Sexual and Reproductive Health: A Practical Guide for Primary Care

Description

This book is a point-of-care resource for effective sexual and reproductive healthcare for patients of all ages, sexual orientations, gender identities and medical backgrounds in the primary care setting. This useful guide is divided into three parts, and other than part three, which deals exclusively with transgender and gender diverse patients, all content will relate to patients of all gender identities.     Part one presents sexual and reproductive health (SRH) using a lifespan approach, including chapters on pediatrics, adolescents and young adults, adults, and older adult patients. Part two presents an approach to common SRH issues that span multiple age groups, including contraception and family planning, sexually transmitted infections and cancer screenings as well as sexual and reproductive health in the setting of common medical conditions.  Part three is dedicated to sexual and reproductive health for transgender and gender non-binary patients, including psychosocial, medical, surgical and legal aspects of health.     This book provides primary care clinicians with a framework for providing effective sexual and reproductive healthcare to patients of all ages, sexual orientations and gender identities in a way that is inclusive, focuses on health, and addresses the needs unique to specific populations. Preface Contents Contributors Part I: Sexual and Reproductive Health Using a Lifespan Approach Chapter 1: Sexual and Reproductive Health in the Pediatric Population Promoting Healthy Sexual Development and Sexuality in the Pediatric Population Infancy (Birth to 11 Months) Early Childhood (1 Through 4 Years) Middle Childhood (5 Through 11 Years) Transitioning to Adolescence Assessing Physical Sexual Development Ambiguous Genitalia Precocious Puberty Addressing Gender and Sexuality in Prepubertal Children: Common Parental Concerns Identifying Abnormal Sexual Behavior Bullying Special Considerations Children Who Witness Intimate Partner Violence Survivors of Child Sexual Abuse Sex Trafficking Children with Disabilities Conclusion References Chapter 2: Sexual and Reproductive Health in Adolescents and Young Adults Introduction The Sexual and Reproductive Health Visit for Adolescents and Young Adults Confidentiality and Consent History Taking Physical Examination Counseling and Education Common Issues in Sexual and Reproductive Health Care of Adolescents and Young Adults Disorders of Pubertal Development and Menstruation Sexual Dysfunction Sexually Transmitted Infections Confidentiality and Consent Counseling Screening for STIs Treatment HIV Prevention Pregnancy Prevention and Family Planning Confidentiality and Consent Counseling Methods of Contraception Emergency Contraception Pregnancy and Abortion Immunizations Cancer Screening Cervical Cancer Screening Anal Cancer Screening Intimate Partner Violence, Sexual Assault, and Sexual Exploitation Intimate Partner Violence Sexual Assault Sexual Exploitation Care of Sexual and Gender Minority Youth Women Who Have Sex with Women Youth Men Who Have Sex with Men Youth Conclusion References Chapter 3: Sexual and Reproductive Health for Adults Introduction The Sexual and Reproductive Health Visit for Adults Confidentiality and Consent History Taking Physical Exam Counseling and Education Common Issues in Sexual and Reproductive Healthcare in Adults Disorders of Menstruation Amenorrhea and Oligomenorrhea Abnormal Uterine Bleeding Premenstrual Syndrome and Premenstrual Dysphoric Disorder Sexual Dysfunction Sexually Transmitted Infections Pregnancy Prevention and Family Planning Unintended Pregnancy Fertility Infertility in Cisgender Patients/Heterosexual Couples Fertility and Family Planning in Same-Sex Couples and Patients Without Sexual Partners Fertility and Family Planning in Patients with HIV Immunizations Cancer Screening Intimate Partner Violence, Sexual Assault, and Sexual Exploitation Care of Sexual and Gender Minority Adults Conclusion References Chapter 4: Sexual Health in the Older Adults Introduction Significance of Sexual Health Aging Considerations in Sexual Physiology The Sexual Health Visit Consent, Privacy, and Confidentiality History Taking Physical Examination Counseling and Education Common Sexual Health Issues Among Older Adults Barriers to Sexual Health Male Sexual Dysfunction Female Sexual Dysfunction Sexually Transmitted Infections (STIs) Epidemiology Background Confidentiality, Reporting, and Consent Counseling and Education Screening for STIs Treatment of STIs Insurance Coverage HIV Prevention and Management Immunization Recommendations Cancer Prevention Sexual Abuse Sexual Health Considerations in Older Sexual and Gender Minority Patients (SGMs) Sexual Health in Other Care Settings (Long-Term Care, Alternate Living Facilities) Sexual Consent Capacity Conclusion Bibliography Part II: Special Considerations Chapter 5: Contraception and Family Planning Contraceptive Options Combined Hormonal Contraception Contraindications to Estrogen How to Choose a Pill Progesterone-Only Contraception Long-Acting Reversible Contraceptive Options Emergency Contraception Tubal Ligation Contraceptive Options for Men or Patients with Male Sex Organs Initiation of Contraception Option Counseling and Unintended Pregnancy Contraception and Family Planning for Special Populations Transgender and Gender Nonbinary Patients Individuals with Intellectual Disabilities Adolescents Preconception Counseling Infertility and Assisted Reproduction Conclusion References Chapter 6: Sexually Transmitted Infections Introduction Prevention Common Sexually Transmitted Infections in the United States Chlamydia and Gonorrhea Trichomonas Syphilis Genital Herpes Simplex Virus (HSV) Human Papillomavirus (HPV) Human Immunodeficiency Virus (HIV) Rare Sexually Transmitted Infections in the United States Chancroid Lymphogranuloma Venereum (LGV) Granuloma Inguinale (Donovanosis) Sexually Transmitted Disease Uncertainty Mycoplasma Genitalium Conclusion References Chapter 7: Sexual Dysfunction Introduction Male Sexual Dysfunction Introduction Hypoactive Sexual Desire (HSD) Diagnostic Workup Treatment Erectile Dysfunction Diagnostic Workup History, Physical Exam, Laboratory Testing Referral and Cardiac Considerations First-Line Treatment Lifestyle Modifications and Modifying Risk Factors Pharmacotherapy Second-Line Therapy Vacuum Constriction Devices Intraurethral Suppositories Intracavernous Drug Injection Third-Line Therapy Penile Prosthesis Experimental Therapies Shock Wave Therapy Premature Ejaculation Diagnostic Workup History, Physical Exam, Laboratory Testing Treatment Behavioral Modification and Psychosexual Counseling Pharmacotherapy Female Sexual Dysfunction Epidemiology Diagnostic Workup History, Physical Exam, Laboratory Testing Treatment Female Sexual Interest/Arousal Disorder Genitopelvic Pain/Penetration Disorder Female Orgasmic Disorder Conclusion References Chapter 8: Pregnancy and the Peripartum Period Introduction Preconception Care Universal Preconception Counseling Preconception Care in Patients with Chronic Illness Pregnancy Care: The Basics Pregnancy Physiology Drug Prescribing and Safety in Pregnancy Prescribing Drug Safety in Pregnancy and Lactation Old and New Drug Labeling Imaging in Pregnancy Ionizing Radiation Non-ionizing Radiation Common Medical Problems in Pregnancy Hypertension Effect of Pregnancy on Hypertension Effects of Hypertension on Pregnancy Management of Hypertension in Pregnancy Risk of Preeclampsia Diabetes Effect of Pregnancy on Diabetes Effect of Diabetes on Pregnancy Management of Diabetes in Pregnancy Venous Thromboembolism Effect of Pregnancy on Venous Thromboembolism Effect of Venous Thromboembolism on Pregnancy Medical Complications in Pregnancy and Future Health Risks Conclusion References Chapter 9: Patients with Congenital Heart Disease Introduction Puberty Contraception Pregnancy Termination of Pregnancy Genetic Screening Sexual Dysfunction Management of Perimenopausal Symptoms Gender-Affirming Treatments for Transgender and Gender Nonbinary Patients with CHD Conclusion References Chapter 10: Patients with Cancer and Survivors Introduction Adult Survivors of Adult Cancers Screening for Sexual Dysfunction Fertility Concerns Late and Long-Term Effects of Therapy Are Dependent on Treatment Modality Hormonally Mediated Symptoms and Menopause Considerations to Manage Hormonally Mediated Symptoms in Patients with Female Sex Organs Considerations to Manage Hormonally Mediated Symptoms in Patients with Male Sex Organs Relationship and Body Image Concerns [30] Survivors Diagnosed with Cancer as a Child, Adolescent, or Young Adult (CAYA) Development of Sexual Identity Fertility Impaired Spermatogenesis Premature Ovarian Insufficiency (POI) Testosterone Deficiency Conclusion Resource List References Chapter 11: Patients with Physical, Intellectual and Developmental Disabilities Introduction Physical, Intellectual, and Developmental Disabilities Education and Anticipatory Guidance for Sexual and Reproductive Health Developmentally Appropriate Communication Supporting Patient Privacy and Appropriate Autonomy Promoting Safe Expression of Sexuality Reproductive Health Exams Cervical Cancer Screening Screening for Breast Cancer Menstruation Contraception and Family Planning Conclusion References Resources Chapter 12: Orthopedic and Physical Ability Issues Introduction Orthopedic Conditions: Considerations and Suggestions Lower Back Pain Recommended Positions for Patients in Position for Penetration Recommendations for Those in Position to Receive Arthritis and Total Joint Replacement Knee Pain Hip Pain Neurologic Conditions: Considerations and Suggestions Spinal Cord Injury Stroke Degenerative Neurological Conditions Medical Conditions: Considerations and Suggestions Conclusion References Chapter 13: Religiosity and Spirituality Introduction Religion, Spirituality, and Health: Setting the Scene Clinical Practice Considerations Specific to Demographic Groups, Stages of the Life Cycle, and/or Targeted Health Promotion Efforts Screening for Prostate Cancer Screening for Cervical and Breast Cancer Neonatology and Infertility Adolescent Sexual Health LGBTQ Healthcare Case Studies Case 1 Case 2 Conclusion Implications for Clinical Practice, Health Promotion Efforts, Research, and Medical Education Resource List References Part III: Sexual and Reproductive Health for Transgender and Gender Non-binary Patients - Section Reviewer Zil Goldstein, FNP-BC Chapter 14: Gender-Affirming Medical Care for Transgender and Gender Nonbinary Patients Introduction General Approach to TGNB Sexual and Reproductive Health Taking a Sexual and Reproductive Health History Reproductive Health Needs and Considerations Gender Inclusive Language Inequities in Sexual Health and Outcomes Physical Exam Considerations Medical Considerations of Gender-Affirming Interventions Social and Nonhormonal Transition Gender-Affirming Hormones Common Approaches to Gender-Affirming Hormones Impact of Gender-Affirming Hormones on Sexual and Reproductive Health Expanded Differential Diagnosis for Common Sexual and Reproductive Health Concerns in TGNB Patients Pelvic Pain Chest Pain Scrotal Pain Diagnostic Testing for Sexual Health Cancer Screening HIV Prevention Transgender and Gender Nonbinary Youth Gender-Affirming Model of Care Social Transitioning Gender-Affirming Medical Treatment Options Fully Reversible Partially Reversible Irreversible Intervention Conclusion References Chapter 15: Gender-Affirming Surgery: Perioperative Care for the Primary Care Clinician Introduction Preoperative Assessment and Care Initial Evaluation Infectious Disease Management Hormone Management Bariatric Considerations Reproductive Planning Mental Health Hospital-Based Pre-admission Testing and Evaluation Cardiac Risk Stratification Noncardiac Risk Evaluation and Mitigation of Existing Risks Pulmonary Hematology Gender-Affirming Surgeries Transmasculine Chest Surgery Transfeminine Breast Surgery Transmasculine Genital Surgery Transfeminine Genital Surgery Conclusion References Chapter 16: Mental Health for Transgender and Gender Nonbinary Patients Introduction Application of Basic Primary Care Mental Health Skills Within a Gender-Affirming, Trauma-Informed Framework Considerations of Mental Health in Transgender and Gender Nonbinary Patients with Sexual Dysfunction Assessment of Mental Health Symptoms in Patients Receiving Gender-Affirming Hormone Therapy Supporting Patients Going Through Gender-Affirming Procedures Conclusion References Chapter 17: Transgender and Gender Nonbinary Medicolegal Issues in the United States Introduction Right to Access to Care Consent: Informed Consent, Parental Consent, and Sterilization Consent Essential ID for Accessing Care, Documentation on Medical Records, Legal Name and Gender Marker Changes, and Use of Gender-Appropriate Facilities Third-Party Payers, Insurance, and Billing Issues Conclusion Index