Woman's health in GP

Question 1

How does the combined hormonal contraceptive help with painful periods?

Answer 1

It gives lighter periods that are more controlled

Question 2

How does mefenamic acid help with painful periods?

Answer 2

It’s an NSAID used for pain but it also works by inhibiting the level of prostaglandin synthesis in the uterus lining.

Prostaglandins are responsible for the feeling of cramps

Question 3

How does tranexamic acid help with painful periods?

Answer 3

It’s an NSAID that helps your blood to clot, which will reduce the bleeding

Also works on prostaglandin in the lining of your uterus, as prostaglandin seems to contribute to heavy bleeding and pain

Question 4

How does the progesterone only oral contraceptive help with painful periods?

Answer 4

It makes the period less heavy and acts on prostaglandins to reduce contraction that contribute to the pain

Progesterone only pills are not as predictable as combined and people may still bleed between periods. It’s unpredictable how people will react to it

Question 5

What is primary dysmenorrhoea?

Answer 5

Painful periods

Question 6

What are secondary causes of primary dysmenorrhoea?

Answer 6

-Pelvic inflammatory disease (PID)
-Fibroids
-Endometriosis
-Cancer
-IUD insertion

Question 7

How do secondary causes of dysmenorrhoea present?

Answer 7

Usually after several years on painless periods

Symptoms: dyspareunia, inter menstrual bleeding, post coital bleeding

Question 8

What is dyspareunia?

Answer 8

Genital pain that can be experienced before, during, or after intercourse

Question 9

What is endometriosis?

Answer 9

When tissue from inside the uterus grows outside of it causing cysts and tissue to stick together

Question 10

What is menorrhagia?

Answer 10

Heavy or prolonged menstrual bleeding

Question 11

What is a ca-125 blood test for?

Answer 11

cancer antigen 125
Used as a tumour marker for endometrial cancer

Question 12

What is a TVS?

Answer 12

A transvaginal ultrasound scan

Question 13

What is the first-line treatment for mennorrhagia?

Answer 13

The mirina coil

Question 14

What are some causes of amennorrhoea?

Answer 14

-Pregnancy
-PCOS
-Eating disorder (underweight)
-Excessive exercise
-Drug induced
-Prolactinoma

Question 15

What are the long complications of PCOS?

Answer 15

-Osteoporosis
-T2 diabetes
-Cardiovascular disease
-Infertility
-Psychological distress

Question 16

How is PCOS managed?

Answer 16

General: weight loss and annual screening (Hb11c, BP, BMI)

Advice for hirsutism, acne, and infertility

Oral contraception for oligomenorrhoea

Question 17

How often is the cervical screening in primary care?

Answer 17

Every 3 years 25-49
Every 5 years 50-64

Question 18

How often is the breast screening on primary care?

Answer 18

Every 3 years 50-70

Question 19

What are the types of symptoms you expect with ovarian cancer?

Answer 19

-New onset IBS 50+ years
-Early feeling of fullness
-Raised ca-125
-Ascites
-Pelvic pain
-Increased urinary frequency
-Blood- stained discharge

Question 20

What symptoms would you expect with endometrial cancer?

Answer 20

-Post menopausal bleeding
-Visible haematuria
-Thrombocythemia

Question 21

What symptoms would you expect with cervical cancer?

Answer 21

-Post coital bleeding
-Intermenstrual bleeding
-Dyspareunia

Question 22

What cancer prevention would you advise to a teenager?

Answer 22

Condom use
Quit smoking
Healthy diet