Academy of Medical Royal Colleges launches Choosing Wisely Campaign with FSRH input

Today the Academy of Medical Royal Colleges is launching its Choosing Wisely campaign and website, with a list of forty treatments and procedures that are of little or no benefit to patients.

The list, drawn up by college and faculty members of the Academy, including the FSRH, provides advice for patients and doctors for treating health related issues.

The Choosing Wisely initiative aims to encourage healthcare professionals and patients to have a fully informed conversation about the risks and benefits of treatments and procedures.

As part of this initiative FSRH has recommended the following:

For healthcare professionals:

If a woman has abnormal vaginal discharge that is likely to be caused by thrush (also known as candida) or Bacterial vaginosis (BV) and she is at low risk of having a sexually transmitted infection, a vaginal swab is not usually necessary.

Evidence/guidance

• PHE: Management and laboratory diagnosis of abnormal vaginal discharge

If a woman over the age of 45 years with typical symptoms of menopause, such as hot flushes and sweats and whether her periods have become irregular, much lighter or have stopped, further bloods tests to check hormone levels are not usually necessary.

Evidence/guidance

• NICE Guidance: Menopause: diagnosis and management

A woman who is thought to be having recurrent thrush should have an examination of the skin around her vagina to exclude other conditions such as lack of vaginal estrogen, allergies or other skin conditions rather than be given another course of thrush treatment.

Evidence/guidance

• NICE Clinical Knowledge Summary: Candida – female genital

Women who have a copper intrauterine device (IUD) or the hormonal intrauterine system (IUS) fitted only need to seek professional advice when they cannot feel the threads which hang from the device. Women should be taught how to feel for these threads.

For patients:

Vaginal Discharge

Most vaginal discharge is completely normal and does not require being seen by a healthcare professional.

However, if you are experiencing frequent episodes of vaginal thrush you should have the skin around your vagina examined, by a doctor or nurse. They should rule out other conditions such as an allergy or low hormones (vaginal oestrogen), rather than start another course of treatment for thrush.

The NHS choices website gives more information on vaginal discharge and the symptoms and treatment of thrush.

Menopause

If you are over 45, you do not usually need blood tests to diagnose the menopause. Typical symptoms include hot flushes and sweats and your periods may be much lighter or irregular in nature.

The NHS choices website provides full information on identifying symptoms and treatments for the menopause.

Contraception (coil)

If you have a coil (intrauterine device) fitted to prevent pregnancy, you should be taught to check its placement by feeling the threads inside the vagina. This should be done regularly in the first month and then after each period or at regular intervals. You only need to seek professional advice when you cannot feel these threads.

NHS choices website provides more information on the coil and how to check it is still in place.

See below to read the full Academy of Medical Royal Colleges press release on Choosing Wisely

Access the full list of recommendations for both healthcare professionals and patients.