Schools should provide free morning after pills and condoms, says NICE

New guidance published by the National Institute for Health and Care Excellence (NICE) has called for schools to offer free morning after pills and condoms to teenage girls to reduce teenage pregnancy rates. NICE even recommended those under the legal age of consent should be provided with contraception.

The guidance aims for more accessible emergency contraception for under-25s; not just contraceptive pills and condoms but also the IUD (intrauterine device, or coil).

The new plans will involve qualified nurses, including school nurses, and pharmacists being able to offer free-of-charge emergency contraceptive pills in accordance with patient group directions (PGDs).

Under PGDs, health workers are able to give medicine directly to the patient without a prescription being required.

Emergency contraceptive pills include Levonelle 1500, which if taken within 72 hours (3 days) of sexual intercourse, will usually prevent pregnancy. Levonelle 1500 can be taken following unprotected sex or if a condom has accidentally come off or split and is available right now from Medical Specialists™ Pharmacy for just £22.50.

Alternatively, women can take ellaOne within 120 hours (5 days) and an IUD may be inserted up to five days following unprotected sex.

The guidance called for young women to be ‘encouraged to consider and choose a suitable form of contraception for their future needs’.

NICE also say that in accordance with best practice guidance, health professionals that are providing emergency contraception should understand they are able to give it to under-16s even without the knowledge or consent of the child’s parent(s).

“Health professionals, including pharmacists, who are unwilling (or unable) to provide emergency contraception should give young women details of other local services where they can be seen urgently”, the guidance states.

Professor Mike Kelly, director of the centre for public health at NICE, said: “It is really important that sexual health services offering information and advice can be found in places where young people have access to them. Evidence clearly shows that the availability of contraception reduces the rate of unwanted pregnancies. Local planners and providers of services must make sure that what they offer is right for their area.”

He added: “Young people often find contraceptive services and advice difficult to locate. This can be for a number of reasons. They may not know where services are, who provides them or when they are open. They can also be wrongly worried that information they give may not be treated confidentially. For that reason, this guidance focuses on ensuring they receive culturally sensitive, confidential, non-judgmental and empathic advice and support tailored to their individual needs.”

Last month saw the Office for National Statistics release figures showing UK pregnancy rates amongst under-18s is at its lowest since 1969 at 27.9% per 1,000 women aged 15 to 17.

It seems things are improving steadily with the number of pregnancies within under-18s dropping to 27,834 in 2012 from 31,051 in 2011, a decrease of around 10%. Meanwhile, 5,432 under-16s became pregnant in 2012, compared with 5,991 in 2011, a decrease of 9.3%.

Brave housewife with PCOS grows her facial hair for Movember

A woman, who has battled hirsutism as a result of abnormal levels of male hormone testosterone, has appeared on ITV’s ‘This Morning’ as her ‘Movember’ charity bid comes to an end.  Movember is a month-long annual event primarily involving men being challenged to grow-out their facial hair. It aims to raise awareness and funds for men’s health; in particularly prostate and testicular cancer.

Siobhain Fletcher 36, from Leek, Staffordshire, suffers from a condition known as PCOS (polycystic ovary syndrome) and has had to try and fight excessive facial hair growth since she was 17-years-old when she noticed whiskers beginning to grow on her upper lip region. During the next few years the hair growth began to worsen and Siobhain found herself having to trim whiskers from her lip and chin almost daily.

Over the next five years she became deeply distraught about her problem and cruel comments from others left her unable to leave the house for the majority of the time.

Speaking to Holly Willoughby and Philip Schofield on This Morning, she explained that a friend’s participation in Movember had inspired her to use her condition positively instead of feeling depressed about her situation. She says “It helps people get checked for prostate and testicular cancer, and hopefully people will, instead of going to a funeral, be going to a remission party.”

Retracing the distressing few years that led up to her joining charity appeal, she said: “I had such low self-esteem. I used to clip it off with scissors, and dress very androgynously. I got stared at a lot and got mistaken for a man. It took its toll. Even though I was pretty, I didn’t feel like that…The only time I left the house was to go and see my horses. They don’t care what you look like, as long as you’ve got food.”

Siobhain tried various hair-removal methods such as waxing and electrolysis, but found no success through either. With her having very sensitive skin, the hot wax ended up removing both her hair and skin.  Electrolysis also proved unsuccessful as it can only remove around 10 to 15 hairs at a time and Siobhain’s facial hair is quite thick. She says: “It didn’t work – the hair grows up my cheeks as well. It was like trying to fell a tree in a forest.”

After continued problems with excessive hair growth in addition to finding herself unable to conceive, Siobhain finally decided to seek medical help and get some answers as to why she was experiencing these symptoms. In 2000 she was formally diagnosed with PCOS, which also causes irregular periods, weight gain, acne and hair loss from the head.

Polycystic ovaries are comprised of many harmless cysts, around 8mm each in size at the very most. Only half these numbers of cysts are found in regular ovaries. Both the follicular cysts and the eggs inside them are underdeveloped and in most cases of PCOS, ovulation cannot occur due to the follicles being incapable of emitting eggs.

The condition affects millions of women in the UK and its exact cause is still unknown but is believed to run in families, with history of high cholesterol and diabetes being contributors. So what are the options to women like Siobhain who cannot afford expensive laser hair removal treatment and will not receive this through the NHS?

Well, there are many inexpensive treatments to help with hirsutism, such as contraceptive pills like Dianette or Yasmin, as well as non-hormonal therapy in Spironolactone.

The combined oral contraceptive pill Yasmin, suppress androgens (male sex hormones) through the drospirenone inside the tablets. Yasmin has also been shown to maintain or even lose weight and just like Dianette, is incredibly effective at combating skin problems such as acne. Dianette and Spironolactone are also anti-androgens. Dianette contains a special hormone called ‘cyproterone acetate’ and is often prescribed to help regulate periods, reduce hair growth, reduce acne and is an excellent contraceptive. Unlike Dianette, Spironolactone is a non-hormonal treatment and thus does not work as a contraceptive method. However, Spironolactone has been used for over 20 years as an anti-androgen in the treatment of acne and hirsutism, being the most widely prescribed medication for these problems in the USA.

If you are still confused as to which treatment is most suitable for you, why not visit the ‘Women’s Health’ section on the Medical Specialists Pharmacy website. Here you can find out plenty of information about these medications and many more.

Female oral contraceptive pills could alleviate menstrual cramps

Oral contraceptive pills such as Dianette are taken by women for everyday for 21 days of their menstrual cycle, followed by a 7 day break when no pills are taken at all (also known as ‘cyclic treatment’). During this one week time period, women are still protected against unwanted pregnancies. In the 7 day rest period, hormone levels in the blood begin to decrease and women will experience a withdrawal bleed that is just like a normal period. Regardless of bleeding, the next pack of 21 tablets is begun after the week is up.

However, some experts are now claiming that women could see health benefits from taking the oral contraceptive pills uninterrupted throughout the menstrual cycle instead of adhering to the usual 21 day block. Specifically, the scientists involved in the study into oral contraceptive pills, allege that this continuous usage can provide women with earlier relief from the symptoms of dysmenorrhea.

Dysmenorrhea is one of the most gynaecologic complaints amongst younger women, with an estimated three quarters of them suffering from such problems and the term can basically be defined as ‘painful periods’. For roughly a fifth of women, the pains are so severe and unbearable that it can actually prevent them from going about their day to day activities. Dysmenorrhea happens during menstruation and is thought to occur because of three main reasons; unusual uterine contractions, more pressure on the pelvic region and a heightened sensitivity to pain.

Dr Richard Legro, professor of obstetrics and gynaecology at Penn State College of Medicine, says, “Between 50 and 90 percent of women suffer from this condition, and it can really limit work, school, or athletic performance. Previous studies have estimated that dysmenorrhea accounts for 600 million lost work hours and $2 billion annually.”

The women involved in Dr Legro’s study, were all experiencing inexplicable menstrual pain. This means that health experts could not pinpoint their pains to typical common problems such as ovarian cysts, endometriosis, any past surgical procedures, or other pelvic or bowel diseases.

Dr Legro commented on the aims of his study and said, “Oral contraceptives are often prescribed to treat this condition (dysmenorrhea), since reducing menstruation is a relatively straightforward way to relieve this cramping. However, we wanted to determine whether there was a measurable difference between cyclic and continuous oral contraceptive treatment methods.”

To judge the effects of a cyclic course of treatment vs. a continuous method of taking the contraceptive pills, Dr Legro split the female subjects into two groups and each group spent half a year on that particular therapy. After the evaluation, it was discovered that both groups had actually seen a decline in menstrual pain over this time. Interestingly though, the group assigned the continuous treatment, overall stated they had experienced substantial pain relief earlier on compared to the others.

Despite the promising indications shown in this study, Medical Specialists Pharmacy do not advise women who are taking Dianette to make any alterations to the recommended course of treatment before consulting their own GP first. We believe further analysis is warranted to fully determine the risks and benefits involved with continuously taking oral contraceptive tablets.