Guest Author - Dr. Denise Howard
Genital discharge, odor and irritation are the “bane of the female existence”. It is by far, the most common reason for a gynecologic visit. The symptoms cause a great deal of annoyance, distress, discomfort and typically occur at an inconvenient time.
Most women worry that the symptoms indicate a serious problem or that their partner has been unfaithful. The irritation and discomfort can be distracting, taking complete priority over other concerns. The irresistible urge to scratch and embarrassing odor can create such distress that solving the problem becomes the primary objective of the day.
Unfortunately for most women, the Gynecologist doesn’t necessarily view it as an emergency or even an urgent problem, thus getting in to see a health care provider can be a challenge as well. This article will describe the common causes and how they are typically managed in hopes that it will bring some reassurance, guidance and relief to those who suffer from it.
The term describing the problem ends with "itis" which means inflammation of the birth canal and the cause can be infectious or noninfectious. In many cases the vulvar area is also involved. The symptoms are varied but usually include one or more of the following: an unusual discharge, itching, irritation, swelling, discomfort, pain, odor and pain with intercourse. These symptoms can be present in many types of processes including those transmitted infections, but the most likely cause is candida(yeast), bacterial or trichomoniasis.
A yeast infection occurs when the normal bacterial flora is disrupted, resulting in an overgrowth of a fungus called Candida. This is second most common cause of genital infections, present 17-39% of the time. The birth canal maintains a normal balance of organisms called the flora. Antibiotics can cause a disruption in this flora leading to an overgrowth of yeast. Other factors that contribute to this include moisture that occurs from sweating, douching or other medical problems such as diabetes.
Symptoms include severe vulvar itching, swelling, and a whitish discharge that sometimes look like cottage cheese. In some instances this infection resolves on its own. Treatment includes either oral or local antifungal therapy. Selective local antifungal agents are available over the counter. If purchasing one, know that there are different types of antifungal treatment and the regimens can be 1, 3 or 7 night treatment. Using the cream externally will temporally relieve the itching but an internal cream or suppository is required to treat the source of the infection.
Bacterial infections results when there is an overgrowth of specific bacterium. It is the culprit in the majority of cases, present 25-50% of the time. Again the normal flora’s balance has been disrupted. Coitus, douching and the use of contraceptive gels may increase this risk.
Symptoms include a copious, malodorous discharge which is sometimes worse after intercourse. The odor has been described as fishy. Treatment entails either a local or oral antibiotic which typically needs to be prescribed by a physician.
Trichomoniasis is the third most common cause of infections. This is caused when the protozoa, trichomonas, is transmitted during relationships. The symptoms include an abnormal discharge which is sometimes greenish or grayish in color, irritation, postcoital spotting and pain with urination.
Treatment consists of an oral antibiotic which can be given in a single dose. Partners must be treated otherwise reinfection will occur. In some cases this organism can reside in the genital tract without causing symptoms and can be found many years after initial infection.
It is important to remember that a discharge can be physiologic (normal) and the volume and appearance may vary depending on the time of the cycle, a woman’s age, and other factors. If however the discharge is accompanied by other symptoms such as odor, itching, pain or urinary symptoms then it is most likely due to an infection.
These infections can be annoying and irritating but they are not life threatening, although can cause problems during pregnancy. Since these infections can interfere with the quality of life, treatment is a must. These infections can also be recurrent and regimens exist to address this issue. If you develop recurrent infections or do not respond to the standard over the counter regimen, then you should see your Gynecologist for further testing and advice.
Future articles will focus on each infection individually, describing treatment options in greater detail and providing advice on prevention.
I hope this article has provided you with information that will help you make wise choices, so you may:
Live healthy, live well and live long!