Posts tagged Sexual Health

1 2 Next Last

Easter 2019 opening hours and last order dates

Posted 17 April 2019 in Allergies, Erectile Dysfunction, Hair Loss, Men's Health, Sexual Health, Weight Loss, Womens health

A quick reminder that Wednesday 17th April is the latest time to place an order for treatments to guarantee free next working day delivery before Easter.

Orders placed before 4pm on Thursday 18th April can upgrade for delivery on Saturday 20th April for just £2.

We will be closed from 5pm on Thursday 18th April until 9am on Tuesday 23rd April; orders received during this time will be delivered on Wednesday 24th April.

STI Testing

The testing lab is open 365 days a year, but DPD and Royal Mail are closed on Bank Holidays and this determines when your sample arrives at the lab. Please bare this in mind when deciding to post your sample to the lab to prevent your sample deteriorating.

Don’t post any samples to the lab from Wednesday 17th April until the morning of Tuesday 23rd April when normal service resumes.

HIV: commonly asked questions

Posted 28 November 2018 in Men's Health, Sexual Health, Womens health

A question mark of pillsNational HIV Testing Week begins on Saturday 17th November 2018 and World AIDS Day on December 1st, so now is the best time to look over some of the most commonly asked questions about HIV (human immunodeficiency virus) testing and treatment!

How soon can HIV be detected by a blood test after contracting the virus?

Generally, it is one month after exposure to HIV that the virus is easily detectable in the blood. Tests done less than one month after exposure are considered unreliable. (1)

What is the window period for HIV testing?

The window period is the one-to-three month time frame following possible exposure to HIV, depending which test you use. The window period for the lab test is 28 days but is 90 days for the “Home” test. If you test before the recommended time frames then the HIV test may need to be repeated. This applies whether an earlier test came back positive or negative, as results from tests conducted earlier than the recommended “window period” for HIV can be unreliable, as previously mentioned. (1)

However, you shouldn’t wait until you may be in the window period before seeking medical help - you should do this as soon as you can if you believe you may have come into contact with HIV. Within the first 72 hours after suspected exposure, a type of medication called post-exposure prophylaxis (PEP) can be taken, which may prevent the infection from taking hold altogether. (1)

Can you receive instant results from an HIV Test?

Tests which provide instant results are available to use. Some genitourinary medicine (GUM) clinics and sexual health clinics offer finger prick testing, and home testing kits can be purchased from some online or high street pharmacies. (1)

How can I test for HIV at home?

There are a number of tests available from Webmed Pharmacy which allow you to test or take a sample in the comfort of your own home.

How accurate are HIV Tests?

  • The latest 5th generation HIV lab test kit is 99.8% effective at detecting HIV at least 28 days after potential exposure. It contains a sterile lancet and a test tube. A blood sample is collected by pricking the little finger with the lancet and massaging a small amount of blood into the tube. This is then sealed (further instructions are found in the kit) and sent off to a lab for testing using the pre-paid envelope included. Results should be available two to three days after the sample is received by the lab – you will be able to access these via your secure account.

  • The 3rd generation INSTI HIV Home self test allows you to sample and test for HIV yourself, all within just 60 seconds. It is only reliable if used at least 90 days after potential exposure. Like the lab test, blood is collected by pricking the finger (full instructions supplied in the kit). The result is clearly shown as one dot for HIV negative, two dots for HIV positive. Negative results are at least 99.5% accurate and positive results are at least 99.8% accurate.

  • The PrEP annual test kit can be used if you are taking pre-exposure prophylaxis (PrEP) – this medicine is used by HIV negative people to prevent infection with HIV. This test can be performed yearly to check HIV status and also kidney function, which can be affected by taking PrEP.

  • The pre-treatment PrEP test kit is suitable if you are thinking of starting PrEP. It checks your HIV status, kidney function and also whether you have hepatitis B.

What should I do if I test positive for HIV?

If you get a positive result, seek medical help. You will need to have regular blood tests to monitor the levels of a type of cell called CD4 lymphocytes. CD4 lymphocytes are one of the types of cells that make up the immune system and are also the cells that are targeted by HIV. HIV particles ‘hijack’ the CD4 lymphocytes, replicate themselves within the cells, and are then released in greater numbers when the cell dies, going on to infect further cells. You will need to start treatment to keep your CD4 levels high enough to keep you in good health - if someone with HIV does not start treatment, their CD4 levels will eventually fall so low that they will be at risk of serious infections such as flu, pneumonia and tuberculosis, which their immune system will not be able to cope with (this is known as AIDS  - see below). (2)

Even if your CD4 levels are high, you will still need to start medication to limit the progression of the disease. The aim of treatment is to achieve an undetectable viral load (levels of HIV in the blood being so low that they do not show up on blood tests).

What medications are available for HIV?

There is a wide range of HIV medications available, which are grouped into the following categories:

Other HIV medications outside these categories include enfuvirtide and maraviroc, which work in different ways to the medications listed above. (3)

Taking HIV treatment correctly should allow you to stay in good health, free from symptoms and to achieve a normal lifespan.

What is the difference between HIV and AIDS?

We often hear the abbreviations ‘HIV’ and ‘AIDS’ used interchangeably, but they are not the same! AIDS, or acquired immunodeficiency syndrome, is the most severe stage of HIV. It is characterised by CD4 levels falling so low that the body is very susceptible to opportunistic infections and cancers. Without treatment, AIDS will lead to death, usually within around three years. Fortunately, it is rare in the present day for people in the UK with HIV to progress to AIDS thanks to the thorough prevention, testing, monitoring and treatment strategies. (4)

References

  1. NHS Choices. HIV and AIDS: Diagnosis [cited 16 Nov. 18] Available at: https://www.nhs.uk/conditions/hiv-and-aids/diagnosis/

  2. NAM Aidsmap. Factsheet CD4 cell counts [cited 16 Nov. 18] Available at: http://www.aidsmap.com/CD4-cell-counts/page/1044596/

  3. British National Formulary (version 2.1.6) [Mobile application software]. Retrieved from: www.bnf.org

  4. CDC. What is HIV? [cited 16 Nov. 18] Available at: https://www.cdc.gov/hiv/basics/whatishiv.html

    Author: Gabby Gallagher MPharm

    Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 28/11/18

Falsified Medicines Directive (FMD): How will pharmacies make sure your medicine is genuine?

Posted 19 November 2018 in Men's Health, Sexual Health, Womens health

Blister packs of various medications. Source: medicalimages.comThe Falsified Medicines Directive (FMD) is to be implemented in all member states of the European Union (including the UK) and the European Free Trade Area on 9th February 2019. This is a response to the growing number of falsified medicines entering the pharmaceutical supply chain, which can have serious consequences for patient health and safety. But how will it work? (1)

What is FMD?

FMD stands for Falsified Medicines Directive, a term used both to describe the process by which pharmacies will identify the medicines they receive from wholesalers as legitimate or falsified, and to refer to the European Directive on Falsified Medicinal Products, the piece of legislation concerning this process. (2)

What are falsified medicines?

Falsified medicines are illegitimate copies of legitimate medicines, from unlicensed manufacturers. Despite tight controls, some find their way into the supply chain, allowing them to reach patients. They have not been produced in the same highly regulated way in which legitimate medicines are produced by licensed pharmaceutical companies, but are often passed off as coming from such companies due to identical or stolen packaging. Falsified medicines can contain too much or too little of the active ingredient(s), no active ingredients at all, different active ingredients to what is stated on the packaging, and potentially harmful, banned or dangerously concentrated excipients (excipients are all ingredients of a medicine other than active ingredients). Clearly, there is a risk posed to patients, with overdose, drug interactions, poisoning or a condition being left untreated all possible outcomes of taking falsified medicines. (1)

How can you tell if you are buying falsified medicines?

Legitimate online pharmacies such as Webmed are approved and accredited by official regulatory bodies including the  MHRAGPhC and CQC. The independence and unbiased nature of these bodies provide regulation, monitoring and inspection to ensure we and our peers are held to the highest standards.

You can rest assured that when you purchase treatments from Webmed (from erectile dysfunction medication all the way to Hair Loss Treatments) you are purchasing legitimate, official medicines.

How will FMD be implemented in pharmacies?

From 9th February 2019, two new features will be present on all prescription medicines supplied to pharmacies (bar a handful of specialist medications):

  • A unique identifier (UI) – a 2D data matrix, or barcode, unique to each pack of medication

  • An anti-tampering device (ATD) – an addition to the packaging that will make it evident whether or not it has been tampered with, such as adhesive seals, shrink wrap, or perforated sections of boxes that must be broken to open the pack. (2)

It is expected that electronic patient medication record (PMR) systems in pharmacies will be updated to incorporate a medicines verification feature that can be used to scan the UIs on packs and identify the medicine as genuine or falsified. By law, stock will not need to be verified until it is being prepared for a patient, but optional verification will most likely be performed when stock is received into the pharmacy, allowing suppliers to be alerted as soon as possible when a suspected falsified medicine is found. (2)

The safest way to verify medicines before supply to patients will be using aggregated codes, if PMR systems allow. During the dispensing process, each pack of medicine will be scanned and codes for all packs to be bagged up for the patient will be ‘aggregated’ and printed on a label to attach to the outside of the bag. Then, when the patient comes in to collect the bagged prescription items (or before handover to delivery drivers), the aggregated codes will be scanned and, if verified as legitimate, all packs inside the bag will be decommissioned, meaning that their UI codes become inactive. Since UIs will be unique by name and nature, the same UI showing up on a further pack will be flagged, highlighting the pack as potentially falsified and unsuitable for supply to the patient. Aggregated codes will be preferable to scanning each item individually as it will mean that the bag does not need to be reopened on handing over to the patient or delivery driver, which will uphold patient confidentiality, save time and lower the risk of a dispensing error. (2)

Once packs are decommissioned, they can be recommissioned (the UI reactivated and the pack put back to stock as long as it hasn’t left the pharmacy) within 10 days. This may happen if a patient no longer requires the item(s) or if a pack is decommissioned in error. (2)

Scanning will also flag up any recalled, discontinued or out of date medicines, further minimising the impact of human error on patient safety. It is hoped that eventually it will even be used to ensure the correct medicine has been picked against the prescription! (2)

Will Brexit have an impact on FMD?

Since FMD is part of EU law, there has been confusion over whether FMD in the UK will be continued after the UK leaves the EU on 29th March 2019. The Department of Health and Social Care (DHSC) and the Medicines and Healthcare products Regulatory Agency (MHRA) have assured “high regulatory alignment” with the EU, meaning FMD will be here to stay. It is also believed that the UK will still be considered part of the EU for the purposes of FMD after Brexit, so the process should remain unchanged – this is the best outcome for ease of operation in pharmacies and for patient safety. (2)

References

  1. UKFMD Working Group for Community Pharmacy. FMD (1): What is the Falsified Medicines Directive? [cited 31 October 2018].

  2. UKFMD Working Group for Community Pharmacy. The way forward for FMD in community pharmacy [cited 31 October 2018]. Available at: https://www.communitypharmacyni.co.uk/wp-content/uploads/2018/02/fmd-cp-working-group-way-forward-paper-jan-18-public-v1-0-final.pdf

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 16/11/18

What's the best erectile dysfunction (ED) treatment? : sildenafil or tadalafil

Posted 24 August 2018 in Erectile Dysfunction, Men's Health, Sexual Health

A man holding a blue pill for erectile dysfunctionThere are a number of things to consider when deciding on a treatment for erectile dysfunction (ED) - how long will the effect last, how often do I need to take it, how much does it cost? But did you know that tadalafil, once only available as the Cialis brand, is now available to buy online as a generic (unbranded) version?

What is Generic Cialis (Tadalafil)?

Generic forms of any medication are medically identical to the branded originals and are quality controlled to the same standards as the brand name versions; they are just as safe and effective but generally cost much less.

Generic tadalafil contains exactly the same active ingredient as Cialis, but at a fraction of the price. This may be of benefit if you’ve thought about trying Cialis in the past but were put off by the cost. However, cost isn’t the only factor to take into account, and the information below aims to help you decide on the best erectile dysfunction (ED) treatment for you.

Which erectile dysfunction (ED) treatment should I choose: Sildenafil or Tadalafil?

Sildenafil and tadalafil are the two most popular treatments for erectile dysfunction (ED), with sildenafil, brand name Viagra, being the oldest and most well known of the two. But which is better?

Sildenafil is taken an hour before sexual activity, and it will help you get an erection up to at least four hours after taking it, sometimes up to six hours (this doesn’t mean you’ll have an erection that lasts for this length of time - just that you’ll have the potential to have an erection if sexually aroused within the four to six hours after taking). Tadalafil, on the other hand, can be taken 30 minutes before sexual activity and will help you to get an erection up to 36 hours later, so it allows for more sexual spontaneity and has been dubbed “The weekend pill”. Both sildenafil and tadalafil should not be taken more frequently than once a day.

The effect of sildenafil can be impaired if taken with or after food, but tadalafil works just as well taken after a meal as it does on an empty stomach.

Which erectile dysfunction (ED) treatment is best for lactose intolerant people?

If you are lactose intolerant, sildenafil may be the best option as it is available as a lactose free formulation. You can buy the Mylan brand of sildenafil at Webmed, which is lactose free.

Tadalafil can also be taken as a daily dose if you are sexually active at least twice a week. This means you don’t need to worry at all about waiting for the effects to kick in - you’ll be ready for sexual activity at any time.

Other erectile dysfunction (ED) medicines are available besides sildenafil and tadalafil - avanafil, available only as the brand Spedra, is the fastest acting, taking effect in just 15 minutes. Vardenafil, marketed as Levitra, may work more quickly and last slightly longer than sildenafil and tadalafil and may be the most suitable ED medication for people with diabetes.

What’s the best erectile dysfunction (ED) treatment?

Overall, it appears that tadalafil comes out on top when compared with sildenafil, with the notably longer duration of action, slightly faster onset of effectiveness, compatibility with food and the option to take it as a once daily dose. But everyone has different needs, and what works for one person may not work for the next. Hopefully, this information will have helped you to decide on which erectile dysfunction (ED) treatment will be best for you.

To see the full list of erectile disfunction (ED) medication available from Webmed, click here.

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 24/08/18

Viagra Connect - Now available over the counter without prescription

Posted 9 July 2018 in Erectile Dysfunction, Men's Health, Sexual Health

Viagra Connect

Viagra Connect is available to buy NOW!

Around 50% of men over the age of 40 suffer some form of erectile dysfunction.

This widespread condition can cause embarrassment, frustration and even depression for those affected. Some men are so ashamed about having erectile dysfunction that they choose not to seek help from their GP. They just continue to put up with the condition or more worryingly, opt to purchase treatment from illegal vendors online.

Purchasing any medicines in this way poses risks as there is no guarantee that they have been produced following the stringent quality and safety procedures and testing that medicines from UK registered and regulated online pharmacies undergo.

The good news is that this has impelled the Medicines and Healthcare products Regulatory Agency (MHRA) to reclassify Viagra Connect (sildenafil 50mg) from a prescription-only medicine (POM) to a pharmacy (P) medicine, meaning that it is available to purchase over the counter without a prescription in the UK from the spring of 2018. (1, 2)

Viagra Connect should be taken around one hour before sexual activity, ideally on an empty stomach as food can slow absorption. No more than a single tablet per day should be taken. Although the majority of men will be successful first time, it may take a few doses (therefore a few separate attempts) to reach the desired effect of a penile erection sufficient for satisfactory sexual activity. If this fails, you will need to see your GP. (3)

Men wishing to purchase Viagra Connect over the counter in a pharmacy will need to have a quick discussion surrounding symptoms, medical conditions and other medicines with the pharmacist, so that it can be determined whether the medicine is suitable or safe to take.

If buying from an online pharmacy, a short medical questionnaire will need to be completed to assess suitability. Certain medical conditions, such as cardiovascular diseases, high cardiovascular risk, and liver or kidney failure, may mean that the medicine cannot be sold and a GP appointment is needed. (2)

Viagra Connect is available to order from Webmed Pharmacy by selecting the medicine after clicking the ‘Treatments’ tab on the homepage. You will need to complete a short confidential online consultation, and then, like in any other pharmacy, the pharmacist will review the information you’ve given and assess whether the medicine is safe for you to take.

This regulatory change will benefit millions of UK men. For many, a trip to the pharmacy seems much more informal and is often more convenient than an appointment with the GP. The patient can even visit a pharmacy they don’t usually go to or use a General Pharmaceutical Council (GPhC) registered online pharmacy such as Webmed if they fear embarrassment. The danger to health of obtaining medicine from illegal, unregulated and unregistered websites will also be reduced. It may even help other underlying conditions to be diagnosed, since pharmacists will inform men buying Viagra Connect that they should make a follow-up appointment with their GP within 6 months so that such conditions can be tested for. (1)

Other options include:-

Viagra is the most well-known treatment for erectile dysfunction, often referred to as “the blue pill”.
The active ingredient in Viagra is sildenafil which dilates the blood vessels leading to the penis to enable a firm, long lasting erection when a man is sexually aroused or stimulated.

Viagra and Sildenafil both contain exactly the same active ingredient. They are both equally effective, but sildenafil is much cheaper.

Tadalafil, the generic form of Cialis, became available in November 2017 when the patent expired and has become very popular.

Tadalafil on demand is known as “the weekend pill” as, due to it's 36 hour duration of action, it can be taken on a Friday night and still be active on Sunday morning.

There is also a low dose tadalafil option taken on a daily basis, called Tadalafil daily, so you don’t have to plan ahead and can be ready for action “anytime, anyplace, anywhere”.

Worried about buying fake medicines online?  Then read our blog on what to look for to prove that it is a fully approved and Regulated pharmacy only supplying genuine UK sourced medication.


References
  1. You’ll be able to buy Viagra for the first time ever- in the UK [cited 20 February 2018]. Viagra Connect to be available over the counter from Spring 2018. Available at: http://fortune.com/2017/11/28/viagra-over-the-counter-uk/

  2. GOV.UK. MHRA reclassifies Viagra Connect tablets to a Pharmacy medicine [cited 20 February 2018]. Available at: https://www.gov.uk/government/news/mhra-reclassifies-viagra-connect-tablets-to-a-pharmacy-medicine

  3. emc. Viagra Connect [cited 20 February 2018]. Available at: https://www.medicines.org.uk/emc/product/8725

    Author: Gabby Gallagher MPharm

    Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 09/07/18

Itching for information about genital herpes?

Posted 6 April 2018 in Men's Health, Sexual Health, Womens health

Taking a pillAffecting approximately 10% of UK people by the age of 25, herpes simplex type 2 (HSV-2), or genital herpes, is one of the most common sexually transmitted infections (STIs) in the country. Once a person is infected with HSV-2, their body will contain the virus for life. For some people, this may cause no further symptoms once the initial infection has cleared, but for others is it a nuisance as recurrent outbreaks can occur. Although there is no cure, HSV-2 symptoms can be managed with the right medication and self-care, allowing you to get on with your life. (1)

What is HSV-2?

HSV-2 is the main virus which causes genital herpes and is a strain of the herpes family of viruses. Other strains include HSV-1 which is responsible for cold sores but can also cause genital herpes, varicella-zoster virus which causes chickenpox and shingles, and Epstein Barr virus which is implicated in glandular fever.

Once it has found a way into the body and has caused an initial infection, HSV-2 remains within the body indefinitely. For most of this time it is in a dormant (inactivated) state within a nerve close to the initial point of infection, but outbreaks of genital herpes can occur and often have a trigger such as ill health, cuts or friction to the area, periods or UV light. (2)

What are the symptoms of genital herpes?

The earliest symptoms of genital herpes are usually a tingling or itching sensation in the genital area, followed by the formation of blisters on the area of the groin that was in contact with the infected area of the other person.

This may be the penis, vulva, anus, thighs or buttocks. These blisters burst, leaving sores which scab then heal. Under the foreskin of the penis and on the inside of the labia, ulcers will form as opposed to blisters.

As part of the initial infection there may be associated general malaise - aches and pains, fever and slightly swollen glands in the neck, armpits and groin. Discomfort when urinating and unusual discharge from the vagina are also possible symptoms. Symptoms of initial infection should clear within three weeks. (1, 2)

Subsequent outbreaks of genital herpes generally involve milder symptoms and clear up in a matter of days. (1)

How can I be tested?

If you have blisters in your genital area and think you may have genital herpes, you can attend a sexual health clinic to be tested. One of the blisters will be swabbed to obtain a sample to send off for testing. The sample can only be taken if there are blisters present. (2)

If your result comes back positive, anyone with whom you’ve been sexually active also needs to be tested. This is because symptoms of genital herpes can, in some cases, take years to appear after initial infection. If you don’t want to or can’t contact the partners yourself, the sexual health clinic may be able to contact them on your behalf. They will not reveal your identity while doing so. (2)

You can also test for genital herpes with our 7-in-1 test kit which tests for the 7 most common STI's.

How is genital herpes treated?

There is no cure for genital herpes, so the aim of treatment is to ease symptoms and sometimes shorten the duration of an outbreak.

Aciclovir, an antiviral drug, is the first line treatment. It is taken in tablet form three or five times a day, depending on the tablet strength, for five days.

The course may be extended if blisters appear after the course is started or if they have not healed sufficiently. Outbreaks can be treated with shorter courses if higher strength tablets are taken. An oral suspension and topical cream are also available. Alternative antivirals famciclovir and valaciclovir can be used orally in a similar way. (3)

For people who suffer from frequent outbreaks, antivirals can also be used for suppression to keep viral levels under control and prevent outbreaks from happening in the first place.

Instead of being taken as a course, they are taken every day for up to a year, after which treatment is halted to determine whether outbreaks return. If they do, treatment may be started again. If outbreaks keep happening despite taking suppressive treatment, your GP may consider referral to a specialist. (3)

Is there anything else I can do to ease the discomfort of an outbreak?

During an outbreak, you may benefit from the following self-care steps:

  • An ice pack covered with a flannel pressed against the area can help to ease the pain of the blisters. Do this for as long as is needed or comfortable.

  • You may want to try pouring water onto the groin as you urinate to reduce pain and discomfort.

  • Petroleum jelly or anaesthetic cream applied to the blisters may also help with discomfort during urination. Always make sure you wash your hands thoroughly before and after touching blisters.

  • Open sores are a potential site of a secondary bacterial infection. To avoid this, bathe regularly using plain or salt water.

  • Wear loose-fitting underwear and clothing to avoid rubbing of the area and therefore pain and potential bacterial infection. (2)

How can I reduce the spread of genital herpes?

The most effective way to prevent infection of partners is to abstain from any sexual contact while symptoms are present, from the tingling or itching until blisters and ulcers have completely healed. This includes sexual activity involving hands, as not only does this mean the virus can be transferred to a partner’s genitals, but it is possible for it to enter the body via the hands. (1, 2)

Additionally, always use condoms for vaginal or anal sex and dams for oral sex or vulval contact between partners, even when there is no outbreak. (2)

Avoid sharing sex toys. If you do, wash the toy thoroughly and cover with a fresh condom before each use. (1)

The antiviral drug valaciclovir can also be prescribed to help make HSV-2 less transmissible to partners. (3)

Is genital herpes a threat to other aspects of my health?

Fortunately, for healthy people, genital herpes is nothing more than an annoyance. It doesn’t predispose you to other diseases, affect fertility or alter your lifespan. Nevertheless, it can cause problems for people with HIV, so people with HIV who catch herpes will be managed by a specialist. If you need any further information or support, click here or consult your GP, pharmacist or sexual health clinic. (1, 2)

References

  1. Herpes Viruses Association. About herpes simplex virus [cited 16 March 2018]. Available at: https://herpes.org.uk/frequently-asked-questions/herpes-simplex-virus/
  2. NHS Choices. Genital herpes [cited 16 March 2018]. Available at: https://www.nhs.uk/conditions/Genital-herpes/
  3. British National Formulary (version 1.3.7) [Mobile application software]. Retrieved from: www.bnf.org

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 06/04/18


The concerning link between STIs and infertility

Posted 19 February 2018 in Men's Health, Sexual Health, Womens health

A couple in a romantic sunsetInfertility affects around 3.5 million UK people, but did you know that as many as one in four cases of infertility are caused by sexually transmitted infections (STIs)? The longer STIs are left untreated, the greater the risk of infertility, which is why it’s crucial to diagnose and treat STIs promptly to maintain the health and wellbeing of individuals and couples wishing to conceive. (1)

Which STIs can cause infertility?

Chlamydia and gonorrhoea are the two most common STIs in the UK, and also happen to be potential causes of infertility if left untreated.

Chlamydia

Chlamydia is the most common STI in the UK, with approximately 70% of cases being under 25 years of age. It is caused by a type of bacteria called Chlamydia trachomatis. Worryingly, it usually doesn’t cause any symptoms, meaning that people don’t know they’re infected unless they have a test. For under 25s it is recommended to have a test for chlamydia yearly or upon getting a new sexual partner. (2)

If a person with chlamydia does experience symptoms, they may include painful urination, unexpected or discoloured discharge from the vagina, penis or back passage, abdominal pain or unusual vaginal bleeding (after sex or when not on your period) in women, and painful inflamed testicles in men. (2)

If you catch chlamydia and it is left untreated, it could eventually cause infertility. In women, this is because the infection can lead to pelvic inflammatory disease (PID), a condition in which the higher portion of the reproductive system becomes inflamed, including the ovaries, fallopian tubes and uterus. PID can cause scarring of these areas, which can make it hard or sometimes impossible for an egg to be released and to reach the uterus. In men, a condition called epididymo-orchitis can develop, which is inflammation of the testicles and sperm ducts. If left untreated, it can damage these areas to the extent of causing infertility. (3)

Gonorrhoea

Gonorrhoea is another very common STI in the UK caused by the bacterium Neisseria gonorrhoeae. Symptoms are usually a thick, yellow or green, unpleasant-smelling discharge from the vagina or penis, painful urination and unusual vaginal bleeding. But, as with chlamydia, some people don’t get symptoms – this is the case for approximately 10% of men and 50% of women infected. (4)

Untreated gonorrhoea may also lead to PID in women, which in turn may lead to infertility. The infection may spread to the testicles and prostate gland in men, occasionally causing a drop in fertility or even infertility. (5)

If you think you may be at risk of having chlamydia or gonorrhoea, you have had any of the above symptoms, or you have had a recent change of sexual partner, you can arrange a test at your GP surgery, a genitourinary medicine (GUM) clinic or a sexual health clinic. Certain pharmacies, contraception clinics and young people’s services may also offer testing. (6, 7)

You can also order testing kits and treatments for a range of STIs including chlamydia and gonorrhoea from Webmed Pharmacy here.

What happens if I test positive for chlamydia or gonorrhoea?

If you have chlamydia, you’ll receive antibiotic treatment. The antibiotics usually used are azithromycin, taken as a single dose, or doxycycline, taken for a week. Other antibiotics can be used if you are allergic to the usual choices, pregnant or breastfeeding. Don’t have sex until you’ve finished the course, or for a week after taking the azithromycin single dose, as the infection may not have fully cleared up within this time. If you take the antibiotics as directed and follow the aforementioned advice, you probably won’t need to have another test to confirm whether the treatment has worked, unless your symptoms persist. (8)

For gonorrhoea, the usual choice of antibiotic treatment is a single dose of azithromycin alongside a ceftriaxone injection. You’ll most likely have a repeat test a couple of weeks later to make sure the infection has cleared – avoid sex until you’ve had a negative result from this test. (9, 10)

If you’ve tested positive for chlamydia or gonorrhoea, then any sexual partners you’ve had within the last 6 months will need to be tested and potentially treated too. If you don’t want to or can’t contact them yourself, you can seek the help of a GUM or sexual health clinic who may be able to find their details and send them a letter advising them to be tested. The letter won’t contain your name. (8, 10)

How can I protect myself from STIs?

Condoms are widely available and highly effective at protecting against STIs. Free male or female condoms are available from contraception clinics, young people’s services and sexual health clinics. Certain GUM clinics and GP surgeries may also supply free condoms. They can be used for vaginal or anal sex, or to cover the penis during oral sex. (11)

Dams are square-shaped barriers made from latex or polyurethane (also used to make condoms). They can be used during oral sex to cover the vagina or anus, or to cover the vulva during skin-to-skin contact with a partner’s vulva.

Avoid sharing sex toys, or wash and cover them with a fresh condom after each use.

Forms of contraception such as the oral contraceptive pill, copper intrauterine devices (IUDs) and spermicides are designed to protect against pregnancy only and will not offer protection from STIs.

References

  1. NHS Choices. Infertility – Overview [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/infertility/

  2. NHS Choices. Chlamydia – Overview [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/chlamydia/

  3. NHS Choices. Chlamydia – Complications [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/chlamydia/complications/

  4. NHS Choices. Gonorrhoea – Overview [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/gonorrhoea/

  5. NHS Choices. Gonorrhoea – Complications [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/gonorrhoea/complications/

  6. NHS Choices. Sexually transmitted infections (STIs) [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/sexually-transmitted-infections-stis/

  7. FPA. Sexually transmitted infections (STIs) help [cited 2 February 2018]. Available at: https://www.fpa.org.uk/help-and-advice/sexually-transmitted-infections-stis-help

  8. NHS Choices. Chlamydia – Treatment [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/chlamydia/treatment/

  9. British National Formulary (version 1.3.4) [Mobile application software]. Retrieved from: www.bnf.org

  10. NHS Choices. Gonorrhoea – Treatment [cited 2 February 2018]. Available at: https://www.nhs.uk/conditions/gonorrhoea/treatment/

  11. FPA. Condoms (male and female) [cited 2 February 2018]. Available at: https://www.fpa.org.uk/contraception-help/condoms-male-and-female

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 19/02/18

Itching to hush irritating thrush?

Posted 9 February 2018 in Men's Health, Sexual Health, Womens health

A man and woman itching with thrushOne of the numerous infections that can be caused by a type of yeast known as Candida, thrush affects around 75% of women at some point in their life, and can affect men too. It can be a nuisance, causing discharge, discomfort and irritation, but if you find it’s a common occurrence it may be a sign of an underlying problem. (1)

What is thrush?

Thrush, also known as candidiasis, is the name given to a number of skin and mucous membrane infections involving Candida, which is a group of several species of yeast (fungus). In society, ‘thrush’ is generally defined as vaginal or penile candidiasis, so the same definition applies to the term ‘thrush’ in this blog hereafter. (2)

Symptoms of thrush in women include an odourless vaginal discharge with the appearance of cottage cheese, irritation and itching of the vagina and vulva, and pain or stinging on urination or during sex. For men, thrush can cause irritation and burning of the head of the penis and beneath the foreskin, pain on retraction of the foreskin, a cottage cheese-like discharge and odour. But not everyone with thrush will have all of the according symptoms listed - in fact, it is possible to have thrush without any symptoms. (2)

What causes thrush?

Candida and certain species of bacteria, known collectively as flora, live naturally in the vagina and are beneficial in that they keep the acidity of the vagina at a healthy level. However, particular factors can upset the balance of the flora and allow Candida to proliferate, leading to thrush. Such factors include antibiotics, pregnancy, being post-menopausal, poorly controlled diabetes, a compromised immune system or broken or irritated skin in the vagina. Sometimes, having sex or even periods can bring on an episode of thrush. (2)

Men may develop penile thrush through sex with a female partner who has vaginal thrush. (2)

How is thrush treated?

If you think you’ve got thrush for the first time, you’ll need to visit your GP for a diagnosis and to rule out anything else. Treatment comes in various forms, namely external and vaginal creams, pessaries and oral capsules. (2, 3)

The mainstay of treatment of thrush in women is a pessary or vaginal cream containing clotrimazole, an antifungal. The pessary or cream usually only needs to be inserted into the vagina once, as long as the high strength is used. Lower strengths are available, but they will need to be used more than once. Other, less common antifungals used in this way include econazole and miconazole. (3)

If the vaginal forms of treatment are unsuitable, fluconazole and itraconazole antifungal capsules are available. Again, fluconazole can be taken as a single dose. (3)

To ease itching and irritation of the vulva while the above treatment takes effect, creams containing antifungals such as clotrimazole can be applied to the area several times a day. (3)

To treat thrush in men, a cream containing an antifungal such as clotrimazole may be applied to the penis, or oral fluconazole can be taken as a single dose. As for women, the cream can be used alongside the capsule to ease symptoms while the capsule works. (3, 4)

If you’ve already had a diagnosis of thrush in the past, you can visit a pharmacy instead of the GP where you can buy clotrimazole-containing external and vaginal creams, clotrimazole pessaries and fluconazole capsules over the counter.

When else will I need to see the GP?

As well as experiencing symptoms for the first time, there are several other instances when you will need to see your GP or visit a sexual health clinic when you develop thrush:

If you fall into one or more of these groups, the healthcare professional you see may need to look at the area to gauge whether it’s thrush or a different infection. If they’re unsure, they may take a sample of the discharge using a cotton swab to send off for testing. If you get recurrent thrush, your GP may run tests to check if there is an underlying problem with your immune system. (2)

In men, thrush can develop into a condition called balanitis. The head of the penis and the foreskin can become red, painful and inflamed, with associated foul-smelling discharge and painful urination. If you think you have balanitis you should visit your GP. (5)

Can I prevent thrush?

There are certain steps you can take to try to prevent bouts of thrush in the future. Opt for showers as opposed to baths, use non-perfumed intimate washes or emollients rather than soap on the groin area, and dry thoroughly afterwards. Wear loose-fitting cotton underwear where possible and don’t douche or use deodorants on your intimate area. (2)

References

  1. raTrust. Vaginal Thrush Overview [cited 7 February 2018]. Available at: https://ratrust.org.uk/sexual-health/stis/vaginal-thrush/overview
  2. NHS Choices. Thrush in men and women [cited 7 February 2018]. Available at: https://www.nhs.uk/conditions/thrush-in-men-and-women/
  3. British National Formulary (version 1.3.4) [Mobile application software]. Retrieved from: www.bnf.org
  4. Canesten. Thrush in Men [cited 7 February 2018]. Available at: https://www.canesten.co.uk/
  5. NHS Choices. Balanitis [cited 7 February 2018]. Available at: https://www.nhs.uk/conditions/balanitis/

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 09/02/18


HIV: is a life-changing formulation in the pipeline?

Posted 11 January 2018 in Men's Health, Sexual Health, Womens health

Daily Pills. Picture courtesy of pixabay.comHIV (human immunodeficiency virus) is no longer the death sentence it once was, thanks to the development of numerous tests and treatments over the years. However, the cocktail of drugs that those diagnosed with HIV must take daily, just to keep the virus at a low enough level to maintain a functional immune system, could be considered a life sentence. Understandably, a way to reduce this frequency of dosing is greatly desired – and recent research shows that in the future it may become reality. (1)

HIV is primarily a sexually transmitted infection, but it may also be passed from one person to another via sharing needles or sex toys, accidentally pricking oneself with a contaminated needle or via blood transfusion. It can also be passed to a baby during birth or breastfeeding if the mother is infected. People at greatest risk include homosexual men, heterosexual black African people of any gender, and anyone who shares needles or syringes with others. (2, 3)

Once HIV has found its way into the body, it hijacks specific cells in the immune system known as CD4 lymphocytes, forcing them to abandon their intended function and instead produce thousands more copies of the virus. The CD4 cells then die, releasing the newly made viruses, which go on to repeat the process again and again over a timespan of up to 10 years until CD4 levels are critically low and the immune system fails. (2)

If HIV is diagnosed early, a course of HIV medication known as post-exposure prophylaxis (PEP) can prevent the virus from taking hold, as long as it is taken within three days of first contact with the virus. If this is unsuccessful, or more than three days have elapsed, medication will need to be started as soon as possible to keep the virus under control. (2)

There is a wide range of HIV medication, also known as antiretroviral medication, available and people with HIV must take a combination of medicines daily to halt the progression of the disease and maintain health. Antiretrovirals are grouped into the following categories:

  • nucleoside reverse transcriptase inhibitors (NRTIs), which include zidovudine, abacavir and lamuvidine, and work by preventing the virus’s genetic material from being copied

  • non-nucleoside reverse transcriptase inhibitors (NNRTIs), including efavirenz, etravirine and rilpivirine, which work in the same way as NRTIs

  • protease inhibitors, such as ritonavir, saquinavir and atazanavir, which prevent formation of new copies of the virus

  • integrase inhibitors, including dolutegravir and raltegravir, which prevent the hijacking of CD4 cells by the virus. (4)

Other antiretroviral medications outside these categories include enfuvirtide and maraviroc, which work in different ways to the medications listed above. (4)

The promising news

Recent research by the Massachusetts Institute of Technology has demonstrated that in the future it may be possible to reduce the frequency of HIV medication dosing from daily to weekly by adopting a new formulation. Pigs were administered various drugs in the form of a capsule containing a star-shaped structure, which broke down much more slowly than a tablet or standard capsule, releasing the medicine gradually over as long as two weeks. Biotechnology company Lyndra is now planning to bring this success forward to human trials over the next year. Such a formulation would be life-changing for millions of people worldwide, making it easier to remember to take medication as well as freeing them of the inconvenience of taking numerous drugs daily. It is too early to know how long it may be before weekly HIV medication becomes mainstream, but this is very exciting news indeed. (1)

Respect yourself and those around you - know your status

Follow these quick easy links to select your products:

HIV lab and home home-self test kits

Pre PrEP treatment test kit

PrEP Annual Test kit

Thinking of taking PrEP - read our informative blog to explain what you need to know.

References

  1. BBC News (2018). ‘Once-a-week pill for HIV shows promise in animals’. Available at: http://www.bbc.co.uk/news/health-42610315

  2. NHS Choices. Causes [cited 9 January 2018]. Available at: https://www.nhs.uk/conditions/hiv-and-aids/causes/

  3. NHS Choices. Overview [cited 9 January 2018]. Available at: https://www.nhs.uk/conditions/hiv-and-aids/#causes-of-hiv-infection

  4. British National Formulary (version 4.2) [Mobile application software]. Retrieved from: www.bnf.org

    Author: Gabby Gallagher MPharm

    Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 11/01/18

Author: Gabby Gallagher MPharm

Medically reviewed by: Superintendent pharmacist Margaret Hudson BSc(Hons)MRPharmS 11/01/18

Is Tadalafil the best solution for my ED?

Posted 19 December 2017 in Erectile Dysfunction, Men's Health, Sexual Health

Genuine Erectile Dysfunction treatment from a UK regulated Pharmacy. Free, discreet, next day delivery in a 1 hour time slot.Cialis has become popular as an erectile dysfunction (ED) prescription medication as it is effective for 36 hours. All other medications, Viagra, Sildenafil, Levitra and Spedra are active for 4-6 hours.

Cialis is the brand name for the medication created by Eli Lilly in 2003. The active ingredient in Cialis is Tadalafil and the composition couldn’t be recreated, by law, until Eli Lilly’s production patent ended on 14th November 2017. Now it can be produced and distributed by other drug manufacturers, in the generic form of Tadalafil.

Generic forms of any medication are medically identical to the branded originals and are quality controlled to the same standards as the brand name versions; they are just as safe and effective but generally cost much less.

Tadalafil on demand is known as “the weekend pill” as, due to it's 36 hour duration of action, it can be taken on a Friday night and still be active on Sunday morning.

There is also a low dose tadalafil option taken on a daily basis, called Tadalafil daily, so you don’t have to plan ahead and can be ready for action “anytime, anyplace, anywhere”.

Cialis (tadalafil) has been licensed in the UK for over a decade. It was the third erectile dysfunction (ED) prescription medication of its type to receive a UK license, after Viagra and Levitra.  Its prolonged duration of action and the option to take a low dose daily tablet have led to Cialis(tadalafil) becoming increasingly popular and being more widely prescribed.

How does tadalafil work?

Erections are primarily achieved through blood flow.Tadalafil works by helping to relax the blood vessels in your penis and the erectile tissue itself, allowing blood to flow into your penis when you get sexually excited. It does not have an effect on your sexual desire but can greatly improve your erection when you become sexually aroused.

Is tadalafil more effective than sildenafil (generic Viagra)?

Both medications have a high success rate, helping the majority of men to regain control over their erection and have an improved sex life. Clinical trials have indicated that both are equally effective.

Does tadalafil have fewer side effects than sildenafil?

As both drugs work in the same way, they share many of the same side effects. These include facial flushing, headaches and indigestion.  However, sildenafil has an effect on your vision that doesn’t seem to affect users of tadalafil to the same extent, as it may produce a green-blue visual tinge.  Headaches also occur more commonly with sildenafil but may last longer with tadalafil.  Any side-effects experienced may last longer with tadalafil.

Is tadalafil a safe medication?

Generally, tadalafil is a safe drug but is not recommended to be taken if you have certain conditions or are taking specific medications that might interact with tadalafil. This is the same for all other phosphodiesterase type 5 inhibitors like Spedra, Viagra, Cialis, Levitra and sildenafil.

Sildenafil and tadalafil should not be taken by men who take medicines or recreational drugs containing nitrates.

Nitrates interact very adversely with all phosphodiesterase type 5 inhibitors like Spedra, Viagra, Cialis, Levitra and sildenafil. They can cause a FATAL lowering of blood pressure and should NEVER be used together.

Nitrates include medications like GTN spray, isosorbide mononitrate, nitrate patches, gel or ointment and nicorandil. These are usually prescribed for heart conditions. If you take nitrates you should consult your GP for other options for your ED. Also, the recreational drugs called "poppers" should be avoided.

Tadalafil should not be taken by men who are on medicines called alpha blockers which are sometimes used to treat prostate problems or high blood pressure. Men who take alpha blockers can use Viagra, sildenafil, Levitra or Spedra but must allow at least a six hour gap between taking the alpha blocker and the ED medication.

There is a full list of the contra-indications and interactions on the website and on the medical questionnaire that is sent to our doctor for approval.

Can I drink alcohol with tadalafil?


Having just one or two drinks is unlikely to affect tadalafil (or any other similar ED medication) or cause any health risks. However, if you drink excessively while taking tadalafil you may experience some adverse effects and not achieve as firm an erection.

The main problem you may experience by drinking too much alcohol while you take tadalafil is orthostatic hypotension. This can cause a headache, dizziness, and fainting, which can lead to you injuring yourself. Hypotension may also make your heart beat at a faster rate which can lead to severe heart problems.

This effect can occur because tadalafil and alcohol both act as vasodilators. Vasodilators are substances that lower your blood pressure by relaxing the walls of your blood vessels, which allow the blood vessels to open wider.

Orthostatic hypotension can be even more likely with tadalafil than with the other erectile dysfunction drugs as it stays in your system longer than the other ED drugs.

Does tadalafil have any advantages over other ED medications of a similar type?

The main differences between tadalafil and other ED medications of a similar type is three-fold.

1) Tadalafil’s long duration of action - 36 hours. Where other Ed products only last for 4 to 6 hours.

2)  Low dose tadalafil can be taken on a daily basis, called Tadalafil Daily, so that you don’t have to plan ahead and can be ready for any sexual activity at any time.

3) It's not affected by food.

Conclusion

Tadalafil is unique in that it can either be taken when required or on a daily basis so that no planning ahead is needed and enables spontaneity. It’s also not affected by food and since it’s now off patent it can be bought at a much lower price than Cialis.

Due to all of these advantages, tadalafil will probably knock sildenafil off the number one spot as the drug of choice for men with erectile dysfunction.

Medically reviewed by: Superintendent Pharmacist Margaret Hudson BSc(Hons)MRPharmS 19/12/17

1 2 Next Last

We use cookies to help us provide you with a better service, but do not track anything that can be used to personally identify you.

If you prefer us not to set these cookies, please visit our Cookie Settings page or continue browsing our site to accept them.