All posts by sarakayat

Zika Virus and the Rio Olympics

Huffington Post Article

If you’ve decided to go to the Rio Olympics, here’s what you need to know about Zika and how to protect yourself.
Despite the birth defects and developmental issues that the Zika virus can cause in babies, the WHO (World Health Organization) rejected calls to move or postpone the 2016 Rio Olympic Games and stated that there was no public health justification.
So the show must go on, and whilst most pregnant women have sensibly, albeit regrettably, forfeited their attendance, there will be a large proportion of people still going who were thinking of starting a family in the near future. So if you are that couple on the brink of procreation, you should be aware of the risks and the ways to prevent it.
The Zika virus, which is spread primarily through the bite of an infected Aedes mosquito, usually causes a mild illness with common symptoms being a fever, rashes, joint pain, and conjunctivitis. These symptoms can be so mild, in fact, that many people might not realize they have been infected. However, there is mounting evidence that the consequences of the infection to a foetus can be devastating, with an increase in cases of birth defects, including microcephaly (an abnormally small head often associated with abnormal brain development) in the areas involved in the Zika outbreak.
Measures can be taken to try and avoid mosquito bites, including wearing clothing that covers your arms and legs (though you should ensure loose and cool materials to avoid over heating) and on skin that is exposed, use an insect repellent containing DEET. At night you can try to sleep under a mosquito tent. However, it must also be noted that there have been a small number of reports stating that Zika virus can also be passed on through sexual intercourse, and whilst the risk is thought to be low, if you find yourselves in the throws of the Latino Rio heat, make sure you use condoms during sex (vaginal, anal and oral).
Unfortunately, when you do finally return home from what is undoubtedly going to be an amazing Olympics, your responsibilities towards Zika do continue. It is recommended by the Centres for Disease Control and Public health England that you avoid becoming pregnant for eight weeks after you return home, and even if you are on an effective contraception, do continue to use condoms for those eight weeks to reduce the risk of sexual transmission. However, if you are a female who has developed any of the above mentioned Zika symptoms in the first two weeks of returning home, you should wait at least eight weeks after your symptoms first appeared before trying to get pregnant.
According to Dr Alastair McGregor, Consultant in Infectious Diseases and adviser to Dr Morton’s – the medical helpline: “The current guidance for women is very conservative and will doubtless be modified as our understanding of Zika improves. However, Zika virus has been detected in men’s semen many months after apparent recovery from illness and there have been a few convincing reports of sexual transmission. The current advice is that men take precautions to prevent infecting their partners for eight weeks after leaving an endemic area but, if they have had an illness compatible with Zika infection, this increases to six months. The proportion of men with Zika who become infectious through their semen, the length of time they remain infectious and the risk of acquisition of Zika from an infected man are all completely unknown so, ultimately, these guidelines are not underpinned by much evidence.”
So to summarise, if you are looking to start a family in the next few months, then you should really weigh up how much you want to see that 100m sprint. Alternatively, should funds allow it, you could follow the lead of Britain’s Greg Rutherford, the Olympic long jump champion, in freezing sperm prior to getting on the plane to Rio.

Painful Smear Tests

It’s cervical screening awareness week ( 13-19 June 2016) , and with 3064 new cases of cervical cancer every year, it is becoming increasingly important that we attend our smear tests to detect the changes to cells on our cervix that might develop into cancer in the future as it is estimated that cervical screening can prevent up to 75% of cervical cancers from developing.

Around 5 million women in the UK are invited for cervical screening each year but unfortunately 1/4 of women don’t attend theirs. A large proportion of these non-attenders are women over 50  (32% of over 50 year olds) who do not feel a smear test is relevant to them, but need to be reminded that 1 in 3 cervical cancer cases are in women over 50.

However the remainder of people who don’t go for their smear tests often have other excuses like not having the time or it being too painful. I’d therefore like to address the latter and give women some hints and tips to try and manage the pain for their next smear:


  1. The majority of pain that people experience is often related to anxiety which causes your muscles to contract, making it more difficult to insert and open up the speculum. One way of managing this is through breathing and relaxation techniques. Practice your abdominal breathing for two weeks prior to your smear test, and think of a place that you find peaceful like the beach or a lake and envisage yourself there. Some people find that talking during their smear test helps keep their mind off the tension and in those that are particularly anxious, I sometimes recommend they listen to their favourite tunes on their iPods.
  2. If the pain is related to the smear taker not usually being able to find your cervix initially and having to spend longer to do so, then it is worth explaining this to the doctor/nurse, and they may want to examine you a bit more thoroughly initially to ensure they can locate the cervix and its angle before putting the speculum in. In some cases it can be easier to find if you place your hands under your bottom to help tilt the pelvis.
  3. We are all  built in different ways and some people have smaller vaginas than others, and we have a lot of different sized speculums to match. Your doctor/nurse could try using a smaller speculum if you have previously suffered with a lot of pain with the larger ones. It may be worth taking a simple pain killer like paracetamol before your smear to help.
  4. In menopausal women the low levels of oestrogen can cause the vagina to be dry and/or inflamed, and this in turn can make the smear test more uncomfortable than usual. This can be corrected by using an oestrogen cream inside the vagina, so please discuss with your GP whether this may be an appropriate management for you.
  5. Remember that just because it was painful on one occasion, it doesn’t mean it always will be, and if you had a bad experience with one smear taker, you can certainly ask to have your smear test done by someone else the next time.
  6. Failing all of the above, another option is trialling medications like diazepam which is a muscle relaxant and  helps with anxiety disorders. However it does have some unwanted side effects and contraindications, so it should only be considered if you really can’t face your smear test otherwise and you would need to discuss with your GP whether this is appropriate for you.