SEXUAL HEALTH WHAT THE FUTURE HOLDS

DR BEVERLY CRUSHER

STAR SHIP ENTERPRISE PEARL INDEX 0 HOW DID THEY DO IT?

SEXUAL HEALTH STRATEGY WHAT ABOUT US? WHAT IS OUR STRATEGY? DO WE NEED ONE?

ANSWERS PROMISED IN “QUALITY AND FAIRNESS” NOT DELIVERED NONE YES

TO DEVELOP GOOD SEXUAL HEALTH SERVICES WHAT ARE OUR AIMS AND TARGETS? WHAT OVERALL RESOURCES DO WE HAVE? HOW DO WE MEASURE OUR ACHIEVEMENTS?

AIMS REDUCE UNPLANNED PREGNANCIES REDUCE STIs ALLOW PEOPLE TO ENJOY HAPPY, HEALTHY SEXUAL RELATIONS

AUDIT WHAT STRATEGY WAS ADOPTED TO ACHIEVE AIMS? HOW ARE YOU GOING TO ASSESS IT? DID IT WORK?

KEY AREAS EDUCATION ACCESS

EDUCATION PRIMARY SCHOOL SECONDARY SCHOOL HEALTH CENTRES, COMMUNITY CENTRES, COLLEGES

ACCESS CONTRACEPTION STI SCREENING AND TREATMENT INFORMATION

ACCESS NATIONWIDE EASY FREE NON-JUDGEMENTAL

ACCESS ADEQUATE TRAINING OF DOCTORS, NURSES, PHARMACISTS

AUDIT DID IT WORK? WHAT DID IT COST? WAS IT WORTH IT? WHAT ELSE COULD WE TRY?

FUTURE OF CONTRACEPTION

HISTORY OF CONTRACEPTION ALREADY HEARD SOME OF THIS NOT A RECENT PHENOMENON COITUS INTERRUPTUS (BIBLE AND KORAN) BARRIERS AND SPERMICIDES (AS EARLY AS 1850 BC) CONDOMS OF ANIMAL BLADDERS (ROMAN TIMES)

RECENT HISTORY IUCDs ABOUT 1962 DALKON SHIELD CONTROVERSY IN MID 70s REALLY ONLY MADE A COME BACK WITH MIRENA IN THE 90s

RECENT HISTORY COC 50 YEARS AGO CYCLE REGULATOR! VTE REPORTS WITHIN 1 YEAR STILL HERE DESPITE SEVERAL SCARES

RECENT HISTORY NORPLANT 1993 LEGAL ACTIONS LED TO ITS DEMISE IMPLANON 2001

PRESENT CHOICE IS THE KEY PILLS, PATCH, VAGINAL RING, POP – IMPROVED – CERAZETTE, IMPLANT, INJECTABLES, IUCDs, IUS, MALE AND FEMALE CONDOMS, DIAPHRAGM AND CAP, MALE AND FEMALE STERILISATION.

TRENDS LONG ACTING METHODS (LARCs) PROGESTERONE LESS DEPENDANCE ON COC

ADVANTAGES EFFICACY FIT AND FORGET REDUCE VASCULAR RISKS COST EFFECTIVE EXTRA BENEFITS

DISADVANTAGES NEED MEDICAL EXPERTISE INHERENT PROCEDURE RISKS

BALANCE SHEET LARCs COME OUT AS WINNERS SO THE TREND SEEMS SET TO CONTINUE

CHALLENGES MEDICAL EXPERTISE EDUCATION TECHNICAL ISSUES (IUCDs / IUSs FOR NULLIPAROUS WOMEN) PROGESTOGEN RELATED BLEEDING ACCESS

ADDED VALUE COC - CYCLE REGULATION COC - ACNE COC - PMS MIRENA - MENORRHAGIA IMPLANON - AMENNORHOEA DEPO - AMENORRHOEA CONDOMS - REDUCED STIs

MEN CONDOMS OR VASECTOMY AT MERCY OF FEMALE PARTNERS! NOT ANY MORE

MALE CONTRACEPTIVE INJECTION SEVERAL TRIALS WORLDWIDE AUSTRALIA, CHINA, UK PHASE 3 STAGE 5 YEARS TO MARKET

MANCHESTER AND EDINBURGH TRIAL 2 DOSES EVERY 8 WEEKS TESTOSTERONE + PROGESTOGEN INHIBITS SPERM PRODUCTION

FEATURES EFFECTIVE REVERSIBLE FREQUENT DR VISITS WELL TOLERATED

WILL WOMEN BE HAPPY? SHIFT OF BURDEN NEW BURDEN OF TRUST! NO STI PREVENTION (MAINLY STEADY RELATIONSHIPS?) LOSS OF ADDED BENEFIT

WILL MEN BE HAPPY? SHIFT OF BURDEN SHIFT OF CONTROL FEAR OF REDUCED VIRILITY FEAR OF SIDE EFFECTS

TIME WILL TELL CONTRACEPTION ASSOCIATED WITH SOCIAL CHANGE. COC LIBERATED WOMEN NEW ADVANCES FREQUENTLY TAKE TIME TO CATCH ON

TIME WILL TELL PATTERN OF ACCEPTANCE FOLLOWED BY ADVERSE EVENTS OR ADVERSE MEDIA COVERAGE LEADING TO A DIP WHICH MAY OR MAY NOT RECOVER MEDIA MORE POWERFUL THAN EVER

SUM UP CONTRACEPTION IS NOT A RECENT PHENOMENON LAST 50 YEARS HAVE BEEN BUSY LAST 15 YEARS HAVE BEEN VERY BUSY

SUM UP LARCs SEEM HERE TO STAY EXTRA BENEFITS AND HIGH EFFICACY NOW MANDATORY MALE CONTRACEPTION SET TO BE THE NEXT “BIG THING”

SUM UP TO MAXIMISE THE BENEFITS OF ALL THIS WE NEED A SEXUAL HEALTH STRATEGY WHICH PROMOTES EDUCATION AND ACCESS FOR ALL SHOULD BE OUR NEXT “BIG THING”