Women's HEALTH

Why is self care awareness important

NHS push patients towards self - care

Decrease in GP availability

increased number of patients being signposted to pharmacy through NHS 111 and pharmacy first.

Becoming a bigger part of the community pharmacists role

More pharmacists working in the GP delivering minor ailments clinics

Topics chosen

Womens health - vaginal thrush and others

Fungal skin infections

Fungal nail infections

Childhood rashes

MSK - self care treatment

How would you speak to a patient about sensitive topics

Privacy - use consultation room/ chaperone

Think how the patient may be feeling

Use open questions e.g. how can i hep

Golden minute

How does it feel

what are your symptoms

Tell me about

What have you tried so far

Summarise

Vaginal thrush - symptoms and causes

Symptoms - itchy and dore, cream coloured thick discharge. Dysuria as area is inflammed

Caused by Candida fungus

causes

• underwear - polyester or non - natural fibre underwear - occlusive environments, so sweat can stay in the area

• external temperature - going to hot climate country etc

• toiletries - can alter natural bacterial flora in the vagina

• medication - antibiotics are not selective in which bacteria they kill, so natural flora can become compromised

• hormonal changes

Be aware of

• always thing of the patient can treat 16 - 60 - may not be thrush otherwise, dryness as result of menopause so these patients are referred appropriately, had to have had it before as well. Can give to males who’s partner has been diagnosed with thrush

• if had more than 2 infections in last 6 months

Treatment - cotrimoxazole 2 percent cream use twice for 7 days - used to treat external

Oral option - fluconazole 150mg as a one off dose (OTC) - internal

Cotrimoxazole pessaries - internal

Treatment based on if its external or internal

If both external and internal it would be fluconazole 150mg capsule plus cotrimoxazole 2 % cream.

Fluconazole has a lot of interactions so check with patient

Can’t sell anything OTC if pregnant or breastfeeding - refer

Other conditions

Have similar and different symptoms to thrush

Bacterial vaginosis

• thin discharge

• white/grey discharge

• fishy odour

smoking and swimming can also cause this

Treatment - metronidazole is first line - effective against anaerobic bacteria

Can be self - limiting

Can also get BV gel which is less effective than AB but helps balance out the microbiome

Smoking can also cause an imbalance

Trichomoniasis

• frothy discharge

• yellow/green discharge

• very sore and painful

Otherwise get appropriate referral

Bacterial vaginosis

Cause is not clear. Vagina naturally contains that keep the environment mildly acidic. If these bacteria are disrupted it allows other bacteria to grow affecting the natural chemistry of the vaginal fluid. BV is not a sexually transmitted disease. Not an STI but can be passed from female to female through toys.

Trichomoniasis is an STI caused by parasite

Red flag symptoms

Bleeding between periods - cancer, hormonal imbalance?

Rough looking raised spots - herpes, genital warts, razor irritation?

Pain in the lower back - could be due to upper UTI

Discomfort during sex - VAGINAL DRYNESS

bleeding after sex - chlamydia

Be aware

• age, pregnancy, menopausal

• other medical conditions e.g. diabetes urinating more glucose - thrush likes warm, moist, sugary environments

• No. of attacks in last 6 months

• previous history of STD’s

• anything abnormal

• partner treatment

Prevention/ self- care

• avoid synthetic underwear which can affect the pH of vagina, compromising the natural flora

• unfragranted toiletries and avoid vaginal deodorants

• wipe front to bck

Other candida infections

• like warm damp environments

• on the skin especially in the folds

• nappy rash in babies

• oral thrush