Volume 31, Number 1

Paul Woolley, Editor

In the summer of 2004, the BBC reported on its website, under the heading ‘Botox could treat sexual disorder’, the results of a little-known study from Iran that had been presented earlier at a European fertility conference in Berlin. Researchers at Tehran University of Medical Sciences had successfully used botulinum toxin to treat vaginismus in 23 women. At the same time, The Daily Telegraph published an online article on the same subject, reporting on the success rate after just the first injection.

David Hicks FRCOG FRCP FFSRH Dip Ven Consultant Physician in Genitourinary Medicine, Royal Hallamshire Hospital, Sheffield; Medical Director, Barnsley Hospital NHS Foundation Trust

It has been an international quest led by an eminent male researcher and his female acolyte to discover a secret so powerful that it could shake the very foundations of mankind. No, it is not the search for the Holy Grail, but the quest to detect the G spot.

Paul Ward Deputy Chief Executive, Terrence Higgins Trust, London

HIV and sexual ill health are at an all time high in the UK. HIV transmission continues to rise and too many people living with HIV are undiagnosed. Levels of sexually transmitted infections (STIs) remain high, and there is still insufficient support for people living with HIV to help them manage their condition.

Laura Waters MRCP Research Clinician, Department of GU/HIV Medicine, St Mary’s Hospital, London; Joel Myers MRPharmS Pharmacist, Department of GU/HIV Medicine, Chelsea and Westminster Hospital, London; Leena Sathia MRCP Specialist Registrar, Department of GU/HIV Medicine, St Mary’s Hospital, London

Hormonal contraception is susceptible to drug–drug interactions when prescribed concomitantly with antiretrovirals, and only barrier methods offer protection against sexually transmitted infections (STIs) – so patients must be counselled accordingly. The second part of this article (part 1 was published in issue 30.4) discusses hormonal contraception, intrauterine devices and sterilisation for HIV-positive women.

Margaret Rees MA DPhil FRCOG Reader in Reproductive Medicine, University of Oxford; Visiting Professor, Faculty of Medicine, University of Glasgow, and Karolinska Institute, Stockholm

The lifetime risk of being diagnosed with breast cancer is one in nine, and there are 44,335 new cases diagnosed each year in the UK. Breast cancer risk is strongly related to age, with more than 80% of cases occurring in women over 50 years old. The highest incidence of breast cancer is in women aged 50–64. However, breast cancer is the most commonly diagnosed cancer in women under 35. By age 35–39, almost 1,500 women are diagnosed each year.

Sailaja Pisipati MBBS MRCS Clinical Fellow in Urology, Manchester Royal Infirmary; Stephen J Bromage BMedSci BMBS MRCS Specialist Registrar in Urology, NW Deanery; Ian Pearce BMedSci BMBS FRCS(Urol) Consultant Urological Surgeon, Manchester Royal Infirmary, Manchester

Premature ejaculation (PE) is the most common form of sexual dysfunction reported by men. It has recently been the subject of much debate and research, which has led to innovative treatment strategies and changes in its definition.4 Despite a prevalence ranging from 21% to 31%, it is the disorder for which men are the least likely to seek professional help. With increasing understanding of the problem, emphasis has moved from purely psychogenic or behavioural origins to an appreciation of the different aetiologies, including organic causes. This review aims to cover the difficulties in defining PE, its epidemiology, recently proposed aetiologies and available treatments.

Fiona M Lewis MD FRCP Consultant Dermatologist, Heatherwood and Wexham Park Foundation Trust

Patients present to the vulval clinic with a range of conditions – infections, pain syndromes, neoplasia and, most commonly, inflammatory dermatoses. In some dermatoses, the vulva may be the only site affected, whereas in many others, the vulva is involved as part of more generalised disease. A knowledge of the basic features of the common dermatoses can lead to rapid diagnosis and the correct management for these women, who may well have delayed seeking advice because of embarrassment or fear of a sexually transmitted disease. This article gives a brief overview of the common inflammatory dermatoses that affect the vulva.