Category Archives: Gynaecology

Postponing menstruation, and amenorrhoea with contraception

Like most GPs, I’ve happily dished out prescriptions for norethisterone when a woman wanted to postpone her period, on a basis of hey, what harm can it do? More than I thought, it turns out; according to an article in … Continue reading

Posted in Credits 2017, Gynaecology, JFPRHC | Leave a comment

Treatment of pregnancy-induced nausea

Today, I was prescribing for a pregnant woman with vomiting and thought it worth checking what the latest recommendations were. According to the RCOG guidelines, the two main classes of drugs recommended are: Antihistamines Phenothiazines (e.g. prochlorperazine) (If neither does … Continue reading

Posted in Credits 2016, Gynaecology | Leave a comment

FSRH guidance – intrauterine contraception

Both the IUS & the Cu-IUD are thought to work primarily through prevention of fertilisation, but the IUS seems to have more of an anti-implantation effect as part of its effectiveness than the Cu-IUD does. Both are extremely effective, with … Continue reading

Posted in Credits 2016, Sexual health | Leave a comment

Vaginal discharge

In women of reproductive age, the commonest causes of vaginal discharge can be categorised thus: Infective: non-sexually transmitted Bacterial vaginosis Candida Infective: sexually transmitted Chlamydia trachomatis Gonorrhoea Trichomonas Herpes simplex (occasional, when the herpes has caused cervicitis) Non-infective Foreign bodies … Continue reading

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Problematic bleeding in women on hormonal contraception

Things to look for include: Pregnancy STIs Cervical cancer Possibly polyps/fibroids/ovarian cysts – debatable whether these could cause irregular bleeding. History Duration of use of the hormonal method – irregular bleeding normal initially Compliance with the method if not LARC … Continue reading

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HRT

Who can have it? Several of the contraindications to combined oral contraception are not contraindications to HRT; in particular, being a smoker over 35 is not considered a contraindication at all, even to oral HRT. I suppose that one was … Continue reading

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Management of irregular bleeding with Implanon/Nexplanon

This month’s JFPRHC had a short but useful article on the management of irregular bleeding with etonorgestrel implants. The authors sensibly pointed out that it’s wise to be fairly proactive in management – a ‘wait and see’ attitude can have … Continue reading

Posted in Contraception, Credits 2014, Gynaecology, JFPRHC | Leave a comment