Week 5: Reproductive Health Flashcards
What is vulvovaginal candidiasis?
- Caused by candida fungi with most infections resulting from c.albicans
What are the risk factors of vulvovaginal candidiasis?
- Diabetes mellitus, HIV
- Antibiotics, corticosteroids, antineoplastic
- Increased estrogen levels
- Contraceptive device use
What are the signs and symptoms vulvovaginal candidiasis?
- Increased pH would indicate an infection that can’t be self-treated
- Absence of a malodor
- Thick, white cottage cheese
- Vaginal erythema, ittitation itching
How do you prevent vulvovaginal candidiasis?
- Shower
- Dry
- Wear cotton undergarments
- Avoid tight fitting clothes
- Avoid douching and bubble baths
- Don’t disturb vaginal pH
- Unscented feminine products
- Eat yogurt
- Decrease sugar
What are OTC antifungals for VVC?
- Clotrimazole
- Miconazole
- Tioconazole
Describe miconazole products?
- Prefilled applicators, itch cream, and combination packs
- 1 day Miconazole nitrate (1200mg)
- 3-day MN (200mg)
- 7 day MN (100mg)
What are example miconazole products?
Vagisil and Monistat
What are example clotrimazole products?
Vaginal cream and Gyne-Lotrimin
What are example Tioconazole products?
Vagistat and 1 dose treatments
How do you counsel a patient using Antifungals for VVC?
- No tampons, douching, spermicides, or vaginal products
- No vaginal intercourse
- Refer to MD if symptoms last for 3-7 days
- Adults and children over 12
When do you refer for VVC?
- No prior VVC infection
- Girls less than 12
- Pregnancy
- First episode (more than 3 times per year, 1 in past 2 months)
What symptoms need to present to refer a patient with VVC?
- Dysuria
- Soreness
- Dyspareunia
- Fever
- Pain in pelvic area
What is tropic vaginotis?
Post menopausal estrogen decline leading to decreased vaginal lubrication
What are the symptoms of atropic vaginitis?
- Dryness
- Burning
- Itching
- Dyspareunia
What are the risk factors of atropic vaginitis?
- Menopause
- Decreased ovarian functioning
- Radiation therapy
- Chemo
- Immune disorder
- Postpartum
- Elevated prolactin
- Antiestrogens
- Estrogen deficiency
- Smoking
What are the types of treatment for atropic vaginitis?
Short term: intercourse
Long term: genital comfort
Personal lubricant
What are the types of personal lubricants?
- Warming liquid
- Astroglide
- Replens
- Vagisil moisturizer
- Vagi-gard
How do you use a long lasting product for atropic vaginitis?
Use one application every 3 days or as needs for day-to-day comfort and moisture
Why is douching bad?
- No biological need
- Vagina is self-cleaning
- Alters pH and predispose to infection or microbial flora imbalance
Why do people douche?
Post intercourse or mentration comfort
Odor control
Douching product?
Summer’s eve
What is menopause?
The cessation of menstrual cycles
What are the symptoms of menopause?
- Hot flashes
- Stress and anxiety
3/ Insomnia - Emotional turbulences
- Headaches
- Palpitations
- Brain fog
8/ Vaginal itchiness and dryness
What are the non pharm treatments for menopause?
- Heat
- Massage
- Loose clothes
- Exercise
- Lubricants
Describe progesterone as a treatment for menopause?
- Preogestorene replacement therapy
- NMCD effectiveness topically
- Long list of ADR
- Not advisable for use without supervision
What is black cohosh?
Natural product found to be effective in treating hot flashes, night sweats, and irratability
What is PMS?
- Cyclic phenomena
- Luteal phase of menstration
- Declines before or during flow
What supplements are good for PMS?
Calcium, vit D, magnesium, Vit B6
What is dysmenorrhea?
Menstrual cramps, dull and throbbing pain in lower abdomen,
What mediates dysmenorrhea?
Prostaglandins and leukotrienes
What are symptoms of dysmenorrhea?
- Bloating
- Pain
- Fatigue
- Headache
- Nausea
6/ Irritabilit
What are the non pharm treatments of dysmenorrhea?
- Heat
- Excersie
- Yoga
- Coping
What are pharm treatments for dysmenorrhea?
- NSAIDs/APAP
- Diuretics (Pamabrom, caffeine)
- Antihistamine (Pyrilamine)
- Non drug thearpy
- Vitamins/Minerals (Calcium, vit E, B6, magnesium)
What is the best choice to relieve cramps?
Oral NSAIDS
What is the most popular med for cramps?
Aleve (naproxen) and ibuprofen (Motrin and Advil)
ACetaminophen (Tylenol)
What treats bloating?
Caffeine > pamabrom
Inhibits renal reabsorption of sodium and water
What are example pamabrom products?
- Diurex
- Pampering
- Midol
What are examples of caffein products?
- Pampering
- Diruex ultra
- Midol complete
What are male concerns?
- Erectile dysfunction
- Libido enhancers
- Prostate hyperplasia
What is libido?
Sexual desire or drive
What is libido?
Sexual desire or drive
What is mama?
Increasing drive
What is impotence?
Man’s inability to have or maintain an erection (physical, mental, both)
What are OTCs for erectile dysfunction?
- DHEA
- Ginseng. Panax
- L-arginine
- Melanotan II
- Propianyl L carnitine
- Yohimbe
What are the symptoms of BPH?
- Decreased urine flow
- Increased frequency
- Night time awakenings
- Incomplete emptying
- Post urination dribbling
What OTC treats BPH?
Beta sitosterol
What does beta-sitosterol do?
Improves:
1. Urninary flow
2. Left over urine volume
3/ Does not affect prostate size
What are contraceptive options?
- Barrier (condoms and sponge)
- Spermicides
- Emergency contraception (Plan B, Next choice)
What is a latex condom?
- Possible allergic reaction
- No oil based lube
- Cheap
What is polyurethane condoms?
- Less allergic
- Can use oil based products
- Les stretchy
- More expensive than latex
- Higher breakage and slippage rates
What is natural membrane condoms?
- Doesn’t protect against STDs
- Prevents pregnancy only
- Better sensitivity
What is a female condom?
- Less popular
- More expensive than male
- Outer ring discomfort
- Vag irritation
- Squeaky
When would spermicides be used?
Use alone or with barriers
What are the ingredients of spermicides?
Nonoxynol 9
Octoxynol 9
Menfegol
How does Nonozynol 8 work?
- Mild chemical detergent that kills sperm
- Doesn’t protect against STDs or HIV
What are the consequences of nontoxynol 9?
Sensitivity or allergy
Local irritation
What are emergency contraceptives?
Levonorgestrel tablets 0.75 or 1.5 mg
What would counseling of intimacy products look like?
- Tact
- Professionalism
3/ Keeping professional face - Watching language
- Avoiding euphemisms
