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Medical Surgical Women's Health: Vulvovaginal Candidiasis (Yeast Infection)

Medical Surgical Women's Health: Vulvovaginal Candidiasis (Yeast Infection)

Hello Everyone, here is a women’s health lecture on vulvovaginal candidiasis made easy to understand to help aide in your study sessions. I have gathered all of the important information from my Med- Surg Book (Brunners and Suddarth 12th edition) that will prepare you for your nursing test whether it is for school or NCLEX.

Here are some Extra information that may help and guide you…

Risk Factors for Vulvovaginal Infections:

• Premenarche
• Pregnancy
• Perimenopause/Menopause
• Poor personal hygiene
• Tight undergarments
• Synthetic clothing
• Frequent douching
• Allergies
• Use of oral contraceptives
• Use of broad-spectrum antibiotics
• Diabetes mellitus
• Low estrogen levels
• Intercourse with infected partner
• Oral–genital contact (yeast can inhabit the mouth and
intestinal tract)
• HIV infection

Vulvovaginal Infections:

Vulvovaginal infections are common, and nurses have an
important role in providing information that may prevent
their occurrence. To help prevent these infections, women
need to understand their own anatomy and vulvovaginal
The vagina is protected against infection by its normally
low pH (3.5 to 4.5), which is maintained in part by the actions
of Lactobacillus acidophilus, the dominant bacteria in a
healthy vaginal ecosystem. These bacteria suppress the
growth of anaerobes and produce lactic acid, which maintains
normal pH. They also produce hydrogen peroxide,
which is toxic to anaerobes. The risk of infection increases
if a woman’s resistance is reduced by stress or illness, if the
pH is altered, or if a pathogen is introduced. Continued research
into causes and treatments is needed, along with better
ways to encourage growth of lactobacilli.
The epithelium of the vagina is highly responsive to estrogen,
which induces glycogen formation. The subsequent
breakdown of glycogen into lactic acid assists in producing
a low vaginal pH. When estrogen decreases during lactation
and menopause, glycogen also decreases. With reduced
glycogen formation, infections may occur. In addition, as estrogen
production ceases during the perimenopausal and
postmenopausal periods, the vagina and labia may atrophy
(thin), making the vaginal area more susceptible to infection.
When patients are treated with antibiotics, the normal
vaginal flora are reduced. This results in altered pH and
growth of fungal organisms. Other factors that may initiate
or predispose to infections include contact with an infected
partner and wearing tight, nonabsorbent, and heat-retaining
and moisture-retaining clothing.

Vaginitis (inflammation of the vagina) is a group of conditions
that cause vulvovaginal symptoms such as itching,
irritation, burning, and abnormal discharge. Bacterial vaginosis
is the most common cause (22% to 50% of symptomatic
women), followed by vulvovaginal candidiasis (17%
to 39%) and trichomoniasis (4% to 35%) (American College
of Obstetricians and Gynecologists [ACOG], 2006a). Other types include desquamative vaginitis, atrophic vaginitis, various vulvar dermatologic conditions, and vulvodynia. The normal vaginal discharge, which may occur in slight amounts during ovulation or just before the onset of menstruation, becomes more profuse when vaginitis occurs. Urethritis may accompany vaginitis because of the proximity of the urethra to the vagina. Discharge that occurs with vaginitis may produce itching, odor, redness burning, or edema, which may be aggravated by voiding and defecation. After the causative organism has been identified, appropriate treatment (discussed later) is prescribed. This may include an oral medication or a local medication that is inserted into the vagina using an applicator.