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!

The Change from Practice Nurse to Nurse Prescriber

I have worked as a Practice Nurse since 2001 and at Students’ Health Service (SHS) since 2003, completing various courses over these years – minor illness/injury, contraception, sexual health and travel health. As a result of this experience and knowledge, I felt the next step was to be able to prescribe for certain conditions that I felt competent in; to complete episodes of care and to help reduce the number of doctors’ appointments within these specialities at SHS.

Therefore in 2011 I qualified as an Independent Nurse Prescriber, which involved undertaking a recognised Nursing and Midwifery Council (NMC) accredited prescribing course through a UK university.

Legislation to allow nurses to prescribe from an initially restricted list was introduced in 1986, and gradually nurses were given more autonomy, eventually culminating in Nurse Prescribers having full access to the British National Formulary (BNF) which has put nurses on a par with doctors in relation to prescribing capabilities. Although we have access to the BNF, this does not mean we can prescribe everything in there – we only prescribe within our own limitations and scope of competence. So, for example, I feel competent to prescribe antibiotics for certain conditions, and contraception methods, but I do not feel competent to prescribe anti depressants or diabetic medications.

Before the Change – Scenarios I would see in Practice…

“I feel REALLY terrible… I can hardly swallow as my throat is so sore, I can’t seem to get warm, but feeling freezing cold and sweating and I have painful swellings around my neck. I’ve come to Student Health and after waiting to see the nurse and having been assessed, I have been diagnosed with Tonsillitis. I’ve been given a leaflet with information about medicines I should take from the pharmacy to help with my symptoms, but I need to see the doctor for a prescription for antibiotics. I have to sit and wait now for my appointment. The waiting room is full, too much noise and I just want to go home and back to bed…”

“Oh… the nurse is running late… I’ve a lecture in 15 minutes. I just want to start the pill. My friends are all taking it and now I’m with Tom, I don’t want to repeat that episode with the split condom and having to take the emergency pill last month- how stressful was that… Hooray! I’ve been called in… after a few checks and lots of questions looks like I’m ok to take the pill- but the nurse cannot prescribe it and I now need to see a doctor… I’ll have to book an appointment on another day for my prescription as I need to go to my lecture…”

 

After the Change…

Advantages for me as a Practitioner

Being a Nurse Prescriber has increased my autonomy and independence at work leading to greater job satisfaction, especially in my specialised field of travel health medicine, which here at Students’ Health is now entirely nurse-led.This independence provides more streamlined care that is patient-focused.

Advantages for you as a Patient

Continuity of care, with particular reference to the scenarios as above – these are consultations I see fairly frequently and can complete independently in one appointment without the need for referral to a doctor for a prescription. This ensures timely access to medicines and treatments, increasing convenience for you.

Advantages for Students’ Health

Nurses being able to prescribe at SHS increases service efficiency by freeing up our doctors’ time to care for patients with more complex health care needs. We have three Nurse Prescribers at SHS.

Advantages for Secondary Care (Hospitals)

Evidence has shown that Nurse Prescribing helps to avoid unnecessary A&E and hospital admissions and improves access to treatment.

So please, when booking your appointments at SHS, check to see if a Nurse Prescriber can help you with your health care need – we are here to help you.

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

A Very Peculiar Practice… or is it?

http://www.bbc.co.uk/cult/classic/verypeculiar/videoclips/video0.shtml

I prefer to think of it as a unique and special GP Practice; after all I have worked at Students’ Health for 25 years!!

Nursing and GP colleagues in other practices have been heard to say at every possible opportunity……. “That must be a doddle, looking after students. They are all so healthy! Nice little job with long holidays!”

I say “come and work a day with us and you will be amazed at what we do!”

We experience the rich diversity of students and their lives, and love interacting with them.

 Our working days are unpredictable; from critical to chronic medical situations, chaotic to highly organised patients, all needing an individual response to meet their needs at that point in their lives!

Young people are the future and deserve the best care that we can offer them. 

Health education as in educating how to look after themselves and make good lifestyle choices not just a “sticking plaster service”.

Enabling our patients to be well informed, learn about and find the right contraceptive method.

The University of Bristol Students’ Health Service is a leading edge primary care practice with highly qualified and experienced staff.

The nurses may not deal with many pressure sores or leg ulcers but when it comes to knowing about contraception and sexual health we certainly know our condoms!

Nursing Team

Consists of 9 nurses including 2 Healthcare Assistants and all have their specialist areas such as:

Smoking cessation

Asthma / allergy

Nurse prescribers

Travel

Sexual Health and contraception

Mental health

Eating Disorders

Deliberate Self Harm

 

What can we offer you?

Great, modern facilities

Warm and reassuring welcome

A genuinely patient centred approach based on your individual needs

We really listen and won’t judge you, whatever you come with we have probably seen it before!

Practical support

Advice

Experience

 

 What can you do to help us help you?

  • Register with Students’ Health Service when you arrive in Bristol, don’t leave it until you are feeling ill or in crisis
  • Keep your appointments and arrive on time

      We have  a wide variety of appointment times available – early morning, lunchtime, evening and Saturday morning

  • Come and see us before a crisis develops
  • Understand that we will always strive for excellent clinical care, even in difficult circumstances
  • Be aware of other students’ needs, these may have to take priority if someone is seriously ill
  • Look out for each other, especially if your friends are ill
  • Our service is confidential so be honest with us

And most importantly of all have a wonderful time at Bristol University, stay safe and healthy

But if you need to……… Come and see us that is what we are here for!

 

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