Doctor and Patient

Well Woman Clinic

Introduction

The Well Women Clinic at the Sunshine Clinic provides a full health screening service, which consists of tests and screening in the following areas:

  • Hearing

  • Vision

  • Joint Examination

  • Thyroid Function

  • Neurological

  • ECG

  • Dietary

  • Drug Dependency

  • Menopause

  • Cholesterol profile

  • Urinary

  • Diabetes

  • Sexual History

The Well Woman Clinic

With today's busy lifestyles, finding time to visit the doctor can often be difficult but it is important not to forget about our health.

Health checks don't take long and they needn't be expensive. However, they have proved to be highly effective and in many cases early screening has literally saved lives. More and more women recognise the importance of an annual health check to pick up indications of any problems at the earliest opportunity. Discuss your general health and have urine, weight, cholesterol and blood pressure checked together with advice on gynaecological problems, family planning (often including IUD fitting), cervical smears, breast disease, menopause. Osteoporosis, emergency contraception.

The menopause

The ending of menstruation average age for a woman to reach the menopause is 52, when periods have stopped for one year post-menopausal. The peroid leading up to the menopause is known as the peri-menopause, during the peri-menopause, is when hormonal and biological changes are associated with the menopause begin. As a result of these hormonal changes, many women experience both physical and emotional symptoms.

If the menopause occurs under 45 years, known as premature menopause. estimated it affects 1% of women under the age of 40 and 0.1% under the age of 30.

Treatments available can ease menopausal symptoms which can be severe or distressing.

Treatment

Hormone replacement therapy HRT is prescribed depending on symptoms and medical history,HRT works by replacing oestrogen, which begin to fall in the approach to the menopause.Taking either oestrogen-only or combined HRT may reduce your the symptoms.

Symptoms - Menopause

  • hot flushes

  • vaginal dryness

  • loss of sex drive

  • mood changes

  • stress incontinence (leaking urine when you cough or sneeze)

  • night sweats

  • thinning of the bone, which can lead to brittle bones (osteoporosis)

Most of these symptoms pass within two to five years, though vaginal dryness is likely to worsen if it is not treated. The risk of osteoporosis also increases with age.

Cholesterol profile

Caring about your health means keeping an eye on your cholesterol levels.About two in three adults have a cholesterol level that is higher than recommended.

Types of cholesterol

Cholesterol is transported around your body attached to a protein in your blood. This combination of fat and protein is called a lipoprotein. There are different types of lipoprotein, depending on how much fat there is in relation to protein

  • HDL (high-density lipoprotein)

  • LDL (low-density lipoprotein)

Symptoms of high cholesterol

A high cholesterol level may only be revealed if you develop symptoms of heart disease. Sometimes, yellow patches (known as xanthomas) may develop around your eyes or elsewhere on your skin - these are cholesterol deposits and indicate that you have

high cholesterol levels in your blood.

Causes of high cholesterol

  • diet high in saturated fat and cholesterol a lack of exercise being overweight

  • drinking more than the recommended daily amount of alcohol

Diagnosis of high cholesterol

  • Measuring cholesterol involves a blood test

  • Treatment of high cholesterol

There are two ways to help lower high cholesterol. First lifestyle changes including changing your diet, managing your weight and increasing exercise. Second is to combine lifestyle changes with cholesterol-lowering medicines.

Cervical smear test

It's estimated that screening for cervical cancer using the smear test saves up to 6,000 lives a year in the UK. But what does it involve and what can it tell you? Women are now invited for their first test at 25. They're then invited every three years until the age of 49, and every five years from 50 to 64. From 65, those who've had recent abnormal tests are offered another test. or on request following the doctors advice. Screening is one of the best defences against cervical cancer

Results of your smear will be available test within weeks.

Blood Pressure

  • Lowering blood pressure helps prevent stroke & heart attack.

  • High blood pressure can be successfully treated & prevented.

What is blood pressure ?

When your heart beats, it pumps blood round your body to give it the energy and oxygen it needs. If your blood pressure is too high, it puts extra strain on your arteries (and your heart) and this may lead to heart attacks and strokes. Having high blood pressure (hypertension) is not usually something that you feel or notice

Vision & Hearing

Vision

A regular eye test can help detect eye conditions before you notice the effect on your sight. Early treatment can often prevent your sight from getting worse.

Discuss any specific problems with your eyes and vision, any special demands on your eyes created by work and hobbies may also need to be addressed. The doctor may also want to know about your general health and health of your family, including if someone in your family has an eye condition.

Hearing

Symptoms of hearing loss

If you have hearing loss:

  • you may be finding it difficult to hear and understand people when you're in a noisy place

  • you may have earache and/or a continual ringing in your ears

Hearing is measured by behavioral tests using an audiometer. Hearing loss can be temporary or permanent and can affect all age groups. Ageing, ear infections and loud noises all cause hearing loss, and hearing aids or cochlear implants may be needed to restore it.

Causes of hearing loss

There are many possible causes of hearing loss. These can be divided into two basic types, called conductive and sensorineural hearing loss.

Conductive hearing loss

This is caused by anything that stops sound moving from your outer ear to your inner ear. The following are possible causes of conductive hearing loss.

Middle ear infections (acute otitis media)

collection of fluid in the middle ear - 'glue ear' (otitis media with effusion). Blockage of the outer ear, usually by wax.

Otosclerosis

a condition where the ossicles of the middle ear harden and become less able to vibrate.

Damage to the ossicles, for example by serious infection or head injury.

Perforated (pierced) eardrum, which can be caused by an untreated ear infection (chronic suppurative otitis media), head injury or a blow to the ear, or from poking something in your ear.

Sensorineural hearing loss

This is caused by damage to the pathway between the inner ear and the brain. It affects sound intensity and makes it more difficult for you to recognise complex sounds. The following are some possible causes.

Age-related hearing loss (presbyacusis). This is a natural decline in your hearing. Many people get this as they get older because of damage to the hair cells in the cochlea.

Damage to the hair cells by loud noises (acoustic trauma). This is more likely to happen if you work in a noisy place.

Certain infections such as measles, mumps or meningitis.

Ménière's disease, which causes hearing loss, dizziness and tinnitus (a persistent ringing in the ears).

Certain medicines, such as some powerful antibiotics, can cause permanent hearing loss. At high doses, aspirin is thought to cause temporary hearing loss and tinnitus.

Certain cancer treatments, such as chemotherapy and radiation therapy, can cause hearing loss.

Acoustic neuroma. This is a benign (non-cancerous) tumour affecting the auditory nerve causing deafness and tinnitus.

Cholesteatoma (benign skin growth) in the middle ear, causing deafness and vertigo (sensation of movement when you're standing still).

Mixed hearing loss is a combination of conductive and sensorineural hearing loss.

Diagnosis of hearing loss

Adults, hearing loss may be very gradual, as in age-related hearing loss, or it can be very sudden, as in some viral infections of the inner ear. If you, your friends or your family think that your hearing is getting worse, you should see a doctor. If you have sudden hearing loss in one or both ears, you should seek immediate advice.

The doctor will assess your symptoms carry-out an examination. also ask you about your medical history how your hearing loss has developed, and what sort of problems it causes. perform a hearing test, or refer you to either an otolaryngologist (a doctor who specialises in ear, nose and throat disorders); an audiologist (a specialist in hearing) or an audiovestibular physician (a doctor who specialises in hearing, balance and communication problems).

Hearing tests

You may have the following tests.

  • Whispered speech test. The Doctor may whisper a combination of numbers and letters behind you and check if you can hear anything by asking you to repeat the combination. or will probably move further away from you each time to test the range of your hearing.

  • Tuning fork test. Different tuning forks can be used to test your hearing at a variety of frequencies. They can also help determine the type of hearing loss.

  • Pure tone audiometry. An audiometer produces sounds of different volumes and frequencies. During the test, you're asked to indicate when you hear a sound in the headphones. The level at which you can't hear a sound of a certain frequency is known as your threshold.

  • If your hearing loss has a sensorineural cause, a number of tests can be performed to pinpoint where the problem lies.

  • Otoacoustic emissions. This is used to measure your cochlear function by recording signals produced by the hair cells.

  • Auditory brainstem response. This measures the activity of the cochlea, auditory nerve and brain when a sound is heard.

  • If the Doctor thinks your hearing loss is due to an acoustic neuroma or cholesteatoma, a magnetic resonance imaging (MRI) scan of your head may be recommended.

ECG & TFTs

ECG

Electrocardiography (ECG or EKG) is the recording of the electrical activity of the heart over time via skin electrodes. It is a noninvasive recording produced by an electrocardiographic device. The etymology of the word is derived from electro, because it is related to electrical activity, cardio, Greek for heart, graph, a Greek root meaning "to write".

Its a simple and useful test which records the rhythm and electrical activity of your heart.Small sticky patches called electrodes applied to your arms, legs and chest. These are connected to an ECG recording machine, which picks up the electrical signals that make your heart beat. The machine records a few beats from each set of the electrodes onto paper. The test will only take a few minutes and is painless.

Its a simple and useful test which records the rhythm and electrical activity of your heart.Small sticky patches called electrodes applied to your arms, legs and chest. These are connected to an ECG recording machine, which picks up the electrical signals that make your heart beat. The machine records a few beats from each set of the electrodes onto paper. The test will only take a few minutes and is painless.

The doctor may require exercise ECG?

This as an exercise stress test or an exercise tolerance test. It’s when an ECG that is recorded while you are walking on a treadmill or cycling on an exercise bike. The idea of this test is to see how your heart works when you are more active.

Your heart needs more blood and oxygen when you are active and the exercise ECG can show if your heart is not getting enough blood from the coronary arteries during physical activity. This can help doctors find out if coronary heart disease is present or how severe it may be. An exercise ECG is also helpful for looking at how well the heart is working after angioplasty or bypass.

Thyroid Function Tests (TFTs)

Thyroid disease is common in approximately 1% of the population. The test which is a blood test, is used for the diagnosis in people with signs or symptoms of possible thyroid disease, or people with suspected goitre or thyroid nodules , TFTs may also be taken in women who have type 1 diabetes

Other

Blood Cholesterol

Cholesterol is a blood fat needed by the body in moderate amounts. However, high cholesterol levels can lead to atherosclerosis and coronary artery disease (CAD) and heart attack. Methods for increasing good cholesterol or lowering bad cholesterol

levels include cholesterol reducing drugs.

Coronary heart disease is the UK's biggest killer, with one in every four men and one in every six women dying from the disease. In the UK, approximately 300,000 people have a heart attack each year.

Coronary heart disease (CHD) is usually caused by a build-up of fatty deposits on the walls of the coronary arteries. The fatty deposits, called atheroma, are made up of cholesterol and other waste substances.

The build up of atheroma on the walls of the coronary arteries makes the arteries narrower and restricts the flow of blood to the heart. This process is called atherosclerosis. Your risk of developing atherosclerosis is significantly increased if you:

  • smoke

  • have high blood pressure

  • have a high blood cholesterol level

  • do not take regular exercise

  • have a thrombosis

  • have diabetes

Sexual History

As with other history taking, the doctor must consider how to put the patient at ease, find out if there are any real problems. As a sexual health professional Dr Sood has through educational practices- sexual history taking has been taught separately, therefore is aware there may be great discomfort, trepidation and even shame felt approaching a medical professional for help in sexual matters. There are many reasons why its important to assess sexual history for example:-

  • Earlier identification and treatment of STIs such as chlamydia or HIV.

  • Increased opportunities for preventative care e.g. hepatitis B immunisation, discussion regarding sexual risk-taking.

Identifying sexual dysfunction:

  • High prevalence in the general population - most often undiagnosed and untreated.

  • As a marker of organic or psychiatric disease e.g. erectile dysfunction (ED) as a risk marker for cardiovascular disease.

  • As an iatrogenic side-effect of medication or surgery

Sexuality and sexual function are integral aspects of an individual throughout life. Sexual health is associated with happiness, longevity and well-being. We increasingly recognise the importance of sex to many of our elderly patients2 and those with chronic illness or disability, as well as the young and fit.