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What
Every Dad and Husband Must Know about
Gynecology and Gynecological Health"
Vulvar
Health
Information,
Resources & Education for Husbands & Dads
What
is "vulvar health"?
Vulvar health is a term that covers the many health issues of a woman's - or young girl's vulva. This includes vulva care, gynecology, feminine hygiene, vaginal health/hygiene, menstruation, and the changes in women's vulvas from menarche to menopause.
Husbands and fathers - as well as women and mothers need to learn more about vulva health, to provide the care and support the special women in their lives may need. Husbands and fathers have a unique role in providing the healthcare and knowledge, especially those single dad's that have young daughters.
Vulva health is an area that is related to the health and care of the vulva. Many men and women are afraid to use the term "vulva" due to its' technical, and medical sound, and most simply prefer to call the vulva a "vagina." Yet that would be incorrect. The vagina is just one part of the vulva. Nobody, with the exception of a doctor, can see a woman's vagina, and only he/she can see a woman's vagina by looking into the vagina, using a special instrument called a speculum.
It's time to begin calling a "spade a spade." When mother's and fathers are bathing, or toilet training their daughters, they should explain that the vulva, which is on the outside, has several parts, and that her vagina, is on the inside.
What is/are Vulvar Diseases?
Vulvodynia-chronic vulva discomfort, vulvar vestibulitis, dysesthetic vulvodynia
Vulvar dystrophy-broad term to describe various epithelial changes. In 1987-ISSVD International Society Studies of Vulvar disease found the following symptoms; a. nonneoplastic. b.intraepithelial neoplasms - spuamous cell CIS c. nonsquamous intraepithelial neoplasia
HSV
Women with HSV reports flu like symptoms, pain, itching, UTI symptoms, vaginal discharge, sores on labia, anus, perineum, buttocks, thighs, dyspareunia Vesicles, ulcers, pustules, tender adenopathy, 70% will have lesion in vagina
Syphilis
Women with syphilis report painless sores in vulvovaginal area. Primary - red, round, firm ulcer with granular base with well-formed edges. Secondary- moist, mucus lesions which resemble herpes. Moist cutaneous lesions called condyloma lata, appear flat and gray. Adenopathy, maculopapular rash.
Condyloma Acuminata
Women with CA report new bump: itching, generalized pruritus, last pap. Warty, flesh colored, sharp and pointed, cauliflower, + acetowhite
Candidiasis
Women with candidiasis report burning, itching, discharge, dyspareunia, vulvar edema, h/o diabetes, high carbohydrate diet, use of AB, frequent intercourse, h/o steroids, HIV.
Bartholin's Gland Infection
Women with barthloin's gland infections eportr unilateral bump. Reports active sex, recent trauma, new sexual partner leading to infections, fever, complaints of pain with intercourse, warmth, tender to touch, difficulty walking, sitting. H/O Crohn’s disease.
Contact Dermatitis
Women with contact dermatitis report vulvovaginal itching, rash, and increased incidence when wearing tight pants. The vulva skin is red, inflamed, edematous, vesicles or bullae if severe, weeping, crusting and lichenification.
Lichen Sclerosus
Women with LS report vulvovaginal itching, familial linkage, edema, superficial ulcers, burning, area feels different. Women with LS in all ages, show symptoms in clitoris, prepuce, labial majora, minora, edema, scarring, color, appearance of tissue paper of skin.
Lichen Planus - Women with lichen planus report vulvar itching, burning, with vulvovaginitis symptoms on mucosal surface of vulva. Dyspareunia, painful erosive areas. Bleeding on contact, stenosis of introitus. The vulva has white raised lesion with reticular, lacy pattern. Erosive reddened area bordered by reticular white epithelium. External labia has appearance of lichen sclerosus + acetowhite. Other signs may appear in her mouth.
Vulvar Neoplasm-Melanoma - affects mostly postmenopausal women that affects the clitoris and labia majora. Usually no symptoms.
Vulvar Intraepithelial Neoplasm - Pruritus, vulvar burning, pain, discharge, bleeding, may report urethra, vaginal and anal symptoms. White, dk, red, ulcerated, raised warty, or nodular lesions. Labia mayora most common site, minora, clitoris and perineum.
Vulvodynia (Vulvar Pain Syndrome) - Various levels of burning, stinging, pain, dryness, irritation, rawness. No pruritus. May report long term hx.
Vulvar Vestibulitis is a burning, dysuria, frequency, with repeated yeast infections or HPV. Significant/severe pain with touch or attempting intercourse.
Paget's Disease
Vulvar
Pruritis, usually affecting older women. The vulva appears red/tan with
scaly lesions.
What
is Vulvar Cancer?
Vulvar cancer is cancer that is found in and on the vulva.
What
is Vulvar Vestibulitis?
Vulvar
Vestibulitis is a condition which causes redness and pain of the vestibule.
Vestibulitis is an inflammation of this skin and the mucous secreting glands
found in the skin. The mucous secreting glands are called the lesser vestibular
glands.
Vulvar Vestibulitis may include all the area around the opening of the vagina but is normally seen in the lower part of the vaginal opening.
Vulvar vestibulitis occurs in
women of all ages. It can occur in women who are sexually active and also in
women who have never been sexually active.
What
are the signs and symptoms of Vulvar Vestibulitis?
* Severe pain with pressure (for example: biking, exercise,
tight fitting clothes ).
*
Vaginal entry such as tampon use or intercourse.
*
Burning, stinging, irritation, or raw sensation within the
vestibular area.
* Vestibular redness
*
The urge to urinate frequently or suddenly.
How is vulvar vestibulitis diagnosed (identified)?
Your doctor or health care provider will examine the vulva and vestibule to identify the common skin changes seen with vulvar vestibulitis. Pain is usually felt if the vestibule area is touched with a cotton tipped applicator. A sample of your vaginal discharge is collected and tested to rule out infection.
What
causes vulvar vestibulitis?
The exact cause is unknown, but many studies are being conducted to determine
the cause of vulvar vestibulitis.
The
following factors have been associated with vulvar vestibulitis:
* HPV (Human Papilloma Virus)
* Chronic Yeast Infections
* Chronic bacterial
infections
* Chronic changes of pH (acid-base
balance in the vagina)
* Chronic use of
chemicals/irritants such as detergents, soaps, spermicides or lubricants.
What
is the treatment for vulvar vestibulitis?
Treatment
may include any of the following:
* Follow the Guidelines
for Vulvar Skin Care
* Steroid Ointments
How
it is used: A thin layer is applied to the vulvovaginal areas.
How
it Works: Decreases redness, irritation, and burning. Caution: Use only as
prescribed by your doctor. Overuse may result in thinning of the skin which will
make your problem worse rather than helping it.
* Trichloroacetic Acid (TCA)
may be used in some cases as determined by the severity of the symptoms you
have. TCA is a chemical that is used to destroy small areas of the irritated
skin allowing new healthy skin to grow in its place.
* Interferon Injections
are used to increase your body's response to infection.
Helpful
treatment hints for vulvar
vestibulitis:
*
Vitamin A and D Ointment How
it is used: Apply to the areas of discomfort.
How
it Works: Protects the skin, decreases irritation, heals, and soothes.
*
Lidocaine Gel may be prescribed after initial treatment.
How it is
used: Apply lidocaine gel to the
vulvovaginal areas of
discomfort.
How it Works: Numbs areas before intercourse.
Caution: After
applying, wait until area becomes less sensitive before intercourse.
Burning may occur for a short time (
* Witch Hazel Pads (TUCS Pads) How it is used: Apply to the vulvovaginal areas of
discomfort.
How it
Works: Decreases burning and irritation after intercourse and urinating.
*
Cleansing Bottle - Pour plain luke-warm water over the vulva after
urinating to remove urine from irritated area.
*
Calcium Citrate Tablets- How it is used: Take orally 1200-1800mg.
elemental calcium every day.
How it Works: Thought to decrease certain crystals in the urine which may
cause burning.
*
Cranberry Juice How it
is used: Drink an 8oz. glass every day.
How
it Works: Increases the acid content of the urine to decrease bladder
irritation.
*
Limit High Oxalate Foods - May decrease amount of oxalate crystals
in urine. Oxalate
crystals cause urinary symptoms such as the urge to urinate frequently or
suddenly.
* Baking Soda Soak- Soak in luke warm bath water with 4 to 5
tablespoons of baking soda to
help soothe vulvar itching and burning. Soak 1 to 3 times a day for 10 to 15
minutes. If you are using a sitz bath, use 1 to 2 teaspoons of baking soda.
What
is a Vaginal Vault Prolapse?
The vaginal vault is the area at the top of the vagina, next to and adjacent to the cervix. It can only “fall” or descend downwards toward the
introitus, or the entrance of the vagina, after a woman's womb has been removed (hysterectomy).
Vaginal Vault Prolapse occurs in about 15% of women who have had a hysterectomy for uterine
prolapse, and in about 1% of women who have had a hysterectomy for other reasons.
What is Pelvic Organ Prolapse?
Pelvic Organ Prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown.
Pelvic Organ Prolapse may also be called; genital prolapse, pelvic relaxation,
pelvic prolapse, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall
prolapse.
What is Pelvic Prolapse?
Pelvic Prolapse is another
term used for "pelvic organ prolapse." Pelvic prolapse is a very common condition, particularly among older women. It's estimated that half of women who have children will experience some form of Pelvic Organ Prolapse in later life. Many women, particularly because they may no longer be sexually active, and fail to continue receiving their annual pelvic exams, don't seek help from their doctor. Therefore, the actual number of women affected by Pelvic Organ Prolapse is unknown.
Pelvic Prolapse may also be called; genital prolapse, pelvic relaxation, uterine prolapse, uterovaginal prolapse, pelvic floor disorder, urogenital prolapse or vaginal wall
prolapse.
What
is a Prolapsed Uterus?
A
Prolapsed Uterus refers to a collapsed uterus, or descended uterus, or other change in the position of the uterus in relation to the surrounding structures within the pelvis. The pelvis contains many soft tissue structures vital to normal body functions, supported primarily by the diaphragms, layers of muscles, fibrous coverings called fasciae, and various ligaments and tendons. These soft tissues of the pelvis derive their ultimate support from the bony pelvis.
A Prolapsed Uterus may be one of three types, depending on the severity:
• First-degree prolapse occurs when the uterus sags downward into the upper
vagina.
• Second-degree prolapse occurs when the cervix is at or near the outside of the
vagina.
• Third-degree prolapse (sometimes referred to as total prolapse) occurs when the entire uterus extends outside the vagina.
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