Gp Womens Health

Front 1

CIs to HRT

Back 1

Hormone dependent cancer e.g. breast, thromoboembolic disease e.g. Afib, Liver disease where LFTs have failed to return to normal

Front 2

Indications for HRT

Back 2

Early menopause ( prescribe until 51)

Hysterectomy before menopause if ovaries are conserved

second line treatment of osteoporosis

Front 3

SE of oestrogen

Back 3

Fluid retention, breast enlargement and tenderness, nausea and headaches

Front 4

SEs of progesterone

Back 4

Headache, weight gain, bloating, depression

Front 5

Risks of HRT

Back 5

Breast ca, DVT, Stroke, Gallbladder disease, Ovarian Ca (if oestrogen only preparation)

Front 6

Short term benefits of HRT

Back 6

Alleviation of Menopausal symptoms e.g Flushes, sweats, vaginal dryness

reduced incidence of UTIs

Front 7

Long term benefits of HRT

Back 7

decreased risk of osteoporosis and Colorectal Ca

Front 8

Diagnosis of bacterial Vaginosis

Back 8

Grey/white offensive fishy smelling discharge with no vulval soreness. pH > 4.5

Front 9

SEs of bacterial vaginosis

Back 9

increased risk of preterm delivery, development of PID and endometriosis following birth, infection post hysterectomy

Front 10

Treatment for bacterial vaginosis

Back 10

Metronidazole 400mg bd for 5 to 7d or 2g single dose or Clindomycin 2% cream nocte PV for one week

Front 11

Treatment of vaginal Candidiasis

Back 11

Clotrimazole pessary

Fluconazole 150mg stat, again after 3d if severe (CI if breast feeding or pregnant)

Front 12

What is required for diagnosis of pcos

Back 12

2 of the following;

1. Oligomenorrhea and/or anovulation

2. Hyperandrogenism

3. Polycystic ovaries. Defined as >12 follicles in each ovary measuring 2 - 9mm in diameter and or ovarian volume >10cm cubed "string of pearls" sign

of note: 1 in 3 premenopausal women will have PCOS on US and 1 in 3 of these will have PCOS

Front 13

Management of PCOS

Back 13

1. weight loss and exercise

2. If oligomenorrhoeic consider progesterones to induce withdrawl bleed every 2 to 3 months. Consider COC pill to regulate menstration. COCs with anti androgen (co-pyrindiol) may decrease Acne/hirsuitism

3. Clomifene can be used to induce ovulation

4. Metformin

Front 14

When can copper IUD be inserted for contraception

Back 14

Up to 5 days after sexual intercourse or 5 days after earliest expected date of ovulation irrespective of irrespective of time since sexual intercourse

Front 15

What is treatment of Menorrhagia

Back 15

1. mirena coil ( if at least 12monts use is anticipates)

2. transexamic acid or NSAIDs or OCP

3. Norehiterone (15mg) daily from day 5 to 26

Front 16

What does T score measure

Back 16

Absolute fracture risk. Less than -2.5 is osteoporosis

Front 17

whats a Z score

Back 17

Individuals relative risk for their age compared with reference values of same age

Front 18

What is Tibilone

Back 18

Weak agonist to oestrogen/progesterone and Androgens. Used in same way as combined HRT. Used in treatment of post menopausal osteoporosis and endometriosis. Used for menopausal symptoms such as vaginal atrophy, libido, vaginal atrophy

Front 19

What is continuous combined HRT

Back 19

has continuous progesterone to induce endometrial atrophy. Has no withdrawl bleed. Should only be given to women who have NOT had a period in last 12 months or who are premenopausal

Front 20

what reduces hot flushes on Tamoxifen

Back 20

Clonidine

Front 21

How is the menopausw diagnosed

Back 21

usually clinically with amenorrhoea >12/12 and no other cause.

If in doubt confirm with FSH >30iu/L on 2 occasions >2 months apart

Front 22

When should menopausal women use contraception

Back 22

>50 use for one year post last period. <50 use for two years post last period