Aimee Chism Holland

Current Evidence Supporting Fertility and Pregnancy Among Young Survivors of Breast Cancer

Approximately 6% of invasive breast cancer is diagnosed in women younger than age 40 of age childbearing potential. Cancer-directed therapies can cause hormonal and anatomical changes that negatively affect the reproductive potential of young survivors of breast cancer. Recent national guidelines on fertility preservation are widely available. However, gaps in care exist in the interdisciplinary evidence-based management of young survivors of breast cancer with fertility and parenting concerns after cancer treatment.

The Role of the Healthcare Professional in Human Trafficking

Paper Presentation Background Human trafficking, also referred to as sexual exploitation, is a widespread problem in the United States, and approximately 80% of exploited individuals are women. Womens health providers play critical roles in identifying these women and providing care for them while they are in captivity and upon their release. Human trafficking is defined as commercial sexual exploitation through force, fraud, or coercion, and traffickers consider these women property that can be continuously exploited. Health problems with specific signs and symptoms are common among these women. The nurse must identify these women, provide care for them, and assist them in finding safe resources. Case A 19-year-old woman presented to the womens health clinic with a complaint of vaginal bleeding. A history was taken by the womens health nurse practitioner prior to the physical examination, but the woman provided vague answers. During the examination, the nurse practitioner observed that the woman was bleeding excessively from two tears at the vaginal introitus. Upon questioning the woman further, the nurse practitioner discovered that the woman was a victim of sexual exploitation. However, she was reluctant to talk about it. Arrangements were made for the woman to go immediately to surgery with the gynecologist. Upon returning to the clinic for her 1-week follow-up visit, the nurse practitioner told the woman about helpful human trafficking resources in the area. The woman declined any assistance and left the clinic. One week later, the woman returned with the same complaint, and she was sent to the operating room for surgery. She did not keep her follow-up visit with the nurse practitioner and to date has not returned to the clinic. Conclusion To help sexually exploited women, the nurse must have a basic understanding about human trafficking. The nurse is one of the few health professionals who has contact with these women during their captivity. The nurse who is aware of the common risk factors, health problems, and sign and symptoms can identify women who are being sexually exploited. Otherwise, an opportunity to assist these women will be missed.

Highlights From the U.S. Selected Practice Recommendations for Contraceptive Use

The U.S. Centers for Disease Control and Prevention recently updated the U.S. Selected Practice Recommendations for Contraceptive Use to foster a reduction in unplanned pregnancy rates and to provide clinicians an evidence-based guide for contraception management. Nurses play an important role in helping women and families with reproductive life planning. By bridging knowledge gaps and removing access barriers with regard to contraception, nurses can contribute to reducing rates of unintended pregnancy. Nurses and other clinicians are encouraged to use the U.S. Selected Practice Recommendations for Contraceptive Use when counseling women about safe and effective contraception management.

Diagnosis and Treatment of Genitourinary Syndrome of Menopause

Genitourinary syndrome of menopause (GSM), formerly referred to as vulvovaginal atrophy or atrophic vaginitis, is a common chronic condition that requires a collaborative treatment plan between a health care provider and a woman to relieve symptoms and improve quality of life. Many women are not aware that symptoms can be controlled with treatment. Current treatment options approved for GSM include vaginal moisturizers, lubricants, and hormones. For women with GSM symptoms that are unresponsive to nonhormonal therapy, low-dose vaginal estrogen therapy is the preferred pharmacologic treatment. Clinicians should be trained to routinely ask appropriate questions during the history to elicit sufficient information to assess for GSM. Physical examination findings may further confirm suspicion of GSM.

Common Sexually Transmitted Infections in Women

The spread of sexually transmitted infections (STIs) remains a significant public health issue in the United States. Social, economic, and behavioral implications affecting the spread of STIs have been identified. The most important social factor in the United States is the stigma associated with discussing sex and STI screening. In this article, specific recommendations for women are included regarding screening, diagnosing, and treating common vaginal and cervical infections. Screening women for infections of the vagina and cervix is essential because untreated infections may result in complications that have current and long-term health consequences and impact quality of life.

Prevention and Treatment of Injuries and Infections Related to Pubic Hair Removal

The 21st century has witnessed an increasingly prevalent trend of women removing their pubic hair. Body hair removal norms have changed significantly over the past several decades. Regardless of the motivation or technique behind pubic hair grooming, this trend is presenting a unique challenge for health care professionals with regard to health education about safe removal and treatment for associated injuries and infections. To provide appropriate education to women, nurses and other clinicians should be familiar with cultural norms, motivations, expectations, methods, dangers, best practices, and treatment options. They should be comfortable discussing grooming practices with women and be prepared to provide guidance on best practices. Women should also be made aware that pubic hair removal may put them at increased risk for transmission of sexually transmitted infections.