Vaginitis (yeast infection, BV, trich)
What is Vaginitis?
Vaginitis is an inflammation, infection, or change in normal flora (good bacteria) of the vagina and the vulva that may cause pain, itching, and discharge. Vaginitis is very common. Three types of vaginitis occur most frequently:
Although these vaginal infections have many common symptoms, each is caused by a different organism and is treated in different ways. The specific organism is determined through a microscopic examination of the vaginal discharge. A pelvic exam and history of your symptoms will help to identify which vaginitis is present, if any. It is possible for more than one type of vaginal infection to be present at the same time. People who have BV or trichomonas are more susceptible to sexually transmitted infections (STI’s) like chlamydia.
All people with vaginas normally have vaginal discharge. It will usually look transparent or cloudy-white and somewhat filmy. When it dries on clothing it is yellowish. Generally, the discharge has little odor and causes no irritation. Normal vaginal discharge is made of mucus secretions from the cervix and vagina plus discarded vaginal cells.
The amount of discharge varies according to the time of a person's menstrual cycle, medications, diet, stress, and state of sexual arousal.
If the delicate balance in the vagina is upset, organisms normally present in the vagina can multiply at a higher rate than normal. Also, the imbalance may make the vagina more susceptible to “invader” organisms which would normally be controlled as they entered the vagina. The organisms (bacteria, fungi or protozoa) create waste products which can irritate tissue, cause a change in discharge, an unpleasant odor, itching, burning, redness, painful sex or urination, spotting, and/or swelling. If you have these symptoms, you should have an exam to see if you need treatment.
Bacterial Vaginosis
Is caused by an overgrowth of vaginal bacteria from a change in the normal acidic environment of the vagina. This infection may occur spontaneously or be related to sexual activity. Things that can upset the balance of natural bacteria can include having a new sexual partner, male ejaculate in the vagina, having multiple partners, or hygienic products. The discharge may be thick or watery and may have an unpleasant odor, often more noticeable after intercourse. Some people note pain or burning with intercourse or urination but rarely have itching or redness. Some do not report symptoms at all. There are different treatments now available, including oral or vaginal medications. Treatment of male sex partners (partners who make sperm) is not recommended because it has not been beneficial in preventing the recurrence of BV. Using condoms with each sex act may prevent future infections. People with sexual partners with vaginas who have BV are at risk due to vaginal fluid transmission.
Yeast (Candidiasis) Infection
This fungal organism is normally present, in small and harmless quantities, in the mouth, digestive tract, and vagina. When the balance in the vagina is upset yeast may overgrow. Things that can upset the vaginal balance include recently taking antibiotics, increased estrogen levels (with pregnancy), having diabetes, or being on a medication that suppresses your immune system. Symptoms of a yeast infection can include: itching, burning, redness, or swelling around the vaginal opening. Discharge is usually white and thick or clumpy. Yeast infections are not usually sexually transmitted.
Yeast infections are usually treated with vaginal creams or suppositories available “over-the-counter” without a prescription. Typically using a 3-day treatment will cure your infection more often than a 1 day treatment. Sometimes prescription creams or tablets are prescribed.
Trichomonas Infection
This condition is caused by a one-celled organism (trichomonas vaginalis) generally called “trich” (pronounced “trick”). It may be found in both men and women and can be transmitted sexually. People who have trich may have a thin but foamy discharge which is greenish or grayish in color with an unpleasant odor. Itching, redness, pain and frequent urination may also occur. An oral antibiotic is the usual treatment. All sex partners should be treated and you should not have sex until treatment is completed. You should be tested for other STI’s.
More on Treatment
It is important to use the medication exactly as it is prescribed. Do not stop using medication when symptoms disappear as some organisms may survive incomplete treatment. Avoid sexual intercourse during the treatment. This will allow irritated vaginal tissue to heal faster. If you do have intercourse, use a condom & water-based lubricant (KY Jelly, Astro-glide, etc.). However, some vaginal medications may weaken the latex in condoms, causing possible breakage.
Prevention of Vaginitis:
Vaginal infections thrive in moisture and warmth. Keep the vaginal area (vulva) as dry as possible. Consider the following suggestions:
- Dry carefully after bathing.
- Avoid frequently wearing leggings, spandex, thong undergarments and tight clothing that trap heat and dampness.
- Wear cotton underwear and don’t use fabric softener on underwear.
- Do not sleep in underwear.
- Do not douche.
- Change out of a wet bathing suit or wet clothing immediately after swimming or exercising.
- Avoid hot tubs or hot baths.
- Avoid deodorant or scented pads or tampons.
- Avoid scented soaps or body wash in genital area; use mild, unscented soaps. Rinse genitals after a bubble bath.
- Limit your number of sexual partners and use condoms.
There is NO evidence from randomized trials that taking supplements of lactobacillus, garlic, tea tree oil, probiotics or eating yogurt with acidophilus are helpful.
If your symptoms don’t get better after treatment, call 812-855-5002 for a medical appointment. If you have questions about vaginitis or other health care concerns call Health and Wellness at 812-855-7338.