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Vaginitis

Normal vaginal discharge consists of mucus secretions from the cervix and vagina and discarded vaginal cells. This normal discharge is 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.

Every woman has some vaginal discharge, but women vary in the amount and consistency of their normal discharge. In addition, the discharge of any particular woman may vary according to the time of her menstrual cycle and her state of sexual arousal.

The vagina of a healthy woman contains bacteria which coexist in biological and chemical balance. Women do not develop vulvar itching, burning, pain, or irritation on urination from a normal discharge. When the normal balance in the vagina is upset by any of several causes, one or more of these "resident" organisms can multiply out of their usual proportions. This upset in balance can also make the vagina more susceptible to "invader" organisms which would normally be killed off or controlled as they entered the vagina.

When an excess of organisms stimulates the immunological defense processes in the vagina, an abnormal discharge usually results. The abnormal discharge may irritate tissues, cause itching, swelling and burning of the vulva, increased frequency of urination or an unpleasant odor. As in any disease, the symptoms vary from woman to woman.

Yeast vaginitis
This is the most common of all vaginal infections, and is called by many different names: yeast infection, candidiasis, moniliasis. Candida is a fungus which is normally present in small and harmless quantities, in the mouth, digestive tract, and vagina. When the balance of the vagina is upset, the fungus grows very quickly. In fact, the infection is sometimes referred to as candida "overgrowth." The discharge caused by candida is white, thick, and may have the consistency of cottage cheese. Often, white deposits are left on the vulva. The odor of the discharge is strong, but not really unpleasant. Vulvar itching and irritation, rawness, and soreness are often present. A variety of intravaginal medications are available to treat yeast infections. This type of infection is not considered to be sexually transmitted, although examination and treatment of the sexual partner may be recommended in cases of frequent recurrence.

Trichomoniasis
Generally called "trich" vaginitis, this infection is caused by a single-celled organism that is found in both women and men and is easily and most often transmitted by sexual intercourse. It may also be acquired by contact with moist objects that are contaminated with the organism. The discharge produced is yellow-green, thin but foamy, and has an unpleasant odor. Vulvar irritation and soreness and burning with urination may also occur. Many men and women have no symptoms. Medication is required for treatment, and sexual partners should be treated even if they have no symptoms.

Bacterial vaginosis
(Formerly called Haemophilus vaginitis, Gardnerella vaginitis or non-specific vaginitis)
This condition is not a real infection, but is caused by an overgrowth of bacteria that may normally be present in the vagina. The most common symptom is a vaginal discharge with an unpleasant "fishy" odor. It may be normal in amount or somewhat heavy, and is typically creamy and gray in appearance. Medication may be required for treatment, but this condition without symptoms does not require treatment. This vaginitis is not necessarily sexually transmitted, and partners are only treated if the condition persists after different treatments have been tried.

Cytolytic vaginosis
Also not a true infection, this condition results from an overgrowth of bacteria called lactobacilli that live in the vagina normally. It usually causes vulvar burning or itching and a discharge that is variable in amount and consistency. Treatment is undertaken to restore the usual mixture of vaginal organisms and to reduce the numbers of lactobacilli. This is not a sexually transmitted infection, and no treatment of partners is indicated.

General recommendations for the treatment of vaginitis
Once your vaginal infection has been diagnosed, you will be given a prescription for medication intended to control the condition. Your health care provider will probably also discuss with you some or all of the recommendations given below. Following the recommendations will help to clear an existing infection and to discourage reinfection. If you are especially susceptible to vaginal infections, you can help avoid reinfection by following the recommendations all of the time--not just while you have an infection.

  1. Use medication exactly as prescribed by your health care provider. Don't stop using it when the symptoms disappear or during menstruation. Use it until it is all gone or until your health care provider advises you to stop. Not using medication long enough is a common cause for recurrence of the vaginitis, since some organisms may survive incomplete treatment.

  2. If your health care provider wants to see you for a follow-up visit, be sure to follow this advice. Microscopic examination is sometimes necessary to determine if the infection is really eliminated.

  3. If you use a vaginal medication, some of it might leak out after you insert it. A panty liner worn during the treatment might make you feel more comfortable. Some medication on the vulva can help treat the infection.

  4. Don't scratch, if you can help it. Scratching can further irritate the area.

  5. The infection spreads in moisture and heat. Keep the vulva as dry as possible. This means careful drying after bathing, wearing all-cotton (rather than synthetic) underpants, and not wearing pantyhose or panty girdles, tight slacks, or other tight clothing. Do not wear underpants while sleeping. Change from bathing suits soon after swimming and from sweaty exercise clothes soon after exercise. Clothing that comes in contact with your vulva should be washed between each wearing.

  6. It is best to avoid sexual intercourse when symptoms are at their worst. If a sexual partner needs treatment, refrain from genital contact until you both have completed treatment.

  7. After a bowel movement, be sure to wipe yourself from front to back--away from the vulva. Some of the organisms which can cause vaginal infections are present in the rectum.

  8. Remember that your body's resistance can be an important factor in whether an infection recurs. Instead of trying to combat a recurrence of vaginitis yourself, go back and work with your health care provider to see if any undiscovered conditions might be contributing to your problem.

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