Sexual Health Genital Symptoms Flashcards
Give some examples of genital symptoms.
Discharge from orifice
Pain
Rashes
Lumps/swellings
Cuts, sores, ulcers
Itching
Change in appearance
Vulvovaginal candidosis?
Yeast inflammatory infection of the vagina and vulva, very common
What is the causative organism of the majority of vulvovaginal candidosis?
Candida albicans
-> about 70%, other 30% caused by Candida glabrata or mixed populations
Where are the organisms causing vulvovaginal candidosis, like Candida albicans, usually acquired from?
Bowel
Vulvovaginal canidiosis can be asymptomatic. However, if symptomatic, which name is commonly given to the condition?
Thrush
What are the symptoms of thrush/vulvovaginal candidosis?
Itch
Discharge- typically described a being like cottage cheese
Which women are more likely to experience candiasis?
It they are:
-diabetic, on oral steroids
-immune suppression including HIV
-pregnant
-are in the reproductive age group
->being of reproductive age is due to the production of oestrogen , which is a glycogen and therefore a food supply for yeast
Diagnosis of thrush/vulvovaginal candidiasis?
Usually based on the characteristic history
->can sometimes use vaginal pH and examination findings (fissuring, erythema with satellite lesions, characteristic discharge)
Investigations used in thrush/vulvovaginal candidiasis?
Gram stained prep
Culture
PCR?
Treatment of thrush/vulvovaginal candidiasis?
Doesn’t always need treating
Azole antifulngals- clotrimazole, fluconazole
Treatment of resistant thrush/vulvovaginal candidiasis?
Determine the species and the sensitivities and treat accordingly
What is the commonest cause of abnormal vaginal discharge?
Bacterial vaginosis
Symptoms of bacterial vaginosis?
Asymptomatic in 50%
Watery grey/yellow ‘fishy’ discharge
May be worse after periods/sex
Sometimes sore/itch from dampness
->as said, not all women have a problem with it. All to do with an imbalance of bacteria in the vagina
Bacterial vaginosis can be a problem because it’s a biofilm problem, like dental caries. What does this mean?
Bacteria create a layer under which they are able produce chemicals which are able to survive the hydrogen peroxide/acid environment which is normally present in the vagina
What are the three issues which contribute to bacterial vaginosis?
Reduction of lactobacilli which reduces the hydrogen peroxide production
Raised pH
Overgrowth of the bacterial vaginosis associated bacteria
Bacterial vaginosis is usually asymptomatic and doesn’t cause problems. However, what are some of the problems it can cause in some women?
Associated with endometritis if uterine instrumentation/delivery
Associated with premature labour
Increases risks of HIV acquisition
Diagnosis of bacterial vaginosis?
Characteristic history
Examination findings- thin, homogenous discharge
Gram stained smear of vaginal discharge
Treatment of bacterial vaginosis?
Antibiotics
Probiotics
Vaginal acidification
->vaginal acidification is to tackle one of the problems mentioned previously about raised pH of the vagina being a contributing factor to bacterial vaginosis
Which antibiotics may be used in the treatment of bacterial vaginosis?
Metronidazole- oral (avoid alcohol), vaginal gel
Clindamycin- vaginal
Balanitis?
One of the commonest conditions seen in men, rash at the end of the penis
Which procedure means men will be very unlikely to get balanitis?
Circumcision
Might be worth watching parts of this on 2x speed to see pictures of some other kinds of conditions which can affect the genitals
There wasn’t much to write notes on but the pictures and descriptions may be of use…idk
Sometimes patient’s may present with ‘changes’ to their genitals which they haven’t noticed before, often after having sex with someone new, and are worried it’s an STI etc.
It’s important to know what’s normal so we don’t give the wrong diagnosis.
Might also be worth looking over this part of the PowerPoint again.
Here are a list of some things which people may present with which are normal:
-Fox-Fordyce spots on penis (sebaceous glands of the skin)
-Vulval papillomatosis (sometimes mistaken for warts)
-Penile pearly papules aka Coronal paillae
-Tyson’s glands
What is vestibulodynia?
A pain syndrome.
Pain is felt around the introitus during penetrative sex or tampon insertion
Vulvodynia?
Another type of pain syndrome
Causes persistent burning or aching
Chronic pelvic pain syndrome?
Usually in men, persistent aching of the genitals even if there is nothing to find in the genitals
Lymphocele?
Blocked lymph duct, causing the lymph vessel to become enlarged.
What can cause a lymphocele?
Increased friction
Sometimes can occur secondary to infection
->e.g. dry masturbating
Treatment of lymphocele?
Often settles spontaneously
