The vagina is a very unique area in women and maintains a specific environment. A small amount of discharge is produced daily and keeps these tissues moist and healthy. It normally contains organisms such as bacteria and yeast in an pH environment of 5.0. Keeping this environment in check is important and simple rules will keep it in balance.
When this environment is affected by a change in the pH, inflammation may occur and result in vaginitis. Causes of vaginitis include: antibiotic use, prolonged tampon use, douching, spermicides, intercourse, infection and hormonal changes (such as pregnancy, menopause).
Your health care provider will diagnosis the cause of your vaginitis after taking a sample of your discharge from the vagina for evaluation. Depending on the testing performed, the discharge may be evaluated in the office or sent to an outside lab. Depending on the test, this may be instantaneously or may take a few days. To ensure accuracy of tests, please avoid intercourse, spermicides or douching prior to visit.
Depending on the type of vaginitis, treatment may be a cream, gel, vaginal suppository or pill. It is important that the full course of treatment is followed to resolve the infection. If symptoms do not improve and resolve, you must return to the office for further evaluation as a different treatment may be needed.
Types of Vaginitis
Yeast infections are caused by overgrowth of yeast normally found in the vagina in small numbers. When the pH changes, overgrowth in the vagina may occur. It is not considered a sexually transmitted infection and treatment of your partner is not necessary. Symptoms often include burning and itching of both the vagina and vulva that can be worse with intercourse or urination. Redness and swelling of the vulva can also occur. A clumpy white discharge can often be present as well, but yeast infections may not have any symptoms at all. Treatment involves a cream or tablet and can be obtained over the counter. Treatment with anti-fungal in a 3 day or 7 day cream is often tried first and many women try over the counter medication first. If symptoms do not resolve, you may have to try a prescribed medication and will need to be seen by your health care provider. Women with chronic medical problems like diabetes and HIV are particularly susceptible to recurrent infections due to poor immune system.
Bacterial vaginosis is caused by the overgrowth of normal bacteria that reside in the vagina. When these bacteria overgrow they can cause a watery, sometimes gray or greenish discharge that can have a fishy odor particularly during intercourse or your menses. Itching is not a common symptom, but can occur with heavy vaginal discharge. Treatment includes either gels placed in the vagina or tablets and alcohol must be avoided if Metronidazole is used. Avoidance of intercourse or use of a condom will prevent inadequate treatment of the infection. Bacterial vaginosis may also reoccur and longer treatment for 3-6 months may be needed. Avoidance of douching, bubble baths and prolonged tampon use may eliminate these infections.
Trichomoniasis is caused by a parasite and is a sexually transmitted disease. Women that have this may have been exposed to other STDs and should be evaluated. Symptoms may include a yellow to green discharge that can have a fishy odor as well. Unlike bacterial vaginosis, this infection may have intense itching and burning associated with it and redness and swelling of the vulva may also occur. Treatment is with an oral antibiotic and you must avoid intercourse and make sure that your partner gets treated before resuming intercourse. Alcohol must also be avoided if Metronidazole is used.
This condition is not caused by an infection, but can cause vaginal and vulvar irritation. It is more likely found in women after menopause with low estrogen levels and in breast-feeding women. It is caused by thinning of these tissues due to low estrogen level and leads to irritation and burning particularly during intercourse. Treatment involves the use of an estrogen cream that is placed in and around the vagina and a water soluble lubricant during intercourse may also be helpful.
If a woman has irritation in the vaginal and vulvar areas, an appointment may be needed. A call to your health care provider is important because you may have another more serious reason for your vaginitis that may require special treatment.
As always, if you have any questions or feel you may have symptoms, please call us at 303-755-0120 for treatment.
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