Making Best Practice, Every Day Practice
This resource is fully searchable using the search box at the top of the page, or to narrow down your selection using filters click on 'Knowledge hub' in the main navigation.
This resource provides access to informative articles on the broad spectrum of obstetric and gynaecological issues managed in primary care including sexual and reproductive health.
These materials cover some of the most important topics in daily care including:
Contraception across different age groups
Early detection of gynaecological cancers
Pre-menstrual syndromes
Use of testosterone
Menstruation and abnormal uterine bleeding
Fertility treatment
and much more.
A 40-year-old woman with hot flushes, tearfulness and low libido could be going through early menopause. But there might be other explanations for her symptoms, and a careful history and investigation are essential to ensure that she receives the right treatment.
Hormone replacement therapy (HRT) is the most effective treatment for menopausal symptoms, but bad publicity means that women ask about other options. This article outlines practical steps to help to minimise mild symptoms, and assesses the evidence for complementary and prescribed alternatives to HRT.
For too long a Cinderella condition, osteoporosis has only recently been included in the GP contract as a Directed Enhanced Service. This article explains how the new FRAX tool can help practices to individualise risk assessment and target treatment to the patients most at risk.
All too many women with urinary incontinence are referred to secondary care when they could be assessed and successfully treated by their GP, practice nurse or local primary care continence advisor. This article explains how one PCT introduced a local pathway that has changed professional behaviour, and proved popular with both professionals and patients.
Despite NICE guidelines, long-acting reversible contraceptives (LARCs) remain little used in the UK, but this looks set to change with their inclusion in this year’s new Quality and Outcomes Framework contraception indicators. The author reviews the currently available LARCs, and discusses how to tailor choice to the needs and preferences of each woman.
In order to comply with NICE guidance and achieve new QOF indicators, general practices must offer women a choice of contraception, including long-acting reversible methods. But practices may struggle if GPs have not maintained their competencies in fitting these devices. The author explains how nurse-led clinics can both enhance services for women and help practices achieve targets.
A woman with faecal incontinence may have suffered for years before she finds the courage to ask for help. Such consultations can be a challenge for both patient and professional. But sensitive, careful assessment and simple, conservative measures will often improve bowel control and restore the patient’s quality of life
In our Contraception and Sexual Health service, we continue to receive a small but steady stream of GP referrals requesting a change of intrauterine device (IUCD) or intrauterine system (IUS) for women with actinomyces-like organisms (ALOs) on their cervical smear report. All of the women have been asymptomatic and happy with their IUCD/IUS. It is time that we cleared up continuing confusion about the implications of colonisation with ALOs to protect women from unnecessary and potentially harmful changes of contraceptive device.
Sexual assault is common. All sections of society are affected, and victims may be men, women or children. Patients attending primary care may have no intention of reporting their assault to the police. But a trusted GP or practice nurse can ensure that victims receive appropriate specialist care through local Sexual Assault Referral Centres (SARCs).
While many women are anxious about starting hormone replacement therapy (HRT), practitioners who regularly see and advise women about menopause increasingly have to address the issue of when to stop HRT. Is there a time when HRT suddenly becomes dangerous? If so, at what age? 58? 60? 70? And what about the woman who is adamant she does not want to stop?
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