Self Care E2_STI and pregnancy

virus, bacteria, fungus, or parasite spread through sexual transmission

STIs

methods of prevention of STIs

1. abstinence

2. partner reduction

3. mutual monogamy

4. barrier protection

5. vaccination

which STIs are vaccine preventable

1. HPV

2. hep B

which STIs are not curable

HPV

HepB

HIV

AIDS

Genital herpes

which STIs are not curable and have no vaccines to prevent them

HIV/AIDs

genital herpes

what does HPV usually infect

infects moist surfaces and inner lining of organs and body cavities

1. cervix

2. vagina

3. vulva

4. penis

5. anus

6. mouth

7. throat

what are the high risk HPVs (aka they cause cancerrr)

16

18

what are the low risk HPVs (aka they rarely cause cancer)

6

11

what are the types of HPV

1. high risk

2. low risk

high risk HPV

may be asymptomatic

precancerous

most likely to cause cancer, most contagious

low risk HPV

rarely cause cancer

if symptomatic, cause warts on the genitals, anus, mouth, throat

what vaccine if available for HPV

Gardasil 9 (9-valent HPV vaccine)

rec number of doses of gardasil 9 for ages 9-14

2

rec number of doses of gardasil 9 for ages 15-26

3

types of hepatitis B

1. acute

2. chronic

acute hepB occur within

6 months of exposure

presentation of acute HepB

can be asymptomatic, mild, or severe requiring hospitalization

chronic hepB clinical presentation

liver remains inflamed for >6 months

chronic HepB can cause

liver damage, cirrhosis, cancer, death

risk factors for hepatitis B

1. incarcerated

2. IVDU

3. MSM

4. STI coinfections

5. HIV

6. healthcare workers

7. dialysis patients

what are the categories for birth control methods

reversible

irreversible

other

reversible BC method options

barrier, hormonal, IUD

reversible barrier BC options

male or female condoms

spermicides

sponge

reversible hormonal BC options

implants

injections

pill

patch

vag ring

what are the synthetic male condom options

1. latex

2. polyurethan

3. polyisoprene

latex male condom is effective the most effective male condom for preventing…

STIs and pregnancy

list the types of male condoms in order of most effective to least

latex

polyurethane

polyisoprene

safe lubricants with latex condoms

1. contraceptive foams/gels

2. water based lubricants or silicone based lubricants (K-Y jelly, astroglide, aqualube)

3. glycerin

4. egg whites

5. saliva

6. water

unsafe lubricants with latex condoms

1. edible oils/fats

2. hemorrhoidal ointments

3. petroleum jelly

4. massage oil/body lotions

5. mineral oil

6. vaginal creams

lambskin/ natural male condoms

typically made using a portion of the lamb intestinal cecum

lambskin condoms protection

can prevent pregnancy but not STIs

type of lubricants used for natural membrane male condoms

oil based

lubricants that can be used with the following

late

polyurethane

polyisoprene

natural membrane

latex: water based

polyurethane: water or oil based

polyisoprene: water based

natural membrane: water or oil based

female condoms prevent

pregnancy and STIs

female condoms can be inserted up to ___ hours before sex

8 hours

vaginal spermicide

nonoxynol-9 (N-9)

MOA of nonoxynol-9 (N-9)

reduced sperm motility and cervical mucus penetration

directions for use of nonoxynol-9

place no more than one hour before sex, leave in place at least 6-8 hours after

dosage forms of nonoxynol-9

1. foam

2. gel

3. cream

4. film

5. suppository

6. tablet

nonoxynol 9 prevention

only preg (NO STDS)

adverse effects of vaginal spermicides

1. disrupt epithelium and icnrease risk for HIV

2. increase risk for UTIs

3. genital irritation

clinical pearl of vaginal spermicides

can use in addition to a male condom, diaphragm, or cerival cap

sponge

protection that contains spermicide and is placed over cervix to act as a barrier

sponge protection

only preg (NO STDS)

directions for use of spogne

moisten with at least 2 tbsp water, squeeze

can insert up to 24 hours prior

must have in for >6 hours after (leave no longer than 30 hours total)

sponges can lead to

toxic shock syndrome

pros of fertility awareness based methods

1. lack of medical adverse effects

2. no chemicals or barriers

3. little to no cost

4. immediately reversible

5. religious obligaions

cons of fertility awareness based methods

1. lack of STI protection

2. higher pregnancy rate

3. periods of abstinence

4. requires diligence from both

calendar calculations for fertility awareness methods of

1. rhythm method

2. standard days method

rhythm method of calendar family planning

uses length of previous 6-12 cycles to predict current cycle

standard days method of family planning

simplified version of rhythm method

assumes a cycle length of 26-32 days

sets a 12 day fertility period from days 8 through 19

when does a womens body temperature change

luteal phase

BBT changes by ___ in the luteal phase

increase of 0.4F or 0.2 C above baseline

when should temperature be measured for basal body temperature charting

early in the morning at the same time each day

required for basal body temperature charting

at least 3 hours of sleep

methods of cervical mucus monitoring

1. billings ovulation method

2. two day method

billings ovulation method of cervical mucus monitoring

measures consistent changes in cervical mucus during a cycle and identifies the onset of the fertile period

requires daily charting

fertility window when using billing ovulation method

first day after meses that mucus is detected until 4 days after the last day of elastic white mucus

changes that are looked for with billings ovulation method

post menstruation: vaginal dryness

5-6 days before ovulation: increased quantity and elasticity, clear due to rising estrogen levels

post ovulation: thick and sticky or absent due to rising progesterone

two day method of cervical mucus monitoring

did have secretions today or yesterday?

yes to either=fertile

important point with cervical mucus monitoring

vaginal forms, gels, creams, and douches will interfere

symptothermal method of monitoring fertility combines which methods

calendar calculations, basal body temperature charting, and cervical mucus monitoring

foundation of symptothermal method

cervical secretions

lactational amenorrhea

the suppression of ovulation and menstruation during breast-feeding

when is it considered lactational amenorrhea

1. infant <6 months

2. infant receives >/=90% of nutrition from breastfeeding

3. mother is amenorrheic

lactational amenorrhea is limited to...

6 moths postpartum

note: cannot breast pump

has highest failure rates at preventing pregnancy

coitus interruptus (aka pull out method)

ovulation predictor kit

method that measures LH in urine to detect LH surge

some tests may measure E3G

only used to aid in becoming pregnant, not prevention

when does LH surge occur in regards to ovulation

24-36 hours before ovulation

estrone 3 glucuronide (E3G)

byproduct of estrogen breakdown

causes mucus to become thin and slippery

____ indicates that a women is in the most fertile part of her cycle

LH surge + E3G

plan B one step (levonorgestrel)

OTC emergency contaception

dose of plan B one step

1.5 mg once

MOA of plan B one step

progestin only pill that delays follicular development when administered before LH increases

prevents/delays ovulation

plan b one step can be used up to ___ after

72 hours

BMI/weight that may make plan b one step less effective

>25 or >165 lbs

notes on nausea and vomiting with plan b one step

1. meclizine or another OTC antiemetic can be take 1 hour before if known to be easily nauseated

2. if vomiting occurs within 2 hours of levonorgestrel, consider repeating dose

if menses is __ late, consider pregnancy test

>/=21 days