Common Reproductive System Flashcards
Family planning
Preventing unintended pregnancy
45% of all pregnant are unintended
Cervical screening
Age 21-29 → every 3 years pap HPV not recommended
Age 30-65 → pap and cervical 5 and pap every 3
Older 65 who have had 3 consecutive - pap = no screening
* does not apply to high risk women
IUD
Highly effective Reversible Side effects: Heavy bleeding Amenorrhea Spontaneous expulsion after 1st year of use →rate is higher after childbirth * contraindications: Pregnancy Distorted uterine cavity Unexplained vaginal bleeding Pelvic TB Cancer PID Post septic abortion Post partum sepsis Prurient cerricitis
Etonogestrel implant
4-cm single rod inserted subdermally in the upper arm
* progestin only
→ back up should be used if insertion occurs after 5 days of the start of menses
Combined ora contraceptive pills.
Mini-pill ( estrogen and progestin or progestin only) Most popular OCP are the 4-week cycle combination pill *non-adherence Suppress ovulation Ethanol estradiol. (EE) All progestins cycle control and minimal metabolic changes * contraindications: Current breast cancer <21 days post partum Severe cirrhosis liver Current/past DVT DM
Instruction for use of bc
Start with the onset of menses or on the first Sunday of the week
Back-up for 7 days
Missed doses:
One dose late or missed → take when remember then next dose at the new time = no back up
2 or more → take missed dose ASAP discard any missing dose, taking remaining dose = back up until pills have been taken for 7 days
If last week pills missed omit placebo → start new pack
→ unable to start new pack use back up until 7 days
Special considerations:
Don’t start until 4-6 weeks after delivery in non-nuring mothers
OCP not recommending for lactating women
→ progestin only
OCP start immediently or within 7 days after abortion or miscarriage
Ist trimester - mid trimester same as postpartum
Adverse effects
Bloating Weight gain Nausea Hair changes Weight gain Leg pain Cramps Swelling Blood clots → stop bc if having surgery → I month before Increased risk in smoking women Alter lipids Decrease glucose tolerance Increase risk for HTN Increased risk mI Increased risk of cervical and cancer in those with HPV Breast swelling and tenderness Vaginal infections such as candida Increased risk of pigmentation
Contraceptive patch ( Xulane)
Bypasses liver Better compliance 99% effective Same contraindications as oral Sensitive skin → first day of menses or Sunday App to ass/ABD/ upper arm or upper torso Avoid boobs * change every 7 days → rotate sites Patch free week Changed within 48 hours = no back up Over 48 hours - back up 7 days
Replace in 24 hours or use back up
Vaginal ring
Combined Same benefits as oral bc Left in place Same contraindications as oral Instruction; Insert on first day of menses Back up → if not inserted first 5 days of cycle * if falls out → rinse - replace Falls out 2 weeks → replace back Up 7 days
Progestin-only
Mini-pill Inhibit ovulation congenitally Thickens cervical Save during lactation Higher risk of failure Contraindications: Breast cancer Pregnancy Dm Cirrhosis Dm retinopathy Neuropathy Vascular/cardiovascular disease CVA Vaginal bleeding unexplained
Depo
Medroxyprogestrone acetate IM every 3 months Given on day 5 of menses or anytime Use back up after 7 days Increase weight and body fat #Blackbox Can cause bone density loss
Breast mass
Lump in the breast Anxiety producing event Benign → fibrocystic changes May fluent in size Management: Avoid trauma Firm bra Eliminating caffeine Vitamin E → danoerine helps with severe pain
Abnormal breeding:
Change in pattern or volume Acute = one epoïdse no pregnant women Requires immediate internet to prevent blood loss Chronic → present for the last 6 months Normal frequency 24-48 days Duration = 4.5-8 days Blood loss → 5ml - 80ml Causes: PALM-COEIN Polyp A adenomyosis L leiomumoia M malignancy / hyperplasia C coagulopathy O ovulatory dysfunction E endometrial I iatrogenic N not yet classified “PALM” structural causes “COEIN” not defined by images or histopathology * management Control bleeding Prevent reoccurrence Teenagers → birth control Women → birth control depo/EE acute bleeding Chronic bleed - bp stable conjurigine
Dysparania
Painful intercourse can occur as a result of introduction of penis or deep Penal penetration → From fingers and toys Causes Vaginal inflammation Structured Vaginal atrophy Insufficient vagina lubrication
* Management: Estrogen K-y jelly STI-ABX Kegal exercises
