Don't want your trip of a lifetime ruined by Delhi belly, seasickness or – worse – malaria? Take Dr Jane Wilson-Howarth’s advice for stress-free, healthy travel
Contraception can be compromised by travel. The distractions and excitements of a honeymoon will make taking the pill easier to forget. Also, if you catch a tummy bug, the pill may not be absorbed, which could lead to a rather permanent souvenir...
You could circumvent this issue by using a long-acting method of contraception - an intra-uterine system (aka Mirena) or sub-dermal implant. Organise the fitting of these devices several months before travel to ensure they suit, and that any side-effects settle.
To do away with periods, discuss Depo-Provera injections with your GP: you have them four times a year and they usually stop menstruation altogether.
When women don't stay well hydrated, cystitis is common. Drink enough for at least three good-volume urinations in 24 hours, especially if baking on hot beaches or doing activities in the sun. Passing urine after sex reduces risk.
The most portable cystitis remedy is sodium bicarbonate (baking soda); a teaspoon in a big glass of water works well (add cordial to improve the taste). When you feel symptoms, gulp down at least two glasses, and continue pouring in fluids until things feel better. Ask your doctor for a short course of antibiotics to keep in case this doesn't help.
Going on safari? Delving into the Amazon? Exploring India? Malaria, a disease transmitted by the dusk-to-dawn-biting Anophelesmosquito, is a risk in most of the tropics and also parts of warm temperate regions, including much of sub-Saharan Africa, parts of Asia and tropical Latin America (for details of malarious areas, see www.malariahotspots.co.uk).
If there is a risk, get a course of antimalarial tablets from your GP/travel clinic. The most protective antimalarials are only available on prescription: Malarone, doxycycline and Lariam. Malarone probably causes the fewest side effects, and you only need to start taking it a few days before travel; however, it is the most expensive. A course of doxycycline must be started a few days before travel, but continued for a month after returning. Lariam must be started one to three weeks before travel.
Also protect yourself with a DEET-based insect repellent, spray your clothes with permethrin (a repellent that can be applied to fabric) and cover up in trousers and long-sleeved shirts.
Cruises quickly cease to be romantic when motion sickness sets in. It's caused by a mismatch of signals arriving in the brain. Once nausea has come on, swallowing pills doesn't usually help; if you're prone to motion sickness, dose yourself well before the motion starts. Hyoscine is the drug most likely to work if you've left it late.
Ginger is highly effective in treating nausea; it works as well as the anti-emetic metoclopramide (Maxolon), which is widely prescribed for morning sickness.
A 'dose' of ginger would be a one gram ginger extract tablet or a handful of fresh root ginger. Travel with ginger in a form you like - eg, as biscuits.
To help keep nausea at bay, eat light, non-greasy foods in small portions (jam sandwiches are good); large volumes of fluids will just slop around in your stomach.
Lie down with your eyes shut - it removes one set of confusing signals to an already baffled brain - and find the place that moves the least. Going up on deck for some fresh air can help; look at the horizon. If you're going to vomit, spit first to check which way it'll blow.
Anxious fliers? Reduce the worry by setting out well prepared
and in plenty of time. A few doses
of Valium (on prescription) help; yoga techniques are also excellent. Stress-free Flying (Quay Books) is useful.
Inactivity in long journeys can lead to deep vein thrombosis (DVT). To avoid this, eat oily fish in the 24 hours before departure, and avoid taking sleeping pills or getting drunk on the flight. Move about the plane and perform exercises that tense the calf and thigh muscles. Buy properly fitted flight socks and put them on before setting out for the airport. DVT is more likely if you have close blood relatives who've had clots, if you've had a major operation, leg surgery or a leg fracture in the past three months, if you have cancer, if you're pregnant, if you're overweight or if you smoke.
It takes about a day for every hour of time difference for your body clock to adjust to new time zones. Melatonin seems to help (sunshine increases your body's own stores), and the homeopathic No-Jet-Lag combination has many fans. It is probably unwise to take sleeping tablets on the plane because of the DVT risk, but a few doses on arrival can help you readjust.
Try to wind down before your trip rather than madly rushing around - start stressed, arrive stressed. Protein-rich breakfasts and lunches and high-carbohydrate evening meals also help readjustment.
Travellers often worry about the water, but foreign food is often most likely to make you ill. You can still enjoy the local cuisine though: just pick piping-hot dishes, and avoid foods that might have been handled by others after cooking. Buffets can be bad - food maintained at blood heat for hours allows bacteria to multiply. Risky foods include: cooked rice (breeding ground for bacteria); unwashed fresh fruit, raw salads and uncooked vegetables (strawberries, watermelons and lettuce are some of the worst offenders); shellfish and seafood; cocktails and ice cubes.
Probiotic and 'friendly bacteria' products are useful in rehabilitating after gastroenteritis. Antibiotics will cure diarrhoea once it has started. The best foods for bad stomachs are bananas, thin soups, local yoghurts, coconut milk, dry toast and biscuits.
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