Making Best Practice, Every Day Practice
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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.
Until recently, there were two options for emergency contraception after unprotected sex or contraceptive failure: an oral progestogen-only tablet, and the copper-containing intrauterine device. These have now been joined by a new oral method, and this article reviews the three options in light of changing guidance on emergency contraception.
The NHS Cervical Screening Programme is universally lauded as a success story, preventing an estimated 2,000 deaths a year from cervical cancer in the UK. The programme continues to be refined in light of new evidence, and the latest development is the introduction of human papilloma virus (HPV) testing alongside cytology.
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).
Thanks to effective treatment, people with HIV are living longer than ever. Older people are now the fastest growing group with HIV in the UK, and as many as one in five adults accessing care is now aged over 50 years. But treatment does not mean cure, and a targeted approach to support is needed, as well as action to halt the growing numbers of older women and men affected by HIV.
The birth of a new baby is usually seen as a cause for celebration. But following delivery, a woman has a greater likelihood of psychiatric admission to hospital than at any other point in her life. This is often due to puerperal psychosis, a serious mental illness requiring prompt recognition and medical treatment. Primary care professionals are well placed to identify early symptoms to minimise risks to mother and baby.
Chronic obstructive pulmonary disease (COPD) is a largely preventable, slowly progressive, inflammatory disease. Rates of COPD are rising faster in women than in men, yet women are less likely to be diagnosed. There is currently no cure, but best-practice management outlined in recently updated NICE guidelines can help to improve patients’ symptoms and quality of life.
Many advanced nurse practitioners (ANPs) are working in innovative ways to enhance patient care in general practice. But little specific training has been available for ANPs in women’s health. This article outlines how a training course was developed specifically to improve and maintain local ANPs’ competencies in managing women’s health in primary care.
Many primary care clinicians worry about how to take an appropriate sexual history. Raising the issue seems straightforward when a woman has symptoms or when contraception or cervical screening feature in a consultation. The challenge occurs when the possibility of sexual health issues may not be so apparent to the patient.
The intrauterine system (IUS) is a very effective long-acting reversible contraceptive (LARC) for appropriate women. But myths and misconceptions may cause some patients to opt for other, less reliable or suitable methods. Addressing frequently asked questions will help GPs to prescribe with confidence and enable women to make informed decisions about their contraception.
The Primary Care Women’s Health Forum is now over one year old. When we met to establish the Forum, we set ourselves several aims and objectives. As we celebrate our first anniversary, our membership continues to grow and we are beginning to deliver on our major objectives: to be the voice for women and improve their healthcare.
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