Obgyn net sex related issues section-Sexual assault - Long - - The Obstetrician & Gynaecologist - Wiley Online Library

E-mail address: lisalong1 nhs. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. The choices for women regarding reporting sexual assault and referral to a sexual assault referral centre should be widely known in obstetrics and gynaecology. The basic laws regarding sexual assault are discussed.

Obgyn net sex related issues section

Obgyn net sex related issues section

Obgyn net sex related issues section

Philadelphia, Pa. They deal with a wide range of issues, including obstetrics, or pregnancy and childbirth, menstruation and fertility issues, sexually transmitted infections STIshormone disorders, and others. A daily pill, Addyi may boost sex drive in women who experience low sexual desire and find it Orgasms by energy. Any queries other than missing content should be directed to the corresponding author for the article. Many women start visiting a gynecologist from their early teens and continue to attend a well-woman clinic for general health issues too. Smith, D. Consideration should be taken in collecting other evidence such as tampons, sanitary towels, clothing and temporary wound dressings. Your doctor Obgyn net sex related issues section recommend blood tests to check for underlying health conditions that might contribute to sexual dysfunction. Rediscover each other and reconnect. Effective treatments for sexual problems.

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E-mail address: lisalong1 nhs. Use the link below to share a full-text version of this article with your friends and colleagues. Learn more. The choices for women regarding reporting sexual assault and referral to a sexual assault referral centre should be widely known in obstetrics and gynaecology. The basic laws regarding sexual assault are discussed.

To understand the prevalence of sexual assault and its impact on women's health. To understand the basic appropriate management of those reporting sexual assault and the different options available to women. To be able to document findings and take early evidence. Healthcare professionals are often frightened of the disclosure.

Careful documentation of history and findings are important in view of possible legal proceedings. Sharing of information with other professionals may need to be considered without having the client's consent to protect vulnerable adults, adolescents and general public.

The aim of this article is to highlight the scale and impact that sexual assault has on women's health. It will cover the important issues that need to be addressed, including provision of immediate care, referral to other services and practical advice for the clinician. Sexual assault can be a terrifying, humiliating and traumatic experience. Women who have been victims of sexual assault need prompt and timely management in an acute setting.

Clinicians need to be mindful of forensic evidence and legal proceedings. Sexual assault covers offences from indecent exposure to rape. The World Health Organization defines sexual violence as any sexual act, attempt to obtain a sexual act, unwanted sexual comments or advances, or acts to traffic, or otherwise directed, against a person's sexuality using coercion, by any person regardless of their relationship to the victim, in any setting, including but not limited to home and work.

Sexual assault places a huge burden on the healthcare system. This encompasses the definition of rape where penetration of the vagina, anus or mouth of a person has occurred with a penis without consent. The absence of consent can apply to one form of penetration even when there has been agreement to another.

Aggravating factors such as a background of intimidation or coercion, abduction or threats to prevent the victim disclosing will increase sentencing. However, it was not Parliament's intention to punish children unnecessarily or for the criminal law to intervene where it was wholly inappropriate.

There is a maximum sentence of life imprisonment for rape, assault by penetration, and causing or inciting a child to engage in sexual activity. Most sexual assaults are not reported to the police. Women who present after sexual assault should be fast tracked to appropriate healthcare professionals with minimal delays. Initial management should include taking a basic history of the event the time of the incident, nature of the event and possible use of drugs or alcohol , including asking the victim to remember what happened, where it happened and with whom.

It is vital to listen to the woman carefully and believe her account. The account should be documented verbatim in the woman's own words in the medical notes. Careful documentation is essential, as discrepancies in accounts of the assault can be used in court to discredit the case. The immediate needs of the woman will be her protection and the need for a place of safety, particularly if she knows the assailant.

This is best achieved by involving the police, who can liaise with other agencies such as social services and the housing department. There are multiple specialist support agencies and resources that women can access. It may be helpful to have the details of relevant organisations in your area readily available. In rare circumstances the clinician should report the crime to the police without the woman's consent. This public interest reporting to police is necessary when serious harm may occur to other individuals, for example from domestic violence when children or others may be at risk.

Many women complaining of sexual assault will have few or no injuries, and those with injuries are likely to be of minor significance. Any injuries should be treated with basic first aid. However, minor injuries that do not require suturing should not be cleaned initially because samples can be taken from these sites for DNA evidence. Injuries that are identified should be recorded accurately. Each injury should be described in the clinical notes, including the shape, depth, colour and tenderness.

The type of injury should be noted, such as bruise, abrasion or laceration. If you are unsure of the type of trauma, it is better to make a careful and concise description. It is possible to photograph the injuries but written consent will be necessary for this. This is the basis of trace evidence collection from a victim of crime. The woman should be advised not to wash or wipe herself if she is considering a forensic medical examination. She should also not eat, drink or pass urine prior to early evidence being collected.

An early evidence kit should be used to collect evidence and this is available in the emergency department. This is a sealed cardboard box containing a plastic pot for a urine sample, a toilet paper sample, mouth swab s and a mouth rinse, and instructions on how to use the kit.

The collection of samples can capture vital evidence, and should be taken at the earliest opportunity. A mouth rinse sample may detect vital evidence where oral penetration has been alleged. Consideration should be taken in collecting other evidence such as tampons, sanitary towels, clothing and temporary wound dressings. Forensic samples taken should be stored securely, and it is essential to document those who have been involved in taking such samples and where and how they are stored to maintain the chain of evidence.

Chain of evidence is a legal concept used for all samples that may be used as evidence in a court case. All samples taken should have an unbroken paper trail account of where and when the evidence was obtained, by whom, and any persons handling the samples and the places and condition of storage. Therefore, consideration should be given to pregnancy prevention.

Any regular contraception, the timing of the woman's menstrual cycle and use of a condom should be ascertained, although the patient may not know whether a condom was used. Women should be offered all methods of emergency contraception, including the copper intrauterine device.

Oral emergency contraception should be offered as soon as possible if an intrauterine device is to be delayed or is not an acceptable option. Women should be referred to a local genitourinary clinic or, if preferable, to their GP for a risk assessment for sexually transmitted infections, HIV and hepatitis B.

Prophylaxis has a limited role as it may lead to unnecessary treatment, reinforce belief that there was a high risk of infection and miss out on partner notification. It is believed that transmission of HIV is likely to be increased during sexual assault. Recommendations vary depending on the type of exposure and risk factors.

Unprotected anal intercourse carries the highest risk. Other factors which increase the risk are a known positive HIV status of the assailant, exchange of body fluids, presence of genital injuries and a multiple assailant assault. Some groups of individuals are at a higher risk of sexual assault.

These include women who are young, poor, living in social housing, in poor health, single and separated or divorced. Migrant and trafficked women and those involved in the sex industry are more likely to encounter sexual violence.

These patients need to be assessed carefully and will need additional support; referrals should be considered to mental health services, general practitioners and other agencies such as drug and alcohol services. Sexual abuse is often a form of domestic violence. Staff involved in the care of these women should assess the risk of domestic violence. After sharing all relevant information they have about a woman, the representatives discuss options for increasing her safety and turn these into a coordinated action plan.

A sexual assault referral centre SARC is a model of service dedicated to addressing the forensic, evidential and aftercare needs of victims of sexual violence. The SARC can also provide sexual health screening, psychological therapy and specialist support to women.

They provide practical and emotional support and information. They advise women on the process involved in reporting a crime to the police and taking their case through the criminal justice process, should they choose to do so. Independent sexual violence advisers work alongside victims from soon after their initial contact with a SARC or other emergency service. Independent sexual violence advisers may be based in SARCs or may operate from specialist sexual violence organisations.

Not everyone who has been sexually assaulted will want to report the assault to the police or have forensic evidence gathered. Women who wish to report the assault to the police immediately should be encouraged to do so. Specialist police officers trained in the management of complainants of sexual assault will take a first account of the incident and arrange a forensic medical examination. The proportion of women who do not want to report the offence to the police should have their wishes respected.

Forensic specimens should only be collected if the clinician has specialist training in this area, therefore is not within the remit of a gynaecologist on call. The type of forensic specimens that are collected depends on the type of sexual assault and the time lapse between the assault and the examination. Swabs are taken to recover body fluids and DNA and are sent to the police forensic science laboratory. A buccal scrape from the inside of the women's cheek is taken as a reference sample for DNA profiling.

Sexual assault nurse examiners in the USA have been independently performing forensic medical examinations since the early s. Baseline bloods are carried out in this initial appointment, if not already done, and review should ascertain whether the woman wishes to continue the medication, as well as any adverse effects and compliance with treatment. Sexual assault can have harmful and lasting consequences for women, their families, and the community.

Sexual assault results in a considerable cost to the healthcare system. Member agencies provide services including crisis support, counselling, telephone helplines, supervision, training, advocacy, information and independent sexual violence adviser services. Most centres offer advocacy, counselling and a telephone support line. Rape Crisis England and Wales: www. Sexual assault is common, and obstetricians and gynaecologists are likely to see women who have experienced this crime, whether recently or in the past.

Sexual violence is a subject that many patients and clinicians alike feel uncomfortable or embarrassed to talk about. It is important to break through our own barriers in order to provide an excellent service for these women. A sensitively asked question provides an opening for someone to disclose what has happened. We must act quickly to provide medical care and support, including early emergency contraceptive advice.

LL is the main author responsible for conception and design, drafting the article and final approval.

Pornhub is the most complete and revolutionary porn tube site. En Latina includes foreign language medical articles, contact information for physicians, a "Latina Chat" section, and a forum section for questions and answers. Redhead teen pussy check-up at obgyn clinic where is a hidden cam Spy Hospital. The best way to treat health and medical issues is with preventive care. SophiaBailey

Obgyn net sex related issues section

Obgyn net sex related issues section

Obgyn net sex related issues section

Obgyn net sex related issues section

Obgyn net sex related issues section. related stories

While reasonable effort has been made to ensure the accuracy of the information, our practice assumes no responsibility for errors or omissions, or for damages from use of the information herein. Please consult your doctor or midwife for specific information. My First Visit is a multi-media presentation about your gynecologic exam, and what to expect. Lots of good information sheets! Sex, Etc. Teen site from Planned Parenthood provides information and news about teen sexuality, sexual health and relationships.

A peer-reviewed site from ob-gyn. Interested in alternative therapies? What precautions should you take if you use herbal therapies? This is a really good resource. Curious about alternative and complementary medicine? Usually we do not feature commercially sponsored sites, but Ethicon has provided a lot of good information on breast biopsies, and what the results mean. The service provides comprehensive and objective information to the general public and health professionals on all aspects of fertility awareness.

Fertility Journey. Confused about the hormone replacement controversies? Lots of good information here! Interested in alternative therapies for PMS? Sexual Relationship Problems? Sexual and relationship problems are surprisingly common and can cause huge distress.

Research suggests that between a third and a half of adults report having sexual problems. At the heart of many relationship breakdowns and divorces are sexual problems. Some of the sperm swim straight up into the fallopian tubes through the cervix and uterus - some of them are so fast, that [sperm has] been found in the tubes in as little as a few minutes after ejaculation.

Some sperms die in the acidic vaginal fluid; and some enter the cervical mucus and cervical crypts. They are stored here and can remain alive here for as long as 48 to 72 hours. During this time, the sperms are released in small numbers and these continue to swim towards the fallopian tubes.

This is why you don't need to have sex every day to get pregnant even though the egg remains alive for only 24 hours. These images include "nudity" and graphic surgical procedures and are provided for educational purposes. For example, the gynecologic images contain images of post tumorectomy breasts, normal uteruses, and cystic uteruses, among other depictions. This section offers translated access to a smaller collection of resources that are edited and compiled by physicians from the U.

En Latina includes foreign language medical articles, contact information for physicians, a "Latina Chat" section, and a forum section for questions and answers. Because there is a growing population of Spanish-speaking U. Medical professionals volunteer their time to participate in the Women's Health Forum.

Postings have included questions about bleeding after sexual intercourse during pregnancy, breast self-examinations, condom breakage, early miscarriage, vaginal itching, and breast feeding. In March , over messages were posted to the women's health forum. For example, in April , one forum participant wrote about how she has experienced serious pain after intercourse with her husband. She wrote, "When I have sex with my husband it hurts, I have a very small opening so it always feels like the first time, we don't have sex that often because all through our relationship I have had monthly yeast infections which actually might be finally stopping, anyway, it hurts during penetration and then after a few minutes my cervix becomes very sore.

Another user posted a question with the subject line saying "An embarrassingly silly question. For example, could you fall pregnant or worse, catch a STD from water from a spa pool, etc. The "For Women" section also includes an "archives section" which features a portion called "The Comfort Zone," in which women exchange stories and post stories and advice about their experiences with, for example, pregnancy, breast cancer and hysterectomy.

The Comfort Zone includes a woman's narrative account of her breast self-examination and discovery of a breast lump, and a woman's letter about her sexual experiences after having a hysterectomy. She wrote, "There is so much literature on this subject [sex after hysterectomies] much of it negative , that it made me wonder if there was anyone out there still enjoying sex after having had a hysterectomy.

I don't know if I would consider this a myth, but I think that the only people talking about it are the ones who are complaining. I feel that for me it's at least as good as before, actually it's better since there is no longer any pain associated with orgasm.

We invite all users to "host" chat sessions on a particular topic and also have a panel of physicians who may also participate in the various sessions.

The registration does not require the user to provide personally identifiable information. We do not require such information because we believe that anonymous use of our site is important for women and older minors who seek sensitive medical information or who are otherwise embarrassed.

We believe that the information we provide will literally save lives, prevent unintended pregnancies, and promote better health. While our advisors review many of the articles that appear on our site and help select sites that are linked to OBGYN. The collection contains hundreds of links organized by subject. Ruth Online. The site is run by Dr.

Ruth Westheimer, a renowned sex therapist, whose award-winning Web site provides honest, informative, and entertaining promotion of sexual literacy. The user will also find links to dozens of other reputable resources on contraception, such as "About Condoms: How to use a condom, and other mysteries.

Girls begin menstruating as early as age ten, and many teenage girls are sexually active. Having access to information about gynecological health may help prevent teen pregnancies and slow the spread of sexually transmitted diseases. Many girls may be too embarrassed or shy to ask their family doctors about gynecological health issues; OBGYN. We believe that, because a portion of the imagery and text on our Web site contains material that may be considered "harmful to minors," OBGYN.

We fear prosecution under the Act and, if the Act is not temporarily restrained, fear that we will be subject to criminal liability because we does not want to self-censor the valuable speech about women's health that we currently make available over the Web. We believe that all the materials on our Web site are covered by the Act. The Act covers any "communication, picture, image, graphic image file, article, recording, writing, or other matter of any kind.

We are worried that some community might find the free availability of such information to minors on our Web site to be "harmful to minors. Although I personally believe that our speech has value for minors, I understand that some people and communities might believe that it is inappropriate for minors, especially younger minors.

For example, I am aware that some people believe that providing birth control information to minors encourages sexual activity among minors, and that some communities believe that sex education in schools is inappropriate. I thus fear prosecution under the Act even though I personally believe that our speech has value for minors. We fear both criminal and civil liability under the Act.

We cannot control the content of the postings of users of our site and believe that some communities may consider some of these postings "harmful to minors. We are unable to determine what would be considered a good faith, reasonable, effective or appropriate action to restrict or prevent access to minors to materials under the Act.

First, we do not know of any technology available for us or our contributors to verify the age of a Web user with whom we or our member contributors are communicating via our bulletin boards and chats.

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Obgyn net sex related issues section

Obgyn net sex related issues section

Obgyn net sex related issues section