Intimate Health Care For Women
Vaginal yeast (monilia) infections are common, but not all vaginal itching and discharge is caused by an overgrowth of yeast. Vaginal infections can be caused by a fungus (yeast), Trichomonas (protozoa) or bacteria. Don't use an over-the-counter yeast medication until you're sure of your diagnosis.
Jule Hallerdin, M.N., M.P.H., assistant professor of master's instruction and director of faculty practice at the Johns Hopkins University School of Nursing, offers these guidelines for recognizing, preventing and treating common vaginal infections.
Yeast Infection
Symptoms: A thick, curdy white discharge, and a burning sensation when urine comes in contact with irritated skin of the external vaginal area (vulva). Symptoms can include itching in and outside the vagina (vulva).
Causes And Prevention: It is normal for all women to secrete moisture and mucus from membranes that line the vagina. Some bacteria grow in the vagina of a healthy woman and most of the bacteria help to maintain the healthy condition of the vagina. This keeps harmful organisms from multiplying and causing infections. Yeast grows naturally in the vagina and usually causes no problems. Taking antibiotics, using birth control pills and vaginal irritations can cause yeast to grow out of control.
To keep the vaginal area dry, change out of a damp bathing suit or sweaty workout clothes as quickly as possible, avoid tight-fitting pants and wear panties with a cotton crotch to allow air to circulate to the vaginal area.
Antibiotics kill harmful bacteria, but they also kill the normal bacteria in the vagina that keep yeast under control. In some women, birth control pills change the normally acidic environment of the vagina and yeast can multiply. While it has not been scientifically proven to work, some clinicians recommend eating a cup of yogurt with live acidophilus cultures daily while on antibiotics, or taking acidophilus tablets (following directions on the label), to replace some of the "good" bacteria.
Douching increases susceptibility to yeast infections by washing away good organisms in the vagina. Do not douche unless it is recommended by a physician. Instead, take a bath or shower daily and gently wash the vaginal area with any nonirritating mild soap.
Treatment: If you have vaginal symptoms and have never had a yeast infection, see a clinician to get a proper diagnosis. If you've experienced a yeast infection and can recognize the symptoms, it's fine to self-treat with an over-the-counter vaginal cream or suppository medication such as clotrimazole (Lotrimin, Mycelex-G), miconazole nitrate (Monistat), butoconazole nitrate (Femstat), terconazole (Terazole) or tioconazole (Vagistat-1). All work similarly, and are effective for most cases of yeast. Depending on the brand and strength, treatments last one, three or seven days. If this does not take away symptoms, see your health care practitioner.
The vaginal tissues are more sensitive just prior to menstruation, so a little itching at that time of the month may just be part of your body's normal fluctuations. If it goes away after menstruation, there's no need to treat it. Severe itching or heavy discharge should always be treated. If you get recurrent yeast infections, see a physician to rule out some other underlying problem, such as diabetes.
Bacterial Vaginosis or BV
Symptoms: A strong, fishy odor and a grayish-white, non-irritating discharge.
Causes And Prevention: No one knows what causes the overgrowth of bacteria that leads to a bacteria vaginosis. It can be related to sexual activity, so many clinicians recommend having your sexual partner use a condom and getting treated if you've had recurrent infections.
Treatment: Prescription oral medication metronidazole (Flagyl), given in a large single dose or course of treatment, or vaginal cream (MetroGel) as prescribed by your clinician.
Trichomoniasis
Symptoms: A foul-smelling discharge that can be profuse and greenish or frothy in severe cases. The external vaginal area can be red and irritated, and there may be some burning when urinating.
Causes And Prevention: Trichomoniasis is a sexually transmitted infection caused by a one-cell parasite (Trichomonas). Since many men with trichomoniasis have no symptoms, it may be impossible to tell if he is infected. The only prevention is to practice safe sex, use a condom or abstain from sexual activity with an infected partner.
Treatment: Prescription oral medication metronidazole (Flagyl), given in a large single dose or for a seven-day course of treatment. Because trichomoniasis is sexually transmitted, both partners need to be treated simultaneously.
Vaginal Irritation
Allergies or sensitivities to fragrances and other additives are common, and may cause itching, redness and irritation in or around the vagina. Use only unscented napkins, pantyliners and tampons, and avoid the use of vaginal sprays or powders.
Many women entering menopause experience atrophic vaginitis, or vaginal drying and itching, which can be made worse during intercourse. Using lubrication such as K-Y Jelly or Astroglide can decrease irritation during sex.
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