Literature DB >> 8776913

Women's experiences of general practitioner management of their vaginal symptoms.

T C O'Dowd1, S Parker, A Kelly.   

Abstract

BACKGROUND: Little is known about the management of vaginal symptoms despite their frequency. Most vaginal symptoms in non-menopausal women are managed as thrush, although bacterial vaginosis is commoner. AIM: The aim of this study was to measure the experiences of women attending their general practitioner with vaginal symptoms including self-reporting of symptoms, duration and severity, informal support, over-the-counter remedies, sources of information, gender of doctor, expected and actual vaginal examination, and explanations and knowledge of common vaginal infections.
METHOD: A postal questionnaire survey was conducted of 490 patients presenting with vaginal symptoms aged between 18 and 48 years who had attended 10 general practices within the previous 3 months in the East Midlands of England.
RESULTS: A total of 85% of patients had suffered a previous episode, with 39% having had three or more infections in the previous year. Overall, 68% consult with each episode, and most consult within 7 days of onset of symptoms (median = 4 days). In all, 68% discussed their symptoms with partners, families or friends, but 32% relied solely on their doctor. Some 33% bought over-the-counter remedies. A total of 65% informed themselves further from encyclopaedias, leaflets and women's magazines, but there was a strong request for more information. Out of those questioned, 75% expected a vaginal examination, whereas 57% had such an examination performed. Most were told their symptoms were caused by thrush (78%), but patients' ideas on causation were varied. Most believed sexual transmission played a role in transmission of symptoms. Women were socially embarrassed by their symptoms, with 46% admitting to having the condition on their minds all or most of the time. Twenty-eight per cent of women wished to see a female doctor, with gender being unimportant to the remainder.
CONCLUSIONS: Vaginal symptoms were commonly recurrent, socially embarrassing and managed as candidiasis. Just over half the patients had a vaginal examination. There is a shortage of suitable information on vaginal infections available to patients, many of whom used over-the-counter medications.

Entities:  

Mesh:

Year:  1996        PMID: 8776913      PMCID: PMC1239694     

Source DB:  PubMed          Journal:  Br J Gen Pract        ISSN: 0960-1643            Impact factor:   5.386


  14 in total

1.  The Lichfield Lecture. Quality assurance in health care: consumers' role.

Authors:  A Donabedian
Journal:  Qual Health Care       Date:  1992-12

Review 2.  Bacterial vaginosis: a diagnostic approach.

Authors:  C S Easmon; P E Hay; C A Ison
Journal:  Genitourin Med       Date:  1992-04

3.  Management of vaginal candidosis: a survey in general practice.

Authors:  P Tooley
Journal:  Practitioner       Date:  1990-05-22

4.  Bacterial vaginosis: treatment with clindamycin cream versus oral metronidazole.

Authors:  C Schmitt; J D Sobel; C Meriwether
Journal:  Obstet Gynecol       Date:  1992-06       Impact factor: 7.661

5.  Relationships of vaginal Lactobacillus species, cervical Chlamydia trachomatis, and bacterial vaginosis to preterm birth.

Authors:  J Martius; M A Krohn; S L Hillier; W E Stamm; K K Holmes; D A Eschenbach
Journal:  Obstet Gynecol       Date:  1988-01       Impact factor: 7.661

6.  Contribution of Gardnerella vaginalis to vaginitis in a general practice.

Authors:  T C O'Dowd; R R West; C D Ribeiro; J E Smail; J A Munro
Journal:  Br Med J (Clin Res Ed)       Date:  1986-06-21

7.  Reliability of diagnosing bacterial vaginosis is improved by a standardized method of gram stain interpretation.

Authors:  R P Nugent; M A Krohn; S L Hillier
Journal:  J Clin Microbiol       Date:  1991-02       Impact factor: 5.948

8.  Anaerobic vaginosis (non-specific vaginitis): clinical, microbiological, and therapeutic findings.

Authors:  A L Blackwell; A R Fox; I Phillips; D Barlow
Journal:  Lancet       Date:  1983-12-17       Impact factor: 79.321

9.  Incidence of pelvic inflammatory disease after first-trimester legal abortion in women with bacterial vaginosis after treatment with metronidazole: a double-blind, randomized study.

Authors:  P G Larsson; J J Platz-Christensen; H Thejls; U Forsum; C Påhlson
Journal:  Am J Obstet Gynecol       Date:  1992-01       Impact factor: 8.661

10.  Association between bacterial vaginosis and preterm delivery of a low-birth-weight infant. The Vaginal Infections and Prematurity Study Group.

Authors:  S L Hillier; R P Nugent; D A Eschenbach; M A Krohn; R S Gibbs; D H Martin; M F Cotch; R Edelman; J G Pastorek; A V Rao
Journal:  N Engl J Med       Date:  1995-12-28       Impact factor: 91.245

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  11 in total

1.  The development of evidence-based guidelines for over-the-counter treatment of vulvovaginal candidiasis.

Authors:  Christine M Bond; Margaret C Watson
Journal:  Pharm World Sci       Date:  2003-08

Review 2.  Vaginal discharge.

Authors:  Des Spence; Catriona Melville
Journal:  BMJ       Date:  2007-12-01

3.  Some dilemmas in managing gynaecological infections.

Authors:  P Owen
Journal:  Br J Gen Pract       Date:  1996-07       Impact factor: 5.386

4.  Her choice: dealing with lactobacilli, vaginitis, and antibiotics.

Authors:  Marie V Pirotta; Suzanne M Garland
Journal:  Curr Infect Dis Rep       Date:  2005-11       Impact factor: 3.725

5.  How is the high vaginal swab used to investigate vaginal discharge in primary care and how do GPs' expectations of the test match the tests performed by their microbiology services?

Authors:  H Noble; C Estcourt; C Ison; P Goold; L Tite; Y H Carter
Journal:  Sex Transm Infect       Date:  2004-06       Impact factor: 3.519

6.  Delays in diagnosis of young females with symptomatic cervical cancer in England: an interview-based study.

Authors:  Anita W Lim; Amanda J Ramirez; William Hamilton; Peter Sasieni; Julietta Patnick; Lindsay Jl Forbes
Journal:  Br J Gen Pract       Date:  2014-10       Impact factor: 5.386

7.  Women's Management of Recurrent Bacterial Vaginosis and Experiences of Clinical Care: A Qualitative Study.

Authors:  Jade Bilardi; Sandra Walker; Ruth McNair; Julie Mooney-Somers; Meredith Temple-Smith; Clare Bellhouse; Christopher Fairley; Marcus Chen; Catriona Bradshaw
Journal:  PLoS One       Date:  2016-03-24       Impact factor: 3.240

8.  Cytology in the diagnosis of cervical cancer in symptomatic young women: a retrospective review.

Authors:  Anita Ww Lim; Rebecca Landy; Alejandra Castanon; Antony Hollingworth; Willie Hamilton; Nick Dudding; Peter Sasieni
Journal:  Br J Gen Pract       Date:  2016-10-24       Impact factor: 5.386

9.  Women view key sexual behaviours as the trigger for the onset and recurrence of bacterial vaginosis.

Authors:  Jade E Bilardi; Sandra M Walker; Meredith J Temple-Smith; Ruth P McNair; Julie Mooney-Somers; Lenka A Vodstrcil; Clare E Bellhouse; Christopher K Fairley; Catriona S Bradshaw
Journal:  PLoS One       Date:  2017-03-09       Impact factor: 3.240

10.  Measuring the nature and duration of symptoms of cervical cancer in young women: developing an interview-based approach.

Authors:  Anita W W Lim; Lindsay J L Forbes; Adam N Rosenthal; Kantipati S Raju; Amanda-Jane Ramirez
Journal:  BMC Womens Health       Date:  2013-11-13       Impact factor: 2.809

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