Contraception! Get it sorted with Students’ Health Service…

Congratulations and welcome to Bristol, a fantastic city to study in and with endless fun to be had…Fresher’s week, parties, music venues, new friends, new surroundings and, last but not least, a new university course to get to grips with!

 

So before you get stuck in, get all your contraceptive needs sorted with us! We pride ourselves on being friendly and approachable and it’s all confidential so just book an appointment and come and talk to us.

 

So what are your options?

There are many different contraceptive methods available and you should choose one that suits you. Long Acting Reversible Contraception (LARC) has become a very popular option, especially for young adults.

We can provide LARC for free here at the SHS, as well as all the other contraceptive methods available.

 

All LARC is over 99% effective and they do not depend on you remembering to take them or use them to be effective…

 

 larc

 

 

 

Implants

 

  • Small flexible rods inserted under the skin.
  • Releases the hormone progesterone
  • Stops ovulation & a fertilized egg implanting
  • Prevents sperm reaching an egg
  • Lasts for 3 years but can be removed earlier
  • When removed, fertility will return to normal.

 

It’s a simple procedure that we can do at SHS and takes very little time. It also does not hurt to have it inserted or removed as we numb your arm!

 

The coil

 

There are two types of coil

The Copper Coil (IUD)

  • Small plastic and copper device inserted into the uterus
  • Prevents sperm reaching an egg
  • May stop a fertilised egg implanting
  • Lasts 5–10 years (depending on type) but can be removed earlier
  • When removed, fertility returns to normal

 

Some women find their periods may be heavier or longer or more painful so it perhaps not the best choice for someone who already has problematic periods.

Mirena (IUS)

  • Small, T-shaped plastic device inserted into the uterus
  • Releases the hormone progesterone
  • Prevents sperm reaching an egg
  • Prevents fertilised egg implanting & may stop ovulation
  • Lasts for for 5 years but can be removed earlier
  • When removed fertility returns to normal.

 

Women usually find their periods usually become lighter, shorter and sometimes less painful and they may stop altogether after the first few months it has been inserted.  A great option for those struggling with painful and/or heavy periods as well as a great contraceptive!

 

Injection

 

  • Injection releases the hormone progesterone which works in same way as implant
  • Lasts for 12 weeks (Depo-Provera)
  • Periods may stop altogether or may become irregular.

 

Your periods and fertility may take time to return after you stop using the injection.

 

 

 

REMEMBER…Most methods of contraception DO NOT protect from STIs so use a condom if required!

 

We can provide these for FREE!

 

If you have had sex without contraception, or you think your method might have failed, please see us ASAP for emergency contraception.

 

If you think one of the above methods might be for you or you want to have a chat about other methods, please give our reception team a call, tell them what you want to discuss,  and they can book you in with the right health care professional. Or you can use our on line booking system.

 

See you all soon!!

Love is in the air………

It’s Valentine’s Day on the 14th February and many people will be thinking about the L word.

Fuzzy feelings and the glow created by cards and poetry can lead to other things, and it is very easy to get carried away and forget the C word – contraception. Or an accident may befall the wearer of a condom and it may tear or fall off at the wrong moment.

It is at this point that Emergency Contraception should be considered and we can provide it to you free of charge. If you are under 25 you can also get it free from pharmacies.

Emergency hormonal contraception (EHC), often called the ‘morning after pill’ comes in two forms:❤ The first must be taken within 72 hours of unprotected sex, and works best if taken within 24 hours. It consists of one tablet of a hormone called progestogen and can prevent ovulation (release of an egg) which will stop pregnancy occurring. It may also make the lining of the uterus (womb) unsuitable for pregnancy to develop. It is not an abortion, and will not affect your future fertility.

❤ The second is also a tablet, called ellaOne. It is licensed to be given 72-120 hours after unprotected sex. This one needs to be prescribed by a doctor.

There are many old wives tales about the morning after pill, but it can be taken more than once in a cycle if necessary, and will not stop you having a baby when you want one.

EHC is not 100% effective and its efficacy is dependent on where you are in your cycle. A copper coil (IUD) is the only sure method of preventing pregnancy. We can fit these at SHS and this will be discussed when you attend for your EHC.

Taking EHC is not as effective as using regular contraception such as the pill, the implant or the copper coil. We offer a wide range of contraception at Students’ Health Service. Please book in to see us and have a chat about the range of contraception that is available.

There is a lot of information on the internet, much of which is not true or causes anxiety. NHS sites will give you the correct information and enable you to make a decision about what would be best for you. The following site is very easy to use, gives information about emergency contraception and regular methods, and the leaflets are the same as we use at Students’ Health Service:

www.fpa.org.uk

❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤❤

Think about sex day; Valentine’s Day 2014!

Are you thinking about sex? Maybe. Studies tell us that on average you will do 19 times a day if you’re a man, and 10 times a day if you’re a woman!

It’s normal!

What sort of thoughts? The more graphic thoughts I will leave to your imagination but there are numerous reasons why people will think about sex.

Let’s think of some of the less positive thoughts that may cause distress:-

– Sex is always painful

– I’m not getting enough sex

– I love sex but I’m not sure I’m any good

– Have a caught an STI (sexually transmitted infection)? HIV? Other?

– Sex brings back awful memories for me

– Where shall I get condoms/emergency contraception/sexual health checks from?

– Am I big enough?

– Do my genitals look odd? Am I normal? Is that a wart?

– Fears of pregnancy?

– I’m embarrassed to get help or ask advice

 

Please don’t sit alone worrying about these things. Often the worry is needless and reassurance is all that is required, but if not, help is out there.

If you’re not sure about what to do about your worry then preferably ask a health professional e.g. GP/practice nurse/local sexual health clinic. Book an appointment with us. Another alternative is to do your own research in books or on the internet but please take care that you use reputable sites.

Sex is normal. Thinking about sex is normal. Do it as often as you like. If you have sex make sure you do it safely.

The most important part is to not be shy or embarrassed but to come and ask. Remember we nearly all do it, think about it and worry about it at some time. If we didn’t then none of us would be here of course!

See below for some great helpful websites and resources

 

http://www.national-awareness-days.com/think-about-sex-day.html

 

Sexual health – Live Well – NHS Choices

FPA – the sexual health charity | FPA

http://www.brook.co.uk

Symptom Checker, Health Information and Medicines Guide | Patient.co.uk | Patient.co.uk

Find Sexual health information and support services – NHS Choices

 

Have a good day!

Cervical screening…what does that mean?

Cervical Cancer Prevention Week 19th – 26th January 2014

Cervical cancer is the 11th most common cancer among women in the UK, and the most common cancer in women under 35, though still uncommon in real numbers. Did you know that the main cause of cervical cancer is the Human Papilloma Virus (HPV)?

HPV can cause abnormal changes to the cells on the cervix (neck of the womb). The HPV virus is a very common infection and most people who are sexually active will get it at some point. Unfortunately, you wouldn’t know that you have HPV as the virus shows no symptoms. Fortunately, the virus usually clears spontaneously, and any changes to the cervical cells usually resolve on their own. However, for some of us, that doesn’t happen. Cervical screening detects these microscopic changes.

If you are a female aged 25 or above you will receive a letter inviting you to make an appointment for cervical screening. It used to be called a ‘smear test’ or ‘pap smear’. When you receive the letter you need to book an appointment at your local GP practice. At Students’ Health Service this procedure is carried out by one of the nursing team in a 15 minute appointment.

It’s important that you tell your GP practice about any change of address so that we’re sure that you’ll receive a letter.  The best time to make an appointment for is around the middle days of your cycle, when you are not bleeding.

The aim of cervical screening is to detect and treat pre-invasive disease of the cervix which could potentially otherwise lead to cancer.

Cervical screening prevents nearly 4000 cases of cancer per year and saves around 5000 lives.

Cervical cancer is more common if you smoke (women who smoke are about twice as likely to develop cervical cancer as non-smokers), take immunosuppressant drugs, started having sex at an early age or have had several sexual partners, or have had a sexual partner who has had several other partners (however, a woman with only one partner could contract HPV if that partner has previously been in contact with the virus). It’s also important to inform a health professional of any unusual symptoms, such as bleeding between periods or after sex.

Cervical screening is one of the best defences against cervical cancer, along with not smoking, and using condoms regularly.

 HPV vaccination

HPV vaccination also helps to prevent cervical cancer by protecting against the most common HPV viruses. The current vaccine protects against 4 of the HPV types, thus preventing approximately 70% of cervical cancers. There are many HPV types, so even if you have had a complete course of HPV vaccinations it’s important to have regular cervical screening to detect any changes caused by the viruses not included in the vaccination programme.

Further information regarding screening can be found at

http://www.cancerscreening.nhs.uk/cervical/screening.html

 

http://www.jostrust.org.uk/about-us/who-are-we

 

The unwelcome memento…

Welcome to a new academic year at university!

Many of you will have enjoyed Freshers week or simply seeing your friends back in Bristol again..…perhaps there has been a bit more celebration than study? Alcohol can contribute to risk-taking behaviour that could lead to unwanted pregnancies and sexually transmitted infections.

A survey of 16 – 24-year-olds (Define 2008) found that after drinking alcohol

 •            One in seven have had unsafe sex (i.e. Not using a condom)

•             One in five had sex and later wished they hadn’t

•             One in 10 were unable to remember whether they had sex the night before

•             Many (40%) agreed that they would be more likely to have casual sex

How many of you are nodding in agreement..?

Worryingly, Public Health England (PHE) published data in June that showed that new sexually transmitted infection (STI) diagnoses rose 5% in 2012 to almost half a million….HALF A MILLION!!!!

Although in part due to improvements in data collection, the high STI rates in England suggest too many people are still putting themselves at risk through unsafe sex, especially young adults, and men who have sex with men (MSM). Does this include you?

Chlamydia remained the most commonly diagnosed STI (46%), but considerable numbers of genital warts (16%) and genital herpes (7%) cases were also reported last year. New gonorrhoea diagnoses rose 21%. Those aged under 25 experienced the highest STI rates, contributing 64% chlamydia and 54% of genital warts diagnoses in heterosexuals in 2012.

But “I don’t have any symptoms……so I am ok…..right?”

Wrong!

50% of men and 70-80% of women don’t get symptoms at all with Chlamydia infection.

You have up to a 1 in 10 chance of testing positive to Chlamydia!

 That’s why the National Chlamydia Screening Programme exists- its target is to control Chlamydia and its complications, which can include pelvic inflammatory disease (PID), ectopic pregnancy and infertility in women and epididymitis in men.

The advice is that sexually active under 25 year olds should be screened for Chlamydia EVERY year, and on change of sexual partner. Over the age of 25 you should still seek a test following any change in partner.

 

So “how can I reduce my chances of picking up an STI?”  Well, you could just stay home and study, but if that isn’t appealing then consider the following options.

 Recalling that many people with infections are unaware of their status, as they don’t have any symptoms (and therefore cant warn you), the best advice is therefore to  –

  • Reduce the number of sexual partners  you have
  • Avoiding overlapping sexual relationships
  • Always use a condom when having sex with casual and new partners
  • Get tested regularly if you’re in one of the higher risk groups (eg MSM)
  • Get screened for chlamydia every year (if aged under 25) and on change of sexual partner.

 

You can access testing through the Students’ Health Service- see the contraception and sexual health section on our website for more details. You can also pick up a self-testing kit for Chlamydia (and it also tests for Gonorrhoea too) in the practice- they are on the windowsills along the corridors and in the waiting room.

So make sure it’s a memorable start to the new academic year…for all the right reasons and that your not left with an unwelcome memento of that big night out!

Anything Goes

Just returned from a backpacking trip? I bet you have brought back lots of souvenirs, mementos, memories, photos, a lovely tan…? What about Chlamydia, Genital Warts, Herpes, or even HIV?

Yes that innocent looking, healthy, gorgeous person you had unprotected sex with may look like they are clean or may have reassured you they have no infections but how do you know? Some sexually transmitted infections (STIs) have no symptoms… (50% of men and 70-80% of women don’t get symptoms at all with Chlamydia infection), so if some people who have an STI don’t know they are infected- how do you know?

Sun, sea and sex can go hand in hand together with perhaps an increased alcohol intake- ‘beer goggles’ can cause misjudgements about people we sleep with abroad. Inhibitions are lowered and an ‘anything goes’ attitude is created. So you may have also brought back more than you expected from your trip in the form of an STI.

STIs are infections that are spread primarily through person-to-person sexual contact. Blood borne viruses e.g. HIV, Hepatitis B can also be transmitted from mother to child during pregnancy and childbirth, and through blood products.

Common infections include:

  • Gonorrhoea
  • Chlamydia
  • Syphilis
  • Chancroid
  • Human immunodeficiency virus (causes AIDS)
  • Herpes simplex virus 1 and type 2 (causes genital herpes)
  • Human papillomavirus (causes genital warts and certain other subtypes lead to cervical cancer in women)
  • Hepatitis B virus (causes hepatitis and chronic cases may lead to cancer of the liver)
  • Trichomonas

World Health Organisation stats:

  • 499 million new infections of curable sexually transmitted (syphilis, gonorrhoea, chlamydia and trichomoniasis) infections occur yearly. throughout the world with the largest proportion in the region of south and south-east Asia, followed by sub Saharan Africa, and Latin American and the Caribbean, in adults aged 15-49 years
  • Sexually transmitted infections are an important cause of infertility in men and women.
  • Drug resistance, especially for gonorrhoea, is a major threat to STI control globally.
  • STIs can increase the risk of HIV acquisition three-fold or more
  • Untreated gonococcal and chlamydial infections in women will result in pelvic inflammatory disease in up to 40% of cases. One in four of these will result in infertility
  • Herpes simplex virus type 2 infection is the leading cause of genital ulcer disease in developing countries. Data from sub-Saharan Africa show that 30% to 80% of women and 10% to 50% of men are infected. Among women in Central and South America, prevalence ranges from 20% to 40%. In the developing Asian countries, prevalence in the general population ranges from 10% to 30%. In the United States of America, the prevalence of the HSV 2 infection among 14–49-year-olds is 19%
  • Hepatitis B virus results in an estimated 350 million cases of chronic hepatitis and at least one million deaths each year from liver cirrhosis and liver cancer.

Condoms Condoms Condoms!

Think about your sexual health (and contraception) before you go, especially if you are visiting one of the higher risk countries on your travels, and always insist on using a condom! Using a condom greatly reduces your risk for an STI or unwanted pregnancy.

 

Take a supply of UK kite mark condoms, which you can obtain here at SHS, and take care with latex condoms as these can be damaged with oil based lubricants- Vaseline, sun screen etc… Take an adequate supply of contraception or emergency contraception as these may not be easily obtained in certain countries.

Watch your alcohol and drug intake too, as an increased consumption of these may lead you to having unprotected sex. Think about having a hepatitis B vaccination course before you travel.

Remember it takes only one episode of unprotected sex to leave you with an STI, unwanted pregnancy or HIV.

If you have had unprotected sex whilst away- book into SHS or your local sexual health clinic for a full STI screen.

Remember that some STIs don’t have any symptoms so it’s always worth having a check up on your return.

If you do develop any symptoms don’t worry, just book an appointment to get yourself checked out.

 

 

http://www.mariestopes.org.uk/documents/travelguide.pdf.

http://www.nhs.uk/livewell/sexualhealth/pages/sexonholiday.aspx.

http://www.nathnac.org/travel/factsheets/stis.htm.

 

Contraception; your options!

Dear students, and in particular those new to the university and Bristol.

Welcome! You have picked a great city and it’s an exciting time for you all. Parties, Fresher’s week, new friends, often your first time away from home and a new course to get stuck into.

First let me introduce myself. I am Dr Tim Percival; lead GP for contraception at the Students’ Health Service (SHS). I felt it was a good time to get the message out to you all regarding your choices, what we can offer and trying to correct some of the common misconceptions regarding contraception.

We have comprehensive facilities to manage the vast majority of all contraception and sexual health issues from:-

  • Choosing the right contraception and sorting subsequent problems
  • Diagnosis and treatment of sexually transmitted infections (STI’s)
  • Taking cervical smears (if over 25 years)
  • Providing condoms and pregnancy tests free of charge
  • Generally helping you with any symptoms and problems ‘down below’.

We pride ourselves on being approachable and friendly, and we take confidentiality very seriously. So please just come and talk to us!

It is commonly thought that the contraceptive pill and condoms are the ‘usual and only’ options.Condoms are good protection from STIs and are a relatively safe method of contraception but ONLY IF USED CONSISTENTLY AND CORRECTLY.

The pill is a very good option too, especially for those that like good control of their periods. It is a misconception that the pill makes everyone put on weight and become very ‘hormonal’…this is unusual. It is also not a problem to continue the pill long term if you’re fit and healthy.

Longer Acting Reversible Contraceptives (or LARC’s) are becoming very popular for good reason. They give you the benefit of highly reliable contraception that is not prone to ‘user failure’ i.e. ‘had a few heavy nights and forgot my pill’! They are also statistically better at preventing pregnancy. The options are:-

  • Contraceptive implant called nexplanon,
  • Contraceptive injection or depo
  • Intrauterine devices i.e. the copper or hormone coils.

Let’s take each of these in turn and try and dispel some common misconceptions!

 Implant

  • Injected into inner upper arm where can’t be seen and releases hormone slowly
  • Lasts 3 years
  • Generally a simple insertion and removal with at most mild pain from small anaesthetic injection similar to vaccination
  • Very highly effective
  • Low risk hormonal side effects

 Injection/Depo

  • Injected invisibly into upper buttock and hormone released slowly
  • Lasts 3 months
  • Mild pain from injection similar to vaccination
  • Very highly effective

 Coils

  • 2 types 1) copper (IUD) and 2) Mirena (Hormone IUS).
  • Copper IUD lasts 10 years, has no hormones but can make periods slightly heavier so good for any of you with lighter periods
  • Mirena IUS lasts 5 years, has very small amounts of hormone that works locally in the womb to lighten periods so good for those with heavier periods
  • Both very highly effective
  • Can be fitted even if not had children!
  • Can be fitted at Students’ Health
  • Do not make you infertile in the long term (only when device in place!!)
  • Usually mild-moderate period like cramps during fitting. Usually not significant pain during insertion as commonly believed

 

Please remember that none of the above methods protect you against STIs so make sure you also use a condom unless:-

  • with a regular partner,
  • AND you have both had comprehensive STI screening
  • AND you are using an alternative contraceptive method e.g. pill/coil/implant etc.

 If you do have unprotected sex then please see us ASAP for emergency contraception. If we are not open chemists, A+E departments and sexual health clinics can also supply this for you. If you do get pregnant and don’t want to be please try not to panic and see us for advice on your options.

Hope this is helpful. Look forward to meeting some of you. EnjoyBristol!

Dr Tim Percival

GP Students’ Health Service

Misconceptions

“To be great is to be misunderstood”

 So wrote Ralph Waldo Emerson, American poet. He wasn’t talking about the Pill, (it was the 19 th century) but he should have been!

 Contraception IS great, but it is very often misunderstood…

We all have an opinion on it, but do we have all the facts?

 At Students’ Health Service we hear all sorts of myths and misconceptions ( sorry, no pun intended!) about various forms of contraception, and Valentine’s Day would seem as good a moment as any to challenge some of the  more common ones ( and one or two bizarre ones). 

 So here goes; in defence of the good old combined oral contraceptive pill; it does NOT make you “mad and fat”. Any hormonal medication could affect your emotions, but alternatives pills can be tried, and there is NO proven causal link between the pill and weight gain.

Your body does not need a ‘break’ from the pill, it is safe and convenient to take 9 weeks straight through.And as long as you always restart your pill after the 7 day break then that pill free week is equally protected.

 So now to the Emergency contraceptive pill (‘morning after pill’); it can be taken up to 72 hours after unprotected sex, and in most cases up to 5 days (an emergency coil fit is an alternative for up to 5 days too) . It does NOT affect your long term fertility at all, even if you take it twice in one cycle.

 You can get pregnant if you have sex during your period, or use the withdrawal method, and even if you have sex standing up against a wall ( I have heard all of these methods mentioned as protective against conception!).

 And finally to the most reliable method of contraception known to woman (except for your chap wearing socks,and nothing else,to bed…) The coil!

 We fit loads of these, you don’t have to have had a baby to have one, nor can they cause burst ovaries, and nor do they adversely affect long term fertility (after removal) so if you are interested, then come and see one of our coil fitting doctors.

 We give out free condoms to anyone who asks during a consultation with a doctor or nurse, and are happy to discuss all the above methods and more if you’re interested in avoiding an unplanned pregnancy during your academic studies! If you do get pregnant by accident we are here to discuss that too. Remember, all contraception is free!

 Men and women are welcome to come and discuss contraception with our clinical team, who are entirely non judgmental.

 We want to help you make the right choice for you, so come and see us soon, don’t leave it too late!

 

fpa  The Family Planning Association has more info available