Ennis doctor’s sex health research on CF males

A YOUNG Ennis medical intern is putting her knowledge and skills to good use through research studies into the sexual health of men with cystic fibrosis.

Dr Rachel Power, 23, from the Showgrounds Road, Ennis, was top of her class in general practice in medicine at University College Cork earlier this year and scooped the prestigious Dr Timothy O’Toole medal in recognition of this result. She was also awarded the Henry Hutchinson Stewart gold medal in surgery by the National University of Ireland after she competed with the top three medical students from each of the national universities in an extra exam for the €1,000 scholarship.
Rachel is the daughter of Fionnuala and Joe Power and is a past pupil of Barefield National School and Coláiste Muire. She is currently working as an intern in the Mercy University Hospital in Cork in gastroenterology. In spring, she will continue her internship in surgery at Cork University Hospital.
“I have a huge interest in medicine, particularly in surgery and in paediatrics and when my internship is complete, I will have to make a decision what to specialise in. I’m currently leaning towards paediatrics,” Rachel explained.
She recently addressed a conference in Baltimore, US, and in Cork on the subject of reproductive and sexual health among male cystic fibrosis patients.
“As part of the final year medicine studies, each student did a research project. Under Dr Barry Plant, the head of the Cork Adult Cystic Fibrosis Centre, who is a consultant pulmonologist, I did research work into the reproductive and sexual health of male cystic fibrosis patients. We carried out a survey of male CF patients from the age of 16 upwards in the Cork area,” Rachel said.
“The findings were very interesting. A majority of those surveyed who wanted to have children had experienced fertility issues as a result of CF. It is an important issue in Irish healthcare as Ireland has such a high prevalence of CF. Between 95-98% of those wishing or trying to father a child had experienced infertility. What is reassuring is that assisted reproductive technologies can and have helped men in this respect. Two-thirds of those who had encountered fertility issues had success in fathering a child as a result of treatment, mainly including ICSI and IVF.”
Rachel also pointed out that survival rates and ages for male CF patients are improving, with some now living into their 50s, which obviously makes fertility more of an issue for them. “With the survey starting with patients as young as 16, half of those surveyed initially said they weren’t bothered by fertility problems, while with increasing age, 57% said it was an issue. It is a fact that men with CF have higher rates of children with CF but what is reassuring is that both partners have to be carriers of the CF gene to have a child with CF. The survey also showed that one-third of male CF patients were not aware of their increased risk of having a child with CF,” she added.
The study also showed that about 23% of CF male patients reported experiencing impotency. “There is a direct link between impotency and testosterone levels so the findings of our study show that there is scope and a real need for testosterone replacement studies and trials to improve the quality of life and sexual health of male CF patients. Also, 70% of male CF patients support neo-natal screening for CF, which is interesting because the HSE is planning to introduce such a programme. Currently, parents-to-be are only tested if there is a history of CF in a family but neo-natal screening would mean earlier detection, which means that more can be done,” Rachel commented.
In terms of their sexual health, the study also looked at the use of contraception by male CF patients. “35% admitted never using contraception, which is very relevant given that CF patients have a higher vulnerability to cross infection.
“Almost 60% also stated that they require further information on fertility and sexual health for male CF patients,” she said.
“With that in mind, we are currently working on compiling a booklet with this information in the CF centre in Cork,” she said.
She added that the study did not look at female CF patients but feels there is scope for such a study too. “We chose to do our study on men because it is true that a lot of men don’t talk about fertility issues or sexual health. We were quite happy with the level of response to the survey, as 60% of those given the questionnaire participated in the study.”
Rachel presented the findings of the study in Baltimore at the North American Cystic Fibrosis Conference in October and at the Irish Thoracic Society Conference in Cork in November.
“I will present the study at the Irish CF Conference in Killarney in February. Both conferences were very interested in the findings of the study. We are now trying to get the research findings published in a European Medical Journal in the new year. This was the first study on the topic in Ireland but similar research has been carried out in the United States, the UK and Australia. Fertility issues of male CF patients had been looked at but not their sexual health,” she added.
Rachel is now starting another research study in cardiology with Dr Tom Kiernan, a consultant cardiologist in Cork University Hospital and Prof David Kerins.
“The study will assess the viability of heart tissues using cardiac MRI and will involve patients who are referred for cardiac MRI. Our plan is to present it at the Irish Cardiac Society annual conference next autumn,” she added.
The young doctor said she is very passionate about medical research and that medicine was her chosen career for some time.
“As a child, I was very accident prone. I broke a lot of bones and had many stitches so I was somewhat of a regular in Ennis General Hospital and I developed an intrigue in medicine.
“I feel working in medicine is very worthwhile and can make a difference to people and there is a lot of opportunities in medicine. There is also a good degree of job satisfaction but we work very hard. Even in times of economic difficulties, there are always good career opportunities in medicine both at home and abroad,” Rachel said.
The medicine bug is definitely running through her family. Her older sister, Maria, is training to be an emergency medical specialist in Perth, Australia, having qualified in medicine from NUIG, while her younger sister, Bronwyn, is a second year medical student in UCC.