Women’s Health And Contraception

Question 1

Which forms of contraception are most likely to help with regulating painful or heavy periods?

Answer 1

1st line: levonorgestrel IUS
2nd line: COCP
3rd line: POP or progesterone injections

Question 2

Which form of contraception may make periods heavier?

Answer 2

Copper IUD- can cause endometrial inflammation and therefore heavier periods

Question 3

What symptoms can a perimenopausal woman experience?

Answer 3

Sexual dysfunction, low libido, depression, anxiety, mood swings, lethargy

Question 4

What are some non-hormonal options for treatment of menorrhagia (heavy periods)?

Answer 4

Transexamic acid or NSAID

Question 5

How long can it take to see improvement in heavy periods following IUS insertion?

Answer 5

At least 6 menstrual cycles

Question 6

What are the benefits of HRT?

Answer 6

Help to relieve most menopausal symptoms, can also prevent osteoporosis

Question 7

What are the risk of HRT?

Answer 7

Some types can increase risk of breast cancer (little/no charge with oestrogen only)
HRT tablets can increase risk of blood clots (not patches or gels)

Question 8

What are some side effects of HRT?

Answer 8

Breast swelling/tenderness, nausea, headaches, bloating, mood swings

Question 9

Which forms of contraception are generally avoided in migraine?

Answer 9

Combined hormonal contraceptives- thought to be from increased stroke risk

Question 10

Can women who have migraines without aura take combined hormonal contraception?

Answer 10

They can unless they have other vascular risk factors like high BMI, BP or family history

Question 11

What long-acting forms of contraception can be given?

Answer 11

Conraceptive injection, hormonal implant, intrauterine device, intrauterine system, sterilisation

Question 12

How effective are female and male sterilisations?

Answer 12

Both are above 99% effective

Question 13

What are some risks of vasectomy?

Answer 13

Chronic post-vasectomy pain 1-14% , small risk of haematoma or infection

Question 14

What are common symptoms of menopause?

Answer 14

Sexual dysfunction, low libido, depression, anxiety, mood swings, lethargy

Question 15

What are some red flags for endometrial cancer?

Answer 15

Unexplained vaginal discharge, unexplained vagial bleeding after menopause, visible haematuria

Question 16

If a woman over 50 starts having irritable bowel syndrome symptoms for the first time, what more serious differentil should you rule out?

Answer 16

Ovarian cancer

Question 17

What are some red flags for ovarian cancer?

Answer 17

Abdo pain, bowel habit changes, urinary symptoms, unexplained weight loss

Question 18

What type of protein is ferritin? What physiological state can affect this?

Answer 18

Acute phase protein, so will be higher in inflammatory processes