Common Discomforts: Leukorrhea, Dyspareunia, Urinary frequency and nocturia
Terms in this set (19)
What is leukorrhea?
profuse, thin or thick vaginal secretion
When does leukorrhea usually occur?
Beginning in the 2nd tri
Etiology of leukorrhea
- conversion of glycogen in vaginal epitheial cells into lactic acid
- production of mucus plug by cervical glands
What microbe contributes to the acidity of vaginal secretions?
Lactobacilli (Doderlein's bacilli)
Differential diagnosis for leukorrhea
- ruptured membranes
- preterm labor
Relief measures for vaginitis
- avoid douching or using feminine hygiene sprays
- clean perineal and vaginal areas ONLY with water
- cotton underwear
- panty liners
Counseling re: leukorrhea?
Patient should be cautious of increased discharge, change in
color and consistency, odor, vulvar irritation, dysuria, and
What is dyspareunia?
Vulvovaginal pain during sex
Etiology of dyspareunia
- physiologic changes such as pelvic/vaginal congestion
- vaginal sensitivity
- vascular engorgement
- vulvar varicosities
Differential diagnosis for dyspareunia
- ovarian cyst
- ectopic pregnancy
- IPV/sexual assault
Relief measures for dyspareunia
Depending on the etiology of the dyspareunia, relief measures can be as simple as positional changes or as complex as therapy. Most women will benefit from a frank discussion about sexual positions and technique to bring greater comfort/pleasure.
What is the most important factor in determining a diagnosis for dyspareunia?
A thorough history. A woman may have previous experience of sexual dysfunction and only reporting it in pregnancy.
What is the definition of urinary frequency?
urinating > 7 times during aytime hours
When does urinary frequency generally occur during pregnancy?
Early on in the first tri and later in the third
Why does urinary frequency occur in early pregnancy?
hormonal changes affecting renal function and hypervolemia
Who is most often affected by urinary frequency in the third tri?
Primips, after engagement has occured
Etiology of nocturia
When a woman is lying in a recumbent lateral position this facilitates venous return from the extremities, then the uterus is
not pressing against pelvic vessels and inferior vena cava. This
causes an increase in urinary output. Furthermore, pregnant
women increase in fluid and sodium excretion at night.
Differential diagnosis of urinary frequency
Relief measures for urinary frequency?
Education on why it occurs, reassurance, and decreasing fluid
intake before sleeping.