Sexual Health Flashcards
Who has breast screening?
Women aged 50-70 evert 3 years
What are some visual signs of breast abnormalities that patients can keep and eye out for?
- Change in size/shape of one breast
- Lumps or thickening
- Change in skin texture
- Redness or rash
- Inversion of the nipple
- Discharge from nipples
- Pain or discomfort
What are the 4 stages of cancer?
1 - Early stage
2 - Localised
3 - Regional spread
4 - Distant spread
What is the most common cancer?
Breast cancer
Which imaging tests are safe in pregnancy?
- Chest x-ray
- Abdominal USS
Which imaging tests are unsafe in pregnancy?
- Isotope scan
- PET scan
- CT scan
If chemotherapy is needed, when is it safest to perform in pregnancy?
2nd and 3rd trimesters, but should finish at least 3 weeks before delivery
What are the different types of treatment for cancer?
- Hormone therapy
- Targeted therapy
- Systemic treatment (e.g. chemo)
- Immunotherapy
- Radiotherapy
Describe hormone therapy
- Blocks/lowers hormone levels
- Only effective in hormone-sensitive cancers
Describe targeted therapy
Potential ability to target cancer cells by identifying specific proteins on the cells
Describe immunotherapy
- Cancer cells usually not recognised by immune system
- This therapy helps to identify and destroy cancer cells using immune system
What are the contraceptive options containing oestrogen?
- The pill
- Evra
- Nuva-ring
How does the pill work?
- Take 1 at same time each day for 21/7, then break for 7/7
- Perfect use = 99% effective
- Typical use = 91% effective
How does the evra work?
- Contraceptive patch
- Releases hormones through skin
- Must be changed once a week
- Perfect use = 99% effective
- Typical use = 91% effective
How does the nuva-ring work?
- Ring inserted into the vagina
- In for 21/7, out for 7/7, then insert new one
- Can be inserted by the user
- Perfect use = 99% effective
- Typical use = 91% effective
How do the contraceptive options containing oestrogen and/or progesterone work?
Tricks the body into thinking its pregnant so follicles don’t develop, eggs aren’t released each month and cervical mucus thickens
What are the contraceptive options containing progesterone?
- Progesterone-only pill
- Injection
- Implant
- IUS (intra-uterine system)
How does the progesterone-only pill work?
- Take 1 pill every day, no breaks
- Perfect use = 99% effective
- Typical use = 91% effective
How does the injection work?
- 1 injection every 12-13 weeks
- Perfect use = 99% effective
- Typical use = 94% effective
How does the implant work?
- Inserted under the skin in the upper arm once every 3 years
- > 99% effective
How does the IUS work?
- Mirena (5 years) or Jaydess (3 years)
- Inserted into the uterus
- > 99% effective
What are the barrier methods of contraception?
- Male condom
- Female condom
- Diaphragm
- Cap
How does the male condom work?
- Apply to penis before sexual intercourse
- Perfect use = 98% effective
- Typical use = 82% effective
How does the female condom work?
- Insert into vagina and ensure external plastic ring remains outside
- Perfect use = 95% effective
- Typical use = 79% effective
How does the diaphragm/cap work?
- Placed over the cervix
- Should be used with spermicide
- Should be left in for 6 hours after sex
- 92-96% effective
What are the options for emergency contraception?
- Morning-after pill
- IUD (intrauterine device)
How does the morning-after pill work?
Levonelle:
- Take within 3 days
- Releases progesterone which delays ovulation
EllaOne:
- Take within 5 days
- Inhibits progesterone to delay ovulation
How does the IUD work?
- Inserted within 5 days
- Releases copper which is toxic to sperm, thickens mucus and prevents implantation
- Stays in for 5-10 years
What is lactation amenorrhoea?
Method of contraception for BF women. Only effective if:
- Exclusively BF
- <6 months old
- Amenorrhoea (no periods)
- Intervals <4 hours between feeds
- 98% effective if all these criteria met
Why should hormonal contraceptives not be recommenced within 3 weeks of delivery?
Increased risk of VTE
How long should BF women wait before recommencing hormonal contraception?
6 weeks
What is the preferable method of contraception for BF mothers?
Progesterone-only pill
What is FGM Type 1?
Partial/total removal of the clitoris/prepuce
What is FGM Type 2?
Partial/total removal of the clitoris and labia minora with/without excision of the labia majora
What is FGM Type 3?
Narrowing the vaginal orifice by creating a seal (e.g. suturing the labia minora/majora together
What is FGM Type 4?
All other harmful procedures to the female genitalia for non-medical purposes (e.g. piercing, incising)
In which countries is FGM prevalent?
- Egypt
- Somalia
- Ethiopia
- Sierra Leone
- Kenya
- Nigeria
- Ghana
- Tanzania
- Sudan
What is infibulation?
Excising the clitoris/labia of a female and stitching together the edges of the vulva to prevent sexual intercourse
If de-infibulation is necessary, when should it take place?
Around 20/40 to allow time to heal before delivery
What are some signs that suggest a woman is fertile?
- Waking temperature increased by 0.2-0.4
- ‘Stretchy’ vaginal discharge
- Breast changes
- Back pain
- Skin/mood changes
What is the average time that women start having sex again after delivery?
6-8 weeks
What is dyspareunia?
Pain during sex
What are some of the causes of postnatal dyspareunia?
- Decreased vaginal lubrication (can be due to decreased libido)
- Inflammation and infection
- Perineal scarring
- Vaginismus due to expecting pain
What advice could be given to women experiencing dyspareunia?
- See GP if infection/ inflammation/ bleeding
- Change positions
- Use of lubricants
- Pelvic floor exercises
Who should teenage mothers be referred to?
Family Nurse Partnership
What is the legal age of consent?
16
