Vaginitis

Although “yeast” is the name most women know, bacterial vaginosis is actually the most common vaginal infection in women of reproductive age. Bacterial vaginosis will often cause a vaginal discharge. The discharge is usually thin and milky and is described as having a “fishy” odor. This odor may become more noticeable after intercourse. Redness or itching of the vagina are not common symptoms of bacterial vaginosis. It is important to note that many women with bacterial vaginosis have no symptoms at all and the vaginitis is only discovered during a routine gynecologic exam. Bacterial vaginosis is caused by a combination of several bacteria. These bacteria seem to overgrow much the same way as Candida will when the vaginal balance is upset. The exact reason for this overgrowth is not known. Since bacterial vaginosis is caused by bacteria, not by yeast, it is easy to see that different methods are needed to treat the different infections. A medicine that is appropriate for yeast is not effective against the bacteria that causes bacterial vaginosis.

What are trichomoniasis, chlamydia, and viral vaginitis?

Trichomonias, commonly called “trite” (pronounced “trick”), is caused by a tiny single-celled organism known as a “protozoa.” When this organism infects the vagina is can cause a frothy, greenish-yellow discharge. Often this discharge will have a foul smell. Women with trichomonal vaginitis may complain of itching and soreness of the vagina and vulva, as well as burning during urination. In addition, there can be discomfort in the lower abdomen and vaginal pain with intercourse. These symptoms may be worse after the menstrual period. Many women, however, do not develop any symptoms. It is important to understand that this type of vaginitis can be transmitted through sexual intercourse. For treatment to be effective, the sexual partner must be treated at the same time as the patient.

Another primarily sexually transmitted form of vaginitis is caused by the germ known as Chlamydia. Unfortunately, most women do not have symptoms. This makes diagnosis difficult. A vaginal discharge is sometimes present with this infection but not always. More often a woman might experience light bleeding especially after intercourse. She may have pain in the lower abdomen and pelvis. Chlamydial vaginitis is most common in young women (18 to 35 years) who have multiple sexual partners. If you fit this description, you should request screening for Chlamydia during your annual checkup. The best “treatment” for Chlamydia is prevention. Use of a condom will decrease your risk of contracting not only Chlamydia, but other sexually transmitted diseases as well.

Many of the germs that cause vaginitis can be spread between men and women during sexual intercourse. Use of a barrier contraceptive such as a condom can help reduce your risk of contracting these and more serious germs such as the human immunodeficiency virus (HIV) which can lead to aids.

Viruses are a common cause of vaginitis. One form caused by the herpes simplex virus (HSV) is often just called “herpes” infection. These infections are also spread by sexual intimacy. The primary symptom of herpes vaginitis is pain associated with lesions or “sores.” These sores are usually visible on the vulva or the vagina but occasionally are inside the vagina and can only be seen during a gynecologic exam. Outbreaks of HSV are often associated with stress or emotional upheaval.

Another source of viral vaginal infection is the human papillomavirus (HPV). HPV can also be transmitted by sexual intercourse. This virus can cause painful warts to grow in the vagina, rectum, vulva, or groin. These warts are usually white to gray in color, but they may be pink or purple. However, visible warts are not always present and the virus may only be detected when a Pap smear is abnormal.