Can we trust symptoms?
P.-A. Märdh
Department of Obstetrics and Gynecology, Lund University, Lund, Sweden
Introduction: It is a common experience among gynaecologists that
there is often a discrepancy between symptoms and signs with regard to diseases
affecting the lower genital tract (LGTI), for example.
Objectives: To correlate symptoms reported by women who had attended
for contraceptive advice and in whom laboratory findings either documented or
could not document presence of a lower genital tract infection with the outcome
of an experimental psychological personality profile survey of these women.
Aims and Methods: One thousand women were studied with an extensive
battery of microbiological tests for bacterial, fungal, viral and parasitic
genital infections and for vaginal flora changes such in vulvovaginal
candidiasis and bacterial vaginosis. The participants were asked to react on a
series of pictures with a given number of alternatives to box graded from do not
agree with statement to agree very much. The Sivik’s test, which we used, had
been validated in a large population-based survey.
Results: The women who were infected were, as compared to those who
were microbiologically negative, showed, e.g. a higher proneness to trust other
persons (p=0.04), had a lower ability to feel guilt and shame (p=0.01) and were
less aggressive (p=0.01). The infected women with no symptoms compared to those
infected who could report symptoms showed less proneness to experience anxiety
(p=0.04), had a higher tendency to expect and/or demand anything from other
people (p=0.05).
Conclusions: Symptoms, regarded as indicative of a LGTI, reported by a
woman at history taking are strongly influenced by her personality profile. This
profile may also influence her risking taking in general, including her risk of
contracting exogenous genital infectious agents.
