Woman's health and Contraception Flashcards
Outline dysmenorrhea as woman’s health
- Period pain usually felt as painful muscle cramps in the stomach which
can spread to the back and thighs - The pain can be either intense spasms or dull and constant
Outline whaty causes dysmenorrhea
- Caused by the tightening (and contracting) of the muscular wall of the womb
- During the period, the wall of the womb starts to contract more vigorously
to help the womb lining shed as part of the period - When the wall of the womb contracts, it compresses the blood vessels in the
womb lining – this cuts off the blood and oxygen supply to the womb - Without oxygen, the tissues in the womb release chemicals that trigger pain
Outline signs and symptoms of dysmenorrhea
- Women aged 30 to 45 are more commonly affected
- The pain usually lasts 48 to 72 hours – it’s usually worse when the
bleeding is heaviest - Cramps and spasms which can vary in intensity during each period
- Pain appears to become less severe as women age
Outline when to refer for dysmenorrhea
- If periods become heavier than usual or irregular
- If period pain is experienced when women are not on their period
- If period pain is not controlled after three months of treatment with
pain killers
Outline treatment options for dysmenorrhea
- Analgesics can be recommended to
help relieve the pain experienced with dysmenorrhea
*Initially over-the-counter analgesics should be considered
*If no pain relief experienced after
three weeks of using over-the- counter analgesics, refer to GP for
review - Naproxen is an alternative if
appropriate
Outline self care advice for dysmenorrhea
- Stop smoking
- Exercise (gentle swimming, walking or cycling)
- Heat – pads or hot water bottles
- Warm bath or shower
- Massage – light, circular massage around your lower abdomen
- Relaxation techniques – yoga or pilates
Outline menorrhagia as woman’s health
- Menorrhagia is the scientific term for very heavy or abnormal periods
- The condition is painful and needs to be differentiated from dysmenorrhea
- Heavy menstrual bleeding is common and most women don’t experience
blood loss of a significant volume to be diagnosed with menorrhagia - Women who do have menorrhagia may find symptoms restrict everyday
basic activities affecting quality of life
Outline what causes menorrhagia
*Hormone imbalances
* Fibroids
*Ovarian dysfunction
* Polyps
*IUD
* Cancer
Outline when to refer for menorrhagia
*Vaginal bleeding so heavy it soaks at least one pad or tampon an hour
for more than two hours
*Bleeding between periods or irregular vaginal bleeding
Outline treatment options for menorrhagia
- Tranexamic acid 500mg tablets are available as an OTC medicine (launched in 2011)
- Usual dose is 2 tablets 3 times a day during the period for a maximum of 4
days - Small market means the product is not popular and hard to obtain
- OTC NSAIDS may also be beneficial
- Please refer to aches and pains lecture for analgesic choices
- Contraceptives, IUS and other treatments are available from the GP
Outline cystitis as womans health
An infection and/or inflammation if the bladder
- more common among women
Occurs when bacteria grow in the bladder
- sometimes bacteria from around the rectum and genitals can spread
to the urethra
The bacteria enter the urethra, travel to the bladder where they
multiply causing inflammation and/or infection
Outline what causes cystitis
Dehydration
Irritation
Toiletries
Clothing
Pregnancy
Outline signs and symptoms of cystitis
- Intense pain and/or burning sensation on passing urine
- Increased frequency of urination
- Passing small quantities of urine
- Greatly increased urgency when a person needs to pass urine;
particularly smelly and cloudy urine
Outline when to refer for cystitis
- If symptoms do not improve within 3 days
- Frequent episodes of cystitis
- Blood in urine
- If you are male
Outline a breakdown of treatment options for cystitis
- Mild cystitis will usually clear up on its own
- More severe cystitis may require antibiotics upon referral to GP
- Analgesics can be used to help reduce any pain-like symptoms
associated with cystitis
Outline 1 treatment option for cystitis
Sodium Citrate sachets
For example: CanesOasis
Mix the contents of ONE sachet with
200ml water and drink immediately. Use
Three times a day for two days
Outline self care advice for cystitis
- Not using perfumed cosmetics around your genitals
- Having a shower rather than a bath
- Stay hydrated
- Wipe you bottom from front to back when you go to the toilet
- Wearing underwear made from cotton
Outline thrush as woman’s health
Fungal infection caused by Candida Albicans
- This is a very common organism that is found naturally in the vagina
and its presence does not usually cause any symptoms
A change in the pH levels of the vagina may disturb the balance
between Candida Albicans and other organisms which allows the
Candida to flourish
Outline what causes thrush
- Taking antibiotics can alter bacteria levels in the vagina allowing the Candida
to over-develop - Hormonal changes – e.g. contraceptive pills, pregnancy
- Wearing tight or synthetic clothing
- or damaged skin
- Poorly controlled diabetes
Outline signs any sympoms of thrush
- Itching and soreness around the outside of the vagina, which may be
worse at night - A white, curd-like vaginal discharge which is odourless
- A stinging sensation when passing urine
Outline when to refer for thrush
- Symptoms of thrush for the first time
- Patients aged under 16 or 60
- Recurrent thrush (more than twice in six months)
- Pregnant/breastfeeding
- If OTC treatment has not worked
Outline general treatment for thrush
- Antifungal treatment can be in capsule, pessary or cream form
- Thrush should clear up within a week, after one dose of medicine or
using the cream daily for seven days - You do not need to treat partners unless they have symptoms
Outline 1 treatment option for thrush and dose
Fluconazole 150mg Capsule
Take ONE dose immediately
Used in adults between 16-60
Outline a 2nd treatment option for thrush and dose
Clotrimazole 500mg pessary
ONE 500mg pessary to be inserted
At night.
Using the applicator provided, the pessary
should be inserted as high as possible
into the vagina.
Outline a 3rd treatment option for thrush and dose
Clotrimazole 2% cream
Calms the symptoms of itching and soreness
Apply two to three times a day until the symptoms completely
disappear
Outline self care advice for thrush
- Use water to wash your genitals not perfumed soaps
- Dry the area properly after washing
- Wear cotton underwear
- Avoid sexual intercourse until thrush has cleared up
- Take showers instead of baths
Outline bacterial vaginosis as woman’s health
Caused by an overgrowth of bacteria in the vagina
- A change in balance of the variety of bacteria in the vagina
Normally due to a change in the vagina’s pH levels
Outline causes of bacterial vaginosis
The causes of bacterial imbalance is not fully understood
* Using perfumed soaps and bath additives
* Using a douche or vaginal deodorant
* Having multiple sexual partners
* Hormonal changes during the menstrual cycle
* smoking
Outline signs and symptoms of bacterial vaginosis
Sometimes can be asymptomatic
A change in vaginal discharge
* Appear white/grey in colour
* Becomes thing and watery
* Strong, fishy odour
Left untreated, some cases of BV may resolve itself
Outline when to refer for bacterial vaginosis
- The condition is not usually serious – but treatment will require
antibiotics - Can increase risk of getting an STI
- If BV is suspected – refer patient to GP
Outline general treatment for bacteial vaginosis
- Usually treated with antibiotic tablets/gels/creams
- Prescribed by a GP or sexual health clinic
- If you have a same-sex partner, they may also need treatment
Outline 1 treatment option for bacterial vaginosis
- Canesbalance BV vaginal gel can help treat symptoms of BV by
restoring normal pH of the vagina. - Treats the unpleasant odour, abnormal
discharge and discomfort. - Use 1 tube applicator at night for 7 days
- Symptoms should improve within 3 days
Outline self care advice for bacterial vaginosis
- Use water and unperfumed soaps to wash your genital area
- Have showers instead of baths
- Do not use vaginal deodorants, washes or douches
- Stop smoking
- Avoid strong detergents to wash your underwear
Outline available contraceptives via NHS
Combined pill
* Diaphragm or cap
* Implant
* Injection
* IUD (coil)
* IUS (hormonal coil)
* Patch
* Progestogen-only pill
* Vaginal ring
* Female sterilisation
* Vasectomy (male sterilisation)
* Emergency Hormonal Contraception
Outline available contraceptives via pharmacy and alternative
- Female condoms
*Male condoms - Emergency Hormonal
Contraception
ALTERNATIVES: NATURAL FAMILY PLANNING
Outline condoms
- Condoms are 98% effective as a method of contraception
*Many varieties so ample choice - Effective at relatively low cost
*Offer protection against sexually transmitted infections if used
properly - Suitable for vaginal and anal penetrative intercourse
Outline 1 emergency hormonal contraception
Levonelle
* Take within 3 days of intercourse
* Course is 1 tablet
*is thought to work mainly by
preventing ovulation and
fertilisation if intercourse has
taken place in the preovulatory
phase
Neither product will affect a fertilised and implanted egg so are NOT abortifacients
Outline a 2nd emergency hormonal contraception
EllaOne
* Take within 5 days of intercourse
* Course is 1 tablet
* inhibits or delays ovulation via
suppression of the luteinising
hormone (LH) surge.
Neither product will affect a fertilised and implanted egg so are NOT abortifacients
