September 2006 Welcome to our Spring 2006, edition of SARHNI,
the Sexual and Reproductive Health Nursing
Information Newsletter for Family Planning NSW
The theme of this edition is Ageing and it has far too many facets to address in a newsletter this size, so we hope that you enjoy reading our selections, which are meant to be food for thought. We look forward to hearing from you, as we have introduced a quick quiz, and would also welcome any feedback that you may have for newsletter themes for 2007.
It is likely that many of the nurses reading
known as the Baby Boomers – one of the
more than four million Australians who
• Use of Viagra had led to the reduction
we might not like to ponder too long on it ,
ageing, and there are some important challenges for those working in the field
will have at least a third of their life to live
following their menopause. This is a considerable period of time in which such
effects of menopause as dry vagina and Not all women will experience a reduced libido can impact on their sexual
advent of Viagra – allowing a number of
Further food for thought is that according
men to remain sexually active into their
experiencing sexual difficulties / painful
primarily because of divorce or death of a
There is a dearth of literature on women’s
safer sexual relationships will be a very
experiences and concerns” Sociology of
Health & Illness Vol. 25 No. 7 (2003) pp.
697 – 719.Some of the highlights of the
article that will provide food for thought
condoms for contraception , and with risk
expectation “healthy” and “normal life”
very well have to be part of consultation
• Viagra’s advent has pathologised what
with clients . For example, discussing the
pap results of LSIL with HPV effect of a
Contributed by Shane Jasiak, Manager Nursing Programs September 2006 SEXUALITY IN THE LATER CONTINENCE AND AGEING
I am sure you are more than aware of the many other issues faced by ageing clients : power surges and hot
The Sexuality in the Later Years Project centred on
flashes; not in the mood, in the mood, moody; packing
several residential care facilities and their residents and
on the pounds; screening – when to and what for?
workers. We consulted with the elderly from the aptly
One issue that I would like to highlight that does not
described “Silent Generation”. We spoke to them
just affect ageing clients but does has significant
about the rights and normalcy of sexual expression in
impact on their well-being is continence. Some of the
general in an aged care setting more specifically. The
important facts and figures available from the
views of workers’ and management’s on an holistic
Continence Foundation of Australia which are of
approach to a resident’s health and wellbeing which
includes sexuality as part of their person centred care, held interesting insights and anecdotes from which we
1. Incontinence is one of the 3 major causes of
admittance to a residential aged care facility, and
bladder control problems treble the cost of care in
The information collected has been used to develop
nursing homes – taking up to 605 of nursing time.
training and a training manual that future participants at Ageing Sexuality workshops can take back to their
2. 40% of over 75 year olds are affected by
The manual will soon be available for sale.
3. 60 – 70% of those affected can be cured or better
This year’s theme of Continence Week was “Pelvic
Floor – use it or lose it”. It is a timely reminder to
continue teaching both male and female clients about
www.continence.org.au, or the National Continence
• physical changes, including stroke, heart disease
A fantastic initiative that you may not be aware of is
the National Public Toilet Map www.toiletmap.gov.au
which has a database of all public toilets nationally.
The site has the capacity for identifying public toilets
on a trip map with details entered by users of start and
• case studies and practical strategies
Contributed by Shane Jasiak, Manager Nursing Programs
Ageing Sexuality Training Workshops can be taken to any area within the Metropolitan area or rural New South Wales. We have brochures available which depict a positive approach to the sexuality of the resident in care and flyers for positive messages to workers regarding the privacy they need for sexual expression.
on (02) 87524 349 athenad@fpahealth.org.au or
Health Promotions Officer, Mary Garwood maryg@fpahealth.org.au.
If you would like this training for your organisation please contact:
September 2006 Go Ask Edith
I am a man in my forties and although I can get an erection, It
FPA Health has an interactive email question
feels as if my head and my penis are disconnected! When I
facility located in the Sex Matters section of
have sex I find that I cum too early. Is there any help for this
the FPA Healthweb, www.fpahealth.org.au. Some examples of a questions from Go Ask
Sorry to hear about your concerns with your love life.
I'm 43yrs old and have only had two periods in the last year.
What you're describing comes under the heading of
Recently, I have begun to have hot flushes and feel as if this
'arousal problems'. Many people men and women will
may be the menopause. What do you think and can I buy books
experience difficulties with arousal as they get older,
work too hard, have other health/mental health concerns or experience difficulties with intimate
Menopause is said to have occurred when, in the absence of a pregnancy, a woman has not had her The first thing to do is to have a check up with your monthly period for more than 12 months. It occurs for local doctor. S/he can do a general health assessment women in Australia on average at about 51 yrs, but can to ensure that their are no problems with your come anywhere between the ages of 40-55yrs. general/mental health. Some men find that talking to Women can feel 'different' at this time in their lives, their local doctor can be a bit worrying, all is not lost much the same way as things felt different all those though as your local Sexual Health Centre can offer years ago as their periods first started. Some of the help with this also. changes women can feel are; hot flushes, occurring Many men find that getting back in touch with their
from every so often at times of stress or maybe with hot 'softer' side can help with arousal. Lot's of guys find
foods, to many times a day which may stop them that they forget the 'warming up' parts of love making
sleeping at night. Some women feel lacking in energy or as they become more experienced. This is something
maybe more moody or teary than usual, some feel that that a good sex therapist can help you with. If you are
their need for sex changes. In one survey, 64% of a reader, you may like to try the following books as
women said that tier sex lives had either not altered or starting points for exploring arousal.
improved following menopause. Others get headaches or a funny creeping feeling under their skin. These new 1.Male Sexuality, Bernie Zilbergeld feelings can last for different lengths of time for different 2.Everyman, Dr Derek Llewellyn Jones women. From months to years. Whilst some women can
FPA Healthline
feel as if this is a door closing, others look forward to a time free of the worry of pregnancy and periods! It is very important for women to take care of themselves at this time. To talk to those around them and get the support and understanding that they need. Making sure that there is plenty of exercise, looking at the stress in their lives and that they are eating a well balanced diet, will help keep women strong and healthy. Some women will get relief from their symptoms by including foods such as lentils and chickpeas, soy products such as tofu and soy milks in their diet. Others will use over the counter products to relieve symptoms. About 30% of women will seek medical help, perhaps Hormone Replacement Therapy, for care of these feelings. A doctor can also talk with women about other medical tests that can be useful at this time for looking at her risk of disease. Some of these might include; cholesterol testing or bone density testing. (particularly if menopause occurs in the forties) FPA Healthrites has many books for sale for women who want to read more on this. Please check our website for a list of books available. Call FPA Healthline 1300 65 8886 to talk to a nurse.
September 2006 Nursing Education Courses Gynaecological Nursing Update Navigating Midlife: women becoming
This popular one-day program has been developed to
themselves by Robyn Vickers-Willis $24.95
support nurses working in gynecology units,
This self-help book for women going through midlife
outpatients and in specialist & GP practices.
changes, focuses on feelings using shared stories,
The program covers common gynaecological
dreams and reflections which can lead them to new
conditions, current management and nursing
attitudes, a feeling of well-being and a more
Presented by doctors and Clinical Nurse Consultants.
Men Navigating Midlife by Robyn Vickers-Willis
• Women’s Responses to Ovarian Cancer
In this book men speak openly and honestly about
their experience of midlife and the ways in which
• Current Research in Sexual & Reproductive Health
they have been challenged to create more fulfilling
lives for themselves. Through this, readers learn
Date: 8 November 2006 (Ashfield)
ways to make choices and changes in their own
Time: Cost: Websites of interest:
Kicking Up Autumn Leaves : A report on the
Women Owning Wellness Evaluation Project ,
which a was a partnership between the Older Women’s Network and North Sydney Central
Coast Area Health Service is now available at
http://www.nsh.nsw.gov.au/HealthInfo/HealthProm/reports/
Nurse Education Coordinator/s Course Coordinator Ann Hutchings 02 4929 4485
TOPICS / IDEAS FOR NEXT YEAR’S NEWSLETTER
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Quick “Sexuality and Ageing” Quiz 1. Name 3 issues that have affected women since the advent of Viagra? ___________________ ______________________ __________________ 2. How many over 75 year olds are affected by incontinence? _______________ 3. What kind of floor is important as you age? ___________________ 4. What is the average age for menopause? _________
Name: …………………………………………………………………………….
Address: …………………………………………………………………………….
Contact number:.……………………….Email: …………………………………
Please fax us your answers to 02 9716 5073 (answers will be supplied in the next newsletter).
A draw will be made of all correct answers on the 1 November 2006 and the winner will receive a
$50 voucher from the FPA Healthrites Bookshop.
September 2006
PROTOCOLE DE JUSTIFICATION THERAPEUTIQUE POUR L'UTILISATION DE BETA-2 AGONISTES 1. Généralités Pour justifier de la prise d'un traitement par les bêta-2 agonistes précités, le sportif doit donc fournir undossier médical établi sur le modèle ci joint (document 1) qui inclura impérativement:- une description détaillée des symptômes respiratoires évoquant une obstruction des v
Préfecture de La Réunion Direction régionale des affaires sanitaires et sociales OBSERVATOIRE REGIONAL DE LA SANTE DE LA REUNION - MAI 2008 Bilan 2007 mitigé : des efforts importants en termes de prévention, de soins et de prise en charge … mais baisse très légère des ventes de cigarettes • Les trois causes de décès les plus directement liées au tabagisme (cancers du poumon, br