Pelvic Pain

This may or may not be related to the menstrual cycle. Premenstrual pain may represent endometriosis. Dysmenorrhoea refers to painful menses, usually of a crampy nature. This is usually central low abdominal cramp but can be referred to the thighs and lower back. Primary dysmenorrhoea – periods have been painful since established menstruation has occurred. […]

Vaginal Candidiasis

Fungal infection—~20% of patients are asymptomatic. Predisposing factors include: • Cushing’s or Addison’s disease • Broad-spectrum antibiotics • Radiotherapy/chemotherapy • Immunosuppression • Steroid treatment • Vaginal trauma • DM • Pregnancy Presentation: Well, pruritus vulvae, superficial dyspareunia, and/or thick, creamy, non-offensive discharge. Examination: discharge (cottage cheese) and sore vulva which may be cracked/fissured. Investigation is […]

Bacterial vaginosis

Vaginal flora is changed from Lactobacillus species to anaerobes. Not sexually transmitted. Affects 10–40% of premenopausal women—about half are asymptomatic. Associated with: • Increase risk of preterm delivery (and decrease risk if treated) • Development of PID and endometritis following abortion or birth • Infection post-hysterectomy Presentation Grey/white, thin, fishy-smelling, offensive discharge with no vulval […]