2. 2 WOMENSHEALTHADVICE.CO.UK MEDIAPLANETAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
READ MORE ON WOMENSHEALTHADVICE.CO.UK
IVF and fertility
author Kate
Brian
discusses access to
fertility treatment
across the UK
P8
Dr Dawn Harper
on a women’s
health issue that’s
more common
than you might
think
P10
Dr Geeta Nargund,
Medical director of
CREATE Fertility,
addresses 12 frequently
asked questions about
egg freezing
IN THIS ISSUE
Time to stop whispering
about women’s health
Now is the right time to speak out about women’s health issues, says gynaecologist
Dr Heather Currie, chairman of the British Menopause Society and MD Menopause Matters.
Please recycleFollow us facebook.com/MediaplanetUK @MediaplanetUK
Managing Director: Carl Soderblom Content and Production Manager: Henrietta Hunter Designer: Vratislav Pecka Business Developer: Dominic McWilliam
Project Manager: Vanessa Dodd E-mail: vanessa.dodd@mediaplanet.com Mediaplanet contact information: Phone: +44 (0) 203 642 0737 Email: info.uk@mediaplanet.com
In loving memory of Christine Malone (née Dodd) 1961 – 2015.
I
n the past, conver-
sations about gy-
naecology, child-
birth, the meno-
pause, or other
problems ‘down
there’ - often called “wom-
en’s troubles” - would be in
hushed tones.
As I trained as a doctor and
gynaecologist I found out
what really goes on ‘down
there’.The knowledge helped
me understand how to keep
myself healthy and today
I want all women to share
that knowledge.
Women now talk more
openly, but there are still
taboos around the meno-
pause,fertility,HRT,and con-
ditions such as breast and
ovarian cancer. Too many
women still do not have the
essential knowledge needed
to keep themselves healthy.
This Autumn events will
bring women’s health to the
fore and make it easier for
women to get the informa-
tion they need.
This is National Breast Can-
cer awareness month, high-
lighting the fact that nearly
Dr Heather Currie
Chairman, British
Menopause Society and
MD Menopause Matters
“Women now
talk more openly,
but there are still
taboos”
55,000 people are diagnosed
with breast cancer in the UK
annually and one in eight
UK women will develop
breastcancer.
National Fertility Aware-
ness Week (November 2-8)
will provide advice, support
andunderstandingtotheone
in six couples struggling to
become parents.
After over a decade of con-
fusion and controversy about
menopause, and in particu-
lar, concern about risks of
HRT, November brings new
NICE guidelines about the
Diagnosis and Management
of the Menopause, which
are expected to raise aware-
ness of the importance of the
menopause and consequenc-
es of estrogen deficiency, as
well as dispel many myths
around treatment options
so that women can make
truly informed decisions
about the management of
their menopause.
It’s time to stop whisper-
ing. Speak up about women’s
health, ask questions and
bringtheissuesintotheopen
so allwomen benefit.
@MediaplanetUK
PHOTO:CRUK
3.
4. WE
TURN
INTEREST
INTO
ACTION
Readmoreaboutwomen’shealth
issuesonourdedicatedcampaignsite,
womenshealthadvice.co.uk
INSPIRATION
STATISTICS
Source: These incidence data were compiled by the Statistical Information
Team at Cancer Research UK using data from the Office for National Statistics
and the regional cancer registries in Wales, Scotland and Northern Ireland us-
ing the latest data for 2012.
CRUK
-Incidence
offemale
cancers
M
any young peo-
plethinkbreast
cancer cannot
afflict them.
But Kris Hal-
lenga knows
it’snottrue.
Kris’s personal story started when, at just
22, she found a lump in her breast. “I went
to the doctor andwas told itwas nothing to
worryabout,”shesays.“Eightmonthslater
it was diagnosed as breast cancer. By then
it had spread to my spine.”
Radiotherapy, chemotherapy and mas-
tectomyfollowed,butwithinafewweeksof
diagnosisKrisandhersisterMarenfounded
the charity CoppaFeel! to encourage young
peopletochecktheirboobsregularly.
Now 29, she says: “We founded Cop-
paFeel! because no-one was addressing
young people about this. We started with
a stall at a music festival, talking about
boobs.A simple message delivered in a fun
way sticks.”
That simple message is: check your boo-
bs and get to know what is normal for you.
“One in eight women experiences breast
cancer and most cancers are detected
through self-checking,” says Kris. “There
is no right or wrong way - just do it. If you
Kris Hallenga’s personal experience
of breast cancer at 22 inspired her
to set up CoppaFeel! - the charity
reminding us that checking our
boobs could be a life saver.
Knowingyour
boobscould
saveyourlife
By Linda Whitney
4 WOMENSHEALTHADVICE.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
Around 3,000
females are diagnosed with cervical cancer*
in the UK every year**
*Cervical cancer (ICD10 C53)
**Annual average number of cases in the UK between 2010 and 2012
Around 7,000
females are diagnosed with ovarian cancer*
in the UK every year**
*Ovarian cancer (ICD10 C56-C57.4)
**Annual average number of cases in the UK between 2010 and 2012
Around 8,500
females are diagnosed with uterine cancer*
in the UK every year**
*Uterine cancer (ICD10 C54-C55)
**Annual average number of cases in the UK between 2010 and 2012
Around 300
females are diagnosed with vaginal cancer*
in the UK every year**
*Vaginal cancer (ICD10 C52)
**Annual average number of cases in the UK between 2010 and 2012
Around 1,200
females are diagnosed with vulval cancer*
in the UK every year**
*Vulval cancer (ICD10 C51)
**Annual average number of cases in the UK between 2010 and 2012
5. findanythingdifferentgotoyourGP.Ear-
ly detection improves outcomes.”
Know the signs and symptoms.
CoppaFeel! advises:
Look for changes in skin texture (puck-
eringordimpling),nippledischarge,inver-
sionorchangesindirection,swellinginthe
armpitorroundthecollarbone,changesin
sizeorshapeandrashesorcrustingaround
thenippleorsurroundingarea.
Feel for lumps, thickening, or constant
paininthebreastorarmpit.
See the instructions at coppafeel.org/
boob-check/
CoppaFeel! offers a text reminder ser-
vice that urges people to check regular-
ly and often. Already 23,000 have signed
up.The #Breastmates campaign encour-
ages people to remind mates to check
their boobs. “My personal Breastmate is
Maren, who urged me to return to the
doctorwith my own lump,” says Kris.
The charity recruits ‘Boobettes’, peo-
ple 18-35 affected by breast cancer, to
give talks to young people. It also runs
Festifeel a festival combining mu-
sic and breast awareness, takes its in-
flatable ‘Boobcube’ to summer festi-
vals, recruits Uni Boob Team leaders to
campaign in universities, and encour-
ages people to take part in events such
as marathons, sometimes wearing a gi-
ant inflatable boob.
It all sounds fun (and they are looking
for more volunteers) but it also saves
lives. “Soon after we started I got an
emailfromagirlwhowasdiagnosedear-
ly because she read my personal story,”
says Kris. “It’s a simple message: check
your boobs.”
“The simple
message is:
check your
boobs
and get to
know what
is normal for
you”
MEDIAPLANET 5AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
Read more at
womenshealthadvice.co.uk
ONCEYOUKNOW
#WHATNORMALFEELSLIKE,
CHECKFORCHANGESLIKE...
ANDIFINDOUBT,GETIT
CHECKEDOUT.
6. 6 WOMENSHEALTHADVICE.CO.UK MEDIAPLANETAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
COLUMN
Experts say that the
benefits of HRT outweigh
the risks and that studies
behind the HRT health
scares are flawed. Is
it time to rethink your
position on HRT?
Many women have suffered
debilitatingmenopausesymp-
toms for years because of can-
cer and heart disease fears
about HRT - but studies that
prompted the scare stories
were flawed, says a leading
menopauseexpert.
Consultant gynaecologist
Professor John Studd, for-
mer chairman of the British
Menopause Society (BMS),
says: “Two studies in the ear-
ly 2000s claimed that HRT in-
creased the risk of cancers
and heart disease, and as a re-
sult over a million women in
the UK stopped taking it. But
the studies were flawed and
the latest findings show that
for most women the benefits
of HRToutweigh the risks.”
The BMS said on October
18ththataUSstudy,“confirms
the safety of HRT, with ben-
eficial effects being shown in
womenwho continued taking
HRTformanyyears,”butsome
doctors dispute this as itwas a
smallstudy.
A combination of estrogen
and progestogen was the cor-
nerstone of HRT for years un-
til a massive health scare was
triggered in the 2002 by the
Women’s Health Initiative
study in the USA, which re-
portedincreasedrisksofheart
attack, stroke, blood clots and
breast cancer among wom-
en on HRT. However, Studd
says: “This study used the
wrong hormones, the wrong
dose and the wrong delivery
methodinthewrongpatients
starting at thewrong age.”
The British Million Women
Studypublishedin2003found
an increased risk of cancers
but there are questions about
its value because of doubts
about data collection.
The case for HRT
As a result of the health scare
HRT use in UK women fell by
halfanddoctorsintheUKwere
advised to limit HRT to the
minimum necessary dose for
theshortestpossibletime.
Studd says: “Today many
GPs have not yet shaken
off the false conclusions of
excess risk. The bad news
from the discredited WHI tri-
al is now in the undergradu-
atetextbooksanditwilltakea
generation to get rid of it.”
However, there is evidence
thatHRT,deliveredintheright
way, using the right dose for
suitablepatients,couldbesafe.
In May 2013 the BMS stat-
ed: “HRT prescribed before the
age of 60 has a favourable ben-
efit/risk profile,” and that, “Ar-
bitrary limits should not be
placedonthedurationofusage
of HRT; if symptoms persist,
the benefits of hormone thera-
pyusuallyoutweightherisks.”
Manywomenwhohavepre-
viouslyrejectedHRTbecauseof
health scares may now want
to reconsider. Studd recom-
mends researching the sub-
jectinadvanceofgoingtotheir
GP so they understand the
latestthinking.
His recommendations for
the safest HRTregime are that
it should be delivered through
theskin,viaapatch,skingelor
implant, rather than as pills.
Women aged 45 to 60 in most
cases should receive the com-
bined estrogen and naturally-
derived progestogen therapy
inthestandarddose,withadd-
ed testosterone to increase en-
ergy, boost mood and improve
libidoifrequired.
For older women the same
combination therapy is suita-
ble,alsodeliveredtransdermal-
lybutinsmallerdoses.
By Linda Whitney
Is it now time for women
to reconsider HRT?
INSPIRATION
Hot Flushes
Hot flushes usually last
and affect upto
of menopausal women.
For around
hot flushes can be severe and can cause
significant interference with work, sleep
and quality of life.
Keep your bedroom
temperature fairly cool at
night
Wear cotton clothing
rather than man-made
fabrics
Wear loose thin layers
rather thanthicktight-
fitting clothes
minutes
of women
3-5
85 %
20%
The Classic Menopausal
Symptom
HERE’S WHAT CAN HELP
SOURCE: MENOPAUSE MATTERS
John Studd
Consultant gynaecologist,
London PMS
& menopause clinic
There is evidence that HRT, delivered in the right way could be safe
PHOTO:THINKSTOCK
7.
8. INSPIRATION
EXPERT TIPS
Professor Felix Day
Medical research council fellow
Geneticstudies
illuminatethe
connectionsbetween
fertilityandhealth
T
here are very clear rec-
ommendations from
NICE, the National In-
stitute for Health and
Care Excellence, about
the most effective way
to treat anyone who
needs help conceiving based on detailed
research and economic analysis.The NICE
guidance, which applies across England
and Wales, says that women of 39 and un-
der who need fertility treatment should be
offered three full cycles of IVF. In order to
qualify, women should have been trying
to conceive unsuccessfully for two years
or should have a proven fertility problem
which prevents them getting pregnant.
A “full” cycle of IVF means that if you
produce any additional embryos, freezing
and then transferring them should be of-
fered as part of the treatment cycle.Asmall
groupofwomenwhoareaged40-42should
be offered one full cycle if they’ve not had
any previous treatment, have been trying
togetpregnantfortwoyearsorhaveagood
supply of eggs.
The guidance may be clear, but in Eng-
land 80 per cent of the Clinical Commis-
sioning Groups who make decisions about
funding treatment have decided not to fol-
lowit.ThismeansthatacoupleneedingIVF
to conceive may find that they will not be
When it comes to fertility, it is not surprising
that there is widespread confusion about
the help that patients can expect from the
National Health Service. In the UK, around
40 per cent of IVF treatment is funded by the
NHS, but whether or not you can access it
depends entirely on where you live.
Fertilityfunding
-thepostcode
lottery
8 WOMENSHEALTHADVICE.CO.UK AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
T
he duration ofyour fertility
lifespan predicts awide range
of other health conditions.
Womenwho reach puberty
earlier are at higher risk of
endometriosis,breast cancer,heart disease
and type 2 diabetes.Thosewho reach
menopause later are at higher risk of
breast cancer but lower risk of osteoporo-
sis. Genetic studies are helping to unravel
the mechanisms that link fertility timing
to health.They show that later menopause
timing is a causal factor for breast cancer,
and that similar biological mechanisms in-
fluence puberty timing,menopause
timing and PCOS (a common cause of
infertility).They have also decoded some
causes of menopause timing,showing that
the body’s ability to repair damaged DNAis
a major factor.These new biological
insightswill hopefully provide a basis for
new treatments.
9. offeredanytreatmentatall,whileafriend
who lives down the road could access two
oreventhreecycles.
Access criteria
In Wales, Scotland and Northern Ire-
land there are standard access criteria
for each country, but they are still differ-
ent from one another. In Wales, there is
provision for two cycles for women un-
der 40; in Scotland, women under 40 al-
so receive two cycles but a recommenda-
tiontoincreasethattothreecyclesisun-
der discussion.Northern Ireland only of-
fers one partial cycle (one fresh cycle and
one frozen embryo transfer), so across
the UK there is a lot to be done to ensure
patients receive equitable treatment.
Just to complicate matters even fur-
ther, access to treatment isn’t only
restricted by where you live but also by
eligibility criteria which vary from one
area to another. Women who are very
underweight or overweight and couples
who smoke are often denied access to
treatment. In some areas, lower and up-
per age limits have been set which leave
a narrower band for access to treatment
than NICE has recommended.
People who already have a child or
children are not usually eligible for NHS-
fundedIVF,andinsomepartsofthecoun-
try this has been extended to include any
children from previous relationships.
A woman with a fertility problem may
feel this is very unfair if she cannot ac-
cess treatment because her partner has a
grown-up child from a previous relation-
shipwhohasneverlivedwiththem.
Of course, provision of services can
change if local commissioners decide
they no longer want to offer IVF.Recent-
ly, the Clinical Commissioning Group
in North East Essex announced that it
had decided to ignore the national guid-
ance entirely and cut all funding for
treatment for fertility patients, follow-
ing similar cuts in Mid Essex. Mean-
while, other parts of Essex are consult-
ingoncuttingNHSfertilityservices.This
makes the countyone of the poorest are-
as of provision in the UK for fertility.
It is evident that the National Health
Service is not offering national provision
for IVF.The campaign group Fertility Fair-
ness and patient charity Infertility Net-
workUKbothencouragepatientstogetin-
volved in pushing for better fertilitytreat-
ment if they are affected by the current
postcodelotteryorfeelthatitisunfair.
“It is evident
that the
National
Health
Service is
not offering
national
provision
for IVF”
Fertility Fairness
www.fertilityfairness.co.uk
Infertility Network UK
www.infertilitynetworkuk.com
MEDIAPLANET 9AN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
Kate Brian
INUK representative and fertility
author and journalist
PHOTO:THINKSTOCK
1
MerckSeronoLtd,BedfontCross,StanwellRoad,MiddlesexTW148NXUK Tel:02088187373Email:medinfo.uk@merckgroup.com
10. 10 WOMENSHEALTHADVICE.CO.UK MEDIAPLANETAN INDEPENDENT SUPPLEMENT BY MEDIAPLANET
DID YOU KNOW...
For the first 10 years of
my GP career I was the
only female partner in a
7 doctor practice and
so inevitably I saw a lot
of women’s health
problems. I could barely
do a surgery without
seeing a lady complain-
ing of vaginal discharge.
Most of them were
convinced they had
thrush. It is after all a very
well known and extremely
common problem.
In fact if I went out in any
high street in Britain and
asked the first 100 people to
tell me what thrush was, vir-
tually all of them would be
able to give me an answer
(and that includes the men!).
Bacterial vaginosis (BV) is ac-
tually twice as common as
thrush and affects as many as
one in three women in their
lifetime and yet vanishingly
few people seem to know an-
ything about it. And that’s a
real shame as the condition
is so often mistakenly self-di-
agnosed as thrush and there-
fore treated incorrectly.
To be fair it is easy to un-
derstand the confusion. Both
conditions cause avaginal dis-
charge. The discharge of BV
however doesn’t tend to cause
the same soreness and irri-
tation as thrush. It is usually
white-grey in colour and has a
characteristicfishyodour.
This is another problem be-
cause the most natural thing
to do if you think you smell is
to wash more frequently. In
the case of BV this can actu-
ally exacerbate the problem.
Perfumed products are slight-
lyalkalineandourvaginasare
slightly acidic. Washing with
soap can alter the pH in the
vagina and make it a better
environment for the bacteria
that cause BV to multiply and
so thevicious cycle sets in.In-
terestingly menstrual blood
and semen are also slightly
alkaline so it is common for
women to experience an at-
tack of BV after a period or af-
ter unprotected sex.
BV symptoms
Bacterial vaginosis is more
common in Afro-Caribbean
women, in women who
smoke and in women who
use the copper coil (IUD) for
contraception. Sadly if you
have had one episode of BV it
is highly likely that you will
have a recurrence within the
next three months and some
women are plagued by fre-
quent and recurrent attacks.
If the symptoms are mild
and the woman is not preg-
nant, BV may not need treat-
ing as the vagina may rebal-
ance itself, but more signifi-
cant symptoms or BV during
pregnancy needs treatment
as BV can trigger early labour
or miscarriage. It is also im-
portant to treat if the wom-
an is at risk of HIV infection
as having BV can increase the
risk of contracting HIV.
Bacterial vaginosis can be
treated with antibiotics ei-
ther by mouth or as a gel or
cream directly into the vagi-
na. This is usually very effec-
tive but I have met women
whooscillatebetweenattacks
of bacterial vaginosis, which
is treated with antibiotics on-
ly to then develop thrush. In
thesewomenitisbettertoopt
for a lactic acid gel which can
be inserted daily into the va-
gina to rebalance the pH in
the vagina and reset the equi-
librium. These are available
on prescription or over the
counter at pharmacies.
Dr Dawn advises on
staying healthy down below
BV is actually twice as common as thrush and affects as many as one in three women
INSPIRATION
Dr Dawn Harper
Doctor, media personality
and television presenter
56% of women don’t
know what BV is
BV is one of the most common vaginal
conditions affecting women1
BV is an imbalance of PH levels
and can be caused by:
Excessive washing
Perfumed Soaps
Menstruation
Sperm
Some Antibiotics
?
1 in 3 women will get BV*
*at some point in their lives2
The main symptoms are:
Fishy odour
White, grey or thin discharge
Discomfort and irritation
92% of 18-24’s self diagnose
intimate health issues online
76% of young women who self-
diagnose online rarely go on
to buy medicine
66% of women misdiagnose
BV as trush3
1 BASHH; 2 The Family Planning Association (2014); 3 Joeseof MR, Schmid G. Bacterial Vagi-
nosis. Clinical Evidence. 2005; 13; 1968-1978
PHOTO:THINKSTOCK
