Module 1: Menstrual irregularities
This module on menstrual irregularities defines common menstrual problems including abnormal menstrual bleeding, dysmenorrhea and premenstrual dysphoria. It includes classification systems, diagnostic criteria, and clinical guidelines for management and treatment of each condition. It offers resources and guidance for treating women presenting with associated symptoms or meet the diagnostic criteria for these disorders. Each condition is discussed including specific guidelines and treatment aims. Screening tools, indications for additional investigations and appropriate examinations are recommended for diagnosis of each condition. The module discusses prevalence, common symptoms and possible patient impacts of menstrual irregularities.
Module 2: Endometriosis, pelvic pain and ovarian cancer
This module recognises that pelvic pain experienced by women can significantly impact their quality of life. Given the complex anatomy of the pelvis and lower abdomen, pelvic pain presents a diagnostic challenge that requires clinical awareness to ensure the detection of serious conditions including endometriosis and ovarian cancer. This module provides practitioners with clinical reasoning models to effectively assess and diagnose acute, chronic, or recurrent pelvic pain including diagnostic models and management guides. Three case studies on women of different ages and conditions illustrate the application of Murtagh’s self-posed questions. There are separate units focused on endometriosis and ovarian cancer and the summary provides a systematic approach to identify, diagnose and manage the various forms of pelvic pain.
Module 3: Family planning
This module discusses the uses, effectiveness, and options for contraception and expands on the role of general practitioners in this area. It creates a detailed framework for making decisions about contraceptives including how to counsel patients about options, recommended examinations, information gathering, patient preferences and other factors to consider. Multiple options for contraception, comparisons of efficacy, delay in return to fertility and STI protection are discussed. Referencing the MEC guidelines, content delineates precautions and contradictions to consider when determining the suitability of contraceptive methods for individual patients. It discusses the differences of combined hormone contraceptives and progesterone-only pills and expands on the risks, side effects, benefits, contraindications, and implementation procedures for each approach. The module provides guidance for contraception at menopause and emergency contraception.
Module 4: Family planning advanced part 1
This module discusses the role of general practitioners in contraceptive counselling including comprehensive information on long-acting reversible contraceptives (LARCs). The nature of LARCs means that there is no difference between typical and perfect use. Their contraceptive effectiveness is outlined. Medical eligibility criteria for contraceptive use are applied to three types of LARC and includes important contraindications. It also presents discussion about the use of LARCs including how a clinician can reasonably exclude pregnancy and institute emergency contraception when warranted. Because of the suitability of LARCS for adolescents, content includes issues of consent and identifies key points of legislation related to informed consent. It also considers the termination of unintended pregnancy from request through to clinical referral. Finally, there is a discussion about the “quick start” method of contraception for women at higher risk of unintended pregnancy.
Module 5: Family planning advanced part 2
This module commences with the description of the different phases of the menstrual cycle and natural family planning methods options. These include fertility awareness, lactational amenorrhoea and withdrawal methods, their effectiveness, advantages, disadvantages and contraindications. Unit two outlines contraceptive needs in women with intellectual disability including legal considerations. Unit three addresses the complexities for women who are culturally and linguistically diverse, including the clinical challenges associated with this group. Statistics, factors influencing contraceptive choices and GP management recommendations are included. Key points of diagnosis, investigations, management, expected response and potential side effects are suggested. This unit also lists resources including public funded interpreter information. Information is provided for GPs working with Aboriginal and Torres Strait Islander women. At the end of this module an overview of new contraceptive products is given.
Module 6: Polycystic ovarian syndrome (PCOS)
This module examines the prevalence, presenting symptoms, contributing factors and underlying problems associated with PCOS. Common features, risk factors and indications for further investigation to diagnose this condition are outlined. A framework for applying diagnostic criteria including presenting symptoms, specific criteria for diagnosis, and the process for eliminating other potential causes and conditions is provided. Tools and resources for screening and management of the condition are included. The module concludes by outlining symptoms of complications to look for and provides instructions for detection and management of these symptoms.
Module 7: Vaginal prolapse and urinary incontinence
This module discusses urinary incontinence and pelvic organ prolapses. Content outlines the types of incontinence, symptoms, diagnosis, prevalence, the causes and the risk factors. Prolapses covered are the anterior and posterior vaginal walls, cervix or uterus and the apex of the vagina. Managing these presentations includes taking a detailed medical and obstetric history, investigating risk factors, physical examination and further investigation options. Questionnaires are provided as a guide for these consultations. Changes are discussed as well as continence aids. Various treatment options including lifestyle interventions, physical therapies, bladder training, medicines and continence aids are outlined. Surgical intervention and the associated risks are considered.
Module 8: Familial risk of breast and ovarian cancers
This module discusses genetics including information, counselling and statistics for hereditary, familial and sporadic distribution of cancer. The role of genes is also examined. Unit two looks at hereditary breast and ovarian cancer and the associated genes. Content includes referral guidelines, BRCA carrier risks, genetic counselling, identifying, and managing patients who are at high risk of hereditary cancers. Genetic testing information includes advances, testing processes and possible funding options, consent requirements, possible results and genetic variant classifications. The module covers management strategies for high-risk breast and ovarian cancer patients including psychological and lifestyle choices, communicating genetic results and informing family members. Counselling considerations including pros and cons for reproductive options, prenatal testing, pre and implantation genetic diagnosis and the role of IVF are included.
Extension module: Sexually transmitted infections (STIs) and cervical screening
This module is separated into two units: Sexually transmitted infections (STIs) and cervical screening.
Unit one identifies several STIs and other conditions associated with sexual activity. It outlines common features and symptoms, routes of transmission, key risk factors for infection and the prevalence of infection. The unit emphasises the importance of early recognition, diagnosis, and treatment of STIs and details the natural progression of each condition if left untreated. Comprehensive information is provided about screening tools and procedures, examinations and testing, and detailed treatment plans. Information is included on contact tracing, notification of proper authorities and opportunistic counselling of patients about prevention of STIs.
Unit two begins with an explanation of the anatomy and functions of the cervix and identifies underlying causes and risk factors for cervical health issues including HPV, cervical dysplasia and cervical cancer. Indications for further investigation including presenting symptoms, risk factors, and potential impacts are covered. Information about current screening tests and ethical considerations related to patient experience and consent are addressed. Important updates in administrative processes, terminology for reporting and models for cervical screening results are explained. The module recognises the inherent limitations of these tests and emphasises their role as one part of the diagnostic process.