Sexual and Reproductive Health
Sexually transmitted infections, contraception and fertility.
- Taking a Sexual History The 5 Ps framework for structuring the history, plus the Gillick/Fraser thresholds and safeguarding red flags an OSCE examiner is checking for.
- Chlamydia Why most infections are silent, the doxycycline-over-azithromycin shift for rectal disease, and why tubal infertility - not the acute infection - is the reason screening matters.
- Gonorrhoea Why culture alongside NAAT and a mandatory test of cure matter more here than for any other STI - antimicrobial resistance is the organism's defining clinical problem.
- Syphilis The primary-secondary-latent-tertiary staging, why a painless palm-and-sole rash should always raise it, and the Jarisch-Herxheimer reaction that isn't a penicillin allergy.
- Trichomonas vaginalis The frothy discharge and strawberry cervix of a protozoan STI, why NAAT has overtaken wet mount, and the metronidazole-alcohol interaction worth flagging to every patient.
- Genital Herpes Why the timing of maternal acquisition - not just infection - drives neonatal risk and delivery mode, and why asymptomatic shedding explains most new transmissions.
- Human Papillomavirus and Genital Warts Why HPV 6/11 cause warts while 16/18 drive cancer, the shift to HPV-primary cervical screening, and what the school vaccination programme actually covers.
- HIV Testing and Prevention Indicator conditions that should trigger a test regardless of risk history, the PEP/PrEP distinction, and why U=U reframes viral suppression as prevention.
- Contraception The UKMEC framework for matching method to patient, why LARC closes the perfect-use/typical-use gap, and the UKMEC 4 contraindications to combined hormonal contraception.
- Emergency Contraception Why the copper IUD beats both oral options, the ulipristal-versus-levonorgestrel trade-off around ovulation timing and weight, and the quick-starting rules for each.
- Termination of Pregnancy The Abortion Act grounds and their time limits, medical versus surgical methods, and the limits of conscientious objection - it never permits obstructing referral.
- Infertility and Subfertility The ovulatory/tubal/male-factor work-up, why letrozole has overtaken clomifene for PCOS, and matching treatment - induction, IUI or IVF - to the cause found.