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VAGINITIS, VAGINAL ITCHING AND DISCHARGE

Vaginitis is a broad medical term that is used to describe the various disorders that cause infection or inflammation of the vagina. Vulvovaginitis refers to inflammation of the external female genitals (the vagina and vulva). These conditions can result from an infection caused by such organisms as bacteria, yeast, or viruses. Irritations from chemicals in creams, sprays, or even clothing that are in contact with this area can also result in vaginitis. In some cases, vaginitis would result from organisms that are passed between sexual partners, vaginal dryness as well as lack of estrogen.

Vaginal itching is a very uncomfortable, sometimes painful symptom that often occurs due to irritation from substances, infections, or menopause. It may also occur as a result of certain skin disorders or sexually transmitted diseases (STDs). In rare cases, vaginal itching might develop due to vulvar cancer.

Often times, vaginal itching is not a cause for concern. However, people should contact their doctor or gynecologist if the itching is severe or if an underlying condition is suspected. The doctor can determine the cause of the itching through an examination and testing. The doctors will be able to recommend appropriate treatments for the symptoms.

Vaginal discharge performs an important housekeeping function in the female reproductive system. Glands inside the vagina and cervix make fluid that carry away dead cells and bacteria. This is the natural way that keeps the vagina clean and helps prevent infection.

Vaginal discharge is perfectly normal most of the time. The intensity, odor and color can vary depending on the time in your menstrual cycle. For example, there will be more discharge when one is ovulating, breastfeeding, or sexually aroused. The discharge may smell different when one is pregnant or has slackened with her personal hygiene.

However, these changes presents no cause for alarm. However, if the color, smell, or consistency seems different, especially if the discharge is accompanied by vaginal itching or burning, it could very well be an infection or other conditions.

THE DIFFERENT TYPES OF VAGINITIS

Doctors refer to the various conditions that cause an infection or inflammation of the vagina as 'vaginitis.' The most common kinds are:

  • Gonorrhea - An infection caused by a sexually transmitted bacterium that infects both males and females. Gonorrhea most often affects the urethra, rectum or throat. In females, gonorrhea can also infect the cervix. Gonorrhea is most commonly spread during vaginal, oral or anal sex.
  • Bacterial vaginosis A type of vaginal inflammation caused by the overgrowth of bacteria that is naturally found in the vagina, this overgrowth upsets the natural balance. Women in their reproductive years are most likely to get bacterial vaginosis, though it can affect women of any age.
  • Trichomoniasis - A very common sexually transmitted disease (STD). It is caused by infection with a protozoan parasite called Trichomonas vaginalis. Although symptoms of the disease vary, most people who have the parasite cannot tell they are infected.
  • Candida or 'yeast' infections - Candidiasis is a fungal infection caused by a type of fungus (a yeast) called Candida. The most common specie of Candida, Candida albicans causes infection in people. Found in places such as the mouth, throat, gut, and vagina, candida normally lives on the skin and inside the body, without causing any problems.
  • Viral vaginitis - One form caused by the herpes simplex virus (HSV) is often just called herpes infection. These infections are spread by sexual contact. The primary symptom of herpes vaginitis is pain associated with lesions or sores.
  • Chlamydia - A sexually transmitted infection (STI) caused by a bacteria called chlamydia trachomatis. Usually it doesn't cause any symptoms and can be easily treated with antibiotics. However, if it isn't treated early it can spread to other parts of the body and lead to long-term health problems.
  • Reactions or allergies (non-infectious vaginitis) - refers to vaginal irritation without an infection being present. Most often, this is caused by an allergic reaction to, or irritation from, vaginal sprays, douches, or spermicidal products. It may be also be caused by sensitivity to perfumed soaps, detergents, or fabric softeners.

WHAT VAGINAL DISCHARGE MEANS

Vaginal discharge is described as fluid released by glands in the vagina and cervix. The fluid carries dead cells and bacteria out of the body, and vaginal discharge helps keep the vagina clean and prevent infection. Normal vaginal discharge varies in intensity. It ranges in color from clear to milky, white discharge. Discharges may have some odor, however, a foul, fishy odor is a sign of an infection.

There are times when discharge intensity can change, immediately after a period, there is almost no discharge. Two to three days after the period ends, there is a thick, white discharge. A few days later, the consistency of the discharge changes to appear more like mucous. The discharge becomes clear and sticky before ovulation, and before the next period, discharge is thick and white.

Vaginal discharge during pregnancy is thin, white, milky and with a mild odor. The intensity of discharge also increases during pregnancy. However, discharge decreases due to low levels of estrogen during perimenopause and menopause,

The following can cause estrogen levels to drop, leading to little to no vaginal discharge:

  • Chemotherapy
  • Medicines or hormones used in the treatment of breast cancer, endometriosis, fibroids or infertility
  • Surgery to remove the ovaries
  • Radiation treatment to the pelvic area
  • Severe stress, depression or intense exercise

VAGINAL DISCHARGE COLOR MEANING

Thick, White Discharge

If this comes along with symptoms such as itching, burning and irritation, it is most likely due to a yeast infection. Otherwise, it is normal discharge. One may also notice an increase in the thick, white discharge before and after a period.

Yellow Discharge

Yellow discharge is definitely an abnormal discharge, it is the sign of a bacterial infection or sexually transmitted infection. There also may be an odor associated with it.

Clear and watery discharge

A clear and watery discharge is perfectly normal. It can also occur at any time of the month. It is likely to be especially heavy after exercise.

Brown or bloody Discharge

Especially when it occurs during or right after the menstrual cycle, brown or bloody discharge is usually normal. A discharge at the end of one's period can look brown instead of red. A woman may also experience small amounts of bloody discharge between periods. This is called spotting.

If the spotting occurs during the normal time of one's period and she has had unprotected sex recently, it could be a sign of pregnancy. The same spotting during the early phase of pregnancy could be a sign of miscarriage, so it should be discussed with their obstetrician/gynecologists.

In quite rare cases, brown or bloody discharge can also be a sign of endometrial or cervical cancer. It could be other problems such as fibroids or other abnormal growths. What is important is for every woman to get a yearly pelvic exam and Pap smear.

Green Discharge

It is not normal to have green discharge. This is a sure sign of bacterial infection or a sexually transmitted infection, such as Trichomoniasis. Anyone experiencing green discharge should see their healthcare provider. If one is diagnosed with Trichomoniasis, she will be placed on antibiotics.

Yeast Infection Discharge

Discharge from a yeast infection is caused by an overgrowth of fungus in the vagina. Symptoms of yeast infection discharge include a thick, white, cottage cheese-like discharge, along with itching, redness, irritation and burning. Most women will have a yeast infection at some point in their life. These infections are not contagious, and antifungal creams which are available over-the-counter can be used by patients. If symptoms does not improve with treatment or if the patient has more than four yeast infections within a year, she should see her doctor.

Clear and stretchy

When the discharge is clear but stretchy and mucous-like, instead of watery, it indicates that the patient is likely to be ovulating. This is a normal type of discharge.

CAUSES OF VAGINAL DISCHARGE

Normal vaginal discharge is a healthy bodily function. It happens to be the body's way of cleaning and protecting the vagina. For instance, it is perfectly normal for discharge to increase with sexual arousal and ovulation. Exercise, use of birth control pills, and emotional stress may also result in discharge.

Abnormal vaginal discharges, however, are usually caused by infections.

Bacterial vaginosis

Bacterial vaginosis is a common bacterial infection. It causes increased vaginal discharge that has a strong, foul, and sometimes fishy odor, although it produces no symptoms in some cases. Women who engage in oral sex or who have multiple sexual partners have an increased risk of acquiring this infection.

Trichomoniasis

This is caused by a protozoan, or single-celled organism. The infection is usually spread by sexual contact, but it can also be contracted by sharing towels or bathing suits. It results in a yellow or green discharge that also has a foul odor. Common symptoms are pain, inflammation, and itching, although some people don't experience any symptoms at all.

Yeast infection

The presence of yeast in the vagina is normal, but in certain situations its growth can multiply out of control. A yeast infection is a fungal infection that produces white, cheese-like discharge in addition to burning and itching sensations. The following may increase one's likelihood of yeast infections:

  • Gonorrhea and chlamydia
  • Pregnancy
  • Stress
  • Diabetes
  • Use of birth control pills
  • Prolonged use of antibiotics

Gonorrhea and chlamydia are sexually transmitted infections (STIs) that produces abnormal discharge. The discharge is often yellow, greenish, or cloudy in color.

Pelvic inflammatory disease (PID)

Pelvic inflammatory disease (PID) is an infection that's spread by sexual contact. It occurs when bacteria spread up the vagina and into other reproductive organs. It may produce a heavy, foul-smelling discharge.

Human papillomavirus (HPV) or cervical cancer

The human papillomavirus (HPV) infection is often spread by sexual contact. If not treated, it can lead to cervical cancer. There may be no symptoms of this infection, however this type of cancer can produce a bloody, brown, or watery discharge with a very unpleasant odor.

SYMPTOMS

Vaginitis signs and symptoms can include:

  • Change in color, odor or intensity of discharge from the vagina
  • Pain during intercourse
  • Light vaginal bleeding or spotting
  • Vaginal itching
  • Painful urination

Usually, the characteristics of the discharge might indicate the type of vaginitis.

Examples include:

  • Trichomoniasis This infection can cause a greenish-yellow, sometimes frothy discharge.
  • Bacterial vaginosis - A grayish-white, foul-smelling discharge might develop. The odor, often described as a fishy, might be more obvious especially after sexual intercourse.
  • Yeast infection - The main symptom is itching, but one might have a white, thick discharge that resembles cottage cheese.

WHEN TO SEE THE DOCTOR

It is really important to see a doctor if the vagina itches severely enough to disrupt daily life or sleep. Although most of the causes are found out not to be serious in the end, there are some treatments that can decrease the discomfort of vaginal itching.

Women should also contact their doctor if vaginal itching persists for more than a week, or if the itching occurs along with the symptoms that follow:

  • An unusual vaginal discharge
  • Ulcers or blisters on the vulva
  • Trouble urinating
  • Genital redness or swelling
  • Pain in the genital area
  • Discomfort or pain during sexual intercourse

Vaginitis isn't usually a major health problem, but it can become serious if one leaves it untreated.

There are many different causes of vaginitis. STDs like gonorrhea and chlamydia can have symptoms that are very similar to vaginitis. A doctor would be best to find out exactly what could be happening, so that the patient can get the right treatment.

To determine what is causing the vaginitis, the doctor may do an examination, take a look at a sample of the vaginal discharge under a microscope, or do other tests, like a urine test.

If the doctor has diagnosed one with a vaginal yeast infection in the past and the patient has the same symptoms, she can go ahead and try over-the-counter yeast infection medicines. But if the patient is not sure, she should see the doctor again.

Lastly if a person used an over-the-counter medicine but the symptoms persist, see a doctor.

RISK FACTORS

Factors that increase the risk of developing vaginitis include:

  • Douching
  • Wearing damp or tightfitting clothing
  • Hormonal changes associated with pregnancy, birth control pills or menopause
  • Sexual activities
  • Having a sexually transmitted infection
  • Some medications, such as antibiotics and steroids
  • The use of spermicides for birth control
  • Uncontrolled diabetes
  • Use of hygiene products such as bubble bath, vaginal spray or vaginal deodorant
  • Using an intrauterine device (IUD) for birth control

DIAGNOSIS

To diagnose vaginitis, the doctor is likely to:

  • Perform pH testing The doctor might test the vaginal acidity or alkalinity by applying a pH test stick or pH paper to the wall of the vagina. An elevated pH can indicate either bacteria vaginosis or Trichomoniasis.
  • Review the patient's medical history This will include history of vaginal or sexually transmitted infections.
  • Perform a pelvic examination - The doctor may use a speculum to look inside the vagina for inflammation and abnormal discharge during the pelvic exam
  • Collect a sample for test in the lab - A sample of cervical or vaginal discharge may be collected for lab testing to confirm the kind of vaginitis the patient has.

TREATMENT FOR VAGINITIS

Vaginitis is usually easy to cure. The type of vaginitis treatment that's best will depend on:

  • The cause of the vaginitis
  • The severity of symptoms
  • Whether or not patient is pregnant

If the vaginitis is caused by a yeast infection, bacterial vaginosis, or trich, the doctor may prescribe creams, suppositories, vaginal tablets, or pills.

Medicated creams or suppositories for yeast infections can be obtained over the counter. Trichomoniasis is the only type of vaginitis that is sexually transmitted, so it's very important for one's sexual partners to get treated, too.

If the vaginitis is caused by an allergy or irritation, the symptoms will usually go away when one stops using whatever could be causing the problem. Sometimes the patient might need to use a cream to help clear up the vaginitis infection.

No matter what type of vaginitis treatment is recommended, ensure to:

  • Refrain from using anybody else's medicine. Even with similar symptoms, one may have a different infection and/or may need a different kind of treatment.
  • Refrain from using old medicine. It could even make the infection worse.
  • Follow carefully the doctor's instructions or the directions that come with the treatment.
  • Ensure to use all of the medication. The infection can come back if all the medicine is not taken. Continue even if the symptoms stop and even if one has her period.

Book a 'follow-up appointment' with the doctor to make sure the treatment was effective.

During the vaginitis treatment:

  • Be sure not to put anything in the vagina except medicine or tampons. Take a break from oral or vaginal sex until the infection is cleared.
  • It is okay to use tampons or menstrual cups during one's monthly period, however, if it is the kind of medicine to be inserted into the vagina, use pads instead.
  • If the treatment entails using gels or creams inside the vagina, use panty liners to help keep the medicine from leaking onto clothes.

How to ease irritating symptoms of vaginitis

  • Try hard not to scratch, even though vaginitis can be super itchy and irritating. Scratching can cause more irritation or cuts in the skin, which can lead to the further spread of germs and lead to more infection. There are several over-the-counter vaginal creams that can be used on the vulva to help calm the irritation.
  • Avoid sex until the infection or irritation goes away (especially so if one has Trichomoniasis. Trich is a sexually transmitted infection that partners can pass back and forth). Friction from sex can cause more irritation or make it harder to heal.

PREVENTING VAGINITIS

As humans we react differently even to same stimuli, as such the things that lead to vaginitis for some people might not always cause problems for others. Generally however, anything that creates a chemical imbalance in the vagina can lead to vaginitis.

Here are a few ways to keep the vulva and vagina healthy:

  • Get to know and understand the genitals. Look at the vulva with a mirror, and pay attention to regular smells and vaginal discharges. Knowing the body well is the best way to tell if something's wrong.
  • Do not douche (douching washes away the good, healthy stuff in the vagina and throws off its natural balance. Vaginas are naturally self-cleaning, so there is no need to clean the inside of the vagina. Washing the vulva with mild, unscented soap or just plain water remains the healthiest way to clean the genitals.
  • Vaginitis develops more quickly in moist conditions, so the genital area must be kept as dry as possible. Do not wear pants that are uncomfortably tight
  • If one is worried about the way the vagina smells do not use scented pads, vaginal deodorants, and perfumed 'feminine hygiene' products.
  • Refrain from using perfumed bath products (including soap and bubble bath) and scented or colored toilet paper especially if they irritate the skin.
  • Rinse the vulva with mild soap and water during a shower. Be sure to wear cotton underwear because they breathe better and can help keep the vulva dry.
  • Be sure to change underwear daily.
  • Change sanitary pads every 4-8 hours and wash sex toys carefully according to their instructions.
  • If germs from the anal area get into the vagina, they can cause an infection. Wipe carefully from front to back after bowel movement to avoid spreading germs to the vulva.
  • Stop using lubricants and spermicide or try a different brand if you have a reaction or find them irritating.

Can one get vaginitis from having sex?

Although often times vaginitis is not spread through sex, sometimes it is caused by a sexually transmitted infection, and trich is a very common STD that is passed easily during sexual contact and which often causes vaginitis.

Sometimes a person's body chemistry can have a bad reaction to another person's semen, which can mess up the normal balance in the vagina. Some studies have shown that having sex with a new partner, or multiple partners, may make one more likely to get Bacterial Vaginosis.

Sex can also lead to vaginitis if one has an allergy or sensitivity to certain types of lubricants, condoms, or sex toy materials. And lots of friction or ruggedness during vaginal sex may cause inflammation and discomfort if the lining of your vagina becomes irritated.

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