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by James Thomas, Friday, 09 February 2018 | Categories: Womens Health

January 22nd - 28th is Cervical Cancer Prevention Week; a Jo’s Cervical Cancer Trust initiative which this year is focusing on the different ways in which women can take small steps towards reducing their risk. By understanding more about the symptoms of cervical cancer, and its risk factors, Jo’s Trust is hoping to lower cervical cancer rates in the UK through education, knowledge, and simple screening.

What is Cervical Cancer?

Cervical cancer occurs when cancerous cells develop in the cervix, and it’s more common than many people think. In fact, cervical cancer is the 13th most common cancer in women (1), and around 3000 new cases are diagnosed each and every year in the UK (2). Sadly, despite high survival rates – women diagnosed with Stage 1 cervical cancer have an 80-99% 5-year survival rate – 3 women lose their lives to the disease every day (3). Many women don’t realise that they have cervical cancer until a later stage.

Improving Awareness

The Jo’s Trust Cervical Cancer Prevention Week is designed to help women become more aware of the signs and symptoms of the disease. The ultimate aim is to improve awareness of the different ways that women can minimise their risk of developing cancer, and take simple measures to ensure that if they do have the disease, the cancer is diagnosed during the early stages for the highest chance of survival.

Here in the UK, many women are not taking advantage of the available screening methods for cervical cancer. There are a number of screening methods available, but one of the most well known techniques is cervical screening, or the ‘smear’ test. Each year, 5 million women in the UK aged between 25-64 are invited for cervical screening (4), although an estimated 1,250,000 won’t make an appointment (5). These statistics are worrying, as it’s believed that regular smears could prevent 75% of cervical cancer cases.

It’s Time to be Proactive

Cervical Cancer Prevention Week is the perfect time for women to be brave, be proactive, and take control. A good starting point is to learn more about the causes of cervical cancer, and how to reduce risk factors. There are many different aspects that can contribute towards the development of cervical cancer, such as chlamydia, smoking, family history, and the use of oral contraceptives, although 99.7% of cervical cancers are caused by the human papillomavirus infection, or HPV (6), which can affect cells.

HPV isn’t always linked to cervical cancer. In fact, HPV is very common and, in many cases, the body is able to successfully fight off the virus without causing any long lasting damage. However, there are some specific forms of HPV – HPV 16 and HPV 18 – which are present in around 70% of cervical cancer cases (7), suggesting that these are typically ‘high risk’ forms. Fortunately, women can determine if they are considered high risk for these forms of HPV by taking a quick and simple HPV screening test at home.

Sharing Knowledge

The Jo’s Trust campaign is also encouraging women to share their knowledge, and ensure that younger girls are growing up armed with the information they need to help protect themselves from disease. The HPV vaccine is now available on the NHS for free for girls aged between 12 and 18, and protects against 4 different types of HPV: HPV 16 and HPV 18, which are most commonly associated with the development of cervical cancer, along with HPV 6 and HPV 11, which can contribute to genital warts.

Reduce Your Risk

Through small lifestyle changes, such as using condoms and stopping smoking, and through regular screening including quick at-home HPV tests, and NHS cervical screening every 3 years (for women aged 25 - 49) or every 5 years (for women aged 50 - 64), women all across the UK can give themselves the best chance to protect themselves from cancer, or catch the disease early to improve their survival rate.

by James Thomas, Saturday, 06 January 2018 | Categories: Sexual Health

Staying Safe in the Bedroom

Christmas and New Year is a time for revelry and fun, with plenty of food and drink... as well as more private activities. The downside to the increased sexual activity at this time of the year is the corresponding rise in the number of sexually transmitted infections, which then have to be treated in the first few months of the New Year. We are already starting to see an uptick in patients presenting with symptoms of an STI. The most common bacterial sexually transmitted infection encountered by us is chlamydia trachomatis.


Chlamydia is a potentially serious infection that can result in infertility in women, as well as the potentially lethal condition known as ectopic pregnancy, if it is not detected and treated as soon as possible.

Chlamydia will normally take around 14 days to appear in a test result but it can produce a positive result earlier. Any negative result prior to 14 days will need to be repeated at the appropriate juncture.


Not everyone who contracts the chlamydia infection will experience obvious symptoms, and screening tests can be done from self taken vaginal swabs or urine samples. 

If a woman is experiencing urinary symptoms then it is probably a better idea to test for chlamydia with a urine sample, rather than a vaginal swab. Urine samples need to be collected at least two hours after the last time urine was passed to ensure an accurate result. 

Sexually active people below the age of 25 should be tested once a year for the infection or every time they acquire a new sexual partner, or in the event of experiencing any symptoms such as pain during urination, painful sex, abdominal pain, or abnormal discharges or bleeding from the vagina. The rest of us need to be tested when we change sexual partner or experience symptoms.


The good news is that chlamydia can be effectively treated either with a single one gram dose of azithromycin or a twice daily seven day 100 mg course of doxycycline. Both of these treatments come with their own advantages and disadvantages.

Doxycycline should not be used in pregnancy.

Anyone who receives any form of treatment should make sure they are tested again from 6 weeks after treatment commenced, in order to make sure the infection has been cured and to avoid the possibility of false results. 

All recent partners from within the last three months should also be given treatment irrespective of their own chlamydia test results. You and your current partners should be simultaneously treated with antibiotics, while abstaining from sex during treatment, even with a condom. 

Long-term complications from a chlamydia infection are much more likely in people who contract the infection numerous times, so anyone who is infected should take additional precautions in the future, in order to make sure that it does not happen again. The use of condoms is vital, and is the only method to protect against infection – but it is not 100% effective and regular screening is still recommended.

by James Thomas, Friday, 17 November 2017 | Categories: Cialis

The Online Clinic is pleased to announce that we are able to offer a generic version of Cialis at a significantly reduced price.

Tadalafil has been one of the most popular treatments for erectile dysfunction because of its relatively long half-life, allowing men more spontaneity than with other erectile dysfunction treatments. Up until now, we have had to prescribe this medication as Cialis as it was still on patent.

Tadalafil as a generic is only available at the 10 mg and 20 mg (on demand doses). If you are using Cialis as a daily medication then we will still have to prescribe as branded Cialis.

If you are already receiving ED medication from The Online Clinic then you can login to request a review of your treatment. If you have not used us before, you can register below.

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by James Thomas, Thursday, 16 November 2017 | Categories: General Health

Antibiotics: Mixed Messages for Patients

Scientific discoveries are happening all the time, and sometimes a new piece of research will come along to dispel everything we thought we knew.

The most recent debate to crop up regards antibiotic resistance. All approved guidance currently relating to antibiotic use tells us that finishing a course of antibiotics is vital, even if we begin to feel better within a couple of days. Now, experts have begun to argue something very different.

A team of UK researchers published a short opinion piece in the BMJ (formerly the British Medical Journal) in July, claiming that there is not enough evidence to suggest that cutting short a course of antibiotics contributes to antibiotic resistance.

One of the researchers, Professor Martin Llewelyn, suggested that long courses were "outdated" and that there is now plenty of evidence that short courses of three to five days work just as well. In his opinion, antibiotics should be prescribed on a case by case basis, tailored towards each patient and their specific infection, and not simply administered in the same way every single time.

While these researchers are not putting forward the idea that patients be allowed to judge themselves when they stop a course, there is concern amongst the medical community that this sort of guidance could end up causing confusion.

Not enough research has been done into the "stop when you feel better" model of antibiotic use, and for that reason Public Health England has recommended that patients continue to follow the advice of their prescribing doctor.

Correct Antibiotic Use

As well as taking the full course of antibiotics that you have been prescribed (whether or not you begin to feel better before the end of the course), there are a few things you can bear in mind if you wish to avoid contributing to antibiotic resistance.

The first thing to know is that antibiotics are only an appropriate treatment in the case of a bacterial infection. They have no effect upon viral infections. The common cold and flu are two types of viral infection, which cannot be treated with antibiotics. 

If you become unwell with a cold, you may be tempted to visit your doctor and ask for antibiotics, but it is always best to wait the infection out, resting at home and taking over-the-counter cold treatments. You should typically only visit your GP if your cold has not cleared after three weeks, or if the symptoms are getting noticeably worse.

The flu tends to be more serious, and you should visit your doctor if you fall into a certain at-risk group such as being over 65 or pregnant. Bear in mind, however, that antibiotics are not an appropriate treatment for the flu, and that the best way to avoid it if you are in an at-risk group is to get the annual flu jab.

Avoiding Infection

If you want to avoid taking antibiotics, one of the best things you can do is to protect yourself against bacterial infections. You can prevent germs from spreading by following the kinds of hygiene tips set out by the NHS here.

Another way to avoid infection is to always practise safe sex. Many STIs are bacterial, which means they should be treated with antibiotics. The problem is that STIs such as gonorrhoea have begun to develop antibiotic-resistant strains, which can be very difficult to treat.

To avoid STIs, you should always:

  • Use condoms during penetrative sex when you aren’t sure your partner is free from infection
  • Use dental dams and condoms during oral sex
  • Avoid sharing sex toys unless they have been cleaned or covered in a new condom

You can read more about the risks associated with specific sexual activities here.

Remember that it’s important to get tested regularly if you’re engaging in any risky sexual behaviours. Getting diagnosed early makes treatment easier and reduces the risk of complications; it will also stop you from passing the infection on to others.

by James Thomas, Thursday, 16 November 2017 | Categories: Mens Health

What Men Need to Know About Prostate Cancer

Since 2003, the Movember Foundation has spent the eleventh month of every year raising awareness for a variety of men’s health issues. In that time, over £400 million has been raised and gone into the funding of over 1,000 different projects looking into issues such as testicular cancer, mental health and prostate cancer.

Prostate cancer is the most common cancer in men in the UK; around 40,000 new diagnoses are made every single year. Though the survival rate for prostate cancer is good (around 84% of men will survive for ten years or more), it’s still a huge health concern for British men. Diagnosis can often be delayed for many years, as symptoms do not always develop in the disease’s early stages, and those who survive can be affected by a number of unpleasant side effects.

In honour of Men’s Health Awareness Month, we’ve put together a guide to prostate cancer. If you’re concerned about your prostate health, or the prostate health of someone you love, read on.

The Causes of Prostate Cancer

No one precise cause for prostate cancer has been established, but there are some risk factors to be aware of. These include:

  • Age: the older you get, the more likely you are to develop prostate cancer (most cases occur in the over-50s)
  • Family history: having close family members who suffered from prostate cancer can be a risk factor
  • Ethnicity: if you are of Afro-Caribbean or African descent, you have an increased likelihood of developing prostate cancer
  • Lifestyle: if you are obese and/or you don’t exercise regularly you are more likely to develop prostate cancer

Lowering your Risk of Prostate Cancer

While you cannot alter your age, family history or ethnicity, knowing that you are high-risk for prostate cancer will typically help with early diagnosis (in the event that you develop the disease).

Men who are not of African descent and who have no family history of prostate cancer may want to speak to their GP about their risk once they hit 50. Men who are of African descent, or who have a family history of prostate cancer, should usually start to talk to a doctor about their risk a few years earlier – normally at around 45. Early diagnosis will usually make treatment easier and more successful.

To mitigate your risk you can also try practising a healthy lifestyle. Try to take regular exercise (the NHS recommends 2.5 hours of moderate exercise, or 75 minutes of more vigorous exercise a week, as well as strength exercises two days a week) and eat a healthy, balanced diet that is low in saturated fat, sugar and salt.

Symptoms of Prostate Cancer

Prostate cancer doesn’t always cause symptoms in its early stages, but it’s still a good idea to familiarise yourself with some of the indications of the disease. Symptoms can include:

  • Needing to urinate more frequently, particularly during the night
  • Difficulty in beginning to urinate, and maintaining urination
  • Weak flow of urine
  • Feeling that your bladder has not totally emptied when you have finished urinating

These symptoms do not necessarily point to cancer – many men experiencing trouble urinating as they get older, often as a result of benign enlargement of the prostate – but it's worth visiting a doctor.

When prostate cancer spreads it can cause other symptoms such as loss of appetite, testicular pain, unexplained weight loss, and pain in the back. Again, none of these symptoms is specific to prostate cancer, but you should visit your doctor if you are experiencing any of them.

Diagnosing and Living With Prostate Cancer

Diagnosing prostate cancer can be tricky, and normally involves a few different tests. You will usually have to give a urine sample, a blood sample, and have your prostate examined by the doctor.

Treatment will depend upon the nature of the cancer, and your age and general health. In some cases, living with prostate cancer will require the treatment of the disease’s side effects.

The good news is that our understanding of prostate cancer is improving all the time, and that there are many resources available to support men with the disease. Learn more by visiting Prostate Cancer UK or talking to your doctor.

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