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Causes of Diseases contagious from vaginal sex

Diseases contagious from vaginal sex Causes: Book Excerpts

• Differential Diagnosis - Dysmenorrhea
• Differential Diagnosis - Vaginal Discharge
• Differential Diagnosis - Vaginal Discharge
• Medical causes - Dysmenorrhea
• Medical causes - Vaginal discharge
• Causes and incidence - Dysmenorrhea
• Medical causes - Dysmenorrhea
• Medical causes - Vaginal discharge
• Differential Overview - Vaginal Discharge
• Medical causes - Vaginal discharge
• Principal Causes of Vaginal Discharge - Vaginal Discharge
• Medical causes - Dysmenorrhea
• Medical causes - Vaginal discharge

Related information on causes of Diseases contagious from vaginal sex:

As with all medical conditions, there may be many causal factors. Further relevant information on causes of Diseases contagious from vaginal sex may be found in:

• Hidden causes of Diseases contagious from vaginal sex

Causes of Diseases contagious from vaginal sex: Online Medical Books

16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the causes of Diseases contagious from vaginal sex.

Dysmenorrhea: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Primary dysmenorrhea
  –Symptoms develop before age 25
  –Pain occurs with onset of bleeding, then gradually diminishes

• Secondary dysmenorrhea
  –Endometriosis (uterosacral ligament nodules, severe dysmenorrhea)
  –Adenomyosis (enlarged uterus, menorrhagia, age 40–50, parous)
  –Acute PID (acute adnexal and cervical motion tenderness, fever, discharge, and/or new-onset dysmenorrhea)
  –Chronic PID (due to scarring)
  –Uterine leiomyoma/fibroids (enlarged, mobile uterus, menorrhagia)
  –Ovarian cysts (new dysmenorrhea, unilateral fullness)

• Mental health issues
  –Somatization
  –Substance abuse
  –Depression
  –Sexual abuse
• Extrapelvic disorders
  –Irritable bowel syndrome
  –Appendicitis
  –Urinary tract infection
  –Inflammatory bowel disease
  –Diverticulitis
  –Cholecystitis
• Fibromyalgia
• Malformations of the müllerian ducts
• Interstitial cystitis
• Intestinal or uteropelvic junction obstruction
• Malignancy (e.g., uterine, ovarian)
• Ectopic pregnancy

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Vaginal Discharge: Differential Diagnosis
(In a Page: Signs and Symptoms)

• Physiologic
  –Many women will have a consistent, slightly clear, non-odor-producing discharge, either midcycle or premenstrually, particularly if they are on oral contraceptives
  –A change in odor, consistency, or color of discharge may signify that evaluation is necessary
  –Increased discharge is associated with pregnancy
• Sexually transmitted disease
  –Trichomonas vaginalis: “Strawberry cervix” with punctate erythema, flagellated oval organisms on wet mount
  –Gonorrhea/Chlamydia may be associated with pelvic pain/dysmenorrhea and dyspareunia
• Bacterial vaginosis
  –Various organisms and changes in normal flora with a characteristic fishy odor
  –Not considered an STD
  –Increases the risk of preterm delivery in pregnant women

• Alteration of normal vaginal flora and/or inflammatory response
  –Candida albicans overgrowth is more common with recent antibiotic use, poorly controlled diabetes, and/or pregnancy; presents with intensely pruritic, inflamed, and erythematous introitus
  –Doderlein's cytolysis (caused by an overgrowth of lactobacilli)

• Atrophic vaginitis
  –Common in postmenopausal women, especially those not on HRT
  –Poor coital lubrication, dyspareunia
  –Dysuria due to atrophic urethral tissue
• Foreign body vaginitis (e.g., retained tampon)
• Noninfectious irritant/allergic contact vaginitis (e.g., soaps, feminine pads, perfumes)
• Cervicitis (usually due to gonorrhea or Chlamydia)
• Cervical dysplasia, cancer, or polyps
• Vaginal or vulvar trauma or cancer

» READ BOOK EXCERPT ONLINE »

Source: In a Page: Signs and Symptoms, 2004

Vaginal Discharge: Differential Diagnosis
(In A Page: Pediatric Signs and Symptoms)

• Physiologic leukorrhea
  –In newborns for 2–3 weeks, due to maternal estrogen effect, and in pubertal girls
  –Discharge typically clear to white, sticky, and nonirritating
  –Newborns may have withdrawal bleeding

• Infections
  –Bacterial vaginosis: Previously known as nonspecific vaginitis; polymicrobial in etiology (coliforms, streptococci, Gardnerella); discharge may be gray and malodorous (fishy smell) but generally nonirritating
  –Candida: Discharge may be cheesy and white with erythematous, pruritic, irritated vulva; typical discharge is rarely seen in prepubertal children; discharge typically has no odor
  –Trichomonas: Discharge may be frothy, malodorous, creamy, green, bloody, or pruritic (or asymptomatic)
  –Chlamydia: Commonly asymptomatic or a nonspecific discharge
  –Gonorrhea: Infection is commonly asymptomatic or has a gray-white, thick, purulent discharge
  –Group A β-hemolytic streptococci: Discharge may be bloody
  –Shigella: Discharge may be bloody

• Irritation/hygiene
  –Due to bubble baths and other chemical irritants, tight clothing, obesity, poor wiping
• Foreign body
  –Commonly includes toilet paper, forgotten tampon
  –Discharge is often bloody and malodorous
• Anatomic
  –Ectopic urethra
  –Rectovaginal fistula
  –Urethral prolapse
• Urinary tract infection
• Masturbation
• Sarcoma botyroides
• Oral contraceptives (estrogen effect)

» READ BOOK EXCERPT ONLINE »

Source: In A Page: Pediatric Signs and Symptoms, 2007

Dysmenorrhea: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Adenomyosis.

In adenomyosis, endometrial tissue invades the myometrium, resulting in severe dysmenorrhea with pain radiating to the back or rectum, menorrhagia, and a symmetrically enlarged, globular uterus that's usually softer on palpation than a uterine myoma.

Cervical stenosis.

Cervical stenosis is a structural disorder that causes dysmenorrhea and scant or absent menstrual flow.

Endometriosis

Endometriosis typically produces steady, aching pain that begins before menses and peaks at the height of menstrual flow; however, the pain may also occur between menstrual periods. The pain may arise at the endometrial deposit site or may radiate to the perineum or rectum. Associated signs and symptoms include premenstrual spotting, dyspareunia, infertility, nausea and vomiting, painful defecation, and rectal bleeding and hematuria during menses. A tender, fixed adnexal mass is usually palpable on bimanual examination.

Pelvic inflammatory disease

Chronic infection produces dysmenorrhea accompanied by a fever; malaise; foul-smelling, purulent vaginal discharge; menorrhagia; dyspareunia; severe abdominal pain; nausea and vomiting; and diarrhea. A pelvic examination may reveal cervical motion tenderness and bilateral adnexal tenderness.

PMS

The cramping pain of PMS usually begins with menstrual flow and persists for several hours or days, diminishing with decreasing flow. Common associated effects precede menses by several days to 2 weeks: abdominal bloating, breast tenderness, palpitations, diaphoresis, flushing, depression, and irritability. Other findings include nausea, vomiting, diarrhea, and a headache. Because PMS usually follows an ovulatory cycle, it rarely occurs during the first 12 months of menses, which may be anovulatory.

Primary (idiopathic) dysmenorrhea

Increased prostaglandin secretion intensifies uterine contractions, apparently causing mild to severe spasmodic cramping pain in the lower abdomen, which radiates to the sacrum and inner thighs. The cramping abdominal pain peaks a few hours before menses. Patients may also experience nausea and vomiting, fatigue, diarrhea, and a headache.

Uterine leiomyomas

If these tumors twist or degenerate after circulatory occlusion or infection or if the uterus contracts in an attempt to expel them, the tumors may cause constant or intermittent lower abdominal pain that worsens with menses. Associated signs and symptoms include backache, constipation, menorrhagia, and urinary frequency or retention. Palpation may reveal the tumor mass and an enlarged uterus. The tumors are almost always nontender.

Other causes

Intrauterine devices (IUDs)

IUDs may cause severe cramping and heavy menstrual flow.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Vaginal discharge: Medical causes
(Handbook of Signs & Symptoms (Third Edition))

Atrophic vaginitis

With atrophic vaginitis, a thin, scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial vaginosis

Bacterial vaginosis (formerly called Gardnerella vaginalis and Haemophilus vaginalis) results from an ecozogic disturbance of the vaginal flora. Causing a thin, foul-smelling, green or gray-white discharge, it adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other signs of vaginal irritation may occur but are usually minimal.

Candidiasis

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine, red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chancroid

Chancroid — a rare but highly contagious sexually transmitted disease — produces a mucopurulent, foul-smelling discharge and vulvar lesions that are initially erythematous and later ulcerated. Within 2 to 3 weeks, inguinal lymph nodes (usually unilateral) may become tender and enlarged, with pruritus, suppuration, and spontaneous drainage of nodes. Headache, malaise, and fever to 102.2° F (39° C) are common.

Chlamydial infection

Chlamydial infection causes a yellow, mucopurulent, odorless, or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially following menses. Many women remain asymptomatic.

Endometritis

A scant, serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, lower back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts

Genital warts are mosaic, papular vulvar lesions that can cause a profuse, mucopurulent vaginal discharge, which may be foul-smelling if the warts are infected. Patients frequently complain of burning or paresthesia in the vaginal introitus.

Gonorrhea

Although 80% of women with gonorrhea are asymptomatic, others have a yellow or green, foul-smelling discharge that can be expressed from Bartholin’s or Skene’s ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer

Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul-smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital)

A copious mucoid discharge results from herpes simplex, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis

Trichomoniasis can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; a red, inflamed vagina with tiny petechiae; dysuria and urinary frequency; and dyspareunia, postcoital spotting, menorrhagia, or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies

Contraceptive creams and jellies can increase vaginal secretions.

Drugs

Drugs that contain estrogen, including hormonal contraceptives, can cause increased mucoid vaginal discharge. Antibiotics, such as tetracycline, may increase the risk of a candidal vaginal infection and discharge.

Radiation therapy

Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Handbook of Signs & Symptoms (Third Edition), 2006

Dysmenorrhea: Causes and incidence
(Professional Guide to Diseases (Eighth Edition))

Although primary dysmenorrhea has no known single cause, possible contributing factors include hormonal imbalances and psychogenic factors. The pain of dysmenorrhea probably results from increased prostaglandin secretion, which intensifies normal uterine contractions. (See Causes of pelvic pain, page 938.) Dysmenorrhea may also be secondary to such gynecologic disorders as endometriosis, cervical stenosis, uterine leiomyomas, uterine malposition, pelvic inflammatory disease, pelvic tumors, or adenomyosis.

Because dysmenorrhea almost always follows an ovulatory cycle, both the primary and secondary forms are rare during the anovulatory cycles of menses. After age 20, dysmenorrhea is generally secondary.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Diseases (Eighth Edition), 2005

Dysmenorrhea: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Adenomyosis

In this disorder, endometrial tissue invades the myometrium, resulting in severe dysmenorrhea with pain radiating to the back or rectum, menorrhagia, and a symmetrically enlarged, globular uterus that’s usually softer on palpation than a uterine myoma.

Cervical stenosis

This structural disorder causes dysmenorrhea and scant or absent menstrual flow.

Endometriosis

In this disorder, steady, aching pain typically begins before menses and peaks at the height of menstrual flow, but it may also occur between menstrual periods. The pain may arise at the endometrial deposit site or may radiate to the perineum or rectum. Associated signs and symptoms include premenstrual spotting, dyspareunia, infertility, nausea and vomiting, painful defecation, and rectal bleeding and hematuria during menses. A tender, fixed adnexal mass is usually palpable on bimanual examination.

Pelvic inflammatory disease

Chronic infection produces dysmenorrhea accompanied by fever; malaise; a foul-smelling, purulent vaginal discharge; menorrhagia; dyspareunia; severe abdominal pain; nausea and vomiting; and diarrhea. A pelvic examination may reveal cervical motion tenderness and bilateral adnexal tenderness.

PMS

The cramping pain of PMS usually begins with menstrual flow and persists for several hours or days, diminishing as flow decreases. Abdominal bloating, breast tenderness, palpitations, diaphoresis, flushing, depression, and irritability commonly precede menses by several days to 2 weeks. Other findings include nausea, vomiting, diarrhea, and headache. Because PMS usually follows an ovulatory cycle, it rarely occurs during the first 12 months of menses, which may be anovulatory.

Primary (idiopathic) dysmenorrhea

Increased prostaglandin secretion intensifies uterine contractions, apparently causing mild to severe spasmodic cramping pain in the lower abdomen, which radiates to the sacrum and inner thighs. The cramping abdominal pain peaks a few hours before menses. Patients may also experience nausea and vomiting, fatigue, diarrhea, and headache.

Uterine leiomyomas

If these tumors twist or degenerate after circulatory occlusion or infection or if the uterus contracts in an attempt to expel them, they may cause constant or intermittent lower abdominal pain that worsens with menses. Associated signs and symptoms include backache, constipation, menorrhagia, and urinary frequency or retention. Palpation may reveal the tumor mass and an enlarged uterus. The tumors are almost always nontender.

Other causes

Intrauterine devices

These devices may cause severe cramping and heavy menstrual flow.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Vaginal discharge: Medical causes
(Professional Guide to Signs & Symptoms (Fifth Edition))

Atrophic vaginitis

In this disorder, a scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial Vaginosis

This infection, caused by Gardnerella vaginalis (formerly called Haemophilus vaginalis), results from an ecozogic disturbance of the vaginal flora. It produces a thin, foul-smelling, green or gray-white discharge that adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other mild signs of vaginal irritation may also occur.

Candidiasis

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chancroid

This rare but highly contagious sexually transmitted disease produces a mucopurulent, foul-smelling discharge and vulvar lesions that are initially erythematous and later ulcerated. Within 2 to 3 weeks, inguinal lymph nodes (usually unilateral) may become tender and enlarged, with pruritus, suppuration, and spontaneous drainage of nodes. Headache, malaise, and a fever as high as 102.2° F (39° C) are common.

Chlamydial infection

This infection causes a yellow, mucopurulent, odorless or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially after menses. Many women, however, remain asymptomatic.

Endometritis

A scant serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, low back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts

These mosaic, papular vulvar lesions can cause a profuse mucopurulent vaginal discharge, which may be foul smelling if the warts are infected. Patients commonly complain of burning or paresthesia in the vaginal introitus.

Gonorrhea

Although 80% of women with gonorrhea are asymptomatic, others have a foul-smelling yellow or green discharge that can be expressed from Bartholin’s or Skene’s ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer

Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital)

A copious mucoid discharge results from this disorder, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis

This infection can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; an inflamed, erythematous vagina with tiny petechiae; dysuria and urinary frequency; dyspareunia; postcoital spotting; and menorrhagia or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies

These products can increase vaginal secretions.

Drugs

Drugs that contain estrogen, including hormonal contraceptives, can cause a mucoid vaginal discharge. Antibiotics such as tetracycline may increase the risk of a candidal vaginal infection and associated discharge.

Radiation therapy

Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Professional Guide to Signs & Symptoms (Fifth Edition), 2006

Vaginal Discharge: Differential Overview
(Field Guide to Bedside Diagnosis)

❑ Physiologic discharge

❑ Candida vulvovaginitis

❑ Bacterial vaginosis

❑ Trichomonas vaginitis

❑ Atrophic vaginitis

❑ Irritant dermatitis

❑ Gonorrheal cervicitis

❑ Chlamydial cervicitis

❑ Herpes simplex

❑ Cervical cancer

» READ BOOK EXCERPT ONLINE »

Source: Field Guide to Bedside Diagnosis, 2007

Vaginal discharge: Medical causes
(Signs & Symptoms: A 2-in-1 Reference for Nurses)

Atrophic vaginitis

With atrophic vaginitis, a thin, scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial vaginosis

Bacterial vaginosis results in a thin, foul-smelling, green or gray-white discharge that adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other signs of vaginal irritation may occur but are usually minimal.

Candidiasis

Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine, red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chlamydial infection

A chlamydial infection causes a yellow, mucopurulent, odorless, or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially following menses. Many women remain asymptomatic.

Endometritis

A scant, serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, lower back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts

Genital warts are mosaic, papular vulvar lesions that can cause a profuse, mucopurulent vaginal discharge, which may be foul-smelling if the warts are infected. Patients with genital warts frequently complain of burning or paresthesia in the vaginal introitus.

Gonorrhea

Although 80% of women with gonorrhea are asymptomatic, others have a yellow or green, foul-smelling discharge that can be expressed from Bartholin’s or Skene’s ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer

Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul-smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital)

A copious mucoid discharge results from genital herpes, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis

Trichomoniasis can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; a red, inflamed vagina with tiny petechiae; dysuria and urinary frequency; and dyspareunia, postcoital spotting, menorrhagia, or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies

These products can increase vaginal secretions.

Drugs

Drugs that contain estrogen, including hormonal contraceptives, can cause increased mucoid vaginal discharge. Antibiotics, such as tetracycline, may increase the risk of a candidal vaginal infection and discharge.

Radiation therapy

Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Signs & Symptoms: A 2-in-1 Reference for Nurses, 2007

Vaginal Discharge: Principal Causes of Vaginal Discharge
(The Diagnostic Approach to Symptoms and Signs in Pediatrics)

1. Prepubertalonset
   1. Physiologicleukorrhea
   2. Vulvovaginitis
      1. Nonspecificcauses
      2. Specific infections
   3. Foreign body
2. Pubertal and postpubertal onset
   1. Physiologicleukorrhea
   2. Vulvovaginitis
      1. Nonspecificcauses
      2. Specific infections
         1. Bacterialvaginosis
         2. Candida species
         3. Trichomonas vaginalis
         4. Herpes simplex virus
   3. Cervicitis
      1. Chlamydia trachomatis
      2. Neisseria gonorrhoeae
   4. Pelvic inflammatory disease
   5. Foreign body

» READ BOOK EXCERPT ONLINE »

Source: The Diagnostic Approach to Symptoms and Signs in Pediatrics, 2006

Dysmenorrhea: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Adenomyosis.In adenomyosis, endometrial tissue invades the myometrium, resulting in severe dysmenorrhea with pain radiating to the back or rectum, menorrhagia, and a symmetrically enlarged, globular uterus that's usually softer on palpation than a uterine myoma.

Cervical stenosis.Cervical stenosis causes dysmenorrhea and scant or absent menstrual flow.

Endometriosis.Endometriosis typically produces steady, aching pain that begins before menses and peaks at the height of menstrual flow; however, the pain may also occur between menstrual periods. The pain may arise at the endometrial deposit site or may radiate to the perineum or rectum. Associated signs and symptoms include premenstrual spotting, dyspareunia, infertility, nausea and vomiting, painful defecation, and rectal bleeding and hematuria during menses. A tender, fixed adnexal mass is usually palpable on bimanual examination.

Pelvic inflammatory disease.Chronic uterine infection produces dysmenorrhea accompanied by a fever; malaise; foul-smelling, purulent vaginal discharge; menorrhagia; dyspareunia; severe abdominal pain; nausea and vomiting; and diarrhea. A pelvic examination may reveal cervical motion tenderness and bilateral adnexal tenderness.

PMS.The cramping pain of PMS usually begins with menstrual flow and persists for several hours or days, diminishing with decreasing flow. Common associated effects precede menses by several days to 2 weeks: abdominal bloating, breast tenderness, palpitations, diaphoresis, flushing, depression, and irritability. Other findings include nausea, vomiting, diarrhea, and a headache. Because PMS usually follows an ovulatory cycle, it rarely occurs during the first 12 months of menses, which may be anovulatory.

Primary (idiopathic) dysmenorrhea.Increased prostaglandin secretion intensifies uterine contractions, apparently causing mild to severe spasmodic cramping pain in the lower abdomen, which radiates to the sacrum and inner thighs. The cramping abdominal pain peaks a few hours before menses. Patients may also experience nausea and vomiting, fatigue, diarrhea, and a headache.

Uterine leiomyomas.If these tumors twist or degenerate after circulatory occlusion or infection or if the uterus contracts in an attempt to expel them, the tumors may cause constant or intermittent lower abdominal pain that worsens with menses. Associated signs and symptoms include backache, constipation, menorrhagia, and urinary frequency or retention. Palpation may reveal the tumor mass and an enlarged uterus. The tumors are almost always nontender.

Other causes

Intrauterine devices (IUDs).IUDs may cause severe cramping and heavy menstrual flow.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

Vaginal discharge: Medical causes
(Nursing: Interpreting Signs and Symptoms)

Atrophic vaginitis.With atrophic vaginitis, a thin, scant, watery white vaginal discharge may be accompanied by pruritus, burning, tenderness, and bloody spotting after coitus or douching. Sparse pubic hair, a pale vagina with decreased rugae and small hemorrhagic spots, clitoral atrophy, and shrinking of the labia minora may also occur.

Bacterial vaginosis.Bacterial vaginosis causes a thin, foul-smelling, green or gray-white discharge, it adheres to the vaginal walls and can be easily wiped away, leaving healthy-looking tissue. Pruritus, redness, and other signs of vaginal irritation may occur but are usually minimal.

Candidiasis.Infection with Candida albicans causes a profuse, white, curdlike discharge with a yeasty, sweet odor. Onset is abrupt, usually just before menses or during a course of antibiotics. Exudate may be lightly attached to the labia and vaginal walls and is commonly accompanied by vulvar redness and edema. The inner thighs may be covered with a fine, red dermatitis and weeping erosions. Intense labial itching and burning may also occur. Some patients experience external dysuria.

Chancroid.Chancroid produces a mucopurulent, foul-smelling discharge and vulvar lesions that are initially erythematous and later ulcerated. Within 2 to 3 weeks, inguinal lymph nodes (usually unilateral) may become tender and enlarged, with pruritus, suppuration, and spontaneous drainage of nodes. Headache, malaise, and fever to 102.2° F (39° C) are common.

Chlamydial infection.Chlamydial infection causes a yellow, mucopurulent, odorless, or acrid vaginal discharge. Other findings include dysuria, dyspareunia, and vaginal bleeding after douching or coitus, especially following menses. Many women remain asymptomatic.

Endometritis.A scant, serosanguineous discharge with a foul odor can result from bacterial invasion of the endometrium. Associated findings include fever, lower back and abdominal pain, abdominal muscle spasm, malaise, dysmenorrhea, and an enlarged uterus.

Genital warts.Genital warts are mosaic, papular vulvar lesions that can cause a profuse, mucopurulent vaginal discharge, which may be foul-smelling if the warts are infected. Patients frequently complain of burning or paresthesia in the vaginal introitus.

Gonorrhea.Although 80% of women with gonorrhea are asymptomatic, others have a yellow or green, foul-smelling discharge that can be expressed from Bartholin's or Skene's ducts. Other findings include dysuria, urinary frequency and incontinence, bleeding, and vaginal redness and swelling. Severe pelvic and lower abdominal pain and fever may develop.

Gynecologic cancer.Endometrial or cervical cancer produces a chronic, watery, bloody or purulent vaginal discharge that may be foul-smelling. Other findings include abnormal vaginal bleeding and, later, weight loss; pelvic, back, and leg pain; fatigue; urinary frequency; and abdominal distention.

Herpes simplex (genital).A copious mucoid discharge results from genital herpes simplex, but the initial complaint is painful, indurated vesicles and ulcerations on the labia, vagina, cervix, anus, thighs, or mouth. Erythema, marked edema, and tender inguinal lymph nodes may occur with fever, malaise, and dysuria.

Trichomoniasis.Trichomoniasis can cause a foul-smelling discharge, which may be frothy, green-yellow, and profuse or thin, white, and scant. Other findings include pruritus; a red, inflamed vagina with tiny petechiae; dysuria and urinary frequency; and dyspareunia, postcoital spotting, menorrhagia, or dysmenorrhea. About 70% of patients are asymptomatic.

Other causes

Contraceptive creams and jellies.Contraceptive creams and jellies increase vaginal secretions.

Drugs.Drugs that contain estrogen, including hormonal contraceptives, can cause increased mucoid vaginal discharge. Antibiotics, such as tetracycline, may increase the risk of a candidal vaginal infection and discharge.

Radiation therapy.Irradiation of the reproductive tract can cause a watery, odorless vaginal discharge.

» READ BOOK EXCERPT ONLINE »

Source: Nursing: Interpreting Signs and Symptoms, 2007

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