British Journal of Sexual Medicine - 2007

Comment: Beware the unexpected
Paul Woolley
pp 3-3
What would you think if a woman came in to see you complaining of having a fish in her vagina? This was a question I was once asked at an interview for a post in genitourinary medicine. ‘I would probably feel sorry for the fish,’ was my reply. The correct reply – ‘She probably has bacterial vaginosis’ – seemed a little too obvious to me. In all branches of medicine the routine can become mundane. The saying ‘if your doctor takes an interest in what’s wrong with you it’s because you’ve got something serious’ probably has a ring of truth to it.

Gynaecological perspectives on chronic pelvic pain
Ying Cheong, Sue Ingamells and R William Stones
pp 4-7
Chronic pelvic pain (CPP) is non-cyclical pain of more than six months’ duration that is localised to the pelvis, the lumbosacral area, the buttocks or the anterior abdominal wall at or below the umbilicus, and is of sufficient severity to cause functional disability or lead to medical care. Pain is generally defined as an unpleasant sensory and emotional experience associated with actual or potential tissue damage. It is important for healthcare professions to appreciate the emotional and subjective nature of pain, in particular CPP.

Biochemical mechanisms of menopausal hot flushes
Robert R Freedman
pp 8-10
Hot flushes are the most common symptom of menopause. Although the appearance of hot flushes coincides with oestrogen withdrawal, this does not entirely explain the phenomenon as oestrogen levels do not differ between symptomatic and asymptomatic women. Luteinising hormone (LH) pulses do not produce hot flushes, nor do changes in endogenous opiates. Recent studies suggest that hot flushes are triggered by small elevations in core body temperature (Tc) acting within a reduced thermoneutral zone in symptomatic postmenopausal women.

One-stop shop: nurse-led sexual health services
Colm O'Mahony
pp 11-12
The Americans were bemused. Were we Europeans testing out their legendary lack of irony or were we for real? It was a joint conference of the American and UK sexually transmitted disease (STD) societies in Baltimore USA and the debate centred on the role and value of nurse-led clinics in the management of sexually transmitted infections (STIs). Eventually, one puzzled American pointed out that American STD clinics had always had nurse-delivered sexual health services and he could not for the life of him see why we were having such a pointless debate.

Management of menopausal symptoms without oestrogen
Margaret Rees
pp 13-15
Publication of the Women’s Health Initiative study and the Million Women Study has led to concerns among both women and healthcare professionals about the use of hormone replacement therapy (HRT). The most common menopausal symptoms for which women seek help are hot flushes and vaginal dryness. This review examines the evidence for the efficacy of non-oestrogen derived preparations and alternative and complementary therapies.

Confidentiality and multiple agency treatment of STIs
Karen Rogstad
pp 16-18
All medical services declare themselves to be confidential. However, confidentiality is not absolute, and patients’ perception of confidentiality varies. Confidentiality in all medical settings is guided by common law, the Human Rights Act, section 60 of the Health and Social Care Act, and the NHS Code of Practice. The General Medical Council (GMC) provides guidance in Good Medical Practice (2006), and Confidentiality: Protecting and Providing Information (2004).

Miracle cure gets to the bottom of the hiccups
David Hicks
pp 19-19
Welcome back gentle reader to the resurrected British Journal of Sexual Medicine and the freshly risen Hicks files. A particular welcome goes out to those who have not read these ramblings before, and for those, some words of explanation are probably required. Contained on this page are my interpretations of any matters sexual that have come across my consciousness from a variety of media sources. The only criteria for inclusion are that they interest me and are printable.