Sterilisation

What is sterilisation?

Sterilisation is a permanent method of contraception, suitable for women or men who are sure they never want children or don't want more children. Male sterilisation is called vasectomy.

How does it work?

Sterilisation works by stopping the egg and the sperm meeting. This is done by blocking the fallopian tubes (which carry the egg from the ovary to the womb) in women or the vas deferens (the tube that carries sperm from the testicles to the penis) in men.
Myths about sterilisation:

• It can easily be reversed. Not true - vasectomy and female sterilisation are difficult to reverse, involving major surgery that isn't available on the NHS.
• Vasectomy is like castration. Not true - vasectomy only involves cutting the tubes that carry sperm to the penis, nothing else is touched.

Male sterilisation

Usually under local anaesthetic, a small cut is made in the skin of the scrotum. The vas deferens are cut and tied or sealed with heat. The operation takes about 15 minutes and can be carried out in a clinic, hospital outpatient department or some general practice settings.
Vasectomy is very effective - about one in 2,000 male sterilisations fails.

Female sterilisation

Under local or a light general anaesthetic, a small cut is made in the lower abdomen. The fallopian tubes are cut and tied, or sealed or blocked, usually with clips.
Around one in 200 females sterilisations fails. The clip method is more effective.
Women considering sterilisation should always be given information about long-acting reversible contraception as these methods are as effective, or more effective, than female sterilisation.

When can I stop using other contraception?

Women should use contraception up to the operation and for four weeks afterwards.
Men will need to use contraception after vasectomy until a semen test shows there are no sperm. This test is usually done around eight weeks after vasectomy.

Advantages and disadvantages

The advantages of sterilisation include:

• After sterilisation has worked you don’t need to think about contraception ever again.
• There are no known serious long-term health risks.

The disadvantages of sterilisation include:

• The tubes may rejoin and you will be fertile again - although this isn't common.
• It cannot be easily reversed.
• It takes at least two months for vasectomy to be effective.

Other things to consider include:

• Sterilisation doesn't protect you against sexually transmitted infections.
• After sterilisation your sex drive and enjoyment of sex should not be affected.

Can anyone be sterilised?

Sterilisation is only for women and men who are sure they don't want children or any more children. It is a permanent method.
Although sterilisation isn’t 100 per cent reliable, and also a reversal can be attempted (although not on the NHS), it should be considered permanent and irreversible for anyone undergoing it. You shouldn't consider sterilisation if you're unsure, under any stress (for example after birth, miscarriage or abortion) or have any family or relationship crisis.
Research shows that more women and men regret sterilisation if they were sterilised when they were under 30, had no children or were not in a relationship.

Where can I be sterilised?

Sterilisation is free on the NHS from contraception clinics, sexual health clinics or general practice.
READMORE:http://www.bbc.co.uk/health

Contraceptive injection

What is it?

The contraceptive injection contains the hormone progestogen. There are two types of injection:

• Depo-Provera provides contraception for three months (12 weeks)
• Noristerat provides contraception for two months (eight weeks)

Depo-Provera is the most used injectable method in the UK. Injectable contraception is a long-acting method of contraception.

How does it work?

The main way it works is by stopping the ovaries releasing an egg (ovulation) each month. It also:

• Thickens the mucus in the cervix, making it difficult for sperm to reach an egg
• Makes the lining of the womb thinner so it's less likely to accept a fertilised egg

Myths about the contraceptive injection:

• It makes you infertile. Not true - but normal fertility can take up to a year to return after using Depo-Provera
• You can only use it for two years. Not true - it can be used for longer providing you do not have any risk factors for osteoporosis (being over 45, poor diet, low exercise or family history of osteoporosis)

How reliable is it?

It's more than 99 per cent effective. This means that using this method, fewer than one woman in 100 will get pregnant in a year. All long-acting reversible methods are very effective because while they're being used you don't have to remember to take or use contraception.

How to use the contraceptive injection

The hormone is injected into a muscle, usually in your bottom. Depo-Provera can also sometimes be given in the leg or arm. The injection can be started up to and including the fifth day of your period. If started at any other time, additional contraception has to be used for seven days.

Advantages and disadvantages

The advantages of the contraceptive injection include:

• It's very effective
• It doesn’t interrupt sex
• You can use it if you can't use oestrogens or are breastfeeding
• It may reduce heavy painful periods and help with premenstrual symptoms for some women
• It may give you some protection against cancer of the womb
• It may give you some protection against pelvic inflammatory disease
• It isn't affected by other medicines

The disadvantages include:

• Your periods may change in a way that is not acceptable to you, or they may stop
• Irregular bleeding may continue for some months after you stop the injection
• You may put on weight when you use Depo-Provera
• Some women report having headaches, acne, mood changes and breast tenderness
• The injection lasts for eight or 12 weeks, so if you have side effects they will continue during this time and for some time afterwards
• Your periods and normal fertility may take some time to return - more than a year for some women
• The evidence about the risk of breast cancer in women using hormonal contraception is contradictory, but research suggests that women who use hormonal contraception may have a slightly increased risk of being diagnosed compared to women who don’t use it

Other things you may want to consider include:

• Once you've had the injection you don't need to think about it until it needs replacing
• You don't need a cervical screening test or internal examination to have the injection
• It doesn't protect you against sexually transmitted infections
• Depo-Provera affects your normal oestrogen level, which may cause thinning of the bones, but once you stop, any risk is reversed - women aged under 18 and over 45 will be carefully counselled about this

Can anyone use it?

Most women can have the contraception injection, but it may be unsuitable if you:

• Think you might already be pregnant
• Want a baby within the next year
• Don't want your periods to change
• Have thrombosis, heart or circulatory disease
• Have active liver disease
• Have breast cancer now or within the past five years
• Have migraines with aura
• Have diabetes with complications or have had diabetes for more than 20 years
• Have risk factors for osteoporosis

Where can I get it?

Injectable contraception is free on the NHS from contraception clinics, sexual health clinics and general practice.
READMORE:http://www.bbc.co.uk/health

HIV

What is HIV?

HIV stands for Human Immunodeficiency Virus (HIV). The virus infects and gradually destroys the cells in the body that usually combat infections leaving the body susceptible to diseases it would normally be able to fight.
Without treatment, the immune system will become too weak to fight off illness and a person with HIV may develop rare infections or cancers. When these are particularly serious, the person is said to have AIDS (Acquired Immune Deficiency Syndrome).

How is HIV transmitted?

HIV can only be passed on through infected blood, semen, vaginal fluids or breast milk.
HIV is mainly transmitted through vaginal or anal intercourse without a condom or by sharing a needle or syringe with someone who's living with HIV.
Other ways that HIV is transmitted are:

• By giving oral sex (although this is rare and will usually only occur if a person has cuts or sores in their mouth).
• From a mother to her baby during pregnancy, birth or breastfeeding (though less than one per cent of babies born to HIV positive mothers in the UK acquire HIV).
• From a needle stick injury in a healthcare setting (although there has not been a case in the UK for more than five years).
• From a blood transfusion or blood products (in the UK all blood and organs are carefully screened to prevent this but in some countries this may not happen).

It's impossible to transmit HIV through saliva and HIV cannot be passed on through casual contact such as kissing or sharing glasses or cutlery. HIV is a very fragile virus so doesn't live long outside the body.

Symptoms of early HIV infection

Not everybody experiences symptoms when they are infected with HIV, but over 70 percent of people who acquire HIV experience some early symptoms, usually in the first few weeks after infection.
These may feel like severe flu and the most common combination of symptoms are a fever, severe sore throat and a rash, all occurring at the same time (which is rare in an otherwise healthy person). These symptoms get better on their own and they may be the only symptoms a person with HIV experiences before becoming very ill with an extremely damaged immune system several years later.

Who's at risk of HIV?

Anyone who's sexually active or shares needles and injecting equipment could be at risk of HIV.
Over 90,000 people are living with HIV in the UK. Around three quarters are gay and bisexual men or African men and women, but the number of people who are diagnosed with HIV who don't belong to either of these communities is increasing every year.
Over a quarter of people living with HIV in the UK are undiagnosed, so unaware of their HIV infection. It‘s important that you don't make assumptions about whether or not your partner has HIV.

What should I do if I think I may have HIV?

If you're worried you might have caught HIV, it's important to get tested. You can take a free and confidential test at any sexual health clinic.
You can also request a test from your GP (which will be put on your medical record) or through a private or online clinic which will charge you.
New tests can reliably diagnose HIV from four weeks after infection, so people no longer have to wait three months to take a test. If you think you've put yourself at risk of HIV, visit a sexual health clinic as soon as possible to get advice.
If you've put yourself at risk of HIV infection in the last 72 hours, you can request PEP (post-exposure prophylaxis) treatment, which will considerably reduce the risk of HIV infection, at any sexual health clinic.

HIV treatment

Although there's no cure for HIV, extremely effective treatment called antiretroviral therapy can keep the virus under control and allow someone with HIV to have an active, healthy life. Treatment is most effective if started early and it‘s important that HIV positive people take their drugs exactly as prescribed in order to stay well.
Someone with HIV who's diagnosed early and responds well to treatment will have a near-normal life expectancy, but some people experience side effects from their medication, such as nausea, diarrhoea, prolonged headaches and changes to body shape. Depression and mental health problems are also more common amongst people living with HIV and there's still little known about the impact of HIV and antiretroviral therapy on the ageing process.

Routine HIV testing

Because of the benefits of early HIV treatment and the risk of passing on HIV if you're undiagnosed and untreated, it‘s important that you're aware of your HIV status. If you're sexually active, it's a good idea to have a regular HIV test as part of maintaining good sexual health. For gay men, an HIV test is recommended at least once a year.
In the UK, all pregnant women are offered an HIV test as part of their routine antenatal care and HIV tests are increasingly being offered in other parts of the NHS, for example as part of the routine health checks when registering with a GP.
READMORE:http://www.bbc.co.uk/health

Narcolepsy

What is narcolepsy?

Narcolepsy is a neurological condition affecting the area of the brain that controls waking and sleeping. The word comes from the Greek and means 'seized by sleepiness'.

Symptoms

The main symptom is falling asleep suddenly. About four out of five people with narcolepsy also experience cataplexy, a sudden loss of muscular tone and control which is usually triggered by emotion, for example laughter. It may cause the jaw to drop and the head to slump, or the legs to collapse.
These attacks can last for seconds or many minutes and can occur many times a day.
Other possible symptoms include temporary paralysis on falling asleep or waking up and visual hallucinations. People may wake during the night with their heart racing, feeling flushed and agitated, and with intense cravings for sweets.
Schoolchildren with narcolepsy may become the focus of ridicule and bullying in school and it becomes difficult for them to engage in usual school activities and study.
Later in life, it can affect someone's education, relationships and career prospects. Consequently, someone with narcolepsy often also has low self-esteem, depression and relationship problems.

Causes and risk factors

Narcolepsy appears to be a condition where normal elements of sleep – specifically elements of REM (Rapid Eye Movement) or dream sleep suddenly occur during a person’s wakeful state.
The cause of narcolepsy remains unclear. Research has identified several different factors which may play a part. Some people may be predisposed to the condition by their genetics – it is much more common among people with certain genetic profiles.There may be abnormal functioning of certain neurotransmitters (brain messenger chemicals) – for example research has identified that it may be caused by a shortage of the chemical brain messenger called hypocretin. Meanwhile other research suggests that narcolepsy may be the result of an autoimmune process, when the body attacks itself.
Suggested initial triggers include infections such as measles or mumps, accidents and the hormonal changes that take place in puberty (because for many people affected, narcolepsy begins in adolescence).
It's believed around one in 2,000 people has narcolepsy. Men and women are affected in equal numbers. It most often begins between the ages of 15 and 30.
Because narcolepsy tends to start in adolescence, the symptoms are often mistakenly put down to behaviour associated with this stage in life. Those who fall asleep in class may be labelled as lazy and blamed for staying up too late. Often the possibility of drug misuse is explored before the possibility of narcolepsy, adding to the distress suffered. These problems may explain why it takes an average of ten years before the real nature of the illness becomes apparent and as a result a diagnosis of narcolepsy is often not made until mid-life.
Many people are also misdiagnosed as having other medical conditions such as:

• Anaemia
• Heart conditions
• Low blood sugar
• Hypothyroidism
• Epilepsy
• Multiple sclerosis

To properly diagnose narcolepsy, the person’s sleep must be monitored overnight using an EEG or electrical tracing that demonstrates distinct brain wave patterns. Invariably it comes as a great relief for someone to know what their problem really is.

Treatment and recovery

Although it's not yet possible to cure narcolepsy, symptoms can be treated to enable someone to lead as normal a life as possible.
Sleep hygiene is important. This simply means taking steps to ensure plenty of good quality sleep, including a regular bedtime and between seven and a half to eight hours sleep every night. Frequent brief naps may also help and should be spaced evenly throughout the day. This can reduce excessive daytime sleepiness but should aim to not interfere with normal daytime activities.
Heavy meals and alcohol should be avoided. During the day rooms should be well ventilated, especially classrooms. It helps if schoolmates, teachers and family are made aware of the problem and how best to support the affected person who may otherwise be teased or bullied.
People with narcolepsy should avoid driving or operating heavy machinery when they are sleepy.
Stimulant drugs such as amphetamines improve symptoms in 65-85 per cent of patients but can produce side effects ranging from headaches and irritability to gastrointestinal problems. A newer drug called Modafinil also promotes wakefulness although it is not yet clear exactly how it works. Antidepressant drugs are often prescribed when cataplexy is a problem but experts have recently pointed out that there is little evidence to suggest they offer much benefit.
Attacks can be kept to a minimum by:

• Reducing stress
• Taking short naps throughout the day
• Taking regular exercise
• Keeping to strict bedtimes

READMORE:http://www.bbc.co.uk/health