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Some women have contraindications to HRT. This means that they have conditions which may be worsened by taking it. There are not many, but they are fairly important. It has been recommended that women who have had proven breast or endometrial (lining of the uterus) cancers should not have HRT. This is because these particular cancers can be hormone sensitive, so oestrogen may accelerate their growth.

Women who have certain liver diseases are advised against taking oestrogen. Progesterone alone is sometimes used to help control symptoms in women who cannot take oestrogen.

The side-effects of HRT. Women do quite often experience some side-effects, particularly when starting HRT a few years after menopause. The most common oestrogen-related ones include breast and nipple tenderness, nausea, headache, leg cramps, bloating and fluid retention, and weight gain (usually 1 or 2 kilograms, sometimes more in women who are overweight to begin with). The progesterone component can give similar symptoms, and a premenstrual syndrome feeling during the time it is being taken. Most of these symptoms subside within a couple of months, and may also be alleviated by a dose adjustment.

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The new methods of contraception: vaginal rings, contraceptive patches, combined injectables, male hormonal contraception and a new kind of hormonal contraception for women called anti-progestins.

What is a vaginal ring? A vaginal ring is a donut-like ring of silastic, which is a type of soft plastic, containing hormones. It is about 5.5 cm in diameter. The ring is placed in the vagina to prevent pregnancy.

How does the vaginal ring work? The vaginal ring contains hormones like the ones in contraceptive pills, but instead of having to be taken as a daily pill, the hormones are slowly released into the woman’s body through her vaginal skin. Vaginal rings will be available with either the combined hormones, oestrogen and progestogen, or with progestogen only. The hormones act in the body to prevent pregnancy in a similar way to oral contraceptive pills.

How effective is the vaginal ring? The combined vaginal ring will be as effective as the combined oral contraceptive pill and the progestogen-only ring will be as effective as the progestogen-only pill. They might be even more effective, because you don’t have to remember to take them every day.

Why would I want to choose the vaginal ring? A vaginal ring could be suitable for you if you like the oral contraceptive pill because it is so reliable, but have trouble remembering to take the Pill every day (or even if you have trouble remembering to take the Pill at the same time every day). It might be an alternative for those people who find it hard to swallow tablets. The vaginal ring could also be a good alternative if you have an illness that stops you absorbing medications from the gut. If you use the Pill and it’s not absorbed into the body very well, the hormone level may not be high enough to stop a pregnancy from happening. Whereas with the vaginal ring, the hormones do not go through the digestive system, but are absorbed into your body through your vagina.

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As its name implies, emergency contraception is meant to be used in an emergency. It is something that is designed to prevent you from becoming pregnant if you have sex and then realize that you were not protected.

We’ve already talked about using emergency contraception if your usual method fails. If your diaphragm or cervical cap gets a little hole or tear in it, or it moves out of place, or a condom breaks or slips off, you may want to use emergency contraception. There may be a time when you completely forget to use contraception. No matter how it happens, you have the choice to use emergency contraception, but you need to use it fairly quickly. It is more effective the sooner it is used after you have had unprotected sex, and it must be used within a few days.

When we talk about emergency contraception we usually mean a special dose of oral contraceptive pills. Having a Copper IUD inserted is also considered to be a method of emergency contraception, although it is rarely used.

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How long does the implant last? Implanon has been designed to last for three years but you can have it removed whenever you like. After three years, if you want to keep using an implant as your method of contraception, you can have a new rod inserted when the first one is removed. If you don’t want to continue with Implanon and you don’t want to be pregnant you will need to start using another method of contraception right away because most women find their fertility returns very quickly, usually within a month.

How is the implant removed? Removing the implant is very simple. You will have another injection of local anaesthetic to make the area feel numb, so it will not hurt The doctor palpates the implant, which means they move it using their fingers, up to the surface of your skin. They nick the skin over the end of the implant with a scalpel and the implant will slide out with a little pressure. After it is removed you will have another pressure bandage over the area so it won’t develop a large bruise.

What does an implant cost? Implanon is on the Pharmaceutical Benefits Scheme (PBS) in Australia and it is available to women with a current Medicare card for about $20 to $25. If a woman has a Pharmaceutical Concession Card she will only pay about $3.50. The doctor or Family Planning Centre may also charge a fee, in addition to the Medicare fee, to insert the implant This fee will vary from doctor to doctor so be sure to ask about this when you are discussing the implant at the first visit

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In her day, Margaret Thatcher was said to have developed a unique method for overcoming the ‘men’s room syndrome’. This is a syndrome which excludes women. It occurs when males use the relative seclusion of the men’s room to lobby, exchange views or collude with one another in the absence of female opposition.

Female executives in the United States complain that a board meeting can be well on its way to reaching agreement when someone suggests a break. In the break the men go off to the cloakroom. When they return, the meeting takes a new direction. This is the syndrome at work.

Thatcher’s solution, it is said, was to make her cabinet ministers ask if they could leave the room. She would then only grant permission for them to go one by one.

There is just no female equivalent of the men’s room. In women’s rooms, cubicles ensure modesty and privacy. At no point in their lives are women expected to stand shoulder to shoulder with one another and relieve themselves publicly. Yet men do it all the time. The urinal is a very open, trusting sort of place, and one that men have fought to preserve grave jeopardy. This prompted the Sydney City Council to consider redesigning future public lavatories to eliminate the common urinal. There was an outcry.

In its editorial, the Sun newspaper argued that urinals should stay because they were open. It warned that replacing them with cubicles was more likely to produce ‘incidents’ because of the privacy these provided. ‘In many parts of Europe the lavatories are so public that any act of indecency or suggestiveness is practically ruled out it said.

Urinals were under threat again in the 1980s. With the new climate of equal opportunity, there was concern that this exclusively male facility was not ideologically correct. At one point the Urban Transport Authority proposed installing ‘uniloos’ at its Port Botany depot.

This unwelcome proposal stirred the male editorial writers at the Sydney Morning Herald. They wanted to know exactly what would happen to the urinals. ‘Will this last bastion of male separatism have a place in the uniloo scheme of things?’ they asked.

When the Western Australian equal opportunity lobby took up the cause and insisted urinals be removed from all boys’ toilets in State schools, the response from the then WA Health Minister, Mr. Taylor, was brief. ‘Bloody ridiculous,’ he said.

Urinal manufacturers dismissed it as ‘absolutely crazy’ and noted that boys were more likely to suffer psychological damage if they left school unprepared for the experience of using a public urinal.

The use of public urinals is governed by strict etiquette. A certain decorum is expected, except, of course, at places like football stadiums where there is high-volume use and an alcohol factor at work. The men’s room at a football match can be a rowdy, unhygienic place.

But, in general, men say urinals are as quiet as churches. Two primary rules are ‘don’t look’ and ‘don’t make chitchat with strangers’. Looking straight ahead or looking up (as people do in lifts) is acceptable. Some men head for the comer because it feels safer, some try not to touch anything (they open the door with their foot), and some just stand there unable to let go.

This difficulty with letting go in public has been called the ‘bashful bladder syndrome’. Researchers say one way to overcome it is to do exponential equations. The man becomes so involved in the equations that nature takes over and before he knows it, his mission is complete.

Perhaps such men would cope more easily at individual wall-hung urinals. Steve Cummings from Caroma Industries, the makers of these urinals, says they are more user-friendly, more aesthetically pleasing and cleaner than slab urinals.

The trend these days is for hotels and office blocks to use individual urinals. However, venues anticipating large crowds still opt for slabs.

But never think that individual urinals are an attempt to reduce the essential openness of this communal male activity. Cummings says they afford no extra privacy. In Japan, for example, individual urinals have wings or side shields which, he says, do nothing more than create an illusion of privacy.

When George Freedman designed the men’s room at Bilson’s restaurant at Circular Quay, Sydney, he positioned mirrors so that a man standing at one wall-hung urinal could quite easily view the man at the neighbouring one without being detected. ‘Many men I know have come out of there saying, “Now that is an amusing toilet”,’ Freedman said.

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