Vaginal infections are common and a very uncomfortable problem among women. Itching, burning, irritation of the vulva (outer genitals) and discharge from the vagina are some possible symptoms.
The vagina has a normal discharge (fluid that passes out of the vagina) that is clear or cloudy and whitish. A healthy vagina keeps a balance of many organisms, such as bacteria and yeast. Many factors can affect the normal balance of the vagina.
- Change in the body's normal hormone levels, such as those that occur with pregnancy, breast-feeding, or menopause.
- Sexual intercourse
- Sexually Transmitted Diseases (STDs)
A change in the normal balance can allow either yeast or bacteria to increase and result in vaginitis. Vaginitis can result from irritation, growth or organisms in the vagina, or from infection.
DIAGNOSIS AND TREATMENT
To diagnose vaginitis, your provider will take a sample of the discharge from your vagina and look at it under a microscope. Your provider may also suggest other tests. To ensure the results of any tests are accurate, do not douche or use any vaginal medications or spermicide before you see your provider. Treatment may depend on the cause of the vaginitis, as well as on your special needs. Treatment may be either with a pill or by applying a cream or gel to the vagina. Follow your provider's instructions exactly, even if the discharge or other symptoms go away before you finish the medication. Even though the symptoms disappear, the infection could still be present. Stopping the treatment may cause symptoms to come back. If symptoms reoccur after the treatment is finished, see your provider again - a different treatment may be needed.
TYPES OF VAGINITIS
Yeast infection is also known as candidiasis. It is one of the most common types of vaginal infection.
Causes: Yeast infection is caused by a fungus called Candida. It is found in small numbers in the normal vagina. However, when the balance of the vagina is changed, the yeast may overgrow and cause an infection. Many women who take antibiotics will get yeast infections. The antibiotics kill normal vaginal bacteria, and the yeast then has a chance to overgrow. A woman is more likely to get yeast infections if she is pregnant or has diabetes. Overgrowth of yeast can also occur if the body's immune system, (protects the body from disease) isn't working well. For example, in women infected with HIV (Human Immunodeficiency Virus), yeast infections may be severe. They may reoccur often. In many cases, the cause of a yeast infection is not known.
Symptoms: The most common symptoms of a yeast infection are itching and burning of the vagina and vulva. The burning may be worse with urination or sex. The vulva may be red and swollen. The vaginal discharge is usually white and may have a slight musty odor. It may look like cottage cheese. Some women with yeast infections notice an increase or change in discharge. Others do not notice a discharge at all. Some women may have no symptoms.
Treatment: Yeast infections are usually treated by placing medication into the vagina. Some providers may prescribe a single dose you take by mouth. In most cases, treatment of male sex partners is not necessary. You can buy over-the-counter yeast medications, but be sure to see your provider if:
- This is the first time you've had a vaginal infection
- Your symptoms do not go away after treatment
- Your vaginal discharge is yellow or green or has a bad odor
- There is a chance that you may have an STD
Sometimes a woman thinks she has a yeast infection when she actually has another problem. If there is another cause, it may be harder to find if a woman is taking medication for a yeast infection.
Causes: The bacteria that cause bacterial vaginosis occur naturally in the vagina. Bacterial vaginosis is caused by overgrowth of several bacteria. It is not clear whether it can be passed through sex.
Symptoms: The main symptom is increased discharge with a strong fishy odor. The odor is stronger during your menstrual period or after sex. The discharge is thin and dark or dull gray. Itching is not common, but may be present if there is a lot of discharge. Some women may have no symptoms.
Treatment: Two antibiotics are used to treat bacterial vaginosis. One is a drug called metronidazole. It can be taken by mouth or applied to the vagina as a gel. The other drug is called clindamycin. It can also be taken by mouth or applied to the vagina as a cream.
When metronidazole is taken by mouth, it can cause side effects in some patients. These include nausea, vomiting, and darkening of urine. Do not drink alcohol when taking metronidazole. The combination can cause severe nausea and vomiting. Usually there is no need to treat a woman's sex partner. But if the woman has repeated infections, treatment of the partner may be helpful. Some providers may suggest that the couple not have sex or that they use a condom during treatment. Bacterial vaginosis often comes back. It may require long-term or repeated treatment. In most cases, treatment eventually works in time. Sometimes when bacterial vaginosis keeps coming back it may mean that you have another STD. Your provider may test you for other infections.
Causes: Trichomonas is a parasite that is spread through sex. Women who have trichomonas vaginitis are at higher risk for infection with other STDs.
Symptoms: Signs of trichomoniasis may include a yellow-gray or green vaginal discharge. The discharge may have a fishy odor. There may be burning, irritation, redness, and swelling of the vulva and vagina. Sometimes there is pain during urination.
Treatment: Trichomoniasis is usually treated with a single dose of metronidazole by mouth. Do not drink alcohol for 24 hours when taking this drug because it causes nausea and vomiting. Sexual partners must be treated at the same time for treatment to work.
This type of vaginitis is linked with not having enough estrogen. It can occur during breast-feeding and after menopause. Symptoms include vaginal dryness and burning. Atrophic vaginitis is treated with estrogen, either taken by mouth or applied as a vaginal cream. If for some reason a woman cannot take estrogen, she may find a water soluble lubricant helpful.
WHAT YOU CAN DO
There are a number of things you can do to lower the risk of getting vaginitis:
- Do not use feminine hygiene sprays or scented, deodorant tampons. You should not try to cover up a bad odor. It could be a sign of infection that should prompt you to see your provider.
- Do not douche. It is better to let the vagina clean itself.
- Thoroughly clean diaphragms, cervical caps, and spermicide applicators after each use.
- Use condoms during
- Check with your provider about preventing yeast infections if you are prescribed antibiotics for another type of infection.