Combined Oral Contraceptive Pill (COCP) Progestin Only Pill (minipill) Implanon-NXT Depot-Provera Intrauterine-devices Nuvaring Permanent Contraception Emergency-Contraception Range of options includes: Combined Oral Contraceptive Pill (COCP) Mechanism of Action Hormonal Components Generations and Progestogens Generation Progestogen Example OCPs Effect Indication 1st Norethisterone BrevinorBrevinor-1SynphasicNorimin Low potency, non-androgenic; potential for breast tenderness, nausea,…

Differential Diagnosis To reach the exact diagnosis of dyspareunia is a tricky one as it can be confused with other disorders of similar complaints. Several disorders must be ruled out based upon the history and physical examination before making the diagnosis of dyspareunia. Some of these are listed below: Vaginismus…

Cervical polyp Valval Dermatoses Vulval irritants Lichen sclerosis  Vaginal prolapse Atrophic vaginitis  Urethral caruncles Vulval candida Vulval Itch Vuvlodynia Bartholin cyst  Valval Dermatoses Vulval irritants Lichen sclerosis  Vaginal prolapse  Atrophic vaginitis  Causes: Symptoms: Bacteria in the Vagina: Physical Appearance: Diagnostic Tests: General Measures: Estrogen Treatment: Side Effects and Risks of…

Ovarian cysts are fluid-filled structures that may be simple or complex. They are commonly found incidentally during physical examination or imaging. Complications such as rupture, hemorrhage, and torsion can be gynecological emergencies requiring prompt diagnosis and treatment to avoid high morbidity and mortality. Epidemiology: Pathophysiology: Etiology: Symptoms Management Postmenopausal Women:…

Definition/Introduction: Issues of Concern: Clinical Significance:

Dysmenorrhoea + menorrhagia + abdo/pelvic pain

Amenorrhea, the absence of menstruation, can be The evaluation involves a comprehensive history, physical examination, pregnancy test, hormone testing, and pelvic imaging Primary: 1. Anomalies of the Outflow Tract 2. Primary Ovarian Insufficiency (POI) 3. Central Anomalies (Hypothalamic-Pituitary) 4. Other Endocrine Disorders Physiologic and Medication-Induced Amenorrhea: Key Diagnostic Steps: Management:…

  BPS/ interstitial cystitis IBS irritable bowel syndrome Pelvic floor dysfunction pudendal nerve entrapment Endometriosis Pain Pain worsens as bladder fills and improves after voiding Rome criteria:-Continuous/recurrent abdominal pain, relieved with defaecation/ associated with change in frequency/consistency of stool+/- disturbed defecation (2 or more of: altered stool frequency/ consistency/ passage…

Most likely Serious disorders The evil quintuplet Pitfalls

Causes Clinical presentation Physical examination Diagnosis Tests Management

Etiology of Female Infertility Epidemiology Pathophysiology of Female Infertility Anovulation Type Explanation Result Common Causes/Symptoms Analogy Hypogonadotropic Hypogonadal Anovulation (e.g., Hypothalamic Amenorrhea) Insufficient GnRH from the hypothalamus leads to low FSH and LH from the pituitary. Low estrogen, no ovulation. Stress, excessive exercise, eating disorders. Control center (hypothalamus) not sending…

OLIGOMENORRHOEA  (< 9 menstrual cycles/ year) DIFFERENTIALS: Polycystic ovary syndrome Incidence prevalence Causes ‘- may be insulin resistance with resultant hyperinsulinemia stimulating excess ovarian androgen production Diagnosis (Rotterdam consensus group criteria) Assessment Examination Investigations  Management: Indications for specialist consultation  Hirsutism Causes of Hirsutism Investigation for Hirsutism Hyperandrogenism Causes of Hyperandrogenism:…

BENEFITS RISKS – Reduces bowel cancer – Increased endometrial Ca IF >5 YEARS!! – Reduces osteoporosis – Increased breast Ca (slight) – Risk decreases after cessation of MHT – Reduces fractures – Increased VTE – Increased CAD/CVA IF > 5 YEARS!! Note: Estrogen alone does not increase coronary heart disease…

Stages of Menopause: Stopping Contraception at Menopause: Advice on stopping contraception for women aged 50 years and older according to method Method  Advice LNG-IUD, POP, ENG implant Amenorrhoeic for ≥12 months:Check 2 x FSH levels at least six weeks apart and if both are ≥30 IU/L advise that contraception is…

Term Abnormal uterine bleeding pattern Oligomenorrhea Bleeding occurs at intervals of > 35 days and usually is caused by a prolonged follicular phase. Polymenorrhea Bleeding occurs at intervals of < 21 days and may be caused by a lutealphase defect. Menorrhagia Bleeding occurs at normal intervals (21 to 35 days)…

– common problem, 50% breast problems in GP, 14% referral to breast clinic – typical age 30 – 50yrs, peak 35-45yrs – only 1 in 200 with breast pain have breast Ca, <10% breast Ca present w pain There are 4 types =  Sx heaviness or discomfort in breast or…

Common % Mammary Dysplasia 32 Fibroadenoma 23 Cancer 22 Cysts 10 Breast abscess / periareolar inflammation 2 Less common – mammary duct ectasia, duct papilloma, lactation cysts, Paget disease of the nipple, fat necrosis/fibrosis, sarcoma, lipoma mammary dysplasia (aka fibrocystic disease) = most common in women 30 – 50yrs &…

Primary Amenorrhea: Secondary Amenorrhea: