Module 19 sexual health Flashcards
dysmenorrhea
painful mestration
- usually begins with the onset of menses or 1-2 days before
dysmenorrhea associated s/s
nausea vomiting diarrhea headaches dizzy back pain
primary dysmenorrhea
recurrent, menstrual-related pain in the absence of pelvic pathology
- thought to be due to release of prostaglandins from the endometrium
secondary dysmenorrhea
describes painful menstruation in the presence of pelvic pathology
- endometriosis
- ovarian cysts
- infection
best contraception for young women
long-active reversible contraception
progesterone only Hormonal contraception
implant
IUD
Depo
mini-pill
combined hormonal contraception
oral contraceptive pills
skin patch
vaginal ring
implant
subdermal space of the upper inner non-dominant arm
controlled release of etonogestrel over a period of 3 years
MOA: ovulation suppression
- prevent conception by thickening the cervical mucus and altering the endometrial lining
Copper IUD
ParaGard
approved for 10 years
MOA: produce a sterile foreign body reaction within the uterine cavity -> hostile environment for the sperm
Hormonal IUD
Liletta: 3 years Mirena: 7 years Skyla: 3 years Kyleena: 5 years MOA: create a sterile foreign body reaction within the uterine cavity -> hostile environment for sperm
DEPO
progestin-only contraceptive injection every 3 months - intramuscular (150mg) or subQ (104mg) Repeat injections every 11-13 weeks Can go as long as 15 weeks
Transdermal contraceptive patch
Xulane
thin, beige adhesive patch w/ progestin norelgestromin and ethyl estradiol
- apply to torso, buttocks, upper arms
- change weekly
Nuvaring
soft, clear, flexible ring that releases the progestins etonogestrel and ethinyl estradiol
- insterted into the vagina
- replaced monthly
combined hormonal contraception MOA
progestin component provides the majority of the contraceptive effect by preventing ovulation via negative feedback on the HPO axis
estrogen component is added to stabilize the endometrium and all for better cycle control
progestin only pills, mini-pill
MOA: thickening of cervical mucus, blocking sperm from entering uterus
Emergency contraception
used after unprotected sex or if there is a method failure
MOA: delay or inhibit ovulation
Copper IUD as emergency contraception
prevent sperm from fertilizing an egg and may prevent implantation if inserted within 5 days of unprotected sex
Male condom
no age restrictions on buying
carry a condom with you if sex is possible
check expiration date
ensure package is not damaged
use a water-based lubricant
unroll on an erect penis
withdraw when the penis is still erect, holding onto the base
vasectomy
interrupts the vas deferens
-> prevents passage of sperm into the seminal fluid
vasectomy advantages vs disadvantage
Advantage - highly effective - performed in clinic - cost effective - no effect on sexual function Disadvantage - takes 2-4 months to be effective - f/u visit to ensure effectiveness - procedure complications -> infection, hematoma, granuloma, swelling, persistent pain - non-reversible - no STI protection
Female sterilization
surgery to remove or interrupt the patency of fallopian tubes
Female sterilization advantages and disadvantages
Advantage - dec. risk of ovarian cancer (40%) Disadvantage - Regret - invasive surgical procedure - no STI protection - Complications -> Minor: infection, wound separation -> Major: hemorrhage, viscus injury, anesthesia complications
Lactational amenorrhea method
breastfeeding delays return to fertility
- prolactin inhibits ovulation
- baby must be exclusively breast fed
- infant less than 6 months old
- woman must be amenorrheic
LAM advantage vs disadvantage
Advantage - free - breastfeed advantages Disadvantage - return of ovulation unpredictable - breastfeeding issues - tender breasts may dec. sexual pleasure - difficulties maintaining EBF - no protection for STI
fertility awareness methods
monitoring cycle and only having intercourse during infertile phases - woman must have regular cycle Methods - calendar - standard days - cervical mucous - two-day - basal body temp - post ovulation - symptothermal - marquette
FAM advantage vs disadvantage
Advantage
- no change on menstrual cycle
- only acceptable method in certain religions/cultures
- can assist in achieve pregnancy when used in reverse
Disadvantage
- requires discipline
- peak libido tends to be during ovulation
- may be impacted by stress: cycle change
- no STI protection
- high failure rate
cervical caps and diaphragms
can be placed anytime before intercourse
- usually in conj. with spermicide
should be left 6-8 hours after sex
may be left in up to 48 hours after
cervical caps and diaphragms advantage vs disadvantage
Advantage - woman in control - active immediately - may be used while lactating Disadvantage - no STI protection - may develop odor - difficult to insert - UTI's may increase - require fitting in clinical setting
contraceptive sponge
prefilled with spermicide
- leave in place 6-24 hours after intercourse
Spermicides
MOA: attacks sperm flagella and body to reduce motility
- Women at high risk of HIV or HIV + CANNOT use this
spermicides advantages vs disadvantages
Advantage - lubrication - easy application - OTC - low cost - may be used while lactating - immediately effective (foam, jelly) Disadvantages - needs 15 min to work (films, suppositories) - messy - unpleasant taste - vaginal, oral, anal, and penile irritation - high failure rate
absolute NO to combined hormonal contraception
breast, cervical, endo CA hx blood clots breastfeeding migraine with aura uncontrolled HTN complicated cardiac surgeries will by laying for long periods
