Monday, December 22, 2014

Vaginal Infections

Definition

Infection of the vagina with one or more bacteria, yeast or protozoal organism.

Description

Vaginal symptoms are among the most common reasons that women consult primary care physicians. Most women have a vaginal infection now and then, and many women have them often

The vagina normally contains large numbers of organisms called Lactobacillus (or acidophilus). Vaginal infections happen when other organisms grow and change the normal balance of organisms in the vagina.

A vaginal infection is present when the normal vaginal discharge changes color, becomes heavier or smells different, or if there is itching, burning, swelling, or redness around the vagina.

A normal discharge does not smell bad and is not accompanied by redness, swelling, or itching. Most vaginal discharges are normal. A vaginal discharge is often present at some stages in the menstrual cycle. This discharge may be most noticeable at the middle of the cycle, which is close to the time of ovulation.

The most common form of vaginal infection is called bacterial vaginosis. Women with this infection have a large number of organisms called Gardnerella vaginalis, as well as many other organisms, in their vagina. If an infection is present, there will be a vaginal smell that is strongest after sexual intercourse, and perhaps an increased amount of thin vaginal discharge, which may be white or discolored.

A yeast infection, or Candida vaginitis, is another common type of vaginal infection. If this is present, there may be larger amounts of thick, white discharge, or no discharge at all. Other common symptoms include itching, swelling, irritation or redness around the vaginal area.

Trichomonas vaginitis, which is sometimes called "trick," is the third most frequent vaginal infection. Like bacterial vaginosis, this infection often causes an increased amount of discharge, which may be discolored. Sometimes, the discharge smells different. Itching may be present but is less likely than with a yeast infection.

In about one of every three women with vaginal symptoms, the cause of the symptoms may be harder to find. An infection of other parts of the urogenital system may be present, such as gonorrhea, chlamydia or herpes. Low hormone levels, related to menopause, or an allergy may also cause vaginal infections.

Causes

Most vaginal infections have no apparent cause. They sometimes occur in times of stress or other illness. They also often occur (especially yeast infections) following a course of antibiotics taken for other reasons.

Some vaginal infections are a result of sexual intercourse, but the organisms covered in this topic area tend not to be ranked as seriously as other sexually transmitted diseases.

Symptoms

Symptoms can range from minimal discharge, odor or irritation, to copious discharge with substantial irritation and pain.

Diagnosis

These causes of vaginal infection can usually be easily diagnosed by your doctor in the office using simple techniques. Often, just the history and clinical presentation is enough to conclude which type of infection it is.

Treatment

The treatment for vaginal infections depends on the cause.

Bacterial vaginosis is often treated with a prescription medication called metronidazole (Flagyl, Protostat). This medication is taken by mouth. Sometimes it causes an upset stomach or nausea. If you drink alcohol while taking this drug, you may have nausea and vomiting. There are other medicines that may be taken by mouth for this infection, such as clindamycin (Cleocin), and there are also vaginal creams and gels.

A yeast infection is usually treated with creams and suppositories that are placed in the vagina. The length of treatment may vary from one to seven days. Some of these medicines are now available without prescription, such as miconazole (Monistat) and clotrimazole (Gyne-Lotrimin or Mycelex-G), and you may use then when you know you have a yeast infection. If the infection does not get better or comes back soon, you should see your doctor to make sure of the diagnosis and treatment.

Trichomonas vaginitis is also treated with metronidazole, taken by mouth. However, because this infection is often passed back and forth between sexual partners, it is necessary that the partner also take the medication to prevent it coming back.

Questions

Do the symptoms indicate a vaginal infection?

What is it called?

What treatment do you recommend?

Which drugs will you use?

How can this infection be prevented?

Is the OTC drug Gyne-Lotrimin helpful if the infection comes back?