eLetters

51 e-Letters

  • Comment on 'The policing of abortion services in England'
    Matthew Phillips

    I was deeply saddened to read the opinions of Dr Rowlands in his article entitled 'The policing of abortion services in England' in the April 2013 issue of the Journal.[1] Although the argument is clear that the requirement for two signatures on the HSA1 form is burdensome, and is not seen as necessary by everyone, the article seems to miss a key point. An overriding ethical duty for any clinician is truth telling, with...

    Show More
  • Comment on 'Statement on combined hormonal contraceptives containing third- or fourth-generation progestogens or cyproterone acetate, and the associated risk of thromboembolism'
    Mishka Terplan

    Despite the increased interest in evidence-based medicine, many medical guidelines and statements of medical professionals are based primarily on opinion rather than scientific facts. The 'Statement on combined hormonal contraceptives containing third- or fourth-generation progestogens or cyproterone acetate, and the associated risk of thromboembolism' raises such concerns.[1]

    While we agree that the importance...

    Show More
  • IUD insertions and analgesia
    Sheila E Brown

    I am pleased to note on reading Dr Duncan’s letter[1] in the January 2013 issue of the Journal that I am not the only person who waits a full 3 minutes after using local anaesthetic gel prior to fitting an intrauterine device/system. I totally agree that this makes a difference to the pain experienced by women. I have been fitting 'coils' for almost 30 years and when I started was totally reliant on a good 'vocal local' to get...

    Show More
  • Experience and removal of damaged implants
    Janet Bentley

    Dr Elliman[1] asked whether other clinicians had experience of damaged implants. Rekers[2] replied that breakage is rare and would not alter contraceptive efficacy.

    I have removed damaged implants from seven patients since June 2011, all of which were sited correctly. Two patients underwent subsequent removal of a second damaged implant. All the patients were aware of abnormality, but only one remembered trauma...

    Show More
  • Comment on 'An emergency contraception algorithm based on risk assessment: changes in clinicians' practice and patients' choices': authors' response
    Rebecca J McKay

    We thank Drs Cogswell and Lipetz[1] for their comments on our article[2] and for sharing the interesting results of their audits. They have clearly demonstrated the importance of staff training in increasing uptake of the emergency intrauterine device (IUD). Further work within our service supports their conclusion.

    In response to the apparent fall in IUD uptake when ulipristil acetate (UPA) was introduced, the...

    Show More
  • Involving young people in service design
    Sharmila Parks

    I read with interest the article Garrett and Kirkman et al.[1] wrote on the limited success of the pilot telemedicine sexual health service and their reflections on needing more advice from what young people thought to have got it right.

    A 2008 UNICEF statement entitled 'Young People: Partners for Health'[2] written by an international group of young people states: "Young people need to be at the forefront in the...

    Show More
  • Comment on 'An emergency contraception algorithm based on risk assessment: changes in clinicians' practice and patients' choices'
    Charlotte Cogswell

    As with McKay and Gilbert[1] in Cambridge, UK, we also developed an emergency contraception (EC) algorithm following the introduction of ulipristal acetate (UPA), likewise recognising that fitting an intrauterine device (IUD) was the 'gold standard'. Our ongoing experience is rather different, however, in that our rates of emergency IUD fitting have increased since the introduction of our algorithm from 6% to at least 9%...

    Show More
  • Unusual shaped IUS
    Alwyn R N Lloyd

    I read with interest Anne MacGregor's letter in the January 2013 issue of the Journal describing the removal of an unusually shaped intrauterine system (IUS) and asking if others have had similar experiences.[1]

    A couple of years ago I too was alarmed as I removed an IUS through a slightly tight cervical os and noted an odd shape. On closer inspection the device was removed intact but as in Dr MacGregor's case t...

    Show More
  • Comment on 'Impact of UK Medical Eligibility Criteria implementation on prescribing of combined hormonal contraceptives': author's response
    Paula Briggs

    On behalf of all the authors I would like to thank Sarah Holden for her comments[1] on our recently published article.[2]

    When designing the study, we recognised that the majority of women receive their contraception from their general practitioner (GP). Our study compares the prescribing habits of GPs in 2005 pre-UK Medical Eligibility Criteria (pre-UKMEC) to those in 2010 (post-UKMEC).

    Whilst the aut...

    Show More
  • Early implant removal
    Jane M Wilson

    I read the letter on 'Early implant removal: an ethical dilemma' by Bari et al.[1] in the January 2013 issue of the Journal with interest, a great feeling of disappointment and I shared the feelings of alarm with the authors. The piece reported a 29-year-old woman who was so dissatisfied with her subdermal implant that she attempted removal herself without anaesthetic and she broke the device. She had requested removal f...

    Show More

Pages