PH1122 - Sexual Health Flashcards
Describe the symptoms of Chlamydiain both women and men.
Women: bleeding between periods/heavier periods, bleeding after sex, lower abdominal pain, unusual discharge, pain when passing urine
Men: white/cloudy discharge from penis, pain when passing urine, pain in the testicles
How is chlamydia spread ?
Spread through unprotected vaginal, oral or anal sex, sharing unwashed sex toys
what percentage of people with chlamydia are asymptomatic ?
And what can occur if untreated ?
50% of men and 80% of females will be asymptomatic
If Chlamydia is left untreated, it can cause Pelvic Inflammatory Disease (PID) in women
Long-term pelvic pain, blocked fallopian tubes, infertility and ectopic pregnancy
In men, can cause testicular infection (epididymo-orchitis) and decreased fertility
How is gonorrhoea spread ?
Spread through unprotected vaginal, oral or anal sex, sharing unwashed sex toys
What are the symptoms of gonorrhoea for women and men ?
Symptoms
Women: bleeding between periods/heavier periods, lower abdominal pain, unusual discharge, pain when passing urine
Men: green/yellow discharge from penis, pain when passing urine, pain in the testicles
How is genital herpes spread ?
Spread through intimate sexual contact, vaginal, anal or oral sex
What are the symptoms of genital herpes ?
Symptoms
Blistering of genitals, leaving open red sores
Tingling/burning/itching/pain on urination
How can Genital herpes be treated ?
Can be treated, but not cured
Recurrent infection (POM)- Acyclovir 800mg 3 times a day for 2 days, alternatively 200mg 5 times a day for 5 days, alternatively 400mg 3 times a day for 3-5 days
How is genital Warts spread ?
Spread by skin-to-skin contact, such as that during vaginal or anal sex or they may be transferred by sharing sex toys
Can be spread even if no active warts seen
What are symptoms of genital warts ?
Small, fleshy growth that appear on or around genital area
Usually not painful
How is syphilis spread ?
Spread through vaginal, anal, oral sex or by sharing sex toys. Through contact with the ulcers of someone with syphilis
What are the symptoms of syphilis ?
Primary: Genital ulcers
Secondary: Rash on hands and feet, fever, headaches, tiredness
Tertiary: If left untreated, can spread to the brain and cause long term damage
How is trichomoniasis spread ?
Nearly always passed on through unprotected vaginal sex
You can’t get trichomonas from anal or oral sex
Need to treat partners
What are symptoms of Trichomoniasis ?
Symptoms
Abnormal, pale-green smelly discharge, soreness, redness, itching, pain when urinating
How is HIV spread ?
Spread through infected blood, semen, vaginal and anal fluids, breast milk
What are symptoms of HIV ?
Symptoms
Shortly after infection: flu-like fever, rash, joint and muscle pain
Late stage: diarrhoea, night sweats, weight loss, recurrent infections
If untreated, leads to AIDS
Treatable but not curable
How is pubic lice spread ?
Spread through skin-to-skin contact so condoms may reduce transmission but do not prevent
What are the symptoms of pubic lice ?
Symptoms
Often visible, itching, irritation, black powdery droppings from the lice in your underwear
what are the advantages and disadvantages of COCP (Combined Oral Contraceptive Pill )?
ADVANTAGES
Effective in proper use
Pro-menstruation effects
Decreased risk of ovarian & endometrial cancers
Fertility returns to normal when pill is stopped
DISADVANTAGES
Mood changes, nausea, breast tenderness, weight gain, headaches
User dependent
Certain factors such as weight, malabsorption and drug interactions may contribute to contraceptive failure
What does the COCP act as ?
How would it be taken ?
How effective is it ?
Oestrogen and progestogen
Take for 21 days, followed by a 7-day pill-free week (‘withdrawal bleed’)
New guidance: can take back-to-back
12hr window
Perfect use: >99% effective
Typical use: 91% effective
What happens if you miss 1 or 2 pills whilst on a variant of the Combined oral contraceptive pill ?
If 1 pill is missed (at any time in the cycle)
take the last pill even if it means taking two pills in one day and then continue taking pills daily, one each day
no additional contraceptive protection needed
If 2 or more pills missed
take the last pill even if it means taking two pills in one day, leave any earlier missed pills and then continue taking pills daily, one each day
Should use condoms or abstain from sex until they have taken pills for 7 days in a row.
if pills are missed inweek 1 (Days 1-7): emergency contraception considered if unprotected sex in the pill-free interval or in week 1
if pills are missed inweek 2 (Days 8-14): after seven consecutive days of taking the COC there is no need for emergency contraception
if pills are missed inweek 3 (Days 15-21): she should finish the pills in her current pack and start a new pack the next day; thus omitting the pill free interval
What is the progesterone only pill ?
How would you take it ?
How effective is it ?
Progestogen only ‘Mini pill’ Take every day at the same time +/- 3-12hrs, no break (depending on the brand) Desogestrel newer Perfect use: 99% effective Typical use: 91% effective
What are the advantages and disadvantages of the progesterone only pill ?
ADVANTAGES
Used where COCP contraindicated
Not affected by broad spectrum antibiotics
DISADVANTAGES
Spotting, weight gain, headache, mood changes
Less effective than COCP
What are advantages and disadvantages of the implant ?
ADVANTAGES
Not user dependent
Rapid return of fertility
Useful for those who are oestrogen sensitive
Periods may become lighter or stop altogether
DISADVANTAGES Irregular bleeding Headaches, mood swings, breast tenderness, acne Doesn’t protect against STI’s Involves a small procedure by HCP The implant may wander…
How long do people have the implant for ?
how effective is it ?
Progestogen
Lasts 3yrs
Inserted into inner part of upper arm just under the skin
>99% effective
how often does the injection contraception need to be taken ?
Progestogen
Depo-Provera: every 3 months intramuscular
Noristerat: every 8 weeks intramuscular
Sayana Press: every 13 weeks subcutaneous
Perfect use: >99% effective
Typical use: 94% effective
What are the advantages and disadvantages of injection contraception ?
ADVANATAGES Not user dependent Amenorrhoea DISADVANTAGES Weight gain Can take a while for fertility to return to normal Involves a needle!
How long does the Intrauterine System (coil) last and how effective is it ?
Progestogen ‘Hormonal coil’ (Mirena) Lasts 3-5yrs Mirena lasts 5 years >99% effective
What are the advantages and disadvantages of the intrauterine system ?
ADVANTAGES
Not user dependent
Decreased or no periods – first line treatment for menorrhagia
Rapid return of fertility
Hormones are mainly localised in the uterus so likelihood of hormonal side effects is less
DISADVANTAGES Pain/discomfort on insertion Risk of expulsion Perforation of the uterus (<0.5%) Risk of infection (Pelvic Inflammatory Disease)
How long does the intrauterine device last and how effective is it ?
Copper coil- copper acts as a spermicide
Lasts 10yrs
>99% effective
What are the advantages and disadvantages of intrauterine device ?
ADVANTAGES
Not user dependent
Non-hormonal
Regular periods
DISADVANTAGES Heavier, more painful periods Pain Risk of expulsion Perforation of the uterus (<0.5%) Risk of infection (Pelvic Inflammatory Disease)
How effective are condoms ?
Barrier method Male and female condoms (‘femidom’) Only form of protection against STIs Perfect use: 98% effective Typical use: 82% effective
What are the advantages and disadvantages of condoms ?
ADVANTAGES Available for free- C-Card scheme! No serious side effects Protection from STIs Latex-free available for those with allergies
DISADVANTAGES
Can interrupt intercourse
Ineffective if wrong size/fitted incorrectly
how long does sterilisation contraception last and how effective is it ?
Permanent method of contraception
Male: cutting, sealing or tying the vas deferens (the tube that carries sperm from the testicles to the penis)
Femalesterilisation(tubal occlusion) is done by cutting, sealing or blocking the fallopian tubes which carry an egg from the ovary to the uterus
>99% effective
What are the advantages and disadvantages of sterilisation contraception ?
ADVANTAGES
Don’t have to worry about contraception again
DISADVANTAGES
Risk of tubes re-joining and becoming fertile
Can’t be easily reversed
Requires surgery
what are the two emergency contraceptions and how effective are they ?
EHC- the ‘morning-after pill’ Levonelle (levonorgestrel) Take up to 72hrs after unprotected sex. 95% success in 24hrs. 58% success in 72hrs ellaOne (ulipristal acetate) Take up to 120hrs after unprotected sex As effective as Levonelle DOES NOT REPLACE EFFECTIVE REGULAR CONTRACEPTION
What is the general advise given to someone in which an STI is suspected ?
Refer to the GUM clinic
Explain that recent partner should be tested
Suggest using condoms to stop the spread of STI’s in the future.
