Women's Health for FNP Boards: Contraception, STIs, and Screening

Clinical High-Yield · 9 min read · February 24, 2026

Why Women's Health Matters on Boards

Women's health questions appear on every FNP board exam. Contraception, STI management, cervical cancer screening, and prenatal care are all heavily tested. Here's the high-yield framework.

Contraception: The Decision Tree

Combined hormonal contraceptives (pill, patch, ring):

• Absolute contraindications: History of DVT/PE, migraine with aura, smoker >35 years old, uncontrolled hypertension, breast cancer, liver disease
• Benefits: Regulate cycles, reduce dysmenorrhea, treat endometriosis, reduce ovarian/endometrial cancer risk

Progestin-only methods (mini-pill, Depo-Provera, Nexplanon, Mirena/Kyleena IUDs):

• Safe in patients with contraindications to estrogen
• Depo-Provera: Bone density loss with long-term use, return to fertility delayed
• Nexplanon: Most effective reversible method (>99%)

Copper IUD (Paragard):

• Non-hormonal — good for patients who want hormone-free option
• Most effective emergency contraception if placed within 5 days of unprotected sex
• Can worsen dysmenorrhea

Emergency contraception:

• Plan B (levonorgestrel): Within 72 hours (up to 120 hours, less effective)
• Ella (ulipristal): Within 120 hours, more effective than Plan B, especially later
• Copper IUD: Most effective, within 5 days

STI Management

Chlamydia: Azithromycin 1g single dose OR doxycycline 100mg BID x7 days. Screen all sexually active women <25 annually.

Gonorrhea: Ceftriaxone 500mg IM single dose (or 1g if weight >150kg). Always treat for chlamydia concurrently.

Syphilis:

• Primary/secondary/early latent: Benzathine penicillin G 2.4 million units IM x1
• Late latent/unknown duration: Benzathine penicillin G 2.4 million units IM x3 (weekly x3)

Herpes (HSV-2):

• First episode: Acyclovir, valacyclovir, or famciclovir x7-10 days
• Suppressive therapy: Valacyclovir 500mg daily (reduces transmission by 50%)

Trichomonas: Metronidazole 2g single dose (treat partner simultaneously)

BV: Metronidazole 500mg BID x7 days OR metronidazole gel x5 days OR clindamycin cream x7 days

Cervical Cancer Screening (Pap Smear)

• Age 21–29: Pap smear alone every 3 years
• Age 30–65: Pap + HPV co-testing every 5 years (preferred) OR Pap alone every 3 years
• Age >65: Discontinue if adequate prior screening and no high-risk history
• After hysterectomy (for benign disease): Discontinue

Board pearl: Start screening at age 21 regardless of sexual activity onset. Do not screen before 21.

Prenatal Care Highlights

First visit: CBC, blood type/Rh, rubella, hepatitis B, syphilis, HIV, urine culture, Pap if due, genetic counseling

Gestational diabetes screening: 24–28 weeks with 1-hour glucose challenge test

GBS screening: 35–37 weeks

Rh-negative patients: Rhogam at 28 weeks and within 72 hours of delivery

Board pearl: Folic acid 400–800 mcg daily should begin at least 1 month before conception and continue through first trimester to prevent neural tube ...