Discussing gynecological conditions with the patient may be challenging as it requires honesty and patience. An individual may refuse to believe the diagnosis, as well as become upset or aggressive. This report presents a reflection on the woman presented with vaginal discharge. It shows what medical professionals may experience while telling an individual about their diagnosis, as well as the short- and long-term impact of an STI on the patient’s life.
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Discussing STIs with Patients
SL, a 29-year-old patient, presented in the office with vaginal discharge during my practicum experience. She reported yellowish vaginal discharge that had “a strong smell”. Moreover, the woman was concerned about occasional pain during sex. The patient notes that she has never been diagnosed with a sexually transmitted disease (STD) but has had abnormal vaginal discharge occasionally. SL had no significant family history of sexually transmitted infections (STIs); her partner has never been diagnosed with STDs or STIs. The woman noted that she used barrier contraceptive methods rarely as she found them “uncomfortable”. Reported symptoms allowed for consideration of chlamydia as priority diagnosis.
The selected drug therapy for the condition included a single dose of azithromycin orally (1mg). The choice of this treatment method was determined by its effectiveness; it is a commonly recommended regimen for chlamydia (Schuiling & Likis, 2017). An alternative drug therapy included 300mg of ofloxacin orally 2 times a day for a week. Follow-up care included referring SL’s current partner for screening to avoid reinfection, a test of cure in three weeks after treatment, and additional screening in three months (Centers for Disease Control and Prevention, 2015). The patient was advised to abstain from sexual intercourse until the treatment plan for both of the partners is completed.
My experience in telling the patient that she had an STI was complicated. As chlamydia is usually obtained during unprotected sex, SL was most likely infected by one of her partners (Nielsen, De Costa, Danielsson, & Salazar, 2017).
Her current partner, however, insisted that he did not have an STI. I provided the woman with all information about the condition, including the risk factors associated with it. At first, the patient refused to believe me as she “trusted her partner” and “he would never lie about it to her”. I tried to provide my full support and reassured SL that chlamydia could be treated quickly and effectively but some prevention measures were vital. The patient concluded that she could have obtained the infection from one of her previous partners.
The diagnosis will have a short-term effect on SL’s life as she will have to have a discussion about STIs with her partner, which may be challenging for her. The condition may cause fundamental changes in the woman’s relationships with her partner. I believe that the most significant long-term impact of the diagnosis on the patient’s life is that she will consider the benefits of barrier contraceptive methods. During the woman’s visit, I informed her about the risks associated with unprotected sexual intercourse, which may result in severe health complications. Moreover, SL will probably start to test for STIs regularly and avoid risky sexual behavior.
In the case of SL, who presented in the office with the symptoms of chlamydia, initiating the discussion about the condition was challenging. I informed the woman about the risk factors related to the infection and provided her with the recommendations to avoid recontamination. This case shows that patients may encounter difficulties while discussing their conditions, so it is vital to address their concerns and provide full emotional support.
Centers for Disease Control and Prevention. (2015). Chlamydial infections. Web.
Nielsen, A., De Costa, A., Danielsson, K. G., & Salazar, M. (2017). Repeat testing for chlamydia trachomatis, a “safe approach” to unsafe sex? A qualitative exploration among youth in Stockholm. BMC Health Services Research, 17. Web.
Schuiling, K. D., & Likis, F. E. (2017). Women’s gynecologic health (3rd ed.). Burlington, MA: Jones & Bartlett Publishers.