Sexually Related Diseases/Problems in Women

Sexually Related Diseases/Problems in Women: Vaginitis, PID, Unintended Pregnancy
By:Sarah Guerry, MD
Medical Director, LAC STDP
UCLA

Vaginitis:
What is it?
* Clinical syndrome caused by inflammation/infection of the vagina
* Characterized by abnormal vaginal discharge
* Sometimes caused by an STD

Vaginitis: Who Cares?
Vaginitis Etiologies
Differential diagnosis:
* Irritant Dermatitis
* Foreign body
* HSV
* MCP from GC or CT
* Atrophic vaginitis
* UTI
* Desquamative vaginitis

Vaginitis Epidemiology
* Most common reason for doctors visit

Microbiology of the Vagina
Normal Vaginal Physiology
Factors Adversely Affecting Normal Vaginal Flora
* Douching
* Antibiotic and antifungal therapy
* Hormonal changes: pregnancy, OCs
* Spermicides, lubricant
* Foreign bodies: tampons, IUD, diaphragm
* Intercourse, semen
* Menses


Effects of Estrogen Status on Vaginal Microflora
Infection as a Cause of Vulvovaginitis Across the Lifespan
Vaginitis: Clinical Presentation
* Abnormal vaginal discharge
* Vulvar itch
* Odor
* Discomfort
* Burning with urination
* Painful intercourse

Clinical Evaluation of Vaginitis Physical Exam
* Characteristics of vaginal discharge
* Appearance of the vulva
* Appearance of vaginal mucosa
* Appearance of cervix
* Abdominal/bimanual exam

Diagnostic Evaluation of Vaginitis
* Vaginal pH
* Whiff test (amine test)
* Microscopy
* Chlamydia and GC tests

Vaginal pH Measurement
Bacterial Vaginosis A sexually-associated disease
Bacterial Vaginosis
Clinical Presentation of BV
BV: Diagnostic Criteria
BV: Treatment
BV: Complications
BV: Complications in Pregnancy
BV: Screening in Pregnancy
BV: Treatment Criteria
BV: Recurrent Infection
What’s Wrong with Douching?
Vulvovaginal Candidiasis (VVC)
VVC: Risk Factors
VVC: Clinical Manifestations
Yeast Colonization Study
Most Common Misdiagnoses among Women Reported to Have Recurrent VVC
Diagnosis of VVC
VVC: Diagnosis
Uncomplicated VVC: OTC Treatment
Topical Therapies:
Oral Therapy:
Trichomoniasis
Trichomonas: A Pathogen Over Lifetime
Trichomoniasis Clinical Presentation
Trichomoniasis: Diagnosis in Women
Trichomoniasis: Diagnosis in Men
Trichomonas vaginalis
Seattle STD/HIV Prevention Training Center
Trichomoniasis: Treatment
PID Clinical Presentation
Reproductive Anatomy & Spread of Infections
Pelvic Inflammatory Disease (PID):Magnitude of the Problem
PID Diagnostic Considerations
CDC Diagnostic Criteria for PID and much more

Sexually Related Diseases/Problems in Women.ppt