womens Health

Question 1

Cervical screening target age range

Answer 1

25-64

Question 2

Cervical screening frequency of invitations by age

Answer 2

25-49 = every 3 years
50-64 = every 5 years

Question 3

Cervical screening: what is being tested for and how?

Answer 3

HPV.
If HPV positive, a cytology triage test will screen for ‘abnormal cells’.
If HPV positive but no abnormal cells found, a follow up screen happens in 1 year to check that the body has cleared the HPV.

Question 4

Do people who have had the HPV vaccine (since 2008) still have to have the smear test?

Answer 4

Yes, vaccine does not protect against all subtypes of HPV

Question 5

What is the criteria for a targeted screening programme?

Answer 5

UK national screening programme says:

• impact of condition and its disease course is understood.
• Screening test should be simple and suitably accurate in the population where it will be used.
• People must have better outcomes with early or pre-symptomatic intervention.
• Benefits of screening out weight harms of over diagnosis, false reassurance etc.
• Screening programme should be acceptable to public and health professionals.

Question 6

Define FGM

Answer 6

Any procedure that:
- removes or injures any female organs for non-medical reasons (i.e. target tissue is healthy)

Question 7

What are the WHO classifications of FGM?

Answer 7

I: clitoridectimy - clitoris affected
II: excision - clitoris + labia Minora affected. Labia Majora may or may not be removed.
III: infibulation - making the opening to the vagina narrow and sealing it by joining any of the labia (with or w/o removing the clitoris)
IV: miscellaneous e.g. piercing, cauterisation

Question 8

What aspects of FGM are outlawed in the UK (FGM act 2003)?

Answer 8

• to perform FGM in E, W and NI
• to assist in FGM in the UK or abroad when the girl or woman is a UK national or permanent resident

Question 9

How can local authorities legally prevent someone from being taken abroad for FGM?

Answer 9

FGM protection order under the Children act 1989

Question 10

Since when has it been a mandatory requirement for health records to record a patient’s FGM status?

Answer 10

2014. Family history of FGM is also reported to the department of health.

Question 11

What is the time frame to report any FGM in a girl under 18?

Answer 11

FGM discovered during professional work/disclosed by patient should be reported to local police by close of next working day

Question 12

What is the international legal framework covering FGM?

Answer 12

UN convention on rights of the child:
Article 6: right to live and develop healthily
Article 12: right to have a say when adults are making decisions that affect them
Article 19: right to be protected from violence (mental and physical)
Article 24: health services try to abolish traditional practices that affect childrens health

Question 13

When should de-infibulation ideally occur?

Answer 13

Preconception, but if not, in the antenatal period around 20 weeks

Question 14

Which surgical procedures do we need to know about in terms of FGM?

Answer 14

Pre-partum and intrapartum deinfibulation

Question 15

What is secondary amenorrhea?

Answer 15

Someone who has had periods stops having periods

Question 16

What is the definition of oligomenorrhea

Answer 16

Periods more than 35 days apart