Ch 27. Female Genitals

Question 1

First sign of puberty at age

Answer 1

8.5-13

Question 2

Perimenopausal period

Answer 2

could be between 35-67yers, normally around 48-51. Ovarian function declines so periods become farther appart, irregular. Uterus shrink, ovaries atrophy, uterus drops, vagina shorter/narrower

Question 3

Cultural and Social Considerations

Answer 3

• Female circumcision/female genital mutilation
• STIs: Rates for most common infection (chlamydia) continue to increase
• More prone to UTIs

Question 4

Subjective: Female Genitalia

Answer 4

Menstrual history
Obstetrical history (pregnancy hisotry)
Menopause
Self-care behaviours
Urinary symptoms
Vaginal discharge 
Past history
Sexual activity
Contraceptive use
Sexually transmitted infection (STI) contact
STI risk reduction 

Older women 
Bleeding 
Vaginal problems
Incontinence
Sexuality

Question 5

Risk factors of HPV

Answer 5

Older, immigrant, Aboriginal women
Low socioeconomic status
Lack of participation in screening
Sexually active at a young age
Multiple sexual partners/a partner with a history of multiple sexual partners
Smoker
Weakened immune system
Oral contraceptives
Multipara
Use of DES (diethylstilbestrol)

Question 6

What is the main cause of cervical cancers?

Answer 6

Persistance infections of HPV causes 99% of cervical cancers

Question 7

HPV prevention

Answer 7

Vaccine: 3 separate injections over a 6-month period

Annual HPV screening: with Pap smear within 3 years of first sexual activity, until 3 negative tests
If tests remain negative, may reduce screening to every 3 years until age 70

Question 8

Inspection of Female Genitalia

Answer 8

Skin colour
Hair distribution
Labia majora
Any lesions
Clitoris
Labia minora
Urethral opening
Vaginal opening 
Perineum
Anus

Question 9

Developmental Considerations: Older women

Answer 9

Decreased natural lubrication (need more lubrication)
Pedersen speculum
Special needs during exam (lack of flexibility, more comfortable position, pillows)