When was the last time you gave your mum a call? Mums are special people in our lives. Take a few minutes today to give mum a call, send her a message or organise some flowers to be delivered. Sometimes a little affirmation is all you need to get through the day.
This article is about women’s health.
Women’s health was always an area of difficulty for me. This is partly because I have no personal experience with being a woman, and partly because throughout medical school I had very little exposure doing vaginal examinations, or performing cervical screening. I don’t think I’m unique in this experience as it is common for many male doctors. But that just means for people like me, it is an area which needs special attention when studying. Read every article, ask questions from female doctors and take every clinically appropriate opportunity that is presented to you to deal with women’s health issues.
Menopause is an area where a well-versed GP can provide significant improvement to a patient’s quality of life. Recognising the symptoms of menopause – such as altered moods, tiredness, vaginal dryness and hot flushes, is the first step in assisting a patient feel better. The eTG has a very clear and thorough section on hormone replacement therapies, as do the Jean Hailes and Australian Menopause Society websites. Read them well!
Contraception is an area of medicine you need to learn well. The choice of contraception is very individualised and should reflect the patient’s situation, finances, reliability, symptoms and risk factors. The UKMEC guidelines are used extensively in Australia to help determine a patient’s risk when prescribing contraception. When a patient presents for “just the pill thanks Doc”, always double check the risk factors (such as migraine, clots, new vaginal bleeding, blood pressure etc) before blindly giving them the prescription. You can’t be assured that the doctor before you has checked.
Be kind to yourself, and show a little love towards the females in your life this week.
Dr Andrew Harris
Director of Amadeus Education.
Did you know?
According to BEACH data, 4.2% of all encounters in General Practice were specifically related to the female genital system. Consider this as you are preparing for your exams. (Source: General practice activity in Australia: 2015-16. https://bit.ly/2c4d8Em)
These are the common presenting complaints that should be covered for this topic:
- Abdominal pain in women (https://bit.ly/2TPjaZK)
- Abdominal swelling (generalised) (https://bit.ly/2DcixDY)
- Amenorrhoea (https://bit.ly/2FtI1PA)
- Breast lump in women (https://bit.ly/2st3jo0)
- Breast, nipple discharge (https://bit.ly/2APJbkv)
- Breast pain (https://bit.ly/2ANf9hf)
- Hirsutism (https://bit.ly/2FwjTMd)
- Menorrhagia (https://bit.ly/2MefDBz)
- Pelvic pain (https://bit.ly/2FvqQgM)
- Vaginal discharge (https://bit.ly/2RwAPZH)
Vulvar discomfort and irritation (https://bit.ly/2ROAhh6)
These are the common conditions that should be reviewed for this topic:
Abnormal bleeding – including menorrhagia, post-menopausal bleeding, amenorrhoea
Cervical abnormalities – including cervical cancer, screening
Vaginal abnormalities – including discharge, vaginismus, dyspareunia, prolapse
Pregnancy – including termination of pregnancy, miscarriage, antenatal care/post natal care, early pregnancy bleeding
Breast abnormalities – including breast lumps, breast cancer
Ovarian abnormalities – including PCOS, Ovarian pathology
Menopause – including HRT
Lesbian and bisexual patients
These are the medications and doses that should be learned for the exam:
Pelvic inflammatory disease
Here are the list of recommended Checks that would be useful in your study for GP exams (accessed via subscription from http://gplearning.racgp.org.au):
- Female reproductive system, May 2018
- Abuse and violence, January-February 2018
- Perinatal health, July 2017
- Women’s health, August 2016
- Women’s health, September 2014
- Antenatal issues, June 2012
- Breast symptoms, September 2011
- Menstrual disorders, June 2011
Focus on clinical skills:
Here is a brief focus on some OSCE preparation topics related to this topic:
- Contraception counselling
- Pelvic examination
- Cervical screening with counselling
- New pregnancy counselling
- Antenatal examination: https://bit.ly/2RVoBZR
- Menopause counselling
- Hormone replacement therapy counselling
- Breast examination
Focus on medicolegal:
Here is a brief focus on the medicolegal issues covered in Australian Family Physician: Breast screening and failure to diagnose breast cancer. AFP, April 2009. (https://bit.ly/2W8A8o6)
Copyright © 2021 Andrew Harris