Vaginitis Flashcards
(45 cards)
Describe normal vaginal secretions.
slight or no odour
clear to white (consistency of egg whites)
viscous and homogeneous
1-4ml secreted daily
acidic (pH 3.8-4.2)
5-10 bacterial species that can usually be cultured
-lactobacillus predominate
What can impact secretions throughout the cycle?
stress
diet
medications
sexual activity
What are all the different colours of vaginal discharge? What do they mean?
white: healthy discharge, yeast infection
clear: healthy discharge, pregnancy, ovulation, hormonal
imbalances
gray: bacterial vaginosis
pink: cervical bleeding, vaginal irritation, implantation bleeding
red: menstruation, cervical infection, cervical polyp,
endometrial or cervical cancer
yellow-green: sexually transmitted infection
In regards to colour-coded vaginal discharge, what are some variations to keep in mind?
cycle
lifestyle
environment
each individual serves as their own best baseline
What is vaginitis?
inflammation of the vulva (outside), vagina (inside) or both
-with or without vaginal discharge
What are the causes of vaginitis?
majority of the time due to an infection:
-bacterial vaginosis, vulvovaginal candidiasis, trichomoniasis,
or STI
may also be noninfectious:
-atrophy during peri-menopause
-physiologic (change in normal flora, mid-cycle cervical fluid)
-retention of foreign body (tampon)
-allergy
True or false: viral genital infections generally cause vaginitis
false
What are the four types of vaginitis?
vulvovaginal candidiasis
bacterial vaginosis
atrophy
trichomoniasis
Describe vulvovaginal candidiasis.
severe pruritis of vulva and vaginal areas
stinging/burning
“cottage cheese” discharge
odourless
pH<4.5
Describe bacterial vaginosis.
fishy odour
creamy discharge (grey)
pH 5-6
Describe atrophy.
vaginal discharge
spotting
soreness and burning
pH 7
Describe trichomoniasis.
frothy wet discharge
pruritis possible
malodourous
pH>6
Which types of vaginitis do we refer to an MD?
bacterial vaginosis
trichomoniasis
List off things that can alter the normal vaginal flora.
puberty
menstruation
estrogen or OCP therapy
pregnancy
post-menopause
antibiotics
vaginal surgery
What are risk factors for infection?
uncontrolled diabetes
broad spectrum antibiotics
immunosuppression
medications
diet
stress
pregnancy
menses
chemical irritants
synthetic, non-breathable undergarments and clothing
What is the pathogenesis of vaginitis?
an overgrowth of yeast cells Candida albicans that is already present in vulvovaginal area
the overgrowth can be initiated by risk factors
Differentiate between complicated and uncomplicated vulvovaginal candidiasis.
uncomplicated: sporadic, easily treated, caused by Candida
albicans
complicated: recurrent, severe disease, not caused by C.
albicans, or abnormal host factors
When does vulvovaginal candidiasis peak in women?
30-40 years of age
risk increases in 20s and is rare before puberty
What are the signs and symptoms of vulvovaginal candidiasis?
itching, soreness and/or burning discomfort
dysuria
dyspareunia
heavy white vaginal discharge (odourless)
bright red rash affecting inner and outer parts of the vulva
When do we refer vulvovaginal candidiasis to a doctor?
symptoms for 1st time
discharge has colour, coloured or profuse
presence of other symptoms
pregnant
pre-pubertal (<12)
diabetes or other underlying chronic illness
recurrence within 2 months
immunosuppressed
at risk of STI (unprotected sex, multiple partners)
How does the vaginal infection screening test work?
it tests pH, higher pH turns green/blue meaning it is likely not a yeast infection
bacterial vaginosis and trichomoniasis show elevated pH
True or false: there are no long-term consequences of vulvovaginal candidiasis to fertility that we know of
true
True or false: bacterial vaginosis has no associated increased risk of getting an STI
false
risk of getting an STI increases and passing an STI
When is OTC treatment appropriate for vulvovaginal candidiasis?
uncomplicated infection
VVC previously diagnosed
