Vaginal Hygiene Flashcards
What do Bartholin’s glands do
produce secretions in response to sexual stimulation
can become clogged/form cysts
How does the vagina become acidic
- during puberty, cells become stratified squamous and can store glycogen
- L. bacillus species use it to create lactic acid
- Vagina has more acidic pH (3.8 - 4.2)
What are factors that can affect vaginal ecosystem
Hormonal fluctuations - during menses, pH is higher
Drug Therapy - AB rid L. bacillus
Systemic Diseases - diabetes
Hygiene Measures - ex. vaginal douche
Number of sexual partners - introduces more organisms
Leukorrhea
- Normal vaginal discharge that varies in quantity, consistency and appearance throughout the menstrual cycle
- consists of endocervical mucus, serum transudate from vaginal capillary beds, endogenous vaginal flora, and
epithelial cells.
What is the normal amount of vaginal discharge
4 mL/24 hours
What can change amount of discharge
- Emotional stress
- Ovulation (egg white - sticky)
- Pregnancy (more)
- Exercise (runny)
- Sexual excitement (mixed with bartholin gland secretions)
- Certain medications (NuvaRing)
- Certain medical conditions (PCOS)
What colour is the discharge during:
- healthy discharge
- pregnancy
- ovulation
- hormonal imbalances
Clear
What colour is the discharge during:
- healthy discharge
- yeast infection
White
What colour is the discharge during:
- STI
yellow-green
What colour is the discharge during:
- menstruation
- cervical infection
- cervical polyp
- endometrial or cervical cancer
Red
What colour is the discharge during:
- cervical bleeding
- vaginal irritation
- implantation bleeding
- if you become pregnant during cycle
Pink
What colour is the discharge during:
- bacterial vaginosis
Gray
Odour of discharge?
should never have a bad or repulsive odour
Discharge in newborns
There may be a small amount of vaginal discharge +/- bleeding for up to 2 weeks after birth
Discharge during reproductive years
Amount and consistency varies partly due to cyclical estrogen and progesterone
Discharge during menopause
Amount of discharge decreases as estrogen levels fall
increase in pH and more prone to infection
Abnormal vaginal bleeding or discharge is a sign of which diseases
- cervical cancer
- ovarian cancer
- uterine cancer
- vaginal cancer
Red Flags
If presenting with vaginal discharge and…
- Pregnancy
- Prepubertal child
- Fever or pain in pelvis or abdomen
- Persistent and unusually strong vaginal odour
- Inflammation, pain, blisters or ulcers on the vagina or vulva
- Significant change in odour, viscosity, volume and/or colour of vaginal discharge
- Painful urination and/or sexual intercourse
- Suspected foreign object
- Have had a sexual partner with an STI (or if sexual partner is experiencing similar symptoms)
- Unusual bleeding
- Abnormally strong itching or burning sensation
What is S in SCHOLAR
- colour of discharge
- quantity/consistency
- odour
C in SCHOLAR
- irritation (burning/itching)
- changes compared to normal
H in SCHOLAR
- happened before
- past treatment
O in SCHOLAR
- onset
- chronic?
- did anything change when it started (ex. started AB)
L in SCHOLAR
- where is the itching
H in HAMS
- diabetes
- immunocompromised (HIV)
- menopause
A in HAMS
- latex allergies (itching)
M in HAMS
- estrogen (contraceptive)
- CI with antifungals (warfarin)
- AB
- immunosupressants
S in HAMS
- hygiene: how do you wash, what products
- sexual history: sexually active, # of partners
- menstrual history: age of first period
- caffeine/alcohol/smoking
- occupation: swimmers need to change out of wet suits
- what type of underwear?
Hygiene steps for prevention
- Keep genital area CLEAN and DRY; wipe from front to back
- Avoid OTC feminine hygiene products & douches
- Change sanitary pads & tampons regularly; Practice safe sex
Clothing steps for prevention
• Choose 100% cotton underwear (avoid synthetic, silk, or nylon)
`• Avoid tight or restrictive synthetic clothing; avoid thongs
• Promptly change out of wet clothes/swimsuits
Diet steps for prevention
- Balanced, nutritious diet
- Drink sufficient fluids
- Eat yogurt (8 oz/day) with live cultures
T/F: Rx and nonRx are usually not necessary
True
- depends on infection (may require AB or antifungal)
- Sitz bath (using epsom salts) can be used adjunctively
Genital towelettes MOA
Cleanses outside of vagina; eliminates odour-causing bacteria
Genital towelettes examples
- Vagisil Feminine Wipes
- Summer’s Eve Cloths
- Always Wipes
- Coolwipes (Monistat)
Are genital towelettes safe
Safe for occasional use
- avoid alcohol/fragrance
- can be irritating
Genital washes and gels MOA
Cleanses external genitalia; eliminates odour-causing bacteria
Genital washes and gels examples
- Vagisil Feminine Wash pH Balance (topical wash, pH of vulva not important)
- Poise Intimate Liquid Wash
- Summer’s Eve Wash
Are genital washes and gels recommended?
Provide no additional benefit over mild soap & water
GENITAL DEODORANT SPRAYS MOA
Eliminates odour- causing bacteria; absorbs moisture; prevents chaffing
Genital Deodorant Spray Examples
- Vagisil Deodorant Powder
- Summer’s Eve Deodorant Spray
- contain lots of alcohol/fragrance
- need to treat odour, not mask it
Are Genital Deodorant Sprays recommended
NO
- may mask odour of infections
- high incidence of irritation and allergic reaction
Vaginal itching creams MOA
Reduce vaginal and vulvar irritation and itching
Vaginal itching creams
- Vagisil Cream
- Vagisil Cream X-Strength
- Monistat Derm Cream
- Canesten External Cream
Are vaginal itching creams recommended?
Some contain benzocaine & resorcinol and should only be used upon advice from a physician
Vaginal douches MOA
Cleanses inside of vagina; eliminates odour-causing bacteria
Vaginal douches examples
- Summer’s Eve X-Clean
- Vinegar/Water Douche
- Massengil Vinegar/Water
Are vaginal douches recommended?
NO
CI in pregnancy, PID, STI. *Not recommended for any woman!
