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.
Each year 2,500 women with epilepsy have a baby, and before they conceive only 46% are aware that their condition could affect their unborn child. It is essential to encourage women with epilepsy to think about contraception, conception and pregnancy, and the Quality and Outcomes Framework (QOF) now includes an indicator for these very issues.
Recommendations from the National Institute for Health and Clinical Excellence (NICE) aim to prompt rapid investigation of women with patterns of symptoms suggestive of ovarian cancer. But this is just one of a plethora of guidance for primary care, and incorporating it into our daily practice remains challenging. So how should we apply the NICE ovarian cancer guidelines to our patients?
Increasing numbers of healthy women are asking their GPs to refer them for labial reduction. This does not just have potentially important cost implications for service commissioners. There are also considerable ethical issues for GPs to consider before referring women for this form of female genital cosmetic surgery.
In these uncertain times for contraception and sexual health services, the voice of the Primary Care Women’s Health Forum is becoming ever more important. We have been very active in formulating our latest plans, so that we can respond to our members’ concerns and ensure that we protect services for women.
As obesity rates continue to soar in women of reproductive age, gestational diabetes mellitus (GDM) is an increasingly important and prevalent problem. Appropriate recognition and careful management of GDM are essential. This will not only improve the outcomes of pregnancy, but may also have a beneficial effect on a woman’s lifelong risk of developing type 2 diabetes.
A heartfelt, if belated, welcome to 2012. It can be difficult to feel positive at this time of year. The Christmas and New Year celebrations are well in the past, the waiting room is full of patients with coughs and colds, and it can seem a long time until summer. The next few months are likely to seem especially depressing this year given the gloomy economic outlook, but there is still a lot to look forward to in 2012.
The levonorgestrel-releasing intrauterine system (LNG-IUS; Mirena) was first licensed in the UK for contraception in 1995. But it soon became evident that it had other clinical advantages and the LNG-IUS is now also available for the prevention of endometrial hyperplasia in women who are taking oestrogen as part of hormone replacement therapy (HRT).
Traditionally, older women and men have not been seen as being at risk of acquiring sexually transmitted infections (STIs), and have not been considered by policy makers. But infection rates are rising at a time of NHS changes, including the proposed transfer of responsibility for sexual health promotion to local authorities. Significant new resources are unlikely, so we need to think creatively about how to respond to this worrying trend.
Non-menstrual bleeding is alarming for women, and is a frequent reason for a consultation with a health professional. There are many potential explanations. Most are benign, but some are potentially very serious. So a careful history and assessment are essential when a woman presents with post-coital, intermenstrual or postmenopausal bleeding.
Ovarian cysts are found in women and girls of all ages. They are usually asymptomatic, and most are benign and transient. Testing for tumour markers and risk of malignancy indices may help to predict the possibility of cancer, but imaging on ultrasound (US) remains the primary method of evaluating ovarian cysts.
Most women experience occasional pelvic pain, but sometimes the symptom is so severe that it prompts them to seek medical help. Causes of acute pelvic pain in women are many, and can range in severity from a normal physiological event to a life-threatening illness. This article explains how to identify patients with the ‘red flag’ conditions that require urgent hospitalisation.
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