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Test Slide Douglas Ong
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NON-medicinal factors that affect cervical mucus douglas ong
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Common causes of vaginal discharge
“Discharge” from other sources “Normal” discharge “Abnormal” discharge
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“Discharge” from other sources
Urine ( incontinence ) If this is affecting charting refer for treatment
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Cervical Mucus And Its Functions
Fertility Cleansing & vaginal health Ageing Vaginal infection (vaginitis) Foreign body Abnormal growth Benign (non-cancerous) Cancerous Medical illness eg anemia
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Ageing effect on cervical mucus
In young women around puberty S crypts are very numerous As the woman ages, they are replaced by L crypts, At premenopause the number of S crypts is considerably reduced This transformation of L - S crypts is a normal process S (-sperm-transmission) mucus and L (- locking-in) mucus
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Cervical Mucus And Its Functions
Fertility Cleansing & vaginal health Ageing Vaginal infection (vaginitis) Foreign body Abnormal growth Benign (non-cancerous) Cancerous Medical illness eg anemia
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Features of Vaginitis Vaginal infection = Vaginitis Characterised by:
Excessive “abnormal” discharge Odour Irritation Itching pH changes
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“Abnormal” discharge – Simple vaginitis or STD?`
Is it associated with symptoms of: urine infection – painful urination, urgency abdominal pain fever? More likely to be STD
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“Abnormal” discharge – Simple vaginitis or STD?
Is it associated only with: itch and/or vaginal odour? More likely to be a simple vaginal infection
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Discharge due to STD Important to make the diagnosis
Complications of STDs – Severe pelvic infection Infection of other distant organs – liver, brain, blood poisoning Tubal damage and infertility Chronic pelvic pain
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Pelvic Inflammatory Disease
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Long term complications of Pelvic Inflammatory Disease
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Discharge due to simple vaginal infection
Vaginitis Candida (Yeast, Thrush, Fungus) Trichomonas (Trich) Bacterial vaginosis (BV)
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Simple vaginal infections - Yeast
Causative in up to 95% of cases of simple vaginal infection 75% of women will experience at least 1 yeast infection in their lifetime % recurrence May be found in % of women without any symptoms
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Simple vaginal infections - Yeast
Predisposing causes: Broad spectrum antibiotics Steroid medication Poor immunity Diabetes mellitus Pregnancy
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Simple vaginal infections - Yeast
“Milk curd” or “cottage cheese”discharge Vaginal / vulvar itch pH <= 4.5
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Simple vaginal infections - Trichomonas
Protozoan (parasite) Diagnosis: Frothy vaginal discharge, “strawberry cervix” Vulval irritation Vaginal odour pH > 4.5 Microscopy
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Simple vaginal infections – BV (Bacterial vaginosis)
Most common cause of vaginitis among women of childbearing age Reflects a change in balance in vaginal ecosystem
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Simple vaginal infections - BV
Vulvar irritation Watery/clear vaginal discharge Absence of normal vaginal lactobacilli Clue cells Multi-bacterial infection by: Gardnerella, Mycoplasma & Mobiluncus
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Simple vaginal infections - BV
Diagnosis: Fishy odour pH > 4.5
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Cervical Mucus And Its Functions
Fertility Cleansing & vaginal health Ageing Vaginal infection (vaginitis) Foreign body Abnormal growth Benign (non-cancerous) Cancerous Medical illness eg anemia
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Foreign Body Causing Change in Vaginal Mucus
IUCD Retains bacteria Local irritant Frequent non-specific vaginal discharge
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Abnormal Growths Causing Change in Vaginal Mucus
Benign Polyp Malignant Cancer
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Abnormal Growths Causing Change in Vaginal Mucus
Symptoms Increased vaginal mucus Bleeding between periods Bleeding after intercourse Prolonged menstrual staining
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Chronic Illness Causing Change in Vaginal Mucus
Anemia “Anaemias are usually accompanied by an increased amount of L and S mucus. After treatment, these symptoms cease”
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Cervical Mucus And Its Functions
Fertility Cleansing & vaginal health Ageing Vaginal infection (vaginitis) Foreign body Abnormal growth Benign (non-cancerous) Cancerous Medical illness eg anemia
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Thank You Everyone 31
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