Royal College of Obstetricians and Gynaecologists Guidelines
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Association of Reproductive Health Professionals
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Fertility UK is the national fertility awareness & Natural Family Planning service for the UK.
The service provides comprehensive and objective information to the general public and health professionals on all aspects of fertility awareness.
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Understanding the physiology of reproductive hormones, recognising pathology and knowing what tests to order, when to order them and how to interpret the results can be daunting. Hormone tests provide important information when applied appropriately, but often they are used without a clearly thought out diagnostic pathway, or in response to patient demand, rather than being tailored to the right patient in the right situation. In such situations, hormone tests will, at best, be of no clinical use, and at worst, lead to anxiety and uncertainty. We look at some of the more common applications of hormone tests in the general practice setting.
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Clinical Guidance
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General information
Fact sheet on family planning
Fact sheet on emergency contraception
Technical information
Publications
Medical eligibility criteria for contraceptive use
Family planning: a global handbook for providers
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Evidence-based Guidance Developed Through Worldwide Collaboration Family Planning: A Global Handbook for Providers offers clinic-based health care professionals in developing countries the latest guidance on providing contraceptive methods. The book was prepared through a unique collaboration between editorial staff at the Johns Hopkins Bloomberg School of Public Health and technical experts from the World Health Organization (WHO), the United States Agency for International Development (USAID), and over 30 other organizations around the world (see Collaborating and Contributing Organizations). It is published by the Knowledge for Health (K4Health) Project, which is led by the Center for Communication Programs at the Johns Hopkins Bloomberg School of Public Health.
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The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.
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Switching the Pill
NHS Mid Essex Clinical Commissioning Group
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This article offers guidance for managing situations when women who are currently using COCs:
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All licensed oral contraceptives currently available on prescription contain lactose.
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A roundtable discussion among key thought leaders in the area of hormonal contraception was held on October 20, 2006, in New Orleans, Louisiana. These experts addressed the critical questions regarding the practical management of extended regimen oral contraceptives based on information in the medical literature.
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Progestogen Only Pills (POP)
NHS Mid Essex Clinical Commissioning Group
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Contraception and breastfeeding
Breastfeeding delays the return of ovulation. Because of this, all contraceptives have a lower failure rate if used consistently and correctly. Mothers should not wait until the return of their menstrual period before starting contraception as ovulation precedes menstruation making pregnancy possible.
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International Consortium for Emergency Contraception Publications
ICEC has created publications to address EC programs, advocacy, and combating opposition.
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EC Dosing Quick Reference Table
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Emergency hormonal contraception and breastfeeding
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Drug interactions with contraceptives are of concern, particularly when steroid metabolism is induced, as this may reduce contraceptive efficacy. The author discusses the prediction of drug interactions and the interpretation of pharmacokinetic interaction studies of combined hormonal contraceptives.
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Patients often express concerns about interactions between their medicines and alcohol and any illicit drugs that they may consume. Doctors and pharmacists are also often asked about interactions, especially short courses of antibiotics, which might reduce the efficacy of oral contraceptives.
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Among antibiotics, only rifampin has been demonstrated to interfere with the effectiveness of oral contraceptives (OCs) (strength of recommendation [SOR]: C, limited case series).
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Over the past 3 decades, published reports have described hundreds of women taking oral contraceptives who have become pregnant after a course of oral antibiotic therapy. Accordingly, many pharmacists warn patients on oral contraceptives to take additional precautions to avoid pregnancy when antibiotics are used concomitantly.
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This review outlines the physiology and mechanisms of cardiovascular action of contraceptive hormones, particularly those found in OCs. It includes basic science, animal and human clinical studies that address contraceptive hormone use and cardiovascular disease. We also review the current guidelines for contraceptive hormone use in women with elevated cardiovascular risk.
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Society of Family Planning Clinical Guideline for Contraceptive Considerations in Obese Women
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Migraine is very common in women during child-bearing years. Many women need or desire contraception, or may have other conditions such as endometriosis, severe dysmenorrhea, menorrhagia or acne for which may benefit from combination oral contraceptive treatment. Is it is safe to let women migraine patients take oral contraceptives? What are the risks? Are there certain dosages or formulations that may be better than others for women with migraine?
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This article reviews and integrates the most recent evidence, Canadian and international practice guidelines, expert opinion, and clinical experience for the common causes of AUB and current medical and surgical treatment for it.
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This article presents a practical approach to determining the cause of abnormal uterine bleeding and briefly reviews medical and surgical management.
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Pelvic pain is one of the most common problems affecting women of reproductive age. The pain may vary from mildly irritating to incapacitating. Dysmenorrhea and endometriosis are the two most common causes. Nonsteroidal anti-inflammatory drugs (NSAIDs) and cyclo-oxygenase-2 (COX-2)-specific inhibitors are the mainstays of therapy for both disorders. Hormonal manipulation may also be used in treatment. Surgical and alternative treatments are also discussed.
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National Institute for Health and Care Excellence (NICE) Guidance > Heavy menstrual bleeding
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Medical Management of Heavy Menstrual Bleeding
Western Sussex Hospitals NHS
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This section draws together what systematic reviews are available on dysmenorrhoea.
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The prevalence of dysmenorrhoea (painful menstrual cramps of uterine origin) is difficult to determine because of different definitions of the condition - prevalence estimates vary from 45% to 95%. However, dysmenorrhoea seems to be the most common gynaecological condition in women regardless of age and nationality.
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Primary dysmenorrhea usually begins six to 12 months after menarche and is characterized by spasmodic cramping pain in the lower abdomen that can radiate to the lower back and anterior or inner thighs.
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Painful menses or dysmenorrhea affects 40–90% of women. Despite its high prevalence, understanding of its pathophysiology and its relation to other pain syndromes in women is still limited. Dysmenorrhea has been historically categorized into two distinct types: primary and secondary.
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Two-thirds of premenopausal female migraine sufferers self-report that migraine attacks consistently occur during peri-menstrual time periods. These headaches have been referred to as “menstrual migraine”. Interestingly, only attacks of migraine without aura occur more frequently during peri-menstrual time periods. Attacks of menstrual migraine have been found to be more severe, disabling and refractory to abortive medications than those that are non-menstrually related.
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"This is a description of an individual expert practitioner's approach, presented to give the learner some practical ideas.
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This Bulletin discusses the management of premenstrual syndrome (PMS), and the evidence for various treatments that have been proposed for this condition.
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The cause of PMS remains to be established. Current literature leans towards a link between PMS and a deficiency of central serotonergic activity.
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As many women experiencing symptoms of premenstrual syndrome (PMS) seek relief from natural products (NP), health care providers should have quality information available to aid women in making evidence-based decisions regarding use of these products.
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The North American Menopause Society Position Statements & Other Reports
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International Menopause Society Recommendations
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International Menopause Society Position Papers and Consensus Statements
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This publication aims to help all health care professionals gain awareness of all these issues by reviewing what happens to the body during menopause and in the post-menopausal stage, examining the impact of these changes on women, and finally outlining the options for health after menopause.
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Fact Sheets
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This book is intended as a resource for family doctors and specialist nurses. It provides a concise account of recent advances in this exciting field, together with an outline of the evidence which informs current thinking. It is hoped that the information it contains will also prove useful to women interested in the up-to-date facts about HT. For the physician, prescription guidelines are included for women of different ages and clinical needs, highlighting the variety of treatment regimens currently in use.
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The resources which are available for this therapeutic topic can be accessed via the menu on the left-hand side of the page. The e-learning home page suggests ways in which you may like to use the wide variety of e-learning materials.
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All branded oral formulations of oestrogen-containing hormone replacement therapy (HRT) currently available on prescription contain lactose.
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Last Checked: 22/09/16 | Link Error: Report It |
The guide provides details of the key cardiovascular risk factors in women and describes how risk can be determined and monitored within the gynaecological setting, and in which populations. The guide contains practical guidance for menopause physicians to follow to help them to reduce cardiovascular risk in their patients.
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There have been a great many trials of complementary and herbal medicines and some of these have suggested benefits from certain therapies and others have shown no benefit. It can be difficult for consumers and for doctors to interpret this mixed information. This information sheet provides a brief overview of the current evidence for complementary and herbal therapies.
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Ovarian cancer is the fifth most common cancer and the fourth most common cause of cancer death in women in the UK. Survival has improved due to increased use of platinumbased therapy and a greater determination to treat recurrent disease
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New & Notable
BSCCP Lectures
BSCCP meetings on line
BSCCP Audits
Image gallery
Recommended reading
Useful publications
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Guidance to diagnosis of abnormal vaginal discharge using signs and symptoms, and sending specimens to the laboratory for diagnosis.
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2011 European (IUSTI/WHO) Guideline on the Management of Vaginal Discharge
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This Bulletin outlines the correct diagnosis and treatment of vulvovaginal candidiasis(thrush) by patients and by health care professionals. It also discusses some of the commonly held but often incorrect beliefs about the infection.
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This article discusses the pathogenesis, investigations and management of recurrent vulvovaginal candidiasis.
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Existing data indicate that exposure to oral and topical antifungals, topical antiseptics, or corticosteroids during pregnancy is not associated with increased risk of major malformations. Topical azole antifungals are the recommended treatment during pregnancy for at least 7 days owing to increased efficacy. Topical corticosteroids can be used for symptomatic relief.
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This article examines current information regarding vulvovaginitis in diabetic women and therapeutic options for its management.
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Despite the frequency of vulval symptoms, women often find it difficult to obtain expert medical advice. Postgraduate training for general practitioners is not widely available, and special clinics for vulval conditions have long waiting lists. Here, we outline a pragmatic approach to management of chronic vulval symptoms.
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The NVA has partnered with Medscape and Dannemiller in releasing our latest CME/CE-accredited course, Vulvodynia: An Under-recognized Pain Disorder Affecting 1 in 4 Women and Adolescent Girls – Integrating Current Knowledge into Clinical Practice. The self-guided program, which is available for continuing education credit through April 2015, incorporates the latest research findings and covers all aspects of vulvodynia – from the disorder’s prevalence to its differential diagnosis and treatment – in a manner most suitable for clinicians who routinely care for women and girls.
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Acute cystitis is extremely common with 40% to 50% of women reporting at least one urinary tract infection (UTI) in their lifetime. UTIs are much less common in men.
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In this issue
Introduction, Background &
Diagnostic Tests
UTI in non-pregnant women
UTI in pregnant women
UTI in men
UTI in patients with catheters
Acute pyelonephritis
UTI in children
Cranberry products
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Urinary tract infection is a common cause of morbidity and mortality in patients over 70 years of age. The prevention, diagnosis and treatment of infection in this group of patients require an understanding of the different epidemiology and pathophysiology involved.
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What is the treatment of choice for a urinary tract infection (UTI) in a patient with renal failure?
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Cranberries have long been the focus of interest for their beneficial effects in preventing urinary tract infections (UTIs). Cranberries contain 2 compounds with antiadherence properties that prevent fimbriated Escherichia coli from adhering to uroepithelial cells in the urinary tract.
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A joint guide on behalf of the Section of Female and Reconstructive Urology of the British Association of Urological Surgeons and the British Society of Urogynaecology
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Urinary incontinence (UI) is a common problem that affects women of childbearing age and older women. Although the exact prevalence of UI is difficult to determine because women do not always report It, reported rates are generally high.
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The current Letter summarizes the Common Drug Review (CDR) reports on three drugs newly available in Canada for the treatment of overactive bladder (darifenacin, solifenacin and trospium).
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This paper reviews the current anticholinergic pharmacotherapy,which is the mainstay of treatment for this condition.
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There is controversy surrounding the management of IC/BPS, with no clear consensus for its optimal treatment.1 The symptoms of IC/BPS vary among patients, with the definitions of the condition and how to measure outcomes varying as well.
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A: Tamsulosin (Flomax®) is a selective alpha-1a/1d adrenergic antagonist indicated for the treatment of benign prostatic hyperplasia (BPH).
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