19th January 2018 | Posted by Harriet Lewis
Common Cervical Health Questions
Every year in the UK around 3,000 women will be diagnosed with cervical cancer. As January is Cervical Health Awareness Month, Consultant Gynaecologist Mr Pisal shares answers to the frequently asked cervical health questions.
1. Many cervical cancer symptoms overlap with other conditions. What symptoms are distinct to cervical abnormalities and cancer?
It is important to remember that cervical cancer is very rare especially in women who have had regular smears. Red flag symptoms would include bleeding after sex, bleeding between periods and persistent vaginal discharge. If you are concerned for any reason do not hesitate to see your GP or practice nurse for a quick check up.
2. What should women expect to happen for treatment following a diagnosis? What are their options?
More than half the cervical cancers diagnosed in the UK are very early (microinvasive or stage 1A) and are treated by local treatment by removing the cells. This treatment can be carried out either under local or a short general anaesthesia.
If the stage of cancer is stage 1B or more, more extensive surgery may be needed. This will depend on exact circumstances and other factors such as a desire for further fertility. If the cancer cells have gone outside the cervix, additional treatment with chemotherapy and radiation may be needed.
3. Is it possible for cervical cancer to develop during the 3 year cervical smear gap and how accurate are smear tests?
Cervical cancer takes a long time to develop (approximately 15 years) which means that one would have five opportunities (smear tests) for detecting any abnormalities. This makes it safe to have a smear test every three years.
Having said that, sometimes a smear test can be falsely negative as it is a screening test and not a diagnostic test. A negative smear test means ‘low risk’ and not ‘no risk’. It is therefore important to see your GP, gynaecologist or practice nurse, if you have any of the ‘red flag’ symptoms mentioned above.
4. What are the options if a woman missed her HPV vaccination at 12/13 years old?
This is available privately in certain circumstances, please visit our page on HPV vaccination.
5. Are their any support groups or networks you could recommend?
Jo’s Trust provides invaluable support and reliable, validated information to women regarding cervical screening, abnormal smears as well as cervical cancer. It is an amazing charity and London Gynaecology has actively fundraised for Jo’s Trust over last 3 years.
If you have any concerns about your cervical health, don’t hesitate to contact your GP, gynaecologist, or practice nurse, and don’t forget to ensure you are up to date with your smear test. Call us on 0207 10 11 700 or order your HPV DNA self-test kit here.
11th January 2018 | Posted by Admin
HPV is not always well understood, Jo’s Cervical Cancer Trust, the only UK charity dedicated to women affected by cervical cancer and cervical abnormalities, shares answers to the common misconceptions about HPV.
You don’t have to go for cervical screening if you have had the HPV vaccine
The vaccine provides a high degree of protection against cervical cancer however it does not provide full protection. The new vaccine (Gardasil 9) prevents 90% and the old vaccine prevents 70% of all cervical cancer. Therefore, it is very important that you still attend regular screening even if you have been vaccinated to reduce your risk and have maximum protection.
You can’t contract HPV if you use condoms
Practising safe sex through the use of condoms can help reduce your risk of contracting HPV but it will not completely eradicate the risk as HPV lives on the skin, in and around the whole genital area.
You can’t contract HPV if you have only ever been with one partner.
You can contract HPV the first time that you are sexually active and the virus can remain dormant for long periods of time which is why continuing to attend regular cervical screening is important for all women.
You can’t contract HPV if you have only ever been sexually active with a woman.
HPV can be transmitted through skin-to-skin contact in the genital area so anyone with a cervix who has ever been sexually active is at risk of contracting HPV and experiencing abnormal cervical changes. Thus, they should always attend when invited for cervical screening.
For support, visit Jo’s Trust at www.jostrust.org.uk.
10th January 2018 | Posted by Harriet Lewis
Talking to Your Partner About HPV
Approximately 75-80% women (and men) get human papilloma virus at some stage in life. It usually produces no symptoms and many women will not even know that they have had the infection. However for some the diagnosis comes as a result of a routine smear test and this can raise many questions, not just for the patient but for out of concern for her partner too.
If you have been diagnosed with HPV, read the information below for considerations for you and your partner.
Do I need to tell my partner?
This is entirely your decision. Most men and women with HPV infection carry the infection without ever being aware of it. HPV infection does not need to be treated and in 95% cases, you would get rid of it through your immunity.
Currently, validated testing for men is neither needed nor available. If either or both of you also have genital warts, you may need treatment for that.
What are the important things to consider when telling my partner?
You should explain what it means for you as your partner would be concerned about that. As you know, HPV infection is very common and 80% men and women get it at some stage in their life. You should stress on the fact that HPV infection is often transient and no treatment is necessary unless there are abnormal cells (this applies to women). Most men and women would get rid of it through their own immunity.
HPV infection can be transferred through sex but also through skin to skin genital contact as it can be present in the skin around as well. Using condoms therefore does not completely protect against HPV infection.
For men, no further action is necessary unless they have any obvious lesions on the external organs. It is not necessary to carry out any other tests or treatment.
Does it mean they/I have been unfaithful?
Not at all. HPV infection can sometimes remain dormant in the body for several years and it is extremely difficult to say when you acquired it or who from.
Does my partner need an HPV test?
This is not necessary.
If my partner has HPV, what does this mean for him; does HPV affect men similarly to women (ie cause warts / cancer etc)
Medically speaking, it is not necessary to decide if your partner has HPV or not. Currently, HPV testing is not recommended for men. HPV causing cancer is uncommon in men. Men who smoke and may have acquired HPV infection through oral sex may be at a slightly increased risk of throat cancer, but again no tests are needed unless they have symptoms such as change in voice, difficulty swallowing or persistent sore throat and cough.
If my partner doesn’t have HPV, how can I prevent passing it to him?
It is very likely that you both carry the same subtypes of the virus and will have already developed immunity. Hence there is no risk of reinfection for both of you. As mentioned above, there is no fool-proof way of preventing HPV transmission nor is it necessary.
Can my partner re-infect me?
Currently, there is no evidence that you can be reinfected by the same subtype of HPV. So no additional precautions are needed.
I’m bisexual/gay, can I pass this to another woman through sexual contact?
Yes, this is possible through skin to skin contact.
Can men have HPV vaccination?
HPV vaccine is not licensed for men in the United Kingdom, but is routinely given to boys in some other countries (e.g. Australia). Privately, consultants at London Gynaecology are able to offer it to men in selected cases after consultation and counselling.
3rd January 2018 | Posted by Harriet Lewis
Laparoscopic Surgery for the Removal of Fibroids
Fibroids are benign growths within the uterine muscle, and can be very debilitating. Often by the time we see patients they are very symptomatic with heavy periods causing anaemia or a large lump pressing on the bladder and other organs. Whilst benign, fibroids over 6cm can be removed in order to allow the patient to return to and enjoy a normal life.
However, for many patients the thought of open surgery is not very appealing, the large scar and a long recovery time can be off putting. In recent years, laparoscopic or keyhole surgery has provided a viable, and often preferable, option for many fibroid removal procedures.
Laparoscopic surgery is a procedure where 3 or 4 small incisions (5-15mm) are made on the abdomen. A device called a laparoscope (a narrow tube with a fitted camera) is inserted through an incision, to allow the surgeon to see the fibroids. A special device (morcellator) is used to cut the fibroid into smaller pieces which are extracted through the incision. Whilst it is a more complicated procedure, requiring specialist surgical skills and longer time in theatre, it also offers many benefits.
What are the benefits of laparoscopic removal of fibroids?
- Shorter recovery time: The main benefit of laparoscopic surgery is tiny incisions, this means a much shorter recovery time; often patients will stay in hospital for 24 hours and are up and about within a few hours of their operation and can return to work within 2-4 weeks. In comparison, with an open procedure (open myomectomy) patients can expect stay in hospital for 3-5 days after surgery, and return to work within 6 weeks.
- Smaller scar: The reduced incision is cosmetically appealing and for patients who prefer to wear bikinis or who don’t want a “long” or “big” scar, laparoscopic surgery is a very attractive option.
- Lower risk of infection: Medically speaking, where possible, laparoscopic surgery is preferred as there is less risk of wound infection and also pelvic infection as tissue handling is minimal and is carried out by single use sterile instruments.
- Less risk of thromboembolism (blood clot to the legs or lung) as women tend to be mobile sooner which helps with better circulation.
- Better preservation of fertility as there is less risk of adhesions and blockage of tubes.
When is a laparoscopic removal not possible?
There are instances where laparoscopic removal of fibroids simply isn’t possible. The size and location of fibroids will play a role in determining the procedure type, generally speaking fibroids smaller than 12cm can be removed laparoscopically but greater than this will depend on individual circumstances.
Age may also influence the possibility of having a laparoscopic removal. Patients over 50 years of age aren’t suitable for laparoscopic removal of fibroids due to higher risk of cancerous change within the fibroids.
Finding the right surgeon
Laparoscopic surgical skills are specialist skills meaning that not every surgeon is able remove fibroids this way, so it may take more time to find an appropriate surgeon.
Finding the right surgeon is also important as trust plays an enormous role; in some circumstances the surgeon may not be able to decide whether a laparoscopic procedure is possible until the day of the surgery itself. They may begin the surgery laparoscopically and move to an open procedure if it is required to complete the procedure successfully.
This would be discussed at length in the consultation before the procedure is booked so that the patient is comfortable and has had time to understand the situation and discuss the decisions she wishes the surgeon to make on the day.
Every year at London Gynaecology, we complete over 50 fibroid removal operations and over 90% are carried out by key-hole surgery.
Please visit our specialist website, London Fibroids, for more information, or call us on 0207 10 11 700.
14th December 2017 | Posted by Harriet Lewis
Welcoming our Fitness Ambassador
We are very excited to announce 800m athlete Ellie Baker as London Gynaecology’s Fitness Ambassador. With a background as a personal trainer and now as a British athlete, Ellie has first-hand knowledge of the importance of fitness in maintaining a healthy lifestyle.
As a determined young woman actively in pursuit of her goals it’s no surprise that Ellie has already accomplished many achievements. Recently we spoke to Ellie about her journey as an 800m runner and her top fitness tips, read the article below.
When did your athletics journey begin?
As a child (around age 7) I was very sporty, energetic and loved watching athletics on TV. My parents decided to enter me for the local fun run that takes place in Borehamwood, Hertfordshire, and to their amazement I returned as the fastest female/male for my age.
Then, I joined a local fun run club for a couple of years. As I grew better and faster, I decided I wanted to join a proper athletics club and give it a good go. Since then I have never looked back as I knew this was the sport for me and what I wanted to do more than anything!
I started competing in races when I was an under 11. It has taken a lot of hard work, dedication and mental strength to get from that point, to where I am now.
As an athlete, what is your usual training and nutrition routine?
My usual training routine this year is:
- Monday: Morning 5 mile run & an evening run.
- Tuesday: Morning track sessions & strength and conditioning during the evening.
- Wednesday: Morning 5 mile run & either pilates or another run in the evening.
- Thursday: Morning hill sessions followed by strength and conditioning & then a run in the evening.
- Friday: Rest day!
- Saturday: Morning track session or tempo session, followed by strength and conditioning.
- Sunday: A long run, usually around 8 miles.
For nutrition, I always have a protein shake after sessions and hard runs. I eat a lot of protein, carbohydrates, vitamins and minerals. I also drink a lot of water throughout the day.
A daily example of food includes:
- Breakfast: Weetabix with honey and berries
- Snack: Apple or an orange
- Lunch: Chicken, pasta, spinach, and tomatoes
- Dinner: Beef, sweet potatoes, broccoli, and spinach
- Snack: Homemade protein balls
What are your top tips for someone just starting their fitness journey?
- Aim High, Train Clever: This is my top tip. Often when people are just starting their fitness journey, they hit the first couple of weeks hard rather than easing themselves in gently.
- Rest: Sometimes you can get more benefit from a rest day than actually training. It is important to let your body recover, which is why it is essential to place a rest day somewhere in your week of training.
- Never Quit: A fitness journey shouldn’t just be a quick fix for your summer holiday snaps, it should be a lifestyle that you should build into.
- Eat Well: Starting with nutrition, you should fuel you body right to get the most out of your training runs and training sessions.
- Sleep: Another thing to concentrate on is sleep for performance as this is where your body recovers the quickest. Naps are good!
Who is your female role model and why?
My female role model is Jessica Ennis as she is a motivated, strong, dedicated and hard-working character.
As an athlete, your physical health is so important. Is there anything you do to look after your mental health also?
Mental health and strength is massively important in sport and I don’t think there is enough enthusiasm on this issue. A lot of athletes I know will sometimes meditate which is good, however I personally prefer to go to Yin Yoga as it relaxes me and allows be to switch off from everything.