History and Examination of the Reproductive System
History and Examination of the Reproductive System
Female reproductive history:
- Age, gravidity (no. of pregnancies, including miscarriages/ectopics/stillbirths), parity (no. of livebirths), LMP (last menstrual period)
- History of presenting complaints: o Nature and duration o Relation to menstrual cycle o Vaginal discharge o Vaginal bleeding o Urinary symptoms (dysuria, frequency, urge/stress incontinence) o Bowel symptoms
- Previous gynaecological history: o Periods – regular, duration (n/28), flow, dysmenorrhoea (painful period -> endometriosis?), IMB/PCB (post-coital bleeding), LMP, menarche (younger women) o Contraception o PID (pelvic inflammatory disease)/STI o Pap smear o Dyspareunia (pain on intercourse)/intercourse/libido o Breast examinations/galactorrhoea
- Previous obstetric history (gravida, parity) o Previous miscarriages/preg 20 weeks and outcome
- Obstetric history o Age, gravidity, parity o Mode/timing of delivery o Labour details/birth weight/breastfeeding/progress o Previous pregnancy complications
- Antenatal history (of current pregnancy) o EDD confirmation of dates o Screening (routine; every four weeks until second trimester – maternal and foetal wellbeing) o Complications (e.g. gestational diabetes, preeclampsia)
- Previous medical/surgical history
- Medications/IVDU/allergies
- Family history o Thalassaemia, thrombophilia
- Systems review o Thyroid (HP axis)
- Social history o Relationship, job, finances, JW
Male reproductive history
- Discharge
- Dysuria/haematuria
- Frequency/nocturia
- Obstructive – dribbling, poor stream, hesitancy
- Testicular lump/pain
- Impotence
- Premature ejaculation
- Previous medical/surgical history
- Medications/IVDU/allergies
- Family history o Fibroids, endometriosis, cancers, DVT/PE
- Systems review o Thyroid (HP axis)
- Social history o Relationship, job, finances, JW
Examination – consent, chaperone, privacy
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Female reproductive history:
- Age, gravidity (no. of pregnancies, including miscarriages/ectopics/stillbirths), parity (no. of livebirths), LMP (last menstrual period)
- History of presenting complaints: o Nature and duration o Relation to menstrual cycle o Vaginal discharge o Vaginal bleeding o Urinary symptoms (dysuria, frequency, urge/stress incontinence) o Bowel symptoms
- Previous gynaecological history: o Periods – regular, duration (n/28), flow, dysmenorrhoea (painful period -> endometriosis?), IMB/PCB (post-coital bleeding), LMP, menarche (younger women) o Contraception o PID (pelvic inflammatory disease)/STI o Pap smear o Dyspareunia (pain on intercourse)/intercourse/libido o Breast examinations/galactorrhoea
- Previous obstetric history (gravida, parity) o Previous miscarriages/preg 20 weeks and outcome
- Obstetric history o Age, gravidity, parity o Mode/timing of delivery o Labour details/birth weight/breastfeeding/progress o Previous pregnancy complications
- Antenatal history (of current pregnancy) o EDD confirmation of dates o Screening (routine; every four weeks until second trimester – maternal and foetal wellbeing) o Complications (e.g. gestational diabetes, preeclampsia)
- Previous medical/surgical history
- Medications/IVDU/allergies
- Family history o Thalassaemia, thrombophilia
- Systems review o Thyroid (HP axis)
- Social history o Relationship, job, finances, JW
Male reproductive history
- Discharge
- Dysuria/haematuria
- Frequency/nocturia
- Obstructive – dribbling, poor stream, hesitancy
- Testicular lump/pain
- Impotence
- Premature ejaculation
- Previous medical/surgical history
- Medications/IVDU/allergies
- Family history o Fibroids, endometriosis, cancers, DVT/PE
- Systems review o Thyroid (HP axis)
- Social history o Relationship, job, finances, JW
Examination – consent, chaperone, privacy
-