18 - Female Genetalia Flashcards
Menarche
first menstruation and initiation of cyclic menstrual function***
Menopause
absence of menses for 12 consecutive months, usually occurring between 48 and 55 years***
Postmenopausal bleeding
bleeding occurring 6 months or more after cessation of menses***
Amenorrhea
absence of menses
***
Dysmenorrhea:
painful or difficult menstruation
Primary = no actual pathology
Secondary = endometriosis, other
***
Premenstrual syndrome
a cluster of emotional, behavioral, and physical symptoms occurring 5 days before menses for 3 consecutive cycles
***
Abnormal uterine bleeding
bleeding between menses; includes infrequent, excessive, prolonged, or postmenopausal bleeding
Pap smear begins at _____
Age 21
Regardless of behavior, risk factors, and age of first sex
***
21-29 year olds
Cytology only every three years, no HPV testing
30-65 year olds
- Co-testing: cytology and HPV testing
- Cytology and HPV testing every 5 years (preferred)
Cytology alone every 3 years (acceptable)
HPV alone NOT RECOMMENDED
***
After 65
Depends on previous results
65+ and past 5 years were negative
No further testing
This means 3 consecutive negatives or two consecutive co-tests
Continue screening 65+ if…
CIN2, CIN3 or adenocarcinoma
65+ and hysterectomy
No further testing if cervix removed & no history of CIN2 or higher
Screening continues every 3 years, next 20 years if high-grade lesion prior to hysterectomy or cuff recurrence
Guidelines do NOT apply to…
HIV infection
Immunosuppression
Exposure to diethylstilbestrol (DES) in utero
History of cervical cancer
Cervix points posteriorly
Anteverted uterus
Cervix points anteriorly
Retroverted uterus
Cervix in horizontal positon
Midposition uterus
Cervix should be…
Midline
Normally, if you go straight in, you will see the cervix
Cervix usually protrudes…
Cervix usually protrudes 1-3 cm into vagina
HPV vaccine
Gardasil
Targets HPV-16 and HPV-18, 2 most common cancer causing HPV types
HPV vaccine limitations
Vaccine does not protect against 30% of cervical cancer caused by HPV types other than 16 and 18
Level of protection
- Nearly 100% protection if women are not exposed to the virus and get the vaccine
- Less level of protection if a woman was already exposed to HPV 16 or 18
- May not see impact of vaccine for 15-20 years, thus still need to screen regularly
- Now given to both males/females
