Women's Health

Women's Health

Women's Health

1 of 13

Cystitis

  • Common condition amongst women
  • Consider anatomy - urethra
  • Estimated that more than one in two women will experience at least one episode during their lives
  • Infections of the urinary tract are especially common in women
  • Peak incidence: early 20s
  • Symptoms
    • 'Itching' of urethra indicates an attack
    • Urgency and frequency to urinate
    • Dysuria (discomfort/burning sensation when passing urine)
2 of 13

When to Refer

  • Longer than 7 days
  • Women over 70
  • Children under 16
  • Diabetics
  • Haematuria (blood in urine)
  • Men
  • Immunocompromised
  • Pregnancy
3 of 13

Cystitis: Treatment Options

  • Analagesics
  • Potassium and sodium citrate
  • Antimicrobial therapy, where indicated, is highly effective
  • Cranberry juice - evidence?
4 of 13

Cystitis: Advice

  • Ensure large fluid intake
  • Do not resist the urgency to pass urine
  • Empty the bladder fully
  • Avoid agents that may worsen symptoms:
    • Carbonated drinks
    • Coffee and alcohol
    • Feminine hygiene products
    • Bath oils, bubble bath
    • Clothes detergents
    • Vaginal deodorants
5 of 13

Cystitis: Advice

  • Wipe from front to back
  • Sexual intercourse trigger - empty the bladder before and after
  • Use a water based lubricant/no spermicide
  • Avoid tight underwear made from synthetic materials
  • Avoid tight fitting trousers
6 of 13

Vaginal Thrush

  • Pruritis (itch) often intense and burning in nature
  • Vaginal discharge is usually, but not always, present
  • Discharge varies from watery to a creamy-coloured, thick discharge
  • Discharge is odourless
  • Dysuria (pain urinating)
  • Dyspareunia (painful intercourse)
  • Treated without examination by GP but persistence indicates that a swap should be taken so refer back
7 of 13

When to Refer

  • Discharge that has a strong smell
  • Diabetes
  • Treatment failure
  • Under 16s and over 60s
  • Pregnancy
  • Recurrent attacks
8 of 13

Vaginal Thrush: Treatment Options and Advice

  • Fluconazole 150mg
    • Internal pessary - 500mg pessary with applicator
  • or intravaginal cream - 5g of 10% clotrimazole
  • and/or external cream - 2% clotrimazole cream
  • Advice:
    • Avoid wearing nylon underwear and tights
    • Do not use vaginal deodorants, foam baths or perfumed soaps
    • Recurrent symptoms require medical referral
    • Topical imidazoles can damage latex condoms and diaphragms
9 of 13

Primary Dysmenorrhoea

  • Most common in adolescents and women in their 20s
  • Pain is usually described as cramping
  • Pain is rarely severe
  • Onset occurs shortly before the onset of menses and rarely lasts for more than 3 days
  • When to refer:
    • Heavy or unexplained bleeding
    • Pain experienced before menses or increasing after menses
    • Signs of systemic infection
    • Bleeding in postmenopausal women
    • Women over 30 with new/worsening symptoms
10 of 13

Period Pain: Management

  • NSAIDs
    • ibuprofen
    • naproxen
  • Hyoscine butylbromide
11 of 13

Menorrhagia

  • Heavier than normal bleeding
  • It can interfere with normal activities
  • Can occur with other symptoms
  • Need to be able to exclude sinister pathology
  • Medication related?
    • Anticoagulants
    • Monoamine oxidase inhibitors (MAOIs)
    • Cimetidine
    • Steroids
    • Thyroid hormones
12 of 13

When to Refer and Management

  • Intermenstrual bleeding
  • Pelvic pain
  • Post coital bleeding/pain
  • Treatment failure
  • Management
    • Tranexamic acid
    • NSAIDs if also experiencing dysmenorrhoea
13 of 13

Comments

No comments have yet been made

Similar Pharmacy resources:

See all Pharmacy resources »See all PH1122 resources »