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by James Thomas, Saturday, 10 September 2016 | Categories: General Health

Who handles pain better, women or men? This simple question is hotly debated in the medical community and, indeed, many social circles. There’s the argument that women naturally handle pain better, because they have to experience menstrual cramps and childbirth. This is fairly convincing until you consider the fact that in a recent study of 11,000 patients, women were consistently found to have elevated clinical pain scores in comparison to men.

Pain is, of course, a totally subjective thing, and there are many different factors that must be called into account when examining the way one person handles it. A man may understate the severity of his pain in an attempt to seem more masculine. Two women may experience the same injury, but experience it differently due to one of them living with a pre-existing condition that causes chronic pain.

What is undeniable is that, for doctors, fairly evaluating a patient’s pain level is no easy task. And if recent reports are anything to go by, this is leading to unfair treatment of female patients. According to research carried out over the past few years, women’s pain is – by and large – taken less seriously than men’s. Abdominal pain is just one instance where men and women are treated very differently, with men waiting an average of 49 minutes in A&E and women an average of 65 minutes.

Some may argue that doctors are more likely to downplay abdominal pain in women, because they make the assumption it is related to menstrual cramps (which are agonising but otherwise harmless). But in this worrying story penned by journalist Joe Fassler, we see an example of a potentially life-threatening condition ignored by hospital doctors and nurses for many hours. Recently, coverage of endometriosis – a condition in which cells similar to those in the womb lining grow outside of the uterus – has also revealed how women suffering with this debilitating condition are often dismissed by doctors.

Regardless of what pain may indicate, it’s important as a patient to feel as though your suffering is acknowledged and understood. The question is: how should women go about seeking medical help for pain when doctors are more likely to dismiss it?

What to Do If You’re Experiencing Pain

The hard and fast rule for any health-related issue is to trust your instincts. If you begin to experience pain that you have never felt before and that doesn’t go away on its own, it is always worth seeking medical help.

There are also certain symptoms that, according to medical advice, should never be ignored. These include:

  • A sudden, severe headache, especially if it is accompanied by visual aura. This could indicate a number of acute conditions that require immediate medical attention.
  • Bad toothache where the tooth throbs or twinges. If left untreated, a damaged nerve can become infected, and this infection can spread through the body causing serious complications.
  • Severe, stabbing abdominal pain that travels to your lower right-hand side and becomes worse as time goes on. This could indicate appendicitis, but it could also be a sign of an ovarian cyst. In either case, do not ignore the pain.
  • Constant back pain and numb feet. This is an indication of a problem in the spine, caused by a spinal disc slipping or rupturing and pressing on the spinal nerves.
  • Chest pain, shortness of breath and a feeling of tightness or pressure in the chest. This can indicate a heart attack.

Living with Chronic Pain

In some cases, pain is not something that requires urgent medical treatment. For people who suffer from conditions that cause chronic pain, it’s simply a part of everyday life.

There are many different ways of managing chronic pain, but some things that are known to help include exercise, physical therapy and painkillers. The psychological aspect of chronic pain can also be very damaging; for that reason, it’s advised that you try and live as normal a lifestyle as possible. Staying in work, continuing to see friends, and making sure you leave the house every day are all key to maintaining a positive outlook.

The NHS has further resources dedicated to living with pain, which you can explore here. Otherwise, speak to your GP or visit The Online Clinic’s Pain Management centre, where you can learn more about managing pain and request safe prescription painkillers.

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by James Thomas, Saturday, 10 September 2016 | Categories: Womens Health

Emergency contraception is something that most sexually active heterosexual women end up using at least once in their life. No matter how well prepared we are, accidents happen; whether it’s a condom splitting or slipping off, a missed pill, or simply getting caught up in the heat of the moment.

The good news is that the morning after pill and the emergency IUD (coil) are now widely available in the UK from NHS centres, private clinics and high street pharmacies.

In a shocking turn of events, though, the most popular form of emergency contraception has been challenged by a new study, which claims that the morning after pill Levonelle is ineffective in women over a certain weight. Recent research by an American university has shown that emergency contraception containing levonorgestrel (the active ingredient in Levonelle) is less effective in women considered obese. More specifically, the amount of levonorgestrel in their bloodstream after taking the morning after pill was 50% lower than in women of a healthy weight.

The woman leading the study, Alison Edelman, spoke to Women’s Health about her findings, and discussed how doubling the dose of levonorgestrel for obese women seemed to be an effective solution to this problem. However, she felt she could not recommend this as an appropriate course of action until further research was carried out.

Misleading Information

While this new research is cause for concern, it’s important to bear a few things in mind. First of all, this study only looked at ten women – a very small sample size. Secondly, many press outlets are conflating Edelman’s results with an entirely different story which originated in 2013.

Three years ago, European morning after pill Norlevo hit headlines when it released packs printed with a new warning. According to this warning, Norlevo (which contains the same dosage of levonorgestrel as Levonelle) was:

  • Less effective for women weighing 75kg (165 pounds/11st 11lb)
  • Ineffective for women weighing over 80kg (176 pounds/12st 8lb)

This warning was later removed from packs, following advice from the European Medicines Agency which found that: "the data was [sic] not robust enough to conclude with certainty that contraceptive effect is reduced with increased bodyweight".

Despite this retraction, many press outlets reporting on Edelman’s research have incorporated Norlevo’s statistics into their stories – presumably in a bid to create better headlines! In actual fact, the weights suggested by Norlevo would not indicate obesity in the average woman.

Using the NHS BMI calculator, you’ll find that a 25-year-old woman who is 5’5’’ tall, weighs 165 pounds (11st 11lb) and is moderately active has a BMI of 27.4. This puts her firmly in the category of overweight – but not obese. Even a woman weighing 176 pounds (12st 8lb), who is similarly 5’5’’ tall and moderately active, has a BMI of 29.2. This is still classed as overweight, and is only just on the cusp of clinical obesity.

If Edelman’s research is to be trusted, a woman would have to have a BMI of over 30 for the morning after pill to be ineffective. Coupled with the other characteristics listed above, that works out to a weight of 181 pounds (12st 13lb).

Is it still safe to take the morning after pill?

Yes, it is still safe to take the Levonelle morning after pill as a means of preventing pregnancy. If you have had unprotected sex and you do not want to get pregnant, it is still better to use Levonelle than nothing at all – even if you are overweight. However, if your BMI does place you in the category of obese, and you are concerned that Levonelle may not work, you can always speak to a doctor about using an alternative form of emergency contraception.

There is currently no evidence to suggest that the efficacy of the morning after pill EllaOne is affected by weight. Unlike Levonelle, EllaOne can be taken up to five days after unprotected sex (Levonelle only has a window of three days).

You can also have the emergency IUD (coil) fitted up to five days after unprotected sex. This can only be done by a medical professional, but it is free from NHS clinics.




by James Thomas, Thursday, 21 July 2016 | Categories: Smoking

Is There Really an "Easy Way" to Stop Smoking?

It’s a question that thousands of smokers around the world ask themselves every day: Is there an easy way to stop smoking? Something that will prevent withdrawal symptoms and eliminate all those pesky cravings?

The short answer is no – but that doesn’t mean you should lose hope. Quitting smoking is a complex process that differs hugely from person to person, and how difficult you find it depends upon factors that include how much you smoke, and what kind of lifestyle you live.

Today, many "stop smoking" treatments are available – as well as other options, which are not treatments as such, like e-cigarettes. And unsurprisingly, all have been subject to various criticisms from both users trying to quit and the medical community trying to protect their health.

The E-Cigarette Argument

There’s been a great deal of controversy surrounding the safety of e-cigarettes. In 2014, the World Health Organization called for e-cigarettes to be banned indoors and advised that manufacturers not be allowed to market their devices as smoking cessation aids. But then last year, Public Health England declared that e-cigarettes were 95% safer than regular cigarettes, and recommended that the UK’s eight million smokers switch over to vaping.

Unsurprisingly, this was met with criticism, and earlier this year the British Medical Association echoed the advice of the WHO by recommending that vaping be banned indoors, a statement that has in turn been criticised by tobacco control experts keen to encourage smokers to quit.

Like any hot issue under debate by the medical community, the discussion around e-cigarettes is unlikely to die down for some time – and until more studies are carried out into the long-term effects of vaping on our health, we won’t have any firm answers about whether or not it’s a safe alternative.

Smoking Cessation Treatments Approved by the NHS

If you’re looking to quit smoking but you feel dubious about using e-cigarettes there are some other ways to kick-start the process.

*Nicotine Replacement Therapy*

Nicotine replacement therapy (or NRT) is available over the counter in any high street pharmacy. As most of us are aware, the addictive ingredient in cigarettes is nicotine; by substituting cigarettes with skin patches, chewing gum, inhalators, tablets or sprays that contain nicotine (but none of the other poisonous chemicals) you can start to break your smoking habit.

Taking nicotine replacement therapy regularly after you stop smoking helps to minimise cravings and withdrawal symptoms, and allows your body to adjust slowly. Normally NRT lasts eight to 12 weeks before the dose of nicotine is reduced, allowing you to wean yourself off.

Champix and Zyban

Two other stop smoking treatments are Zyban and Champix. Both these medicines come in the form of a tablet, taken daily, and work by breaking down your addiction to nicotine.

It is not completely understood how Zyban works; however, Champix is known to prevent nicotine from binding to the parts of the brain that respond to it. This helps to slowly diminish the pleasant "reward" feeling you get from smoking.

For treatment with Zyban or Champix to work, you should start taking your tablets seven to 14 days before you quit smoking. A full course of Zyban normally lasts for seven to nine weeks, and a full course of Champix normally lasts 12 weeks – however, further courses can be prescribed if you are at risk of starting smoking again.

The Online Clinic does not prescribe Zyban.

Additional Stop Smoking Tips

Other tips that can help you quit for good include:

  • Downloading a "quit smoking" app to your phone that keeps track of your progress
  • Avoiding foods that make cigarettes taste good when you’re having a craving (that means swapping out meat for cheese, fruit and vegetables)
  • Avoiding drinks that make cigarettes taste better when you’re having a craving (that means avoiding fizzy drinks, alcohol and caffeine – sorry!)
  • Creating an action plan for dealing with your worst cravings
  • Exercising to combat cravings, withdrawal symptoms and low moods

Lastly, remember that asking for help is the best way to stop smoking for good – according to the NHS, smokers are four times more likely to quit if they use NHS services and resources.

You can also start your smoking cessation journey by requesting a prescription for Champix tablets through The Online Clinic. Click here to find out more.

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by James Thomas, Wednesday, 20 July 2016 | Categories: General Health

Listen Up: Tips for Ear Health!

Our ears are incredibly important to our everyday lives yet caring for their health often seems to be little more than an afterthought for many people. The good news is that it is not difficult to take a little extra time to make sure you are caring for your ears in the correct manner.

Cleaning ears

It is important that you take extra special care when you are cleaning your ears. You should use a tissue or a gentle washcloth to wipe the outside of the ear, and nothing smaller than an elbow should be placed inside your ear! Cotton buds or any kind of pointed, sharp object should not be used to clean out your ears as they can injure the eardrum or ear canal.

The ear has its own mechanism for cleaning itself in the form of ear wax but if your hearing is being blocked by a wax build-up then you should see your doctor in order to have it professionally removed. If your ears begin hurting or itching go to your doctor to find the best treatment method; you may need to be referred to a specialist in some situations. People with pierced ears should regularly use rubbing alcohol to clean both the earrings and their earlobes.

Illnesses and medicines

Ears can suffer illnesses and infections just like any other part of the human anatomy, and need to be treated by a health professional. Treating infections of the upper respiratory system in a prompt manner, however, can help with cutting down on the risk of developing an ear infection.

There are a number of medical conditions and illnesses that can have an impact on your hearing, so see your doctor immediately if you suddenly experience a loss of hearing or endure a constant noise in your head or ears. Ear drainage is abnormal and often indicative of some kind of infection, so consult a healthcare professional as soon as you can.

Hearing can also be affected by some medicines, so be sure to take them only as directed and visit your GP if you are experiencing ringing in the ears, balance problems or any kind of unusual hearing.

Noise issues

If you are going to be exposed to loud noise levels at work or at home, such as when using power tools, a lawn mower or leaf blower, then you need to wear protection. Noisy work environments require hearing protection by law. Hearing is not protected by the use of ear buds and it can actually be dangerous to your hearing to listen to music while using power tools. High volume levels should also be avoided with home theatre systems, stereos and any kind of personal sound system. If you are going out to a motor sport event, nightclub or rock concert, you should wear earplugs.

Safety

If you engage in activities that put your head and ears at risk of injury, such as biking, skiing or rollerblading, you should always make sure to wear a helmet. If you're taking a flight, then you should yawn and swallow continually when the plane is in ascent or descent in order to equalise the pressure in your ears. If you have a sinus infection or cold, then you can consume a decongestant a couple of hours prior to descent or make use of a decongestant spray before descent and landing.

General ear care tips

Your doctor should give your ears a check-up on a regular basis. A sunscreen needs to be used on your ears in sunny weather as it does with any other exposed area of your body. Consult a doctor if you find any scaly areas or strange bumps on the exterior of your ear.

Finally, it is also a good idea to be aware of some things that can be warning signs for hearing loss; these include:

  • Difficulty in hearing conversations, particularly when there is background noise
  • Misunderstanding other people and making inappropriate responses
  • Needing the television to be louder than is preferred by others in the room
  • Noise within the ear not the result of external sources



by Robert MacKay, Saturday, 18 June 2016 | Categories: Migraine

Migraine Information for Women (and Men!)

Everyone experiences a bad headache now and then – whether it’s caused by dehydration, a bad cold or just a little too much weekend indulgence. But for one in every five women, and one in every 15 men in the UK, that headache comes in the form of a migraine and is accompanied by intense pain, vomiting and even visual hallucinations. With such symptoms, daily life can become incredibly challenging.

Though it’s not known precisely what causes migraines, the condition is more common in women. Hormonal changes related to oestrogen levels in the body have long been recognised as significant, as many women experience migraine onset around the time of their period or find that their symptoms alter after menopause. Recent research has helped to cement this theory, with one study finding that in women who suffer from migraines, oestrogen levels drop more rapidly than usual at the start of their menstrual cycle.

This is significant, because plunging oestrogen levels before menstruation already contribute to mood swings and other unpleasant premenstrual symptoms. Oestrogen levels falling more rapidly could worsen symptoms such as stress and lack of sleep, in turn leading to migraine-triggering habits like eating unhealthy foods and drinking alcohol.

In simple terms, what the study points to is a "two-hit" process, whereby women who already suffer from migraines have their condition exacerbated by their rapidly falling oestrogen levels.

The good news is that there are ways to combat the unpleasant symptoms of a migraine. But the first step towards treatment is understanding a little more about its causes and symptoms.

What causes a migraine?

As we've seen, the exact causes of migraine are still unknown. However, research in recent years has seemed to confirm that genes play a role.

If you are susceptible to migraines, it’s important to understand that they can be triggered by many things. These including hormonal changes as discussed above. Other common triggers include emotional stress (anxiety, shock, depression) and physical strain (lack of sleep, tiredness, tension in the neck and shoulders, poor posture, strenuous exercise, low blood sugar).

Dietary decisions and lifestyle choices can also play a part in the onset of a migraine. Caffeine, chocolate, citrus fruit, cheese and certain additives are known to be triggers, as are smoky, stuffy or loud environments. For a more comprehensive guide to migraine triggers, click here.

What are the symptoms of a migraine?

A migraine can be defined as a very intense, painful headache lasting for up to three days. However, there are some specific symptoms, which differentiate it from a normal headache. The most distinctive is that the pain occurs on one side of the head and is accompanied by a strong throbbing sensation.

Other symptoms that commonly occur with a migraine are:

  • pain in the neck or face
  • nausea
  • vomiting
  • sensitivity to bright lights and loud noises
  • sweating
  • difficulty concentrating
  • feeling very hot or cold
  • stomach pain
  • diarrhoea

You may also experience what is known as "aura" before your migraine begins. This is where you experience a series of visual hallucinations such as flashing lights and patterns, along with feelings of confusion, dizziness and tingling. Some people experience aura without the accompanying headache.

In many cases, a migraine will develop in four stages. In the first stage, which will start a few days or hours before the headache begins, you might experience changes in mood, behaviour and appetite. After this may follow aura, as described above, and then the headache itself. The fourth stage marks the end of the migraine – a recovery period in which you may feel tired for a couple of days.

How is a migraine treated?

Unfortunately there is no cure-all treatment for migraines. However, there are a number of targeted painkillers that can help to ease the discomfort. Many people find that over-the-counter painkillers such as ibuprofen and paracetamol are sufficient. However, others will require prescription medicine. Common prescription treatments are triptans (painkillers) and anti-sickness medication.

If you suffer from migraines and are seeking effective medication from a trusted online source, consider making an order from The Online Clinic. Find out more about our migraine medicines and how our secure prescription service works, by clicking here.





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