World Contraception Day

World Contraception Day is an international campaign day launched ten years ago by the European Society of Contraception (ESC). The ESC was concerned that the high number of unplanned teenage pregnancies and the rate at which young people were being infected with Sexually Transmitted Infections (STIs) because they were not taking steps to protect themselves during sex.

World Contraception Day has the support of 16 Non-Governmental Organisations, medical and scientific bodies and governmental organisations from around the world. The day aims to improve young people’s awareness of the various methods of contraception available to empower them so they can make an informed choice when it comes to their reproductive and sexual health.

Since it was founded in 2007, the Your Life campaign has encouraged young people around the globe to talk more openly about sex, contraception and protection against sexually transmitted diseases. The various educational and scientific events, which are held in over 70 countries, as well as online, have reached an estimated 110 million people.

In order to spread the message about safe sex, 10 World Contraception Day Ambassadors have been appointed as part of a 3-year project with Women Deliver, a leading global advocate for the health, rights and well-being of girls and women. These ambassadors are young people from around the world. Each ambassador will tell their own story so they can offer a unique perspective on what it means to be a young person seeking information about sexual health and reproduction in their local communities.

Unplanned pregnancies are a serious public health issue. It's estimated that 225 million women who would like to prevent pregnancy do not use an effective method of contraception.

To celebrate World Contraception Day, here is a quick guide to the various types of contraception, which are available. 

Non-hormonal Contraception

Non-hormonal methods of contraception usually take the form of a barrier, which is placed between the sperm and the ova. The forms of non-hormonal contraception, which are currently available are:

• Condoms
• IUD coil
• Diaphragm
• Cervical cap

Hormonal Contraception

Hormonal contraception - commonly referred to as "the pill" alters the hormonal balance of the female body to suppress ovulation. There are two forms of hormonal contraception. 

Progestogen-only Method

The progestogen-only pill causes the cervical mucus to thicken and prevents the ova from attaching itself to the lining of the uterus.

The Combined Method

The combined pill contains the hormones oestrogen and progestogen. While the progestogen thickens the cervical mucus, the oestrogen suppresses the release of the ova.

Hormonal Patches and Implants

If you do not want to worry about taking a pill every day, you may wish to opt for a hormonal patch or implant. Hormonal patches are applied to the skin once a week and have the same effect as oral contraceptives.

A birth control implant is a small plastic rod, which is implanted under the skin in your arm. The implant will slowly release hormones into your body to prevent you from becoming pregnant. Implants are a long-term solution, which can last up to 3 years.

It is important to remember that birth control methods will not protect you from sexually transmitted infections. The only effective protection against STI is to use a condom.

You can learn more about contraception and safe sex by visiting The Online Clinic.

The term cystitis is used to describe a bladder inflammation, generally caused by a UTI or urinary tract infection. It's a common mistake to believe that only women can get cystitis; in fact, men are also able to develop it. The likelihood of cystitis in men is lower for one simple reason – the relative length of the urethra in men and women. In women, the potential transfer of bacteria into the urethra is made easier as the opening of the urethra is closer to the anus. This is not the only possible cause of cystitis, but it does explain the varying rates of the condition.

The condition known as interstitial cystitis, however, is somewhat different, both in terms of symptoms and of possible treatments. The main symptoms include a sensation of pain in the bladder (it's sometimes known as bladder pain syndrome, or IC/BPS) but without a clearly identifiable infection, as might be expected with cystitis. Pain like this is experienced in the lower abdomen, and is coupled with unusually frequent, strong urges to urinate. These symptoms may come and go in cycles over a few months.

The differences between cystitis and IC have led some researchers to believe that the condition is misleadingly named, and in fact the exact causes of IC are the subject of debate. Allergies have been suggested as a possible cause, as well as problems with the lining of the bladder or the pelvic floor muscles. It's also possible that IC may sometimes be a symptom of a separate condition (e.g. irritable bowel syndrome).

Possible new treatments for interstitial cystitis

The US-based Interstitial Cystitis Association suggests that up to 8 million American women suffer from IC, with possibly half as many men. The confusion surrounding the causes of IC (as opposed to cystitis) has led some US researchers to propose a step-based programme of treatments aimed at minimising its symptoms. In the early stages of treatment, these include lifestyle and dietary changes and advice on pain management. Dietary changes may include gradual elimination of certain types of food and drink, in order to find out which may be triggers for the symptoms. Some over-the-counter medications may also be prescribed by GPs.

The "steps" in this kind of approach to treating IC are ordered by risk factor; if the least risky strategies provide acceptable relief, there's no need to proceed to the next level. As an example, the fourth proposed stage of treatment may include Botox injections, while the following stages could involve surgery.

Cystitis: symptoms and treatment options

Cystitis itself is easier to treat than IC, and in fact some over-the-counter medications, as well as antibiotics in some cases, are available from The Online Clinic. While milder instances of cystitis often clear up without treatment, if you experience frequent symptoms, or the condition doesn't get better after a few days, you should see a doctor. Men with cystitis symptoms should always seek medical advice, and children complaining of similar symptoms should also be taken to a doctor. More severe symptoms may include fever and/or passing blood during urination.

Preventative measures are centred around avoiding bacteria entering the urethra (allowing bladder infections to develop) as well as certain lifestyle changes. While cranberry juice has long been thought of as a cure or prevention, there's very little scientific evidence that this is the case. Making sure you've completely emptied your bladder when you urinate is recommended, as well as wearing looser underwear made from natural fibres (e.g. cotton). Drinking plenty of water in order to flush out the urinary system is also a good idea.

It's also possible that irritants in certain kinds of shower gels, shampoos, bubble baths and similar products could be a problem; avoid perfumed varieties, and if possible take a shower rather than a bath. If you suffer from cystitis, try avoiding any drinks containing caffeine. These will not cause cystitis in themselves, but may aggravate the symptoms. Some medical professionals believe that the use of a bidet could be a risk factor for cystitis, as bacteria can be washed upwards towards the urethra.

It is important to see a doctor if cystitis symptoms don't clear up, as there is a possibility of contracting a kidney infection in some cases. However, cystitis is generally simple both to diagnose and to treat.

How does HRT affect dementia risk?

Hormone replacement therapy (or HRT) has long been the subject of controversy. First made available in the 1940s, it was created as a means of tackling the unpleasant – and for some women, debilitating – symptoms caused by the menopause.

In the 1990s and 2000s, studies were undertaken to study HRT’s long-term effects. When they found evidence that it could increase a woman’s risk of cancer and heart disease, the reaction was swift. Medical bodies began urging doctors to prescribe it only in its lowest effective doses, and many women stopped taking it altogether.

Today, those three letters still evoke a lot of uncertainty in patients and doctors. Many doctors feel uncomfortable prescribing it; many more menopausal women automatically rule it out as a potential treatment because of the risks it may carry.

In an interesting turn of events though, the studies that caused the initial panic have recently been challenged. According to new research, it now looks like HRT is perfectly safe for menopausal women to use. In fact, the latest studies seem to suggest that hormone replacement therapy could be seriously beneficial to post-menopausal women when it comes to staving off dementia.

The Menopause and Dementia

Earlier this year, it was reported that early menopause as caused by surgical removal of the ovaries is linked to a reduction in memory and thinking skills. The fear is that this could in turn lead to early-onset dementia and Alzheimer’s.

It isn’t understood precisely why the removal of the ovaries might have these worrying effects, but the doctor running the study, Gillian Einstein, believes that this indicates the importance of oestrogen in healthy brain function for women.

One fascinating offshoot of this study is that hormone replacement therapy (which artificially boosts oestrogen levels) could now play a seriously important role in maintaining brain health for post-menopausal women. In fact, this isn’t just speculation – in 2014, researchers at the Stanford University School of Medicine found that, when given to post-menopausal women who were at risk of dementia, HRT actively prevented brain degeneration.

While the sample size used in this study was too small to draw any definitive results, it is interesting to consider this research in conjunction with Dr Einstein’s more recent study. If oestrogen is the key to maintaining a healthy brain after the menopause, then it seems only logical that HRT would be the way forward.

All dementia-fighting powers aside, there are plenty of reasons why HRT would appeal to a menopausal woman living with unpleasant symptoms.

The Benefits of Hormone Replacement Therapy

The menopause is a natural part of ageing, which occurs when a woman’s oestrogen levels begin to decline. This predominantly causes period cessation, but other symptoms include:

• Hot flushes, which can incorporate heart palpitations, sweating, and skin reddening

• Night sweats and problems sleeping

• Vaginal dryness, which can cause pain and discomfort during sex

• Anxiety and low mood

• Reduced sex drive

• Difficulty concentrating

Hormone replacement therapy works by boosting oestrogen levels artificially. In turn it helps to tackle all of the symptoms listed above, as well as osteoporosis (the weakening of the bones), which is more common in post-menopausal women. HRT is usually taken for a few years, after which the doses are gradually reduced and treatment eventually ceased.

Types of HRT

There are many different types of HRT available, and the exact kind you are prescribed will depend upon your medical history, symptoms, and how advanced your menopause is.

Women who have had a hysterectomy (i.e. their womb has been removed) can safely take oestrogen on its own; women who still have their womb will have to take a combination of progesterone and oestrogen.

Cyclical HRT is recommended for women experiencing menopause symptons but still having periods, while continuous combined HRT is recommended for post-menopausal women who are no longer having periods.

HRT treatments also come in a variety of preparations. You can take tablets, use patches that stick onto your skin, apply an oestrogen gel directly to your skin or vagina, or even have an implant fitted that gradually releases hormones into your bloodstream.

To find out more about HRT, or to obtain a safe prescription through The Online Clinic, click here.

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.

Even though female contraception was introduced more than 50 years ago, it is still a topic that causes much debate around the world. Recently, we were surprised to read the reactions to research indicating that there was a need for pericoital contraceptives among women who attended family planning clinics.

The research, which was published in Contraception, took place in family planning clinics. The researchers surveyed 1616 women who attended clinics about their attitudes to using pericoital pills. The purpose of those pills is to be taken right before intercourse. Within that sample, 635 women had visited the clinic to have advice on abortion. The key findings indicated that 69% of the women visiting the centres to discuss abortion were positively inclined towards the contraceptives and 50% of patients who had visited the clinics for family planning would consider the treatment. The researchers stressed that there was a need for further research to consider exactly what demographics would benefit from this treatment the most and whether the pill would be effective.

To us this sounds like standard research that should not really cause too much controversy. However, as the study came in the wake of Bill and Melinda Gates awarding funding to an organisation to consider the efficacy of such treatment, the issue became more real to laypersons and politicians.

Perhaps that is why several news sources, including New York Magazine, dubbed the pill as the “slut pill” and compared it to the morning after pill. Many debates online appeared to focus on it as an easy solution that only a certain kind of woman could use. Yet, the researchers clarified that this treatment would probably be the most suitable for women who did not have regular intercourse.

Passing off this research as something that relates to promiscuity and assumed immorality completely misses the mark of the purpose of the current research. Based on our experience, we think it is fair to say that unprotected sex is far more common than it may be made out to be in some of the debates. It is also fair to say that not all women have equal access to contraceptives due to a multitude of reasons. From the sounds of it, the pericoital pill appears to have less severe effects than the morning after pill.

Clinicians that understand the sensitive nature of sexual health treatment also understand the need to lessen barriers to treatment and listen to research rather than debates. However, based on what we know about the pericoital pill today it is clear that more research is needed to substantiate the findings, to understand the potential risks and benefits and to evaluate the cost of the treatment. If future trials come to find a safe and effective pericoital pill, then we see little reason for denying women this choice.

We are happy to report that the popular oral contraceptive pill, Cilest, is now back in stock following the manufacturing problem. This item is available for immediate dispensing and next day delivery. If you are already approved for an oral contraceptive pill then you can login to your account and make a purchase. If you have not already registered with The Online Clinic then you can begin by clicking on the button below.

In the US, the morning after pill has been made available for women over the age of 15 and is to be sold over the counter, rather than on prescription only. This increased availability for a younger population has been met with scepticism among critics. Here we consider the main issues.

The pill, which goes by the name Plan B One-step, works for 72 hours after intercourse and can be effective in one of three ways. Firstly, it may delay or prevent ovulation. Secondly, it may impede the fertilization of an egg. Lastly, it works by altering the lining in the uterus, thereby preventing fertilized eggs from being implanted in the uterus. Overall, there is no evidence that points to the treatment harming an unborn foetus or terminating a pregnancy. Moreover, the treatment does not protect against sexually transmitted infections.

While proponents of the ruling argue that wider availability of this pill is beneficial to womens’ health and breaks down barriers to treatment, opponents maintain that if the product were to be sold without prescription young girls would be put at risk. Another argument that has been put forth is that as the treatment is already available in pharmacies, the over-the counter availability may confuse individuals seeking to buy treatment. Although the age-restrictions have been lowered, retail assistants are still responsible for asking for the age of the person buying the treatment and are not to sell it to young-looking women who fail to provide proof of age. However, it is not clear where the supposed confusion would stem from, or who would be responsible for addressing it.

We are not surprised that this treatment has been made available over-the-counter as we are aware of many barriers to getting this treatment, with stigma perhaps being the most obvious one. Given the reports of high rate of unintended pregnancies in the US, it is important that the issue is given due attention. From what we have seen in media reports, the outrage stems from either misunderstanding of the treatment (assuming it is for abortion purposes) or from the fact that it would be given to younger women (and put them at risk). We feel that enabling the product for a lower age group is in line with research findings on unintended pregnancies. In addition to that, there are no reports to our knowledge on the risks being increased for younger patients or the treatment resulting in termination of pregnancy. We always aim to base our opinion on scientific evidence, rather than stigma or social pressures. Based on what we know from research to date, it is clear that the criticisms are unfounded.

A common home remedy for protecting against cystitis has been to drink cranberry juice. The use of cranberries, whether it is through juice, tablets or capsules have been so pervasive that there have even been reports of doctors recommending that patients drink cranberry juice.

However, a recently published review in TheCochrane Library argues that the use of cranberry supplements in general and use of cranberry juice in particular is not very effective for preventing cystitis.

The review considered 24 high quality studies that were either Randomised Controlled Trials (RCT) or Quasi Randomised Controlled Trials (QRCT). Combined together, the studies had a total sample of 4473 individuals. The samples were wide ranging and included children and pregnant women as well as elderly men and women. The treatment groups in the studies had received: either cranberry juice; tablets; or capsules containing the active ingredients. The control groups had received one of various controls such as methenamine hippurate, placebo cranberry products, antibiotics, or lacto bacillus. There were also studies included where the control group had not received any treatment at all.

Overall the findings pointed towards the argument that cranberry juice may have minimal benefits for individuals that had recurring infections. However, the effect was so low that it would require the person to consume at least two glasses of cranberry juice daily and over a long period of time in order to prevent re-infection. In terms of studies using capsules’ or tablets, the findings were less clear as many of the tablets lacked reports of the specific amount of the active ingredient. This made it hard to form a clear conclusion.

The review raised other issues as well. For instance, the attrition rate in studies that were giving participants cranberry juice was high. This led the researchers’ to suggest that drinking cranberry juice over long periods of time might not be acceptable and could affect whether individuals comply with this recommendation in the long term.

Perhaps the most important conclusion to come from this review was that the researchers advocated that there is no further need for research into the effectiveness of cranberry juice to protect from cystitis. We are not surprised, as this issue appears to have had a consistent lack of support from the research community in the past. Research into products that contain derivatives of cranberries may be justified as there is evidence that a compound in cranberries prevents bacteria sticking to the wall of the urethra but whether this can be consumed in sufficient quantities to provide any significant degree of protection is debatable.

We quite often receive approaches from women going through the menopause who are beginning to notice a change in their weight and body shape. Most women attribute this to lifestyle but that is not always the case for post-menopausal women. The menopause causes the body to behave differently: a reduction in the production of certain hormones will cause the body to change shape and for the distribution of fat to alter. Many women will notice that their previous pear-shape transforms into an apple-shape.

What can be done? Well, this is a natural part of aging unfortunately but there is no reason to take this lying down. If you are prepared to consider hormone replacement then you should consult your GP in the first instance to get your hormone levels checked. If appropriate, your GP will prescribe a suitable type of HRT (hormone replacement therapy.) HRT can cause side effects so this option needs to be carefully considered.

We would always recommend that you watch your diet, menopause or not. The first thing to avoid is refined sugar. Cut down your sugar consumption and up your intake of fruit and vegetables. A recent study in the US indicated that a diet rich in fruit and vegetables could help post-menopausal women keep weight gain at bay.

It is very important to resist the temptation to go on a crash diet. This action could send the body on famine alert, so it will store more fat in anticipation of a future period of reduced availability of food – this is a deep-rooted survival mechanism.

Up your levels of aerobic exercise! This will help to increase your metabolic rate and reduce the amount of food intake stored as fat.

Our top tip for anyone looking to lose weight is to look at what you drink as well as what you eat. A lot of flavoured drinks (including so-called health drinks) are full of sugar. Avoid flavoured drinks and stick to water.

Due to the fact that the Olympics are likely to cause a certain amount of disruption in the coming weeks, the emergency contraceptive pill will become widely available and free of charge in London since it could potentially be difficult for women to access sexual health services during this busy period.

The organisation responsible for the supply is a charity known as the British Pregnancy Advisory Service (BPAS). Following a phone consultation with a nurse, they will post a kit to you that will contain the morning after pill and a supply of condoms.

The charity stresses that by having the morning after pill ‘just in case’ does not mean that it is predicted that women will take chances but that it is there in case something goes wrong. We do not believe that the emergency contraceptive pill should be used as a retrospective contraceptive. Because of sexual health issues, we advocate condom use in non-exclusive relationships. However, accidents happen and for women who need emergency contraception, we think this is service is a very good idea.

The human sex drive is often thought to be greater among men and this has always been put down to the higher levels of testosterone in the male body but a recent study carried out at the University of Michigan has prompted us to question the role of testosterone in sexual desire. The results of the study are published in the Archives of Sexual Behaviour and offer us further insight into the validity of an area of medicine that has been labelled female sexual dysfunction (FSD).

105 men participated in the study and 91 women and they answered questions regarding their sex lives, their attitudes towards sex, to their own bodies and with sexual desire. Their testosterone levels were also checked.

Having always thought that a high level of testosterone in men was the reason that men had greater sex drives than women, the researchers were surprised to discover that women who had higher levels of testosterone in their bodies were less inclined to want to have sex with a partner than women with lower levels of testosterone. Furthermore, women with higher levels of the sex hormone were more inclined to masturbate than women with lower levels of testosterone, even though they did not desire sex with a partner as much. Sexual desire seems far more layered an issue than previously thought. Maybe our definition of sexual dysfunction is not even correct?

Although the study size was very small, the outcome leads us to think that this whole area of female sexual dysfunction is wrong-headed. If a woman does not desire sex with another person and she is happy with that, is this sexual dysfunction? If she is unhappy with the situation then that is a completely different matter. If the findings of this study are borne out in a further, much larger study, it would lead us to the conclusion that scientific research focussing on testosterone levels is heading in the wrong direction. Remember that the biggest sexual organ in the body is the brain, not the testes or the ovaries. Our guess is that the scientific community is looking in the wrong area for a solution – if indeed there is a problem to begin with…

The Online Clinic are now prescribing treatment for Thrush, a fungal or yeast infection that both men and women can suffer from and can recur.  We are happy to treat those who have been diagnosed with the infection before and are familiar with the symptoms when they recur.

We now prescribe Fluconazole and it can be purchased online after a medical consultation has been filled out and a patient has been approved for treatment. Fluconazole is an oral treatment in the form of a capsule. Only one capsule is required to treat the infection. Symptoms will disappear within a period of 10 days. We are also prescribing Gyno-Daktarin cream and pessaries for women.

All of our treatments are available for next day delivery once orders are placed between Monday to Friday and before 4pm.

You can get your thrush treatment by clicking here.

It has been proposed in an NHS report that young girls are offered the contraceptive pill when they are as young as thirteen years of age and without seeing a doctor. It is without a doubt that something needs to be done in order to decrease the number of women requiring emergency contraception and abortions but is this the way? A pilot study carried out with the intention of targeting black women of British, African and Caribbean backgrounds who were between the ages of 20 and 24 and who had never used the contraceptive pill before appeared to have an impact. But does this make the case for making the contraceptive pill readily available to young girls who have barely had an education in sexual health?

The study was far too small to predict with any certainty that the rates of pregnancy and abortion among young people would decrease with the implementation of this sort of action. Furthermore, with the NHS advocating such independence for girls so young, they are also in a way saying it is ok or expected that unprotected sex will occur and as long as we are sending this message to young people, STI rates will continue to climb.mWe believe that condom use should be advocated before putting teenage girls on the pill. However you look at this, it must come back to education. People need to know what they are doing and the potential consequences of unprotected sex.

Once again the topic of the female orgasm has come up in the news and it confirms that there is still a lot we don’t know about the female body and how the orgasm occurs. There is some empirical evidence linking the orgasm to exercise. 40% of the women participating in a survey reported such an experience in places such as their gym, embarrassingly, or even their sitting room carpet where the orgasm was brought on by repetitions of tummy crunches and other such abdominal exercises. The correlation between orgasm and these exercises was particularly strong among the women who participated but others experienced orgasm while climbing rope, lifting weights or running even.

Interestingly, these events were not associated with sexual fantasy or sexual thoughts of any kind, allowing us now to look at exercise as a form of treatment for this branch of female sexual dysfunction. If nothing else, this discovery might give some of us the impetus to go to the gym more often!

Teenage girls have been fitted with a contraceptive device at school without the knowledge or consent of their parents. Naturally, parents are in uproar over the fitting of these implants which also involved minor surgery to fit and are effective for years. The NHS says that this has led to a 22% decrease in the number of teenage pregnancies but is this really the way to go about it?

Recent figures suggest that around 5,000 school-going girls, who were not yet at the age of consent, were fitted with the contraceptive device. 5 years ago this figure was 800.

It is suggested that this is down to government plans to stamp out the ever rising rate of teen pregnancy. 2,500 thirteen and fourteen year old girls were given the implant or injection last year owing to the fact that councillors in Southampton gave orders 3 years ago to have such devices offered at schools. 9 schools are said to have complied.

According to the parents of these young girls, all that was required of the children was a brief medical questionnaire and no follow-up visits were arranged.

It feels like we are skipping a huge step by not prioritising the sexual health education of these girls. By fitting them with a device for precaution sake and not teaching them about safe sex first, we are asking for a nationwide increase in sexually transmitted infections.

One in three women between the ages of 50 and 70 are not aware that a cervical screen is a test that all women should take and among those who had never had one of these tests, the number of women who are not aware of how vital the test is grows to 67%. This is especially the case for women who are single or who are not engaging in sexual activity. Women who are divorced, separated or single were more likely to never have had a screen compared with those in a relationship. These figures come from a YouGov survey which was carried out for Jo’s Cervical Cancer Trust.

Across England, the number of 50 to 70 year olds attending for cervical screening fell. In 2010, the numbers fell below 80% and they dropped again in 2011. A statistic released by the NHS Cervical Screening Programme Audit of Invasive Cervical Cancer ’07-’10, reveals that 56% of women between the ages of 50 and 64 who had cancer had not had a screen for 7 years. The equivalent figure for women without cervical cancer was 16%.

This was quite a large survey where 2,397 women between the ages of 50 and 70 were questioned. Worryingly, two thirds of these women were not aware that most cases of cervical cancer were caused by the human papilloma virus (HPV). More than half of them thought that this form of cancer was caused by having a number of different partners and one in five thought that the cancer was hereditary.

Those at the Trust state that the vital message is that a woman can have only one partner in her lifetime and still contract HPV.

Two Australian researchers have stated in a Lancet article that nuns should take the contraceptive pill. What they are really saying is that women who do not have children, nuns being the most obvious example, should be taking the contraceptive pill and their reasoning for this is down to the observed phenomenon that women who do not have children or breastfeed are at a higher risk of cancer of the breast, womb and ovaries due to the fact that they have more periods throughout their lifetime. In accordance with the rules of the Catholic Church, nuns are not allowed to use any form of contraception, another reason that the researchers are focusing their research on this community.

Supporting the article is previous research and theory, including an Australian gynaecologist from the University of Adelaide, who has not contributed to the article, but explains that the female body is designed to, at some point, become pregnant and to lactate. He highlights that women having hundreds of menstruations in their lifetime is a relatively new trend that has been recognised over the years as a potential cause of tumours. Women now have up to 400 cycles in their lifetime whereas women living a century ago experienced on average 40 cycles because of the higher pregnancy rate back then.

The authors of the Lancet article claim that the general rate of mortality is decreased by 12% among those who take the pill compared with those who do not. Furthermore, the risk of breast, womb and ovarian cancer specifically is reduced by more than 50% among those who take the pill. The reason the pill is said to protect against cancers of the uterus is attributed to the dose of oestrogen and progesterone that causes a withdrawal period rather than a real period where the endometrial layer becomes much thicker.

There is not sufficient evidence available to absolutely prove these observations and there are even studies in existence claiming to show that the pill actually increases a woman’s risk of developing breast cancer and other complications. These claims have been contradicted by a 1996 meta-analysis of previous studies in which 9,200 women were questioned; the analysis totally refuted claim of any link between breast cancer and taking an oral contraceptive.

A 39 year study carried out in the University of Aberdeen in 1969 does however, according to New Scientist, show that the benefits of taking the pill outweigh the risks. 46,000 women were observed for this period of time and it was found that those who had developed cancer of the ovaries or uterus and died were more inclined not to have taken the contraceptive pill.

The hormone DHEA, taken in low doses, has been shown to work as well as hormone replacement therapy, commonly abbreviated as HRT, in order to relieve the symptoms associated with menopause and improving the sex life of those who suffer from low libido. The study, carried out at the University of Pisa, is published in Climacteric. Larger studies will decide whether or not DHEA is a proven alternative but this pilot study has achieved important ground work in the future of HRT alternatives.

DHEA is widely available and most commonly used as a synthetic nutritional supplement. The natural hormone is made in the adrenal glands, liver and testes and affects the production of the sex hormones in men and women. The difference between this hormone and HRT is down to the fact that DHEA increases the amount of androgenic hormones (effecting male characteristics) and HRT increases oestrogens.

48 women took part in a recent study and showed that DHEA could help menopausal women with their symptoms. According to the study’s authors, the synthetic hormone will be especially beneficial for women who have not found success or have experienced complications with HRT. Women who had requested HRT to relieve their symptoms were put on an alternative treatment. One group were given DHEA, a second group were given combination hormone therapy, and the third group received tibolone (a synthetic version of HRT) and a fourth group received vitamin D and calcium. Ease of symptoms was noted across the board other than for those who took vitamin D and calcium.

Although no women reported low libido at the study’s outset, one year on, the women who received DHEA and HRT reported an improvement in their sexual function.

Clearly this study is extremely small but it does provide proof of concept, paving the way for larger studies to take place.

In the run up to Christmas, the British Pregnancy Advisory Service (BPAS) is advising women to plan ahead and obtain their emergency contraception before it is more difficult to obtain over the Christmas period: a time when STI infection rates and the number of unplanned pregnancies increase and the pharmacies and surgeries close.

BPAS has announced today that the morning after pill is being offered free of charge and is available online after a consultation with a nurse and it will arrive in the post with a supply of condoms.

A spokesperson for the British Pregnancy Advisory Service refutes criticisms which suggests the organisation is promoting risky behaviour and explains that planning ahead does not suggest one is planning on taking risks but rather one is making sure that nothing is left to chance. The health charity, Life, says that if emergency contraception is available in the home, then the female is more inclined to engage in a risky event than she would without this sort of back-up.

Is this sort of promotion in fact going to increase the rates of sexually transmitted infections over the festive period? And how will the nurses know that they are not supplying under-age girls? Surely this quick fix solution to risky, unnecessary behaviour is not the sort message a health charity should be sending out to the public.

Surely such efforts in the name of public health should focus on safe sex. At the very least, when a woman comes in to see a doctor in a face to face environment seeking emergency contraception, a doctor can then discuss issues such as STIs with her. Encouraging women to stock up on emergency contraceptives online or over the phone does nothing to help such causes and in fact puts them in greater danger of contracting bacterial infections or worse, an virus they could have for life.

A European study shows that women who have been taking the contraceptive pill have been 10 years or more are significantly reducing their risk of developing ovarian cancer. This massive study involving more than half a million people reveals that a woman’s risk of developing ovarian cancer decreases by 45% having taken the pill for such a length of time. The study is published in the British Journal of Cancerand was carried out at the European Prospective Investigation of Cancer (EPIC).

In addition, taking the pill at any stage seems to have an effect on a woman’s likelihood of developing this type of cancer. Women who took the pill for over one year or even a few months had a risk of approximately 28 in every 100,000. These women were compared to women who had never take the pill and whose risk of developing the cancer was approximately 38 in every 100,000.

Women who had become pregnant at some stage in their lives also had a lower incidence of ovarian cancer. There was a 29% disparity in the number of instances of the disease between those who had never become pregnant and those who had at least one full term pregnancy. Furthermore, the more pregnancies one had, the less likely they were to develop ovarian cancer.

EPIC remind us that there is also evidence to suggest that taking the contraceptive pill will increase  risk of developing breast cancer but the incidence is low (50 per 100,000 higher than it would have been otherwise).

A recent study carried out by Bayer Healthcare has highlighted the growing number of women who take risks when having sexual intercourse by not thinking about contraception. In fact, over half of sexually active women are throwing caution to the wind in this way. 58% of women are putting themselves at risk including one third who have had unprotected sex on at least five occasions and with almost 50% of women forgetting to take their birth control pills.

Of the 3,000 women surveyed, one in ten of them said that on occasion they did not use contraception so as not to kill the passion but only 16% of these women are using longer lasting contraceptives such as the coil in order to protect them from pregnancy. These forms of contraception do not need to be ‘remembered’ each time.

Despite the fact that these women could be protecting themselves from pregnancy with longer lasting forms of contraception, they should also be protecting themselves against sexually transmitted infections. This is the more worrying observation of the study.

Cystitis is the name given to the condition that includes urinary tract infection and infection of the bladder. Interstitial cystitis (IC) is a form of chronic cystitis where the wall of the bladder becomes inflamed. Doctors often misdiagnose IC as recurring bouts of urinary infections and women are prescribed antibiotics with no effect time and time again. With IC Awareness month upon us, current treatments and diagnosis are once again under scrutiny.

This year, the pelvic floor muscle is inspiring much discussion. According to one consultant urogynecologist at Imperial College London, it is the tightening of the pelvic floor muscles that leads to pain when urinating and pain during sexual intercourse. When the muscle tightens, it goes into spasm. This also means that the bladder often does not empty properly allowing it to become infected more easily. Pelvic floor exercises have notoriously been recommended by physiotherapists and doctors especially when women complain that they are leaking urine. This is thought now to be detrimental to recovery and may even be the cause of interstitial cystitis according to a physiotherapist at the White Hart Clinic.

The future in IC treatment will hopefully involve a multi-disciplinary approach that the White Hart Clinic advocate and will include an ultrasound in order to see the bladder and pelvic floor muscle in action as one stands up straight, lies down and exercises. Treatments will be a combination of muscle relaxants, anti-inflammatory treatment and antibiotics. Physiotherapy will be employed in order to relax the pelvic floor muscles. This form of treatment is popular in the United States and is very new here but has been proven to work in previous studies.

Now that medicine and physiotherapy are finally being combined, we might finally see a breakthrough for Interstitial Cystitis treatment.

Two reports recently published in the British Medical Journal explain that women who were taking birth control pills containing drospirenone, for example, Yasmin and Yaz, were 2 to 3 times more likely to develop blood clots that were considered life threatening than those on alternative oral contraceptives. The Therapeutic Goods Administration in Australia has issued a warning.

The administration states that all oral contraceptives carry risk and that they will not remove Yasmin from the market but state that they are taking all new information seriously. Although there are rumoured connections between the drug and the death of a woman in Melbourne, the evidence suggests that the risk of this happening is so small. A British study revealed that out of 100,000 British women who took Yasmin, only 23 developed a blood clot. The study in the British Medical Journal has been described as flawed by Bayer (the pharmaceutical company behind Yasmin) and also the Royal College of Obstetricians and Gynaecologists.

The latest research on the economics of free provision of the morning after pill reveals that free availability over the counter has not prevented teenage pregnancies and may have actually contributed to an increase in the number of sexually transmitted infections. The retrospective contraception is also available in certain pilot study areas to those under 16 years, does not require a prescription and is free of charge.

The business school at Nottingham University has demonstrated that making this drug more accessible is doing more harm than good. The results of their study revealed that there were as many teen pregnancies among the under 16s who had this free contraception available to them as there were pregnancies among those under 16 who did not have such access to the drug. They also discovered that sexually transmitted infections increased by 12% among this age group when the over the counter emergency contraception was made available and free from local pharmacies. The study will be published shortly in the Journal of Health Economics.

Although teenage pregnancies have fallen over the last 10 years, the UK still has the highest rate in western Europe.

The number of cases of breast cancer in Western countries is five times higher than the number of cases in other developed countries. The Kimmel Cancer Centre, Jefferson, carried out a study revealing that high fat and cholesterol levels that are characteristic of the average American diet play a huge role in the developing and the spreading of breast cancer. The study was published in The American Journal of Pathology.

Mice were tested and fed a Western diet, typically higher in fat and cholesterol than the diet associated with other developed regions. The results convey that mice on the Western diet grew tumours that were 50% larger and that grew at a much faster rate than the tumours in mice that were fed a controlled diet.

We already know that immigrant populations, who have come from areas recording lower rates of the disease, experience an increased number of breast cancer cases than in their region of origin. The effect of diet on breast cancer development and spread is palpable. Fat and cholesterol levels should be monitored consistently as a preventative measure.

It is Interstitial Cystitis (IC) awareness month across the USA, and now IC patients and the rest of us have the opportunity to inform ourselves of the plight of the sufferers and of the best ways of coping with and tolerating this condition. This year the focus is on discrimination. Most of us have probably never spared a thought for those who might suffer from bladder pain syndrome or IC if we have not experienced it ourselves. For many of us, if denied bathroom access, it is no big deal however some sufferers’ lives revolve around the possibility of bathroom access wherever they go.

Many patients need to urinate up to 60 times per day. Pain is felt as the bladder fills and so constant relief is sought. Others feel an urgency to pass urine all the time or pain is continually experienced and sexual intercourse becomes impossible. While dealing with all of the symptoms and obstacles associated with IC, those who have it are often discriminated against. 63% are unable to work but those who do are constantly battling with having to frequent the bathroom.

Thankfully, there are ways to improve the condition. Diagnosing the condition early enough means that symptoms can improve with time. There are many treatments and physical therapies that may be employed to ease symptoms and improve quality of life. Diet is a huge factor when IC has been diagnosed. If changes are not made to diet, then IC can get worse and serious health problems will follow.

This month patients are exchanging their stories and experiences of living with IC on the IC Network website and Facebook. Patients are getting quite involved and along with striping their hair blue, they are asking their city councils for more research funding for IC. In addition, they are approaching state representatives in the hope that proclamations in support of IC patients will be passed.

Interstitial Cystitis should not be confused with common cystitis, which is caused by an infection that is easily treatable with antibiotics.

Health experts have warned that British women have dangerous diets, with teenagers relying on faddy food plans and pensioners not getting the necessary nutrients.

Scientists reviewed 110 different sets of research into how British women eat and discovered that women in the prime of life are routinely not getting the right nutrition. Girls of school age are also very likely to be missing out on crucial vitamins, with over half of girls aged between 11-18 not getting the recommended intake of minerals.

30% of teenage girls are not getting enough potassium, 16% are lacking iodine and nearly 50% are not getting enough iron.

In older women, zinc deficiency and a lack of vitamin D was a particular problem. Pregnant women need vitamin D to strengthen their unborn child’s bones and ensure that they are not born underweight.

Even as women approach retirement, their diets do not improve. As women get older, they need more vitamin D to prevent brittle bones but the collective research seems to suggest that only a third of women over 65 are getting their recommended daily allowance.

The team behind the review are from the Manchester Metropolitan University and began the study after being commissioned by the Health Supplements Information Service, a independent body.

They concluded that women need to make better food choices to ensure that they are taking in their daily recommended vitamins and suggested that those not following sensible diet plans should round out their diet with daily multivitamins.

Tragic news for the legions of women who have been squeezing themselves into the corset-like anti-cellulite pants which have become so popular – they don’t work.

Nicknamed ‘magic pants’ they promised to help women look thinner, with no extra exercise. Packaging claims that the pants, stocked by M and S, “smooths, slims and shapes’. The company saw customers flock to buy them and sell three times as many as regular pants. John Lewis and Debenhams also stock versions of the knickers.

Which? magazine however say that women are being misled by the packaging. They consulted two plastic surgeons and a dermatologist to see whether the pants, with their special ingredients of aloe vera and caffeine embedded in the fabric, could actually banish cellulite as promised.

They concluded that it was doubtful that the knickers were actually effective and said that any underwear as tight as them would in any case smooth skin. They also questioned whether the magic ingredients were present in sufficient qualities to have any effect.

A spokesperson for Marks and Spencer pointed out that the packaging did not claim to get rid of the cellulite itself, but rather diminish its appearance. She added that the ingredients are widely used in anti-cellulite creams.

If anyone saw the ravaging hoards of women buying up the pants when they were first released, there is no doubt that this will be a huge blow to women eager to look slimmer. Personally, the horror of trying to cram myself into them only to see something in the mirror strongly resembling an over-stuffed sausage skin will live with me for a very long time. I’d take cellulite and giant granny pants over revisiting that particular trauma anytime.

They say abstinence is the best way to prevent the spread of sexually transmitted infections and for 1 in 4 women over 35, they are certainly playing their part to keep the STI rates down. A survey has revealed that over 25% of UK women over 35 ‘never’ have sex.

Scotland had the highest proportion of women who don’t ever make love (38%) while in the Midlands 32% of women say they have sex once a week.

The high proportion of women who don’t engage in sex was partly explained when most women said that working every day impacted on their sex lives. It was discovered that the less women work, the more they enjoy their sex lives, with 2/3s of those working part time reporting regular orgasms, compared to just over half who work full time.

Childless women were more likely to have a greater number of orgasms than mothers. 41% of women with no children said that they orgasmed most of the time, falling to 12% for those with one child and 14% for those with two.

26% of women said they were concerned that the menopause would cause them to lose their sex drives, as well as affecting their memory.

The survey was commissioned by Sky Real Lives as part of the launch of their new TV show, The Secret Guide To Women’s Health. Fronted by Colleen Nolan, of the exquisitely annoying Iceland adverts,  the show hopes to provide a platform for women to discuss the health problems they can’t talk about with friends (there seems to be a bit of flawed logic going on there – oh, no, of course most people would rather talk to Colleen Nolan on national TV if they are too embarrassed to speak to their best friends.)

As January came around, many people’s thoughts turned with vim and determination to sales shopping. Off half the nation trotted, sharp elbows out, to battle their way through the department stores to get that discounted magimix or the perfect pair of boots.

Whether or not you managed to find the perfect buy or came home with a top three sizes too small you’re planning on ‘dieting into’, just the act of shopping could be good for your health. It has been worked out that walking between shops and lifting heavy shopping bags is like doing a workout, burning 385 calories a week for the average British woman.

The figures come from Debenhams, who tested 10 shoppers, half of whom were women and half who were men, and then carried out a further survey of 2,000 shoppers. They discovered that women browsing the shops cover an average of nearly 3 miles during a standard 2.5 hour shopping session.

Men however are less determined when they shop, spending just 50 minutes in the stores and covering only 1.5 miles.

The NHS recommends that people should take 10,000 steps everyday and a vigorous buying session comes close to meeting this target, with women taking an average of 7,300 steps per trip. The large number of steps is explained in the results of the shopper questionaire, where nearly half of the women who took part said that they ‘shop till they drop’, not stopping for a rest until they have found that they are looking for.

Debenhams said that the survey shows that not only that Britons ‘love to shop’ but that the health benefits mean that exercise and weight loss are easily achievable through everyday activities. Admittedly the statement is slightly flawed as unless you are a millionaire with no job, a 2.5 hour shopping session is not exactly an ‘everyday’ (or even ‘every week’) activity, but it’s still nice to know that searching for the perfect outfit is making you healthier!

Look at any of the slew of adverts for perfume, make-up or clothes and the message coming across is very clear – thin equals sexy, erotic and desirable. However, good news has been announced for everyone packing a few extra pounds – bigger men and women are apparently better in bed.

The newspapers have been using this as a fantastic excuse to compare skinny and curvier celebrities, with the Mirror running the headline, “Kelly Brooke is better in bed than Cheryl Cole!” (conjuring up images of a staff writer desperately trying to kid himself his knowledge is based on personal experience rather than lustful conjecture).

In a study commissioned by bedmakers Silentnight, 89% of men said that they preferred curvier sexual partners to  thin women. Of those men, 56% of them said that they thought partners with curves were more considerate about pleasing them when in bed.

Furthermore, when the romping is over, you’re more likely to sleep better if your partner is curvy. During the two-year study, it was discovered that thin people toss and turn up to 10 times a night on average, whereas those who are heavier only turn over twice.

It is thought that this is due to thin people suffering more from their pressure points being triggered while they sleep, decreasing their circulation and forcing them to turn more often to relieve the pressure.

The company’s sleep scientist Iftikhar Mirza commented that curvy men and women ought to be ‘feeling pretty happy right now’ as not only were they considered good in bed but were also better to sleep next to.

That hard-to-lose fat around your waist tends to be a bit of a nightmare to shed, as well as being an early indicator for health problems such as diabetes. Now, for those women who’ve always dreamed of boosting their boobs, hate their muffin tops and have a few grand to splash about, the perfect solution seems to have come along.

A new cosmetic procedure has been developed which sees fat taken from around the waist and inject into the breasts.  Described as a “two for one” procedure, the operation has been greeted by cosmetic surgeons as the new breakthrough in surgery.

The president of the British Association of Aesthetic Plastic Surgeons, Nigel Mercer, said that the new procedure was on the agenda for the annual meeting this week in Cardiff of the top plastic surgeons in the world.

Mr. Mercer added that fat grafting techniques have been around for a while but previously were not widely offered due to concerns over safety and whether the body would accept the fat. He added that the Association was not yet sure whether the procedure could be widely offered to the public. There are also concerns that the fat might calcify and be mistaken for a tumour during a routine mammogram.

The Harley Medical Group chain of plastic surgeons is planning to offer the treatment and Mel Braham, their chairman, described trials of the technique as “astonishingly successful”. He said that it offered the opportunity to provide patients with two procedures while other surgeons have said that fat taken from the body would act as a more natural implant.

The medical world has become more and more aware of the difficulties faced by women who lack sexual desire, leading to the condition Female Hypoactive Sexual Desire Disorder being accepted as a medical condition.

However a new study has revealed that when it comes to women having sex, desire is often the last thing to cross many women’s minds. A new book entitled, Why Women Have Sex highlighted the 200 top reasons women gave for why they had sex, with sexual feelings coming extremely low down on the list.

Cindy Meston and David Buss, psychology professors at the University of Texas and co-authors of the book, questioned 1,006 as research for the tome and concluded that while men find most women attractive in some way, most women do not find most men sexually attractive at all.

The answers that the women gave for why they went to bed with someone were fairly wide-ranging, from “for a clearer complexion”  (apparently this was Joan Collin’s response) to “because I felt sorry for them.” 1 in 10 women admitted to having sex because someone gave them presents or bought them an expensive meal. Other respondents said they had sex to cure headaches and improve their sexual skills. This last one was a popular response, and one girl said that she saw each encounter with her boyfriend as a chance to ‘heighten’ her skills.

Perhaps the most depressing answer was “I have sex to relieve the boredom. Because its easier than fighting. Plus it gives me something to do.”

The two researchers concluded that women’s sexual attraction was usually triggered by that most Mills and Boon-y character, the tall, deep-voiced man who smelled good, as these qualities indicate high levels of testosterone. However there was hope for short, squeaky-voiced fellows who smell bad, as men with a lower level of testosterone are seen as good long-term prospects, as they are less likely to run off with other women.

The New York Times has run a story claiming that the Republican ex-vice-presidential candidate Sarah Palin’s hair has started thinning with the stress of the past year. They quoted her hairdresser Jessica Steele as saying that Ms. Palin needed emergency help to cover up the loss, after a spate of political setbacks “just broke her heart.”

Hair loss in women is still seen as a rather taboo subject, though it is increasingly common. Like men, women often find that their hair loss can be triggered by stress.

Looking at Sarah Palin, the shock could be any number of stressful events in her life, from an investigation into her taxes, allegations that she abused her position to get her brother-in-law fired and a public feud with the American TV host David Letterman after he make a joke about her daughter. This has all been topped off by her resignation as the Governor of Alaska, a move some say is part of a run-up to a shot at the White House.

The stress-related hair loss syndrome is known as telogen effluvium and describes when hairs in their growing phase are pushed suddenly into their resting phase by a shock to the system. The resting phase then prompts them to fall out.

There are some specific options for women than can halt the hair loss, such as the version of the topical gel Regaine which has been developed especially for females. Unfortunately, the prescription-only medicine Propecia only cures male-pattern baldness, and cannot be taken by women. Some women are opting for the more extreme – and expensive – option of hair transplants.

German health care regulators have warned that the celebrity trend of losing baby fat in the shortest possible amount of time is not only unrealistic but also dangerous. The experts have said that while celebrities are frequently shown in magazines, such as Heat, 6 weeks after the birth of their baby with amazingly flat stomachs, in actuality it takes between 6 months and a year to shed the weight gained during pregnancy.

The German Institute for Quality and Efficiency in Health Care said that women are being put under too much pressure to lose the weight as soon as they have delivered and are being given an unrealistic image of how long it takes by celebrities such as Victoria Beckham and Heidi Klum, both whom were pictured very shortly after their pregnancies with pre-pregnancy figures.

The director of the Institute, Professor Peter Sawicki, said that women often after giving birth will find that weight naturally “melts away”, due to the calories expended during breastfeeding and while looking after a newborn.

However he warned that women should watch their weight while pregnant, especially if they were already overweight or had a tendency to pile on the pounds.

Lack of female sexual desire is basically impotence’s poor little sister. And by poor we mean starving-tramp-in-the-streets-begging-for-a-cup-of-tea poor, as opposed to erectile dysfunction’s billionaire status. There is even a fair amount of dispute amongst doctors as to whether hypoactive sexual desire disorder is even a medical, potentially treatable disorder.

Any news of research being done into the condition is always cheering, so we were pleased to hear about the findings of a team of researchers based in America, at the University of North Carolina’s Gillings School of Global Public Health. They conducted a series of phone interviews with just over 1,000 post-menopausal women to discover how many of them were experiencing a reduced sex drive. The results indicated that between 9 to 26% of women suffered from this problem and furthermore concluded that a significant number of those women were twice as likely to report other health problems, including back pain, fatigue and concerns about their memory.

The researchers discovered that women experiencing HSDD were significantly more likely to be depressed and battling dissatisfaction with their home lives and partners. The team state that their research proves that HSDD is a serious problem and places a weighty burden on the shoulders of those who are suffering. Andrea K. Biddle, associate professor of health policy and management at Gillings, said : “Our research shows that HSDD is a significant and clinically relevant problem, and not a normal or inevitable part of the aging process...Women with the disorder experience health burdens similar to individuals with serious chronic conditions."

It is always encouraging to hear that that we are moving one step closer to seeing this condition more widely recognised. The attitude amongst certain sections of the scientific community that lack of female sex drive is unfortunate but not very worthy of treatment is incredibly depressing, since we know that sexual problems can be hugely damaging to mental health and relationships. It was a big enough struggle to raise erectile dysfunction’s profile, but considering the historical attitude towards female sexuality (ie. if you’re not having fun, lie back and think of England) which still impacts on how we think of women’s – and especially older women’s – sex lives, it seems likely that the road will be even more uphill when it comes to this disorder.

The menopause can be a difficult time, with women experiencing hot flushes, night sweats, mood swings and often a great sense of sadness at the perceived loss of youth. The NHS estimates that eight out of ten women experience symptoms when going through the menopause. Of these women, while some take HRT to ease their severity, others have turned to herbal remedies to combat symptoms after a spate of HRT-related health scares. However there has been a recent warning that these remedies may not only be ineffective but even detrimental to health.

A report in the Drugs and Therapeutic Bulletin has said that there is no strong evidence of the efficacy of herbal treatments and has warned that because there is little clinical research done on herbal treatments, not enough is known about their safety or potential interactions. The Medical and Healthcare Products Regulatory Agency is attempting to better monitor herbal remedies, giving Menoherb (which contains black cohosh, thought to ease hot flushes and sleep problems) a Traditional Herbal Registration. However there are still many treatments, from red clover to ginseng, which have been insufficiently researched. The bulletin identified the lack of extended clinical data on herbal remedies as a big problem; in studies on black cohosh, for example, results were “equivocal” and there are concerns that it may damage the liver. Studies often don’t include a large enough sample of patients and are poorly designed and fail to account for the different chemical makeup of different preparations of the same herb.

A survey in 2007 published by Menopause International found that two fifths of women had tried alternative treatments to combat menopausal symptoms. Herbalists have said that just because there is no reliable data does not mean treatments are not effective, but the authors of the article have expressed concern that doctors may be unaware women are taking herbal supplements and need to routinely ask this when conducting a consultation.

The regulation of herbal medications and food supplements has been coming under increasing scrutiny, with experts in the field of obesity, sexual dysfunction and women’s health warning that consumers are frequently being ripped off or even put at risk by products that are untested and ineffective.

A scheme to give the contraceptive pill out without prescription is being piloted in the London boroughs of Lewisham and Southwark. Prompted by the boroughs’ high teenage pregnancy rate, it is hoped that by improving access to contraception, unplanned pregnancies are more likely to be avoided. Women over 16 will be able to obtain it after consulting with a pharmacist. The pilot has aroused some controversy, for while some believe a new approach to contraception is needed, others argue that it will put patients’ health at risk.

Currently, the contraceptive pill is only available with a doctor’s prescription. This can be got either by visiting your regular GP or by attending a family planning or sexual health clinic. The new scheme will see pharmacists being trained to conduct the same interview a doctor would, to ensure that the woman’s medical history make her suitable for the contraceptive. Chief executive of the Family Planning Trust Julia Bentley is positive about the pilot: "Pharmacists are highly skilled professionals. With the right training and clinical support, they are well placed to conduct consultations with women, ensure patient safety and prescribe the pill in the same way that nurses already do."

The pilot comes a year after Lord Darzi, Minister for Health, announced plans to train pharmacists across the UK to dispense the pill without prior consultation with a doctor. Public health trusts, doctors and pharmacists will work together to create an arrangement called “patient group direction”, where a doctor authorises another health professional to give medication to a specific group of patients. £26.8 m is set to be spent on the scheme, which Lord Darzi has promised will take place under ‘robust’ monitoring.

£30,000 is being spent by the Southwark and Lewisham Primary Care Trusts, and if successful we will doubtless see similar trials being rolled out throughout the country. Doubters fear it will lead to a rise in STIs if young women are pressured into going for the ‘quick’ solution rather than being carefully talked through all their options. The Family Education Trust have also been critical of this approach to cutting teenage pregnancies, for they believe it shows the government to be “more interested in getting young people to use contraception than discouraging them from engaging in sexual activity in the first place”

Certainly teenagers need to be made aware of the other risks of unprotected sex, namely catching an STI, and whoever is giving out the medication needs to be certain they are freely choosing to have sex. However, women of all ages are likely to be in favour of the scheme for it will make managing their sex lives far more convenient. The main question seems to be how well pharmacists will be trained in performing consultations and whether high teenage pregnancy rates will indeed prove to be rooted in ease of access to contraception.

Currently, there is not a huge amount of options available for women suffering from low sex drive. Indeed, it has been fairly hard to get female sexual dysfunction (FSD) acknowledged as a medical issue, rather than one rooted solely in the mind. It is therefore always heartening to hear that new treatments are in the pipeline, and so we at The Online Clinic will be watching medical firm BioSante’s clinical trials of their two new treatments with interest.

The first is an interesting variation on birth control, named ‘Pill-Plus’. The pill acts as a triple-hormone contraceptive, which means that as well as containing the hormones estrogen and progestogen, it also contains the hormone andogen. Decreased andogen levels lead to a waning in sexual desire, sexual activity and cause mood swings. It is thought that ironically enough, women on normal oral contraceptives can experience reduced sex drive due to the other two hormones. BioSante put out a press statement in September stating that their clinical trials had shown testosterone levels (testosterone being the hormone blamed for lowered female desire) revert to healthy levels in test subjects taking the pill. Clinical trials will be continuing in 2009.

The second drug being tested by BioSante is LibiGel, a gel-based formulation of testosterone that is applied to the arm and quickly absorbed into the system. The phase-two trial showed that the drug significantly improved sexual experience for surgically-induced post-menopausal women. A second trial is focusing on the effect of the drug in women experiencing a naturally-induced menopause (the majority of FSD sufferers are thought to be post-menopausal women). The trial had positive results and the company is now embarking on phase three of their clinical trials, intended to meet the safety regulations of the FDA (the U.S Food and Drug Administration).

The agreement reached between BioSante and the FDA, setting the parameters for eventual FDA approval, could have far reaching consequences for the future treatment of FSD, for it indicates that the FDA acknowledges that female sexual dysfunction is a treatable medical condition. Currently, no medication is approved by the FDA for the alleviation of FSD, though Instrina, Proctor and Gamble’s testosterone patch, was granted a license by the European Medicines Agency in 2007 and is prescribed by The Online Clinic where appropriate. In a press conference, Stephen M Sines, CEO of BioSante said, "This action by the FDA confirms the FDA's position that FSD and Hypoactive Sexual Desire Disorder are true diagnosable conditions ... with measurable endpoints that can be evaluated and which deserve therapeutic options”.

Though LibiGel is unlikely to be on the market until 2011 and Pill-Plus is still in the early testing stages, the prospect of new FSD treatments will be greeted enthusiastically. The only current option, Intrinsa, is suitable for just a limited number of patients. It is particularly encouraging that the drugs would appeal to two very different markets, pre and post-menopausal women, indicating that sufferers of all ages may eventually have access to suitable treatment.

For many years there have been tales of how a mother’s eating habits could influence the sex of her unborn child. These claims have often been dismissed as old wives tales but now it seems that there could be an element of truth to be had in these stories.

New research claims that a high-calorie diet and regularly eating breakfast in the run up to conception increases the odds of having a boy. It also suggests that a high glucose diet at this time will increase the chance of having a son. It is not exactly clear why this dietary pattern might have an impact but it has been known for some time in IVF research that high glucose levels inhibit the development of a female embryo whist encouraging the development of the male embryo. Although these two observations are separate, there might be some connection in the influence that environmental factors have on the sex of a foetus.

This latest research appears this month in the Royal Society journal Biological Sciences. It followed the eating patterns of 740 first-time mothers-to-be during the months leading up to conception and throughout the pregnancy. The results showed that 56 percent of mothers with the highest calorie intake had boys compared with just 45 percent with the lowest. The scientists also discovered that women who had eaten the widest and highest quality nutrients were more likely to have a son.

The modern trend in developed countries is for women to eat low-calorie diets. This social habit has led to a decline in the number of boys being born: in the last forty years for every thousand children born the number of boys, per year, has dropped by one.

Why diet might have an influence on sex is purely conjecture but nature has a strange way of influencing the balance of the species in response to various external conditions and, in evolutionary terms, a plentiful supply of food would provide a better environment for a male who is capable of fathering more offspring than a female is capable of producing, thereby making potential grandchildren more viable.

Although the results of the research are interesting from an academic point of view, women should not restrict their diets in an attempt to influence the sex of the child. Even minor alterations at the time of conception and throughout pregnancy could affect the life-long health of their unborn baby.

The findings of a study into the effects of hormone therapies have finally been published in the British Medical Journal, five years after the trial was stopped. The WISDOM study was set up to examine the effects of HRT in post-menopausal women began in 1999 but was abandoned in 2002 after initial findings that HRT could be linked to wider health problems.

The researchers have completed the study in their own time and maintain that, while older women should not commence a course of HRT many years after the menopause, it is perfectly safe for younger women to use oestrogen therapies to relieve symptoms such as hot flushes and vaginal dryness as they go through the menopause.  This study now confirms earlier findings that women in their sixties who take HRT have a higher incidence of cardiovascular problems.

Back in January we brought you news of an exciting new drug in development which can be used to treat erectile dysfunction in men and hypoactive sexual desire disorder in women.  We now have information that the Phase IIb trials for use in men were a success and a meeting has been arranged with the FDA in August to discuss the results and to run through the requirements for the Phase III trials.  Bremelanotide tackles erectile dysfunction in a completely different way from the current generation of drugs such as Viagra.  Bremelanotide targets the central nervous system and is the first medication in a class known as melanocortin agonists.  Because of the way that this new medicine works, it is unlikely to be contraindicated for patients with heart problems or who use nitrates.  Although it will be a while before this medication is available to prescribe, initial findings do appear positive.

The new prescription treatment for Female Hypoactive Sexual Desire Disorder is now available to prescribe.  The Online Clinic is one of the first websites to offer this treatment.  Please follow this link to read about Intrinsa and register - Buy Intrinsa

Intrinsa is not suitable for everyone so please register so that one of our doctors can assess your suitability.  The registration process only takes around 3 minutes.

If you have any questions, please do not hesitate to contact The Online Clinic direct.  A member of staff will be glad to help you.

Intrinsa, the much heralded pharmaceutical patch to help women with a low libido is about to be available to prescribe in the UK.  This is the first of a number of pharmaceutical products currently in development to help women with a low sex drive.  Intrinsa has been launched by Proctor and Gamble which received approval for this product from the European Medicines Agency last July.

The patch works by supplying the body with additional testosterone – a hormone that occurs naturally but is often found to be low in women who complain of having a low sex drive.  The testosterone is delivered via a transdermal patch to reduce the potential side effects.  The patch is placed on the lower abdomen and should be changed every 3 to 4 days.  Trials have shown that women who use the patch are inclined to feel like having sex more frequently.

Intrinsa is a prescription only medication and it will not be appropriate for everyone.  We will provide more information when it becomes available.

If you would like to register your interest in this product, please feel free to send an e-mail to consultations@theonlineclinic.co.uk and we will notify you when we have this product available to prescribe.