Theresa Lowry-Lehnen
ISHA Assistant PRO & Student Health Nurse, IT Carlow
Dr Aoife O’Sullivan
ISHA President & GP, Student Health Dept, University College Cork
The Irish student population continues to grow year-on-year, and with it, the demand for Student Health services in third-level education.
CSO statistics show 52.2% of the 225,628 third-level students in 2016/17 were women. 68.5% of all 20-year-old women were students, highlighting the need for more awareness and promotion of women’s health issues, as well as better resourcing of services to meet the specific health requirements of female students.1
Help with health during college
Student health services are not gender-specific, but women’s health needs often are – menstrual issues,contraception, pregnancy, breast care, cervical screening – but other health issues such as UTIs, STIs, and some mental health problems, especially depression and anxiety, are also prevalent in female students.
Contraceptionis one of the main health concerns among female students, with a clear demand for convenient, reliable, affordable contraception, especially long-acting reversible formulations (LARC), which should be the method of choice for this population group. This is so because of their vastly superior efficacy in relation to failure rates, and as they are the only form of contraception linked with a reduction in abortion rates.3,4,5
Abortion is free; contraception should be free too!
Emergency contraception is now accessible over-the-counter, but the cost for all methods of contraception, particularly LARC, is still an issue for many students. With termination of pregnancynow available – free – in Ireland, the provision of free contraception, especially LARC/emergency contraception, needs to be addressed to ensure provision of evidence-based best practice and care to young Irish women.
Furthermore, other important health issues include education about cervical screeningand encouraging regular self-breast examinationfrom a young age.
Increase in STIs among 15-24yr old women
Recent national figures published in November 2018 show a 5% increase in STIs, up to 13,629. Among 15-24 year-olds, 59% of recorded STIs were in women. 62% of all chlamydia and 81% of genital herpes cases in this age group are also in females.6
The provision of free, accessible STI screening nationwideis vital for third-level students, as is sexual health educationregarding risks and prevention. Many UCC students surveyed only reported condom use ‘some of the time’ – the need for female students to have to insist on condoms is a very concerning trend, male students must also be encouraged to insist on using protection.
Chlamydia is the most common STI, with diagnoses increased up to 7,408.6Up to 80% of females with chlamydia have no symptoms. Likewise, most recent figures show gonorrhoea diagnoses in Ireland have risen to 2,249 cases.6Undiagnosed chlamydia/gonorrhoea can affect future fertility – an added concern for young women and men.
Female students’ mental wellbeing is lower than male peers
College students represent a vulnerable population regarding mental health issues.The years during which young adults enter into and attend third-level education, represent a high-risk period for mental health disorders. In a 2012 national survey regarding the mental health profile of over 8,000 young Irish adults (17-25yrs), females presented with lower levels of wellbeingthan males.
Overall, 48% of female students reported a score indicative of poor mental wellbeing. Body image issues and eating disorders are also more prevalent among female students.7,8
Sexual harassment/violenceis another serious issue. In a 2018 survey of 632 students, by the NUI Galway SMART Consent research, 54% of first-year women students reported experiencing sexual hostility or crude gender harassment at some point since starting college. This in fact rose to 64% among second-year and 70% among third-year female students.9
Increased alcohol consumption among female students
A notable recent health-related behaviour change is an increase in alcohol consumptionamong female students. They are now drinking as much as – and more – than male students. In a 2015 UCC study, 67.3% of women reported hazardous alcohol consumption, versus 65.2% of men.10
More womenare being diagnosed with smoking-relatedcancers, with lung cancer now the main cause of cancer death among women. Low self-esteem, worries about weight gain, or wanting to fit in, contribute to young women starting/continuing to smoke.11
Education and healthy lifestyle advice for women regarding consent, vaccination, contraception, screening, nutrition, exercise, dangers of drugs, alcohol and smoking is ongoing in student health centres. It is important we support, promote and improve the health choices of our female student population.
References:
1.CSO Statistics. Women and Men in Ireland: Education. Central Statistics Office. Dublin Available at https://www.cso.ie/en/releasesandpublications/ep/p-wamii/womenandmeninireland2016/education/
2.Department of Justice and Equality (2017). National Strategy for Women and Girls2017-2020: creating a better society for all. Department of Justice and Equality. Dublin.
3.Contraception.ie (2018). Is the pill really my best option. Available at https://www.mycontraception.ie/static/media/pdfs/LARC_Options.pdf
4.FSRH Clinical Guidance: Contraceptive choices for young people. https://www.fsrh.org/standards-and-guidance/documents/cec-ceu-guidance-young-people-mar-2010/
5.Association between long-acting reversible contraceptive use, teenage pregnancy and abortion rates in England. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247139/
6.Sexually Transmitted Infections (STIs) in Ireland, 2017. Health Protection Surveillance Centre, Dublin. http://www.hpsc.ie/a-z/hivstis/sexuallytransmittedinfections/publications/stireports/
7.Dooley, B. & Fitzgerald, A. (2012). My World Survey – National Study of Youth Mental Health. Dublin: Headstrong (The National Centre for Youth Mental Health) & University College Dublin School of Psychology.
8. Reach Out Ireland (2015). Reaching Out in College: Help-Seeking at Third Level in Ireland, ReachOut Ireland. Available athttps://www.hse.ie/eng/services/list/4/mental-health-services/nosp/research/reports/reachingout-college.pdf
9.NUIG (2018) Smart Consent Research Report. National University of Ireland Galway. Available at http://www.nuigalway.ie/smartconsent/
10.Alcohol consumption and related harm among university students in Ireland. https://cora.ucc.ie/handle/10468/2286
11.HSE (2018) Adult Smoking in Ireland. Report prepared on behalf of the Tobacco Free Ireland Programme. Health Service Executive. Dublin. Available at https://www.hse.ie/eng/about/who/tobaccocontrol/tobaccofreeireland/adult-smoking-in-ireland.pdf