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Treatments for Vaginitis
Treatment list for Vaginitis:
The list of treatments mentioned in various sources for Vaginitis includes the following list. Always seek professional medical advice about any treatment or change in treatment plans.
- Treatments for inflammation without any underlying infection:
- Vaginal creams
- Anti-inflammatory creams
- Hydrocortisone cream
- Treatments for bacterial or parasitic infections:
- Treatments for fungal infections:
- Miconazole
- Clotrimazole
- See treatments for vaginal candidiasis
- Hormone replacement therapy - for vaginitis related to menopause
- Treatments for any underlying condition
Treatments of Vaginitis: Online Medical Books
16 MEDICAL BOOKS ONLINE! Review excerpts from medical books online, free, without registration, for more information about the treatments of Vaginitis.
Vaginal Discharge:
Treatment
(In a Page: Signs and Symptoms)
- See most recent CDC guidelines for all STDs
-
Trichomonas
–Metronidazole single dose or for 7 days (avoid alcohol with metronidazole use)
–Intravaginal clotrimazole if pregnant or unable to use metronidazole
–Oral ciprofloxacin or IM ceftriaxone
–Metronidazole single dose or for 7 days
–Clotrimazole cream or intravaginal suppository
–Fluconazole single dose
–Topical or oral hormone replacement if appropriate
Vaginal Discharge:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- Physiologic leukorrhea: Provide reassurance
- Irritative vaginal discharge: Educate on proper wiping techniques, avoidance of tight clothing and irritants
- Foreign bodies such as toilet paper can usually be removed with gentle vaginal lavage, sitz baths
-
Treatments for infectious causes of vaginal discharge:
–Bacterial vaginosis: Metronidazole or topical clindamycin
–Candida can be treated with topical or oral antifungals
–Trichomonas is treated with metronidazole
–Group A β-hemolytic streptococci: Penicillin
–Chlamydia is treated with doxycycline or azithromycin
–Gonorrhea: Ceftriaxone, ciprofloxacin, or ofloxacin
–Shigella is treated with trimethoprim-sulfamethoxazole- Encourage barrier contraception in sexually active adolescents
Abnormal Vaginal Bleeding:
Treatment
(In A Page: Pediatric Signs and Symptoms)
- Physiologic anovulation does not usually need to be treated unless it persists beyond 2 years past menarche
- Polycystic ovary syndrome treat with: Oral contraceptives, androgen inhibitors (spironolactone) as adjunct, insulin sensitizing medications (metformin)
- Hyperprolactinemia: Treat with bromocriptine
- Hypothyroidism: Treat with L-thyroxine replacement
- Coagulopathy: Referral to hematologist for management
- Gynecologic tumor or foreign body: Surgical exploration and resection
- Intracranial mass (pituitary tumor): Referral to oncologist, endocrinologist
-
Menorrhagia
–Oral estrogen is required to stop an acute episode
–Patient with very heavy bleeding may require
–OCPs or progestins are useful to prevent recurrences
Vulvovaginitis:
Treatment
(Professional Guide to Diseases (Eighth Edition))
The cause of vulvovaginitis determines the appropriate treatment. It may include oral or topical antibiotics, antifungal creams, antibacterial creams, or similar medications. An antihistamine may be prescribed for allergic reactions. Cold compresses or cool sitz baths may provide relief from pruritus in acute vulvitis; severe inflammation may require warm compresses. Other therapy includes avoiding drying soaps, wearing loose clothing to promote air circulation, and applying topical corticosteroids to reduce inflammation. Chronic vulvitis may respond to topical hydrocortisone or antipruritics and good hygiene (especially in elderly or incontinent patients). Topical estrogen ointments may be used to treat atrophic vulvovaginitis. No cure exists for herpes-virus infections; however, oral and topical acyclovir decreases the duration and symptoms of active lesions.
If a sexually transmitted disease (STD) is diagnosed, it’s very important that partners also receive treatment, even if there are no symptoms. Failure of partners to receive treatment can lead to continual reinfection, which may eventually lead to infertility and affect the patient’s overall health.
Vaginal cancer:
Treatment
(Professional Guide to Diseases (Eighth Edition))
In early stages, treatment aims to preserve the normal parts of the vagina. Topical chemotherapy with 5-fluorouracil and laser surgery can be used for stages 0 and I. Radiation or surgery varies with the size, depth, and location of the lesion and the patient's desire to maintain a functional vagina. Preservation of a functional vagina is generally possible only in the early stages. Survival rates are the same for patients treated with radiation as for those with surgery.
Surgery is usually recommended only when the tumor is so extensive that exenteration is needed because close proximity to the bladder and rectum permits only minimal tissue margins around resected vaginal tissue.
Radiation therapy is the preferred treatment of advanced vaginal cancer. Most patients need preliminary external radiation treatment to shrink the tumor before internal radiation can begin. Then, if the tumor is localized to the vault and the cervix is present, radiation (using radium or cesium) can be given with an intrauterine tandem or ovoids; if the cervix is absent, a specially designed vaginal applicator is used instead.
To minimize complications, radioactive sources and filters are carefully placed away from radiosensitive tissues, such as the bladder and rectum. Internal radiation lasts 48 to 72 hours, depending on the dosage. (See Safe time for radiation implant.)
Vulvar lesions:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Show the patient how to give herself a sitz bath to promote healing and comfort. If she has a sexually transmitted disease, encourage her to inform her sexual partners and persuade them to be treated. Advise her to avoid sexual contact until the lesions are no longer contagious. Provide information about safer sex practices.
Vaginal bleeding, postmenopausal:
Patient counseling
(Professional Guide to Signs & Symptoms (Fifth Edition))
Reassure the patient that most cases of postmenopausal vaginal bleeding are benign and not cancer related.
Vulvovaginitis:
Treatment
(Handbook of Diseases)
Common therapeutic measures include the following:
❑ oral metronidazole for the patient with trichomonal vaginitis and for all sexual partners
❑ topical miconazole 2% or clotrimazole 1% for candidal infection
❑ metronidazole for Gardnerella
❑ systemic antibiotic therapy for the patient with gonorrhea and for all sexual partners
❑ doxycycline or erythromycin for chlamydial infection
❑ topical estrogen cream, which may be helpful for patients who have irritation and inflammation caused by a low estrogen level (post-menopausal).
Cold compresses or cool sitz baths may provide relief from pruritus in acute vulvitis; severe inflammation may require warm compresses. Other therapy includes avoiding drying soaps, wearing loose clothing to promote air circulation, and applying topical corticosteroids to reduce inflammation.
Chronic vulvitis may respond to topical hydrocortisone or antipruritics and good hygiene (especially in elderly or incontinent patients). Topical estrogen ointments may be used to treat atrophic vulvovaginitis.
No cure exists for herpesvirus infections; however, oral and topical acyclovir decreases the duration and symptoms of active lesions.
Vaginal discharge:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Teach the patient to keep her perineum clean and dry. Also, tell her to avoid wearing tight-fitting clothing and nylon underwear and to instead wear cotton-crotched underwear and pantyhose. If appropriate, suggest that the patient douche with a solution of 5 tbs of white vinegar to 2 qt (2 L) of warm water to help relieve her discomfort.
If the patient has a vaginal infection, tell her to continue taking the prescribed medication even if her symptoms clear or she menstruates. Also, advise her to avoid intercourse until her symptoms clear and then to have her partner use condoms until she completes her course of medication. If her condition is sexually transmitted, instruct her on safer sex methods.
Vulvar lesions:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Show the patient how to give herself a sitz bath to promote healing and comfort. If she has an STD, encourage her to inform her sexual partners and persuade them to be treated. Advise her to avoid sexual contact until the lesions are no longer contagious. Provide information on safer sex practices.
Vaginal bleeding, postmenopausal:
Patient counseling
(Signs & Symptoms: A 2-in-1 Reference for Nurses)
Reassure the patient that most postmenopausal vaginal bleeding is benign and not cancer related.
Metrorrhagia:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Encourage bed rest to reduce bleeding.
▪ Give an analgesic for discomfort.
Patient teaching
▪ Explain signs and symptoms that require immediate attention.
▪ Explain all procedures and treatments.
▪ Discuss the importance of regular gynecologic examinations and Pap smears.
Vaginal discharge:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Obtain cultures of the vaginal discharge.
▪ Give antibiotics, antivirals, or other drugs, as ordered.
▪ Observe standard precautions to prevent the spread of infection.
Patient teaching
▪ Explain to the patient the cause of vaginal discharge and its treatment.
▪ Teach the patient proper perineal hygiene and advise her to avoid tight-fitting clothing and nylon underwear.
▪ Suggest douching with vinegar and warm water to help relieve discomfort, if appropriate.
▪ Tell the patient to continue taking prescribed drugs even if her symptoms clear.
▪ Advise the patient to avoid intercourse until symptoms resolve.
▪ Provide information on safer sex practices.
Vulvar lesions:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Give a systemic antibiotic, antiviral, topical corticosteroid, topical testosterone, or an antipruritic, as ordered.
▪ Follow standard precautions.
Patient teaching
▪ Teach the patient comfort measures, such as a sitz bath.
▪ Discuss safer sex practices with the patient.
▪ Tell the patient with a sexually transmitted disease that her sexual contacts will also need testing and treatment.
▪ Explain to the patient the cause of vulvar lesions and its treatment.
Vaginal bleeding, postmenopausal:
Nursing considerations
(Nursing: Interpreting Signs and Symptoms)
▪ Prepare the patient for diagnostic tests, such as ultrasonography, endometrial biopsy, colposcopy, dilatation and curettage, and vaginal and cervical cultures.
▪ Discontinue estrogen until a diagnosis is made.
Patient teaching
▪ Reassure the patient that postmenopausal vaginal bleeding may be benign, but careful assessment is needed.
▪ Teach the patient about the underlying cause and its treatment.
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