SOAP: Vaginal Dryness
***
NUR 7011-812
***
November 27th, 2025
Log ID: 251118194400
, 2
SUBJECTIVE
CC: “I’m not sure if it’s vaginal dryness or irritation, but I have itching, pain during sex,
and sometimes it burns when I pee.”
HPI:
49-year-old female with no past medical history who presents with complaints of vaginal
dryness and irritation. Accompanied by itching, pain with sexual intercourse, and burning
with urination. Symptoms have been gradual in onset and have persisted over the last
several months. Symptoms worsen with sexual activity. The patient tried over-the-
counter lubricants, which provided minimal relief. Denies vaginal discharge, fever, chills,
increased urinary frequency, urinary urgency, flank pain, or odor. Reports being sexually
active with 1 male partner, does not use protection, reports no recent new partners, denies
a history of STIs, and denies having a partner with symptoms. Her last STI test was over
10 years ago. Reports LMP 1/1/2025. Denies recent antibiotic use.
PMH: None
PSH: None
Family History: Noncontributory
Social History:
The patient is married and sexually active with 1 male partner (husband). Does not use
protection during sex. Reports no new sexual partners. Her last STI test was over 10
years ago. Reports pain with intercourse. Husband reports no symptoms. G2P2002. Her
last Pap smear was on 12/1/2024 and was normal. LMP was on 1/1/2025. The patient is a
dentist and reports adequate hydration and bathroom breaks. Reports exercising
frequently in tight-fitting, synthetic clothing.
Medications: None
***
NUR 7011-812
***
November 27th, 2025
Log ID: 251118194400
, 2
SUBJECTIVE
CC: “I’m not sure if it’s vaginal dryness or irritation, but I have itching, pain during sex,
and sometimes it burns when I pee.”
HPI:
49-year-old female with no past medical history who presents with complaints of vaginal
dryness and irritation. Accompanied by itching, pain with sexual intercourse, and burning
with urination. Symptoms have been gradual in onset and have persisted over the last
several months. Symptoms worsen with sexual activity. The patient tried over-the-
counter lubricants, which provided minimal relief. Denies vaginal discharge, fever, chills,
increased urinary frequency, urinary urgency, flank pain, or odor. Reports being sexually
active with 1 male partner, does not use protection, reports no recent new partners, denies
a history of STIs, and denies having a partner with symptoms. Her last STI test was over
10 years ago. Reports LMP 1/1/2025. Denies recent antibiotic use.
PMH: None
PSH: None
Family History: Noncontributory
Social History:
The patient is married and sexually active with 1 male partner (husband). Does not use
protection during sex. Reports no new sexual partners. Her last STI test was over 10
years ago. Reports pain with intercourse. Husband reports no symptoms. G2P2002. Her
last Pap smear was on 12/1/2024 and was normal. LMP was on 1/1/2025. The patient is a
dentist and reports adequate hydration and bathroom breaks. Reports exercising
frequently in tight-fitting, synthetic clothing.
Medications: None
