Why codeine is addictive

Why codeine is addictive, by ex-pharmacy chief


A Community Pharmacist and exChairman of Association of Community Pharmacists of Nigeria, Lagos State branch, Aminu Abdulsalam, shares some insights with OYEYEMI GBENGA-MUSTAPHA on codeine regulation by the Federal Government. Excerpts:

The Federal Government recently streamlined production and access to codeine cough syrup because of high rate of abuse, what is your view on this?

The way the Minister of Health announced the ban of codeine was not appropriate. Codeine is in the World Health Organisation’s model list of Essential Medicines as an important medicine to be provided in all basic health system. Codeine had been in use for a very long time. Therefore; the problem is not about the availability of codeine, but mainly about the chaotic drug distribution system that predisposes vulnerable people to substance abuse.

I was expecting the Minister to use the opportunity provided by the codeine abuse saga to address the chaotic drug distribution system, which is fundamental to medicine abuse and misuse in Nigeria. We all know that addiction to any substance does not develop overnight, and addiction is not a matter of choice, but a matter of process. Therefore, banning any form of codeine preparations is not a solution to the problem of abuse. It is a well-known fact that there are many banned substances that are still in circulation in medicine distribution chain. As long as the demand is there, and our distribution remains in chaos as we currently have, illegal supplies will find their way to all the illegal drug markets across the country.

How do you think the minister should have handled the matter after the BBC report?

Rather than just placing blanket ban on codeine cough preparations in Nigeria, I expected the Minister to first place a temporary suspension of dispensing use, sales, importation and manufacture of codeine cough syrup so as to pave way for thorough investigation by the relevant regulatory agencies; this should be followed by inventory of the codeine preparations in the value chain. The inventory should include those raw materials already on the way to Nigeria from overseas after the approval has been given. Then a stakeholder forum called, made of representatives of all stakeholders in the distribution chain to brainstorm on the issue and proffer solutions to the problem. The outcome of such forum could have perhaps produced a more objective solution that could save the nation from further embarrassment of such international dimension. The pronouncement of the minister was just an emergency save-face approach which does not solve the problem.

Can you shed more light on what codeine is?

Codeine belongs to a class of drugs called opiate because it was derived from opium poppy plant. It is in the same class as morphine, which is highly controlled, heroin and opium which are classified as illicit or illegal drugs. Codeine is also in the class of Narcotics because it depresses the central nervous system, like other narcotics, it slows down the messages travelling between the brain and the body. Codeine is in the World Health Organisation’s model list of essential medicines as an important medicine to be available in all basic health system. It is considered to be the safest and least addictive among the opiate drugs, which accounts for its being the most widely used medicine within this category of pain killers. Codeine has been in use in Nigeria for a very long time.

Under what condition is codeine useful?

Codeine is a very old medicine. It has been used effectively to treat mild to moderate pain, severe pain when combined with other pain medicines, like paracetamol and ibuprofen. Codeine presented as cough syrup suppresses a dry irritating cough. But we have to know that cough is usually a symptom of underlying disorder, such as asthma, gastro esophageal reflux disorder, and chronic obstructive pulmonary disease, to mention a few.

Where there is no identifiable cause, cough suppressant like codeine cough syrup may be useful, especially when sleep is disturbed. It is important to know that the advantage codeine has in stopping one’s cough can also be seen as its danger, since cough reflex is there for clearing the throat to allow for unrestricted breathing. When this reflex is suppressed unnecessarily through the abuse of codeine, one runs the risk of suffocation during sleep or when lying down on bed. It may also cause sputum retention and this may be harmful to patients with chronic bronchitis, asthma and other related disorders. Codeine has also been used to treat diarrhea. Please note that codeine is relatively safe on the condition that it is used as recommended by qualified healthcare providers.

You said codeine had been in use for a long time, why has it become so bad to have necessitated its regulation by the Federal Government?

As stated earlier, codeine will continue to be of benefit to the users only on the condition that the users adhere strictly to the official recommendation by qualified healthcare providers. Unfortunately, many Nigerians have formulated other benefits that are turning codeine against their own health through abuse. One would not have problem with codeine if used at the recommended dosage, frequency and for a specified duration. It is now evident that the global epidemic of opiate abuse is very much with us, because many Nigerians are now using codeine habitually, not for the treatment of any identified disease but rather to alter mood, consciousness and body functions unnecessarily.

This habit constitutes drug abuse and it is a self-damaging habit, which could lead to tolerance, dependence and addiction. Apart from these, it could also lead to serious physiological injuries, such as damage to body’s vital organs, like liver, kidney and heart or psychological harm such as dysfunctional behavioral pattern and or death. This situation is so bad, apart from the international embarrassment from the documentary on the abuse of codeine.

Substance abuse in Nigeria is now known to be playing significant roles in many social problems, such as drug driving, insurgency, kidnapping, armed robbery, child abuse, rape, loss or missed works and schools, homelessness and other criminal activities. Therefore, there is need for action to save the future of the youths of this country. However, outright banning is far from being the solution.

How tolerance, dependence and addiction are related to drug abuse.

Substance abuse disorder is not a matter of choice, but of process. It is a chain of reactions with one process leading to another. When one keeps taking codeine repeatedly, it can lead to tolerance. Tolerance is said to have developed if there is decrease in response to drug after repeated use. That is, higher dose would subsequently be required to achieve the same effect, leading to taking overdose and consequently toxicity, organ damage and possibly death.

Dependence on drug use is an adaptive state, which develops from repeated drug use, leading to withdrawal effects if the use of such drug is stopped without medical supervision. That is to say, individual who depends on drug would subsequently need one or more drugs to even function normally. After tolerance and dependence, if there is no effort to manage the situation, it will lead to addiction, which is a very serious disease state. Addiction is a compulsive out-of-control drug use despite the negative consequences. Note that craving or intense feeling of compulsion to use a drug is the dividing line between addiction and dependence. An addict can do anything to get the drug he or she is hooked on.

Why is codeine so addictive?

Codeine is said to be the least addictive among the opioids. However, regular use of any product containing codeine in whatever form, tablet or syrup is as dangerous as regular use of illicit drugs like heroin or any other opiate drugs, the difference being that it might take a longer period of continual use of codeine to become addicted compared to heroin. But once addicted, the withdrawals and the road back to where one was before starting the use of codeine is usually arduous and painful and to have successful outcomes, it usually requires professional rehabilitation.

The answer why opioids are so addictive is said to be in human brain. Opioids are known to activate several brain reward systems, including one that motivates a person to take more of the drug. The motivation to take more of the drug is the euphoria associated with the use of the drug. Euphoria is an overwhelming feeling of happiness, satisfaction, joy and a state of wellbeing. People experiencing euphoria may feel care free, safe, bold, confident and free of stress. This emotion can either be a normal reaction to happy events, like sex, delicious meal, achievements, etc, or symptom of substance abuse.

But because we all want to feel good at all time, users get into the habit of taking the drug repeatedly. At the same time opioids cause changes in another part of the brain that limits a person’s ability to stop taking the drugs. The limiting factor here is the uncomfortable withdrawal effects when users attempt to stop taking the drug. Anxiety, profuse sweating, sleeplessness, rigour, pain, tremor nausea, diarrhea, hallucination, psychosis, suicidal and homicidal tendency are some the uncomfortable withdrawal effects that may put the users under compulsion to go back to the drug.

When these two brain processes work in combination, that is, the motivation to take more of the drug in one part of the brain and the limit of person’s ability to stop taking the drug in another part of the brain, the effect is like hitting the accelerator in a car-without having any brakes. A person addicted to codeine feel intense urge to take it again, and also has a hard time resisting that urge.

The longer someone misuses codeine and other opoids the higher the chance of it taking over the chemistry of one’s brain and the less self-control one will have; it gets more and more difficult to resist taking the drug, or to follow through on a resolution to quit. The drugs diminish the person’s ability to make a different choice. Taking the drug becomes a priority and even linked to survival. The brain of such addict is like a car that, besides having no brake, has a steering wheel that works poorly or doesn’t work at all.

Considering all you have said about codeine, what is your advice on its use?

One should always use codeine as prescribed by the authorised healthcare providers because it is an opioid can affect a person in such negative ways to the extent of ruining a bright and promising future, permanent disability and untimely journey to the grave. It is also important parent monitor their children lifestyle and closely mark their relationship with their peers, and report any strange behaviors of their children.

You have said so much about the addictive properties of codeine and the likes, is there any other side of codeine that is important for the public knowledge?

Like many other drugs, codeine is associated with various adverse effects, especially when abused or when an overdose is taken. The common adverse effects associated with the use of codeine apart from euphoria include constipation, urinary retention, respiratory depression, diminished sexual drive, and apathy and memory loss. Respiratory depression (not being able to breathe) is a potentially serious adverse effect. This effect is said to be dose related and potentially fatal consequence of over dose.

Those who abuse codeine cough syrup are also at risk of over dose of other non-addictive components of the preparation which put the vital organs to damage. While it is an effective cough suppressant at low dose it is said to be a weak pain reliever, and needs to be converted to morphine in the liver of the user. According to a report, morphine is responsible for the pain relieving and the euphoria effects of codeine. The report indicated that there is genetic variation in the individual ability to change codeine to morphine. On one side, there are those in the population who have innate ability to change codeine to morphine rapidly, those are more predisposed to codeine toxicity within a short time. At the other end, there are those who are naturally very slow in changing codeine to active morphine, such people are less likely to develop toxicity within a short time of use. Therefore, reactions to codeine abuse vary from individual to individual. In order words, your brother may develop sign of toxicity very much earlier than you, even if you were exposed to the same dose at the same time if your brother is a rapid metaboliser.

It is expected that drug with such a high potential to cause injury to users should be strict controlled. It is obvious there is no adequate measure to control its use…

Honestly, there are adequate control measures in our system to prevent or reduce the extent of abuse of drug. Unfortunately, the problem is poor implementation or enforcement of those measurers. One of the measures was the establishment of the National Agency for Food and Drug Administration and Control (NAFDAC) by Decree 15 of 1993, NAFDAC ACT CAP N1 Laws of the Federal Republic of Nigeria, 2004. The agency is responsible to ensure that foods, drugs, cosmetics circulating in the country are of good quality and safe, and to ensure that all regulated products are used rationally in our communities.

Nigeria is a party to many treaties under various international conventions to regulate the use of narcotics and control substances. The treaties under the various International Conventions are aimed at combating drug abuse by a co-ordinated international action. It is expected that each party gives special attention to substance abuse and take all practicable measures for the prevention of drug abuse and for the early detection, treatment, education, after-care rehabilitation and social integration of the persons involved. NAFDAC is the agency saddled with the responsibility of ensuring that Nigeria fulfills all the control obligations under various international drug control conventions. Unfortunately, there was a square peg in a round hole, as arrowhead, which caused a very serious setback to the good left behind by the late Prof. Dora Akunyili. What we are experiencing today on drug abuse could be a fall out of wrong appointment into the agency, which spanned close to 10years. Honestly speaking, it is quite dangerous to appoint a wrong person into an agency responsible to safeguard the health of the people. However, the current government must be appreciated for correcting the wrong appointment by recently appointing a highly qualified professional person, a pharmacist to the position of the Director-General to lead the agency once again.

There is also the Pharmacists Council of Nigeria (PCN) established by Decree 91 of 1992, now PCN Act Cap P 17. Laws of the Federal Republic of Nigeria, 2004, charged with the responsibility of ensuring that only certified and licensed persons and premises engaged in manufacturing, importation, distribution, sales, and dispensing of medicines.

The National Drug Law Enforcement Agency (NDLEA) established by Decree 48 of 1989, now Act of Parliament to enforce laws against the cultivation, processing, sale, trafficking and use of narcotic drugs and psychotropic substances and to suppress the demand for illicit drugs and other substance of abuse.

The revised National Drug Policy document of 2005 is comprehensive enough to address many of the problems if implemented. Unfortunately, most of the expectations were unrealised due mainly to lack of political will by the past governments and the absence of a well-structured monitoring system.

Government needs to fund and give all the agencies maximum power to enforce the relevant laws. Adequate funding and collaboration among the relevant agencies can make our lot better. It is important that each agency must have adequate power of enforcement. There is the saying that a ‘chain cannot be stronger than the weakest of its links’.

We have heard that chaotic drugs distribution and sales in the open market are responsible for the circulation of fake drugs, irrational drug use and abuse, why has the situation not been addressed?

Acknowledging the fact that the drug distribution system in Nigeria was in chaos and portends serious negative consequences, the Pharmaceutical Society of Nigeria (PSN) has a very long history of tackling the Federal Government to address the distribution problem in Nigeria.

It was not until 2009, when the call for structured medicines distribution in Nigeria by PSN was heeded to, and the process of developing the National Drug Distribution Guidelines commenced as a collaborative effort of the Federal Ministry of Health, Presidential Committee on Pharmaceutical Sector Reform, almost by all the relevant stakeholders in the industry. By the first quarter of 2011, the committee had produced very comprehensive drug distribution guidelines, acknowledged to be well researched and with very broad scope of consultation.

The main attraction of the guideline was that drugs would no longer be hawked, sold in cluster, market places or by unqualified persons, all inconsonance with the National Drug Policy. The guidelines put orderliness in drug distribution in Nigeria. According to the document, the implementation of the guideline was to commence in July, 2012.

While the National Drug Distribution Guideline had gone through several reviews after its production in 2011, the light of implementation has been dimmed by the government persistent lack of political will to address the problem. Between 2012 to date, the goal post of implementation flag-off had been shifted four different times. When 2012 failed, 2014, 2015, 2017 were all target dates of implementation of the guidelines, but respectively, no implementation took place. The new date of flag-off, according to the Minister of Health, is January next year. It is our hope that the new date would be a reality.

Sequel to the BBC documentary on codeine abuse in Nigeria, the senate responded promptly by proposing two bills; Mental Health Bill to establish National Council for Mental Health and Substance Abuse Services and National Drug Control Bill to establish National Council for the Regulation of Control Substances. Do you think such agencies can solve the problem of drug abuse in Nigeria?

We must appreciate the senate for promptly coming up with two bills to tackle the problem. However, as I had mentioned earlier, we already have a system in place to tackle the problem. What the government needs to do is to adequately fund all the relevant agencies: Pharmacists Council of Nigeria (PCN); National Agency for Food and Drug Administration and Control (NAFDAC) and National Drug Law Enforcement Agency (NDLEA) and encourage effective collaboration among the relevant agencies.

Information available is that these agencies are operating far below capacity, as a result of poor funding. Establishing two agencies at the sametime under the Federal Ministry of Health where the existing ones are not adequately funded can be a misplaced priority. The government should also implement all the relevant health and drug policies, including the National Drug Distribution Guidelines.The journey to drug abuse free society starts from a well-structured drug distribution system.

Health benefits of bitterkola

Benefits of Bitterkola

by Nwokorie Jennifer

Bitter kola also known as Garcinia kola is a specie of flowering plant in the Guttifeae family. It has been used for centuries in “Folk medicine“ to treat aliments from fever and cough.

According to report from the Center of International Forestry Research, Bitter kola trading is still important to the tribes and villages in Nigeria. It is used by African medicine.

The seeds are used for treating cough, fever, head and chest colds, throat infections etc.

Bitter kola has many benefits which most people are not aware of.

Some of these benefits are:

1. It improves the functions of the lungs: Bitter kola helps to treat chest cold and asthma. It also stabilizes the other counter effects in the system and helps to increase immunity level, thus making the lungs perform well.

2. It fights Glaucoma: Glaucoma is a condition of increased pressure within the eyeball which can lead to loss of sight. It could lead to permanent blindness if not treated early. But, Bitter kola has been found to be the cure\remedy for the eyes. When Bitter kola is taken often it helps to reduce the eye pressure. It also improves the clarity of the vision.

3. It improves Sexual Impotence: Bitter kola improves the sexual performance in men. Before sexual intercourse you are to take at least two or more Bitter kola.

4. It fights against STDs: Sexual Transmitted Disease (STD) is a dangerous disease that is contracted through Sexual Intercourse. This disease can be transmitted through passing of blood or other bodily fluids and sharing of sharp objects. But here, Bitter kola have serve as a medicine that will fight against STD. It also cleanses the effects, and enhances the function of the liver and gall bladder. Is seen as the anti-bacteria fighter.

5. It is an anti-malaria agent: Bitter kola helps to fight against malaria in the system. Bitter kola has some chemical constituent that fights and make the system healthy.

Credit: The Nation

Managing mental health issues

Managing mental health issues

By Geraldine Akutu

Experts say one of the biggest challenges facing mental health in the country is stigmatisation, low level of knowledge and awareness regarding mental health. President, Resident Doctors’ Association at Neuro-Psychiatric Hospital, Yaba, Dr. Raliat Akerele in this chat with GERALDINE AKUTU, enlightens on mental health, treatment of mental disorders and how families can help their loved ones with mental illness.
What does it mean to have a mental health issues?

To understand mental health illness, we need to understand mental health first.

Mental Health is an individual’s ability to recognise his or her talents, use it to cope with everyday life stresses, while working productively and fruitfully and contributing to society.

Therefore, mental health disorder occurs, when an individual loses these functions.

It is an illness with psychological or behavioural manifestations in thoughts, emotions, beliefs, and behaviour of an individual.

This means the individual starts to think strange and unusual things and act out of character.

Who does mental illness affect?

It can affect anyone regardless of age, gender, tribe, religion or socio-economic status. Most mental illnesses start during adolescence and maintain a lifelong course.

What causes it and what are some of the warning signs?

There are numerous causes of mental illness but for ease, I’ll divide it into biological, psychological and social causes.

Biological factors like defective genes that form due to injury to the foetus in pregnancy can lead to a mental illness later in life.

These genes could also be inherited from parents or grand parents, meaning it’s a familial disorder.

Another biological cause of mental illness is long-standing medical conditions like hypertension, diabetes and sickle cell disease, among others.

Note that a gene is a very important part of the cells in our body, which controls our growth, development and our physical characteristics.

Psychological causes of mental illness include, personality traits, which can predispose an individual to develop a mental illness.

For example, there are people that require excess approval to function. They are more at risk of a depressive illness, if they don’t get the validation they need.

Another cause of mental illness is environmental/social factors. These are life events that can either be positive or negative e.g. parental neglect in childhood, pregnancy or delivery and loss of job, among others.

All these factors interact and exert their influences on the brain in a nature and nurture interplay, thereby, altering the way the gene is expressed.

The extent to which these factors are implicated depends on the individual’s level of resilience.

Visible warning signs of mental illness are persistent unusual thoughts and or behaviour that cause distress to the individual, society and affect the individual’s functioning.

I stress persistent, because we all behave out of character occasionally for one reason or the other.

Examples of these are talking to self, undue suspiciousness and decline in personal hygiene to name a few.

Can one have mental health condition and not know?

People who have mental illnesses usually are initially aware that there has been a change in their behaviour, or how they perceive things, but the stigma borne of ignorance that persists with mental health issues does not allow them to accept it. When the condition progresses, they lose that awareness.

More so culturally, Nigerians have a strong bias to label unusual phenomenon as spiritually caused and we are more comfortable with that option. However, not all mental illnesses cause loss of awareness about the condition.

Does stress lead to mental illness?

Stress is a very important precipitant of mental illness. Note that I said precipitant. T

his is because the individual would already have been predisposed to having the illness during pregnancy or childhood by some of the factors I mentioned earlier.

So, recent stressful events like infertility, loss of spouse and even financial constraints, which is a form of stress, can then precipitate the illness.

What treatment options are available?

We have come a long way from treating mental illnesses with exorcism, rituals, flagellations and bloodletting. Treatment options include medications, depending on the particular condition, psychotherapy (talk therapy), social therapy and other physical therapy.

Social therapy is targeted at resolving the life event that might have precipitated the breakdown, because if it persists, it’s an ingredient for delay in resolution of symptoms or future re-occurrence of symptoms.

Other physical treatments include use of electroconvulsive therapy and neurosurgical procedures that are usually not the first option.

How does one handle a mentally ill person before help arrives?

To ensure that a person suffering from mental illness is taken care of before he or she gets available treatment, the onus lies on the family and friends to be empathetic and supportive.

Let the individual know (s)he is not alone and reinforce this at every opportunity.

Then reach out to a specialist for more information on signs the family has noticed, so that useful information can be passed along to the sufferer, which will convince him/her to present in the hospital.

Despite this, some individuals would still be in denial and would have to be brought to the hospital via subterfuge.

Above all, always reassure them that their experiences though unusual can be managed, that there is hope and they are not alone.

It will be counter productive to deny the signs or encourage them to visit religious homes only, because early presentation in the hospital produces the best outcomes.

What is the role of family and society in managing mental illness?

The family and society have a huge role to play in mental health issues, because these are the people those with mental illness interact with daily.

Any stereotypical comment or discrimination can affect them adversely, causing a reoccurrence of symptoms.

This can lead to loss of productivity in the individual, which will ultimately affect the family and society.

Since the family and society are a large body of people compared to just an individual, there is the advantage of being able to pool resources, such as donation of funds for acquiring office space for clinics and residential treatments, training of staff, organisation of mental health awareness campaigns, subsidising mental health care (MH care isn’t under NHIS), so that those affected can afford treatment and providing motivation and support for those in recovery.

Volunteering in existing mental health institutions is also a way for the family to be involved in the care of these people.

Above all, government has to pass the mental health Act, which outlines a structure for promotion of mental health, prevention, treatment and rehabilitation of mental illnesses.

Ctedit: The Guardian

Keeping the female reproductive organ safe and healthy

Keeping the vagina safe and healthy

Monica Taiwo
The woman’s vagina is designed to naturally keep itself clean with the help of its natural secretions or discharge. For all women, looking after your everyday health can help keep your vagina in good shape,

Generally, good vaginal health is maintained by making sure the woman is generally healthy; this includes a healthy diet and exercise. Note that normal exercise helps maintain good vaginal function the way walking and running help the pelvic floor tone up. Here are a few things you should know if you want a clean and healthy vagina.

Vaginal secretions or discharge: Apart from the period which is part of your natural menstrual cycle, it is normal to produce clear or white secretions/discharge from your vagina. This mucus is produced naturally from the neck of the womb, known as the cervix.

Vaginal discharge is not always a bad sign unlike the general belief by some women that the clear or white discharge is associated with s3xually-transmitted infections. Changes in the amount of discharge could be hormonal; in other words, it could belinked to the menstrual cycle, pregnancy or menopause.

The character and amount of vaginal discharge vary throughout your menstrual cycle. Around the time your ovary releases an egg; ovulation, the discharge usually becomes thicker and stretchy, like raw egg white. A healthy discharge doesn’t have a strong smell or colour. There may be an uncomfortable wetness, but there shouldn’t be any itching or soreness around the vagina. If there are changes to the discharge that you are not used to, such as a change in colour or if it starts to smell or itch, then you need to see a doctor as you might have an infection

Bacteria in the vagina: There are lots of bacteria inside the woman’s vagina, and they are there to protect it. According to Professor Ronnie Lamont, spokesperson for the Royal College of Obstetricians and Gynaecologists, “The vagina contains more bacteria than anywhere else in the body after the bowel, but the bacteria are there for a reason.”

Functions of the good bacteria inside the vagina includes:

provide “numerical dominance”; they outnumber other potential harmful bacteria that might enter the vagina
help keep the vagina’s pH balance (how acidic the vagina is) at an even level, which helps keep the balance of bacteria healthy
can produce bacteriocins (naturally occurring antibiotics) to reduce or kill other bacteria entering the vagina
produce a substance that stops invading bacteria sticking to the vagina walls, which prevents bacteria invading the tissues
If the balance of bacteria is disturbed, this can lead to infection and inflammation. Bacteria called lactobacilli help keep the vagina’s pH balance at its normal low level), which also prevents the growth of other organisms.

If the pH of the vagina increases; it gets less acidic, that is, the quality or amount of lactobacilli can fall and other bacteria can multiply. This can result in infections such as thrush, which can cause symptoms which include itching, irritation and abnormal discharge.

Washing your vagina: It is a good idea to avoid perfumed soaps, gels and antiseptics as these can affect the healthy balance of bacteria and pH levels in the vagina and cause irritation.

Use plain, unperfumed soaps to wash the area around the vagina gently every day. The vagina will clean itself inside your body with natural vaginal secretions/ discharge.

During your period, washing more than once a day may be helpful, keeping the perineal area between the vagina and anus clean is important. A good perineal hygiene is necessary by washing that area at least once a day using your normal bathing soap.

However, not all women are the same; some may wash with perfumed soap and not notice any problems. But if a woman has vulval irritation or symptoms, one of the first things you can do is use non-allergenic, plain soaps and see if it helps.

Vaginal douches: A douche flushes water up into the vagina, clearing out vaginal secretions. Some women use a douche to clean the vagina, but using a douche can disrupt the normal vaginal bacteria. There is also no evidence douching protects against STIs or vaginal infections, and it may even increase the risk.

Scented wipes and vaginal deodorants: These perfumed products can disrupt the vagina’s healthy natural balance. “If nature had intended the vagina to smell like roses or lavender, it would have made the vagina smell like roses or lavender,” says Professor Lamont.

Washing with water and a plain soap should be all a woman needs to keep her vagina healthy. It is normal for the vagina to have a scent. Vaginal odour can change at different times of the reproductive cycle and should not always be thought of as being a sign of infection or illness

Safer sex: Some bacteria and viruses can get into the vagina during s3x. These include the bugs that cause chlamydia, gonorrhoea, genital herpes, genital warts, syphilis and HIV. You can protect your vagina against these infections by using a condom when you have s3x with multiple partners.

Cervical screening: All women aged from 25 to 64 are advised to go for cervical screening. Being screened regularly means any abnormal changes in the cervix can be identified early on and, if necessary, treated to stop cancer developing.

Additional report from Women’sHealth

Credit: Tribune

How to manage chlamydia infection

How to manage chlamydia infection

Rotimi Adesanya

Chlamydia is a sexually transmitted infection caused by bacteria known as ‘Chlamydia trachomatis’. The disease, which affects both men and women, is spread by having unprotected vaginal, anal or oral sex with an infected person. It is also transferred to newborn babies from infected mothers.

Most people infected chlamydia don’t notice any symptoms and so they don’t know they have it. Research suggests that 50 per cent of men and 70-80 per cent of women don’t get symptoms at all with an infection. They can pass it to others without knowing it. If a pregnant woman has chlamydia, it can be passed to her baby during birth.


A big problem with chlamydia is that it often produces no symptoms. If left undetected and untreated, complications can occur. People who have the disease can still transmit the infection, even if they don’t have any symptoms themselves. When symptoms do occur, they may not appear until several weeks after having sex with an infected person.

Women: They frequently develop abdominal or chronic pelvic pain and the continued spread of the disease. Other symptoms are burning desire to urinate, an abnormal vaginal discharge, blood in the urine, urinary urgency (feeling an urgent need to urinate) and increased urinary frequency can occur if the urethra is infected.

Men: Chlamydia can be difficult to spot in men because the symptoms are rare and not consistent between men. More common symptoms include a white, cloudy or watery discharge from the tip of the penis, difficulty or pain during urination, swollen and sore testicles.

Newborn: Pregnant women infected with chlamydia can pass the infection to their babies during childbirth. This could result in the baby developing conjunctivitis (eye infections) and pneumonia (chest infections).


Women: If it isn’t treated, the infection can sometimes spread to other parts of the body and lead to serious long-term health problems, such as pelvic inflammatory disease, ectopic pregnancy (in which a pregnancy develops outside the uterus, such as in the fallopian tubes) and infertility (not being able to have children), due to infection and scarring of the fallopian tubes.

Men: If left untreated, chlamydia can cause internal scarring of the genitals, a lower sperm count with less fertile sperm, and can lead to additional health conditions.

Newborn: Chlamydia can lead to blindness or complicated pneumonia in the newborn baby.


If you think there is a chance you might have chlamydia, getting tested early on is important, and so is avoiding spreading it to others. Testing for the infection is done with a urine test for men. Women can have a urine test or a swab taken from the cervix or vagina. Treatment normally involves antibiotic drugs.


Chlamydia can be cured with the right treatment. If your doctor detects c the infection, it can usually be treated with special class of antibiotics. It is important that you take all of the medication your doctor prescribes to cure the infection. When taken properly it will stop the infection and could decrease your chances of having complications later on.

It is advisable for infected persons to avoid having sex while taking the antibiotics for a week so that he or she does not pass on the infection to someone else or become re-infected. It is recommended that the infected person do another test for chlamydia three months later to make sure there is no re-infection. Anyone who has had sex with an infected person in the past six months should also be tested and may need treatment at the same time. This is called contact tracing.

As Chlamydia is transmitted through unprotected sex, the doctor may suggest that you undergo screening for other sexually transmitted infections and if necessary, you and your partner(s) treated.


Having oral sex or anal sex with someone who has chlamydia can result in infection of the throat or the rectum, thereby causing pain and a discharge of pus or mucus that could be painful when you urinate, an unusual discharge from the penis, vagina or rectum or, in women, bleeding between periods or after sex.

One can getting infected with chlamydia (and other sexually transmitted infections) by practising safe sex. This means using a condom during vaginal or anal sex.

The universal method of prevention of sexually transmitted infections is the ‘ABC’tip.


B–Be Faithful to a partner who is also faithful to you

C–Condoms: Use them correctly.

Credit: The Punch