With 80% of pharmacy patients being female, there is no doubt that Australia’s 5450 plus community pharmacies play a critical role in women’s health.
More often than not women are the carers and gatekeepers of family health, yet they can neglect their own healthcare needs.
Thus supporting and educating women on healthcare matters can go a long way towards helping community wellness as a whole.
What women want
The Women’s health information needs in Australia survey 2015, conducted by Jean Hailes as part of Women’s Health Week, captured the views and opinions of 3325 women and health professionals of differing ages, cultural backgrounds and from a range of metropolitan, regional, rural and remote locations around Australia.
The survey revealed that the health topics women worry about most include:
- healthy living; weight management, physical activity, ageing, fatigue and diet;
- cancer, in particular breast, skin and ovarian cancer;
- mental and emotional health including depression, anxiety, memory, dementia and stress;
- cardiovascular health including high blood pressure, stroke and cholesterol; and
- sexual health, especially painful sex.
“Painful sex comes up a lot in the pharmacy. It presents with younger women when they’re concerned with having a vaginal infection, which could be associated with a fungal infection such as thrush. This is when it’s important that pharmacy does its job properly as thrush shouldn’t be painful,” says pharmacist Samantha Kourtis from Capital Chemist Charnwood, ACT.
“We often get young girls requesting a thrush treatment and when we have a conversation with them painful sex is mentioned. This is an alarm bell for us, indicating the possibility of a more sinister infection,” she says.
“Conversations about painful sex also arise when certain medications cause vaginal dryness—particularly in women post breast cancer treatment.
“Women with hormone positive cancer are prescribed medicines that block their estrogen receptors and when we block estrogen receptors we get dry all over. Skin dries out and also vaginal secretions dry out and if you don’t use adequate lubrication and have enough foreplay sex can become painful,” explains Kourtis.
“However, this is not spoken about. It comes under the survivorship area of cancer but conversation focuses on the cancer itself, the treatment, the cure rate and by the time you’ve had the surgery, chemotherapy, radiation and are placed on a maintenance prescription dose and sent back home, talking about sex is one of the last things that comes up.
“Likewise contemplating the side effects of medication often doesn’t really come up either. In many instances these women start their medication and they have no idea this is going to happen.”
Kourtis believes this is definitely an area where pharmacists can help fill the gap and provide a vital support service to women.
She says, “We have so many women that come and see us every month for these particular drugs and from my experience in this space, it’s a conversation that most people don’t have. There needs to be increased awareness in the whole of community pharmacy about what these women might be facing and, because painful sex is a difficult conversation to have, the pharmacist needs to broach it discreetly.
“There are other meds such as tricyclic anti-depressants, which are used for depression but also nerve pain, that can cause vaginal dryness and again this is going to cause painful sex.
“If we’re not talking to women about the possibility of vaginal dryness they might not know about it until painful sex arises.
“It’s two-fold; it’s important to know that medications can bring about that problem and it’s important to know that if a women presents with painful intercourse we need to rule out infection, but we also need to be aware of what the causes might be and there are some really common medication causes.”
When it comes to talking about painful sex or vaginal dryness Kourtis advises:
- Be upfront.
- Explain that it’s a common problem.
- Tell them it can easily be treated.
She says, “It’s important to be good at facilitating the transition to a private room. If you’re a good communicator you can pick the personality of the person you’re working with.
“For instance, if a female customer comes in saying, “I think I need a thrush treatment” I respond by saying, “I have some intimate questions to ask and I don’t want to do it in the open”—I grab some products and say, “come with me”.
“I take them into the consult room and explain, “It’s so much easier to talk about vaginas with the door closed”, and that just breaks the ice.
“Pharmacy gets complacent, because we talk about these topics every day we forget they might be sensitive and very private topics for other people.
“You get much better outcomes if you hold discussion around ‘sensitive’ topics in private,” she notes.
For more, see the March edition of the AJP.
by Leanne Philpott