Emma Soos was welcomed into the BBC Radio Nottingham studio’s to talk to presenter Mark Dennison about The Women’s Health Clinic record success in the area.

From a starting point as a urinary nurse in the NHS in Nottingham and Leicester to joining the private sector in 2002, Mark wanted to know just what gave Emma the impetus to launch The Women’s Health Clinic.

Originally known as ‘Genesis’, Emma decided to rebrand as The Women’s Health Clinic so that women from all over the UK could immediately grasp that this was a safe place for them.

A full transcript can be found under the video.

Host: So then, carrying a baby for 9 months can take quite a toll on your body, not to mention of course delivering the baby when the time comes. For many women, this is a long drawn out process that can have a lasting effect, on you and your body, and one part of your body in particular. Tell you more about this; Emma Soos is here from Edwalton. Formerly a urology nurse for the NHS. She was left with problems after she had her own children and when she couldn’t get the treatment that she needed she thought “Right I’m gonna see what I can do about this” and she has and she’s hear at BBC radio Nottingham now, hello.

E: Good morning.

H: So what happened then? Talk us through your own experience…

E: Well I’ve had two children, first one was a cesarean and the second one was a normal vaginal delivery and there were a few complications, which a lot of women suffer from, resulting in some stitches. And there are some issues that a lot of women have: long labours, difficulty going to the bathroom and difficulty in the bedroom afterwards. And getting the help after that was quite difficult which is a challenge for a lot of women, it’s not a new thing. We’ve got a greater NHS but post baby it can sometimes be difficult to go through your GP to get the right person for some help. Now I was quite lucky in terms of the fact that I knew who to speak to and how to get help. To cut a very long story short I happened to meet a wonderful woman’s physio who helped me to get better. It was quite traumatic to get to that stage. And I’m quite a sensible person and not every woman has got the ability to pipe up when they need help. It highlighted to me as a nurse as well as a mum that this isn’t a problem that just goes away without any intervention but it is difficult to speak to your GP in 10 minute slots that you sometimes have if you’re lucky about difficulties you may be having with your relationships or what’s happening in the bedroom or the bathroom.

Host: These are quite embarrassing subjects in lots of ways.

E: Well they’re perceived to be that way, although we’re in 2017 it can be quite challenging to see women as sexual beings shall we say and that’s natural to speak about, you know ladies might speak with their friends about it but not necessarily to a healthcare practitioner, because we’re not actually broken, there’s not a problem, but sometimes women do need to explore around what’s happened to them physically after they’ve had a baby and what’s going on in their relationships with other people as well.

Host: Well it’s important at the end of the day…

E: It is

Host: I just wonder as well with your own experience then Emma there you are as a new mum but also having worked as a nurse that obviously gives you some extra insight doesn’t it, into what is happening, so I just wonder if that makes you even more attuned to what is going on, it must do…

E: Yes. It does. The biggest thing we have found with what we do with our business is that women need to talk to explore those things. A lot of women come to us because is it normal, do I look normal, is it ok to feel this way, can it be fixed because there is very little follow up beyond that initial few weeks with a health visitor and midwife and GP and some of these issues don’t present until quite a few years down the line as well and women can be frightened by what’s happening to them and sometimes just need a bit of reassurance.

Host: So it’s probably worth explaining and exploring a little bit more about what some of these physical effects can be, and we should, we always have to put out a little bit of a warning at this point that we might be talking about some particular bits of biology for want of a better expression but we’re gonna do this because it does affect a lot of people. So what kid of effects can it have?

E: Well there’s the mechanical incidents of having a baby so tears, for example, some people have simple tears, some people have a complex, a third or 4th degree tears where they will tear through the vaginal into the back wall. There can be issues with prolapses a few years down the line, sexual function so enjoyment, satisfaction, difficulty and pain without going too much into at this time of day, and then we look long term, there are physical changes with the ageing process that women go through, so as we go into menopause we have things like estrogen levels diminishing which have an effect n the actual structures themselves which can also be compounded by the fact that they may have had previous surgery as well. Things like, presenting complaints typically will be be incontinence, difficulty in the bedroom in terms of satisfaction and all the other things that go with that, difficulty in relationships, relating and being able to communicate with their partner as to what’s happening in their body and also the fear and stigma around all of that as well.

Host: Yeah. Again as we mentioned before, it can be quite a tricky, it can be one thing having a conversation with your partner about all of that, let alone someone who is effectively a stranger. How would you advise someone to broach that first conversation?

E: Well one of the things that we’ve done with the business is that we have made it accessible to all our women in terms of, there is, we don’t have any sales people, everything is done, your first port of contact is a nurse, so you will speak to a nurse. If you pick up the phone now you will speak to a nurse. So some people are quite open and they want to speak, before a patient will have come to our clinic they will have filled in all of their documentation online, so questions that are quite challenging to ask and be asked are already broached, so the patient will often know when they arrive through our door that it is an open forum, so we’re asking about particular things in the bedroom and particular things in the bathroom, so that when the patient comes they know that I can talk about these things it’s not going to be embarrassing, I’ve not got to try and find out if it’s ok to talk about that, we’ll will have all of that information beforehand and nurses with all sorts of different backgrounds in our network, so we’ve got midwives, we’ve got sexual health experts, we’ve got genito-urino medicine, we’ve got urology and we make sure that he patients based on that are directed to the most suitable specialists for their needs.

Host: We’ll talk about more of what you’ve actually done on the business side of things in just a few moments time, this might be something you yourself might relate to-

BREAK

Host: This is BBC Radio Nottingham I’m Mark Dennison. With me this morning Emma Soos is here from Edwalton, former NHS urology nurse who has developed her own treatment. So this is for women who are left with various problems, intimate problems in particular, after childbirth. Just to recap a little bit then Emma, would you say this is more about bathroom problems or bedroom problems?

E: Combination

Host: A bit of both

E: Looking at them hand in hand

Host: Right. And how soon after childbirth would women generally start to notice some of these things?

E: It varies; some of those issues are age related as well so we’ve got to factor into that, but the earliest we would ever see a patient is at least 12 weeks after a baby. And that would have to be with a nurse directly, make sure they’ve had no complications as such. But at any point a woman can present. I mean our average age is between 40 to 45.

Host: Right. So quite often this will be quite often further down the track then.

E: Yeah

Host: And you were just telling me as well that sometimes the issue is that you might mention this to a medical expert and they might say something like, “Ah its cos you’ve had a baby or gone through the menopause,” and it’s kind of normalized.

E: A lot of the medical side of things is looking for problem solving, so are you functional at the minute? So can you go to the bathroom? Can you partake in intercourse? And if you sort of tick those boxes it’s ok, well those are things that you live with, but often women need to explore their sexuality side of things and their feelings, we also get a lot of women in the middle age bracket for want of a better term, who are venturing onto new adventures and are looking for a bit of confidence, so they may have lost a partner or be moving into a new journey, they may have new symptoms present and they’re alarmed and wonder if this is a health problem and just seeking advice really…

Host: Right. So let’s come on to what you actually do then. What is it?

E: Laughs. How long have you got? So we initially started out with our new our new vaginal tightening treatments, this is something that is not new, it’s been out for a while and it became very apparent very quickly that tightening of the vagina is a small part of the sexuality side of things and that women were presenting with very complex issues, sometimes relating to menopause sometimes relating to illness, and what we’ve done is we’ve developed a clinic network with a group of nurses who have got a range of experiences far and wide, so we have midwives, sexual health specialists, genitourinary medicine, and so on and so forth. Because when women were coming to us, they were telling us that there is nowhere for me to get a one stop help shop from, I have to go to my GP or my aesthetic practitioner, or I have to go to my midwife of my practice nurse and we found very quickly that there was a real need for women to have time. What we decided to do was to develop from the vaginal tightening treatment, to expand into things like menopause, heath, sexual health for example, you know STI rates are going through the roof in the over 50s, that’s well document now. We did a survey, we’ve done a 400 patients treatments across the board in the last year across the 6 clinics that we’ve got, and out of those 400 we did a survey, and the things that cropped up over and over were having a private place to speak, having a nurse face-to-face at the end of the phone was an important thing, having all female staff, now that’s quite a big thing for ladies to being able to speak to a woman about woman’s things cos it helps if you have the equipment to be able to understand how it feels. Also that people were finding it difficult to access a service that suited them. We can refer onwards if we need to into traditional mainstream NHS medicine but we’ve also got enough expertise within our network to be able to offer that to patients as well.

Host: Right. And the tightening itself, what would that be a general anesthetic, local…?

E: No it’s a very simple procedure, it involves the use of a special laser and what happens is what happens when we hit the golden age of 27 Mother Nature starts to withdraw a few services so we start to decline so to speak, so things like collagen production will slow down. And this is why we start to get loosened tissue as well as the mechanics of having a baby. The only way to stimulate new collagen is to produce an injury, a controlled injury, so if you think for example I injured you now you would get red, it would get bruised, it would be swollen and you would, if it were a small injury you wouldn’t get a scar because there’s enough resources around it to fix it, so in essence what we do is we would insert the laser in the vagina, whilst the patient is awake, very little discomfort, we cause superficial micro injuries, the result of which long term is that you produce new collagen which cause the tightening effect as well. It also increases new blood supply to that area which is why a lot of our women will say that sexual gratification has improved. In terms of urinary incontinence, which is a complaint that a lot of our women have, a full assessment of things like their pelvis floor ability and their tone is quite important because a lot of women don’t actually do those exercises correctly and the only way for a nurse to make that assessment is to actually feel the muscles as the patient contract them, so a little a bit when a personal trainer is with you at the gym and they watch you lift a weight and tell you the technique the same sort of thing, but the only way that can happen is if a patient was being examined at the time.

Host: Right, I’m guessing this is private then-

E: Yes, it is-

Host: This isn’t on the NHS. And how much would something like that be, ballpark figure…

E: We’ve priced it so it’s more available, there are other clinics out there that do similar types of treatment that charge quite a lot and we didn’t feel that was acceptable for women across the board because 95 to 98 per cent of us have issues. For a single treatment we charge £499. The recommended gold standard in literature, research in clinical data going back over 20 years, is that three treatments is a good starting point with maintenance, because obviously we’re still ageing, and we price that £995.

Host: I was going to ask you, about the whole thing of you know, is this just a one magic kind of treatment and everything is fine, it sounds like you have to have more than 1 then…

E: Typically, each woman is different. We leave it up to women to decide themselves based on their responses. The treatment itself is a small part of what is going on. The talking side of it is also a big thing because psychosexual issues are also a big issue sand connecting body and mind is a really important thing and that’s where the talking therapies as well as the lasers come into that and supporting ladies as they transition in their different phases. So a woman in her 20s to 30s has got very different issues to somebody who is approaching menopause or going through or who is post menopausal and we need to be able to support hem along that journey in all our services.

Host: Very interesting. Thank you for coming in, explaining more. That’s Emma Soos from Edwalton on BBC Radio Nottingham with her own story and what she’s doing now as well…