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.
5 Reasons Sex Hurts Vagina Edition
While it's important to understand the pleasurableaspects of sex, it's also important to understand why and how sex can be painful. Accordingto the American College of Obstetrics and Gynecology, three out of every four women will experience painful intercourse at some point during her life. Her are five of the most common reasonswhy for some cisgender women and transmen sex hurts. Vulvodynia is a complex disorder most commonlycharacterized by a burning pain and other uncomfortable symptomsand around the vulva.It can be extremely frustrating for patients not only because it makes things like sexor even sitting for long periods of time uncomfortable,
but also because there are no outward symptomsand has no links to previous infections, it can take a while for s to reach thatdiagnosis. Vulvar vestibulitis is actually a subset ofvulvodynia which denotes localized pain around the vestibule, or the vaginal opening, whichmakes vaginal penetration extremely uncomfortable. Up to onethird of people with vaginas willexperience symptoms of vaginitis. This vaginal inflammation which includes delightful symptomssuch as discharge, itching and burningand out of the vulva region is usually linkedto yeast or bacterial infections. The vagina is an ecosystem and sometimes itspH levels just get out of whack and that's
okay. Although they sound a lot alike, vaginismusis a lot less common than vaginitis. This condition is actually an involuntary spasmingof the muscles surrounding the vagina which closes off the vaginal opening making sexincredibly painful if not impossible. It's also been described as a vaginal panic attackbecause a lot of times it is linked to anxiety, shame or even past sexual trauma. If you are experiencing frequent and severelypainful sex, go see a . Treatments are available for all of these conditions althoughsome might take a little bit of time for you
to start seeing a difference but the sooneryou start, hopefully the sooner you can start experiencing that kind of pain. Finally painful sex can also be symptomaticof other issues such as skin problems that can lead to tearing of the vuvular skin, endometriosis,ovarian cysts or even simply not being aroused when vaginal penetration happens. A lot oftimes when it comes to that bleeding on the first time you have vaginal intercourse, it'snot so much to do with anything breaking or popping. A lot of times it's because womenaren't sufficiently aroused and thus lubried enough for smooth insertion without tearingthe skin. That might have been too much information.
If it is the case of sexual response, thingslike masturbation to better understand what gets you going and also foreplay are usuallyadvised as helpful ways to make sex less painful and hopefully a lot more, well, more sexy. Is there ever too much information thoughwhen it comes to understanding what's going on inside our vaginasé No, the answer is no.No.