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Lower HPV vaccination coverage among girls with mental health conditions

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Girls with mental illness or neurodevelopmental conditions are less likely than their peers to be vaccinated with the HPV vaccine that protects against future cervical cancer. 

The study involved more than 115,000 girls covered by the Swedish school-based human papillomavirus (HPV) vaccination programme. The vaccine, which prevents cervical cancer, among other things, is offered to all children in Sweden and given by school health services.

The researchers found significant differences when examining the association between vaccination coverage and psychiatric diagnoses or the use of psychotropic medications.

Girls with psychiatric diagnoses had an 11 per cent lower vaccination coverage of the first dose of the HPV vaccine compared to girls of the same age without such diagnoses. The difference was particularly pronounced among girls with autism or intellectual disability, who had over 20 per cent lower vaccination coverage.

Girls who received medication for mental health conditions had a 7 per cent lower vaccination coverage, but the figures varied significantly depending on the type of medication prescribed. Among girls receiving antipsychotic medication, vaccination coverage was as much as 32 per cent lower compared to girls of the same age without such medication.

“Our study emphasises the need for targeted interventions to ensure equitable healthcare for all children,” says Kejia Hu, postdoctoral researcher at the Institute of Environmental Medicine, Karolinska Institutet.

“All girls should have equal access to life-saving vaccines regardless of their mental health status.”

In contrast, girls with psychiatric diagnoses or mental illness who received the first dose of vaccine were as likely as their peers to receive the second dose of vaccine, which is given within one year of the first dose. In addition, parental mental health conditions did not significantly impact vaccination coverage in their daughters.

“More research is needed to find out the underlying reasons why fewer girls with mental illness or neuropsychiatric conditions are vaccinated against HPV so that we can tackle this challenge,” says Karin Sundström, senior researcher at the Center for Cervical Cancer Elimination at the Department of Clinical Science, Intervention and Technology, Karolinska Institutet.

The study was carried out by the Karolinska Institutet in Sweden and published in The Lancet Public Health.

Fertility

Most NHS regions in England limit IVF to single cycle, research finds

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Nearly 70 per cent of NHS regions in England fund only one IVF cycle for women under 40, breaking national guidelines, new research has found.

Twenty-nine of the 42 integrated care boards, which control local NHS budgets, now offer only one round of treatment, after four reduced access in the past year.

National Institute for Health and Care Excellence (Nice) guidelines recommend three full cycles for women under 40 who have been unable to conceive for two years.

Only two of England’s 42 integrated care boards have policies consistent with these guidelines, which they are not legally obliged to follow.

The research was conducted by the Progress Educational Trust, a fertility charity.

Sarah Norcross, the director of PET, said the impact was “devastating” for couples struggling with infertility.

She said: “Infertility is already incredibly stressful for people, and it puts them under even more pressure, because there is so much riding on whether that one NHS-funded cycle is going to work.

“And for some people, that will be their only chance, because private fertility treatment is so expensive.”

The data showed regional variations, with the whole of the north-west offering just one cycle.

“It’s a postcode lottery, and we’re seeing a race to the bottom,” said Norcross.

Of the 29 integrated care boards that offer a single cycle, 19 provide only a partial cycle, where not all viable embryos created are transferred.

There was just one recent example of improved services, from NHS South East London, which in July 2024 went from one partial to two full cycles.

The NHS estimates that about one in seven couples may have difficulty achieving a pregnancy. One cycle of IVF can cost from £5,000 at a private clinic.

Fertility rates in England and Wales have fallen since 2010 to 1.41 children per woman in 2024, the lowest on record and below the replacement level of 2.1 at which a population is stable without immigration.

Health minister Karin Smyth said in a written parliamentary answer last month that it was “unacceptable” that access to NHS-funded fertility services varied across the country.

Revised Nice fertility guidelines are due this spring, but Norcross said changing them seemed pointless.

She said: “Fertility treatment has always been a Cinderella service. It’s always been the one they’ve chosen to cut or to ignore.

“Nice has recommended three full NHS-funded cycles, for women under 40, for more than 20 years. This has never been implemented across England, unlike in Scotland.”

Norcross advocated centralised commissioning and replicating Scotland’s approach, which included financial modelling and a phased implementation starting with two cycles to avoid long waits, moving up to three once capacity was achieved.

“It is a tried and tested plan that England could follow,” Norcross added.

A Department of Health and Social Care spokesperson said: “We recognise access to fertility treatment varies across the country and we are working with the NHS to improve consistency.

“Nice provides clear clinical guidelines, and we expect integrated care boards to commission treatment in line with these.

“Updated Nice fertility guidelines are expected this spring and we will continue to support NHS England to make sure the guidance is fully considered in local commissioning decisions.”

An NHS England spokesperson said: “These clinical services are commissioned by integrated care boards for their area based on the needs of the local population and prioritisation of resources available.

“All ICBs have a responsibility to ensure services are provided fairly and are accessible by different population groups.”

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Mental health

Fear of ageing may age women faster, study suggests

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Ageing anxiety may accelerate biological ageing in women, with fears about worsening health linked to faster epigenetic ageing, according to new research.

The study found that greater anxiety about growing old was associated with accelerated epigenetic ageing, as measured by the DunedinPACE clock, based on biological markers in blood samples.

Epigenetic changes are shifts in how genes are switched on or off without altering DNA itself, which can influence how the body ages and functions.

“Our research suggests that subjective experiences may be driving objective measures of ageing,” said Mariana Rodrigues, a PhD student and the first author of the study.

“Ageing-related anxiety is not merely a psychological concern, but may leave a mark on the body with real health consequences.”

Researchers analysed data from 726 women in the Midlife in the US study.

Participants were asked how much they worried about becoming less attractive with age, having more health issues and being too old to have children.

Blood samples were used to assess ageing with two epigenetic clocks: DunedinPACE, which estimates the pace of biological ageing, and GrimAge2, which estimates cumulative biological damage.

The study was conducted by researchers at NYU School of Global Public Health.

Worrying about declining health showed the strongest links with epigenetic ageing, while anxiety about attractiveness and fertility was not significantly associated with biological markers.

The authors suggest health worries are more common and persist over time, whereas concerns about appearance and reproduction may fade with age.

“Women in midlife may also be multiple in roles, including caring for their ageing parents,” Rodrigues said.

“As they see older family members grow older and become sick, they may worry about whether the same thing will happen to them.”

The authors caution that the study offers a snapshot in time and other factors may influence these biological changes.

When analyses were adjusted for health behaviours such as smoking and alcohol use, the link between ageing anxiety and epigenetic ageing decreased and was no longer significant.

“Our research identifies ageing anxiety as a measurable and modifiable psychological determinant that seems to be shaping ageing biology,” said Adolfo Cuevas, associate professor of social and behavioural sciences and the study’s senior author.

They call for more research to clarify how this anxiety influences ageing over time, to guide support for those experiencing ageing anxiety.

“Ageing is a universal experience.” Rodrigues said.

“We need to start a discourse about how we as a society, through our norms, structural factors and interpersonal relationships, address the challenges of ageing.”

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Insight

WUKA and Royal Yachting Association partner to support women and girls in sailing

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WUKA has announced a groundbreaking partnership with the Royal Yachting Association (RYA), including RYA Scotland and RYA Northern Ireland, supporting women and girls in sailing.

Building on WUKA’s growing #TackleAnything campaign – which has already reached thousands of girls across sports in the UK – this collaboration brings practical period solutions into sailing.

Together, WUKA and the RYA are committed to breaking down barriers so periods never limit confidence, participation, or performance on the water.

Ruby Raut, WUKA founder & CEO, said: “Partnering with the RYA has been incredibly important for us at WUKA.

“Sailing is an amazing way for women and girls to build confidence, and periods shouldn’t hold anyone back from enjoying the water or reaching their full potential.

“Through this partnership and our #TackleAnything campaign, we’re proud to provide practical solutions and innovative products that help female sailors feel comfortable, confident, and free to focus on learning, performing, and having fun.

“Breaking down barriers and supporting women to tackle anything — on land, at sea, and everywhere in between – has never felt more meaningful.”

WUKA, which stands for Wake-Up Kick Ass, shares the RYA’s commitment to inclusivity and empowerment.

In 2023, WUKA launched #TackleAnything, a campaign supporting women, girls and sportspeople with periods. Since its launch, the initiative has reached 3,576 girls across 46 clubs and partnered with a range of sports across the UK – from Scottish Gymnastics to Titans wheelchair basketball – helping young athletes play without limits and stay confident, comfortable, and in the game.

The brand offers period-friendly aquatic apparel and practical solutions that help women train and compete with freedom of movement and total assurance.

Through this partnership, WUKA will provide innovative period swimwear for young sailors across key RYA programmes, including the NI Sailing Team, the RYA Scotland Performance Pathway Programme, and the British Sailing Pathways Talent Academies.

By combining WUKA’s mission to challenge stigma with the RYA’s commitment to inclusion, the partnership ensures young sailors can focus on what matters most – learning, performing, and enjoying their time on the water – with confidence and comfort. RYA members will also receive a 10 per cent discount on WUKA products.

Sailing offers incredible benefits for women and girls, but time on the water can present unique challenges -particularly during menstruation.

Together, WUKA and the RYA are providing practical solutions that remove these barriers, helping young sailors participate fully and confidently in the sport.

Sara Sutcliffe, RYA CEO, said: “At the RYA, we have been making strides to break down barriers for women of all ages to help ensure they can experience the water in a supportive and positive environment.

“From education workshops and practical sessions, we want to make sure our female sailors are empowered and this partnership is another great example of how we can demonstrate possible tools to equip them to succeed”.

This partnership is part of the RYA’s wider commitment to making sailing a sport where women and girls can thrive. Alongside initiatives such as the Female Futures Group, the Women’s Race Officials Programme and all new Talent Academy Female Future’s Camps; it demonstrates a continued focus on removing barriers and creating meaningful opportunities across every stage of the sailing.

WUKA’s involvement ensures that practical solutions are available on the water, from innovative period swimwear to support resources, helping young sailors feel fully equipped and confident during training and competition.

By integrating these tools into RYA programmes, WUKA brings a new level of comfort and assurance to female athletes, allowing them to focus entirely on performance, enjoyment, and growth in the sport.

For any women and girls looking to learn more about sailing, visit www.rya.org.uk.

For more information on WUKA visit www.wuka.co.uk.

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