There are three main types of vaginal infections: bacterial vaginosis, yeast infection and trichomoniasis. Bacterial vaginosis is the most common and most serious, and its treatment requires prescription medication. Experts advise women with abnormal vaginal discharge, itching or burning to consult their doctor for an accurate diagnosis and cure.
Vaginal infections are easy to diagnose and treat. The normal vagina is a balanced ecosystem where many microorganisms live. When this balance is altered, one kind of bacteria or fungus can multiply, upsetting the normal population mix. Intruding organisms that normally would have been repelled can also flourish.
Factors that can upset the balance of the vagina include sexual activity, antibiotic use, menstruation, pregnancy, birth-control pills, damp underwear, tight pants, poor diet and vaginal products such as douches, feminine hygiene sprays, lubricants and birth-control devices.
Normally, there is some discharge from the vagina. It originates in the cervical glands as a clear mucus; as it travels through the vagina, it mixes with discarded cells from the vaginal wall and with normal bacteria.
When this usually clear or white secretion is seen on underwear, it may appear pale yellow. Some increases in vaginal discharge are normal. Mucus secretions rise with estrogen levels as ovulation approaches in the middle of the menstrual cycle. Sexual arousal can increase vaginal mucus.
At menopause, declining estrogen levels can cause symptoms that might mimic vaginal infections. Hormonal declines can cause a decrease in discharge and also cause atrophic vaginitis, a condition that may cause occasional vaginal discharge, soreness, dryness, itching, and pressure and burning after intercourse.
Estrogen replacement therapy or estrogen-containing vaginal creams can help. Typically, an increased vaginal discharge accompanied by an unpleasant odor signals a vaginal infection.
Here are characteristics of the most common vaginal infections:
• Bacterial vaginosis, or BV, usually causes an increased milk-like discharge that is thin and often has a foul or fishy odor. This abnormal odor may occur in varying degrees and may be particularly noticeable after sexual intercourse because semen, an alkaline substance, alters the natural acidity of the vagina, which in turn intensifies the odor associated with bacterial vaginosis.
BV often causes itching. BV is the most common and by far the most serious type of vaginal infections. It has been found in 12 to 25 percent of women in routine clinic populations, 10 to 26 percent of women in obstetric clinics and 32 to 64 percent of women in clinics for sexually transmitted diseases. It has been associated with pelvic inflammatory disease, which can lead to infertility and endometriosis, cervical infection, pregnancy complications, post-operative infections and other health problems.
Some recent study data suggest bacterial vaginosis may be linked to cervical intraepithelial neoplasia, a condition of abnormal cervical cells that can lead to cancer. Because BV has been linked to preterm birth, low birth-weight babies and other obstetric complications, it is especially important for women who are pregnant or considering pregnancy to discuss vaginal symptoms with their health-care provider.
A recent study found bacterial vaginosis in 15 to 23 percent of pregnant women, and half of the patients had no symptoms. The most common prescribed treatment for BV is the antibiotic metronidazole taken orally or applied intravaginally. Another antibiotic, clindamycin, may be prescribed as an alternative. If BV symptoms are present, products like douches or deodorant sprays that mask vaginal odors should not be used. They won’t cure the infection, and they can make it difficult to determine if BV is present.
• Yeast infection is the second most common type of vaginal infections. It sometimes causes an increased discharge, which may be white and curdy in appearance, similar to cottage cheese. It can cause intense discomfort, including itching and burning, prompting most sufferers to seek treatment, but it is not associated with serious health risks.
Yeast infections are caused by one of many types of fungus called Candida, which are normally found in small numbers in the vagina as well as the mouth and digestive tract. As with bacteria, when the balance of organisms in the vagina is upset, the yeast may overgrow and cause infection.
Yeast infections often start when a woman takes antibiotics for an unrelated bacterial infection. The antibiotics unintentionally kill health-promoting bacteria called lactobacilli, which normally produce hydrogen peroxide to prevent yeast overgrowth.
Other factors that may upset the vaginal balance and lead to yeast infection include pregnancy, obesity, diabetes, birth-control pills, steroids, prolonged exposure to moisture and poor hygiene. Yeast infections are usually treated with over-the-counter, intravaginally applied anti-yeast creams or suppositories.
• Trichomoniasis is a vaginal infection characterized by increased discharge that is typically frothy, sticky and yellow to green in color. It is caused by a parasite known as a trichomonad and, unlike BV or yeast infection, it is usually transmitted through sexual intercourse.
The parasite rarely causes symptoms in men, so reinfection of women by untreated men is common. For this reason, if a woman is treated for trichomoniasis, her sexual partner should be treated at the same time. Both will be prescribed metronidazole tablets.
Nearly every woman will experience some type of vaginal infections during her lifetime. Here are some steps you can take to protect and maintain your vaginal health.
• Know what is normal. Menstruation and vaginal discharge are normal. Pay attention to changes.
• Know the signs. Any itching, unusual odor or change in vaginal discharge can be a sign of infection.
• Act promptly. Most doctors check for vaginal infections only if you tell them about your symptoms. There is a quick, simple and painless test to determine if there’s an infection, what it is, and how to treat it.
• Don’t self-diagnose or self-medicate. Unless you have recently been diagnosed with a yeast infection and are now experiencing the exact same symptoms, don’t use over-the-counter medication. Several common and potentially senous vaginal infections have similar symptoms, and require prescription treatment.
• Use good hygiene. Keep the vaginal area clean by washing daily with mild soap; rinse and dry well. Always wipe from front to back to avoid spreading bacteria from the rectum. Many infection-causing organisms thrive on moisture, so wear cotton undergarments, avoid tight clothing in hot weather and remove wet clothing promptly.
• Avoid douching. A healthy woman does not need to rinse her vagina. Douching can change the alkalinity of the vagina and encourage infection. Feminine hygiene sprays should also be avoided.
• Don’t rely on Pap smears to identify vaginal infections. Pap smears are designed to detect precancer and cancer of the cervix, not a vaginal infection.
• Follow medication orders. Take all medication as prescribed, until all the medicine has been taken, even if the symptoms go away.