Vaginitis

Vaginitis, Vulvitis, Vaginosis... another vaginal infection?

Unfortunately, even if you are not yet sexually active, you can still develop a vaginal infection. What type of infection? We will review the most common types of vaginal infections and the recommendations made to you by your physician in your treatment and prevention plan.

Once symptomatic, one of two things may occur; your symptoms may resolve on their own or not. At times, your symptoms seem to resolve only to recur on a cyclical basis (often with each menstrual period). While it is true that over-the-counter products are available in your local pharmacy specifically for the treatment of vaginitis, if you are at risk for an STI... consult!

What is Vaginitis?

Vaginal infections cause frequent distress and discomfort in adult women. Vaginal infections are often accompanied by vaginitis, which is an inflammation (swelling and irritation) of the vagina characterized by discharge, irritation, and/or itching. Not very agreeable to be sure! The cause of vaginitis cannot be adequately determined solely on the basis of symptoms or a physical examination. In addition, these symptoms can mask the presence of a sexually transmitted disease - not cool! Furthermore, mixed or multiple infections are a distinct possibility. Laboratory tests allowing microscopic evaluation of vaginal fluid are required for a correct diagnosis.

What are the causes of Vaginal infections and Vaginitis?

The following are the most common causes of vaginitis;

• Fungal or yeast infections (candida albicans vaginitis);
• Bacterial vaginosis (caused by the bacteria Gardnerella vaginalis);
• Trichomonal vaginitis (this vaginal infection may be transmitted by sexual contact);
• Allergic or contact (chemical) dermatitis.

Vulvovaginal candidiasis (VVC), sometimes referred to as candidal vaginitis, monilial infection, or vaginal yeast infection, is a common cause of vaginal irritation. VVC is caused by an overabundance or overgrowth of yeast cells (primarily Candida albicans) that normally colonize in the vagina. Several factors are associated with increased rates of VVC in women, including pregnancy, uncontrolled diabetes mellitus, and the use of oral contraceptives or antibiotics. Other factors that may increase the incidence of VVC include the use of douches, perfumed feminine hygiene sprays, topical antimicrobial agents, and tight, poorly ventilated clothing and underwear. (See the environmental checklist below). There is no direct evidence that VVC is transmitted by sexual intercourse

What are the symptoms of Vaginitis?

The most frequent symptoms of vaginitis in women are itching, burning, and irritation of the vagina. Painful urination and/or intercourse are common. Abnormal vaginal discharge is not always present and may be minimal.

A) Vulvo-vaginal candidiasis (yeast infections).

So your doctor has just diagnosed you with a yeast infection. Let us review together the typical symptoms:

• Redness of your external genitalia (vulva, perineum - the area between the vagina and the anus, and the peri-anal skin,
• Swelling of your external genitalia,
• Itchiness!!
• Pain may be present or not,
• A burning sensation when you pee may be a frequent complaint,
• Thick white discharge (often described as having the appearance of cottage cheese) is common, while the amount of discharge varies from none to WAY too much.
• Infrequent odors
• Occasional vulvo-vaginal pain upon penetration during sexual relations

B) Bacterial Vaginosis (BV). Typical symptoms include;

• Increased vaginal discharge (creamy and varying color changes),
• A fishy vaginal odor that may be worse after sexual relations,
• A burning sensation that may be worse during or after sexual relations,
• Cramping or bloating may be present,
• Redness of the external or internal genitalia may be present,
• Itchiness of the genital may/may not be prominent.

C)Trichomonas vaginitis (TV) Typical symptoms may include;

• Increased vaginal discharge (often discolored – greenish),
• A change in the odor of vaginal secretions,
• May include prominent itchiness of the genitals.

How is Vaginitis spread?

Some vaginal infections are transmitted through sexual contact (trichomonal vaginitis), but others such as candidiasis (yeast infections) are not. Most male partners of women with VVC do not experience any symptoms of the infection. However, a transient rash and burning sensation of the penis have at times been reported after intercourse if condoms were not used. These symptoms are usually self-limiting.

Candidal vulvo-vaginitis (VVC) or bacterial vaginosis typically become symptomatic when the vaginal flora has been altered. The healthy stable vulvo-vaginal environment or flora (occupied by both bacteria and yeast) is strongly tied to your local (vulvo-vaginal) pH or acidity. Those events, products or infections that cause an imbalance in your normal pH and equilibrium can allow the abnormal proliferation of yeast or bacteria...the result - a vaginal infection. Common culprits are antibiotics (discuss this with your physician), harsh or chemical soaps, bubble baths, shampoos or cream rinses, scented sanitary napkins, massage oils, etc. As you can see, if you are suffering from a vaginal infection it is important to evaluate your environment and identify any potential causes. These products may destroy your pH and flora or may be directly irritant (cause an allergic reaction). Obviously, we are not all created equal and some women are susceptible while others are not. Preventive measures include the elimination of all potentially irritant products that may imbalance or irritate your vulvo-vaginal environment.

Probiotics -treatment and prevention 

Probiotics do not represent a magic bullet, but evidence is accumulating that the use of proven probiotic strains and manipulation of the host's own intestinal and vaginal/urethral microbiota will provide valuable options to help restore and maintain urogenital health, once a sexually transmitted illness has been excluded.  Probiotics are live microorganisms that, when administered in adequate amounts may confer a health benefit in terms of treatment or prevention of recurrent vaginal infections.