Vaginal Conditions Flashcards
what happens to the vagina at puberty
due to estrogen, vaginal lining changes to stratified squamous epithelium whihc contains glycogen
what is the glycogen used for
lactobacillus use the glycogen to form lactic acid to create an acidic environment 3.5-5.5
the acidity helps maintain the normal vaginal flora and inhibits growth of pathogenic organisms
what happens to the vagina after menopause
thinning of the vaginal lining occurs and lacto bacilli decline bc less glycogen causing the ph to rise
what factors influence the vaginal flora, ph and glycogen
aging menstrual cycle hormone fluctuations diseases diabetes - glucose peed out meds douching - wash away normal flora number of sexual partners - increases exposure to organisms
what shouldnt vaginal discharge cause
irritation
burning
itching
what are some adverse effects of douching
disrupts normal flora increasing the risk of irritation or infection
risk of genital tract infections, ectopic pregnancy, cervical cancer
prevent detection of infection
why do you avoid douching in pregnancy
preterm births
low birth weight infants
decreased fertility
when should you avoid use of douching
as a contraceptive
for infections
1-2 days before gynecologic exam
at least 3 days after last dose of a vaginal antifungal medication
problems with genital towelettes
may contain perfumes, astringents, emollints and antiinfectives which may lead to irritation or allergic reactions
what works better than cleanser or towelettes
mild soap and water
risks of using feminine deodorant sprays
mask an infection
cause irritation
allergic reaction
non pharms to prevent vaginal irritation
wear cotton underwear bc dries out quickly
avoid tight fighting and synthetic clothing
change pads and tampons regularly
avoid vaginal sprays and deodorants
change out of damp wear
avoid long exposure to hot conditions where you sweat
wipe front to back
what is bacterial vaginosis
imbalance in normal vaginal flora
cause of bacterial vaginosis
increased growth in organisms normally found in genital tract and a decrease in lactobacilli
complications of bacterial vaginosis
second trimester miscarriage
pre term birth
pelvic inflammatory disease
risk factors for bacterial vaginosis
sexually active
new sexual partner
IUD
douching
is bacterial vaginosis sexually transmitted
no
signs and symptoms of bacterial vaginosis
thin, off white yellow or grey discolored discharge vaginal pH5-6 fishy odour may be asymptomatic minimal itchign
in asymptomatic bacterial vaginosis who do you treat
high risk pregnancy
prior to iud insertion or gynecological procedures
treatments for bacterial vaginosis
oral metronidazole or clindamycin
clindamycin 2% cream
metronidazole 0.75% gel
*all prescription so a referral
does the male partner need to be treated in bacterial vaginosis
no
when is a bacterial vaginosis recurrent
occurs 1-3 months of previous treatment
must be confirmed by physician
which treatment is preferred for bv in pregnanct patients
oral
topical may cause adverse outcomes to newborn
what is trichomoniasis
sexually transmitted infection caused by a protozoa
complications of trichomoniasis
low birth weight
tubal infertility
risk factors for trichomoniasis
multiple or new sexual partner
nonuse of barrier contraception
presence of other STIs
signs and symptoms of trichomoniasis
large amounts of white or yellow frothy discharge
redness of vulva and cervix
vaginal ph over 6
symptomsof trichomoniasis
no odor
vaginal discharge
itching
may be asymptomatic
trichomoniasis treatment
oral metronidazole
do you treat sexual partners as well in trichomoniasis
yes regardless of symptoms
causes of vulvovaginal candidiasis
candida albicans
normal vaginal flora when there is a change in the vaginal environment
not sexually transmitted
signs and symptoms of vulvovaginal candidiasis
white clumpy discharge inflammation/redness ph under 4.5 severe itchign pain during intercourse no odor stinging, burning may be asymptomatic
risk factors for vulvovaginal candidiasis
antibiotics hormone ingestion chemotherapy menses (rare before and after menopause) pregnancy stress immunocompromised diabetes tight clothign irritant
goals of treatment for vulvovaginal candidiasis
relieve signs and symptoms of the infection
eradicate the infection
prevent recurrence
prevent misdiagnosis and therefore delay in treatment
when can you self treat vcv
uncomplicated - not recurrent
previously diagnosed as VVC to confirm its not other things
mild-moderate symptoms
not pregnant bc if so have to confirm that it is not another infection that is dangerous for the infant
over 12
had less than 3 episodes in the past year
no signs within the last 3 months
red flags for vcv
first episod e
under 12
pregnancy
fever, pain in lower abdomen back or shoulder
corticosteroids or immunosuppressive drugs
diabetes
HIV
recurrent (less than 2 months, 4 infections in 12 months)
non pharms for vcv
avoid vaginal deodorants, douching, harsh soaps, perfumed products to prevent irritation
avoid tight clothign and synthetic underwear
recommend cotton underwear
side effects of clotrimazole
itching
burning
bloatin
irritation
products of clotrimazole available
canestan 1 - ovule or cream
canesten 3 - tablet or cream
canesten 6- cream
side effects of miconazole nitrate
itching burnign headaches allergic contact dermatitis skin rashes
miconazole products
monistat 1 - ovule
monistat 3 - ovules or cream
monistat 7 - ovules or cream
expected improvement for imidazoles
relief in 1-2 days
week for complete relief
use of imidazoles
once daily at bedtime
dont use tampons for 3 days after
dont use condoms or diaphragms during or 3 days after because oil based and may cause them to fail
side of effects of fluconazole
headache nausea abdominal pain dyspepsia dizziness
contraindications of fluconazole
pregnancy
under 12
unless doctor recommended
products available for fluconazole
1 oral capsule
side effects of butoconazole
irritation
burning
itching
contains mineral oil
can you use butoconazole in pregnancy
second and third trimester but studies lacking
products available for butoconazole
gynazole cream prescription only
side effects of terconazole
headache abdominal pain burnign itching fever chills
can you use terconazole in pregnancy
avoid durign first trimester
products available with terconazole
cream and ovules
prescription only
monitoring parameters for vcv
improvement of symptoms in 2-3 days
resolutionof symptoms in 7 days
referral if symptoms dont resolve in 7 days or symptoms worsen
recurrence of symptoms within 2 months
what is wrong with vagisil
contain local anesthetics that are supposed to relieve irritation and itching
dont treat cause of itchign and can cause local reactions
who is at risk of toxic shock syndrome
menstruating women using tampons
contraceptive sponge, diaphragm, cervical cap
surgical wound infection
symptoms of toxic shock syndrome
sudden high fever diarhhea vomit dizzy weak muscla ache fainting rash in palms of hand and soles of the feet
what do you do if someone is experiencing toxic shock syndrom
immediate medical attention can be fatal
