introduction to women’s health care. what in the world is a women’s health exam? why would...
TRANSCRIPT
Introduction to
Women’s Health Care
Women’s HealthWhat does a teen girl need to know? What in the world is a women’s
health exam?
Why would anyone have one?
Do I need one?
Rachel Sieman, CNMCertified Nurse-Midwife
Nurse MidwifeMidwife: “with woman”
Women’s Health CarePregnancy and
Birth
Women’s Health CareAnnual exams and PAP testsBirth controlSTD testing and treatmentCommon problems
Pregnancy and BirthPrenatal careBirth
Everything you need to know(but were afraid to ask) Why do I need an exam? When do I need one? Who will do my exam? What will happen?
Why does anyone need an exam? Screening for breast and cervical
cancer Common gynecologic problems Family planning STD testing and treatment
Why? Breast Cancer Screening Lifetime risk is 12.8%
This is one out of every eight women!
Breast cancer is the second most common cancer among women (skin cancer 1st)
Lung cancer is leading cause of cancer death in women, breast cancer is second
Breast Cancer Risk FactorsNon-Modifiable Modifiable
Being femaleAgingFamily historyGenetic RisksPersonal historyCertain types of breast cancerMenstrual historyRace
Reproductive historyOral contraceptivesHormone replacementAlcoholWeight
*Injury to the breast is NOT a risk factor
Breast Cancer Facts
Early diagnosis is the key to surviving breast cancerNearly 97% of women who are
diagnosed with breast cancer at an early stage survive for more than 5 years
Breast cancer occurs when there is erratic cell growth and proliferation in the breast tissue
Normal Breast Structure
Cancer vs. Non-cancer
Malignant(cancer)
Non-malignant(not cancer)
Invades, compresses and destroys normal tissue
80% of breast lumps
Cells may break away to form new tumors
Do not invade or spread
Life-threatening Not life-threatening
Breast Cysts Fluid-filled sacs within the breast May become enlarged and tender
just before your period Not cancer, but any new lump should
be checked out by a health care provider
Treatment: possibly decreasing caffeine
Early Detection Methods:3 ways to catch breast cancer early Screening Mammogram
Yearly for women over 40 Clinical Breast Exam
Performed by a doctor, nurse practitioner
or nurse-midwifeYearly for women >40Every 3 years for women 20-39
Breast Self Exam (BSE)Monthly
Mammogram
X-ray of the breast to detect breast cancer
Can detect a lump before it can be felt
Studies demonstrate that mammograms reduce the risk of dying from breast cancer
How to do a Self Breast Exam (SBE)
When to contact your health care provider You feel a lump There is a change in your skin
DimplingRetractionLooks like an orange peelRed, warm, swollen
Your breasts hurt, and it’s not related to your cycles
Nipple discharge when you are not pregnant or breastfeeding
There is anything that concerns you
A word about nipple piercing Potential complications
Infection, can be severeNerve damage*Blood-filled cystScarring, including keloid formationCan contract hepatitis B or C, or HIV (rare)Allergic reaction to the metal Damage to the nipple if pulledNeed to remove to breastfeed, may leak
breast milk through piercing hole
Why? Cervical cancer screening
Abnormal cells on the cervix that multiply out of control
Most cases of cervical cancer caused by HPV virus
Human Papillomavirus Common virus: more than 100
subtypes 30 of these sub-types are sexually
transmittedHigh-risk strains cause cervical cancer,
cancer of the tonsils and throat** Low-risk types cause genital warts
How common is cervical cancer?
Most common sexually transmitted infection
11,000 new cases each year 3,600 women die each year
(that’s 10 per day in the U.S.)
Worldwide, the 2nd most common type of female cancer
Cases of Cervical Cancerhave decreased 75% in last 50 years in the U.S.
Surviving Cervical Cancer: better screening is key
Overall 5-year survival rate for women diagnosed with cervical cancer, regardless of stage - 73%
Screening done with PAP testCells collected from cervixLooked at under microscope
How common are abnormal PAP test results?
Abnormal Pap test results are quite common
They are usually only slightly abnormal
If followed up and treated early, you can prevent the abnormality from turning into cervical cancer
When do I need a PAP test?
Starting at age 21 Every year until age 30
After age 30, if you have had only normal results, you may have them every 2 to 3 years (after talking with your health care provider about your level of risk)
Why do I need to keep getting tested?
PAP testing is not a one-time test
New changes (abnormalities) can occur after you get tested, even if you have not had new partners
It could take many years for changes to develop or to be noticed
Your risk changes if you have new partners, or if your partner has other partners *
When should I have my first women’s health exam?
Age 21 When sexually active (or considering
it) Women’s health problem
Women’s health problems
Abnormal vaginal bleedingPeriods more often than every 3 weeksPeriods less often than every 6 weeksBleeding between periodsPeriods that last longer than a weekVery heavy periods (soaking a pad per hour)
Painful PeriodsCramps that interfere with your lifestyleHeadaches that occur with menstruation
PMS
Other reasons to see a health care provider Breast lump or pain Vaginal itching, burning, or odor Painful urination, or blood in your
urine
Testing for STDs Family planning (birth control) Pregnancy care
Who will do my exam?
Women’s health providerPhysician or physician’s assistantNurse practitionerNurse-midwife
Male or Female
Physicians and Midwives also deliver babies
The GYN exam and PAP test:
What to Expect First things first
WeightBlood pressure
Lots of Questions(while you are still dressed)
Know the first day of your last menstrual period
Medical history (asthma, diabetes, etc.)
Surgical history (tonsils, etc.) Menstrual history Sexual history Problems you want to address
General exam
Breast exam
Positioning for the PAP test and pelvic exam
The Pelvic Exam with PAP testExternal exam
Examine external anatomy
Internal exam: 2 parts1. Speculum Exam
Examine vaginal walls and cervixPAP test and testing for STD’s can be done
2. Bimanual Exam Feel uterus and ovaries
Instruments
Speculum
Collection devices and liquid medium
Speculum Exam
What is a PAP test?
Cells are collected from the surface of your cervix by a health care provider
Bimanual exam
What now?