsure why it reactivates but it can be due to changes in immune system

Smoking, immunosuppressant medication, HIV, autoimmune diseases can affect how well your body can clear HPV

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322 High Street, St Mary Cray
Orpington

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Tuesday 8am - 6:30pm
Wednesday 8am - 6:30pm
Thursday 8am - 6:30pm
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