Contraception
When Mei sought a contraceptive method, what is the major comparison she would be asked about to determine her type of contraceptive use?
Non-hormonal and Hormonal
COCP = combined EE and progestogen
Progestogen only tablet
Are all STI's bacterial?
Discuss
No!
Bacterial, parasitic, fungal and viral
What is FGM? examples.
Female Genital mutilation
- excision
- clitoridectomy
- infibulation
What is the pearl index?
system used to determine the likelihood of falling pregnant.
Pearl index of 3 means 3 in 100 women fall pregnant
Mei is confused, what are the different tiers and types of contraception?
Tier 1:
- LARCS
- irreversible methods
Tier 2:
- COCP
- POCP
Tier 1:
- condoms
- fertility awareness
- peri-coital i.e. diaphragms, spermacidal gels, rings
Mei is curious and wants to know the role of ethinylestrodial and progestogens on the menstrual cycle
EE = inhibits FSH so prevents the follicular stage from progressing
Progestogens = Inhibits LH thus prolonging/delaying ovulation AND thickens cervical mucus preventing implantation
A recent test showed clue cells present in the microscopy, what is this indicative of, and what is the treatment methods?
bacterial vaginosis
- Clindamycin topical cream
How does sexual abuse change pubertal development?
sexual abuse at a young age makes the individual more inclined to go through puberty at an earlier age.
Can you use spermamicidal gels by themselves or do you use them with other methods?
You technically can but shocking pearl index of 36 in 100, so normally used in addition to diaphragm or condom
If Mei and her boyfriend decided to adopt the fertility awareness method, what days/times would abstinence be advised?
days 9-18 just incase
Mei wants to know the risks associated with use of the OCP and repercussions of long term use
When on it:
- increased DVT risks
- increase in LDL (depending on OCP given)
- potential increased risk of CV event
No long term effects of use!
A man presents to ED and is diagnosed with proctitis, what infection is he most likely to have?
chlamydia
Mei's parents are considering arranged marriage as they are not fans of her current boyfriend. Is this legal in Australia?
Yes, so long as both partners willingly consent, with no duress
What is the trade name of the implantable contraceptive?
Implanon
Mei took an emergency contraceptive the following day, but what are her options and if she presented to the doctor 2 days later and hadn't taken anything yet?
- Yupze method = EE and levonorgestrel combo 3 tablets
- Positnor = levonorgestrel
- EllaOne = ulipristal acetate
- Copper IUD = 5 days later
Progestogen excess:
Oligomenorrhoea
Amenorrhoea
Appetite
Breast size & tenderness
Dry vagina
Depression
Libido
Mei's boyfriend presents with a genital ulcer which was painless but now he has a very painful lymph node above his genitals. What does he have and how do you treat it?
What if the lymph node was also painless?
LGV, azithromycin and abstinence for a week
if painless lymph node consider syphillis
Why are men more likely to perform pedophillic acts?
Once men enter their 30's they begin to become attracted to females slightly younger than them (evolutionary bc reproductive age). Pedophilia is associated with an extreme attraction to younger females.
Discuss the stages of syphillis in the body.
What stage of syphillis is the most infective?
Primary:
Secondary:
Tertiary:
Late:
In 15 years, Mei and her partner are now wanting to fall pregnant in the next few months. Is this possible with all contraceptive methods?
No, the DMPA injection is unpredictable and even though it only provides cover for 3 months, it can take anywhere from 9-18 months for fertility to come back
We need to work out the main differences between the 2nd and 3rd generation progestogens, to ensure we can target what Mei wants out o the pill, what are they?
2nd gen = more androgenic
3rd gen = less adrenergic
Mei is treated with Azithromycin, what could she possibly be being treated for?
Gonnorhea, Chlamydia, LGV and Chancroid
What is the Westermarck Effect?
When a young woman is adopted into a family with a son, and is raised with him, eventually to be married there is a lack of sexual attraction, thus decreased fertility and fewer kids
A certain contraception cant be used for breastfeeding mothers - what is it and explain the physiology
COCP
after giving birth - the first 6 weeks of breastfeeding the mother already has high levels of oestrogen and so giving more would decrease production of prolactin and thus breastmilk production would decline