Vaginal Infection is a general medical term referring number of fungal, bacterial, and parasitic conditions that effect, but are not limited to, the vaginal area. Vaginal infections are commonly called, yeast infections, vaginitis, yeast overgrowth, or Candida. Doctors will use more specific terms like, Bacterial vaginosis (BV), candidiasis, genital candidiasis, vulvovaginal candidiasis (VVC), or Trichomoniasis (Trich).
Vaginal Infections cause a wide range of symptoms, including one or more of the following : itching, burning, and irritation in the vaginal area; painful intercourse, abnormal vaginal discharge, white “chunks” that resemble cottage cheese, foul odor, fishy odor, inflammation and swelling of the genital area, and burning during urination. A healthy vagina has a pungent odor unique to every person. Normal discharge is clear to white, turning yellow when exposed to air. The color and amount of discharge varies through the monthly cycled and depends largely on estrogen levels.
Bacterial vaginosis is responsible for at least 50% of vaginal infections. BV is caused by the growth of an unfriendly bacterium called Gardnerella vaginalis that lives in low-oxygen environments. When the vagina loses its natural acidity the Gardenerella bacteria thrives in the altered pH-neutral environment. A bacterial infection with Garnerella causes a fishy odor along with vaginal itching and irritation. Discharge may vary from yellow to grayish white. BV does not cause pain during intercourse and sometimes causes no symptoms at all.
The common yeast infection is caused by the overgrowth of a genus of yeast called Candida Albicans. This fungus–all yeasts are fungi–is present throughout the mouth and digestive tract in nearly 80% of the population, with little noticeable effects. This yeast starts out as a single-celled organism, but in the right conditions it will, literally, go crazy, producing a huge branching structure of filaments, much like a tree with many, many branches. This tangled mass produces a visually identifiable infection called Candidiasis, which is responsible for vaginal yeast infections and mouth infections called thrush. In the most severe cases, Candida can invade the nose, organs, brain, and blood.
Hormones are another cause of vaginitis. Atrophic vaginitis, also called Senile vaginitis, can occur in females of any age from fluctuating levels of estrogen. This type of vaginitis causes painful intercourse due to the thinning of the vaginal wall and decreased lubrication associated with low estrogen. Atrophic vaginitis affects postmenopausal and postpartum women as well as pre-pubescent girls with naturally low estrogen levels. There is no unusual odor or discharge associated with this type of vaginal inflammation.
Irritant and Foreign Body Vaginitis is caused by the retention of spermicidal sponges, condoms, and tampons or allergies to personal care products, latex allergy, spermicide ingredients, douches, vaginal hygiene products, detergents, fabric softeners, and fragrances. Vaginitis and foul odors caused by a forgotten tampon or lost condom will clear up after the foreign object has removed, no further treatment is necessary.
Vaginitis caused by irritants can be harder to pinpoint, because of the prevalence of these products and sudden onset of allergic symptoms. For persistent or unexplained vaginal irritation switch to a hypoallergenic fragrance-free detergent and discontinue using scented menstrual pads, douches, and other products with ingredients that could cause irritation.
Trich & STD’s
Trichomoniasis, also called trich, (pronounced “trick”) is a sexually transmitted infection which is caused by a parasite Trichomonas vaginalis. This infection is carried by men who are almost always asymptomatic. Because men don’t show outward symptoms it’s imperative that they receive the same anti-parasitic treatment as females to prevent the infection from being passed back and forth. Trich is characterized by foamy greenish yellow vaginal discharge, itching, irritation, and in some cases severe swelling of the vaginal area.
Vaginal infections and irritation can also be caused by sexually transmitted diseases and sexually transmitted infections, like gonorrhea, Chlamydia, mycoplasma, herpes, and campylobacter. Some parasites and improper hygiene, like wiping back to front, can cause similar infections, although these are less common causes.
Vaginal yeast infections occur most frequently after a course of antibiotics. Medications like penicillin kill all kinds of healthy bacteria, including the good vaginal flora.
Patients on steroidal medications and women on birth control pills or using IUDs are more likely to experience frequent yeast infections. Some women on birth control can develop yeast infection symptoms monthly, which subside at the beginning of the cycle and return again before menstruation.
Diet is a major influence on the body. Unhealthy food causes imbalances in the vaginal microflora. Diet can influence everything from blood sugar to pH and both are key causes of vaginal infections.
Although yeast infections are not sexually transmitted women who have frequent unprotected sex are at in increased risk this simply because sperm and ejaculate are highly alkaline, making the vagina work harder to correct the acid balance.
Serious medical problems like diabetes, leukemia, and HIV or AIDS can cause in increased occurrence of vaginal infections, particularly yeast infections with Candida. Diabetes alters body chemistry, pH, and causes elevated blood sugar that yeast thrives on. People with compromised immune systems, including patients with HIV or AIDS, are at an increased rick for persistent yeast infections, including oral thrush.
After a course of antibiotics take a probiotic supplement to help reestablish the healthy microorganisms and prevent a full-blown infection.
Proper Dieting & Comfortable Clothing
Excellent diet is the key to preventing the reoccurrence and length of infections. Yeast, in particular, feeds on sugars in refined starches. A died heavy in processed foods and empty carbohydrates causes spikes in blood sugar that yeast needs to survive. Limit consumption of potatoes, white flour, breads, crackers, and anything made with starches. Consuming any of these foods, particularly in excessive quantities, only fuels the fire.
Regular consumption of yogurt is extremely effective at balancing the natural healthy flora in the intestines and vaginal area. Using milk supplemented with Sweet acidophilus cultures is another way to correct the natural balance of healthy bacteria in the vagina. Avoid synthetic underwear made from polyester, which can trap air and moisture. Wear cotton undergarments that naturally absorb moisture and promote air circulation.
Don’t use harsh soaps on the vaginal area. Although it may seem counter intuitive, washing thoroughly with water is more effective at maintaining a healthy vaginal balance than using soap. Wear loose clothing. Under certain conditions the combination of tight clothing and undergarments can lead to vaginal infections or cause additional discomfort to an active infection. For comfort and to encourage good air circulation wear loose fitting clothes or skirts.
Change cloths and underwear after working out or getting wet. Bacteria and fungi thrive in this warm and humid environment. Remove underwear during the night for better air circulation. This can be especially comfortable during an active infection.
Tests, Diagnosis, and Considerations
Most women can easily recognize the symptoms of a yeast infection even if they have never had one before. Because the symptoms of different vaginal infections are so similar, women occasionally mistake the symptoms of a bacterial infection for a yeast infection.
At home yeast infection test kits are available. These kits use a basic litmus paper pH test to determine if the infection is caused by Candida or Gardnerella. Users find these at home pH tests to be rather inconclusive because the pH of the vagina usually stays under 4 and both fungal infections and bacterial infections occur in this same range. A healthy vagina has an acidic pH between of 3.8 and 4.2. A pH over 4.5 is on the alkaline side and could indicate one or more the infections are at work.
The medical diagnosis of vaginal infection is really quite simple. When a patient presents the symptoms of a vaginal infection the doctor will do a pelvic exam with a speculum, just like a pap test, to look at the cervix and vaginal tissue. In some cases the doctor will visually diagnose a yeast infection, other times a sample of the vaginal discharge will be taken on a swab and examined under a high powered microscope. Doctors use several methods to narrow down the true cause of the infection.
First, a doctor may do a pH test. A high pH over 4.5 indicates the infection likely caused by gardnerella. Second, the cells are placed on a slide and mixed with a salt solution or dye to identify “clue cells” distinctive vaginal skin cells covered with speckles the gram-negative Gardnerella bacteria. Doctors will also use a wiff test to identify bacterial vaginosis. A wiff test uses a sample of vaginal discharge combine with 1 drop of potassium hydroxide, an extremely strong alkali (base) that is then sniffed for a fishy odor indicating an infection with the Gardnerella bacteria.
Pharmaceutical Treatments Prescription and OTC
The usual treatment bacterial vaginosis is 7 day course of antibiotics taken twice a day. Metronidazole is the antibiotic that most often prescribed. It’s a common antibiotic that targets bacteria and protozoa, making it an effective treatment for Trich. Antibiotics are affordable and readily available with a prescription, but they do cause side-effects, including nausea and diarrhea.
For common yeast infections doctors usually recommend an over-the-counter pharmaceutical treatment that contains an anti-fungal drug belonging to the “azole” class, (meaning the active ingredients all end with the suffix azole.) These anti-fungal treatments come in a number of forms from oral tablets to intravaginal suppositories and topical creams. The most popular treatment for yeast infections is a vaginal suppository that contains Miconazole.
These products are sold worldwide under the brand names: Miconazex, Monistat, Femizol and Gyno-Daktarin. As most women know, the feminine care aisle is a veritable jungle of products; even vaginal suppositories come in an amazing and confusing array of varying strengths, most commonly 1-Day, 3-Day, and 7-Day courses. Despite the different duration, these suppositories contain similar total amounts of the medication, but the longer courses are gentler and in some cases more effective.
Mild to severe burning and added swelling and irritation are the most common side-effects caused by applying harsh ingredients on irritated skin. Yeast infections are also known to return after these anti-fungal treatments, because they treat these symptoms not the root cause. Brands like Monistat can be purchased at the drugstore for under $20. Store-brands and generic forms are also available for about half the cost.
Doctors will also prescribe oral anti-fungal medications to control yeast infections. The most common anti-fungal is Fluconazole, which is commonly sold under the brand names Diflucan, Trican, and Alfumet. Many women prefer this oral treatment because it doesn’t cause additional irritation to the vagina like topical treatments can. With generic drug programs this prescription medication can be purchased for under $10.
Brand Name Tips
Brands like Vagisil are constantly marketing their vaginal creams that provide “all day relief.” These medications contain topical pain killers, Lidocaine in the UK or Benzocaine in the US. These products don’t treat the infection, but they are helpful for reducing the symptoms temporarily. Users say the 20% Benzocaine is the most effective for numbing the vaginal area. Side-effects include burning and added irritation from the ingredients and fragrance. Vagisil is available at every grocery store and drugstore for about $6.
Natural and Homeopathic OTC Products
There are a host of natural and homeopathic treatments for yeast infections and bacterial vaginitis. These all natural products are aimed at rebalancing the vagina flora. Many of these products contain the healthy Lactobacillus bacteria along with herbal ingredients traditionally used to treat vaginal infections. Prices for these natural remedies are comparable to pharmaceutical over-the-counter treatments, usually $6-$24.
Natural products come in every form conceivable from gel creams to suppositories and oral tablets. YeastGard, AZO Yeast, Nature’s Cure, YeastAway by Boiron, and Hyland’s Vaginitis tablets are all available at most mainstream drugstores. Thursday Plantation has a line of tea tree oil-based suppositories and Yeast Arrest is another vaginal suppository, but it uses boric acid along with a number of antibacterial and anti-fungal botanicals.
Yeast Arrest is a harsh treatment intended for acute and chronic infections. The most common side-effect is burning. Yeast Arrest cures severe infections in 3-14 days.
Plain yogurt is one of the best home remedies for soothing irritation and restoring a healthy vaginal pH. Yogurt can be frozen in the fingers of rubbers gloves for a home remedy that soothes in two ways or a non-applicator tampon can be dipped and yogurt and inserted overnight for several consecutive nights.
Oils & Other Solutions
Coconut oil is a natural antibacterial used topically in India for centuries. Dip a non-applicator tampon is warmed coconut oil and insert overnight for 4 to 5 consecutive nights. Use all natural coconut oil intended for cooking.
Tea Tree Essential Oil is already approved to treat yeast infections in Italy. 10 drops can be added to a sitz bath or bucket to soak the pelvic area. Alternately, dip a non applicator tampon in olive oil or coconut oil (K-Y jelly is fine too) and apply one or two drops of tea tree oil, insert overnight for 4 to 5 consecutive nights.
Tea tree essential oil is available at health food stores about around $10 depending on the quantity. Check to make sure the oil is not diluted with alcohol. Tea tree oil is a power antibacterial use only a few drops at a time. The most common side effect of tea tree oil is burning.
Wash a diluted vinegar solution to restore the naturally acidic vaginal pH. Mix 1 tablespoon of vinegar with a quart of water. A squirt bottle, like the type used for dish liquid, works great.