music It's a typical day. A patient has noticedsome itching, or maybe an unpleasant vaginal odor. During her exam, the ian willcheck vaginal pH, examine any discharge that's present, and collect a sample. Then, it'son to the microscope. music This is where you'll gather more specificinformationabout what's causing those vaginal symptoms. We'll show you how to prepare andexamine vaginal wet preps and how to do a whiff test. The results, combined with the patient's vaginal pH test, will aidthe diagnosis.
Under the microscope, you'll be looking for trichomonads, yeast, and the clue cells associated with bacterial vaginosis. We'll show you how to recognize them. music First, the microscope itself: This is a compoundlight microscope. It has several objective lenses on a rotating mount. For our purpose,one of these has to be a 10x low power objective, and one has to be a 40x for greater magnifiion.This flat part, under the objectives, is the stage. Under the stage is the condenser. Belowthat, at the base of the microscope, is the light source. There are two knobs that controlfocus; one for coarse adjustment and one for
fine adjustment. And these are the oculars,or eyepieces. We'll come back to the microscopea minute, but first, let's look at how to prepare wet mount slides. The complete vaginal wet mount involves botha saline prep and a potassium hyoxide, or KOH, prep. When the vaginal sample was collected,the swab was placeda test tube with approximately half a milliliter of saline. So, for the salineprep, you only have to take a op of the suspension and place it on a slide. Add acoverslip, being careful to avoid trapping air bubbles. Your saline slide is ready.Place a second op of the vaginal sample on another slide and add one op of 10 percentKOH. Sniff the preparation immediately, using
your hand to waft any odor toward your nose.This is the whiff test. Note if there's a fishy or amine odor. Then add a coverslip,avoiding air bubbles. Keepmind that you must work quickly to prepare and examine thewet mounts. That's because trichomonads may lose their characteristic motility within15 to 20 minutes. Before we move on now, though, let's lookat the cast of characters you may discover. These are normal squamous epithelial cellsfoundthe vagina. They're large, flat cells with a small nucleus and a large area of cytoplasm.Note that there is some granularitythe cytoplasm.
Polymorphonuclear leukocytes are known asPolys, or PMNs. They may also be called white blood cells, or WBCs. These are small roundcells. Several lobes of the nucleus are visible within the surrounding cell cytoplasm. Findingmany PMNs may indie infection. Trichomonads are pearshaped protozoa whichmove by means of flagella. Trichomonads are similarsize to PMNs and are identifiedby their characteristic jerking movement. The actual flagella may be too thin and toorapidlymoving to be seen. A clue cell is a squamous epithelial cellcoated with enough small bacteria that at least 75 percent of the cell's border is obliterated.It may look as if someone has spread glue
over the cell and pressed itsand. Cluecells are associated with bacterial vaginosis, a conditionwhich the normal microbialflora of the vagina is disrupted. Yeast may be foundtwo forms. Pseudohyphaeare the long, tubular, branching forms. Budding yeast are paired yeast cells that resemblea shoe print. The larger part is the sole and the smaller bud is the heel of the shoe. The saline prep will allow you to see epithelialcells, PMNs, trichomonads, and clue cells. You can also see yeastsaline, but sometimesit's hidden by epithelial cells or by PMNs. Red blood cells, sperm, and bacteria can alsobe seen.
My Vaginal Discharge Smells Like Vinegar
My vaginal discharge smells like vinegar. Discharge is normally a little acidic andsmells a little like vinegar. We'll just say the smell is bad enough tobe more than normal. Fortunately, the cause of that isn't asfishy as it sounds, I mean smells. It is a little fishy, yes, but I'm not usedto it smelling like this. If you were used to yeast infections, youeither have a depressed immune system or diabetes. I know out of control diabetes means highblood sugar. I didn't think it could cause too much yeastmy own body.
It could also be because you're pregnant.The immune system decreasessome regards while pregnant to not harm the baby, raisingthe odds of a yeast infection. I don't think I'm pregnant. If the vaginal discharge smells bad and lookslike curds, you have a yeast infection. It is also more likely if the itching is bad,skin is red and it hurts when you pee or have sex. If I had that many symptoms, I wouldn'tbe having sex. You could also have bacterial vaginosis.
Just what I need, a social disease. You could have thick discharge that smellsmore than usual due to bacterial overgrowth of the bacteria normally there and it isn'tclassified as a social disease. So how could I treat ité Don't douche like you might do, since thosecleansings actually worsen the normal bacterial balance. And you need yogurt That sounds like a fancy new age treatment,up there with herbs and lotionsmy underwear. You eat the yogurt to help restore your body'sbacterial balance. There are some people who
do put yogurt up there, but it isn't recommended,though tea tree oil is. inking herbal teas is supposed to treateverything. What else can I doé Make sure you wipe front to back when youpoop so there isn't any bacteria making it from back to front. Any other ideas of what could be causing thisé It could be something sexually transmitted,especially if the cervical mucus is yellow or green or streaked with blood. I suppose the blood would be from lesionsor sores.
Yes, and you'll want to see a forany social disease. And it can be mistaken for a yeast infection, since the itching,burning and so forth are similar unless someone actually looks at it. Which is pretty much impossible for me unlessI reach the next levelyoga. You can try over the counter yeast infectiontreatments and diet changes, but if you have more than foura year or it resists treatment,you need to see a .
My Vaginal Discharge is Bleaching My Underwear
My vaginal discharge is bleaching my underwear. That can happen when you have an ammonialikedischarge. That doesn't tell me what causes it or howto cure it. Your vagina usually maintains an acidic pH. I really don't know what it is supposed tosmell like, so I can't tell you if it smells very different. The ammonia like smell can be similar to thatlike pee. I am not peeingmy pants.
If you are dehyated, the ammoniatheurine can get concentrated and make things smell even more strongly, even a few ops.And some women do mistake a leaky bladder for vaginal discharge. I know women often use light days menstrualpads for bladder leakage, but that would stain my underwear yellow not white, and I knowwhat pee smells like. Bacterial vaginosis is a common cause of avagina that smells like ammonia. The odds you have that are higher if you have itching,burning a fishy smell, grey or offwhite discharge. All the discharge is off white.
During your fertile time, it becomes thinnerand white, normally. I'm not paying attention to what normallyhappens except that my underwear sometimes turns white after I wash it, right where thevaginal discharge wascontact with it. If you have a bacterial vaginal infection,you can try over the counter treatments, or you need to talk to the . I don't have symptoms that seem like an infection. It can cause bleaching, though, when the badbacteria turn nitrogen into ammonia, creating the smell and discoloration.
What else can do thisé Next I'd have to ask about your diet. It's healthy, so don't blame this on junkfood or too much sugar. And if I had diabetes, I'd get more yeast infections and sugarysmellingurine. If you eat a lot of nitrogen rich vegetableslike broccoli and asparagus, you can get that ammonia smellthe vagina. I don't need yet another reason to not eatasparagus, and you can have a healthy diet without that.
If you're doing a high protein diet for weightloss, eating a lot of foods like eggs, meat and dairy with high nitrogen levels can causethe ammoniathe urea to build up. That would be ammonia smelling pee, not vaginaldischarge. The ammonia smell can get into your skin andexcreted as sweat, and depending on how you work out, the chemicals can build up therewhile it evaporates off your arms and legs. And I thought a rich sweat odor was the worstI could worry about. I've heard of vaginal discharge turning bleachywhen someone had polycystic ovaries or another hormonal disorder. Getting that under controlor eliminating gluten and high sugar foods
helps. For all the reasons one might say a glutenfree diet helped their warobe, this was never on the list. Everyone can brag about esses fitting betterand old jeans actually fitting without a muffin top, but few people admit anything about lacyunderwear except maybe that they are wearing it. Just having some ways I could wear the blackones without them going grayodd places would be progress.