Presumptive Diagnosis: Primary Dysmenorrhea and or / Bacterial Vaginosis. Plan
Considering the above patient assessment and lab tests, it is possible to suggest that the patient has bacterial vaginosis (Hemalatha, Ramalaxmi, Swetha, Balakrishna, & Mastromarino, 2013). For the mentioned disease, one of the best practices is to perform local therapeutic interventions. A good curative effect is indicated for drugs from the group of nitroimidazoles, including metronidazole, trichopolum, metro girl, etc., which are to be prescribed intravaginally in the form of tablets, tampons, or candles (Thulkar, Kriplani, & Agarwal, 2012). The comparative study of the efficacy of topical probiotics was carried out recently. Since there were no significant differences in the results of treatment in patients who received or did not receive these drugs, they are currently not recommended for the treatment of bacterial vaginosis (Mastromarino, Vitali, & Mosca, 2013). The pivotal aim of the treatment plan is to reduce the severity of clinical symptoms, normalize laboratory indicators, and prevent the development of possible complications.
Education
Consistent with the recent study by Yzeiraj-Kalemaj, Shpata, Vyshka, and Manaj (2013), it is safe to assume that education is critical to bacterial vaginosis treatment. To prevent this disease in the future and treat it, it is essential to follow the rules of hygiene. It is recommended not to wear tight underwear that disrupts blood circulation in the pelvic organs and leads to changes in the composition of the vaginal microflora (Huppert et al., 2012). It is better to replace synthetic linen and underwear with cotton.
Follow-Up
Laboratory control of the effectiveness of the therapy should be performed immediately after the isotropic treatment. In particular, with microscopy of vaginal smears stained by Gram, it is necessary to state the degree of eradication of microorganisms associated with bacterial vaginosis, while sowing vaginal discharge to identify cases of facultatively anaerobic and conditionally pathogenic microorganisms. When bacterial vaginosis comes with urogenital chlamydia and / or mycoplasmosis, laboratory testing should be repeated three weeks after the end of the therapy (Gallo et al., 2012). If symptoms of dysmenorrhea or bacterial vaginosis occur, the patient should contact a gynecologist to exclude a possible gynecological or other pathology. The patient is to be advised of the adverse effects of bacterial vaginosis and recommended to have a regular gynecological examination. With timely diagnosis and adequate treatment of bacterial vaginosis, the prognosis is usually favorable.
Self Assessment
The key methods of self-diagnosing of dysmenorrhea and bacterial vaginosis are complaints of the patient for characteristic painful sensations (Fethers et al., 2012). A visit to the doctor is necessary if a woman regularly notices unusually abundant secretions. They may be uniform, foamy or viscous, gray-white, or yellowish-green in color and have an unpleasant smell of fish. If secretions are evenly distributed across the walls of the vagina and intensify after sexual intercourse as well as before and after menstruation, it may be signs of the disease (Fethers et al., 2012). In some cases, it also causes itching, burning, and pain in the lower abdomen. Moreover, in some women, bacterial vaginosis can be completely asymptomatic. To test themselves and diagnose bacterial vaginosis at home, women who regularly monitor their health can try a new diagnostic test pad for self-diagnosis of the pH level of vaginal discharge. The mechanism of the test is based on the determination of the change in pH level and the buffer capacity of vaginal secretions. It is critical to remember that timely diagnosis and early self-assessment ensure proper and effective treatment.
References
Fethers, K., Twin, J., Fairley, C. K., Fowkes, F. J., Garland, S. M., Fehler, G.,… Bradshaw, C. S. (2012). Bacterial vaginosis (BV) candidate bacteria: Associations with BV and behavioural practices in sexually-experienced and inexperienced women. PLoS One, 7(2), 1-7.
Gallo, M. F., Macaluso, M., Warner, L., Fleenor, M. E., Hook, E. W., Brill, I., & Weaver, M. A. (2012). Bacterial vaginosis, gonorrhea, and chlamydial infection among women attending a sexually transmitted disease clinic: A longitudinal analysis of possible causal links. Annals of Epidemiology, 22(3), 213-220.
Hemalatha, R., Ramalaxmi, B. A., Swetha, E., Balakrishna, N., & Mastromarino, P. (2013). Evaluation of vaginal pH for detection of bacterial vaginosis. The Indian Journal of Medical Research, 138(3), 354-359.
Huppert, J. S., Hesse, E. A., Bernard, M. C., Bates, J. R., Gaydos, C. A., & Kahn, J. A. (2012). Accuracy and trust of self-testing for bacterial vaginosis. Journal of Adolescent Health, 51(4), 400-405.
Mastromarino, P., Vitali, B., & Mosca, L. (2013). Bacterial vaginosis: A review on clinical trials with probiotics. New Microbiol, 36(3), 229-238.
Thulkar, J., Kriplani, A., & Agarwal, N. (2012). A comparative study of oral single dose of metronidazole, tinidazole, secnidazole and ornidazole in bacterial vaginosis. Indian Journal of Pharmacology, 44(2), 243- 258.
Yzeiraj-Kalemaj, L., Shpata, V., Vyshka, G., & Manaj, A. (2013). Bacterial vaginosis, educational level of pregnant women, and preterm birth: A case-control study. ISRN Infectious Diseases, 2(1), 1-4.