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Medical MattersNever FEAR the SMEAR!Dr Cath Hughes dispels the myths and reminds us that having a smear can potentially save your lifeDoes this sound familiar. Are you anything like me, an envelope arrives - is it a bill, a cheque (OK, an outside chance!) The dentist - you need a check-up? Oh no, it's at least 50 times worse - your cervical smear is due. How can 3 years possibly have passed since the last one? (or less, if you've been unlucky). Oh no, I've got to make an appointment, and then, I know when I get there, I've got to take my knickers off. It all seems like too much to bear! (bare!).More often than not, my patients arrive and then say "I really hate this".My response - "if you liked it, I would think you are seriously weird!" Cue laughter (I hope).Cervical smears are worth the bother! They are 'bother savers'- they are going to prevent you having more serious bother in the future. The whole point is to prevent more serious things developing, saving you time, energy, worry, and emotional exhaustion having treatment, and giving you longer life. For me, the difficult thing to understand is how screening procedures work- how do we work out when to start, how often and when to stop? Different countries have slightly different protocols - the Australians start much younger, and have more regular smears, our American friends are even more zealous, other countries start later, and have longer recall times, and there are a lot of differences in stop times. There are even differences between England and Wales. The debate will probably continue for ever between the boffins of cervical screening, but for regular ordinary people like me and you, my advice 88Network She I Autumn/Winter 2012Originaly from the North East Dr Cath Hughes qualified in 1986 from Westminster Medical School, London. A full time GP in Llanfairfechan and formally Staff Grade in GUM in North West Wales for more than 10 years, giving it up because "I had too much to do, not because I didn't like it". Cath is married with three grown up and lovely step children, and three step grand daughters (and counting!). She confesses to "Always wanted to be a rock star but never quite made it". Dr. Cath Hughes

www.networkshe.com89Medical MattersOk so you do have to bare your nethers, but it's a very short and painless procedureDear Zoe,There are lots you can do together to get your 'Mo-Jo' back. Be assured this is a common problem in long-term relationships. I see you said what can I do, in reality, in a relationship no one person 'owns' the problem, so it's always best to seek help as a couple. You say you are well, but it's worthwhile seeing your GP to rule out any physical cause. If there is no physical cause for your lack of sex drive, then we have to consider other reasons, this is where it becomes trickier to tease out the reasons why women (and men) go off sex. Basically there are two fundamental causes: the relationship or the sex! (often it's a combination of both). Ask yourself two simple questions - 1) Do I still love or fancy him? 2) Is sex fulfilling? If the answer to question one is 'No' then it makes sense that you won't find sex with a person you no longer care for exciting, or fulfilling. If the sex leaves you unfulfilled despite your affection towards your husband then you must seek the help of a sex and relationship therapist. They can advise and guide you through a sexual growth programme and an exercise called Sensate Focus, designed to reignite the old flame you once had! No guarantees but it's always worth trying (and it's fun!)Revive your driveDear Dr. Edna,I seem to have lost my Va Va Voom in the bedroom, we laughed it off at first as 'just one of those things' but I can't get it back. We've been married fifteen years, are both fit and well, have two beautiful children and although sex wasn't everything in our relationship, it was great when it happened! We are getting upset about it now. What can I do?Zoehas to be to turn up when you are invited. Let them worry about the minutiae.OK, so you do have to bare your nethers, but it's a very short and painless procedure. We do not, and never have, used metal clamps, contrary to popular belief. Speculums, (the technical word) are plastic, come in various sizes, and can be warmed up if thought necessary. They are specially designed two piece hinged "tubes" that are inserted into the vagina, and opened gently so that we can see the cervix, which is the bit of the anatomy that we want to sample. If you have never had sex, it is not necessary for you to have a smear, so don't worry. (I know, I know, there will be somebody out there who will be the exception that proves the rule). We are bombarded by health care advice from all sides, me included, and my closing comments are personal, and probably not shared by all my colleagues. Illness is indiscriminatory, and however hard we all try to live a healthy life, illness strikes in the least expected places. Our screening procedures are designed to be the best with the information available they are not infallible and are designed to reap maximum benefit, to maximum numbers, with the added remit of trying not to cause anxiety. Having a smear can potentially save your life, remember, we are not looking for cancer, we're trying to prevent it. Waiting for the result is always anxiety provoking, but better than not having a smear at all. So, next time you get the invite, shout "whoopee, I'll be there!"Or maybe, just turn up.Dr Cath Hughes and Sex Therapist Dr Edna Astbury-Ward are unable to enter into correspondence other than through this feature, please send your questions to, Medical Matters, Network She, PO Box 142, Llandudno, LL30 9BL or email magazine@networkshe.co.uk. Should you have serious concerns or an acute condition we urge you to seek immediate medical advice from your own doctor.Sex therapist Dr Edna Astbury-Ward gives advice on how to get your Mo-Jo back in the bedroom.