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Checking in on Malaria Risk Levels Around the World

Posted Friday 08 March 2019 12:03 by in Express Pharmacy by Tim Deakin

malaria protection

As one of the most dangerous and widespread diseases in the world, malaria is a condition that is constantly evolving. By looking at how the condition has changed and spread throughout the world, we can gain a clearer understanding of how to avoid it effectively when travelling.

Every traveller should be aware of the potential risks posed by infectious conditions such as malaria. Put simply, malaria is a serious tropical disease, spread by mosquitos. It can be fatal if left untreated, and a single mosquito bite is all it takes for someone to become infected with malaria.[1]

Despite still being a significant travel health risk today, the origins of malaria date back millions and millions of years. In fact, fossil mosquitoes have been found in geological strata 30 million years old.[2] What’s more, a variety of studies have suggested that P.falciparum malaria probably jumped from great apes to man, most likely by a single host transfer by vector mosquitos.[3] Findings indicate that malaria traces back to gorillas.[4]

As well as having a long and complex history behind it, the condition also has a huge geographical spread. Let’s take a closer look at malaria risk levels across time periods and around the world.

A timeline of malaria

We’ve already mentioned that, as well as being a dangerous and widespread condition, malaria is also an ancient one. In truth, the origins of malaria dates back hundreds of millions of years, yet it remains a significant health risk in several parts of the world today. Below is a timeline of how malaria has transformed over millennia.

Half a billion years ago: Existence of a pre-parasitic ancestor of the vector mosquito

150 million – 200 million years ago: Appearance of early Dipterans, ancestors of mosquitoes

130 million years ago: Evolution of two-host life cycle in Dipterans and vertebrates

130 million years ago: Divergence of the bird and mammalian malaria parasites

100 million years ago: Divergence of P.malariae, P.ovale and P.vivax lineage

5 million years ago: Evolution of P.falciparum

2-3 million years ago: Divergence of P.vivax from P.cynomolgi

10,000 years ago: Malaria appears in Africa

10,000 – 5,000 years ago: Malaria appears in Mesopotamia, the Indian peninsula and South-East Asia

4000 – 10,000 years ago: Appearance of the lethal strain of P.falciparum

5000 years ago: Malaria appears in China

4000 – 5000 years ago: In Africa, Anophelines develop highly anthropophilic habits

3000 years ago: The lethal P.falciparum strain of malaria reaches India

2500 – 2000 years ago: Malaria reaches the shores of the Mediterranean

1000 – 500 years ago: Malaria reaches Northern Europe

Late 15th Century: Malaria reaches the New World and much of the western hemisphere

Mid-18th Century: Malaria spreads across North America

19th Century: Malaria is now present across the globe

Early 20th Century: Millions of people die from malaria all over the world

Early 1950s: Malaria has almost disappeared from North America and from almost all of Europe

Present: Malaria fatalities almost entirely limited to sub-Saharan Africa.

Malaria worldwide

anti malarialThe World Health Organisation (WHO) estimates that 219 million cases of malaria occurred across the globe in 2017. Of these cases, around 435,000 people died from the disease. This number mostly consisted of children under 5 years of age in sub-Saharan Africa.[5]

International travellers could find themselves at risk of malaria infection in 87 countries around the world, most notably in Africa, Asia and the Americas. Those who do become infected with malaria often experience initial flu-like symptoms, as well as fever and chills. If left untreated, these symptoms can escalate into severe complications and even fatality.

Symptoms of malaria usually appear after a period of seven days or longer, though it can be sooner.

Malaria is caused by the Plasmodium parasite, transmitted by female Anopheles mosquitos which bite between dusk and dawn. Five strands of the Plasmodium virus regularly infect humans. These are falciparum, vivax, ovale, malariae and knowlesi.[6] While P.falciparum is the most dangerous strand, P.vivax is now the most geographically widespread of the human malarias, as it is estimated to account for 100-300 million clinical cases of the infection across Asia, Central and South America, and the Middle East.[7]

The deadly P.falciparum strand of malaria is considered a serious public health concern in most countries within sub-Saharan Africa.

Preventing malaria

In many instances, malaria can be prevented. An easy way to remember the precautions you should take is by thinking of them as the ABCD approach.[8] This consists of:

Awareness of risk: find out whether your destination carries a risk of malaria before you travel

Bite prevention: avoid mosquito bites by using things such as insect repellent and an insecticide-treated mosquito net. You should also cover your arms and legs whenever possible

Check whether you need anti-malarial medication: Explore the various treatment options available. Always ensure you use the right dose and finish your course of medication

Diagnosis: Seek immediate medical advice if you develop any malaria symptoms for as long as up to a year after you return from your travels abroad.

Always speak to your GP if you’re planning to visit an area where there is a malaria risk.

Malaria risk countries

One of the most important questions to ask yourself when travelling is whether malaria is a risk factor in your destination. Being aware of potential malaria risks before you travel is essential, as the most serious forms of malaria can become life-threatening after just 24 hours.[9]

Most malaria cases in 2017 were within the WHO African Region (92%, or around 200 million). This is followed by the WHO South-East Asia Region (5% of cases) and the WHO Eastern Mediterranean Region (2%).[10]

Almost 80% of global malaria cases occurred within just 15 countries in sub-Saharan Africa and India, and five countries accounted for almost half of all malaria instances worldwide: Nigeria (25%), Democratic Republic of the Congo (11%), Mozambique (5%), India (4%) and Uganda (4%).[11]

If you’re planning to travel further than Europe, you should carefully research any potential malaria risks in your area.

Understanding malaria is key to avoiding the condition when travelling further afield. If you’re worried that you may be at risk of the condition while travelling, contact Express Pharmacy today. We can provide effective anti-malarial medication such as Malarone and Doxycycline. Speak to one of our pharmacists today by calling 0208 23 07 03 or by using our discreet online Live Chat service.


[1] NHS UK. Malaria Overview. 2018 [Accessed March 2019]

[2] Carter, R., Mendis, K.N. Evolutionary and Historical Aspects of the Burden of Malaria. Clinical Microbiology Reviews. October 2002; 15(4) [Accessed March 2019]

[3] Alcock, K. Cerebral malaria may have passed from gorillas to us. 2010 [Accessed March 2010]

[4] Liu, W. et al. Origins of the human malaria parasite Plasmodium falciparum in gorillas. Nature. September 2010 [Accessed March 2019]

[5] World Health Organisation. Malaria, Information for Travellers. 2019 [Accessed March 2019]

[6] Public Health England. Advisory Committee for Malaria Prevention. Guidelines for malaria prevention in travellers from the UK. 2018 [Accessed March 2019]

[7] Rich, S.M., Ayala, F.J. Evolutionary Origins of Human Malaria Parasites. Springer US. 2006 [Accessed March 2019]

[8] NHS UK. Malaria. 2018 [Accessed March 2019]

[9] NHS Fit For Travel. Malaria. 2019 [Accessed March 2019]

[10] Travel Health Pro. Malaria Factsheet. 2019 [Accessed March 2019]

[11] World Health Organisation. World Malaria Report 2018 [Accessed March 2019]

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Is It Possible to Avoid Pregnancy Without Contraception?

Posted Thursday 28 February 2019 12:05 by in Emergency Contraception by Tim Deakin

avoiding pregnancy

According to the NHS, there are 15 methods of contraception to choose from, each with its own level of effectiveness to consider. [1] However, this does mean that there are plenty of options for every individual and circumstance.

So surely, there’s no reason not to use protection of some kind if you’re trying to avoid pregnancy? Well, not everyone agrees. There are, of course, religious and cultural factors to take into account, as well as a host of myths and theories surrounding contraception and safe sex that have the capacity to confuse matters.

From contraception-free sex methods to myths about contraception itself, let’s see how some of these theories stand up to scrutiny.

Having sex on your period

There is a lot of talk surrounding the notion of having sex on your period. First of all, period sex is safe, and can actually lead to benefits such as relief from menstrual cramps.

However, your period should not be relied on as an effective method of contraception. Although you’re most likely to get pregnant during ovulation, every cycle is different and getting pregnant around your period can happen.[2]

The pull-out technique

The pull-out technique of contraception involves relying on a male partner’s timing. When the male partner feels that the point of climax is approaching, he ‘pulls out’ of the female in order to avoid releasing sperm into the vagina. However, in the heat of the moment, this can be difficult to time effectively, meaning the pull-out technique is not a guaranteed way to avoid pregnancy. In fact, if 100 women were to use the technique for pregnancy prevention each year, roughly 22 would have an unintended pregnancy.[3]

Having sex while breastfeeding

Many women assume that there is a direct correlation between their sex life and their decision to breastfeed. A study in 2005 found that women who were breast-feeding were more likely to delay resuming intercourse than those who were not breastfeeding.[4]

Research has shown that breastfeeding may help to prevent pregnancy if certain conditions are met, namely that the woman is within six months of having delivered the baby, has not had a menstrual cycle and if the baby is feeding only on breastmilk. All three of these conditions need to be met in order for breastfeeding to help in any way with contraception, and even then there is still a significant chance that pregnancy will occur.

The myths surrounding female contraception

The use of modern contraception has increased slightly in recent years, according to the World Health Organisation. In 1990, 54% used modern contraception, compared to 57.4% in 2015. However, this still almost half the female population who are not practising safe sex.[5]

This is partly due to the myths which surround female contraception. One such myth is that birth control causes severe weight gain. An analysis of 49 studies in the Cochrane Database of Systematic Reviews found that going on the pill made no significant different to a woman’s weight.[6]

Another common misconception is that the use of birth control can lead to birth defects in children. Several studies have found no evidence between taking birth control and the likelihood of birth defects.[7]

contraception

Contraception is key

No matter when and how you’re having intercourse, practising safety throughout contraception is an important part of the process. The World Health Organisation summarises some of the key benefits of contraception, including empowering people, reducing adolescent pregnancies, slowing population growth, reducing infant mortality rates and helping to prevent the spread of diseases.[8]

If you’re nervous about seeking contraception from your GP, you can obtain safe and effective contraception discreetly by order from Express Pharmacy. If you have any more questions, you can get in touch with our pharmacists today by calling 0208 123 07 03 or using our online Live Chat service.


[1] NHS UK. What is contraception? 2019 [Accessed February 2019]

[2] NHS UK. Can I get pregnant just after my period has finished? 2018 [Accessed February 2019]

[3] Women’s Health Institute. Contraception myths. Cleveland Clinic, 2018 [Accessed February 2019]

[4] Rowland, M, Foxcroft, L., Hopman, W.M., Patel, R. Breastfeeding and sexuality immediately post partum. Can Fam Physician, 2005 [Accessed February 2019]

[5] World Health Organisation. Family Planning Fact Sheet. 2015 [Accessed February 2019]

[6] Gallo, M., Lopez, L., Grimes, D., Carayon, F., Schulz, K., Helmerhorst, F. Combination contraceptives: effects on weight. Cochrane Library, 2014 [Accessed February 2019]

[7] Sifferlin, A., Birth Control Pill Not Linked to Birth Defects: Study. TIME, 2016 [Accessed February 2019]

[8] World Health Organisation. Family Planning Fact Sheet. 2015 [Accessed February 2019]

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Visiting Africa: What You Need to Know Right Now

Posted Monday 25 February 2019 16:08 by in Travellers Diarrhoea by Johanna Galyen

travelling to Africa

As the weather starts to warm up and the spring flowers begin to bloom, you may be finding yourself getting ready to travel again. But before you pull out the suitcases, it’s time to make a plan. Whether you are looking forward to the majestic Mount Kilimanjaro or the plains of Kenya for a wildlife safari, spend some time making the right preparations to make sure that your vacation is extra-special and not filled with nasty surprises. In this article, we’ll be looking at a general overview of Africa and what you need to know to make this holiday the trip of a lifetime.

When and where are you visiting?

Africa is the world’s second largest continent, according to National Geographic, and given that it spans both the tropics of Cancer and Capricorn with coasts that touch many different seas and oceans, getting your packing, preparation and itinerary right can be quite a challenge. Some of the key attractions that you should consider are:

  • Savannas – these are the vast grasslands that play host to some of the world’s most captivating animal species. Kenya is one such popular destination where you may wish to head out on safari to see giraffes, elephants, and wildebeest. If you were to continue south, you would enter the Ngorongoro Crater in Tanzania. This a vast area filled with wild animals and has been called Africa’s Eden.
  • Nile River – you can take a historical trip down the Nile river (the world’s longest) and explore the area and times of the Pharaohs so many years ago. Make sure you stop and see Valley of the Kings and those epic burial pyramids.
  • Lake Victoria – this large body of water is one of seven great lakes in Africa, and is a hotspot for tourists. Choose between a thatched-roof cottage or a private villa on one of the small islands. Either way, you will get to enjoy all that the beauty and thrills that the destination can offer you.
  • Mount Kilimanjaro – if trekking up to see a dormant volcano and the highest point in Africa is your idea of a vacation, then Mount Kilimanjaro is just for you. This hike should be done with careful planning and consideration as it is not a simple day hike; it is suggested that you plan for a week to help acclimate your body to the changes in elevation and plan for weather.
  • uShaka Marine World & South African Coastline – while this is not the quintessential African destination that comes up for most people, the southern part of Africa offers many different holiday experiences. Children and adults alike will love the large marine park as well as the gorgeous views of the Indian Ocean that the South African coastline can bring.

visit mount kilimanjaroWhen visiting Africa, it is crucial to know where and when you are planning a trip because packing for a holiday in Africa is a more complicated affair than you might think, given that the climate can vary dramatically from region to region. Africa has two seasons, instead of the four we are familiar with in the temperate areas of the Northern hemisphere. They are the dry and rainy seasons. No, you probably won’t need snow boots in May & June, but visiting the northern, eastern, and western side of Africa means that you will almost certainly be rained upon every single day during certain months of the year. If you are visiting Africa in July, you can expect hot and dry weather with extreme temperatures reaching 47 degrees Celsius or 117 F with the night temperatures dipping to -4 degrees Celsius.

What you should know in advance

Rural or urban visit

Holidaying in some parts of Africa can be quite different from a city break or even a rural retreat in Europe. Due to the sheer scale of the continent and the vast unpopulated spaces in many countries, some locations - such as safari holidays - can take you to extremely remote places. If an authentic expedition or adventure holiday is what you are seeking, be prepared for periods of time without Internet, phone signal or even electricity.

In the first instance, you may wish to check with your phone’s internet provider if your contract includes coverage for the country that you’re visiting.

Clothing and culture

When you consider packing clothing for your trip, there are many considerations. It is good to know what your plans entail so you can make the right decisions. If you’re hiking up a mountain, you may want to wear something more than a t-shirt and shorts. The hot days can turn into a cool evening very quickly, so remember to pack a warm sweatshirt or jacket. A hat is very helpful to shade yourself from the hot sun and can also help prevent a nasty sunburn.

Cultural considerations are also important when visiting local areas in Africa. Women may want to pack long skirts or have a sarong ready to cover up bare shoulders depending on the region you are visiting. A head covering is also important if you’re planning to visit local mosques or areas where cultural or religious traditions may differ from your own.

Electricity

Always remember that technology can take on different meanings in different countries of the world. On your packing list, make sure you get a few electrical converters for your electronic equipment. Always get the ones that have surge protectors in them; the electricity output can differ from place to place, and you might just get a nasty surprise and shock when you plug your electronics into the outlet.

Time to eat

Holidaying in a new area might conjure up visions of new delectable treats but, like many parts of the world, you should be cautious about the food that you try in Africa - particularly street food. Nothing can ruin a holiday faster than an upset stomach or food poisoning, so make sure you are extra careful about what you choose to eat.

Food suggestions

African street foodHere are some great tips when eating your next meal:

  • Only eat hot foods when they are hot. Meats should be thoroughly cooked through. Avoid rare and medium-rare cooked meats
  • If the food is served cold, make sure it is a reputable place to ensure that the food has stayed cold the entire time. Do not eat room temperature food; soft or uncooked eggs; rare meats or fish
  • Fresh fruit should only be eaten if you can peel it such as bananas and mangoes.
  • Avoid fresh salad items like lettuce, tomatoes, and celery if you cannot be confident that they have been cleaned properly. Washing salad in dirty water is a prime cause of water-borne diseases.
  • Dry packaged foods are usually safe as long as handled appropriately when opened.
  • Be very cautious about street vendors as they may not have proper food-handling and refrigeration techniques.
  • When on safari, avoid bushmeat (a wild game that is unknown to you). This also means no adventurous eating of bats, rodents or monkeys.

Water and beverages

Living in an industrialised city has many luxuries. Typically, most people in the UK don’t need to worry about the safety of the drinking water from the tap. However, this cannot be assured abroad - as the water from the tap may not be clean. The same also applies when brushing teeth and showering.

Chlorinated and filtered water rarely comes out of the tap in many remote or undeveloped regions of Africa. Freshwater lakes and streams may carry schistosomiasis, a parasitic flatworm, that can cause many stomach complaints and an itchy rash. It is worth remembering that the same rivers and lakes that is used for drinking water may also be used for bathing and laundering clothes. Where sanitation is poor, there is also a chance of waste making its way into the water.

So remember: if it goes anywhere near your mouth, it must be clean and safe for you. Here are some other extra tips to quench your thirst.

  • Bottled or canned drinks are usually considered safe. Use bottled water for drinking and brushing your teeth.
  • Avoid ice cubes in your drinks unless you have seen the water poured from a bottle before freezing.
  • Alcoholic beverages should only be served from sealed containers or well-known bartenders to ensure that you are drinking what is listed on the bottle.
  • Be careful when drinking fresh juices as the fruit and juicing equipment may have been washed with unclean water.
  • Pasteurised milk that is sealed is safe to drink. Avoid unpasteurised or fresh milk.
  • Coffee drinkers beware! While hot coffee made with clean water is fine, be very careful about adding fresh cream.
  • Try not to splash water into your mouth when showering or bathing.

Preparing for your health

Mosquitos

After a long day’s travel, you’ll be wanting to find a relaxing bed to stretch out and get some rest. But before you get that much-needed sleep, check to see if you should be sleeping under a mosquito net. According to the Against Malaria Foundation, mosquitos that carry malaria bite most frequently between 10pm and 2am. The mosquito net should be treated with Permethrin that will kill the bugs as well as protect you from the pests.

Bug Repellant is also another way to protect yourself from mosquitoes and flies. Many travellers choose a product with DEET in it – ranging from 7% for children and all the way up to 50% for the most adventurous travellers. There are also DEET-free options using Lemon Eucalyptus oil that can be purchased. No one wants to get bitten by a bug, so using the highest level of DEET protection may seem an obvious choice. But remember, DEET is a potent and toxic chemical. It can erode plastic coatings on clothing and watches and is harmful to breathe in – you may be coughing and feel like your lungs are on fire if you inhale it in.

Vaccines

Your health is one of the most important priorities when planning a trip to Africa, and while you are planning your trip, it is a great time to stop and check your immunisations. The Centre for Disease Control recommends that everyone who visits other countries to have the standard childhood vaccines and ensure that no boosters are missed. These will include the DTaP, MMR & shingles, Polio, Pneumonia, Meningococcal, and HPV vaccines.

Here are the specific vaccines that are recommended for Africa:

  • Hepatitis A and B vaccines,
  • Rabies
  • Typhoid
  • Yellow Fever
  • Meningococcal
  • Cholera vaccine

Medications for your trip

He who cures a disease may be the skillfullest,

but he who prevents it is the safest physician. Thomas Fuller

As Thomas Fuller so poignantly stated back in the 1800s, preventing disease is very important to your health. Because of this, when planning your trip to Africa, you should sit down with your GP, pharmacist or travel clinician and discuss which preventive and prophylactic medications you are going to need for your trip.

Anti-malarial medications

Remember those mosquitos that the nets and the bug spray help to deter? While those are extremely important and should be used by everyone, you still may want to consider taking oral medication to help prevent malaria.

The disease of malaria is carried by mosquitoes, but only a particular type of mosquito. According to the World Health Organization, the Female Anopheles mosquito acquires the parasite Plasmodium when she bites people to get blood to feed her eggs. Then when she bites again (after being infected), the parasites are put into the person’s blood supply. Her bite is not like the annoying mosquito that is itchy and welted-up; no, her bite is a stealthy bite that doesn’t leave a mark.

Because the Female Anopheles bites in the middle of the night, most people do not even know that they have been bitten until a 10-14 days later when the first symptoms start to appear. These can include fever, headache, severe chills, and vomiting. The parasites can also be deadly as they kill red blood cells and then clog up the blood supply to the brain and vital organs (such as the liver or heart).

You should be concerned about malaria if you are visiting parts of Africa, including Chad, Cameroon, Congo, Ghana, and Kenya. Take some time and look at a malaria countries map and see if your travels intersect any of these areas. The risk in particular regions can vary over time and so consulting the WHO website is a good starting point. Some areas are worse than others, but, for example, the high prevalence of malaria in Ethiopia shows that it is one of the countries in which there is a heightened risk of catching the disease as a traveller.

It is also important to note that if you visit an endemic malaria area, some hospitals will not let you donate blood for up to three years after visiting these areas. Also, if by some terrible chance you do get malaria, you will also not be able to donate blood to those in need.

Preventative anti-malarial medications

Killing the Plasmodium parasite in the bloodstream can also be performed by anti-malarial medications. There are three specific medications that most people choose from to take for their anti-malarial needs. These are Doxycycline, Malarone (atovaquone and proguanil hydrochloride), Lariam (mefloquine).malarone malaria treatment

Some medicines are taken daily, and others are taken once a week. They all have positive and negative things that you should be aware of; so it is vital to speak with your pharmacist, travel clinician or GP about which one is best for you. Your medical history, current medications, planned activities, and specifically, where you will be going all determine which medication you should take. An easy way to help understand this information is the website Fit for Travel; it can help you look which medications may fit the best for you.

Anti-diarrhoeal

In some countries, it’s called Montezuma’s Revenge but the more common term for loose stools and stomach issues while abroad is Traveller’s Diarrhoea. But if you get it, you’ll just call it misery. A miserable time of living on the porcelain throne (toilet) and wishing your stomach would just calm down. Food and water-borne diseases can easily be obtained when travelling to different countries as foods may not be cooked as thoroughly as they should be before eating.

Also, if cups and plates that are not cleaned properly, or if the water is not purified correctly, it can cause you to be ill. The bacteria that cause this can be E-coli, Salmonella, or even parasites such a Giardia.

Traveller’s diarrhoea is different than just an upset stomach from too many spicy foods; it is three or more watery stools in 24 hours or less. You can also have nausea, vomiting, stomach cramps, and many sudden urges to have a bowel movement. Typically, these symptoms are mild-moderate and can last up to five days without treatment. If it lasts more than 5 days, or if you cannot function with the symptoms that are getting worse, then it becomes more severe.

Treatment for diarrhoea

First of all, if you find yourself in this unfortunate position, the primary treatment is treating the possible dehydration. Clear fluids, hydrating drinks (such as Gatorade or Powerade-like drinks that have electrolytes and rehydration salts in them) are the best thing for you. You do need to drink lots and lots of them. Not only with the fluids keep you from getting dehydrated, but they also help to flush out the bacteria.

Secondly, for those who are having the stomach cramping pains, some over-the-counter medications can help calm your stomach down. These would include Loperamide (Immodium) and Bismuth Subsalicylate (Pepto-Bismol).

Lastly, there are prescription medicines that your GP or pharmacist may prescribe for you in case you do have worsening symptoms. These would be Lomotil (diphenoxylate and atropine), Azithromycin, and Ciprofloxacin. Lomotil is a stronger medication that specifically helps the colon spasms to calm down; it contains atropine, which is a controlled substance in some areas, so to obtain this, your GP will need to prescribe it.

The other medications, Azithromycin and Ciprofloxacin, are antibiotics that will fight against the bacteria that causes the traveller’s diarrhoea. These medications are not taken like preventative medications, but should only be taken when your GP instructs you to – typically, this is if specific symptoms appear – so, it is important to write down the instructions and put them with the medications so if you do get sick, you will know what you should take.

Conclusion

Travelling to Africa can be the trip of a lifetime with the right preparations. The more you can plan in advance for your time away, the more enjoyable it can be. So get out that packing list and start checking the things off as you get them done. The mountain of Kilimanjaro and the African safari animals are waiting for you! Bon Voyage!

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The Complex Relationship Between Periods and Pregnancy

Posted Thursday 21 February 2019 22:55 by in Emergency Contraception by Tim Deakin

pregnancy and periods

The relationship between periods and pregnancy is one which is constantly being questioned. A lack of open discussion and education has left many women unsure of the impact a period may or may not have on conception and contraception. Last year, there were 792,636 contacts to Sexual and Reproductive Health Services in the UK made by women with enquiries about pregnancy and contraception. The most likely age group to contact Sexual and Reproductive Health Services for contraception were 18-19 year old females.[1]

So to help clear things up, here are some of the most frequently asked questions about periods and pregnancy.

Is it possible to get your period during pregnancy?

In short, no. You cannot experience a genuine menstrual period while you’re pregnant. The reason many women are confused by this fact is that it is possible to experience vaginal bleeding during pregnancy, but this is not the same thing as menstruation. In most cases, this spotting is the result of ‘implantation bleeding’, or due to a Pap smear, vaginal exam or sex. However, it can also be a sign of something more serious such as infection, placental issues, miscarriage or ectopic pregnancy. If you experience any bleeding during pregnancy, seek advice from your GP as soon as possible.

When is the best time of the month to try for a baby?

One question many women ask themselves is ‘can you get pregnant anytime of the month?’ This is often born out of frustration at taking a long time to conceive. However, while just over a third of healthy couples will conceive in the first month of trying, it can often take longer. In fact, if you’re under 35 and in good health, it’s perfectly natural for conception to take up to a year.[2] What’s more, it’s estimated that around one in seven couples struggles to conceive.[3]

For the best chances of conception, couples should engage in intercourse within a day or so of ovulation. This describes the point when an egg is released from the ovary, and usually occurs around 14 days after the first day of your last period.

Do irregular periods make it more difficult to conceive?

According to clinical professor of obstetrics-gynaecology and reproductive sciences at the University of California, Amy Audrey, MD, at least 30% of women have irregular periods during their child-bearing years.[4]

The effect this has on your chances of getting pregnant really depends on the underlying cause of your irregular periods. In most cases, it will have very little effect on your ability to conceive. However, in certain cases irregular periods can be the result of something more serious like fibroids, blood clotting, polyps or thyroid issues, which can impact your chances of getting pregnant as well as your overall health.

Can you get pregnant on your period?

This is one of the most frequently asked questions when it comes to pregnancy and periods. The answer is that while you are far less likely to get pregnant on your period, you shouldn’t rely on this alone as a method of contraception. Monthly cycles can be unpredictable, and women with shorter cycles have an increased chance of getting pregnant during their period. Furthermore, it is perfectly possible to fall pregnant just before or just after your period, so using this as a method of contraception can be extremely risky.

The Importance of Contraception

No matter what method you choose, contraception is vital for preventing pregnancy and increasing the safety of your intercourse. The contraceptive pill is typically between 91-99% effective when it comes to preventing pregnancy, while an IUD is more than 99% effective. Male condoms are between 82-98% effective and female condoms are between 79-95% effective.[5]

Simply put, you shouldn’t rely on timing sexual intercourse around your period as your sole method of avoiding pregnancy. If you want to enjoy intercourse without the risk of pregnancy, the right contraception is an absolute must.

Both female contraception and emergency contraception are available safely and discreetly from Express Pharmacy. For further information and guidance, speak to one of our NHS-approved pharmacists today by calling 0208 123 07 03 or by using our online Live Chat service.


[1] NHS UK. Sexual and Reproductive Health Services. 2017. [Accessed February 2019]

[2] Clearblue UK. How long does it take to get pregnant? 2018. [Accessed February 2019]

[3] National Institute for Clinical Excellence (NICE). Fertility – assessment and treatment for people with fertility problems. 2013. [Accessed February 2019]

[4] Everyday Health. The Facts About Irregular Periods. 2010. [Accessed February 2019]

[5] NHS UK. How effective is contraception at preventing pregnancy? 2017. [Accessed February 2019]

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New Research Suggests Magnets Could Be Used to Treat Migraines

Posted Friday 15 February 2019 22:31 by in Migraines by Tim Deakin

magnets for migraines

In the UK, migraines are an extremely common complaint. In fact, it is estimated that there are 190,000 migraine attacks every day in England alone, and UK-wide there are 6 million suffering with migraines. Prevalence of migraines has been reported at 5-25% of women and 2-10% of men, while it’s estimated that as many as 1 in 1,000 people live with chronic migraines.[1]

Now, however, recent research suggests that pocket-sized magnets could be used to provide fast relief from migraine symptoms. Magnets have been used in the treatment of migraines for decades, but these smaller sized versions could make the treatment more accessible.

Dr Richard Lipton, vice chair of the department of neurology at Albert Einstein College of Medicine in the Bronx and director of the Montefiore Headache Centre explained the effectiveness of migraines when speaking to the New York Post, saying:

“Magnets stimulate the brain. Forms of magnet therapy have been used as both diagnostic and therapeutic tools for a very long time. The challenge was building a lightweight, portable device. But now we’ve accomplished that.”[2]

The research

The trail of this new magnet treatment was completed by Guy’s and St Thomas’ NHS Foundation Trust. It involved the use of treatment known as single pulse Transcranial Magnetic Stimulation (sTMS), which has previously only been available in hospitals, and transferring it into a portable device.

The subject of the research was Barrington Simner, 72, from Bromley in south-east London, who suffered from migraines for more than 20 years.

Simner received sTMS in the form of a portable device placed on the back of the head for a few seconds, pressing a button to deliver a painful magnetic pulse into the brain. This works by stimulating cells in the outer surface of the brain, reducing the severity and frequency of migraines. It can be used up to eight times a day.

Describing his feelings towards the treatment, Simner commented:

“I started getting migraines when I turned 50 and over time they got progressively worse. At one point I was getting a migraine twice a week. They were completely debilitating […] I tried lots of different powerful painkillers, but the side-effects made me drowsy. sTMS is the only treatment that has worked for me.

“I’ve massively reduced the amount of painkillers I take. I am now able to volunteer, spend time gardening and enjoy life. I’m really thankful to the team at Guy’s and St Thomas’ for the care I’ve received. The treatment has completely changed my life.”[3]

Currently, Guy’s and St Thomas’ headache centre is the only NHS centre in the UK to offer this treatment.

Migraines are complex problems with many associated causes and symptoms

Migraines are the third most common disease in the world, with an estimated global impact of 14.7%, which works out at around one in seven people.[4] Despite this, the true cause of migraines has not yet been determined, and research into migraines is the least publicly funded of all neurological illnesses relative to its economic impact.[5]

With this in mind, it’s important to look at the research from Guy’s and St Thomas’ with a critical eye. While the results of the research into portable sTMS is promising, the experience of having a migraine is different for every sufferer, as is the treatment which works best. For many, taking steps to prevent triggers is the best solution.

For some people, lifestyle changes such as improving diet, drinking plenty of fluids, engaging in exercise and taking time away from electronic devices can all positively impact migraine symptoms. For others, effective medication is the only way to treat the condition in the long-term. For example, upon its release in the early 1990s, studies found sumatriptan to be “an effective long-term acute treatment for migraine.”[6]

Leading migraine treatments such as Sumatriptan and Imigran can be obtained quickly and easily from the NHS-approved pharmacists at Express Pharmacy. For more information, call us on 0208 123 07 03 or use our discreet live chat


[1] National Institute for Clinical Excellence (NICE). Botulinum toxin type A for the prophylaxis of headaches in adults with chronic migraine. 2011 [Accessed February 2019]

[2] Malamut, M. The next big thing in migraine pain relief is already here. New York Post. 2019 [Accessed February 2019]

[3] Guy’s and St Thomas’s NHS Foundation Trust. Grandfather thanks hospital for life-changing migraine treatment. NHS UK. 2019 [Accessed February 2019]

[4] Steiner, T.J. et al. Migraine: the seventh disabler. The Journal of Headache and Pain. 2013 [Accessed February 2019]

[5] Shapiro, R.E., Goadsby, P.J. The long drought: the dearth of public funding for headache research. Cephalalgia, 2007 [Accessed February 2019]

[6] Pilgrim, A.J., The clinical profile of sumatriptan: efficacy in migraine. 1994 [Accessed February 2019]

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