Preface viii Acknowledgements x 1 The Anatomy and Physiology of the Female Reproductive System 1 Introduction 1 The Female Reproductive System 3 The Ovaries 3 Oogenesis and Follicular Development 4 Corpus Luteum 6 Role of Female Sex Hormones 6 The Internal Organs 8 The External Genitalia 13 The Breasts 14 The Menstrual Cycle 15 Conclusion 16 Glossary of Terms 17 Multiple Choice Questions 18 References 19 2 Engaging with Patients and Assessing the Female Reproductive System Introduction 21 Language and Its Impact on Female Reproductive Health 21 Promoting Patient-centred Communication 23 Valuing the Patient''s Experience 25 Collaborative Relationships 27 Cultural Sensitivity 28 Health Literacy 29 Assessing the Female Reproductive System 31 The Patient History 33 Physical Examination 39 Tests and Investigations 44 Vital Signs and Other Observations 45 Clinical Judgement and Communication 45 Documentation and Interpretation of Findings 46 Conclusion 46 Glossary of Terms 47 Multiple Choice Questions 48 References 49 3 Health Promotion Introduction 51 Health Promotion 52 Biopsychosocial Model and Reproductive Health 54 Inclusive and Culturally Safe Practice 59 Public Health Approaches 60 Common Female Reproductive Health Conditions 63 Primary, Secondary and Tertiary Prevention 64 The Role of Those Providing Care and Support 66 Supporting Behaviour Change in Reproductive Health 68 Digital Health 69 Conclusion 70 Glossary of Terms 71 Multiple Choice Questions 72 References 73 4 Planning Care: Cervical Cancer Introduction 76 Cervical Cancer 76 Prevalence and Demographics 79 Types of Cervical Cancer 80 Pathophysiology of Cervical Cancer 81 Patterns of Spread 82 Clinical Staging 82 Overview of Cervical Cancer 83 Cervical Cancer and Systemic Illness 84 Signs and Symptoms of Cervical Cancer 86 Diagnosing Cervical Cancer 89 Communicating the Diagnosis 90 Planning Individualised Care 91 Digital Tools 93 Management of Cervical Cancer 93 Care Considerations 95 Side Effects and Late Effects 96 Psychosocial Support 96 End-of-life Care Planning 96 Survivorship Care and Secondary Prevention 97 Promoting Equality 97 Conclusion 97 Glossary of Terms 98 Multiple Choice Questions 99 References 100 5 Vital Signs Introduction 102 Vital Signs in Context 102 Clinical Decision-making in Practice 104 Clinical Reasoning Cycle 104 Core Vital Signs 106 Hormonal and Endocrine Dynamics 107 Vital Signs Across Life Stages 110 Menopause 112 Transgender and Non-binary People 112 Clinical Considerations 113 Chronic Reproductive Conditions 113 Long-term Contraceptive Use 114 Technology and Future Directions 115 Conclusion 116 Glossary of Terms 116 Multiple Choice Questions 117 References 119 6 Cervical Screening Introduction 121 Cervical Screening 121 Obtaining Informed Consent 124 The Procedure 129 Communication 133 Interpretation of Results 134 Post-procedure Care 136 Conclusion 163 Responding to Concerns 137 Conclusion 138 Glossary of Terms 138 Multiple Choice Questions 139 References 141 7 Female Genital Examination 143 Introduction 143 Gender-affirming Care 144 Genital Examinations and Role Development 145 Rationale for Performing Genital Examinations 146 Professional Issues 146 Patient Autonomy and Advocacy 147 Confidentiality and Privacy 147 Chaperones 148 Infection Prevention and Control 149 Professional Communication 149 The Care Environment 150 The Procedures 152 External Genital (Vulval) Examination 154 Speculum Examination 154 Bimanual Vaginal Examination 156 Transvaginal Ultrasound 160 Transvaginal Ultrasound for Patients Without a History of Penetrative Sex 160 Female Genital Mutilation and Genital Examinations 162 Glossary of Terms 163 Multiple Choice Questions 165 References 166 8 Specimen Collection 168 Introduction 168 Principles of Safe and Effective Specimen Collection 168 Communicating Effectively 172 Vaginal Specimen Collection 174 Key Notes 174 Cervical Screening 174 Uterine and Endometrial Specimen Collection 174 Risks and Contraindications 176 Urine and Non-invasive Specimens 177 Vulval and External Genital Specimens 179 Documentation, Transport and Chain of Custody 180 Ethical and Legal Considerations 181 Conclusion 182 Glossary of Terms 183 Multiple Choice Questions 184 References 185 MCQ Answers 188 Index 189.