Vaginitis

Every woman has some vaginal discharge, and every woman’s vagina contains organisms necessary to keep bacteria in normal balance. When the normal balance is upset, the vagina may be susceptible to an overgrowth of troublesome bacteria. Symptoms of vaginitis include abnormal discharge, itching, burning and odor.

Pelvic examinations are usually recommended to determine the kind of infection you may have and the proper treatment for it. There are three major types of vaginal infections, including monilia, bacteria vaginosis (or BV), and trichomonas. Vaginal or vulval irritation which is not caused by one of these infections may be due to an allergic reaction or mechanical or chemical irritation.

Yeast infections, sometimes called “candida” or “monilia”, are a common form of vaginitis. They are caused by a fungus which usually does not pose any serious health hazard, but the symptoms can be very annoying.

The main symptoms are itching and/or swelling of the vagina or surrounding area often accompanied by a thick, white discharge which may have a strong odor. Other symptoms may include painful intercourse and irritation or pain with urination.

Although monilia is not considered to be a sexually transmitted infection (STI), it is possible to get monilia from your sexual partner. Uncircumcised males may harbor the fungus under the foreskin, which would look red and scaly. Frequent recurrent yeast infections may be associated with diabetes or HIV infection.

Treatment
If you are experiencing symptoms of a yeast infection, see a clinician or doctor as soon as possible. Though over-the-counter treatments are available, it is best to verify the diagnosis with routine lab tests, especially if you have these symptoms for the first time or have not previously been diagnosed with a yeast infection.

Monilia is treated with an antifungal medication. This may be in the form of vaginal suppositories, creams, or oral tablets and should always be used as prescribed.

Several organisms, including Gardnerells, are the cause of most bacterial vaginitis. Symptoms of Bacterial Vaginosis may include a watery vaginal discharge which often has an unpleasant odor, and can be irritating. Some women with BV also notice painful intercourse or discomfort with urination.

Treatment
Bacterial vaginosis is treated with antibiotic vaginal creams or suppositories and oral antibiotics.

Males may harbor these bacteria with no obvious symptoms. Consistent use of condoms, after treatment, may help to prevent reinfection.

Often simply called “trich” (trick), this form of vaginitis is caused by single-celled organisms (protozoa), which may infect both men and women. Trich is considered a sexually transmitted infection, and both partners must be treated.

Trich is not as common as yeast and BV, but the symptoms are just as annoying. Symptoms may include a greenish-yellow discharge accompanied by an unpleasant odor and sometimes itching. Men usually have no symptoms, but can still spread the infection.

Treatment
Treatment for trich is usually tablets called Metronidazole or Flagyl taken orally. Metronidazole should be taken with a large glass (10 to 12 oz) of water. It is also very important to abstain from any alcohol while on this medicine as alcohol use while on Flagyl can cause severe nausea and vomiting. Both sexual partners should be treated simultaneously and any sexual contact should be avoided until both partners complete treatment. Condom use is also recommended after treatment, and reexamination is advised.

 It is important to use all the medication as prescribed even though your symptoms may resolve sooner. Inadequate treatment can result in a return of symptoms. Check with your clinician about any other medication you may be taking. Some kinds of medication may make your vagina more susceptible to infection. Infection spreads in moisture and heat. Keep the vulva as dry as possible.

Poor diet, lack of sleep, stress, or the presence of other disease or infection can lower your body’s resistance to vaginitis. Medications such as antibiotics, hormones and douching also can increase susceptibility. Other contributing factors may include psychological factors, childbirth, cuts or abrasions, intercourse without enough lubrication, and even tight-fitting clothing

• If you are unsure of your sexual partner’s contacts outside your relationship, insist that a condom be used during sex.
• Using a condom will help prevent sexually transmitted infections (STIs) and vaginitis. Lamb skin condoms do not protect against STIs because the membrane is too porous; use latex or polyurethane condoms instead.
• We also recommend use of additional lubrication with condoms if needed. “Astroglide” or “KY Jelly” applied externally to the vaginal area can help decrease friction and irritation with condom use.
• If you or your partner notice any genital sores or penile discharge, do not have sexual intercourse until you both have been treated.
• Do not use bubble baths, douching, deodorant tampons or pads, or colored or scented bathroom tissue.
• Wear cotton underwear and change at least every 24 hours.
• Sleeping without underwear is also helpful.
• Always wipe from front to back after a bowel movement. Bacteria from the anal area can cause vaginitis.
• Douching is not necessary for feminine hygiene. If you feel the need to douche, please discuss this with your health care provider.