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May 16, 2008  
EDUCATION CENTER: Diagnosis and Treatment

Clinical Overview
Definition
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  • Vaginitis

    Diagnosis and Treatment
    Yeast infections of the vagina are what most women think of when they hear the term "vaginitis." They are caused by one of the many species of fungus called Candida. Candida normally live in small numbers in the vagina as well as in the mouth and digestive tract of both men and women.

    Yeast infections produce a thick, white vaginal discharge with the consistency of cottage cheese. Although the discharge can be somewhat watery, it is odorless. Yeast infections usually cause the vagina and the vulva to be very itchy and red.

    Since yeast is normal in a women's vagina, what makes it cause an infection? Usually this happens when a change in the delicate balance in a woman's system occurs. For example, a woman may take an antibiotic to treat a urinary tract infection and the antibiotic kills her "friendly" bacteria that normally keep the yeast in balance; as a result the yeast overgrows and causes the infection. Other factors which can upset the delicate balance include pregnancy which changes hormone levels and diabetes which allows too much sugar in the urine and vagina.

    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 (Acquired Immune Deficiency Syndrome).

    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.

    Last updated: 28-Feb-07

       
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