Welcome to the brave new world of the NHS, or is it back to the future? GPs are to be the lynchpins of the health service, again taking charge of local budgets and deciding which services – both community and hospital – to fund.
Editorial
Nexplanon: the next step for the contraceptive implant
The contraceptive implant Implanon was introduced into the UK in 1999, and has proved itself over the last 11 years, with over 280,000 insertions last year. Careful insertion technique is important to avoid difficulties with removal, but the risk of these problems should be
Taking a positive approach to fibromyalgia
Adiagnosis of fibromyalgia on a patient’s record will immediately produce a negative reaction in health professionals whom they meet for the first time. This reflects the difficulty in managing some of these patients. But most people with fibromyalgia benefit from a clear explanation of their symptoms and a management plan.
Promoting contraceptive choice in the south Asian community
Lack of awareness of contraceptive choices has fuelled rising abortion rates among women of Asian heritage. By engaging and empowering women themselves and developing community partnerships, one PCT has increased the take-up of long-acting reversible contraception (LARC) and reduced the number of abortions.
Back to Basics: Causes of vaginal discharge
Why is there such a fuss about chlamydia?
At first sight it is difficult to understand the controversy about chlamydia. It is the commonest sexually transmitted bacterial infection. It is easy to acquire. If untreated, it can have devastating consequences. There is an easy test for it, and effective treatment. But there are important reasons why screening has become such a controversial issue.
Could she have painful bladder syndrome?
How many times have you been to the toilet today? Where’s the nearest toilet? Why does it always hurt when I need the toilet? These questions are all too familiar to patients with painful bladder syndrome (PBS). By considering the condition when women present with bladder symptoms, GPs and practice nurses can ensure prompt referral for appropriate treatment.
Sexual problems in women
A consultation in which a woman reveals a sexual problem can be challenging for her GP or practice nurse. But a sympathetic and systematic approach to history and examination usually reveals the likely source of the problem and the right approach to appropriate treatment.
Heavy menstrual bleeding: no need for hang-ups in primary care
Clinical guidelines and technological advances mean that most women with heavy menstrual bleeding (HMB) could be managed outside hospital. One primary care trust has developed a patient pathway, based on a unique primary care service that offers hysteroscopic diagnostic and treatment procedures, including endometrial ablation under local anaesthesia.
Endometriosis
Endometrial ablation: the right choice for the right patient
p>About one in five women suffers from reduced quality of life due to heavy menstrual bleeding (HMB). Many patients choose and respond to first-line treatment, but for others endometrial ablation may be a more appropriate option. The author discusses patient selection, and advises on post-discharge management in primary care.
More than a headache: managing migraine in women
Migraine is over twice as common in women as in men. In most cases, management is identical regardless of the patient’s gender, but there are a number of additional issues to consider when managing women presenting with this debilitating condition.
