Women between the ages of 25 and 64 are invited for regular cervical screenings where a healthcare professional looks at the health of the cervix to detect any cell changes or abnormalities. However, in 2020-2021, the number of women attending their cervical screen has fallen, with a decrease of 5.3% compared to the previous year. This is deeply concerning as over 3000 women are diagnosed with cervical cancer each year and 99.8% of those cases are preventable. Prevention is better than curing, and the earlier you are aware of any cell changes, the easier it is to treat.
Why do some women not attend their cervical screenings?
One of our general practitioners, Dr Belinda Griffiths, has found that in her experience women don’t attend their cervical screenings for a number of reasons including: difficulties with taking time off work for a GP appointment, fear of embarrassment, and fear of the process being uncomfortable or painful.
However, to combat these concerns, the NHS has launched at-home HPV kits. Dr Griffiths explains how they work – “The HPV test is highly sensitive so it separates out those who are HPV-positive and HPV-negative. Those who are HPV-negative will be considered ‘low risk’ for cervical cancer and will be asked to do a future test. Those who are HPV-positive will be deemed ‘high risk’ and be asked to attend for follow-up with a clinician whereby they will conduct a cervical screening to check the health of their cervix and investigate if any abnormal cells are present.”
These new tests are the same process as at-home STI tests whereby a simple swab collects the sample from the vagina. Having the option of this sort of test at home removes the fear some women may have surrounding the slightly more intrusive cervical screen.
What is HPV?
HPV (human papillomavirus) is a common virus passed on via skin-to-skin contact, usually through genital contact. There are many types of HPV, most of which are harmless, don’t usually cause any symptoms and the infection will go away on its own. However, others are deemed ‘high risk’ as they can persist and cause cell changes which can lead to cancer. It is thought that these ‘high risk’ HPV strains are responsible for around 80% of cervical cancer cases, making the detection of HPV all the more important.
How can you prevent HPV?
You can be protected from certain HPV strains through vaccination. There are two HPV vaccines currently available in the UK: Gardasil which protects against 4 strains of HPV used in the NHS and the vaccine used here at the Fleet Street Clinic, Gardasil-9, which protects against 9 of the high-risk HPV strains.
When can you be vaccinated against HPV?
The NHS now routinely offers the Gardasil vaccine to girls and boys around age 12/13, before the age people generally become sexually active. However, the vaccination programme only came into full force in 2019, meaning many people are currently unvaccinated. It should be pointed out that adults can get vaccinated at any age and even if you have already been exposed to HPV, the vaccine can still offer protection against other strains to which you have not yet been exposed.
It is a particularly good idea for people to get vaccinated before they attend university or before they go travelling on a ‘gap year’, as these are typically times where young people are more sexually active and therefore more likely to be exposed to HPV.
It is important to note that getting the HPV vaccination most certainly doesn’t mean missing or not participating in HPV tests or cervical screenings. A combination of these preventative measures gives you the highest possible chance of preventing cervical cancer.
Sleep is one of our greatest allies when it comes to health and wellbeing. It is associated with a number of health benefits which can have a huge positive impact on our daily lives.
Conversely, a lack of sleep can be detrimental – research has even found that not getting enough sleep can negatively impact some aspects of brain function to a similar degree as alcohol intoxication!
Dr Belinda Griffiths discusses some of the mental and physical health benefits of getting a good night’s sleep.
During sleep, your body releases cytokines, which are essential for the regulation of the immune system. Cytokines are required in increased amounts when you are attacked by a pathogen (when you’re ill) or under stress. The level of cytokines increases during sleep, and therefore lack of sleep hinders the body’s ability to fight infections. This is also the reason why the body tends to sleep more while suffering from an infection.
When you’re well-rested, you’re less hungry. Being sleep deprived disrupts the hormones in your brain (Leptin and Ghrelin) that control appetite.
With those out of balance, your resistance to the temptation of unhealthy foods goes way down. And when you’re tired, you’re less likely to want to get up and move your body. Together, it’s a recipe for putting on the pounds!
If your sport requires quick bursts of energy, like wrestling or weightlifting, sleep loss may not affect you as much as endurance sports like running, swimming, and biking. But you’re not doing yourself any favours. Besides robbing you of your energy and time for muscle repair, lack of sleep saps your motivation, which is what gets you across the finish line. You’ll face a harder mental and physical challenge – and see slower reaction times. Proper rest sets you up for your best performance.
When you’re tired, you can have difficulty recalling information. That’s because sleep plays a big part in both learning and memory. Without sufficient sleep, the brain finds it difficult to focus and take in new information in the first place and then doesn’t have enough time to properly store information as short-term memories. Sleep helps enable you to retain memories and store information.
Sleep also allows for your mind to rest, repair and rebuild, the same way it does for your body. As you sleep, your brain begins to organise and process all the information you’ve taken in during the day. It converts these short-term memories into long-term memories – this helps you to learn.
Not sleeping properly can mean that both your body and brain don’t function properly the next day. It can impair your attention span, concentration, strategic thinking, risk assessment, reaction times and problem-solving skills. This is particularly important if you have a big decision to make, are driving, or are operating heavy machinery. So, getting plenty of sleep can help you stay sharp and focused all day long.
Another thing your brain does while you sleep is process your emotions. Your mind needs this time in order to recognise and react in the right way. When you cut that short, you tend to have more negative emotional reactions and fewer positive ones. Lack of sleep can cause bad temper and anxiety, so the better you sleep, the better your ability to stay calm, controlled and reasonable.
Chronic lack of sleep can also raise your chance of having a mood disorder. One large study found that people with insomnia were five times more likely to develop depression, and the odds of having anxiety or panic disorders are even greater.
A refreshing slumber helps you hit the reset button on a bad day, improve your outlook on life, and be better prepared to meet the challenges of the next day.
While you sleep, your blood pressure goes down giving your heart and blood vessels a bit of a rest. The less sleep you get, the longer your blood pressure stays up during a 24-hour cycle. High blood pressure can lead to heart disease and strokes. Therefore, it is important to keep your blood pressure down.
Poor sleep and pain mutually reinforce each other. Sleep deprivation increases pain sensitivity and reduces pain tolerance. Therefore, something will feel more painful when you’re tired.
It is clear that sleep is an essential part of helping us stay physically and mentally healthy. What better excuse to have a few extra hours of sleep a day!
If have any concerns about your health, book a GP appointment today.
Summer is the perfect opportunity to dust off your bike and think about turning that commute into an opportunity to get fitter or shed a few pounds!
Cycling – a low impact sport
Compared to many sports, cycling is one with a relatively low injury rate. Crashes and collisions apart, cycling is impact free – good for your joints and muscles. In addition, if you select the correct gear to match the terrain, it means that you can avoid overloading your muscles and joints, keeping the cranks spinning rather than pushing a big gear.
Also important is that because your feet are fixed in place, spinning the cranks requires very little coordination, which also reduces the risk of injury due to poor technique, which is very common while running. Still, despite all these advantages, cyclists can, and regularly do, suffer overuse injuries.
Fix a good riding position:
One of the main issues is the set up of the bike itself. Here are a few pointers as to how to best achieve a good riding position:
This should be positioned so that when the pedal is at the bottom of the stroke and the ball of your foot is on the pedal, your knee should have a slight bend in it. If you want to get technical, saddle to pedal distance should be 109% of your inside leg measurement. Hips shouldn’t move sideways during crank rotation and you shouldn’t have to stretch at the bottom of the pedal stroke. Don’t be put off by feeling you have to come off the saddle to touch the floor.
This should be in a horizontal position, parallel with the floor when viewed side on (but sometimes a very slight downwards tilt can be helpful for those who experience a lot of pressure in the perineum area. However, don’t do this just because it feels more comfortable, as this can cause lessen support and affect riding position).
POSITION OF THE SADDLE
With the pedals adjusted so that they are at the three o’clock and nine o’clock positions, a vertical line dropped from the kneecap of the forward knee should pass through the axle of the pedal.
This is where opinion varies a little. Racers want the handlebars low to lower wind resistance, climbers want the handlebars low so they don’t feel too high when the bike’s angled up. The rest of us want them higher than this. A good rule of thumb is that you don’t want to be leaning on the handlebars too much, only holding them. If it feels like your upper bodyweight is being supported by the handlebars, try them up a little. Not all bikes are adjustable enough at the front but a stem raise is a cheap efficient way of remedying this. A bit more height in traffic is safer anyway.
And if you haven’t bought your bike yet, put a bit of research into what frame/wheel size you need before you do.
Cycling is a great way to get fit and works well with core stability, however, if any injuries do niggle don’t push through and do get them checked out!
Osteopath at Fleet Street Clinic
Andrew Doody is an osteopath at Fleet Street Clinic and is fully registered with the General Osteopathic Council (GOSC).
For more information on our osteopathy services, click here.