Vaginal Hygiene Flashcards
physiology of the vagina
- positioned at a 45 deg angle
rugae of vaginal wall allows for flexibility of size and shape
- noral vaginal length if 9-10 cm
- upper end is closed except cervical os & lower open vulvar end
- vulva = external genetal organs -> sexual purpose
- Bartholin/s glands: produce secretions in response to sexual stimulation
describe the vaginal ecosystem
- balanced by:
> number & types of endogenous organisms (90-95% lactobacillus)
- > vaginal pH (3.8-4.2, increases during menses)
- > glycogen concentration (used to produce lactic acid)
*antibiotics can alter pH, diabetes can alter blood surgars both promote microbial growth
normal vaginal discharge
- varies in quantity, consistency and appearance throughout the menstrual cycle
- consists of endocervical mucus, serum transudate from vaginal capillary beds, endogenous vaginal flora and epithelial cells
*up to 4mL of dischange/day is normal
what causes inc in quantity of vaginal discharge
- emotional stress
- ovulation (dischage becomes like egg whties)
- pregnancy
- exercise
- sexual excitment (normal secretions + secretions from bartherians glands)
- certain medications (nuvaring)
- certain medical conditions (PCOS)
colours of vaginal discharge
- Clear
- healthy, pregnancy, ovulation, hormonal imbalnce
- White
- healthy
- or yeast infection
- Red
- menstrucation
- cervical infection, polyp, endometrial or cervical cancer
- Pink
- cervical bleeding, vaginal irritation, implantation bleeding
- Gray
- never normal -> bacterial vaginoses
- Yellow/green
- never normal -> STI
how does vaginal discharge change from being newborns, reproductive years, menopause
newborns: small amount of vaginal discharge +/- bleeding for up to 2 weeks after birth
Reproductive years:amount and consistency varies partly due to cyclical estrogen and progesterone
Menopause: amount of discharge decreases as estogen falls
why vaginal symptoms are important to monitor
red flags for vaginal discharge
- abnormal vaginal discharge when pregnent: ALWAYS REFER
- prepubertal child: potential sexual abuse
- fever or pain in pelvis or abdomen
- presistent and unusually strong vaginal odour
- inflammation, pain, blisters or ulcers on vagina/vulva
- sig change in odour, viscosity, volume and/or colour of dischage
- painful urination or sex (vaginal dryness or toher cause)
suspected foreign object (tampon or condom)
- have a sexual partner with an STI
- unusual bleeding
- abnormally storng itching or burning sensation
3 critical questions for vaginal assessment
- colour
- Qty/consistency
- odour
Scholar for vaginal discharge assessment
- Symptoms
- colour, odour, consistency
- Characteristics
- burning, irritation, itchy, changes compared to normal
- History
- happened before? what ddi you use to treat, how was it used/did it work
- Onset
- is it chornic (wondering if its PCOS), new onset (has anyhting changed, any antibiotics)
- Location:
- itching extenal or internal
- Aggrevating
- what makes it worse
- Relieving
- what makes it better
HAMS for vaginal discharge assessemnt
- Health status
- immunocompromised? timing in life -> starting menopause?
- allergy
- latex allergy
- medications
- estrogen/progesterion, meds w. contraindications w/ antifungals (warfarin), on any antibiotics or immunosuppresants
- Social
- Hygeine (vaginal)
- what products are you using (shoudl only be soap and warm water)
- are you sexually activa -> if not more likely to be self care case
- when was last period
- caffeine/alc
- smoking, risk factor for vaginal infections
- swimmer: is sitting in wet bathing suit
- Hygeine (vaginal)
vaginal hygiene measures for prevention
- hygiene
- keep genital area clean and dry, wipe back to front
- avoid OTC geminine hygiene products and douches
- change sanitar pads and tampons regularly, practica safe sex
- Clothing
- choose 100% cotton underwear
- avoid tight or restrictive synthetic clothing; avoid thongs
- promptly change out of wet cloths/swimsuits
- Diet
- balanced and nutrious
- drink sufficient fluids
- eat yogurt 8oz/day, with live cultures?
therapeutic optiosn for vaginal hygeien
prescription: not necessary -> dependent on infection/organisms isolatied may need an antibiotic or antifungal
nonprescription: not usually necessary 0> sitz bath of epsom salts may be sued adjuctively if irritation prestn
genital towelettes for vaginal hygeine
0 no benefit but if not allergenic and want to buy them sure
- MOA: cleanses outside of vagina ane eliminated odour causing bacteria (but shouldnt have odour causing, if do then there is a problem)
- ex: vagisil feminine wipes, summers eve cloths, always wipes, coolwipes
*safe for occasional use, may be irritating/ cause allergic rxns esp if has alcohol
genital washes and gels for vaginal hygene
- just overpriced, no additional benefit over mild soap and water
- cleanses external genitalia, eliminates odour causeing bacteria
ex: vagisil feminine wash pH balance (external, dont care about external pH), poise intimate liquid wash, summers eve wash
