21) Inflammatory Diseases of Female Genital Organs; Vaginitis - Types, Sx, Tx

Question 1

What is Vulvovaginitis?

Answer 1

• Inflammation of the Vulva + Vaginal Tissues
• Characterised by Vaginal discharge, vulvar itching + foul odour
• DUE to = Infections, Allergic-Contact, Atrophic Vaginitis

Question 2

What are the 3 Types of Vulvovaginitis INFECTIONS?

Answer 2

1) Bacterial Vaginosis

2) Candida Vaginitis

3) Trichamonas Vaginalis

Question 3

What is Bacterial Vaginosis?

Answer 3

• Clinical Syndrome where lactobacilli are replaced with anaerobic bacteria + Gardnerella Vaginalis (change in vaginal flora + increase pH)
• Characterised with thin, frothy, white-greyish discharge
• DUE TO: = Oral Sex, Antibiotics, Soaps
• DIAGNOSIS = pH is HIGHER than 4.5, fishy odour
• TREATMENT = Metronidazole Gel, Clindamycin Cream - applied intravaginally

***NB!

Question 4

What is Candida Vaginitis?

Answer 4

• Also known as Yeast Infection - presented with thick, odorless, cottage-cheese-like discharge (Leukorrhea)
• Most common in Child-bearing ages

DUE to:

• Pregnancy, Oral Contraceptives
• Uncontrolled Diabetes
• Immunodeficiency
• INCREASED Vaginal pH - from menstrual blood, semen, or tight-fitting garments

CFs = Leukorrhea, Vaginal Pruritis + Erythema, External Dysuria (painful piss), and Dysparaeunia (painful sex)

Tx for CV = Topical Azoles

Question 5

What is Trichomonas Vaginalis?

Answer 5

• It’s an anaerobic PARASITE that Sticks to epithelial cells of UROGENTIAL TRACT
• It’s Sexually Transmitted
• Presents with frothy YELLOW-GREY Discharge and STRAWBERRY Cervix (due to Punctate Hemorrhage)
• CFs = Vaginal Pruritis + Erythema, External Dysuria (painful piss), and Dysparaeunia (painful sex)
• Tx for TV = Metronidazole

Question 6

What is CONTACT Vulvovaginitis?

Answer 6

• The exposure of vulvar epithelium / vaginal mucosa to irritant / allergen
• Examples incl - perfumes, dyes, soaps, tampons, tights
• CFs = Local Swelling, itching + burning sensations, ulcerations
• Tx for Contact = Topical Corticosteroids, Oral Histamines - otherwise resolves ON ITS OWN!

Question 7

What is ATROPHIC Vulvovaginitis?

Answer 7

• Where there’s LOW Oestrogen levels, usually in POST-MENOPAUSE - causing a thin, pale vaginal mucosa + dry labia
• RFs = Cigarettes, vaginal nulliparity, pregnancy, menarche, lactation
• CFs = loss of vaginal secretions, Dysparaeunia (painful sex), Leukorrhea (vaginal discharge), vulvar pruritus, and Urinary Sx
• Tx for AV = Estrogen Replacement Therapy

Question 8

What is Genital Herpes?

Answer 8

• Due to Herpes Simplex Virus 2
• Presented with fluid-filled vesicles –> well-circumscribed ulcers
• Lasts for about 4 - 15 Days
• CFs = Inguinal Lymphadenopathy, Pelvic Pain, Urethritis, Urinary Sx