Comment: Cumulative effect of sexual behaviour change Paul Woolley pp 4-4 Although the emergence of the oral contraceptive pill in the 1960s has long been attributed to increased sexual freedom and more frequent sexual partner change, this has been just one facet in a change in the female role in society which began in the 1940s. Before the Second World War, most married women had yet to be considered as anything more than housewives and mothers. Then, with the need for munitions, large numbers of women entered the labour force for the first time, many continuing in employment afterwards as the country struggled to rebuild.
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Defining the difficulty – approaches to the diagnosis of female sexual dysfunction Pippa Green pp 5-8 These are exciting times for sexual therapy. Following the introduction of Viagra® (Pfizer, UK) in the late 1990s for the treatment of erectile dysfunction in men, we entered the new millennium with intensified interest in both the understanding of female sexual dysfunction (FSD) and the development of pharmacological treatment for it. Models of human sexual response have been reviewed and classifications of FSD updated.
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Access to family planning for HIV-positive women Sue Russell pp 9-11 All women of childbearing age should be able to walk into any family planning clinic and be treated equally. In the early days of HIV the only forms of contraception available to HIV-positive women were condoms, sterilisation and termination. This article discusses whether as reproductive practitioners we have evolved with the growth of HIV to offer good, effective and accessible treatment whenever it is needed.
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Surgical management of excessive menstrual loss David E Parkin and Stuart A Jack pp 14-17 The symptom of ‘menorrhagia’ or ‘excessive menstrual loss’ is one of the most common causes for referrals to specialist clinics (accounting for 12% of all referrals) and is the main presenting symptom for half of the hysterectomies performed in the UK. Despite the advances in medical treatment, in particular the use of the Mirena® (Schering HC, UK) system, many patients require or seek surgical treatments. In England and Wales approximately 25,000 hysterectomies and 10,000 endometrial resection/ablations are undertaken for menstrual problems every year.
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The cost of HIV treatment are care in England since HAART – part 1 Eduard J Beck and Sundhiya Mandalia pp 19-23 The introduction of highly active antiretroviral therapy (HAART) into routine clinical practice has profoundly reduced HIV disease progression, and associated mortality and morbidity in HIV-infected individuals. Despite side-effects or problems with resistance to antiretroviral therapy (ART), increasing numbers of patients infected with HIV are being diagnosed and coming forward for treatment and care in the UK, in parallel with a worldwide increase in the number of people living with HIV.
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Psychosexual therapy – the role of Relate Jane Roy pp 26-28 Relate is the largest single provider of psychosexual therapy in the UK and offers approximately 900 hours of case work per week throughout England, Wales and Northern Ireland. A quarter of clients are referred by their GP or another healthcare professional. Another quarter are referred by counsellors, usually Relate’s relationship counsellors. The remaining clients contact Relate on their own initiative and have found out about the service from a variety of sources.
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A tough nut to crack David Hicks pp 31-31 Raynaud’s phenomenon is temperature-sensitive vasospasm of the hands and feet. At its worst it can result in digital gangrene, and to date no reliable or consistently effective treatment has been described. Why am I telling you this? Well, it seems that one bright spark of a rheumatologist has put together the necessary calculations to come up with the conclusion that sildenafil citrate (Viagra®) could help in this condition.
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