O+G Flashcards
In women going through menopause, contraception is needed until age ____
55
- 1 year if periods stop >50
- 2 years if periods stop <50
FSH investigation for menopause is indicated when…
age <45
FSH > ____ is indicative of POI/ menopause
30IU/L
HRT and POI advise
Protective against osteoporosis
No excess risk up to age of natural menopause
Contraception still needed as spontaneous ovarian function can occur
IVF still possible with oocyte donation
Absolute contraindications for COCP (UKMEC 4)
Pregnancy
- <6 weeks post-partum, breastfeeding
Co-morbidites/ cancer
- Migraine with aura
- Major surgery + Prolonged immobilisation
- Coagulopathy
- Current rbeast cancer, live tumours
- DM with kidney disease
CVD
- Cardiovascular conditions: AF, IHD, stroke, history of VTE, vascular disease
- SBP > 160, DBP >100
Social
- Smoking >15 cigarettes/ day
Contraindications for COCP (UKMEC 3)
Cardiovascular
- Multiple CVD risk factors: smoking, DM, HTN, obesity, dyslipidaemia
- Controlled hypertension
- Systolic >140, DBP >90
- First degree relative <45 with VTE
Social factors
- Smoking/ stopped within 1 year.
Co-morbidities
- BMI >35
- Hx migraine with aura (>5 year)
- Immobility unrelated to surgery
- Unexplained vaginal bleeding
- Past breast cancer
Non-pharmacological management for primary dysmenorrhoea
Hot water bottle
Yoga
Massage
TENS
First line management of fibroids (<3cm)
IUS
Tranexamic aicd
What contraception is best indicated for hirsutism in PCOS
Cyproterone acetate + ethinylestradiol
First-line medication for postponing periods
Norethisterone 5mg TDS
- Taken 2-3days before event
- peroid starts after stopping
Norethisterone is contraindicated in…
Previous/ current VTE
Has increased risk of DVT
Risk factors for post-natal mental health disorders
Previous hx of mental health disorder
Previous trauma/ abuse
Poor health / complications in pregnancy/ birth
Stress
Difficult birth
Unsupportive environment during/ after birth
Management options for post natal mental health disorders in GP
Medication
Specialist perinatal mental health team
Counselling
Self-guided help
Peer support groups
Post natal depression is screed using ______ in GP
Edinburg Post natal depression scale (Health visitor)
Patient health questionnair 9 (PHQ9)
Whooley questions
