Christina Leanos
Sherry Ann
Week 5 terms
Oligomenorrhea
1. Definition: Oligomenorrhea is an infrequent or very light menstruation. Oligomenorrhea can
become amenorrhea if menstruation stops for six months or more.
2. Signs and Symptoms
a. Menstrual periods at intervals of more than 35 days
b. Unusually light menstrual flow
c. Irregular menstrual periods with unpredictable flow
d. Difficulty conceiving
3. Treatment
a. Treatment options for light periods will depend upon the cause of the condition.
These treatments can range from reducing environmental factors, such as stress, to
medications, such as hormones like birth control pills.
4. Medications
a. Birth Control
i. These hormone medications help stabilize hormone levels in the body,
which will help to regulate menstruation.
5. Athletes can participate in sports.
6. http://www.womenhealthzone.com/womens-reproductive-health/menstrualcycle/oligomenorrhea-a-treatable-menstrual-cycle-complication/
Kidney Stones
1. Definition: Arise in the kidney when urine becomes supersaturated with salt that is capable
of forming solid crystals
2. Signs and Symptoms
a. Sever pain
b. Unilateral flank pain that radiates to the groin
c. Nausea
d. Vomiting
e. Flank tenderness
f. Costovertebral angle tenderness
g. Testicular pain
h. Possible fever
3. Treatment
a. Most stones pass spontaneously, but some individuals affected require
hospitalization for unremitting pain, dehydration, associated UTI, or inability to pass
the stone.
b. Pain management
c. Maintenance of adequate hydration
4. Medication
a. NSAIDS
b. Ketorolac (Toradol)
c. Antiemetic medication for nausea
d. Oral or intravenous fluids
5. On the basis of the type of stone present, treatment options to reduce the risk of recurrence
are available. Return to sport can be achieved after passage of the kidney stone and
adequate rehydration.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
198-199). Mosby.
Sports Hematuria
1. Definition: Is benign, self-limiting presence of three or more red blood cells per high-power
field in a centrifuged urine specimen and is directly associated with exercise or activity
2. Signs and Symptoms:
a. By definition sports hematuria is asymptomatic
3. Treatment:
a. Rest for 24 to 72 hours
4. Medications:
a. N/A
5. Sports hematuria is a benign and self-limiting condition.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
199-200). Mosby.
Urinary tract infection
1. Definition: (UTI) occurs in either the upper or lower urinary tract.
2. Signs and Symptoms:
a. Dysuria
b. Increased frequency of urination
c. Small amounts of urine relative to their normal pattern
d. Lower pelvic discomfort
e. Cramping
f. Presence of gross hematuria
g. Abnormal vaginal bleeding
h. Fever
3. Treatment
a. UTIs are treated with antibiotics
4. Medication:
a. Antibiotics
i. Uncomplicated
1. Trimethoprim-sulfamethoxazole, ciprofloxacin, or ofloxacin
a. 3-day course
ii. Recurrent
1. 7-10 day course of antibiotics depending on the urine culture
iii. More than three UTIs in a given year
1. Prophylactic antibiotics may be used for prevention
iv. Complicated
1. 10-14 day course
5. Uncomplicated UTI will generally not preclude participation in athletics. For a few
individuals developing a complicated UTI, return-to-play decisions need to be based on the
athlete’s unique complication. Athletes with fever or poor fluid intake as a result of nausea
or vomiting should be observed and return to play after symptoms resolve with treatment.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
200-201). Mosby.
Urethritis
1. Definition: Urethritis is swelling and irritation (inflammation) of the urethra. The urethra is
the tube that carries urine from the body.
2. Signs and Symptoms
a. In men:
i. Blood in the urine or semen
ii. Burning pain while urinating (dysuria)
iii. Discharge from penis
iv. Fever (rare)
v. Frequent or urgent urination
vi. Itching, tenderness, or swelling in penis or groin area
vii. Pain with intercourse or ejaculation
b. In women:
i. Abdominal pain
ii. Burning pain while urinating
iii. Fever and chills
iv. Frequent or urgent urination
v. Pelvic pain
vi. Vaginal discharge
3. Treatment
a. You may take pain relievers (including pyridium, which works on the urinary tract)
along with antibiotics. People with urethritis who are being treated should avoid sex
or use condoms during sex. If an infection is the cause of the inflammation, your
sexual partner must also be treated. Urethritis caused by trauma or chemical
irritants is treated by avoiding the source of injury or irritation. Urethritis that does
not clear up after antibiotic treatment and lasts for at least 6 weeks is called chronic
urethritis. Different antibiotics may be used to treat this problem.
4. Medications
a. Antibiotics to get rid of the infections
b. Pain medication including pyridium
5. Athletes can participate as long as the symptoms are not too severe. It might be
uncomfortable to wear certain clothing and may make the symptoms worse. If this occurs
then the athletic trainer may need to hold the athlete out until the infection gets better.
6. http://www.ncbi.nlm.nih.gov/pubmedhealth/PMH0001475/
Testicular torsion
1. Definition: Testicular torsion occurs when a testicle rotates on the spermatic cord, which
provides blood flow to the testicle. This rotation cuts off the flow of blood and causes
sudden, often severe pain and swelling. Testicular torsion is most common in males 10 to 25
years old, but it can occur at any age.
2. Signs and Symptoms
a. Sudden or severe pain in one testicle
b. Swelling of the scrotum — a loose bag of skin under your penis that contains your
testicles
c. Nausea and vomiting
d. Abdominal pain
e. A testicle that's positioned higher than normal or at an odd angle
f. Sudden testicle pain that goes away without treatment — this can occur when a
testicle twists and then untwists on its own (intermittent torsion and detorsion)
3. Treatment
a. Surgery is required to treat testicular torsion. In some cases, the doctor may be able
to untwist the testicle by pushing on the scrotum (manual detorsion), but you'll still
need surgery to prevent torsion from occurring again. If testicular torsion occurs
before birth, surgery may not be possible.
b. Surgery for testicular torsion is usually done during general anesthesia, which means
you won't be conscious. The surgery is straightforward and generally doesn't require
a stay in the hospital.
4. Medications
a. N/a
5. If an athlete has testicular torsion they will not be participating in sports because they will
have emergency surgery done. After surgery, you'll need to avoid strenuous activity for
several weeks. Ask your doctor when it's OK to resume normal activities.
6. http://www.mayoclinic.com/health/testicular-torsion/DS01039/DSECTION=treatments-anddrugs
Hydrocele
1. Definition: A hydrocele is a fluid-filled sac surrounding a testicle that results in swelling of
the scrotum, the loose bag of skin underneath the penis. They are common in newborns,
but most hydroceles disappear without treatment within the first year of life. Older boys
and adult men can develop a hydrocele due to inflammation or injury within the scrotum.
2. Signs and Symptoms
a. painless swelling of one or both testicles
b. discomfort from the heaviness of a swollen scrotum
3. Treatment
a. For baby boys, hydroceles typically disappear on their own within a year. If a
hydrocele doesn't disappear after a year or if it continues to enlarge, it may need to
be surgically removed.
b. For adult males as well, hydroceles often go away on their own within six months. A
hydrocele requires treatment only if it gets large enough to cause discomfort or
disfigurement. Then it may need to be removed.
c. Another option is to remove the fluid in the scrotum with a needle.
4. Medication
a. N/A
5. Athletes can participate in sports no problem. If they are in a high contact sport a cup would
be a good consideration to wear. Since the problem usually goes away on its own then it’s
just something to keep an eye on.
6. http://www.mayoclinic.com/health/hydrocele/DS00617/DSECTION=risk-factors
Varicocele
1. Definition: Varicocele is a dilation of the pampiniform venous plexus and the internal
spermatic vein within the scrotum.
2. Signs and Symptoms
a. Men are generally asymptomatic
b. Occasionally report an aching pain or heaviness in scrotum
c. Soft thickening just above the testicle (“bag of worms” feeling)
3. Treatment
a. No medical treatment for the asymptomatic
b. Surgical treatment involves the ligation of the involved veins in order to prevent
continued abnormal blood flow
4. Medication
a. N/A
5. The presence of a varicocele poses no known risks to the athlete involved in individual or
team sports. After surgical correction of a varicocele, return to play is generally within 2 to 6
weeks but will depend on specific circumstances for the athlete and recommendation of the
surgeon. Use of a protective cup is recommended for involvement in contact or collision
sports if early return is allowed.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
204). Mosby.
Vaginitis
1. Definition: Vaginitis is an inflammation, usually derived from infection, of the vagina. In the
sexually active athlete, bacterial vaginosis, trichomonas, and candidiasis are three common
conditions that may account for 90% of all cases of vaginitis.
2. Signs and Symptoms
a. Bacterial Vaginosis
i. Vaginal discharge
1. Thin, white, or gray in color
ii. Malodorous
iii. Vaginal itching
b. Trichomonas
i. Asymptomatic
ii. Vaginal discharge
1. Thick, frothy, and green or yellow in color
iii. Vaginal itching
iv. Discomfort with voiding
c. Candidiasis
i. Vaginal Discharge
1. Thick, white (cottage cheese)
ii. Vaginal Itching or burning
iii. May also involve the vulva and surrounding skin
3. Treatment
a. Treatment when it involves the vulva includes the use of antifungal agents
b. Yogurt with active cultures in the diet can help with certain cases of vaginitis
4. Medications
a. Metronidazole
b. Antifungal agents
5. Athletes with vaginitis can participate fully in their sport.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
207-208). Mosby.
Pelvic Inflammatory disease
1. Definition: PID is defined as a bacterial infection of the upper genital tract that originates in
and ascends from the lower genital tract. These infection usually are a result of sexually
transmitted organisms
2. Signs and Symptoms
a. Abnormal vaginal bleeding
b. Amenorrhea (3mo or more)
c. Dyspareunia(painful intercourse)
d. Lower abdominal tenderness
e. Adnexal tenderness
f. Cervix motion tenderness
g. Fever
3.
4.
5.
6.
h. Elevated erythrocyte sedimentation rate.
i. Elevated C-reactive protein
j. The presence of leukocytes on a saline preparation of vaginal secretion
k. Abnormal cervical or vaginal discharge
Treatment
a. Surgery may be required for certain individuals
Medication
a. Antibacterial
Before return to sports participation by the affected athlete, adequate antibiotic therapy is
instituted, fever is resolved, nausea and vomiting are rectified to ensure adequate hydration
status, and pelvic or abdominal pain is minimized. If a surgical procedure was performed,
the surgeon will determine when return to activity will be allowed.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
208-209). Mosby.
Dysmenorrhea
1. Definition: Dysmenorrhea is described as severe cramps and pain associated with
menstruation or painful menstruation and is categorized as either primary or secondary.
a. Primary dysmenorrhea is not associated with gross pathology but rather involved a
type of prostaglandin that acts to constrict blood vessels within the uterus, causing
ischemia and subsequently painful uterine contractions during menstruation.
b. Secondary dysmenorrhea is caused by a gross pathological process involving the
uterus. This can include endometriosis, in which endometrial tissue is found outside
the uterus, PID, uterine fibroids or polyps, pelvic tumors, ectopic pregnancy, and
spontaneous abortion. In these cases, the painful uterine contractions are a result
of the associated condition.
2. Signs and symptoms
a. Primary dysmenorrhea
i. Symptoms typically begin just before or at the onset of menses and last
through the first day or two of menstruation.
ii. Cramping of the lower abdomen or back
iii. Radiating pain to the thighs
iv. Nausea
v. Vomiting
vi. Diarrhea
vii. Headache
b. Secondary Dysmenorrhea
i. Symptoms may not be as closely tied to the onset of menses, and symptoms
may last for a longer time but may still have some relation to the menstrual
cycle.
3.
4.
5.
6.
c. If an athlete has been diagnosed with primary dysmenorrhea and the treatment
such as NSAIDs or oral contraceptives has failed, then a pathological cause must be
considered and the athlete should be reevaluated.
Treatments
a. Medications can be taken to help with the symptoms.
b. If your menstrual cramps are caused by an underlying disorder, such as
endometriosis or fibroids, the surgical removal of the abnormal tissue may help
reduce your symptoms.
Medication
a. NSAIDs
i. Ibuprofen
1. Advil
2. Motrin
ii. Naproxen
1. Aleve
iii. Prescription NSAIDs
1. Mefenamic acid (Ponstel)
Athletes can participate in sports as long as the symptoms do not make it unbearable to
practice. If the athlete has surgery to help correct the problem then they cannot participate
until cleared by the physician.
Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed., pp.
209-210). Mosby.
Amenorrhea
1. Definition: Classically defined as the absence of menarche (menses) before age 16.
Secondary amenorrhea is defined as the cessation of menses after it has previously
been normal.
2. Signs and symptoms
i. Genetic disorders and anatomical abnormalities of the reproductive system
(primary)
ii. Obstruction of outflow tract
1. Imperforate hymen.
2. Labial agglutination.
3. Uterine synechiae.
4. Scarring.
iii. Ovarian failure
iv. Hypothalamic-pituitary axis problems
1. Deficient, absent, or inappropriate secretion of GnRH
v. Symptoms similar to menopausal women
1. Hot flashes
2. Vaginal dryness
3. Mood changes
3. Treatment
i. Depends on etiology and the sequelae that are trying to be eliminated or
prevented.
ii. Dietary changes
iii. Hormone supplement treatment
iv. Decrease in activity
v. Surgery
vi. Birth control methods
vii. Disordered eating treatment
4. Medication
i. Birth control pills
ii. Nutritional supplements
iii. Nasal calcitonin
iv. Biphosphorates
v. Selective Estrogen Receptor Modulators
5. Participation
i. Depends heavily on etiology
ii. No specific return to play guidelines in place
iii. Must be discussed, case-by-case, with athlete, athletic trainer, physician,
dietician, coach, and possible mental health provider.
6. Cuppett, M., & Walsh, K. M. (2012). General medical conditions in the athlete. (2nd ed.,
pp. 209-210). Mosby.
Candidiasis
1. Definition: An infection caused by a group of yeast. Commonly called a yeast
infection.
2. Signs and symptoms
a. Depend varying on location of infection
i. Vaginally
1. Thick, white discharge.
2. Itching and irritation.
3. Pain with intercourse.
4. Burning with urination.
ii. Orally
1. Thick, white lacy patches on top of a red base on the
tongue, palate, or elsewhere inside the mouth.
2. Pain.
3. Difficulty eating.
4. Treatment options
5. Over the counter and/or prescription medication
3. Treatment
a. Medication is the only treatment, besides having good hygiene.
4. Medication
a. OTC
i. Miconazole (Monistat-Derm, Monistat Vaginal)
ii. Tioconazole (Vagistat Vaginal)
iii. Butoconazole (Femstat)
iv. Clotrimazole (Femizole-7, Gyne-Lotrimin)
b. Prescription medications
i. Azole medications (Antifungals)
ii. Polyene antifungals
iii. Nystatin
iv. Amphotericin B
5. This condition should not interrupt athletic participation, unless otherwise specified
by medication precautions and/or physician recommendations.
6. http://www.webmd.com/skin-problems-and-treatments/candidiasis-yeast-infection
2. Hemorrhoid
1. Definition: Swollen and inflamed veins in the anus and lower rectum. Hemorrhoids may
result from straining during bowel movements or from the increased pressure on these
veins during pregnancy, among other causes. Hemorrhoids may be located inside the
rectum (internal hemorrhoids), or they may develop under the skin around the anus
(external hemorrhoids).
2. Signs and symptoms
i. Painless bleeding during bowel movements.
ii. Itching or irritation in anal region.
iii. Pain or discomfort.
iv. Swelling around anus.
v. Sensitive of painful lump near anus.
vi. Leakage of feces.
3. Treatment
i. OTC medications.
1. Creams
2. Ointments
3. Suppositories
4. Pads
ii. Minimally invasive procedures.
1. Rubber band ligation
2. Injections
3. Coagulation
iii. Surgical procedures.
1. Removal
2. Stapling
4. Medication
i. OTC creams, ointments, suppositories, and pads which contain witch hazel or
hydrocortisone, to decrease itching and discomfort.
5. Hemorrhoids should not deter athletic participation, except for avoiding heavy lifting
and straining. Exercise and staying active actually benefits those suffering from
hemorrhoids.
6. http://www.mayoclinic.com/health/hemorrhoids/DS00096