Women's health

Question 1

What are the two types of cystitis?

Answer 1

A lower UTI and an upper UTI

Question 2

What are the symptoms of a lower UTI?

Answer 2

• Painful urination
• Needing to pass urine more often
• Lower abdominal discomfort
• Dark and cloudy urine with a foul smell
• Not feeling emptied
• No blood and no discharge
• Generally feeling unwell

Question 3

How can you treat a lower UTI?

Answer 3

• Simple analgesia
  NSAIDS (ibuprofen)can reduce inflammation
  -Drinking plenty of water to flush out bacteria
  -Urinate after sexual intercourse
  -Avoid having sex whilst you have the infection
  -Wear loose clothing rather than tight so you do not give the bacteria an environment to grow
  -Cranberry drinks can reduce urine acidity
  *do not have if taking warfarin
  -Wear cotton underwear rather than nylon
  -Diaphragms as contraceptives can increase risk of UTI
  -Do not wash genitals with soap or bath oils
  -Wipe front to back

Question 4

Referral Criteria

Answer 4

• Over 7 days
• Upper UTI symptoms
• severe abdominal pain, fever and chills, nausea and vomiting, elderly (confusion), blood in urine, cloudy and smelly urine
• Frequently recurring UTIs
• Blood
• A man
• Under 16 or over 70
• Diabetic
• Immunocompromised
• Suspected STI

Question 5

What are the symptoms of a painful period?

Answer 5

• Cramping starting a day before bleeding and up to two days after
• Back pain
• Nausea
• Emotional disturbances
• Bloating
• Fatigue
• Diarrhoea

Question 6

What treatment can you offer?

Answer 6

1) NSAIDS
Ibuprofen
Naproxen - GP can prescribe 
2) Oral contraceptive from GP
3) Buscopan for cramps
4) Stopping smoking
5) Hot water bottle on stomach
6) Gentle exercise (endorphin release)
7) Warm bath or shower

Question 7

What would make you suspected an underlying condition?

Answer 7

• Irregular periods
• Heavy bleeding
• Severe pain, uncontrolled by painkillers
• Pain lasting long after bleeding ends
• Spotting
• Symptoms of bacterial infection
• Bleeding in post menopausal women
• Women over 30 with new, worsening symptoms

Question 8

What are the symptoms of vaginal thrush?

Answer 8

• Itching or burning around genitals
• Thick, white discharge or watery discharge
• No smell to discharge
• a foul smell may indicate BV
• Painful urination
• Pain during intercourse

Question 9

Treatment

Answer 9

• Canesten cream
• good for external symptoms, not good for internal thrush
• Canesten internal and external creams
• local effects
• Canesten pessary and external cream
• local effects
• Canesten oral capsule and external cream
• good for those who do not use pessaries

Question 10

General advice

Answer 10

• Avoid tight clothing
• Do not use vaginal perfumes, foams or bath oils
• Do not have sex whilst having treatment
• Use live yoghurt
• Wipe back to front

Question 11

Referral Criteria

Answer 11

• Foul smelling discharge
• Diabetic
• Recurrent - 2x in last 6M
• Treatment failure
• Pregnant
• Under 16 or over 60
• Immunocompromised