Vaginal Infections: A Guide

One of the common gynecologic problems that we frequently see is a vaginal infection. These infections cause inflammation of the vagina. The symptoms can vary but often include redness, swelling and irritation of the vaginal tissues. There can be a discharge, burning, itching and odor. Vaginitis does not pose major health problems, but it often does not go away on its own. Fortunately medications can be very effective in treating and curing infections of the vagina.

The vagina normally has microscopic organisms, as does the rest of the body. These bacteria break down substances in the vaginal secretions and produce an acidic environment which helps protect the vagina against infection by keeping down the number of potentially harmful organisms. However, the environment can sometimes be altered by antibiotics, douching too often, tampons, tight clothing, extra weight, diabetes, pregnancy, birth control pills, and having intercourse. A change in the acidity of the vagina can allow potentially harmful organisms normally living there to rapidly multiply and cause inflammation with an abnormal discharge.

A certain amount of vaginal discharge is normal. A normal discharge is clear or cloudy and doesn’t smell, itch or burn. If you notice a vaginal discharge that does not seem normal, and you notice burning, itching or odor, then an infection may be present. If you call us about it, we can see you and do an exam to determine the cause of your symptoms, depending on which type of infection may be present.

Many women believe that a yeast infection refers to any and all vaginal infections. Actually there are different types of vaginal infections. We will discuss the more common ones.

Yeast, also called Candidiasis, fungus, or Monilia, is the most common type of vaginal infection that causes symptoms of irritation. It is often hard to get rid of, and recurrences are common. Many women have a thick, white or greenish discharge that is odorless and looks like cottage cheese. The main symptoms are intense itching and  sometimes burning, with redness and swelling. It is more frequent among women who are pregnant, diabetic, or obese. Antibiotics, birth control pills, and any situation that promotes moisture, such as exercising, wearing a wet bathing suit, or having intercourse can lead to it. We often make the diagnosis of this infection during an exam where we examine a small amount of the discharge under the microscope. Yeast infections are usually treated with an anti-fungal medicine. It can be a cream which is available with or without prescription, or a prescribed pill such as Diflucan which is taken orally. In most cases treatment of the male sex partner is not necessary unless the symptoms seem to recur following the usual treatment. Sometimes a woman thinks she has a yeast infection when a different infection is present. If you have an infection that will not improve, please call us about it as more testing may be needed.

Bacterial Vaginosis, also call BV, is the most common cause of a malodorous vaginal infection. The main symptoms include a milky discharge with an odor. The odor becomes worse after having sex or having a period. If is often “fishy.” The cause of this particular infection is a group of organisms that occur naturally in the vagina. Here again it is simple for us to detect this vaginal infection during a pelvic exam and examining the discharge with a microscope. The treatment is a medicine called metronidazole which can be given in pill or in gel form. If you are given this prescription, it is important to remember to not drink alcohol during the time you are taking the medicine, for a severe upset stomach could occur. This infection can be transmitted back and forth during intercourse. In some cases we may recommend treating your partner as well.

Trichomonas and Group B Strep are other causes of a vaginal infection characterized by inflammation and itching. These infections are frequently mistaken for yeast as the symptoms are very similar. An examination by microscope or obtaining a culture can help distinguish which germ is responsible so that the right treatment can be chosen.

Sometimes more serious infections such as herpes or warts may be present. If you are not seeing an improvement, it is important to let us know about it.

There are things you can do to help keep the vagina healthy. Avoid spreading bacteria from the rectum to the vagina. After a bowel movement, wipe from front to back. Avoid irritating agents such as harsh soaps or detergents. Use condoms during sex. Avoid wet bathing suits and clothes that trap moisture by being too tight. Sometimes eating yoghurt can help replace the good bacteria that fights infection.

Vaginitis can be uncomfortable, but it is usually not harmful and it can be cured. If you suspect you may have an infection, call us about it. With good medical care, the problem will soon go away and you can resume your usual lifestyle without the worry and discomfort of a vaginal infection.

About Mark Seigel, MD

I'm an ObGyn with offices in Rockville and Germantown, Maryland. Our modern practice includes electronic medical records, advanced ultrasound, and in-office procedures. We offer gynecologic services, as well as normal and high risk obstetrics. I have three great partners, Drs Emily Gottlieb, Jennifer Jagoe and Supriya Mishra. We are part of George Washington University Medical Faculty Associates. I enjoy reading, swimming, and blogging.
This entry was posted in Gynecology, Our Office and tagged , , . Bookmark the permalink.

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s