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.
Vaginal Discharge During Pregnancy
I want your opinion of vaginal discharge duringpregnancy. If you have a sudden white mucus plug comeout, you're about to end the pregnancy and go into labor. I'm not that far along. The vaginal discharge will go back to whiteand thick after you ovulate. If you conceive, there may be ops of blood mixed in, or justbrown or orange streaksthe discharge. I'm a little farther along than that. The vaginal discharge usually increases involume during pregnancy, starting after implantation.
However, it remains white and thick throughoutunless something is wrong. I know any red bloodvaginal dischargeis dangerous, whether a sign of a miscarriage or uterine tear or something else only the will know. When you are pregnant, any bleeding is a reasonto go to the ER. Fortunately, I'm not seeing that type ofvaginal discharge. You'll normally see more white and thickvaginal discharge. Some women wear menstrual pads when pregnant to contain it. That sounds fishy to me. I didn't thinkI'd need diapers until after I had the kid.
If the vaginal discharge smells fishy or likevinegar, you have a yeast infection. I can't even take a pain reliever rightnow. What do I do about a yeast infectioné It is safe to use over the counter yeast infectiontreatment when pregnant, and you may need several. Pregnancy throws off your pH balanceand makes yeast infections much more likely. Glad I don't have that fishy smell downthere, then. It is thick and offcolor though. If it is green or yellow, you may have a bacterialovergrowth. That's dangerous during pregnancy. It could make things smell, and you do wantto talk to a about it. However, if
there are any lesions, itching and other signsof a social disease, you have to talk to a . Technically, life is sexually transmitted. A sexually transmitted disease contractedbefore or during pregnancy puts the kid at risk, and it may be flaring up worse whilepregnant because pregnancy compromises the immune system. Yes, I'd talk to the if I was worriedabout it, but I am not. Then you'll just see more white and thickdischarge. It would have increasedvolume
as the cervix thickened and rose up from thelow point after ovulation. But not as high as it would be if I wasn'tpregnant. That's where a lot of the mucus is comingfrom, but know that it will become y if you're dehyated just as when you'renot pregnant.
Vaginal Discharge During Menopause
I need your input on vaginal discharge duringmenopause. When you're going through menopause, you'llhave your period less often or less intensely before it finally shuts off. I know menopause isn't an off switch butmore a slow fade. When you're going through menopause, you'llsee similar shiftsvaginal discharge like white and sticky to y right before yourperiod, but you may not see the clear and slippery phase for ovulation. Because I might not ovulate.
However, when you're going through menopause,there's still a chance you'll get pregnant. And have a kid with a higher risk of healthproblems. Or multiples. As your eggs hit their expirationdate, the body offsets it by releasing multiple eggs. What other vaginal discharge should I expectduring menopauseé If it starts to smell sweet down there, you'reprobably developing diabetes â€“ especially so if the urine smells sweet and looks likesyrup too. A rash of repeated yeast infections can bea symptom of diabetes too.
And your odds of adult onset diabetes go upwith age. What else should I knowé With age, the vaginal discharge goes down,which is why older women tend to need lubriion, since the body doesn't make as much. And while a lack of lubriion and make youmore sensitive to yeast and bacterial infections, using too much lubriion can alter pH levelsand do the same. You'll know you have one of those infectionsby the foul smelling discharge if it is bacterial and the fish smell with yellow and solid massesif yeast based.
Fortunately, I haven't had to do a smelltest to see what is wrong. If you get red or brown vaginal discharge,you'll probably want to talk to a . We already discussed how your period fadesaway at this age. Yes, but red blood that's constant indieslesions or a serious infection, while brown blood can be a period that's not completeor internal bleeding. Okay, that's a reason to talk to the . And just because you don't have to use birthcontrol anymore doesn't mean you don't have to use birth control.
Menopause is all natural birth control. Just because you can't get pregnant anymoredoesn't mean you can't get a sexually transmitted disease anymore. And green, yellowand red vaginal discharge, especially with redness, itching or sores are strong signsof an STD. What a pain. Any discharge with pain means talking to a, too. Whether an STD or fibroids or worse, only the doc could say.