Despite a recent decline, the UK still has the highest rate of teenage pregnancy in Western Europe. Young women themselves explain why, although access to contraception is relatively easy in theory, they find it difficult in practice to overcome the many barriers to its successful use.
Back to Basics: Infertility
Constipation in palliative care: dignity matters
The impact of constipation in palliative care cannot be overestimated. It is an unpleasant, distressing symptom that often has a profound effect on quality of life. This article explores the complexities of assessment, highlights the challenge of managing opioid-induced constipation, and reviews recent advances in management.
Chronic pain in women
Compared to men, women report pain that is more frequent, severe and longer lasting. Women are also more likely to experience multiple pain conditions, increasing their risk for the onset of new pain disorders. But studies show that men are more likely to receive effective treatment. Women would benefit particularly if more multidisciplinary pain clinics were established in primary care.
Secondary prevention of fracture: time to work together
Half of women with a hip fracture have already suffered a fragility fracture that went untreated. If these women had received secondary prevention, their future risk would have been reduced. The need to improve patient care, and the potential cost savings, form the rationale for a local multidisciplinary fracture prevention pathway.
Looking forward to more success for the forum
Last year was momentous for the Primary Care Women’s Health Forum. We held two very successful meetings, and announced the first winner of our Best Practice Award. This year we aim to ensure that the Forum continues to flourish, so that we can support our members in working together to improve standards in women’s health in primary care.
Miscarriage: facts, feelings and the GP
Miscarriage is common, accounting for 75% of all gynaecological emergencies and about 50,000 hospital admissions each year in the UK. Although secondary care is usually responsible for immediate management, there is often no follow-up. So GPs and practice nurses have an important role in offering support and explanation to women and their partners.
Editorial
Now that we have the details of the Spending Review, we know that times are going to be tough. So this might not appear to be the best time to be taking on extra work. But this is exactly the prescription for GPs from the King’s Fund. A research paper argues that as well as providing general health care, GPs should become more involved in maternity care, from before conception to after the birth.
Solving problem bleeding in implant users
Over 280,000 etonorgestrel (ENG) contraceptive implants (Nexplanon) are fitted in the UK each year. Continuation rates are good at 55% at two years. But almost one third of women who do discontinue the implant cite ‘bleeding problems’ as the reason. Healthcare professionals are often unsure what to do when faced with unscheduled bleeding, but help is at hand.
Effective treatment of benign vulval skin diseases
Vulval skin diseases are common after the menopause, but women can often be too embarrassed to seek medical help. This can result in much discomfort and morbidity and, more worryingly, progression to malignancy. However, women can be reassured that treatment is usually simple, well tolerated and highly effective.
Back to Basics: Osteoporosis
Improving early access to abortion
The law allows doctors to perform abortion provided it is done within the legal framework. Although most NHS-funded abortions are now performed at less than 10 weeks gestation, the rate varies considerably between primary care trusts. Extending the role of nurses who provide abortion care would further improve access for women, potentially reducing the already small proportion of late procedures.
