Women's health nursing
Nathan Wilson, Peter Lewis, Leanne Hunt, Lisa Whitehead in Nursing in Australia, 2020
This chapter provides the reader an outline of the influence of sex and gender on health, an insight into the health issues facing women and girls across the lifespan, and a description of how nurses contribute to the advancement of women's health. It provides an overview of the challenges for nurses working in this area. The Australia healthcare system is under increasing pressure due to the increasing complexity of older women's health and the prevalence of multiple morbidities. Changes in oestrogen levels during menopausal transition can cause the vaginal mucosa to become thinner, drier and less elastic or flexible and change vaginal discharge. Around one in six women have experienced physical and/or sexual violence by an intimate partner, and for many, violence is recurring. Domestic and interpersonal violence against women is a pervasive problem for many Australian women linked with reduced mental health, physical function and general health.
Women's health
Gina Johnson, Ian Hill-Smith, Chirag Bakhai in The Minor Illness Manual, 2018
The two commonest causes of abnormal vaginal discharge in primary care are bacterial vaginosis (BV) and candida. BV is more common than candida but under-diagnosed, candida is over-diagnosed and over-treated. Microscopy is the most reliable way to make a diagnosis, but it is unlikely to be available in primary care. Caused by an overgrowth of anaerobic bacteria in the vagina at the expense of the normal commensal lactobacteria. A change in pH or hormone balance, or a course of broad spectrum antibiotic, may trigger yeast multiplication and symptoms. Heavy Menstrual Bleeding is a common problem; in 50% of women, no underlying cause can be found. Possible diagnoses include fibroids and endometriosis. Vomiting and persistent, severe diarrhoea can interfere with the absorption of combined oral contraceptives. A woman whose period is due when she is on holiday, or taking part in a religious or sporting event, may request medication to delay her period.
Symptom sorter
Sarah Bekaert in Women's Health, 2018
This chapter explores the possible signs and symptoms of common health concerns which women present. Hot flushes are one of the most common symptoms of the climacteric or menopause, and are due to decreasing oestrogen levels. Therefore anything that interferes with oestrogen levels can cause hot flushes. Premenstrual symptoms can be both physical and emotional. There is a spectrum of mild but identifiable symptoms. In premenstrual dysphoric disorder the symptoms are severe and disabling. Vaginal dryness is a common condition that affects women of all ages. It is estimated that 10-40% of women who have reached the menopause have symptoms related to vaginal dryness. Vaginal discharge is usually a symptom of the reproductive years, and is influenced by the menstrual cycle, use of the oral contraceptive pill, pregnancy and sexual activity. Breast pain is a common symptom in up to two-thirds of women, and is usually associated with cyclical hormonal changes.
Bacterial vaginosis: a primer for clinicians
Published in Postgraduate Medicine, 2019
Suzanne Reiter, Susan Kellogg Spadt
Bacterial vaginosis (BV) affects approximately one third of women in the United States. While often asymptomatic, BV infection may be accompanied by serious health consequences, such as preterm birth and pelvic inflammatory disease, and may facilitate acquisition of sexually transmitted infections. Identifying appropriate patients for screening, such as pregnant women, women planning pregnancy, and women with multiple and/or new sexual partners, is imperative for treatment. Diagnosis of BV has traditionally depended on the presence of vaginal discharge and odor, elevated pH, and clue cells as determined by microscopy, but newer diagnostic modalities that utilize molecular techniques allow for more convenient and accurate testing for BV. Approved treatment options consist of antibiotics administered as oral or intravaginal formulations. Patient counseling and education regarding treatment options, including adherence to prescribed treatments, appropriate hygienic practices, and treatment of symptomatic same-sex partners, are crucial to optimize patient outcomes and prevent recurrence.
Migration of a fractured ring IUD resulting in vesicovaginal fistula and vaginal calculus
Published in The European Journal of Contraception & Reproductive Health Care, 2018
Dewen Yan, Zhan Shi, Liping Wang, Xiumin Zhao
Case: Although many complications have been reported with intrauterine contraceptive devices (IUDs), vesicovaginal fistula with secondary vaginal stones is rare. We report the case of a 46-year-old woman who presented with a vaginal discharge lasting 2 months. Two years previously, she had undergone cystoscopic lithotripsy and surgery to remove an IUD, after pelvic radiography had revealed a fractured Chinese stainless steel ring IUD with secondary vesical stones that had been the cause of her urinary tract symptoms. When she again complained of vaginal discharge, vaginal stones and a vesicovaginal fistula were found on physical examination and CT urography. The patient underwent stone removal and concurrent vesicovaginal fistula repair. IUD fragments were found in the vesicovaginal and rectovaginal spaces. No abnormalities were found at follow-up 6 months after surgery. Conclusion: In any woman undergoing surgery to remove a migrated IUD, complete exposure and removal of the IUD are necessary to avoid fracturing of the IUD, secondary breakage and residue.
Ospemifene efficacy and safety data in women with vulvovaginal atrophy
Published in Gynecological Endocrinology, 2020
Lino Del Pup, Rafael Sánchez-Borrego
Vulvovaginal atrophy (VVA) is a frequent, underreported and underdiagnosed condition. Ospemifene is a third-generation Selective Estrogen Receptor Modulator (SERM) that has been shown to be effective in women with VVA and dyspareunia, vaginal dryness and vulvar vestibular symptoms. Some of the possible side effects included by FDA and EMA are hot flushes, headache, muscle spasms, vaginal bleeding and vaginal discharge. Ospemifene does not increase the incidence of endometrial cancer or hyperplasia. While the efficacy is comparable with that of estrogenic treatments, ospemifene is not only well tolerated and safe but also reduces bone turnover in postmenopausal women, and available data indicate no safety concerns for breast tissue.
Related Knowledge Centers
- Amniotic Fluid
- Menstrual Cycle
- Mucus
- Ovulation
- Vagina
- Vaginal Diseases
- Sexually Transmitted Disease