Women's Health Ireland - Q1 2020

Q1 / 2020 AN INDEPENDENT PUBLICATION DISTRIBUTED ON BEHALF OF MEDIAPLANET WHO TAKE SOLE RESPONSIBILITY FOR ITS CONTENTS

HELEN FORRISTAL, MARIE KEATING FOUNDATION

“People with BRCA gene mutations are at greater risk of developing cancer.” » p2

PROFESSOR CATHERINE KELLY

“The most common part of the body for breast cancer to travel to is bone.” » p3

DR CAITRÍONA HENCHION, IRISH FAMILY PLANNING ASSOCIATION

“Access to contraception is key to health and wellbeing.” » ONLINE

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With the information and advice you receive, you can begin to plan and move forward if it feels like the right thing to do.

Promoting breast cancer awareness in schools IVAN AHERN Director, Cornmarket

A newly expanded education programme from Cornmarket & Breast Cancer Ireland aims to help women spot breast cancer early.

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ornmarket has teamed up with Breast Cancer Ireland to expand their awareness and education programme and help women recognise the signs and symptoms of breast cancer.

There is a common misconception that breast cancer only affects older women.

However, the statistics tell a different story, with 30% of women diagnosed with the disease aged between 20 and 50*.

Early detection of breast cancer is key to survival, and if women can be educated to self-check, this will help increase awareness and ultimately save lives.

The awareness and education programme supports visits to schools to educate teachers, as well as transition year students, on the signs and symptoms of breast cancer.

Initially when Cornmarket came on board the programme was aimed solely at transition year students and secondary school teachers. The scope of the project has now grown significantly, and has been expanded to target primary school teachers too.

The programme is available in schools throughout Ireland and is delivered by qualified Breast Cancer Ireland representatives, including both breast cancer survivors and nurses. They have a genuine passion for educating others and sharing their stories.

As part of their presentations in schools, these representatives use a specialised mannequin for medical instruction, which allows participating teachers to feel for lumps and learn what to look out for during a self-examination.

Presentations are free of charge and can be arranged for 20-25

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minutes during lunch or 45 minutes after school hours.

Feedback on the programme has been positive and continues to gain momentum.

• 100% of respondents rated the programme as excellent or very good • 98% of respondents said they were not self-checking correctly before the presentation • 100% of respondents said they would recommend the programme to a friend. *Breast Cancer Ireland 2019

Cornmarket is proud to sponsor this programme and through its support of Breast Cancer Ireland, understands that knowledge is power and awareness saves lives.

To register your interest in a presentation for your school, visit: www.cornmarket.ie/intobreast-health-programme Presentations are on hold until after Covid-19, however you can still register your interest in advance.

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How the BRCA gene affects your likelihood of developing cancer The BRCA1 and BRCA2 gene, or the ‘Angelina Jolie gene’ as many know it, is a human gene that produces tumour suppressor proteins.

HELEN FORRISTAL Director of Nursing, Marie Keating Foundation

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ut at i ng or a lter i ng this gene can result in incorrect functioning and, as a result, increased likelihood of cells developing genetic alterations, which can lead to cancer.

Put simply, if you test positive for a BRCA gene mutation, you are at an increased risk of developing certain cancers in your lifetime.

The BRCA1/2 mutation does not cause cancer to occur on its own, though, and having a positive BRCA gene mutation doesn’t necessarily mean you will definitely develop cancer. However, people with BRCA gene mutations are at greater risk of developing cancer because their cells’ ability to repair DNA damage may be impaired by the gene mutation. It is the accumulation of DNA damage that can cause a cell to change into a cancerous cell.

Is the BRCA gene inherited?

Many things are passed down in a family’s genealogical lineage, and the BRCA gene is no different.

If you are a woman who has had breast cancer or ovarian cancer in the past, you may be the first in your family to have developed the BRCA mutation, but it could also be a result of someone in your family line passing the mutation down.

Both men and women can carry the BRCA gene and, for women, this increases their risk of developing breast and ovarian cancer. But, why is it important to know whether you have a BRCA gene mutation?

Well, it’s important to know so that other members of your family are aware of the risks and can take proactive steps if desired.

What should I do if I am BRCA positive?

It is important to have BRCA testing done so that you know for sure if you are BRCA positive. You will need to talk to your GP in the first instance and seek a referral to a genetic counsellor.

With the information and advice you receive, you can begin to plan and move forward if it feels like the right thing to do. For many, deciding to get this test done can be daunting, but you can begin to take control of your health and think about the best options for you.

Once tested and if you are positive, it is very important that you share this information with your family so that they can make the decision on whether they would like to be tested too.

The gene is passed down from your parents, so both your siblings and children have a 50/50 chance of having the same mutation. This is why it’s important that they know the risks and are allowed to make the decision for themselves. Advice on how to tell your family members that you are BRCA positive, and information on risk-reducing surgery is available on our BRCA page www.mariekeating.ie.

For anyone newly diagnosed or needing further information or support, please have a look at our peer-to-peer support network who have all tested positive to the BRCA gene and are willing to help you at www.mariekeating.ie/cancer-services/brca/. The network provides a space where questions can be asked and answered in confidence by people that have gone through the same process.

Due to the essential decisions that have been made by the Government in relation to gatherings and social distan c in g, th e Mar ie Keat in g Foundation has been forced to cancel all of its upcoming fundraisers, which has had an immediate impact on the cancer charity’s income. As a result, the Marie Keating Foundation is making an urgent appeal for the public’s help as they face an unprecedented situation with fundraising being curtailed and ser vices stretched. If you can, please donate at www.mariekearing.ie/donate

About the Marie Keating Foundation:

Following their mother Marie’s death from breast cancer in 1998, the Keating family committed to ensuring men and women in every community in Ireland had access to the necessary information to prevent cancer or detect it at its earliest stages.

The Marie Keating Foundation is now a leading voice in cancer awareness and information for both men and women in Ireland. The Foundation’s mission is to make cancer less frightening by enlightening and it provides support and information on all the common cancers including breast cancer, cervical cancer, bowel cancer, lung cancer, skin cancer and prostate cancer among others.

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Bone health and metastatic breast cancer

A person has metastatic breast cancer when breast cancer spreads to other parts of the body for example bones, liver, lung or brain.

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he most common part of the body for breast cancer to travel to is bone. When breast cancer is in the bones we say the person has bone metastases. The diagnosis is usually made when the person complains of bone pain and tenderness.

In most cases the diagnosis is straightforward, however, sometimes, it can be difficult if the person has other bone and joint problems such as a degenerative disease, inflammatory joint conditions or previous bone injuries that cause them ongoing pain.

There are many different radiological tests that are used to detect and determine the extent of bone metastases. These include plain X-rays, CT, MRI and bone scans.

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Treatment options for bone metastases Bone metastases can cause a number of problems such as fractures, bone pain, pressure on nerves and in some cases levels of calcium in the person’s blood can increase and make them feel unwell. Thankfully, there are many excellent treatment options.

Medical oncologists can prescribe bone modifying agents. These are drugs typically used to treat osteoporosis and they have resulted in a dramatic reduction in the number of skeletal complications seen in people with bone metastases.

They are also associated with improvements in bone pain and quality of life. Treatment with these drugs can cause blood levels

of calcium to fall so patients need to take regular calcium and vitamin D supplements to prevent this.

For painful bone metastases a single dose of radiation is often very effective Another important side effect associated with these drugs is a condition called osteonecrosis of the jaw. In order to minimise the risk of ONJ a dental review before starting bone modifying drugs is advised.

PROFESSOR CATHERINE KELLY Consultant Medical Oncologist Maintaining quality of life and mobility For painful bone metastases a single dose of radiation is often very effective and in some cases orthopaedic surgeons can stabilise or insert pins into bones that have become unstable as a result of the bone metastases. Palliative care specialists are also crucial in making sure pain is not a problem and this is essential to maintain quality of life, and mobility.

For postmenopausal women with a history of breast cancer that has been fully removed, bone modifying

drugs i.e. osteoporosis drugs can be prescribed to reduce the risk of their cancer coming back in their bones. Often these women are taking hormonal treatments that can cause a reduction in their bone density so giving them an osteoporosis drug can have two benefits.

Firstly, it can improve their bone density, and secondly it can reduce their risk of breast cancer reoccurring in their bones.

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Breast health and how to self-check DR ANN SHORTT GP, Emergency Medicine Consultant and Director, Full Health Medical

Women shouldn’t struggle on with menopause

As women become older, changes in their body can impact their lives, whether that’s difficulty sleeping, becoming more emotional or mind fog.

A recent bout of media attention on the changes women go through while ageing has been helpful in raising awareness.

DR CLIONA MURPHY, FRCPI FRCSI MRCOG BSCCP Chair of the Institute of Obstetricians and Gynaecologists, and Consultant Obstetrician & Gynaecologist, Coombe Women’s and Infants’ University Hospital

New ‘Pink Power’ initiative sponsored by Cornmarket successfully raises awareness by 50% and could save many lives.

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ne in nine women will be diagnosed with breast cancer in Ireland in their lifetime. It’s the biggest “female” cancer with 3,100 new cases diagnosed annually*. Thanks to research by Breast Cancer Ireland and other agencies, it is becoming a more treatable, curable illness.

New tests mean the ability to personalise treatment plans, allowing clinicians to gauge the effectiveness of treatments and the likelihood of the cancer returning.

In the next ten years, it’s expected that most breast cancers will become treatable with drug therapy, and surgery; making invasive chemotherapy a thing of the past.

What to look for However, even with all the advances in research, awareness and early intervention remain central to the fight against breast cancer. If you experience any of the following symptoms you should get checked by your GP without delay:

Pink Power Don’t forget to check your insurance policy too – many are now offering wellbeing programmes with really valuable benefits. For example, insurance brokers, Cornmarket, recently launched a programme called Pink Power to thousands of their customers.

Pink Power offers a face-to-face appointment with a GP for a one-off physical exam, education on how to self-check, and a referral for further investigation if needed (mammogram, ultrasound, biopsy). Cancer was caught in 14 customers. Many said it saved their life. Meanwhile, 90% said they were more confident to self-check after their appointment, compared to only 40% before**.

Cornmarket’s Pink Power initiative is an excellent example of how we can increase awareness in women, and ultimately save lives. *Breast Cancer Ireland, Feb ’20. **Cornmarket, Feb ‘20.

For more information visit cornmarket.ie/pink-blue-power

• • • • • • • •

A lump in the breast or breast area A swelling in the armpit Enlargement of the glands around the breast Puckering of skin in the breast A change in skin around the nipple or nipple discharge Dimpling of the nipple or nipple retraction An unusual increase in the size of one breast One breast unusually lower than the other.

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and breastcancerireland.com, where you can download a free app, “Breast Aware,” for reminders and guidance on how to self-check.

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or Dr Cliona Murphy, as Consultant Obstetrician and Gynaecologist in the Coombe Women and Infants University Hospital and Tallaght University Hospital, it is her role to support women as they go through changes in life, such as menopause, and she says ‘awareness’ is key.

“When women get to their 40s, they’re often not expecting their periods to change. While that can be the first sign of the menopause, there are many more side effects that can come with it. Symptoms can include hot f lushes, night sweats, an uncontrollable rush of blood to the face; all of which can all be distressing.

“Many might have disturbed sleep and feel exhausted in the morning, which can play havoc with work situations and can be distressing. There are also more physical causes such as palpitations, feeling that their bones are aching, lacking energy, experiencing joint pains, or experiencing vaginal dryness, making sex painful. What women need to realise is that these symptoms are absolutely normal and that they don’t need to struggle on.”

Menopause isn’t a disease Dr Murphy is spreading the message that menopause isn’t a disease, it is just a way of life. She says, “For many years, focus has been on maternity and gynaecological problems that need surgery. But, while these are important, we still need recognition about the second phases of our life.

“In England and Ireland, women are living to 78-80, so our quality of life has to be prioritised. To do

We can protect against osteoporosis with a diet rich in calcium and vitamin D, combined with exercise this, I‘d like to make links with midwifery colleagues when it comes to planning for the future.

I would also like to see links with other colleagues for the ‘whole life’ concept of women’s health and see how we can integrate things more.”

Preparing women for menopause This approach would become heavily focused on preventative med ic i ne, g iv i ng adv ice a nd actively preparing women for the peri-menopause and menopause.

From addressing fears and concerns such as prolapse, to information on physiotherapy and strengthening the pelvic floor as well as offering support with diet and exercise. Dr Murphy adds, “These are all nonsurgical interventions that can optimise people’s wellbeing before they even need surgery.”

With our lifestyles constantly changing, cases of osteoporosis are on the rise and some factors – such as taking certain contraception or HRT – can inflate these risks. The benefits of the modern age, however, mean that GPs can now prescribe much more tailored options to suit our personal circumstances and family history.

Protect against brittle bones “ We c a n prote c t a g a i n s t osteoporosis with a diet rich in calcium and vitamin D, combined with exercise – particularly weightbearing – to help protect our bones.

If the diet is low in those vitamins, supplements can help.”

When women reach middle age, they should attend their screening checks, such as mammograms and smear tests, and if possible, have an overall health check.

Dr Murphy adds, “I use my time with patients to go through family history, check they’ve attended their screenings and ask them about diet.

These touch points can add value to any visit. But the most important thing is to make women see that if there are any changes along their journey into the second phase, whether that’s menopause or other symptoms, they should be able to go and ask their GP for help.”

More info: For further advice about menopause, the British Menopause Society has a range of helpful information online.

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Overactive bladder - what you need to know Overactive bladder (OAB) is a very common condition affecting about one in five women of all age groups. It is estimated that about 350,000 above the age of 40 in Ireland have this condition.

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A B is a condition that causes symptoms such as needing to run to the toilet to pass urine (urinary urgency) and, possibly, urinary leakage before getting there (urinary urge incontinence). It also causes an increase in the number of visits to the toilet during the day and at night (urinary frequency). OAB is still largely a ‘hidden’ condition.

Patients do not readily admit to symptoms because they feel embarrassed or attribute them to the process of ageing.

More than two-thirds of women with OAB report a negative effect on daily life. OAB has been associated with many other problems including depression, falls and fractures in the elderly (as a consequence of rushing and frequent visits to toilet at night) and, as a result, increased admission to hospitals and nursing homes.

Diagnosis and treatment options for OAB The cause of OAB is still unknown.

A d iag no s i s of OA B i s m ade based on the person’s symptoms and by ruling out other causes like neurolog ical diseases or, more c om mon ly, i n fe c t ion s.

Investigations that the doctor may order include a bladder diary and urine analysis. Secondary investigations include urodynamic testing, a cystoscopy, and imaging of the upper urinary tract.

Once the diagnosis has been made, treatment includes lifestyle modifications like adjusting the volu me, t i m i ng a nd t y pes of fluid intake. The recommended volume of f luid intake in this climate is 1,500-2,000 ml per day.

It’s also recommended to reduce the intake of caffeine-containing drinks (tea and coffee), alcohol and carbonated drinks.

It is imperative that we encourage women to not endure these symptoms and instead to seek medical attention.

In addition to lifestyle modification, exercises aimed at strengthening the pelvic floor musculature are a key part of managing OAB. Patients are also taught bladder training, which aims at increasing bladder capacity and subsequently increasing the interval between toilet visits, thus decreasing the symptoms or urgency.

The importance of seeking medical attention M e d i c a l m a n a g e m e nt i s a n important part of controlling the

PROFESSOR BARRY O’REILLY Consultant in Obstetrics and Gynaecology, Cork University Maternity Hospital

symptoms of OAB. The choice of therapy should be guided by the individual’s other medical conditions or other drug therapies, as not all the drug options are the same.

It is often useful to consider combination therapy if the symptoms are difficult to control.

If medical management fails, other treatment options include Botox injections into the bladder, or st i mu lat ion of t he ner ves responsible for bladder control, which can be performed in an outpatient setting. Other options would include major surgery to increase bladder capacity.

OAB is a prevalent and debilitating condition with a significant impact on the quality of life of the patient. It is imperative that we encourage women to not endure these symptoms and instead to seek medical attention.

It is also as important to enforce

preventative measure on a national basis including raising bladder awareness, good toileting habits and pelvic floor exercises.

Sources: 1: Source: Milsom et al. How Widespread are the Symptoms of OAB? BJU Intl. 2001; 87: 760-766.

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A guide to contraception Access to contraception is key to health and wellbeing: it enables people to have a satisfying, safe sex life and plan if and when to have children.

When women can control their fertility, they can plan their lives.

Which method should I use?

Not every contraceptive suits everyone, and the same contraception won’t suit every woman throughout her life. Many women switch contraceptive methods as their needs and priorities change.

Fortunately, there have never been so many contraceptive options.

• Barrier methods (diaphragms and condoms).

• Short-acting, hormonal contraceptives (combined pill, mini pill, vaginal ring, patch): these work by stopping the ovaries producing eggs.

• Long-acting, reversible contraceptives (hormonal coil, copper coil, implant, injection): these highly effective, long-lasting contraceptives last anywhere from three months to ten years.

• Emergency contraception (emergency contraceptive pill, copper coil): effective for up to five days after unprotected sex, MEDIAPLANET

Fortunately, there have never been so many contraceptive options this post-coital contraception prevents pregnancy when regular contraception has failed or wasn’t used.

• Permanent methods (vasectomy, tubal occlusion): for those whose family is complete or de c ide t hey don’t w a nt to have children.

• Fertility awareness methods (n at u r a l f a m i l y pl a n n i n g) involves tracking ovulation.

These are much less reliable fo r p r e g n a n c y p r e ve nt io n than modern methods.

DR CAITRÍONA HENCHION Medical Director, Irish Family Planning Association

Is contraception free?

Contraception is not free yet! Last year, health minister Simon Harris announced that contraception would be free in 2021. But, for now, most people in Ireland must pay.

The most effective long-acting reversible methods can be out of reach for many women, because of the high upfront cost of purchasing the device and having it inserted.

But over the time a woman has one, the total cost is much less than for oral contraceptive pills.

If we want a society where women c a n pa r t ic ipate i n education, employment, in their communities and in politics, remov ing cost and prov iding universal free access to contraception will take us a step further towards that goal.

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Protecting yourself from fertility’s ageism Whether you’re years away from, or thinking of trying for a family soon, knowing your reproductive health information gives you options. Know your numbers. Don’t wait and see with something as important as fertility.

DR JOHN WATERSTONE Medical Director and Consultant Gynaecologist, Waterstone Clinic

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odern life is demanding longer timescales for family planning than biology is sometimes able to provide. Young people deserve information about their reproductive health and the scientific evidence to inform their decisions about family planning.

Fertility is a medical issue, and we must destigmatise it: there is no ‘failure’ in infertility or sub-fertility, and it affects men and women equally. We must also not take it for granted, as up to one in six couples will have difficulties conceiving.

What can we do to protect our fertility?

We know that female age is the most predictive factor of the ability to conceive, and this ability declines rapidly with age. We also know, however, that fertility is individual, and averages are not one-size-fits-all: we need fertility health checks.

Get a health check Semen analysis testing for men, and Anti-Müllerian hormone (AMH) testing, alongside a fertility-focused ultrasound scan for women, give valuable insights.

For women, the number of

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eggs in the ovaries provides information they can use to consider proactive steps – such as egg freezing – to preserve their fertility before their mid-30s. The younger you are, the more likely your eggs are healthy and normal.

As you age, however, the quantity of those eggs decreases, and so does the number of eggs that are normal and could produce a pregnancy.

Protecting your fertility – by having health checks at a fertility clinic – must become as routine as general health checks. Even if you don’t want a family right now, being proactive about your fertility can make all the difference when you are ready.

Accessing your reproductive health information will empower you to make decisions about your future and take out the guesswork: if you don’t wait and see in other areas of your life, why would you with something as important as fertility?

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How to increase your chances of conceiving naturally PROFESSOR MARY WINGFIELD Member of the Institute of Obstetricians and Gynaecologists, and Clinical Director at the Merrion Fertility Clinic, Dublin

The older you are, the less likely you are to conceive naturally. So, while lifestyle changes can boost your chances of pregnancy, the best advice is, ‘don’t leave it too late’.

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ertility issues are far more common than people realise.

In fact, figures show that one in six couples of reproductive age have problems conceiving. For many, this is devastating — and the emotional impacts can have farreaching consequences.

“Fer t i l it y issues can affect people’s self-esteem and make them feel helpless,” says fertility expert Professor Mary Wingfield from the Institute of Obstetricians and Gynaecologists in Dublin.

“It can affect their work, general wellbeing and their relationships.

One of the difficulties is that people experiencing fertility problems may feel as though it’s ‘their fault’ in some way, when it’s absolutely not.

It’s very unfair.”

Why age is an important factor in pregnancy Age plays a significant role in the chances of conceiving naturally.

Decline in fertility varies from person to person, but, generally, fertility at the age of 35 is roughly half of what it is at the age of 25.

A 30-year-old woman trying to conceive has a 75% chance of getting pregnant naturally within a year. At 35, she has a 66% chance; and at 40 she has a 44% chance.

“Women and men are postponing pregnancy for all different reasons,” says Professor Wingfield. “This seems to be one of the biggest causes of fertility issues in the developed world because, as they

Fertility issues can affect people’s selfesteem and make them feel helpless

get older, women’s eggs don’t work as efficiently.

“One study shows that if you want a 90% chance of having one child, you need to start trying to conceive by the time you’re 35. If you want a 90% chance of having three children, you need to start by the time you’re 28.”

Age isn’t the only contributing factor, however. Infertility due to sperm issues makes up a quarter of all cases Professor Wingfield sees.

Ob e s it y app e a r s to h i nder conception, as does pelvic damage caused by chlamydia and other sexually transmitted diseases (which can cause problems for both men and women).

How lifestyle changes increase the possibility of conception To boost your chances of conceiving naturally, there are things you can do. Lose weight if you need to (but make sure you’re not underweight, because that can cause problems

too, warns Professor Wingfield), eat a healthy, preferably Mediterranean diet, and cut out cigarettes, as smoking is thought to reduce fertility by around 50%.

But what are the alternatives if none of this works? “See your GP to understand whether there’s anything obvious in your history, and check the woman is ovulating and free of cysts or fibroids,” says Professor Wingfield. “After that, we’re increasingly recommending fertility treatments such as IVF (in vitro fertilisation) and IUI (intrauterine insemination).”

However, the chances of having a baby via these routes depends on age (the older you are, the less successful treatment may be, while the risk of miscarriage increases) — and it can be expensive.

Ultimately, Professor Wingfield’s best advice is: don’t leave it too late.

“Fertility treatment success rates are increasing all the time,” she says. “So, you can be lucky. But the fact is you have the rest of your life to focus on houses and jobs, while the window you have to get pregnant is very narrow. And once you lose those years, you can’t get them back.”

WRITTEN BY TONY GREENWAY

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Get tested. Get treated.

Get on with your life.

If you are sexually active, regular STI screening is important. STIs can cause long-term problems, such as infertility and you could pass an infection on to someone else. Testing is easy and all STIs can be treated.

How do I get a STI? STIs are passed on through sexual contact: e.g. vaginal or anal intercourse, genital to genital skin contact, oral to genital or anal contact.

The risk of an STI is increased by having more sexual partners. But it’s possible to get an infection the first time you have sex if your partner has had any previous partner.

How can I protect myself from infection?

The risk of infection is significantly reduced by using male condoms and dental dams during sex. However, no method provides 10 0 % p ro te c t ion: i n fe c t ion s such as wart virus, herpes virus and syphilis can be passed by skin contact.

How do I know I have an STI? Only by getting tested can you k now i f you have a n ST I, as many people have no symptoms following infection. Symptoms can include lumps, sores, ulcers or blisters in the genital area or mouth, vaginal or anal discharge, needing to pass urine more often, stinging or burning when passing urine, pressure or pain in the lower abdomen, discharge from the urethra (where the urine comes out) and pain in the testicles.

Only by getting tested can you know if you have an STI, as many people have no symptoms following infection.

How do I get tested and treated?

Most GPs and sexual health clinics provide screening for STIs. Free testing is available from GUIDE or GUM Clinics.

Chlamydia, gonorrhoea and syphilis can be cured with antibiotics. Antiviral treatment for HIV can now reduce the viral load to the point where a person is healthy and well and will not transmit the virus to a partner.

BY CAITRÍONA HENCHION Medical Director, Irish Family Planning Association

Hepatitis can also be fully cured.

The body’s immune system will clear wart virus, but treatments such as freezing can speed this up.

Herpes virus remains in the body, but outbreaks are treatable with antiviral drugs and usually become less painful and less frequent over time.

I f you a re sex ua l ly ac t ive, get tested regularly. If you are d iag nosed w it h a n ST I, it is important to inform any recent sexual partners.

If a past or current partner tells you that they have an STI, attend a doctor for testing and treatment.

It may not be welcome news, but it w i l l help you prote c t your health.

Read more at healthnews.ie

Key information • STIs are passed on through sexual contact • The risk of an STI is increased by having more sexual partners • Risk of infection is significantly reduced by using male condoms and dental dams during sex • No method provides 100% protection • Most GPs and sexual health clinics provide screening for STIs • If you are sexually active, get tested regularly.

Get checked, get treated, live free of bacterial vaginosis

Bacterial vaginosis is a common infection that is easily treated, but embarrassment can stop women from seeking the help they need.

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on’t be embarrassed about bacterial vaginosis (BV) – it’s more common than you might think, and we’ve seen it all before.

That’s the message from one of Ireland’s leading sexual health clinicians, who has advised women to get checked, and get treated.

“BV is an inflammation in the vagina caused by an overgrowth of one of the bacterial species called anaerobes naturally found in the vagina. These overgrow the ‘good bacteria’ called lactobacilli, so in effect it is an imbalance between the bad bacteria and the good bacteria,” says Dr Dominic Rowley, a Consultant Physician in Genitourinary Medicine.

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“In effect, it’s bacterial imbalance between the bad bacteria and the good bacteria, not a sexually transmitted infection (STI) and it’s not contagious, but it can be difficult to live with and can occur in women in their early teens right up to those in their forties.”

Causes and symptoms of BV The main causes of the infection, which can result in an unusual white or grey discharge, an unpleasant fishy odour, vaginal itch or pain when urinating, are multiple sexual partners, a change in partner, using sex toys, and douching.

BV is different from thrush and has different symptoms needing different treatments.

“Some people douche because it’s something that their mothers and grandmothers have always done, but it’s not necessary because the vagina is self-cleaning,” explains Dr Rowley.

“It c a n b e s e l f-p e r p e t u ating – women use a douche then notice the symptoms of bacterial vaginosis, so they do it again and that makes it worse.”

Treatments for BV BV is one of the most common vaginal infections, but it is easily treated. Doctors can prescribe a week-long course of antibiotics, and over-the-counter gels are also available. Some of these gels treat and can also prevent recurrence of BV.

DR DOMINIC ROWLEY Consultant Physician Genitourinary Medicine, Midlands Regional Hospital Portlaoise, and Medical Director, Letsgetchecked “The gels aren’t as effective as the antibiotics, which clear about 80% of infections,” notes Dr Rowley.

“However, over-the-counter medications are available in pharmacies and online, and women who lead a busy life do not have to go to a GP to get these gels.”

Complications Untreated BV can make women more susceptible to contracting STIs, and, in pregnant women, can lead to premature delivery and lowweight babies.

What’s more, women who have

BV and HIV are more likely to pass the HIV infection onto their partners. In rare cases, BV can also lead to pelvic inflammatory disease, which can cause infertility.

“My key piece of advice would be if you have a discharge that’s not normal for you, please come into a sexual health clinic,” Dr Rowley concludes. “Don’t be embarrassed – it’s one of the most common things we see and it’s really easily treated.”

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