when good vaginas go bad n.
Download
Skip this Video
Loading SlideShow in 5 Seconds..
When Good Vaginas Go Bad PowerPoint Presentation
Download Presentation
When Good Vaginas Go Bad

Loading in 2 Seconds...

play fullscreen
1 / 40

When Good Vaginas Go Bad - PowerPoint PPT Presentation


  • 92 Views
  • Uploaded on

When Good Vaginas Go Bad. Susan H. Oakley, MD January 23 rd , 2013. HOT TOPICS. Background Info Normal Female Parts Menstrual Cycle Abnormal Menstruation, Diagnosis & Treatment Pregnancy and Prevention Sexually Transmitted Infections (STIs/STDs) and Prevention Pelvic Exam. Background.

loader
I am the owner, or an agent authorized to act on behalf of the owner, of the copyrighted work described.
capcha
Download Presentation

PowerPoint Slideshow about 'When Good Vaginas Go Bad' - malha


Download Now An Image/Link below is provided (as is) to download presentation

Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author.While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server.


- - - - - - - - - - - - - - - - - - - - - - - - - - E N D - - - - - - - - - - - - - - - - - - - - - - - - - -
Presentation Transcript
when good vaginas go bad

When Good Vaginas Go Bad

Susan H. Oakley, MD

January 23rd, 2013

hot topics
HOT TOPICS
  • Background Info
  • Normal Female Parts
  • Menstrual Cycle
  • Abnormal Menstruation, Diagnosis & Treatment
  • Pregnancy and Prevention
  • Sexually Transmitted Infections (STIs/STDs) and Prevention
  • Pelvic Exam
background
Background
  • Average age of MENARCHE = 12yo
  • Typical Menstrual Cycle = 21 to 35 days
  • Bleeding lasts < 7days
background1
Background

Young Women…..

  • Seen in a variety of clinical practice settings by providers with different backgrounds and training
  • Account for ¼ of sexually active population aged 15-44 years, but
  • Acquire nearly ½ of all new STIs
  • 88% of new STI cases are from 3 infections: HPV, trichomonas, and chlamydia

Weinstock et al., Persp Sex Reprod Health, 2004

background2
Background
  • First Visit to Ob/Gyn @ 13-15yo
  • First Exam when SEXUALLY ACTIVE
  • First PAP smear for cancer screening @ 21yo

- every 2 years from 21-29

- every 3 years from 30+

- may discontinue at age 65-70

ACOG Practice Bulletin 109, December 2011

background3
Background
  • High Adolescent Pregnancy Rates in the USA
  • Adolescents = highest rates of HPV
  • Adolescents can legally give consent to be tested for and treated for STIs
  • Adolescents need parental consent for “procedural” contraceptive methods
hormones
HORMONES
  • ESTROGEN
  • PROGESTERONE
  • TESTOSTERONE
  • SHBG
abnormal menstruation
Abnormal Menstruation
  • Menorrhagia
  • Metrorrhagia
  • Menometrorrhagia
  • Polymenorrhea
  • Oligomenorrhea
diagnosis of abnormal bleeding
Diagnosis of Abnormal Bleeding
  • History and Physical Exam
  • 20% of all AUA due to bleeding disorder
  • UPT
  • CBC
  • TSH
  • PAP*
  • Chlamydia
  • +/- TVUS

ACOG Practice Bulletin 128, July 2012

how to make bleeding better
How to Make Bleeding Better!
  • OCP
  • Patch
  • Ring
  • Injection
  • Implant
  • IUD
  • Non-hormonal
  • NSAIDs
pregnancy stats
PREGNANCY STATS
  • National Youth Risk Behavior Surveillance System

- ↓in high school students who have ever had sex 1991-2009: ↓54% to →46%

- ↓in high school students reporting sex with >4 persons 1991-2009: ↓19% →14%

  • 6/10 teen girls have had sex < 18 yo
  • 1/3 of adolescents wait 1 year after initiating intercourse to obtain contraception
  • Most popular = OCPs and condoms
  • Failure rates can  15-18% in adolescents
pregnancy prevention
Pregnancy Prevention
  • Non-hormonal

- Paraguard (copper based) IUD

- Condoms

- Rhythm method (~basal body temperature)

  • Hormonal

- OCP

- Patch

- Ring

- Mirena (progesterone) IUD

- Implanon (subdermal implant)

- Depo-Provera

sexually transmitted diseases1
Sexually Transmitted Diseases
  • HPV
  • HIV
  • HSV
  • Chlamydia
  • Gonorrhea
  • Hepatitis
  • Syphilis
  • Trichomoniasis
slide31

Chlamydia

Chlamydia — Positivity among 15- to 24-year-old women tested in family planning clinics by state: United States and outlying areas, 2003

Note: Includes states and outlying areas that reported chlamydia positivity data on at least 500 women aged 15-24 years screened during 2003.

SOURCE: Regional Infertility Prevention Projects; Office of Population Affairs; Local and State STD Control Programs; Centers for Disease Control and Prevention

slide32

Gonorrhea

Gonorrhea — Positivity among 15-24 year old women tested in family planning clinics by state: United States and outlying areas, 2003

*States reported gonorrhea positivity data on less than 500 women aged 15-24 years during 2003. Note: Includes states that reported gonorrhea positivity data on at least 500 women aged 15-24 years screened during 2003 except for Minnesota which submitted gonorrhea positivity data for July-December 2003 only.

SOURCE: Regional Infertility Prevention Program; Office of Population Affairs; Local and State STD Control Programs; Centers for Disease Control and Prevention

primary and secondary syphilis rates by state united states and outlying areas 2003

Syphilis

Primary and secondary syphilis — Rates by state: United States and outlying areas, 2003

Note: The total rate of primary and secondary syphilis for the United States and outlying areas (including Guam, Puerto Rico and Virgin Islands) was 2.5 per 100,000 population. The Healthy People year 2010 objective is 0.2 per 100,000 population.

Source: CDC/NCHSTP 2003 STD Surveillance Report

slide36

The GYT campaign is a youthful, empowering social movement to reduce the spread of STDs among young peopleVisit the web sites for provider resources, tools, and GYT materials to help support your local STD prevention efforts:

http://provider.gytnow.org

www.cdcnpin.org/stdawareness

www.findstdtest.org

www.itsyoursexlife.com/gyt