The accuracy of women performing vaginal pH self-testing.

OBJECTIVE: To determine if women could measure their vaginal pH as accurately as could physicians. METHODS: Each participant measured her vaginal pH using a swab, completed a survey, and then was seen by her physician, who also performed a vaginal pH test. The physician did not have access to the patient's pH reading; only the study coordinator recorded patient results. Accuracy of patient measurements compared with physician results was analyzed by the kappa statistic. RESULTS: A total of 161 women were enrolled in the study. The average difference between the patients' pH readings and the physicians' readings was <0.5. Overall, 85% of the patients' readings were in agreement with the physicians' readings, and the kappa statistic was 0.6. CONCLUSIONS: Study participants could accurately measure vaginal pH through self-testing. Vaginal pH self-testing may be a convenient tool to help women determine whether they should use an over-the-counter (OTC) antifungal medication or go to a physician for diagnostic workup.

Self-reported sleep in postmenopausal women.

OBJECTIVE: We aimed to find how self-reported sleep (measured by the St. Mary's Hospital Sleep Questionnaire) in postmenopausal women having hot flash activity was related to objective sleep (actigraphy), psychological and somatic symptoms [Women's Health Questionnaire (WHQ)], and cognitive test performance (computerized tests). A secondary aim was to find if self-reported sleep showed expected correlations with hyperarousal (Hyperarousal Scale). DESIGN: Drug trial baseline data from 88 healthy, postmenopausal women were retrospectively analyzed. Multivariate regression was used to adjust for confounder variables and test whether differences in self-reported sleep measures were systematically associated with differences in objective sleep, WHQ symptom measures, or cognitive test performance scores. RESULTS: Increased self-report scores for low sleep quality were associated with an increased risk of WHQ symptoms and reduced cognitive test performance. Self-reported sleep measures showed little correlation with their analogous objective measures. Self-reported low sleep quality proved most closely associated with the WHQ symptoms of tiredness, clumsiness, and difficulty concentrating. Women whose self-reported sleep-onset latency times were longer than the median overestimated their objective sleep onset time by 30 min, whereas the other women underestimated theirs by 15 min (P < 0.0001). Women whose self-reported total sleep was longer or shorter than the median, respectively, underestimated objective sleep times by 9 and 71 min (P < 0.0001). High hyperarousal scores were associated with underestimations of objective sleep. CONCLUSION: Self-reports of lower sleep quality were associated with increased WHQ psychological and somatic symptom measures and decreased cognitive test performance more than with differences in objective sleep. Self-reported trouble sleeping may signal problems independent from objectively low sleep quality, such as subjective distress or diminished cognitive function.

External occlusive devices for management of female urinary incontinence.

OBJECTIVES: Urinary incontinence affects 11 million women in the United States and is most common in older women. There are several different forms of urinary incontinence, which can be distinguished by their associated pathophysiologic conditions and signs. Genuine stress incontinence is the instantaneous leakage of urine in response to raised intraabdominal pressure associated with such activities as lifting, sneezing, and coughing. Risk factors for development of this form of incontinence include vaginal delivery, vaginal surgery, inadequate estrogen levels, and advanced age. Surgery, the most effective curative treatment for stress incontinence, is invasive and expensive and can lead to impairment of normal urinary tract functions. Other management options include pelvic floor rehabilitation by means of exercise, pharmacotherapy, intravaginal and intraurethral devices, absorbent products, and external occlusive devices. METHODS: A review of publications on the effectiveness of available external occlusive devices is presented, with special emphasis on a new, single-use, disposable urethral cap device which offers women with stress incontinence an over-the-counter product that enables them to independently manage their incontinence according to their individual needs. RESULTS: Non-surgical methods of managing urinary incontinence are available, with newer methods providing a greater range of choices for women. CONCLUSIONS: External occlusive devices can be effectively used by women with urinary incontinence who will not or cannot have surgical correction of the problem.