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Media reports

July Journal published as Impact Factor soars to 2.1!

20 Jun, 13 | by shellraine, e-Media Editor

The July edition of the Journal is now available online and includes:

Venous thromboembolism and COCs: an ongoing saga

This ongoing controversy recently resulted in the decision of the French authorities to withdraw the combined oral contraceptive (COC) containing ethinylestradiol (EE) and cyproterone acetate (i.e. Diane 35®) from the market. This consensus statement from 26 international experts in contraception concludes that “Both epidemiological data and clinical trials must be taken into account when best practice is defined. Regulatory restrictions of previously registered methods should only be made after careful assessment of all the available evidence”. See page 156

Serum CA125 for ovarian cancer screening

This timely commentary raises questions about the widespread use of screening women with non-specific symptoms by measuring serum CA125 levels, following the publication of the NICE guideline on ovarian cancer in 2012. The authors acknowledge that there are barriers that prevent women with symptoms associated with ovarian cancer from presenting to their general practitioner. However, the authors also point out that this will lead to increased use of CA125 in general practice and raise concerns about how women with raised CA125 in the absence of evidence of any disease should be managed. See page 160

Ovarian cancer symptom awareness and help-seeking behaviour

Ovarian cancer symptom awareness is low in the UK, and varies widely between symptoms. In this study, Low et al. identify variables that may be implicated in a longer time to help-seeking for possible ovarian cancer symptoms, and highlights the need for more in-depth research into the factors related to time to help-seeking in real-world situations. See page 163

Fertility preservation decisions faced by women with breast cancer

This article presents a contemporary summary of fertility preservation techniques available to women of reproductive age with breast cancer. It offers unique insights into the difficult treatment decisions coupled with the difficult fertility preservation treatment decisions that these women face. The article highlights a number of themes that influence the decision-making process for these women. Egg and embryo banking appear to be the fertility preservation treatment of choice. Finally, this work may assist health care commissioners when deciding funding priorities within a health economy such as the NHS in the UK. See page 172

Correlates of unprotected sex in drug-injecting women

This study demonstrates that despite the high risk for HIV acquisition or transmission and unintended pregnancy, condom use among women who inject illicit drugs or who have sexual partners who inject drugs in St Petersburg in Russia is low. Programmes to investigate and improve contraceptive use, including condoms, among this vulnerable group of women are needed and might benefit from addressing alcohol misuse. See page 179

Contraception in a university environment

This is a very simple real-life observational study of a cohort of young, nulliparous women in a university-based general practice choosing and continuing with long-acting reversible contraceptive methods (LARCs) as their first line method of contraception. This article urges the health professional reader to consider offering this ‘fit and forget’ method of contraceptive to our younger population as a matter of routine. See page 186

Impact of UKMEC on CHC prescribing

Briggs et al. have assessed the effect of the UKMEC on prescribing of combined hormonal contraceptives (CHCs). Sadly, although there has been a small decrease in the proportion of higher-risk women being prescribed CHCs, their results suggest that in 2010 7.3% of CHC users had UKMEC Category 3 or 4 risk factors, particularly BMI ≥35 kg/m2. The authors point out that it is likely many of these women were being placed at an unnecessarily high risk of cardiovascular events, given the availability of lower-risk alternatives. See page 190

Financial cost to patients of a suspected ectopic pregnancy

In this article, Unger and colleagues in Edinburgh report on their assessment of an area of patient experience that is not often considered when assessing medical interventions. The financial impact on patients’ lives of the need to seek medical attention can be considerable and may become more significant as economic hardship increases. This article describes a well-conducted questionnaire study on the costs that patients themselves incurred in attending their general practitioners and a hospital clinic with a suspected ectopic pregnancy. The authors argue that such costs need to be factored into decisions regarding the cost-effectiveness of medical procedures. See page 197

Emergency contraception algorithm based on risk assessment

Introduction of a standardised protocol for the provision of emergency contraception (EC) has significantly increased the proportion of women offered an intrauterine device (IUD) as postcoital contraception, particularly in women at high risk of conception. Introduction of ulipristal acetate as an alternative method of EC has resulted in a reduction in the uptake of the emergency IUD. McKay and Gilbert state that this is cause for concern, and further investigation into the reasons behind this decrease in IUD uptake is needed. See page 201

No need for water torture

Cameron and colleagues set out to answer a simple question, namely does a full bladder assist insertion of intrauterine contraception? In the world of assisted conception a full bladder had been shown to aid intrauterine catheter insertion for embryo transfer, but could this knowledge be transferred usefully to the world of contraception? This simple question was answered in a simple and elegant way with a properly constructed and conducted randomised trial, which showed that we needn’t ask our clients requesting IUD/IUS insertion to arrive bursting – a fact for which both they and clinic staff will be duly grateful. See page 207

New monophasic natural estradiol COC

Lee Shulman reviews a new monophasic natural estradiol COC, Zoely®. This COC benefits from the progestogen nomegestrol acetate (NOMAC), which appears to result in good cycle control, with a 24/4 regimen. Since it is monophasic, it also has potential for extended cycle use. The great hope is that natural estradiol COCs will have a lower risk of venous thromboembolism (VTE) than EE-containing pills, but it should be stressed that there is currently no actual evidence for this. Studies are ongoing, but at present these COCs should be treated just like any other from the point of view of VTE. See page 211

Brook/FPA UK Sexual Health Awards 2013

The Journal’s Consumer Correspondent writes about the recently awarded Brook/FPA UK Sexual Health Awards, and opines that awards of this type are a good thing for the SRH profession generally and so rightly should be regarded as a highlight of the sexual health year. See page 219


An obituary for Dr Alison Bigrigg by Dr Audrey Brown; an organisational factfile on Tommys; a conference report from the FSRH Annual Scientific Meeting at University of Warwick;

And last, but by no means least, the Journal Impact Factor has risen, once again, to 2.1. Many congratulations to Anne Szarewski and her team.


New injectable – Sayana Press and Dianette VTE update

17 Jun, 13 | by shellraine, e-Media Editor

Sayana Press®

is a progestogen-only injectable contraceptive licensed for subcutaneous use. It contains 104mg of medroxyprogesterone acetate (MPA) in 0.65ml suspension and is bioequivalent to IM depot medroxyprogesterone acetate. It is administered at intervals of 13 weeks +/- 7 days via a new delivery system (Unijet) – a single dose pre-filled injector.


Although ideal for self-administration it is not currently licensed for use in this way.  The April issue of the Journal included a commentary on SC MPA by Sharon Cameron from Edinburgh.

Further information for professionals including a step-by-step administration guide will be available via MedIsis website.

Dianette® and cyproterone acetate products: strengthening of warnings, new contraindications, and updated indication

In agreement with the MHRA and European Medicines Agency (EMA) Bayer has written to health professionals about Dianette®, co-cyprindiol and cyproterone acetate products. This follows the outcome of a review of the known risk of thromboembolic events by the EMA’s Pharmacovigilance Risk Assessment Committee (PRAC). There are no new data, but there has been a “scare” in France which led to this and other so-called third generation products being removed from the market leaving very limited options for women.

The PRAC recommendations include:

  • Dianette® and other medicines containing cyproterone acetate 2mg/ethinylestradiol 35 mcg are indicated for the treatment of moderate to severe acne related to androgen-sensitivity (with or without seborrhea) and/or hirsutism, in women of reproductive age.
  • For the treatment of acne, Dianette® and other cyproterone acetate 2mg/ethinylestradiol 35 mcg products should only be used after topical therapy or systemic antibiotic treatment have failed.
  • Since Dianette® and all other cyproterone acetate 2mg/ethinylestradiol 35 mcg products are also a hormonal contraceptive, they should not be used in combination with other hormonal contraceptives.
  • To increase awareness of the risk and risk factors of thromboembolism in relation to the use of Dianette® and other cyproterone acetate 2mg/ethinylestradiol 35 mcg products (e.g. increasing age, smoking, immobility), the warnings and precautions regarding this risk have been strengthened.



Sexual health improvement framework, comments and other News

22 Mar, 13 | by shellraine, e-Media Editor

A Framework for Sexual Health Improvement in England’ sets out the government’s ambitions for improving sexual health.

Designed to be used by local organisations when they are looking at how best to provide sexual health services in their area. This includes the need for:

  • a fall in the number of unwanted pregnancies
  •  greater efforts to prevent STIs and HIV
  •  an increase in the number of people in high-risk groups being tested for HIV
  • building an honest and open culture where everyone is able to make informed and responsible choices about relationships and sex
  • making sure that all people have rapid and easy access to appropriate sexual health services
  • offering counselling to all women who request an abortion so they can discuss the options and choices available with a trained counsellor

Responses to ‘Framework for Sexual Health Improvement’.

 The Sex Education Forum, based at leading children’s charity The National Children’s Bureau, welcomed the publication of the government’s strategy for improving sexual health and its focus on preventative measures, such as good quality sex and relationships education (SRE). However, more needs to be done to ensure all schools step up to the mark, in providing the information, support and advice that children want and need.

FPA welcomes the Government’s long-overdue publication of its Framework for Sexual Health Improvement in England document, which finally provides guidance to local government to help ensure that the nation’s sexual health improves.

Although we support the Government’s formal endorsement of the need to improve areas of sexual health like sexually transmitted infection (STI) and teenage pregnancy rates, we are acutely aware that there is absolutely no guarantee that local councils will actually act on this guidance.

We know from our Unprotected Nation report, released in January, that if the situation worsens, and local government chooses not to invest in sexual health services, the additional cost to the economy is likely to be over £135 billion over the next few years.


Responding to the publication of A Framework for Sexual Health Improvement in England Simon Blake OBE, Brook’s Chief Executive, said:

“We are pleased that the Framework for Sexual health has been published just in time for the move to local authorities and that there are clear aspirations for the improvement of young people’s sexual health, in particular that all young people have access to confidential services and support.

“We are also pleased to see the ambition that all children and young people should receive good quality Sex and Relationships Education (SRE) at school which we know is vital in preventing abuse and exploitation and promoting positive relationships. However, this ambition will never be realised whilst the Department for Education fails to ensure that every school is required to deliver a comprehensive programme of SRE.

“As we move towards 1st April we look forward to working local authorities to realise these ambitions and improve young people’s lives.”

FAMILY PLANNING 2020 names Director of the global partnership

The Family Planning 2020 (FP2020) Reference Group announced that long time global advocate for family planning and reproductive health Valerie DeFillipo has been named Director of the global partnership. FP2020 builds on the partnerships launched at the London Summit on Family Planning. It will sustain the momentum from London and ensure all partners are working together to achieve and support the goals and commitments announced at the Summit.


21 Feb, 13 | by shellraine, e-Media Editor

JFPRHC is looking for a dynamic reader to take on the role of social media editor

The Journal already has a strong readership and offers online features such as a blog, podcasts, Facebook and Twitter.  This new post has been created to assist the editorial team in improving the journal’s interactivity and web presence via these and other social media, by promoting the journal’s content as well as helping its core readership to stay up to date with news and developments in the field.

You should be educated to degree level with knowledge of the journal’s subject area. Some experience of science communication and/or web content management systems such as Twitter, Facebook andWordPress would be preferred, but the main criteria for the successful applicant will be enthusiasm for the subject area, creativity, and an interest in using new technologies to disseminate scientific research.

The role would be ideally suited to a junior researcher or practising clinician. The full advert, and how to apply, is available at:

Sexual Health Commissioning

the Local Government Association and Public Health England have produced a document of FAQs. They address a number of transitional issues relating to the transfer of responsibility for commissioning sexual health services to local government.  In addition to these FAQs the Department of Health will shortly publish guidance on local government’s mandatory responsibilities for sexual health.

Reminder to register as stakeholder for NICE Patient group directions Good Practice Guidance

Management of PGDs will change from the 1st April when commissioning of services changes. All those involved in development or use of PGDs can contribute at the  consultation stage by registering as a stakeholder now. Individuals can contribute as service providers.

To register your organisation as a stakeholder send registration details (name of contact, name of organisation, email address) to using the subject heading Patient group directions GPG stakeholder registration 2012/13

National Infertility Awareness Campaign Welcomes updated NICE Guideline on Treating Infertility

The National Infertility Awareness Campaign (NIAC) has welcomed the new clinical guideline on the assessment and treatment of couples with fertility problems, published by NICE yesterday but fears remain over its implementation.

People experiencing fertility problems will be able to seek NHS help sooner and get the medical treatment they might require earlier. The updated guideline also includes other specific groups of people for the first time; these include same sex couples, those who carry an infectious disease, such as Hepatitis B or HIV and those who are unable to have intercourse (for example, if they have a physical disability). It also includes updated recommendations for people who are preparing for cancer treatment who may wish to preserve their fertility. However, as NICE clinical guidelines are not mandatory, fears still remain over local implementation as patients may continue to face a ‘postcode lottery’ approach to funding. This coincides with the release of the

Latest UK fertility treatment data and figures: 2010-2011

Published this week by the HFEA – ‘Fertility Treatment in 2011: Trends and Figures’

Education about abortion in the UK is failing young people

A report published by Brook and Education For Choice (EFC) finds that education about abortion in the UK is failing young people.  Some schools are addressing the topic as part of comprehensive sex and relationships education (SRE), but there is evidence of widespread bad practice including medical misinformation being provided by teachers and visitors to schools.  The report pulls together findings from surveys with schools and young people, and an audit of teaching materials used. Young people describe negative experiences of the education they received, and report that some schools are using inappropriate teaching materials including graphic images and distressing, inaccurate video material.



SRH News

28 Jan, 13 | by shellraine, e-Media Editor

Education for Choice hightlights misleading pregnancy counselling

Education for Choice support young people’s right to informed choice on abortion. They report that Feminist Action Cambridge held a demo in Cambridge city centre to raise awareness of local ‘crisis pregnancy centres’ which they feel are ‘using emotionally manipulative techniques’ and misinformation ‘in order to increase the guilt women might feel at having an abortion.’ They sent mystery shoppers to three counselling centres in Cambridgeshire and found that, at each one, women were being given some kind of false information about abortion and/or subjected to ‘counselling’ which was biased and often based on personal anecdotes.

New NICE Clinical Guideline: Ectopic pregnancy and miscarriage

This clinical guideline offers evidence-based advice on the diagnosis and management of ectopic pregnancy and miscarriage in early pregnancy and is available from NICE at:

The Morning After: A Cross Party Inquiry into Unplanned Pregnancy

2020Health.Org report that “Over half of unplanned pregnancies happen because people are not using sufficient contraception, according to a survey by a Cross-Party Parliamentary Inquiry.

Th inquiry, supported by 2020health, into unwanted pregnancies, highlights three main findings:
1.That a large proportion of unwanted pregnancies are happening because people are not using sufficient contraception;
2. That there is inadequate Sex and Relationship Education in schools; and
3. That there is a lack of access to contraception for over 25s.



ICEC has relaunched its website with easily accessible information on all aspects of emergency contraception worldwide. The map of registration status of EC pills is particularly interesting as is the status and availability database


New IUS launched

Skyla, has gained FDA approval and is due to be launched in the USA next month – the first new device to come to market in 12 years.  Skyla contains 13.5 mg of Levonorgestrel and differs from Mirena in that it prevents pregnancy for 3 years rather than 5 and appears to be aimed at younger women who have not had children.



MEDFASH eBulletin

Read all the latest SRH news here




World AIDS Day 2012 – News

30 Nov, 12 | by shellraine, e-Media Editor

“Getting to Zero: Zero new HIV infections. Zero deaths from AIDS-related illness. Zero discrimination” is the theme of World AIDS Day 2012 on 1 December. Life-saving antiretrovirals have reduced new HIV infections and deaths. The 2015 target of 15 million HIV-infected people on antiretroviral medicines worldwide looks more achievable now than ever before.


World AIDS Day – BMJ special promotion 

The BMJ Group is putting together a special promotional webpage for World AIDS Day on 1st December that will offer a week’s free access to all relevant content published by our full range of journals. Please click here for access

New resources for young people living with HIV 

To mark World AIDS day on the 1st of December, the Children and Young People HIV Network, based at leading children’s charity the National Children’s Bureau, is sending a message of support to young people with HIV by launching a range of materials to support them in managing life with the condition.

The ‘Your Life’ leaflets and the ‘Studying with HIV’ guidance and LifeLinks resources are all available from

More than Half of those with HIV in the UK are Overweight:  The Surprising Issues Facing Those Living with HIV

The British Dietetic Association (BDA) will once again be supporting World Aids Day on 1st December. Early data from the BDA’s DHIVA specialist group audit suggests that more than half of people living with HIV in the UK are overweight or obese, with only about one-in-nine being underweight.

In fact by far the most common issues facing HIV dietitians in the outpatient clinic these days are dyslipidaemia, hypertension, diabetes and osteoporosis, with over 75% of HIV patients Vitamin D deficient. Dealing with these issues is not as straightforward as it might seem, with HIV-specific barriers to lifestyle change emerging.

Members report common themes from their patients, including a fear that deliberate weight loss might lead to others guessing their HIV status (“why are you getting thin – you don’t have AIDS do you?”), and a feeling that being overweight is safer (“I remember how ill and thin I was before starting ARVs and I don’t want to go back there again”). from Alastair Duncan, Chairman of the BDA’s DHIVA (Dietitians in HIV/Aids) specialist group.


UNITAID welcomed the good news this World AIDS Day that the number of children newly infected with HIV continues to decline but urges the international community to step up efforts for those children already living with the disease. more from the website

    2012 UNAIDS World AIDS Day Report



MedFASH celebrates 25 yrs

15 Nov, 12 | by shellraine, e-Media Editor

The Medical Foundation for HIV and Sexual Health is 25 yrs old (rebranded as MEDFASH). Established in 1987 by the BMA, as an independent foundation, with the aim of improving knowledge and understanding of HIV among health professionals it has grown and spread to encompass all aspects of sexual health.

As part of this celebration the foundation has a new website and has launched its Sexual Health & HIV Policy eBulletin.  MEDFASH Chief Executive, Ruth Lowbury, introduces the eBulletin: it is designed with local sexual health and HIV commissioners and providers in mind. It will give a concise and regular round-up of emerging policy developments, relevant evidence updates and available tools and resources across the field of sexual and reproductive health and HIV. It will also consider the impact the change agenda is having on this area of healthcare through a series of eFeature articles and interviews with those working at both national and local levels. This is particularly useful now at a time when service delivery is changing and many of us will be involved with new (and possibly challenging) ways of working and new communication channels.

Amonst other things the first issue includes: transfer of sexual heath services to local authorities; local transition arrangements; re-tendering of GUM services; Healthwatch England (the new consumer champion for health and care in England); HIV treatment for overseas visitors.

HPV, HIV & UK Sexual Health Awards

2 Nov, 12 | by shellraine, e-Media Editor

Australia Adopts Herd-Immunity Approach in Fight Against HPV

On July 12, 2012, Australia took a stand to become the first country to provide coverage of the Gardasil® vaccine to boys between the ages of 12 and 13, through a National Immunization Program-sponsored school-based initiative. In her press release, the minister of health, Tanya Plibersek, stated that the government-sponsored initiative was targeted to synergize with the current immunization program in girls to decrease the incidence of human papillomavirus (HPV) infection in the Australian population.

Girls don’t see HPV vaccine as green light for sex

A study by Bednarczyk et al in Atlanta and published in Pediatrics has concluded that HPV vaccination in the recommended ages was not associated with increased sexual activity–related outcome rates.

Nurses in Zimbabwe to prescribe HIV drug

Faced with the ambitious target of reaching 85 percent of people in need of HIV treatment by the end of 2012, the Zimbabwean government has announced that nurses will be trained to prescribe and manage antiretroviral (ARV) drug treatment. Experts welcomed the move but warned that nurses would have to be adequately prepared and supported to take on the additional duties. Previously, nurses were allowed only to administer the drugs after a doctor had prescribed them. Now, changes made in the job descriptions of nurses by the Nurses’ Council of Zimbabwe will see them prescribing the medication. Report from HIV/AIDS/Zimbabwe (HAZ)

UK Sexual Health Awards 2013

Nominations are invited in the following catergories:

  • Sexual health professional of the year.
  • JLS young person of the year.
  • Adult sexual health service/project of the year.
  • Pamela Sheridan young people’s sexual health service/project of the year.
  • Rosemary Goodchild Award for excellence in sexual health journal.
  • Sexual health media campaign/storyline of the year.
  • Durex community pharmacy award.

More information and nomination forms from fpa/Brook

Sexual Abuse in Childhood

15 Oct, 12 | by shellraine, e-Media Editor

By coincidence, the publication of this season’s Journal occurred at the same time as the mushrooming revelations around Jimmy Savile’s abuse of many of his fans over many years. The press are currently talking about 50 or 60 people but he must have come into contact with thousands of vulnerable young, star-struck youngsters in his time. The abuse appears to have been well masked (or ignored) because of the money he was then able to donate to many good causes.

The Commentary and Lead Article in the Journal demonstrate one of the many serious outcomes for future health that childhood abuse can have using attitude to cervical screening in later life as an example. These also highlight the value of one particular organisation who are likely to be inundated with more calls for help and support.


NAPAC is the only UK national charity that supports adult survivors of all forms of childhood abuse. Founded in 1997, NAPAC runs Britain’s only free phone support line for adult survivors and is accredited by the Helplines Association. The support line is staffed entirely by volunteers some of whom are survivors themselves. The organisation was profiled in the Journal in 2011 by our consumer correspondent Susan Quilliam.  The organisation can be contacted at, email at: or the freephone Support Line on 0800 085 3330.

To learn more about the work of NAPAC follow this link to the podcast featuring Sarah Kelly, Training and Development Manager:

Abortion Matters

14 Oct, 12 | by shellraine, e-Media Editor

The First centre to offer abortions in Ireland to open in Belfast.

Marie Stopes International is set to open the ground-breaking clinic next week and, as to be expected, has polarised opinion. Women and sexual health providers welcome the move while there is the usual uproar from those against women’s choice. The clinic will only be offering what is already allowed within the current law but with the added benefit of somewhere women can go for help and support should they need to travel to England or Scotland to access services. Officially anounced today, though leaked last week, Dawn Purvis, Programme Director at Marie Stopes Northern Ireland said: “We believe this is great news for the people of Northern Ireland because we will be able to meet their family planning and sexual health needs in a way that has not been seen here before.  We have a new, purpose built, centrally-located specialist centre; our team are highly trained and dedicated health care professionals; and our services will be delivered in a confidential, sensitive and non-judgemental way”. The Service will offer contraceptive options, HIV testing, STI testing and treatment, ultrasound scanning, and medical abortion up to nine weeks gestation. More from


Science ‘contradicts’ Cabinet Ministers’ claims

Attempts to reduce the time-limit on abortions following Maria Miller’s claim that “science has moved on” will hopefully flounder – assisted by the newly published infant mortality rates for 2010 which show no improvement in survival for extremely premature babies born at 22-23 weeks. More from ONS .
In addition, David Cameron stated in an interview that “… people need to know the govenment has got no plans to bring forward any legislation in this area, and any vote that does happen will be a free vote.” The last time MPs voted on the issue was in 2008 when they decided to retain the 24 weeks limit. In reality only one in ten abortions in England and Wales takes place after 13 weeks.

Cross-party unwanted pregnancy inquiry launches online survey

Amber Rudd MP has launched an online survey for women in the context of her parliamentary inquiry into unwanted pregnancy. It can be accessed at:

While in the US,

Free access to long-acting, reversible contraception has been shown to significantly reduce unplanned pregnancies and abortions. The ongoing Contraceptive CHOICE Project in Missouri featured mostly young and poor women from St. Louis.

Latest from JFPRHC

Latest from JFPRHC