womens health Flashcards
what are the symptoms of lower urinary tract infection (UTI)
- increased frequency of passing urine
- urgent need to pass urine
- burning/ pain when passing urine
- cloudy urine
- sensation of incomplete emptying when urinating
- traces of blood in urine (not visible)
usually self limiting or can be treated with antibiotics if bacterial infection
when should you refer a patient with symptoms of a UTI
if they have:
- children with symptoms of UTI
- men with symptoms of UTI
- back pain
- fever
- visible blood in urine
- fever
these are symptoms of an upper urinary tract infection
what are the treatments for UTI
- mild symptoms likely to resolve themselves
- patients can be prescribed:
a 3 day course of trimethoprim or nitrofurantoin for non-pregnant women. 7 day course of these in men - Urinary alkalinising products, e.g. potassium citrate, sodium citrate and sodium bicarbonate are designed to reduce discomfort during urination. But little evidence to support this
what should patients taking nitrofurantoin for UTI avoid
they used avoid urinary alkalinising agents, these reduce efficacy of nitrofurantoin
which patients should avoid/use with caution products containing potassium (urinary alkalinising products)
- hyperkalaemia,
- renal or cardiac impairment
- patients taking potassium-sparing diuretics, aldosterone antagonists or ACE inhibitors
which urinary alkalinising products are contraindicated in pregnant women and those with hypertension
high sodium containing products e.g sodium citrate or sodium bicarbonate
when can cranberry containing products (capsules or juice) be used for UTI
There is evidence that using these can prevent (not treat) UTI. They are thought to prevent e.coli bacterial from adhering onto the lining of the bladder
what lifestyle tips can help to manage/ prevent UTI
- drink normally and avoid irritants such as alcohol or caffeine
- strain to expel residual urine 10-15 seconds after passing urine
- hot water bottle may relieve discomfort
- urinate after sex
- wipe from front to back
when should you refer a woman with suspected vaginal thrush
- under 16
- over 60
- pregnant patients
- anyone with recurrent thrush (more than 2 cases in 6 months)
- patients who have not experienced symptoms before (diagnosis needs to be confirmed by gp)
what is the treatment for thrush
- The imidazoles; clotrimazole, econazole and miconazole are equally effective (topical)
- fluconazole 150mg caps
Intravaginal treatment, via a pessary or intravaginal cream, is more effective than external application of the cream alone. external cream will soothe symptoms
which patients cannot use (contraindicated) oral thrush treatment (fluconazole 150mg)
- pregnant
- breastfeeding
what are the symptoms of thrush
- itchy vulva
- white, odourless, thick (cottage cheese-like) discharge
- pain when urinating
- pain during intercourse
when should you refer a patient with vaginal dryness
if they also have symptoms of dry eyes or dry mouth.
This can be a sign of an autoimmune disease known as Sjörgen’s syndrome
what is the treatment for vaginal dryness
- otc lubricating gels and vaginal moisturisers e.g Replens MD® and Sylk
- water-based lubricants e.g KY jelly can be used before sex
note hormone replacement therapy (HRT) and oestrogen cream which can relieve symptoms of menopause are prescription only
what is the first line treatment for dysmennorhea (period pains)
- NSAIDS e.g ibuprofen because they decrease the uterine prostaglandin levels (which cause pain)
- note:
- aspirin (NSAID) is not recommended as its less effective than other NSAIDS
- NSAIDS may be more effective than paracetamol
- codeine can be added for stronger pain relief but OTC codeine preparations are subtherapeutic so more likely to cause side effects than increased pain relief)
