Women's Health
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Consideration is given to women's health under the following:
Contraception:
The Clinic provides a full contraceptive service for the large number of young women living and working in the area. Appointments can be made for routine doctors' surgeries. The combined contraceptive pill is still the most popular choice. Advice on the full range of other options is available. Arrangements for the insertion of the Mirena Coil can be organised by the surgery. The Implanon implant can be fitted by making a specific appointment. Emergency contraception, formerly called “the morning after pill”, is prescribed.
Cervical Screening:
Smear tests, for the detection of changes that indicate a woman may be at risk of cancer of the cervix (neck of womb), are available daily. The practice nurse generally carries these out.
The Belgrave Clinic is registered with the National Cervical Screening Programme CervicalCheck. This National Cervical Screening programme provides free smear tests to eligible women between the ages of 25 - 60 yrs (women aged 25-44 yrs will be screened at three yearly intervals and women aged 45-60 will be recalled every five years for smear tests) .
You can have your first smear taken with this programme regardless of when you had your last smear taken. Participation in this programme CervicalCheck does not prevent you from having a smear test more frequently if you desire but there will be a charge.
Appointments can be made with the nurse by ringing reception. Your PPS number will be required. You must receive a letter of invitation from CervicalCheck before making a cervical smear appointment. This can be done by logging on to www.cervicalcheck.ie or by ringing 1800 454 555
Cervical Cancer Vaccine
We provide HPV vaccination (Gardasil). If you are interested, please make an appointment with one of our doctors to discuss vaccination further.
The charge to receive this vaccination has been reduced by the pharmaceutical company and is as follows:
Initial doctor's visit: €55, Vaccines: €120 each - three vaccines
nurses's visits: €20 each - three visits
Cancer of the breast is a major cause of concern to all women and any woman who develops a breast lump in particular. A woman finding a breast lump will be seen on that day at the doctor's surgery. Advice will be given on the nature of the lump and an appropriate management option will be taken with the patient to alleviate her concerns. This may include referral to any one of the three excellent rapid access breast clinics at local hospitals or to one of the specialists in this field working privately. The practice nurse advises on routine breast examinations. Routine mammograms can be organised at local clinics. The “Breast Check” programme for women between 50 and 65 years of age inform us of our patients screening results.
Pregnancy tests are carried out on request. We invite every patient who is pregnant to receive care, advice and management at the Clinic under the Combined Ante-natal Care Programme.
This is a free service to the patient for 7 visits before and 2 visits after birth of her baby on registering with the Scheme. It is available to all pregnant women and is not means related. It is carried out in association with the hospital or private consultant of choice of the patient. The patient is free to attend the service of convenience or choice at any time during the pregnancy with no restriction having registered on the Combined Care Scheme.
We will advise patients of the range of antenatal care options available at the Coombe, Rotunda, Mount Carmel and Holles Street Hospitals. We recommend the innovative Domino service provided by Holles Street for those living in the South Dublin catchment area.
Patients who are distressed at the news of having an unplanned pregnancy will be received with respect and will be supported throughout their pregnancy and after. There are a large number of groups and counsellors close to us in Ranelagh/Rathmines that we can call on to further support patients with a crisis pregnancy; Positive Options. In particular, we will guide and care for any woman who has to deal with her antenatal care and birth with little personal support.
Under the “ Regulation of Information Act 1995”and in association with ICGP guidelines, we will refer any woman who has opted for abortion after non directive counselling, to an agency who has experience in dealing with this. We will invite them to return to us for follow up upon return to Ireland.
Doctors at the Clinic will help women who have difficulty in conceiving to find the appropriate advice and investigations with regard to their infertility problem. View more information at Womens Clinic. We can organise routine blood tests. We will work in support of the various treatment programmes in Dublin and nationally by administering treatment and giving advice. Irish Information.
This is a common condition in women leading to reduced menstruation, very often associated with a bad acne condition or excessive body hair. It can lead to infertility problems later in life. It is a concern to young women and its diagnosis and management is an important feature of our health service to this group of women.
The menopause can be associated with distressing physical and psychological symptoms. Blood tests can tell us the stage a woman is at in relation to the menopause and there are a number of treatment options available that we can prescribe. We can also refer to appropriate gynaecologists and other investigation centres.
The normal physiological and psychological changes that take place in a woman's life can present different challenges. The stages of life present threats from different diseases and conditions also. Minor illness affects all ages and should be managed promptly. Sexually transmitted diseases are a risk to younger women. The complications of heart disease, hypertension and smoking, are a threat to middle aged and older women, as are cancer and chronic diseases like diabetes, arthritis and bronchitis. Osteoporosis prevention and management, and social problems brought on by old age and death of a spouse, are features in the older population. Our general practice service deals with all of these issues and aims to help women take steps that lead to a healthier life.
Sexually transmitted diseases are an increasing feature of everyday general practice. We offer comprehensive sexual health screening service including full STI testing, and treatment where required.
The service consists of an appointment with the doctor for full review of sexual health, advice and clinical examination followed by blood tests / samples as appropriate, taken by practice nurse. Results are discussed at a follow up visit within 2 weeks.
Where necessary, treatment such as cryotherapy for warts is undertaken as part of the service and referral to specialist service will be advised and arranged if needed. The service is completely confidential and can be arranged by contacting reception at short notice where necessary.
The following are the principal Sexually Tramsmitted Infections (STI's) diseases which may be contracted in Ireland:
- Chlamydia
- Genital Warts
- Gonnorhoea
- Genital herpes
- Trichomoniasis
- Human Immunodeficiency virus (HIV)
- Hepatitis B
- Hepatitis C
- Syphilis
What are Sexually Transmitted Infections (STI's)?
They are infections caused by viruses or bacteria which can be passed from one partner to another during sexual contact. They can cause serious and long term damage if not treated appropriately.
What Are The Symptoms?
There are often no physical or visible symptoms, however if you are sexually active and develop any of the following conditions you should contact us immediately.
- Sores in the genital area
- Irritation or itching in the genital area
- Pain during sexual intercourse
- Pain while going to the toilet
- Unusual discharges from your vagina
Who Can Get an STI?
Anybody can be infected with an STI from one sexual contact with an infected person. STI's are very common but can often lie dormant for considerable periods of time. It is often quite possible that your sexual partner may have an STI but be unaware of the fact and so would be unaware that they had passed an STI on to you. The most effective way to prevent the transfer of an STI during sexual contact is to use a condom properly.
Chlamydia is a common sexually transmitted infection caused by a bacterium Chlamydia Trachomatis. This STI is increasing at an alarming rate among young Irish men and women. It is known as a “silent” disease because about 75% of infected women have no symptoms. If symptoms do occur, they usually appear within 1 to 3 weeks after exposure. If untreated, Chlamydia infection can lead to chronic pelvic pain, infertility and ectopic pregnancy. Symptoms include an abnormal vaginal discharge or a burning sensation when urinating. If pelvic infection follows the patient may experience lower abdominal pain, nausea, fever, pain during intercourse or bleeding between periods. Chlamydia infection is diagnosed either by taking a swab from the cervix or by urine sample. It is easily treated and cured with antibiotics. All sexual partners should be tested and treated. The patient and her partner should then abstain from sexual contact until they have both tested negative for infection three to four weeks after completing their treatment.
At least 50% of sexually active women acquire genital Human Papilloma Virus (HPV) infection at some point in their lives. Most who have a genital HPV infection do not know they are infected. The virus lives in the skin or mucous membranes and usually causes no symptoms. Most people who become infected with HPV will not have any symptoms and will clear the infection on their own. Some women get visible genital warts, or have pre-cancerous changes in the cervix. Genital warts usually appear as soft, moist, pink, or flesh-coloured swellings, usually in the genital area. They can be raised or flat, single or multiple, small or large. They can appear on the vulva, in or around the vagina or anus, or on the cervix. After sexual contact with an infected person, warts may appear within weeks or months, or not at all. Genital warts are diagnosed by visual inspection. Visible warts can be removed by medication applied by the patient, or by treatments performed by their doctor. There is no “cure” for HPV infection, although in most women the infection goes away on its own. For those women whose HPV infection persists, regular smear tests are essential to ensure that the pre-cancerous changes caused by HPV do not progress to life-threatening cervical cancer.
Gonorrhoea is an STI which cause little or no symptoms in women. The symptoms can be vague and easily confused with a bladder or vaginal infection. The initial signs and symptoms include pain when urinating, increased vaginal discharge, and vaginal bleeding between periods. It is diagnosed by swab test from the cervix or urethra, and is treated with antibiotics. Gonorrhoea is a common cause of pelvic inflammatory disease (PID). This can lead to infertility, chronic pain and ectopic pregnancy.
This is an STI caused by the Herpes Simplex virus type 1 and type 2. Most genital herpes is caused by HSV Type 2. Most women have no symptoms or signs from this infection.
When signs do occur, they appear as one or more blisters around the genital area. These break, leaving tender sores that may take two to four weeks to heal.
Typically another outbreak can appear weeks or months after the first, but it is almost always less severe and shorter than the first outbreak.
Although the infection can stay in the body indefinitely, the number of outbreaks tends to decrease over a period of years. The virus is released from the sores but it can also be released between outbreaks from skin that does not appear to be broken or to have a sore.
Generally a person can only get HSV-2 infection during sexual contact with someone who has a HSV Type 2 infection. Transmission can occur from an infected partner who does not have a visible sore and may not know he or she is infected.
HSV-Type I can cause genital herpes but it more commonly causes infections of the mouth and lips, also known as “cold sores”. HSV-1 infection of the genitals can be cause by oral-genital or genital-genital contact with a person who has HSV-1 infection. Generally HSV – 1 outbreaks recur less regularly than genital HSV-2 outbreaks. If the woman develops signs and symptoms on their first outbreak they can be quite marked. The first outbreak usually occurs within two weeks of contact with an infected person. Apart from genital pain patients can experience flu-like symptoms and swollen glands. Most can expect four to five outbreaks in the first year. Genital Herpes is diagnosed by visual inspection and swabbing the area of the sores. There is no treatment that can cure herpes, but antiviral medication can shorten and prevent outbreaks during the time the person takes the medication.
This is a sexually transmitted disease cause by a parasite called trichomonas. It usually presents as an unpleasant, foul-smelling yellow-green discharge from the vagina. It can also cause vaginal itching or discomfort during sex.
However nearly 50% of cases are detected during routine STI screening i.e. the patient has no symptoms. This infection is usually treated with an antibiotic taken orally called metronidazole (flagyl). Male partners should also be treated with similar medication.
Human immunodeficiency virus (HIV) is a virus that causes acquired immunodeficiency syndrome or AIDS. AIDS is a condition in humans in which the immune system begins to fail, leading to life-threatening infections.
Infection with HIV occurs by the transfer of blood, semen, vaginal fluid, pre-ejaculate, or breast milk. The four major routes of transmission are unsafe sex, dirty needles, breast milk and transmission from an infected mother to her baby at birth (vertical transmission).
HIV infects about 0.6% of the world's population. Medication reduces both the death rate and the sickness rate of HIV infection. Most people infected with HIV eventually develop AIDS. They mostly die from infections or cancers associated with the progressive failure of the immune system.
HIV progresses to AIDS at different rates; HIV-specific treatment delays this process. Most will progress to AIDS within 10 years of HIV infection: some will have progressed much sooner and some will take much longer.
Treatment with anti-retroviral medication increases the life expectancy of people infected with HIV. Even after HIV has progressed to AIDS, the average survival time with medication is estimated to be more than 5 years. Without medication, someone who has AIDS typically dies within a year.
Hepatitis B is a disease of the liver caused by the hepatitis B virus. Anyone can get hepatitis B, but some people are at higher risk, including
- being born to a mother with hepatitis B
- having sex with an infected person
- being tattooed or pierced with unsterilized tools that were used on an infected person
- getting an accidental needle stick with a needle that was used on an infected person
- using an infected person’s razor or toothbrush
- sharing drug needles with an infected person
Hepatitis B usually has no symptoms. Hepatitis B is chronic when the body can’t get rid of the hepatitis B virus. Children, especially infants, are more likely to get chronic hepatitis B, which usually has no symptoms until signs of liver damage appear. Without treatment, chronic hepatitis B can cause scarring of the liver, called cirrhosis; liver cancer; and liver failure.
Hepatitis B is diagnosed through blood tests, which can also show if you have chronic hepatitis B or another type of hepatitis.
Hepatitis B usually is not treated unless it becomes chronic. Chronic hepatitis B is treated with drugs that slow or stop the virus from damaging the liver.
Hepatitis C is a liver disease caused by a virus called hepatitis C. You could get hepatitis C from:
Most people have no symptoms until the virus causes liver damage, which can take 10 or more years to happen. A doctor can test you for hepatitis C.
Hepatitis C is chronic when the body can’t get rid of the hepatitis C virus. Although some people clear the virus from their bodies in a few months, most hepatitis C infections become chronic. Without treatment, chronic hepatitis C can cause scarring of the liver, called cirrhosis; liver cancer; and liver failure.
Hepatitis C is diagnosed through blood tests, which can also show if you have chronic hepatitis C or another type of hepatitis.
Hepatitis C is not treated unless it becomes chronic. Chronic hepatitis C is treated with drugs that slow or stop the virus from damaging the liver.
Syphilis is a sexually transmitted disease (STD) caused by the bacterium Treponema pallidum. It is a disease that is rarely seen nowadays, but there are outbreaks that occur sporadically, particularly amongst sex workers.
Syphilis is passed from person to person through direct contact with a syphilis sore. Sores occur mainly on the external genitals, vagina, anus, or in the rectum. Sores also can occur on the lips and in the mouth.
Transmission of the organism occurs during vaginal, anal, or oral sex.
Pregnant women with the disease can pass it to the babies they are carrying.
Many people infected with syphilis do not have any symptoms for years, yet remain at risk for late complications if they are not treated.
The primary stage of syphilis is usually marked by the appearance of a single sore (called a chancre). The time between infection with syphilis and the start of the first symptom can range from 10 to 90 days (average 21 days). It appears at the spot where syphilis entered the body. The chancre lasts 3 to 6 weeks, and it heals without treatment. However, if adequate treatment is not administered, the infection progresses to the secondary stage.
Skin rash and mucous membrane lesions characterize the secondary stage. This stage typically starts with the development of a rash on one or more areas of the body. In addition to rashes, symptoms of secondary syphilis may include fever, swollen lymph glands, sore throat, patchy hair loss, headaches, weight loss, muscle aches, and fatigue. The signs and symptoms of secondary syphilis will resolve with or without treatment, but without treatment, the infection will progress to the latent and possibly late stages of disease.
The latent (hidden) stage of syphilis begins when primary and secondary symptoms disappear. Without treatment, the infected person will continue to have syphilis even though there are no signs or symptoms; infection remains in the body. This latent stage can last for years. The late stages of syphilis can develop in about 15% of people who have not been treated for syphilis, and can appear 10 – 20 years after infection was first acquired. In the late stages of syphilis, the disease may subsequently damage the internal organs, including the brain, nerves, eyes, heart, blood vessels, liver, bones, and joints. Signs and symptoms of the late stage of syphilis include difficulty coordinating muscle movements, paralysis, numbness, gradual blindness, and dementia. This damage may be serious enough to cause death.
Some clinics can diagnose syphilis by examining material from a chancre (infectious sore) using a special microscope. If syphilis bacteria are present in the sore, they will show up when observed through the microscope.
A blood test is another way to determine whether someone has syphilis. Shortly after infection occurs, the body produces syphilis antibodies that can be detected by an accurate, safe, and inexpensive blood test. A low level of antibodies will likely stay in the blood for months or years even after the disease has been successfully treated
Genital sores (chancres) caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present.
Syphilis is easy to cure in its early stages. A single intramuscular injection of penicillin, an antibiotic, will cure a person who has had syphilis for less than a year.
Because effective treatment is available, it is important that persons be screened for syphilis on an on-going basis if their sexual behaviors put them at risk for STDs.
The doctors at the Clinic are aware of the significant and very often hidden problem of domestic violence. Women who have been abused in such a fashion can expect to be received in an understanding environment where they will be supported in efforts to resolve their problems. Appropriate agencies that have expertise in this area will be contacted if required. Womens Aid
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