Women's Health Flashcards
Bacterial Vaginosis (BC)
Thin, watery, fishy odor, discolored
Trichomoniasis
Frothy, copious, malodorous, discolored
VVC – Vulvovaginal Candidiasis
Thick, “cottage” cheese like, no odor, normal pH
VVC (AKAYEAST INFECTION)
Candida fungi are the primary causative agents
¡ Candida albicans
¡ Causes
¡ High dose combined oral contraception, estrogen, pregnancy, corticosteroid use
¡ Food (high in sugar)
¡ Clothing (tight fitting, nonabsorbent)
EXCLUSIONS TO SELF-CARE
- ¡ Medically diagnosed with VVC at least once
- ¡ Younger than 12 years old
- ¡ Pregnant
- ¡ Diabetes mellitus
- ¡ HIV-positive or AIDS
- ¡ Have impaired immune function, including use of medications that may impair function of the immune system
Treatment ( Pharmaco)
- ¡ Imidazole
- ¡ butoconazole, clotrimazole, miconazole,
- tioconazole
- ¡ Available as vaginal creams, suppositories, and
- tablets
- ¡ MOA: change fungi membrane permeability
- ¡ Treatment: 1, 3 or 7 days
- ¡ ADE: burning, itching, irritation
- ¡ DDI: Warfarin & Miconazole
- ¡ Check INR
- ¡ Monistat Vaginal DRUG CARD
PATIENT COUNSELING
- Seek medical evaluation
- ¡ Symptoms persist beyond 1 week after treatment or if they recur within 2 months
- ¡ >3 times in 12 months
- ¡ On warfarin
- ¡ Use once a day (night is preferred)
- ¡ Symptom resolution within 2-3 days but may take a week for complete resolution
COMPLEMENTARY THERAPIES
- ¡ Lactobacillus preparations
- ¡ Vaginal tea tree oil preparations
- ¡ Gentian violet – resistant VVC for 1-2 times a day for up to
- 5 consecutive days
- ¡ Boric Acid - 600mg pv daily-bid x14d
- ¡ Non C. albicans infections
medical evaluation should be obtained if symptoms persist beyond __ after treatment or if they recur
within _____
1 week; 2 months
Use of the product only once a day for the______ of time should be stressed.
specified length
ATROPHIC VAGINITIS
- Inflammation of vagina due to atrophy of vaginal mucosa
- Decrease in estrogen such as in menopause, after birth, or during breastfeeding
- Meds: antiestrogenic drugs (MPA, danazol,GNrH inhibitors)
- Vaginal dryness, irritation, burning, dyspareunia (Slight discharge or “spotting”)
- New episode of postmenopausal vaginal bleeding need medical referral to rule out endometrial cancer
PRIMARY DYSMENORRHEA
- Increase in prostaglandins & leukotrienes
- Inflammation & pain
- Uterine contractions
TREATMENT
- § OTC NSAIDs – 1st line - Begin at onset of menses/pain, scheduled doses not prn
- ¡ Naproxen, Ibuprofen, ASA – need higher doses to get anti-inflammatory effects.ADE: GI symptoms (Take with food)
- Acetaminophen : 1000mg 4x day (still less effective than ibuprofen)
- COC, levonorgestrel IUD (Mirena), medroxyprogesterone acetate (Depo-Provera)
PATIENT COUNSELING FOR PRIMARY DYSMENORRHEA
- ¡ Primary dysmenorrhea is normal
- ¡ Understand when to seek medical evaluation
- ¡ NSAIDs are preferred therapy
- ¡ If response to the first agent is not adequate, another NSAID can be tried
PMS TREATMENT
- Pyridoxine (B6) Up to 100mg daily (ADE: neuropathy)
- Calcium & Vitamin D 600mg PO BID, may cause constipation, stomach upset
- Magnesium 300-360mg PO Daily during premenstrual interval only– food sources of Mg – spinach; swiss chard, nuts, legumes and whole-grain cereals; may cause diarrhea
- NSAIDs – for HA and muscle joint pains and mood symptoms
- Diuretics (combined with APAP, NSAIDs) – relieving water retention, weight gain, bloating, swelling, and feeling of fullness
- ¡ Ammonium chloride
- ¡ Caffeine
- ¡ Pamabrom
*
