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.
Colposcopy – detailed examination of the cervix under magnification – remains the standard assessment tool for cervical abnormalities found on screening. An invitation to attend the colposcopy clinic can cause anxiety, but women can be reassured that it is a safe procedure and that many problems can be treated in just one visit.
It looks like it is going to be a long hard winter. The media have already been reporting restrictions on referrals and rising waiting times. It is likely that things can only get worse given the pressures on primary care trusts and local authorities. At times of economic stringency, women’s sexual and reproductive health can seem an easy target. But this is short-sighted and probably not costeffective given the UK’s high rates of teenage pregnancy and sexually transmitted infections. It is time for an approach to service configuration that goes beyond knee-jerk slash and burn.
Getting people to act on advice is a continuing challenge for health professionals, particularly in the self-management of chronic conditions. In this article, we explore why men are less likely than women to fully engage with their own health needs and what health professionals can do to help men get better at this. Using the behavioural theory of communication – the Theory of Primitive Concerns – we will look at how different responses to risk – with women typically being risk-averse and men being risk-seeking – mean they respond differently to two alternative styles of clinical instruction based on using ‘power language’ and ‘safety language’. The theory is that we can help men to look after their own health by using language that matches their attitude to risk and presents self-care in a more powerful way.
This supplement is supported by Consilient Health Ltd on behalf of whom this Expert Working Group was convened and funded. Consilient Health Ltd also provided a framework for the discussion.
This supplement was developed in conjunction with and its production paid for by Merck Sharp & Dohme Limited.
The Department of Health certainly gave us all something to think about over the Christmas break and well into the New Year. In the middle of last December, Secretary of State Andrew Lansley confirmed that the Coalition Government is pressing ahead with its radical structural changes to the NHS in England.1 This was despite concerns by professional and patient organisations, and indeed the House of Commons Select Committee,2 about the feasibility of introducing major reforms when the NHS is under increasing financial pressures.
Vulvovaginal candidiasis, or thrush, is very common, affecting 50-75% of women during their lifetimes. About half of women who experience an episode will suffer a further attack and 5% will develop recurrent disease. Recurrent episodes are associated with depression and loss of libido, but a combination of lifestyle advice and antifungal treatment should control symptoms for most women.
Think of a disease in which diagnostic delay may kill the patient, yet early diagnosis is extremely difficult. Add that the disease is quite rare, and symptoms mimic much more common benign conditions. If that is not tough enough, screening has not (yet) been shown to be helpful, and the primary diagnostic test is quite specialised. Does this add up to a problem? Of course it does, and the diagnostic nightmare is ovarian cancer.
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.
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.
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