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Healthy Sexy & Wise - July 2003

Volume 1, Issue 3, 2003

Editors Note

Welcome to the July edition of Healthy Sexy & Wise.

If you would like future issues of Healthy Sexy & Wise emailed to you Contact Us.

In this issue:

Please feel free to circulate and distribute this newsletter to anyone you know that may benefit from the information. They can go on the mailing list by emailing me their details.

If you have any suggestions, ideas or comments about the newsletter, you can email me – be sure to let me know if there are any topics you would like to see covered in the future. Look out for the next Healthy Sexy & Wise in late October - this issue will include a story on joint FPWA and WA AIDS Council projects.

Rebecca Smith
Editor

Sex in a library? FPWA Library and Bookshop

FPWA Library

Everyone is familiar with public libraries as sources of information, but a lot of people are unaware of the many special libraries that are open to the public. What makes a special library “special”? It’s a library maintained by an association, government agency, health service, voluntary body, commercial organisation, or similar whose resources generally focus on a specific field or subject.

FPWA has an extensive sexual health library and bookshop on the first floor of our Northbridge premises. There is no charge to access the library and everyone is welcome. FPWA Library provides information on a wide range of sexual health topics and has a large selection of resources for loan, hire and sale. The library collection focuses on sexual and reproductive health and related issues. There are books, journal articles, videos and teaching kits providing information suitable for individuals, students and professionals.

The library and bookshop are open weekdays from 9.30 am to 5 pm, and until 6.30 pm on Thursday evenings. Services are offered statewide and queries can be answered by mail, phone, fax and email. More information about the FPWA Library and Bookshop

Low-dose pill approved to treat acne

Australian approval of an oral contraceptive pill for the treatment of acne comes as good news for the many women who suffer from this condition. Loette is the first low-dose oral contraceptive to be granted approval for the treatment of moderate acne by the Therapeutic Goods Administration (TGA). It can be prescribed after topical preparations have failed to improve the skin.

Around 80-90 percent of young women and up to 30 percent of older women suffer from acne. The normal hormonal changes that occur throughout the menstrual cycle can trigger or worsen acne in some women. Taking an oral contraceptive pill like Loette means a more constant hormonal dose throughout the month, so many women will find that their acne symptoms settle down while they are using it. The Pill also tends to reduce the levels of specific hormones called androgens in the blood stream, and it is these androgen hormones that are particularly involved in the development of acne.

Although doctors have been prescribing oral contraceptives to improve the appearance of skin for years, this new approval means that GPs can confidently prescribe Loette to help with acne. Having acne can have a negative effect on a woman’s self-esteem, and can lead to her feeling less confident. The approval of Loette for treatment of acne is good news for acne sufferers who have found little relief from other forms of treatment, such as antibacterial face washes. It is also a very attractive option for women who not only require treatment for their acne, but who also want effective oral contraception.

Sexual Health Q&A

Can I get Hepatitis C from having sex?

Hepatitis C is transmitted by direct blood to blood contact, eg sharing needles or toothbrushes and razors, and rarely occurs through sexual activity. There is a risk however, when sharing sex toys that might cause tiny nicks or cuts, especially during menstruation, so always practise safe sex and use a condom.

Some people infected with Hepatitis C have no symptoms at first, while others get a mild ‘flu-like’ sickness. If you think there is a chance you may have been infected, it is important to see your doctor as soon as possible to arrange for a blood test.

Do lesbians need to have Pap smears?

Yes. Many lesbians and their partners have had sex with men in the past. This means they may have been exposed to Human Papilloma Virus (HPV) at some stage, which is one of the main causes of cervical cancer. Regular Pap smears help detect early warning signs of cancer.

HPV and other STIs can also be passed on through female to female sex, so lesbians should always practise safe sex by using female condoms and dams. Recently the first case of female-to-female sexually transmitted HIV was documented, with the main risk thought to be overly vigorous use of sex toys leading to blood exchange.

Does the contraceptive pill cause high blood pressure?

Most women taking the pill will experience a slight rise in their blood pressure reading, but this should not take their reading outside of the normal range. It is important that all women on the pill have their blood pressure reading taken every time they get a new pill prescription (usually once a year). Most doctors do this as a matter of course. Only one out of every 100 women using the pill will have a blood pressure reading that is a problem for their health. If this is the case, the doctor will look at alternative contraception options with them.

Women with established high blood pressure (and who are well controlled with medication) can use the contraceptive pill, but need to be closely monitored by their doctor. Women who have untreated high blood pressure (hypertension) will usually be subject to further investigation by their doctor prior to commencing the Pill.

How can I tell if I have chlamydia?

Chlamydia is Australia’s most common sexually transmissible infection (STI) among men and women aged 15-25. Some people have symptoms of an infection, such as discharge, abnormal bleeding or pain when urinating. However, many people with chlamydia have no symptoms at all, so until you’re tested, you can’t tell if you or your partner has it. It is important to practice safe sex to reduce the risk of contracting chlamydia, as it can lead to infertility if left untreated. Chlamydia can be detected by a simple test involving a urine sample and/or a swab from the cervix. It is easily treatable and can usually be cleared up with a dose of antibiotics.

What is an IUD and who can use one?

SHH

Intrauterine devices (IUDs) are an effective, safe and reliable long-term method of contraception for many women (more than 99.9% effective for between five to eight years). They are small plastic and copper devices which are inserted into a woman’s uterus by a doctor. IUDs work mainly by preventing sperm from fertilising the egg. In the rare instance an egg is fertilised, the IUD prevents the egg from attaching to the lining of the uterus so a pregnancy does not occur.

Your doctor will take a detailed medical history to ensure that an IUD is suitable for you. IUDs need to be inserted and removed by a trained doctor and can be taken out at any time. They do not provide protection against sexually transmissible infections (STIs).

For confidential answers to your sexual health queries, phone the Sexual Health Helpline on 9227 6178 or freecall 1800 198 205 (country callers).

Don’t leave it too late to have children

Putting off having a baby to save for a house or holiday may seem like a good idea, but is one that can end in heartbreak. While recent trends show more women are delaying having children, those waiting too long can often find their childbearing years are behind them.

Many women in their 30s think they have plenty of time when it comes to getting pregnant, but unfortunately this is not always the case. FPWA is seeing more and more women who have missed their chance to have a baby, simply because they left it too late.

Women in their early 30s wanting to have children need to think hard about their time-frame. Even by the age of 35 a woman’s fertility slows down - her ovaries have aged and her egg cells are dwindling.

Many women don’t appreciate how hard it can be to get pregnant, not just in their 40s, but also in their late 30s. They are also not aware that menopause can occur before the age of 40.

It can be very distressing for a woman to wait until she is 38 to have a baby, only to find out she is in the early stages of menopause. FPWA’s advice to women in their early 30s wanting to have children is to move quickly.

Advances in fertility treatments can also give women a false sense of security. Reports of women storing their eggs for future use has lead many women to incorrectly believe that they will be able to conceive later in life. This technology is still highly experimental and may never be available to the general public - women shouldn’t rely on new technology being available to help them conceive down the track.

Some women also think that IVF can be of assistance if they are running out of time, but in reality the success rate of IVF in women aged 40 and over is around 2%. There is a lot of pressure on women these days, both financially and professionally, and many want to be secure in these areas before they think about having children. At the end of the day, if a woman wants to have a baby, other aspects of her life may need to be put on the back burner – she can always get a pool or new car later on, but this may be her last chance for a child.

HT findings no reason to panic

Recent media attention surrounding the risks associated with hormone therapy (HT, commonly referred to as HRT) has unnecessarily alarmed many women.

The way the results of several studies were reported caused anxiety for many women taking any form of HT, particularly in regards to breast cancer. One study showed that taking HT increased the risk of breast cancer, causing many women to stop their treatment immediately.

This is not new information - it is known from previous studies that breast cancer is slightly more common in women taking HT. One study calculated that after four years of treatment, there would be about eight more women in 10,000 who would get breast cancer per year. Other studies have similarly calculated that in every 1000 women taking HT for 10 years, there may be a total of six extra breast cancers.

These figures are relatively small, as it is important to remember that the incidence of breast cancer increases with age in all women and that one in 11 women will get breast cancer in their lifetime.

While HT can slightly increase the risk of breast cancer, it does not appear to increase the risk of dying from it. An interesting aspect is that women who do develop breast cancer on HT actually respond better to treatment than those not on HT, so there is no difference in mortality rates from breast cancer in these two groups.

Studies have not only shown an increase in survival from breast cancer in oestrogen (HT hormone) users, but also that HT users seem to develop less aggressive tumors that are less likely to spread and are more easily treated.

A recent American study found that there was an increase in heart disease, stroke and blood clots in women taking HT, but this was mainly in women already at risk of these conditions. The same study also found a reduction in osteoporotic fracture and bowel cancers, which is good news for HT users.

FPWA’s advice to women who are concerned about the results of studies relating to HT is not to panic. Many of the recent studies only looked at the way particular types of HT affected specific groups of women and the results are therefore not relevant to all women. Australian doctors are very concerned about safety aspects of HT and will help a woman to carefully weigh up the risks and benefits of HT for her personal situation.

Last month new information was released from the US Women’s Health Initiative Memory Study, which assessed the incidence of dementia in HT users. The rate of dementia in users of HT was twice that of placebo treated women.

These studies were done on women whose average age was 71, with no menopausal symptoms. Most women who need HT to control severe menopause-related symptoms will be in their forties and fifties, when dementia is a very rare problem.

It is important that women get as much information from their doctors as they need to be able to make an informed choice about their treatment. At the end of the day the decision to take HT is an individual one and improving the quality of life doesn’t necessarily mean reducing its quantity.

Conception through reproductive technology – what to tell children

By Jane Irvine, Counselling Consultant

All parents are faced with the inevitable ‘where do I come from question?’ at some point, but for the parents of children born as a result of assisted reproductive technology (Donor Insemination and In Vitro Fertilisation), answering can prove a little more difficult.

Deciding when and what to tell your child about their conception is a complex and sensitive issue. Many children born after a battle with infertility are particularly ‘precious’ and it is understandable that parents have concerns about how ‘telling’ will affect the child and relationships within the family.

Every situation is unique and there is no ‘one way’ to address the issue. There are, however, two important things that parents should consider. Firstly, it is crucial that they tell the truth - trust can easily be broken if a child learns about their conception from a source other than their parents, and secrets have the potential to create numerous problems within a family.

Parents also need to ask themselves ‘Ethically, do I have a right to keep this information from my child?’ From a medical point of view, it can often be very useful for adults to know their genetic make –up.Secondly, correct and relevant information is the key. The best person to guide a parent about what is relevant is the child itself - some children want to know details and will ask questions, while others may be completely disinterested. If parents provide too much information, or give the information too early, it may be confusing and distressing, especially if the child has not yet begun to think about these issues.

Some parents choose not to think about how their child was conceived, and hope that the topic won’t come up. Occasionally the issue can arise quite unexpectedly - IVF and donor insemination are touched upon quite regularly in the media and infertility is often a topic addressed in T.V serials. This may prompt children to ask about their conception in a way they may previously have asked about adoption, which is much less common these days.

For this reason, it’s a good idea for parents to give some thought to the issue, such as how comfortable they are with the topic and what they may say if questioned. Withholding or glossing over information can lead to a sense of secrecy, shame and insecurity. It’s important that a child feels good about his or her origins, and that how they came about is not something to ‘cover-up’ or be ashamed of.

If parents want to raise the subject of conception they need to individually assess the right time to talk to their child. It’s important to assess a child’s emotional and intellectual readiness and this may vary among siblings. Younger children need short and simple information - if they want more, they will keep asking questions.

If a child is older, and understands how babies are made, words like ‘sperm’ and ‘egg’ can be used.Children also naturally lean towards a family context, as opposed to a technical one, so choose a word or a description that you feel comfortable with to describe the "donor". Some parents with younger children use the description of "the person that helped mummy and daddy have you", while terms like "biological father" can make more sense to older children and adolescents.

During adolescence, children may ask more detailed questions either from their parents or their peers. Some will react with disgust and resentment, which is typical at this age as children are struggling with their sense of identity, so stay calm and be available to talk to them more.

At the end of the day, kids cope well with the truth. They need parents to be open and up front, and at the same time feel that their parents are being sensitive to their individual needs.

Roe Street Centre for Human Relationships offers counselling sessions on telling children about their conception. Phone 9228 3693 to make an appointment.

Book Reviews

Urgent / Ryan, Joleen; Torpey, Julia; Torpey, Megan; Watson, Tegan. -- Milsons Point, NSW: Random House, 2003.

'I'd like to tell the story of a patient, Albert Thompson. I met many people like Albert, who was stolen from his family at the age of four and was unable to resolve his loss. One day, I was called to Albert's isolated shack at the end of a bumpy dirt road though a dense rainforest. When I arrived, I found him dead, curled up awkwardly on his stretcher bed, a large envelope marked 'urgent' in his arms. I am sending you a copy of the extraordinary contents. Should I write to his daughters? What would you say to them? What would you do?'

Urgent asks you to step into Albert Thompson's fictional shoes, and imagine life from the point of view of his daughters, who grew up never knowing they had sisters. With contributions from young Indigenous and non-Indigenous people, and based on true experiences, Urgent is a powerful account of identity, forgiveness and understanding.

Towards reconciliation in Aboriginal health : initiatives for teaching medical students about Aboriginal issues / Rasmussen, Lisa. – Parkville, VIC: VicHealth Koori Health Research and Community Development Unit, Centre for the Study of Health and Society, University of Melbourne, 2001.

Towards reconciliation in Aboriginal health : initiatives for teaching medical students about Aboriginal issues presents a body of research conducted over recent years in the Faculty of Medicine, Dentistry and Health Sciences at the University of Melbourne.

The research takes as its starting point focus group discussions and attitudinal surveys exploring medical students’ perceptions of Aboriginal people, health and current teaching methods. From this, the work proposes a new teaching model. A cross-cultural pilot teaching project was developed, delivered and evaluated in light of this model. The book concludes with a series of recommendations regarding teaching Aboriginal issues in undergraduate medical curricula.

Lisa Rasmussen is a lecturer in Aboriginal health at the VicHealth Koori Health Research and Community Development Unit at the University of Melbourne. Prior to this Lisa worked as a doctor at the Victorian Aboriginal Health Service.

Website news

http://www.healthinfonet.ecu.edu.au/

The Australian Indigenous HealthInfoNet ensures comprehensive, up-to-date knowledge and information is accessible to people interested in the health of Indigenous Australians.

HealthInfoNet also works directly with Indigenous people to improve their use of the Internet, and assists Indigenous and other relevant agencies in making their information available. The published, unpublished and specially-developed material about Indigenous health is relevant to policy makers, service providers, researchers, students and the general community.

There is information about specific health conditions, which includes: an overview of the topic; policies and strategies; case studies; references of recent journal articles, publications and theses; preventive and clinical guidelines; a bibliography of relevant sources; and links to organisations and other Internet-based materials. The material is authoritative and peer-reviewed.

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Page last updated Mon, 12 Jun 2006 14:34