sexual and Reproductive health Flashcards
list some of the myths about HIV
- can be cured by sleeping with a virgin
- women are the vectors
- douching prevents transmission
- condoms are for prostititues
- if a woman wants a condom she is cheating
- free condoms cause AIDS
How would you manage an HIV positive woman presenting asking for emergency contraception
ARVs may interfere with the EC.
Aluvia, Kaletra or Rifampicin particularly.
Offer IUD for these women
If unacceptable, give the drugs at higher doses
-3mg levonorgestrel tablets stat (instead of 1.5m)
OR
-3 Ovral tablets 12 hours apart (instead of 2 12hours apart)
define infertility
No pregnancy after 1 year of trying to fall pregnant and having unprotected intercourse
How would you approach/manage couples presenting with infertility in a tertiary care facility
- Establish underlying cause
-Midluteal phase serum progesteron
-US to exclude PCOS, ovarian,uterine or tubal pathology
-Semen analysis
-HSG to assess tubal potency
-HIV, VDRL, Rubella - Establish treatment plan
-Medical ovulation by clomiphene citrate
-Artificial insemination
-Reconstructive uterine or tubsl surgery ie removal of fibroids
-Adoption or fostering - Education, Support and Counselling
what is the referral criteria for infertility clinic
Younger than 41
BMI less than 35
Infertile couple in stable relationship atleast 2 years
lesbian couple or woman needing donor insemination
no more than 1 child in union
Results of HIV, VRDI, Rubella and pap available
Discuss managemnt of Female Sexual dysfunction
PLISSIT
permission to think and feel sexually, learn to recognize and express sexual needs and guide partner
limitted information - provide info about anatomy and physiology of male and female sexual responses
Specific suggestions- suggestions to improve relationship, communicate feelings, encourage intimacy
Intensive therapy
-Refer for sex therapy, relationship counselling, psychotherapy as appropriate
