Category Archives: Sexual health

Recurrent vulvovaginal candidiasis

History, examination, and swabs to a) make sure the diagnosis isn’t something completely different and b) check type of candidiasis; non-albicans responds better to nystatin. Risk factors include: Antibiotics Oestrogen (however, evidence contradictory on whether COC is a risk) Daily … Continue reading

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Dyspareunia

(A really old one; BMJ practice pointer article from 2018) Note that this may present indirectly; repeated failure to attend cervical screening, persistent dissatisfaction with contraception, describing disgust with her genitals, dissociating during examination. History Open questions, kept to a … Continue reading

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Contraception in the perimenopause

DMPA and Sayana Press do cause decrease in bone density, but this is reversible and thus not considered an absolute contradiction to contraception over 45. Review every two years for other risk factors is advised. The FSRH do advise against … Continue reading

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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

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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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