Vaginal Disorders Lecture Flashcards
Self treatable conditions
VVC
Atrophic vaginitis/vaginal dryness
Overactive bladder
Not self treatable conditions?
BV
Trichomoniasis
Lactobacillus species?
Important in creating a acidic environment
pH 4-4.5
~90% of vaginal flora
– acidic environment helps protect the vagina from infection due to bacteria
Vaginal discharge?
Leukorrhea
~1.5 gm produced dialy
Odorless, clear or white, viscous or sticky
Increased vaginal discharge due to?
Ovulation Pregnancy Menses Sexual excitement Emotional flares
Changes in vaginal flora are due to?
Hormonal fluctuations Drugs Douching Number of partners Vaginal irritants: deodorant products, tampons, contraceptive products
What is BV?
Most common Sexually-active women Polymicrobial infection resulting from imbalance in normal flora - Not typical to treat sex partner - Uses OCs and condoms
Common signs/symptoms of BV?
FOUR ODOR Increased discharge Discolored discharge (gray, green, tan)
Risk factors of BV?
New sex partner African-american IUD Douching Oral Tobacco Prior pregnancy
What is trichomoniasis?
Trichomonas vaginalis
STI
Treat sex partners
Use condoms
Common signs/symptoms of trichomoniasis?
Erthema
Vulvar edema
YELLOW DISCHARGE
Risk factors of trichomoniasis
Multiple sex partners
New sex partners
Nonuse of barriers
Presence of other STIs
What is VVC?
Yeast infection Affects 50% of all women by 25 Candida fungi - Not typical to treat partners - Tight fitting clothes, pantyhose, increased intake of sugars - Does not effect pH
Signs/symptoms of VVC?
Erthema, itching, vulvar edema
Thick “cheesy” discharge
ABSENCE OF ODOR
Risk factors of VVC?
Pregnancy High dose combo OCs Diabetes Recent antibiotic use Immunosuppressive drug use
Non-treatment can lead to?
PID
UTI
Endometriosis
Preterm labor
VVC Self-care exclusions?
Pregnant Under 12 Fever Low ab, back, shoulder pain Predisposing meds Reccurent: 3 per year or within past 2 months HIV
Goals of therapy for VVC
Relieve symptoms
Eradicate infection
Reestablish normal flora
Non-pharmacologic treatment options?
Decrease dietary consumption of sucrose and carbs
Consumption of live cultures
Discontinue causative drugs
Pharmacologic treatment options?
Imidazole products
- First like therapy
- Relieves external itching and irritation
Imidazole products MOA?
Alter the membrane permeability of fungi resulting in loss of normal membrane function
Vaginal formulations come in?
Suppositories, tablets or creams
Couseling points?
Do not skip days
No tampons
Okay during periods
Single-dose regimens?
Gynazole
Monistat
Vagistat
What are non-curative products for itching and irritaiton?
Vagisil
Massengill
Pusatilla
- Decreased efficacy, frequent local site reactions, longer treatment durations
What are complementary therapies for VVC?
Lactobacillus preparation
Gentian violet
Boric acid
Lactobacillus preparation?
Eat yougurt
Reestablish normal flora
Gentian violet?
Dye used for resistant vaginal candidal infection
Stains fabric and skin
Boric acid?
Non-C. albican infections
600 mg
85-95% effective
Define atrophic vaginitis
Inflammatory response
Due to atrophy of vaginal mucosa or decrease in estrogen levels
10-40% in postmenopausal women
Reuslt in dyspareunia (painful intercourse)
Signs and symptoms of atrophic vaginitis?
Irritaiton
Dryness, itching, burning
Dyspareunia
Vaginal bleeding/discharge
Treatment of atrophic vaginitis?
Vaginal/topical/personal lubes (short term improvement)
- Astroglide, KY jelly, replens
What is overactive bladder?
Bladder squeezes too often or without warning
Chronic condition
Categorized by: frequency, urgency, urge incontinence
Treatment of OAB?
Oxytrol patches
- 18+
- 3.9 mg dialy
- Relaxes bladder muscles
- Adverse effects: dry mouth, dizziness, drowsiness, skin irritation
Counseling for OAB?
Apply and leave on for 4 days
Rotate application site
Wear under clothing – no light
Do not treat OAB if?
Burning upon urination Blood Lower back or side pain Male History of bladder cancer Recently pregnant
Define douching
Irrigating the vagina
Achieve good vaginal hydien or vaginal cleanse
Water and vinegar douching?
Acetic acid
- Minimal effect on lactobacilli but inhibit some pathogens
Povidone/iodine douching?
Inhibit all flora
May allow growth
Adverse effects of douching?
Increased risk of PID Reduced fertility Ectopic pregnancy Vaginal infections STI Low birth weight Cervical cancer
Counseling for douching?
Not recommended
Not to treat infection, as birth control
Do not use if?
Used a diaphragm, cervical cap or spermicide (for 8 hours after) 3 days after teh last vaginal antifungal 48 hrs after gynecologic exam Pregnant or breast feeding More than twice weekly If dryness or irritation occur
