Diagnosis
Morning-after pill now free across pharmacies in England

The NHS has made the morning-after pill free at almost 10,000 pharmacies in England, ending postcode lottery access to emergency contraception.
Women can now obtain the emergency pill without charge at their local pharmacy, removing the need to visit a GP or attend a sexual health clinic. Some pharmacies had previously charged up to £30 for the service.
The NHS described the rollout as “one of the biggest changes to sexual health services since the 1960s.”
Dr Sue Mann, the NHS’s national clinical director for women’s health, said the expansion was “a gamechanger in making reproductive healthcare more easily accessible for women.”
She said: “Instead of trying to search for women’s services or explain their needs, from today women can just pop into their local pharmacy and get the oral emergency contraceptive pill free of charge without needing to make an appointment.
“With four in five people living within a 20-minute walk from a pharmacy, this service is another example of how the NHS is already delivering on our 10-year health plan commitment to shift care into the heart of communities.”
The announcement coincides with the NHS expanding pharmacy services to include support for people newly prescribed antidepressants, who can now seek advice and guidance about their medication and healthy lifestyle changes from their local pharmacist.
Henry Gregg, chief executive of the National Pharmacy Association, which represents about 6,000 independent pharmacies across the UK, welcomed the change.
He said: “We’ve long called for the national commissioning of emergency contraception so this is good news for patients and pharmacies alike that this is launching today.
“For too long, access to free emergency contraception has been a postcode lottery for patients, with local arrangements only existing in certain parts of the country.
“It’s really important that pharmacies, which are under significant pressure and closing in record numbers, are sustainably funded so they can continue to provide services to patients such as these.”
Stephen Kinnock, minister for care, said: “This is a major step forward that removes barriers of access to reproductive care that have let women down for too long.
“Pharmacies play a central role in communities, trusted by local people and easy to access. That’s why it’s vital there are a wide range of services and medications available.”
Diagnosis
Being female not a universal stroke risk factor for patients with AF, study finds

Female sex may not raise stroke risk across all atrial fibrillation (AF) patients, with higher risk mainly seen in women aged 75 and older, a study suggests.
Researchers said stroke prevention for women with the condition should be more personalised, especially for patients under 75.
Dr Amitabh C Pandey, director of cardiovascular translational research at Tulane University School of Medicine, said: “For years, female sex has been included as a risk factor along with other factors such as high blood pressure and diabetes, meaning women were more likely to be prescribed anticoagulants.
“Our study shows younger women may not have as much added stroke risk as previously thought, while older women, particularly those over 75, appear to have a higher risk that deserves close attention.”
The new Tulane University study challenges a long-standing assumption in heart care that being female automatically increases stroke risk for patients with atrial fibrillation.
Atrial fibrillation, often called AF, is a common heart rhythm disorder that causes the heart to beat irregularly.
It is associated with a higher risk of stroke and is often treated with anticoagulants, also known as blood thinners.
The study found that stroke risk did not increase equally across all female patients with AF.
Instead, researchers said being female may act more as a risk modifier, with increased stroke risk seen primarily among women aged 75 and older or those with a greater burden of other health conditions.
Clinicians often use a scoring system to decide whether people with AF should be prescribed blood thinners.
The system gives points for factors including age, heart failure, diabetes, previous stroke, vascular disease and high blood pressure.
Women also receive one point for sex alone.
Researchers said this can mean women with AF become eligible for blood thinners earlier or more often than men with otherwise similar risk profiles.
While blood thinners can help prevent clot-related strokes, they can also increase the risk of bruising, prolonged bleeding, gastrointestinal bleeding and other serious complications.
The researchers analysed approximately 950,000 patients with AF using TriNetX, a large anonymised electronic health record database.
They compared stroke outcomes between male and female patients across three age groups: younger than 65, 65 to 74, and 75 and older.
Male and female patients were matched based on age, other health problems and whether they had been prescribed anticoagulation medicine.
Among patients younger than 75, the study found no significant difference in one-year stroke risk between men and women.
However, among patients aged 75 and older, women had a modest but statistically significant increase in stroke risk compared with men.
In patients aged 75 and older with no additional risk factors beyond age, women had about one additional stroke per 629 patients compared with their male counterparts.
The findings support growing interest in a newer AF risk score, known as CHA2DS2-VA, which removes sex as a standalone risk factor.
However, researchers said more studies are needed and medical guidance remains inconsistent.
Han Feng, assistant professor at Tulane University School of Medicine, said: “This general approach came from women being underrepresented in AFib trials and studies comprising only about one-third of study populations.
“Our study shows not all women with AFib have the same risk profile, and these decisions should be individualised.
Pandey said: “These findings highlight the need for modern tools and approaches that can personalise risk profiles to individuals.
“The goal is not to undertreat patients who need stroke prevention, but to better identify who is most likely to benefit from anticoagulation and who may be exposed to unnecessary risk.”
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