Term
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Definition
| very sensitive to external irritants & internal vaginal secretions |
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Term
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Definition
| clear or cloudy, no odor, no irritation |
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Term
| Lactobacillus acidophilus |
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Definition
| abundance of healthy vaginal flora which produces hydrogen peroxide, maintaining low levels of unwanted bacteria in the vagina |
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Term
| What can vaginal infections cause?? |
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Definition
increased vaginal pH;
increased risk of ectopic pregnancy;
increased risk of complications for pregnant women (increased pH, increased risk for low birth weight for baby, increased risk for baby developing cerebral palsy, increased risk for miscarriage), increased risk of Pelvic Inflammatory Disease (PID) |
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Term
| Pelvic Inflammatory Disease (PID) |
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Definition
infection of fallopian tubes, ovaries, and/or uterus;
Sx: lower abd pain, pain during intercourse, dysmenorrhea, irregular menstruation, fever;
Scarring may cause INFERTILITY if untreated;
After 3 infections, 40% infertility risk |
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Term
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Definition
Most common in women of childbearing age;
Cause is UNKNOWN but prolly polymicrobial;
Sx: bad odor, discharge worse after intercourse, possible itching, may be asymptomatic;
Risk: new or multiple sex partners, douching, IUD in place;
Vaginal pH >4.5;
Discharge: thin, white/gray, often increased |
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Term
| Vulvovaginal Candidiasis (Yeast infetion) |
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Definition
About 75% of women will develop at least 1 during lifetime;
Cause: Candida albicans;
Sx: itching, burning, discharge;
Risk: pregnancy, DM, use of antibiotics or corticosteroids;
Vaginal pH: >=4.5
Discharge: thick, white, curdy, "cottage cheese-like", dyspareunia;
20-30% of women will experiene recurrence |
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Term
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Definition
5 million cases annually in US;
Cause: Trichomonas vaginalis invades vagina or urinary tract;
Sx: frothy discharge, bad odor, dysuria, vulvar pruritis, dysuria;
Risk: Sexual transmission;
Vaginal pH: >=4.5
Discharge: green-yellow, frothy, increased amount;
Symptoms appear 4-20 days after exposure; |
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Term
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Definition
Most prevalent STD in US, 4 million people per year diagnosed;
Vaginal pH: increased;
Cause: Chlamydia trachomatis;
Sx: mostly ASYMPTOMATIC;
Risk: young age (15-19), new or multiple sex partners, concurrent or previous gonorrhea infection;
Discharge: NORMAL |
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Term
| Normal Vaginal Environment |
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Definition
Vaginal pH: 3.8-4.2
Discharge: white, clear, flocculent |
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Term
| Needed to Self-treat Yeast Infection |
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Definition
1) previous diagnosis of yeast infection & sx are identical;
2) >2 months since last yeast infection;
3) no pain, no odor;
4) NOT pregnant;
5) >12 yrs old |
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Term
| Goals of Treatment for Vaginal Infections |
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Definition
eradicate infection;
prevent reoccurrence;
prevent complications; |
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Term
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Definition
drugs of choice for tx of bacterial vaginosis;
CAN be given to BOTH non-pregnant & pregnant women;
Non-pregnant women: 500 mg PO BID x 7d;
Pregnant women: 500 mg PO BID x 7d for 2nd & 3rd trimester only |
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Term
| Counseling Points for Metronidazole (Tx of Bacterial Vaginosis) |
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Definition
Avoid intercourse for 7 days after start of treatment;
Take ALL doses for entire length of treatment;
Causes metallic taste, dark urine;
Avoid EtOH --> disulfiram-like rxn;
ADRs: N/V/D |
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Term
| Treatment for Uncomplicated Vulvovaginal Candidiasis |
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Definition
OTC anti-fungals: butoconazole cream, clotrimazole cream, miconazole cream/vag suppository, tioconazole ointment;
RX:
Oral Fluconazole (Diflucan) 150 mg tab PO x 1 dose |
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Term
| Treatment of Vulvovaginal candidiasis in Pregnant Patients |
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Definition
| recommended use of only TOPICAL AZOLE antifungal therapies (butoconazole, clotrimazole, miconazole, tioconazole) |
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Term
| Treatment of Vulvovaginal candidiasis in pts w/ recurrent infections OR immunocompromised pts |
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Definition
Oral: repeat fluconazole (Diflucan) 150 mg PO q3 days x 3 doses;
Topical: 7-14 days of treatment (butoconazole, clotrimazole, miconazole, tioconazole)
FOLLOW with 6 months of a maintenance regimen (i.e. fluconazole 150 mg PO weekly) |
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Term
| Counseling Points for treatment with fluconazole |
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Definition
Avoid intercourse for 7 days after tx;
Take all doses for the entire length of treatment;
C/I in pregnancy & women <12 yrs old;
Only women who have been previously diagnosed should self-treat;
3-day rule: if Sx do NOT improve within 3 days, seek medical attention;
Long-term: avoid EtOH, check LFTs;
Topicals: single-dose tx as effective as 3- or 7-day treatment;
Protect from extreme temps |
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Term
| Tx for Trichomoniasis vaginitis |
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Definition
treat both partners to eliminate parasite;
Drug of choice: metronidazole 2 g PO x 1 day including women in 2nd or 3rd trimester of pregnancy; |
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Term
| Tx of Chlamydia vaginitis |
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Definition
treat both partners;
Drugs of Choice:
azithromycin (Zithromax) 1 g PO x 1 dose
OR
doxycycline 100 mg PO BID x 7 days |
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Term
| Counseling Points for Azithromycin/tx of Chlamydia vaginitis |
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Definition
Avoid intercourse during treatment;
Take all doses for entire length of tx;
Avoid antacids for 2 hrs, do not take with food;
ADRs: N/V/D |
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Term
| Counseling Review for Tx of Vaginal Infections |
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Definition
Avoid intercourse during treatment;
Take all doses for entire length of treatment;
Wash hands & applicator;
3-day Rule: If Sx don't improve within 3 days, seek medical attention;
ADRs/Interactions of drugs of choice for treatment |
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Term
| Prevention of Vaginitis - Clothes |
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Definition
Wear cotton or silk underwear "breathe";
Avoid tight fitting clothing & nylons;
Use perfume-free laundry detergent;
Avoid fabric softeners/dryer sheets;
Remove wet bathing suits/exercise clothes ASAP;
Change underwear daily |
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Term
| Prevention of Vaginitis - Sexual Health |
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Definition
use condoms;
limit # of sexual partners;
check size of diaphragm;
go to OB/GYN annually;
change spermicides; |
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Term
| Prevention of Vaginitis - Hygiene |
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Definition
Wash genital area w/ mild soap;
Take showers instead of baths;
Do NOT douche! Avoid feminine sprays!
Use perfume-free & dye-free toilet paper;
Use unscented, deodorant-free pads & tampons |
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