The vaginitis monologues: women's experiences of vaginal complaints in a primary care setting.

Vaginal complaints are a common presenting problem in primary care settings. A disease model has dominated current research and treatment paradigms, with little attention to the illness or experiential dimensions of vaginal complaints. In this paper, we report data from a qualitative study of the experiences of women diagnosed with vaginitis. In semi-structured interviews with 44 women in New York City, United States, we investigated women's interpretations and explanations of their illness, their accounts of its impact on their lives, their experiences with treatment, and the role of vaginal symptoms in communicating distress and anger. We found that women's explanations of vaginal complaints differed strikingly from the current medical model described in the literature on vaginitis. Vaginal symptoms often occasioned extreme anxiety; their impact on social and sexual functioning could be severe. Finally, vaginal symptoms often functioned to express distress and gender conflict. These findings have important implications for the management of the disorder.

The psychosexual impact of human papillomavirus cervical infections.

BACKGROUND: Occult human papillomavirus (HPV) infection, present in approximately 20% of women in the United States, is usually sexually transmitted, associated with substantial health risks, and unpredictable in its resolution. The potential for adverse psychosexual alterations due to HPV infection in women considered at low risk for bacterial sexually transmitted diseases is substantial, but data is lacking. METHODS: This cross-sectional study was conducted with sexually active women aged 18 to 60 years who had been enrolled at community-based offices in the University of Michigan Vaginitis Study. Women found to have occult HPV infection of the cervix were notified, received physician consultation, and were encouraged to have colposcopy performed to assess lesion status. Responses to a follow-up written questionnaire for differences in psychosexual functioning and attitudes following diagnosis were compared among these women and those without HPV infection. RESULTS: The women enrolled were primarily white and had a current sexual partner at the time of enrollment. They had few sexually transmitted infections and few risk factors, yet 20% had unsuspected HPV infection. Psychosexual characteristics at baseline and at follow-up, as well as perceived changes in these characteristics by the women, did not differ between women with HPV infection and those without. Stratification by potential confounders, including the presence of a vaginal infection at the time of study enrollment, household income level, ethnic background, age, marital status, and sexual history, did not alter these results. CONCLUSIONS: Women at low risk for sexually transmitted diseases, but who had a cervical HPV infection, were similar to those not infected in reported psychosexual characteristics and functioning. Adverse changes in these characteristics between the time of the diagnosis and subsequent follow-up were no more likely in those with the diagnosis than in those without.

Local treatment of colpitis with Betadine vaginal suppository.

Observations made with Betadine vaginal suppository in the treatment of 60 women suffering from colpitis have been discussed. The results of microbiological examinations of vaginal discharge sampled before 1 week and 4 weeks after the onset of therapy were compared. The effectiveness, tolerance of therapy, and the subjective opinion of the treated women were analysed. According to the results of the examinations in response to Betadine vaginal suppository the positivity of vaginal discharge for Candida decreased from 16 to 3 cases, for Trichomonas from 8 to 1 case, for aerobic bacteria from 16 to 7 cases, and the occurrence of mixed infections from 20 to 2 cases. Subjective complaints, burning, stinging sensation were rapidly moderated. In 52 of the 60 women discharge ceased, in another 4 cases it significantly decreased. In 51 cases burning sensation in the vagina ceased, and in 5 women it significantly decreased. Recurrence was not observed when a control examination was done after 1 month. The women tolerated Betadine vaginal suppository well and found it effective and easily applicable. At the beginning of treatment burning sensation was aggravated in 3 cases. These patients refused to further participate in the examination and received systemic treatment. Due to its broad bactericidal, fungicidal, protozoicide action and its good tolerability Betadine suppository was found to be useful for the local treatment of colpitis.

Psychosexual functioning in symptomatic and asymptomatic women with and without signs of vaginitis.

Women with symptoms of vaginitis, but no microbial etiology for their condition (the experimental group) were compared to women with symptoms and abnormal findings on examination, women with no symptoms and abnormal findings on examination, and women with no symptoms and normal findings on examination. Comparison was on a variety of measures of personality, marital satisfaction, and sexual function. All women were found to have normal personality structure as measured by the Minnesota Multiphasic Personality Inventory (MMPI). However, the experimental group differed from the others in their objective sexual function, subjective level of enjoyment, and the extent to which they were affected by their vaginal symptoms.

[Psychosomatic problems in urology. Experiences of a practising urologist (author's transl)]. / Psychosomatische Probleme in der urologischen Sprechstunde. Erfahrungen aus der Tätigkeit des niedergelassenen Urologen.

50% of all patients being treated by the author do not reveal any pathological organic findings. Most of these patients show symptoms of a so-called "Prostatitis" or "Urethro-Vaginitis". The authors findings are in accordance with those made in outpatient clinics of large medical centers. On the basis of the authors longterm experience three factors seem to be of most importance in treating such patients: 1. the full acceptance of the symptom, 2. the acknowledgement that he is a real patient although his symptoms are psychosomatic. 3. the strict avoidance of treating psychosomatic symptoms with conventional therapeutic measures such as antibiotics. The detailed discussion of the patients problems should be the centerpoint in the management and treatment of psychosomatic cases.