Comment: Relationship boundaries
Paul Woolley
pp 4-6
Have you ever found yourself wondering: can I set limits and still be a loving person? How can I answer someone who wants my time, love, energy or money? Why do I feel guilty when I consider setting boundaries? In their book Boundaries: When to Say Yes, When to Say No, To Take Control of Your Life, clinical psychologists Henry Cloud and John Townsend try to answer these and other questions about setting healthy boundaries with your parents, spouse, children, friends, co-workers and even yourself.
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Sexual problems in men and women with diabetes
Moayyad Kamali
pp 7-9
Sexual dysfunction is common among patients with diabetes. While most studies in the literature focus on men with erectile dysfunction (ED), this article will review sexual dysfunction in both men and women with diabetes. Loss of libido in diabetic patients can occur due to metabolic reasons. For example, poor glycaemic control may result in malaise and lethargy that consequently reduce interest in sexual activity, especially in diabetic patients with renal complications. Other more obvious factors that may influence libido arise from amputation or blindness, causing the patient to feel unattractive.
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Hormone replacement therapy – current status
Margaret CP Rees
pp 12-14
The final publication of the oestrogen and progestogen arm of the Women’s Health Initiative (WHI) in July 2002, along with other papers, has led to debate in the media and uncertainties within regulatory authorities and the pharmaceutical industry. Healthcare professionals and women are confused. The findings of the WHI from one particular combination in a specific population are being applied generically, even though they may not hold true for other types of hormone replacement therapy (HRT) used in different populations. This review will assess the place of oestrogen-based HRT.
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Vasomotor symptoms in men - causes and mechanisms
Anna-Clara Spetz and Mats Hammar
pp 16-19
Vasomotor symptoms (hot flushes and sweating) are well known in women around the menopause. They also occur in men, especially in those who have had castration therapy, such as bilateral orchidectomy or medical castration with gonadotrophin-releasing hormone (GnRH) analogues, due to advanced carcinoma of the prostate. Although hot flushes in men are often reported to be very distressing, they have received little medical attention. This article will discuss the prevalence and physiology of vasomotor symptoms in men and the possible mechanisms behind these symptoms.
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The Harrison Wing - managing a changing HIV population
Amanda Clarke and Annemiek de Ruiter
pp 22-24
The Harrison Wing is the HIV outpatients department of Guy’s and St Thomas’ Hospital NHS Trust in London. It was named after Colonel Lawrence Whitaker Harrison DSO, who opened the first sexually transmitted infections (STI) clinic at St Thomas’ Hospital (STH) after the First World War – the ‘model clinic’, on which others around the country were to be based. In 1983, the Harrison Wing was established as a clinic for patients with persistent generalised lymphadenopathy (PGL), and was located within the genitourinary medicine (GUM) department, initially with only a handful of patients.
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Small isn't beautiful? Male body dysmorphic disorder
Kevan R Wylie
pp 26-27
For as long as records have existed, man has placed great emphasis on the size of his penis. To most men it demonstrates evidence of virility and is a key indicator of manliness. Many men describe concern about their penile size, although most men do not seek the advice of clinicians. It is often seen as a comorbid condition in patients with erectile dysfunction and ejaculatory problems.
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SSRIs in the treatment of premenstrual syndrome
Paul Dimmock and Shaughn O'Brien
pp 28-30
A woman has premenstrual syndrome (PMS) if she complains of recurrent psychological or somatic symptoms (or both) occurring during the luteal phase of the menstrual cycle and resolving by the end of menstruation. Typical symptoms are irritability, depression, lack of co-ordination, headache, bloating, cramps and leg/back pain. These symptoms can be so severe that they disrupt normal functioning, quality of life and interpersonal relationships.
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When the earth moves
David Hicks
pp 31-31
Some years ago, when my children were younger, I asked them to characterise me in terms of an animal. Their responses were black panther (thank you), owl (what?) and squirrel. The last suggestion related to my habit of keeping and filing away reams of photocopied articles from medical and other literature. With the advent of some new furniture for my office at home I have revisited some of the squirrel’s hoardings and would like to share a couple of them here.
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