​Sore throats left untreated can cause Rheumatic FeverTamariki at risk of developing rheumatic fever from a sore throat can be swabbed at community pharmacies listed belowTamariki are at risk of developing rheumatic fever if they are aged between 3-19 years, have a sore throat and have one of these criteria:

• are Maori or Pacific
• live in high-risk areas (most of the Eastern BOP,  Greerton and Gate Pa in Tauranga)
• live in over-crowded housing
• have a family history of rheumatic fever 

Your pharmacy can provide a throat swab with the help of  parents/guardians of children aged 3-19 with a sore throat and one of the above risk-factors.
These pharmacies are able to provide antibiotic treatment for sore throats of high-risk tamariki and/or others in your home aged 3 years or older.  If the swab is positive for strep then we can also swab and treat household contacts 3 years and above.

A Urinary Tract Infection (UTIs) is a reasonably harmless, though painful, condition that many people are too embarrassed to get help for. In some cases ignoring the pain and discomfort can lead to serious complications so it’s important to get it checked out.
The urinary tract consists of the kidneys, the ureter (which connect the kidneys to the bladder), the bladder and the urethra. A UTI is caused when this area becomes over populated with bacteria.
Although most common in women, because they have shorter urethras then men, it is still possible (although rare) for men and children to get a UTI.  Symptoms are often specific to either the upper or lower areas of the urinary tract. An upper UTI can often be an indicator of more serious complications such as kidney infection and should be seen by a doctor. Any child with a suspected UTI should be seen by a doctor promptly.

Symptoms of a lower UTI include:

• pain and a burning sensation when you are passing urine
• the urgency and frequency of urinating
• feeling like your bladder is full and you can’t empty it
• pain in the lower abdomen
• funny smelling urine.

Symptoms of an upper UTI:

• fever and chills
• nausea and vomiting
• blood in the urine
• pain in the lower abdomen and back.

Pregnancy can often make you more susceptible to a UTI because of hormonal and physical changes, while diabetics are also vulnerable due to higher sugar levels in their blood. Other factors that increase the likelihood of UTIs are being sexually active, changes in the immune system and structural abnormalities in your body.
Treatment
There are a variety of ways to treat an UTI. Your pharmacist or doctor can provide you with advice and the appropriate treatment options. In most cases a short course of antibiotics is required to treat infection and reduce complications that can come from a UTI.
Pharmacists are now accredited to provide a short course of antibiotics to people with uncomplicated UTIs in women aged between 16 to 65 years without a prescription.
Urinary alkalisers may help to ease symptoms and provide relief from burning sensations. However, it is important to note that the evidence for this use is lacking.
Prevention
Preventing UTIs is easier than you think. There are some simple steps you can take, such as:
·         drinking plenty of water
·         wiping from front to back after using the toilet to avoid transferring bacteria from the anal area
·         not using vaginal sprays or douches
·         urinating after sex to flush away any bacteria
·         not holding it in if you need to use the toilet.


There is emerging evidence that D-mannose supplements can be a beneficial aid in the prevention of UTIs.

If you do not mind cleaning your menstrual aids there are some non-disposable products available that will not result in increased landfill or waste. They do require you to be vigilant in your cleaning and skilled in their use. Often it is costly to purchase these products, but they may be reused over several years, so may work out less expensive than needing to keep purchasing disposable pads and tampons.
Sea sponge tampons can be used as you would use a disposable tampon. They are natural sponges which have been thoroughly cleaned to remove any sea creatures and debris. They are inserted dry and removed as you would a tampon. They should also be changed every four to six hours, and replaced with another dry sponge. You need to thoroughly clean each sponge after use and then boil them in order to ensure that they will not harbour any infection. You will need at least two sponges and they will probably last at least six months. 

Menstrual cups are rubber or latex-based bell shaped devices that need to be folded and inserted into the vaginal canal with the stem pointing towards the outside of the body. Care must be taken to place them so that they collect or stop the flow of the menstrual fluid, which then falls out or is tipped out on removal of the cup. The cup may then be rinsed and reinserted. Menstrual cups come in different sizes, as women that have given birth will usually need a larger cup in order for the cup to remain in place. Menstrual cups, if carefully washed and dried, may last for several years. They should be removed and then reinserted if needed, at least every eight hours, or more often during the day.
You may also use cloths to soak up menstrual fluids. These should be made of soft natural material, such as cotton or other natural fabrics, that are thin yet absorbent. They should be frequently changed, rinsed thoroughly and then soaked in solution similar to baby napkins. This soaking solution needs to be removed by several cold water rinses so you don’t cause skin rashes and irritation to the external vaginal area.
Your community pharmacist can advise you on the appropriate natural menstrual aids, and how you may clean and use them in order to lessen the environmental impact of your menstrual cycle. Most pharmacies have some natural menstrual products and will secure you any products and advice you may need to help manage your menstrual periods.   

Menstrual aids have been used for centuries to soak up the flow of blood from menstrual periods. Since the middle of the 20th century, it has been possible to buy disposable menstrual aids rather than use rags or cloths which needed soaking and cleaning as they were re-used.
Disposable pads used to be secured to the underwear or around the body by pins and ties, but these days are secured to the crotch of the underwear by adhesive strips. Other names for these pads are sanitary towels, pads or napkins. Different brands and ranges have varying degrees of absorbency and shapes (such as ‘wings’ that wrap around the underwear). You can even buy scented or even coloured pads.

​Panty liners are similar and are intended for use on days when the flow of menstrual fluid is light, or when there is light spotting or mucous produced during your menstrual cycle.
Maternity pads are particularly absorbent in order to last longer as the flow of fluid is heavier just after giving birth.
All sanitary pads should be changed every four to six hours or more frequently when the menstrual flow is heavy. The pads may develop an odour after several hours due to the exposure of menstrual fluids to the air. 
Tampons were the next development in the disposable menstrual aids market. These are made of compressed cotton or a blend of cotton and rayon and are cylinders with a cord attached to allow for easy removal.  They are inserted, either with a finger or with the aid of an applicator, into the vaginal canal. They remain there until they are removed by pulling on the cord.
Tampons, like sanitary pads, come in a range of sizes and absorbencies, and should also be changed frequently, at least every eight hours. It may be necessary for you to change your tampon more frequently, or to use both a tampon and a sanitary towel or panty liner, in case of overflow. 
Each tampon should come individually wrapped and be unwrapped immediately before insertion. Once removed, tampons should be disposed of immediately, in either a specific device for sanitary product disposal, or wrapped in toilet paper and placed in the rubbish bin, together with any wrappings and applicators.
All community pharmacies stock menstrual products and can advise you on the most appropriate products you may need to manage the demands of your menstrual cycle. Your community pharmacist will be able to advise you if you have worries or concerns about your periods, particularly if you have noticed any changes or difficulties with your cycle.  

Thrush may be a regular nuisance for some women, while others never experience this infection. If you are taking antibiotics, are pregnant, going through menopause or are on the contraceptive pill you are more susceptible to this infection. But it can easily affect any woman at any stage in their life – many find it unnecessarily embarrassing.
Vaginal thrush (candida infection) is caused by an overgrowth of yeast called Candida albicans. Candida albicans lives quite harmlessly in our bodies until something upsets the body’s natural pH balance. This causes Candida albicans to multiply and symptoms of thrush to appear.
Women, who are HIV-positive, have diabetes or other immuno-compromising conditions, are more likely to experience infections. Some women also get vaginal thrush just before or just after their periods.  Antibiotics can cause vaginal thrush, while tight-fitting pants or underwear made of synthetic fabric, heavily perfumed vaginal deodorants, bubble baths or certain soaps, can also aggravate your body’s normal flora and cause thrush.

Thrush infections can occur in many different sites but vaginal thrush is the most common.  Vaginal discharge changes into a thick white consistency, like cottage cheese.  Other symptoms may include itching, a burning sensation when urinating, soreness around the vagina, or pain during sexual intercourse. These signs all indicate that you may have a vaginal thrush infection.  Your first instinct maybe to scratch, but this will only make the symptoms worse.
However, help is at hand. Community pharmacists are well equipped to diagnose and provide advice on treatment for  vaginal thrush.  They stock a variety of treatments ranging from antifungal vaginal creams to oral medication.  Treatment will vary depending on the person. Ask your pharmacist about the best options for you.
Thrush can be prevented by ensuring your body is in peak condition. Try to steer clear of stress and don’t let yourself get run down. You can also:

• avoid deodorised panty shields, bath products etc.
• wear loose underwear and avoid tight clothing.
• after urinating wipe from the front to the back.

If you are experiencing your first vaginal thrush infection you need to see your doctor. Symptoms such as green discharge, pain in your stomach or an unpleasant smell, can indicate something more serious and you should see your doctor as soon as possible.  ​

Every woman’s experience of menopause is different. And whether you suffer from hot flushes, mood swings or sleeplessness, this “change of life” does not have to mean the end of your way of life.
Menopause is the natural process of your periods becoming irregular and eventually stopping. This means your body has ceased preparing every month for pregnancy - your ovaries stop releasing eggs and your hormone production decreases.
How do you know if you are going through menopause? The symptoms for menopause are varied and vast. You could experience any or all of the following symptoms:

• ​hot flushes
• night sweats
• irregular periods
• loss of libido
• vaginal dryness
• mood swings.

Other changes during menopause may include fatigue, hair loss, sleep disorders, dizziness and weight gain. As bones can get thinner due to hormone changes, some woman are also at risk of developing osteoporosis. Talk to your community pharmacist about managing the possibility of weakening bones.

Many women do not seek treatment for menopause but those that do often experience severe symptoms. Hormone replacement therapy (HRT) is the most common treatment and comes in the form of tablets, creams, patches and implants.
Menopause is generally manageable if you make a few adjustments to your lifestyle. Ask your community pharmacist for advice which may include:

• sticking to a health diet
• getting plenty of exercise
• doing weigh-bearing exercise
• avoiding stressful situations
• getting enough sleep
• stopping smoking
• not drinking coffee, or exercising, before you go to sleep
• sleeping in a well ventilated room
• using lubricant during sex.

It is also critical that you get support from your family and friends during menopause. Their help will assist you during this change in life. Menopause can be managed with the help of health professionals, talk to your community pharmacist about the appropriate treatment options for you.

Years ago it was taboo to talk about erectile dysfunction but thankfully attitudes have now changed. Although some patients may still find it embarrassing to talk to their health care professional about sexual issues, getting help for erectile dysfunction is worth the effort. This is a condition that cannot be taken lightly especially as it can be a sign of a more serious health problem.
Erectile dysfunction occurs when a man is unable to maintain an erect penis sufficient for satisfactory sexual intercourse. It also occurs when sexual stimulation or arousal does not result in enough blood flow to the penis which leads to an erection . This condition only affects men and is more likely to increase with age. Erectile dysfunction is often confused with impotence – this term is used to describe other problems that interfere with sexual intercourse and reproduction, such as lack of sexual desire and problems with ejaculation or orgasm.
This condition is often hard to measure as men are less likely than women to talk about physical conditions as they find it uncomfortable. Erectile dysfunction may be as a result of psychological or physical reasons but either way this condition is distressing. It could lead to a loss of confidence and self-esteem or depression, as well as relationship problems.
Physical reasons for erectile dysfunction could include the following:
•    Cardiovascular disease
•    Nerve damage (which is common in men with diabetes)
•    Brain and spinal injuries
•    Smoking
•    Fatigue
•    Excessive intake of alcohol
•    High cholesterol which narrows the blood vessels.
Psychological reasons for erectile dysfunction could include:
•    Stress
•    Relationship problems
•    Depression
•    Existing values and attitudes to sex
•    Anxiety
•    Intimacy problems
•    Guilt.
But help is available and the condition is totally manageable. 

Erectile dysfunction is treatable at any age and awareness of this fact has been growing. More men have been seeking help and returning to normal sexual activity because of improved, successful treatments.  But first off you have to recognise there is a problem and then talk to your health care professional about treatment solutions. Treatments, especially oral medication, can help relax the blood vessels which then allow the penis to become filled with blood resulting in an erection.
Treatments can include:
•    Vacuum treatment (a physical device to be used prior to sexual intercourse)
•    Counselling to help identify psychological reasons – it is also a good idea to involve your partner
•    Hormone treatment
•    Oral treatments like Sildenafil (Viagra),Tadalafil (Cialis) or Vardenafil (Levitra).
Although there are treatments for erectile dysfunction, it is also a good idea to look at making changes to your lifestyle. Ask your community pharmacist about ways to cut down on alcohol, to stop smoking and to reduce stress.

Toxoplasmosis is a condition that can be transmitted by cats. It is caused by a parasite that lives in the faeces of cats, so it usually only occurs when handling cat faeces, such as changing cat litter trays. Young children may also catch this parasite after playing in soil that may have been contaminated by cat faeces. It may also be present in meat from animals that have been exposed to cat faeces.
Generally toxoplasmosis is not dangerous, unless you are pregnant. It can cause birth defects in the unborn child, or when you have lowered immunity, such as those undertaking chemotherapy.
Those infected with this parasite may develop aches and pains, and may develop swollen lymph glands, for example in the armpits or groin.  The parasite may result in damage to the eyes or brain in those affected.

However, most infestations are minor. A pregnant woman may not realise that she has been affected by this condition, so must be extra careful to avoid being affected if around cats. The first sign that she may have been affected is often the premature delivery of her baby who may have damaged eyes, ears or nervous system.
The only treatment for those that are severely affected by toxoplasmosis are medicines normally used to prevent malaria. These are not widely used in pregnant women unless there is clear evidence that their use is essential.
Pregnant women, or those wishing to become pregnant, are advised to prevent potential toxoplasmosis by avoiding exposure to cat faeces. They should avoid emptying cat litter trays or gardening without gloves in areas where cats are known to live or use as a toilet. All meat should be thoroughly cooked, and all food preparation areas and equipment washed and cleaned if in contact with raw meat.
Pregnant women do not need to avoid all contact with cats, but should wash their hands thoroughly after handling any cat or other items that may have been in contact with cats before they eat or drink.
Consult your community pharmacist for advice about toxoplasmosis.  They can advise you on how you may continue to enjoy the benefits of cat ownership and companionship without exposing yourselves to the unnecessary risk of contracting this or other conditions from your cat.

Stress incontinence occurs when urine leaks out of the bladder due to physical activity, coughing, sneezing, or laughing.  It is not confined to leaky old ladies but can occur in men and women, and in the young as well as the old.
Control of the urge to urinate generally occurs before the age of seven. Children older than seven that still suffer from incontinence should see their doctor to rule out any condition that may be causing this.
Deterioration in bladder control, such as stress incontinence, usually occurs in women, particularly after childbirth; but may also occur from chronic coughing from as poorly controlled asthma or smoking, heavy lifting, constipation, obesity, and advancing age, as our muscle control becomes less efficient. It may also arise from surgery to the prostate gland in men.

The bladder can hold up to about 500ml of liquid, and this remains in the bladder until the valve, or sphincter, relaxes and allows the passage of urine at unintended times.
The cause of incontinence should always be determined by your doctor.  This embarrassing condition affects many, and treatment options generally offer good control of urine flow to normalise activities and improve bladder control.
Women with stress incontinence are generally advised to do pelvic floor exercises to strengthen the muscles supporting the bladder. It is advisable for women to undertake these simple exercises at all stages of their life.  Other exercise regimes to strengthen this area include Yoga and Pilates.
Talk to your community pharmacist, they can give you advice on exercises to help relieve this condition, discuss some potential causes, aids and treatments for you, and ensure you are referred to your doctor to seek help to relieve this condition.

Multiple Sclerosis is commonly abbreviated as MS. It is a condition that affects the nerves of the body and eventually affects the brain and spinal cord. The coating of the nerves deteriorates with MS, and as a consequence impulses no longer travel along the nerves as efficiently as before developing the condition. The nerves become damaged as a result, and this is called sclerosing, or scarring. The ‘multiple’ means that more than one nerve is affected by the scarring.
The exact cause of MS is unknown, but the condition is called one of the ‘auto immune’ diseases where the body appears to fight itself. MS is more common in people exposed to some risks, such as smoking, and it appears to be more common in those people who have relatives who have had the condition. Other risk factors, such as stress, diet and solvents, have not been definitely proven to be the cause of MS, but it is always helpful to avoid these if at all possible.
Symptoms of MS are often vague, so often the condition may be present for some time before definitely being diagnosed. However, at least half of those with MS complain of visual disturbances, memory loss or difficulty concentrating, limb weakness and tingling or muscle spasms causing some difficulty coordinating movement.

Absolute diagnosis generally follows an MRI (magnetic resonance image) scan, and examination of the fluid in the brain and spinal cord, so is not undertaken lightly. These diagnostic tests are either expensive or rather unpleasant, and are only undertaken when there is likely to be clear benefit from testing.  
The major benefit of a diagnosis of MS is ruling out other more sinister conditions. An acute attack or worsening of multiple sclerosis attack is generally treated with oral steroid therapy. This hopefully prevents further damage to the nerves, and helps the sufferer to recover more quickly.  Other treatments are used that will modify or prevent the disease worsening, lessen the intensity of an acute attack, or try to speed the recovery from an attack. The most commonly medicine used as a disease modifier is Interferon, which often causes influenza-type symptoms, so is not always suitable for everyone.
Most people with MS have a decreased quality of life as a result of the condition, or because of the side effects of treatment, but may live with the disease for many decades.
If you or someone close to you is diagnosed with multiple sclerosis then talk to your community pharmacist. They can give you advice about best use of medicines to treat multiple sclerosis. They can also advise and supply you with aids to help manage activities of daily living, to allow independence and an active life for as long as possible.