sexual health Flashcards
emergency contraceptives
Levonorgestrel — a progestogen, taken orally as a single dose 1.5 mg tablet.
Ulipristal acetate — a selective progesterone receptor modulator, taken orally as a single dose 30 mg tablet.
The copper-bearing intrauterine device (Cu-IUD)(also known as the copper coil)
how does the cobrraecpetive levonorgestrel
+ disadvantages
it inhibits ovulation for 5 days , and any sperm in the reproductive tract becomes inactive in the late follicular phase
A repeated dose is required if the woman vomits less than 3hours after taking the tablet.
May be effective for up to 120hours, but it is not licensed for use beyond 72hours (unlike ulipristal acetate).
Is less suitable for women using drugs (or certain herbal preparations) thatinduce liver enzymes.
how does the contraceptive ulipristal acetate work
+ disadvantages
- inhibition and delay of ovulation , suppresses the development of follicles
if the LH surge has started it can delay follicular rapture for up to 5 days when given immediately
disadvantages
repeated dose is required if the woman vomits less than 3hours after taking the tablet.
Is not suitable for women using drugs (or certain herbal preparations) thatinduce liver enzymes.
Breastfeeding should be avoided for 1week after taking ulipristal acetate.
how does Cu-IUD contraceptive work
= disadvantages
- copper is toxic to the ovum and soerm so the cu-iud is effective immediately after insertion and inhibits fertilisation
The copper IUD is less readily available for emergency contraception than levonorgestrel or ulipristal acetate:
Some women have pain during IUD fitting which can persist for a few days.
The IUD may perforate the uterus -the rate of perforation is low - may be due to incorrect fitting of the device.
There is an increased risk of pelvic infection in the 20days following insertion.
when would you refer with emergency contraception
copper intrauterine device to be fitted
clinical conditions where use is not recommended
Patients who have taken CYP3A4 enzyme inducing medicines or herbal products within the last 4 weeks
Pregnancy and suspected pregnancy.
Patients with a previous allergy to active ingredients contained in emergency hormonal contraceptive or excipients.
If unprotected sex or failure of contraception occurred beyond the time limit for the individual product identified suitable for the patient (see tables).
If severe lower abdominal pain is experienced after taking oral emergency contraception refer due to risk of ectopic pregnancy.
vulvovaginal candidiasis
Vulvovaginal candidiasis (genital thrush) is a symptomatic inflammation of the vagina and/or vulva caused by a superficial fungal infection.
Most cases are caused by a Candida yeast-Candida albicans accounts for 80–89% of cases.
Changes in vaginal pH or circulating sex hormones, Candida can multiply, leading to symptomatic vulvovaginal candidiasis.
Vulvovaginal candidiasis can be classified as:
Acute infection - a first or single isolated presentation of vulvovaginal candidasis.
Recurrent infection - four or more symptomatic episodes in one year.
what are the complications of thrush
Treatment failure (failure of symptoms to resolve within 7–14 days of treatment) occurs in up to 10–20% of women receiving antifungal treatment for uncomplicated vulvovaginal candidiasis.
Depression and psychosexual problems may affect women who have recurrent vulvovaginal candidiasis.
Candidal balanitis may occur rarely in male partners of women with vulvovaginal candidiasis.
what are the symptoms of thrush
Pruritus vulvae - itchiness of the vulva
Vulval soreness
White, ‘cheesy’ discharge. The discharge is non-offensive. Foul-smelling or purulent discharge suggests bacterial infection.
Dyspareunia (superficial) – painful intercourse
Dysuria (external) – painful or difficult urination
Symptoms tend to be exacerbated premenstrually and remit during menstruation.
what are some otc treatments for thrush
Either an intravaginal antifungal, such as clotrimazole (imidazole) (or miconazole pessaries – POM), or an oral antifungal, such as fluconazole (triazole).
what are some red flags of thrush
- previous sti
- abnormal bleeding
- ## pregnant or breastfeeding
chlamydia
Genital chlamydial infection is the most common sexually transmitted bacterial infection (STI) in the UK.
Caused by the bacterium Chlamydia trachomatis.
In men, it infects the urethra.
In women, it infects the cervix or urethra, or both.
C. trachomatis can also infect the conjunctiva, rectum, and nasopharynx.
it becomes complicated once it goes up to the upper genital tract
