women's health

Question 1

What is endometriosis?

Answer 1

• A condition where tissue similar to the lining of the womb starts to grow in other places, such as in the ovaries and fallopian tubes. Can also be in other areas of the body.
• This tissue goes through the same menstrual stages

Question 2

What symptoms can endometriosis cause?

Answer 2

• Severe period pain/irregular periods. Can be crippling. Swelling in tissues that were not made to swell. Can have long periods of bleeding.
• Pain during or after sex.
• Nausea, constipation, diarrhoea, haematuria
• Difficulty getting pregnant

Question 3

How is endometriosis relevant prehospitally?

Answer 3

• Calls are likely for pain management or worrying/irregular bleeding
• People may be on strong NSAIDs such as naproxen, or contraceptive pills.
• May have had surgical management and/or hysterectomy

Question 4

What is polycystic Ovary syndrome?

Answer 4

• Irregular periods, eggs are not regularly released
• Excess androgen – high levels of ‘male’ hormones in the body
• Polycystic Ovaries – ovaries become enlarged and contain many fluid-filled sacs (follicles)
• May have extra hair is male-associated places, but thinning of head hair
• 30-40% of people with this syndrome have insulin resistance. The body increases the amount of insulin it produces. Can lead to fatigue and unwellness.

Question 5

What is menopause?

Answer 5

• Permanent cessation of menses for 12 months, resulting from oestrogen deficiency
• Can start with irregularities, and longer gaps between periods until they stop. Can be quite a long process.
• Usually occurs between 45 and 55
• Number of primary follicles reduce which reduces the amount of oestrogen produced

Question 6

What symptoms can menopause cause?

Answer 6

• Hot flushes, night sweats, difficulty sleeping, anxiety/low mood, memory or concentration problems, osteoporosis, weight changes,
• May have hormone replacement therapy (HRT). May be in tablets. May take oestrogen, progesterone or a combination. Can lead to headaches, nausea, GI disruption, PV bleeding, abdominal pain. Can increase risk of breast cancer.

Question 7

What are the symptoms of breast cancer?

Answer 7

• A new lump or thickening in the breast or armpit
• A change in size, shape or feel of the breast
• Skin changes in the breast such as dimpling, a rash or redness of the skin
• Fluid leaking from the nipple in a woman who isn’t pregnant or breast feeding

Question 8

what are the symptoms of cervical cancer?

Answer 8

• Unusual vaginal bleeding
• Pain or discomfort during sex
• Vaginal discharge
• Pelvic pain

Question 9

What are the symptoms of ovarian cancer?

Answer 9

• Feeling full quickly
• Loss of appetite
• Abdominal pain
• Distended abdomen/bloating
• Frequent urination

Question 10

What happens in the first trimester?

Answer 10

• Up to 12 weeks
• Nausea and vomiting
• Cravings
• Fatigue
• Mood swings

Question 11

What happens in the second trimester?

Answer 11

• 13-28 weeks
• Bump growing
• Baby moving

Question 12

What happens in the third trimester?

Answer 12

• 29 weeks +
• Baby kicking
• Swollen feet
• Indigestion
• Frequent urination

Question 13

What questions are important to ask when taking a history of a pregnant person?

Answer 13

• 1st pregnancy/multiple pregnancies
• Gravidity is number of pregnancies
• Parity is number of births
• Previous complications
• Current complications
• How many weeks/when are they due
• Have they been regularly accessing healthcare

Question 14

What are physiological changes that can occur in pregnancy?

Answer 14

• Total blood volume increases by 30-50% due to increased cardiac output. Larger volume of blood but not necessarily increase in red blood cells. Can lead to anaemia.
• Increased coagulation: greater risk of DVT, PE.
• Peripheral vasodilation
• Increased oxygen demand
• Increased tidal volume
• Restricted diaphragm
• Increased renal blood flow causes increased excretion
• Bladder smooth muscle relaxes – can cause urinary statis
• Baby can prevent bladder fully emptying. Belly can prevent proper cleaning leading to UTI.
• Morning sickness
• Stomach displaced upwards
• Lower oesophageal sphincter is relaxed – acid reflux
• Changes in smooth muscle function leading to gastroparesis. Can lead to constipation.
• Hyperemesis is people who are excessively nauseas and continually vomiting, causing issues in nutrition and hydration.
• Increased insulin production leading to insulin resistance and potential gestational diabetes
• Increase in cortisol levels, can lead to weight increase
• Reduced bone density as foetus needs calcium, and may be taken from mother’s bones
• Increased ligament laxity in the lumbar spine can contribute to back pain.
• Front heavy, cant see feet, back ache, swollen feet. Can cause falls. Likely to fall forwards and arms may not be able to protect. May have internal bleeding that they can compensate for a long time until they can’t. Advocate getting it checked.