NR 601 Week 6 TD 1
Ageism and gender bias can affect who and how we ask about sexual health,
sexual activity, and concerning symptoms. Depending on your own level of
comfort and cultural norms this can be a tough conversation for some
providers. But this is an important topic and as our videos discussed, women
are wanting us to ask about sexual concerns. This week we also reviewed
sexually transmitted diseases and the effects of ageism on time to diagnosis
so it is necessary to ask these questions and provide good education for all
patients. You will not know any needs unless you ask.
Discussion Questions:
• Review the required NAMS (North American Menopause Society)
videos. What was the most surprising thing you learned about in the
videos? Explain why it was surprising.
• What is GSM? What body systems are involved? How does this
affect a woman's quality of life?
• What treatment does Dr Shapiro recommend?
• Review one aspect of treatment that Dr Shapiro recommends and
include an EBP journal article or guideline recommendation in addition
to referencing the video in your response.
Sexuality and the older adult
• What is your level of comfort in taking a complete sexual history? Is
this comfort level different for male or female patients? If so, why?
• How will this information impact the way you will interact with
your mature and elderly clients?
Review the required NAMS videos. What was the most surprising thing you
learned about in the videos? Explain why it was surprising.
Nonestrogen dehydroepiandrosterone (DHEA) is an endogenous hormone of
prasterone that gets converted to estrogen and testosterone in the body but
This study source was downloaded by 100000861168648 from CourseHero.com on 04-03-2023 08:32:52 GMT -05:00
https://www.coursehero.com/file/35716034/NR-601-Week-6-TD-1docx/
, serum levels will remain remain low. It will increase vaginal discharge and
decreased vaginal pH. DHEA is not estrogen based so essentially, any
woman in menopause who complains of painful intercourse is a candidate.
The only type of women who should not be considered is one with
undiagnosed bleeding or women with pre-existing cancer. DHEA is
prescribed as 6.5 mg that is vaginally inserted every night at bedtime. The
most surprising part of this video was learning that DHEA was not FDA
approved. This is surprising because providers have been recommending
DHEA for a long time.
What is GSM? What body systems are involved? How does this affect a
woman's quality of life?
GSM stands for genitourinary syndrome of menopause, which has
been endorsed by the International Society for the Study of Women’s Sexual
Health and the North American Menopause Society (Lewis, 2014). The
body system involved is the genitourinary system. GSM can only be
diagnosed if it’s signs and symptoms are attributed to menopause (Lewis,
2014). The symptoms occur related to decreasing levels of estrogen and
other hormones and include dryness, painful intercourse, frequent infections,
dysuria, and urgency (Lewis, 2014). 80% of women will have GSM.
What treatment does Dr. Shapiro recommend?
While Dr. Shapiro is speaking with Dr. Shifren about vaginal health
and menopause, Dr. Shifren recommends using moisturizers, pelvic
physiotherapy, lubricants, or low dose local vaginal estrogen if these
others options do not work.
Review one aspect of treatment that Dr. Shapiro recommends and include an
EBP journal article or guideline recommendation in addition to referencing
the video in your response.
Dyspareunia from vulvar and vaginal atrophy is probably the most
common symptom women experience peri- and postmenopausal
(Jaisamrarn, Triratanachat, Chaikttisilpa, Grob, Prasauskas, &
Taechakraichana, 2013). A deficiency in estrogen during menopause is what
leads to vaginal atrophy, which can result in a decrease of vaginal epithelial
lining, leaving the patient more susceptible to pathogens (Jaisamrarn,
Triratanachat, Chaikttisilpa, Grob, Prasauskas, & Taechakraichana, 2013).
According to Jaisamrarn, Triratanachat, Chaikttisilpa, Grob, Prasauskas, &
This study source was downloaded by 100000861168648 from CourseHero.com on 04-03-2023 08:32:52 GMT -05:00
https://www.coursehero.com/file/35716034/NR-601-Week-6-TD-1docx/
Ageism and gender bias can affect who and how we ask about sexual health,
sexual activity, and concerning symptoms. Depending on your own level of
comfort and cultural norms this can be a tough conversation for some
providers. But this is an important topic and as our videos discussed, women
are wanting us to ask about sexual concerns. This week we also reviewed
sexually transmitted diseases and the effects of ageism on time to diagnosis
so it is necessary to ask these questions and provide good education for all
patients. You will not know any needs unless you ask.
Discussion Questions:
• Review the required NAMS (North American Menopause Society)
videos. What was the most surprising thing you learned about in the
videos? Explain why it was surprising.
• What is GSM? What body systems are involved? How does this
affect a woman's quality of life?
• What treatment does Dr Shapiro recommend?
• Review one aspect of treatment that Dr Shapiro recommends and
include an EBP journal article or guideline recommendation in addition
to referencing the video in your response.
Sexuality and the older adult
• What is your level of comfort in taking a complete sexual history? Is
this comfort level different for male or female patients? If so, why?
• How will this information impact the way you will interact with
your mature and elderly clients?
Review the required NAMS videos. What was the most surprising thing you
learned about in the videos? Explain why it was surprising.
Nonestrogen dehydroepiandrosterone (DHEA) is an endogenous hormone of
prasterone that gets converted to estrogen and testosterone in the body but
This study source was downloaded by 100000861168648 from CourseHero.com on 04-03-2023 08:32:52 GMT -05:00
https://www.coursehero.com/file/35716034/NR-601-Week-6-TD-1docx/
, serum levels will remain remain low. It will increase vaginal discharge and
decreased vaginal pH. DHEA is not estrogen based so essentially, any
woman in menopause who complains of painful intercourse is a candidate.
The only type of women who should not be considered is one with
undiagnosed bleeding or women with pre-existing cancer. DHEA is
prescribed as 6.5 mg that is vaginally inserted every night at bedtime. The
most surprising part of this video was learning that DHEA was not FDA
approved. This is surprising because providers have been recommending
DHEA for a long time.
What is GSM? What body systems are involved? How does this affect a
woman's quality of life?
GSM stands for genitourinary syndrome of menopause, which has
been endorsed by the International Society for the Study of Women’s Sexual
Health and the North American Menopause Society (Lewis, 2014). The
body system involved is the genitourinary system. GSM can only be
diagnosed if it’s signs and symptoms are attributed to menopause (Lewis,
2014). The symptoms occur related to decreasing levels of estrogen and
other hormones and include dryness, painful intercourse, frequent infections,
dysuria, and urgency (Lewis, 2014). 80% of women will have GSM.
What treatment does Dr. Shapiro recommend?
While Dr. Shapiro is speaking with Dr. Shifren about vaginal health
and menopause, Dr. Shifren recommends using moisturizers, pelvic
physiotherapy, lubricants, or low dose local vaginal estrogen if these
others options do not work.
Review one aspect of treatment that Dr. Shapiro recommends and include an
EBP journal article or guideline recommendation in addition to referencing
the video in your response.
Dyspareunia from vulvar and vaginal atrophy is probably the most
common symptom women experience peri- and postmenopausal
(Jaisamrarn, Triratanachat, Chaikttisilpa, Grob, Prasauskas, &
Taechakraichana, 2013). A deficiency in estrogen during menopause is what
leads to vaginal atrophy, which can result in a decrease of vaginal epithelial
lining, leaving the patient more susceptible to pathogens (Jaisamrarn,
Triratanachat, Chaikttisilpa, Grob, Prasauskas, & Taechakraichana, 2013).
According to Jaisamrarn, Triratanachat, Chaikttisilpa, Grob, Prasauskas, &
This study source was downloaded by 100000861168648 from CourseHero.com on 04-03-2023 08:32:52 GMT -05:00
https://www.coursehero.com/file/35716034/NR-601-Week-6-TD-1docx/
