Contraception and Sexual Health Guidelines

Contraception

Contraception for women who are breastfeeding
- A mother should not wait until the return of their menstrual period
1) regular intervals between breastfeedings (4 hours during day and 6 hours during night)
2) supplemental food 5%
3) for 6 months postpartum, when a woman doesn’t have menstruation
- condoms and spermicides can be used immediately
- intrauterine device can be inserted within the first 48 hours postpartum
- progesteron-only pills: 21 days postpartum, do not have any adverse effects on milk volume
- combined oral contraception: from 6 weeks, but it has adverse effect on milk volume- Contraception for overweight women- Overweight doesn't influence on the effectiveness of contraception. - Overweight increases the risk of blood clots and strokes -> use of pills not possible because of the same risk - For obese women (BMI <35) either coil or condom

Contraceptive methods:

1. contraceptive implant, 2. intrauterine system, or IUS, 3. intrauterine device, or IUD
4. female sterilization, 5. male sterilisation or vasectomy , 6. contraceptive injection
7. combined pill , 8. progestogen-only pill, 9. contraceptive patch , 10. female and male condoms, 11. vaginal ring, 12. diaphragm, 13. contraceptive cap

Background=Anamnesis

1. Age, 2. Existing illnesses, 3. Family's risk factors, 4. Age of menarche
5. Lasting, regularity of menstruation, 6. Possible pregnancies, abortions, miscarriages
7. Smoking, use of alcohol or drugs, 8. Starting age of sexual activity
9. Papa-test, chlamydia and gynecological examinations, 10. Previous history of sexual health

Examinations
1. BP, 2. weight, 3. Height, 4. BMI, 5. if it is over 30 ---- Pt-Gluk-R, fP-Kol
6. Papa test, 7. Chlamydia test, 8. pH-test, KOH-test, if necessary
1. Fungal culture test, 2. Urine sample, 3. HIV, 4. Hepatitis B and C, 6. Pregnancy test

Combined oral contraindication

Deep vein thrombosis, Arterial thromboembolism, Unsolved vaginal bleeding Severe liver disease or tumor, Pregnancy or suspected pregnancy, Cancer, Hypersensitivity to the active substance, Pregnancy or suspected pregnancy

WHAT CAUSES PID?

bacteria (germs) move up from her vagina and infect her pelvic organs. Bacteria can cause PID. But, most cases of PID are caused by bacteria that cause 2 common sexually transmitted infections (STIs) — gonorrhea and chlamydia. A few months for an infection to travel up from the vagina to the pelvic organs an STI. Normal bacteria found in the vagina and on the cervix can sometimes cause PID.

PID EXAMINATIONS

Doctor will perform a physical exam, This will include a pelvic (internal) exam discharge from your vagina or cervix called abscesses near your ovaries and tubes organs STIs tract infection, and if needed, pregnancy — a test that uses sound waves to take pictures of the pelvic area (uterine) biopsy — the doctor removes and tests a small piece of the endometrium (the inside lining of the womb) — the doctor inserts a small, lighted tube through your abdomen (stomach area) to look at your pelvic organs. Every time you have sex, limit your number of partners and ask about a potential partner's sexual history. Good hygiene habits.

Sexual Abuse

Offensive sexuality, violence is all that's harassment, speeches or actions that the victim feels awkward or uncomfortable. Violence forms include, for example, harassment, name-calling, advances and rape. It traumatized victim. In health care requires the ability to recognize the situation and the skills to take the violence out discreetly, because the customer does not necessarily themselves do not recognize us their experiences and symptoms. Rape victim's care is a long process. Multi-professional co-operation; physical injuries, pregnancy and inf. prevention, the taking of samples, the spiritual first aid and emergency care. Depression, anxiety, substance abuse problems, sleeping problems, nightmares, panic attacks, eating disorders, self-harm. The most important task is to increase the nursing staff a sense of security. (Empathy, interaction, presence, and provision of the necessary information.)