Vaginal Infections

An introduction to vaginal infections

Vaginitis (Vaginal Infections) is so common that nearly every woman will experience it at some point in their life. Vaginitis describes various types of infection or inflammation of the vagina, which can result in unpleasant discharge, itching and pain.  These conditions can happen when there is a change in the vaginal bacteria present in the body, or when there is an infection. Vaginitis can also occur because of organisms exchanged during sexual intercourse, vaginal dryness, skin disorders, and reduced oestrogen levels.

Symptoms

The symptoms for each vaginal infection can vary. Signs and symptoms can include:

  • Changes in colour, odour, or the amount of discharge from your vagina
  • Itching or irritation of the vagina
  • Pain during sexual intercourse
  • Soreness
  • Pain or burning feeling while urinating
  • Vaginal bleeding or spotting

You should seek medical attention from a gynaecologist if you develop severe or unusual vaginal discomfort.

Causes of various types of vaginitis

Vagina infections include:

Yeast infections
Candida albicans is a type of yeast that can be found in a healthy vagina, that normally lives in the vagina, as well as in the mouth and digestive tracts of both men and women. An infection occurs when there is a change in the woman’s system, which causes candida to overgrow and cause symptoms.

Bacterial vaginosis
This condition happens when there is a change in the normal bacteria found in the vagina. This often causes an abnormal smelling vaginal discharge. The discharge tends to have a “fishy” odour and it is usually thin and milky. This condition might be more obvious after sexual intercourse.

Trichomoniasis
This condition is caused by a tiny single-celled organism called the protozoa. When protozoa infects the vagina, it can cause a thick, greenish-yellow discharge and a foul odour. Women who experience this condition may complain of itching, soreness, and a burning sensation while urinating. The symptoms may worsen after their menstrual period.

Chlamydia or gonorrhoea
Both are sexually transmitted infections and can cause vaginitis symptoms. The correct and consistent use of a condom will decrease the risk of contracting such infections.

Viral vaginitis
This condition can be spread by sexual contact. Viruses such as the herpes simplex virus (HSV) and human papillomavirus (HPV) are common causes of viral vaginitis. HSV is often known as a herpes infection and is associated with painful lesions or sores that can be seen on the vulva of the vagina. HPV is associated with genital warts which can grow in the vagina, rectum, vulva or groin. At times, HPV can only be detected when a pap smear test is abnormal.

Non-infectious vaginitis
A woman may also experience vaginitis symptoms even without having an infection. This can be caused by an allergic reaction or irritation from products that cause irritation. The skin around the vagina may be sensitive to irritants such as scented sprays, soaps or detergents, and any oils. Even a change in vaginal lubricants or brand of condoms may trigger the symptoms.

Atrophic vaginitis
This type of vaginitis results from a decrease in hormones, such as during menopause. Low estrogen (the main female hormone) levels frequently lead to vaginal dryness and the vaginal epithelium (lining) to be thinner and more sensitive. A woman may experience uncomfortable itching and burning, increase urinary urgency, and pain during sexual intercourse.

Treatment

There are a plethora of different conditions and factors that can cause vaginitis. As each type of vaginitis is distinct and requires different forms of treatment and care, it is important to get a proper diagnosis from a professional before embarking on any form of treatment. When in doubt, do visit the gynaecologist and seek clarification. Our experts are readily available to help save you the trouble of buying the wrong type of medication and delaying proper treatment.

What questions should I ask my gynaecologist about vaginitis treatment?

Vaginitis is a common issue among women. You do not have to feel embarrassed or shy to ask the questions that you need to know. Some questions that you can consider asking include:

  • Will the medication prescribed for vaginitis interfere with other medications?
  • Should I avoid having sexual intercourse while undergoing treatment?
  • Should my sexual partner(s) also visit a doctor to seek treatment?
  • When would I know if I have made a full recovery?

Prevention tips

Follow these tips to maintain good hygiene to protect yourself from vaginitis or to relieve existing symptoms.

  • Wash your genital area every day with (not too much) mild soap, especially after sexual intercourse.
  • Maintain good hygiene. Wipe from the front to back after using the toilet and do not douche.
  • Don’t take very long, hot bubble baths.
  • Wear cotton underwear. Avoid garments that retain heat and moisture. Wearing tight garments or non-cotton garments can promote the growth of yeast.
  • Avoid using irritants that can cause irritation. These can include scented products such as pads and tampons, as well as harsh soaps.
  • Don’t use a vaginal douche unless your doctor recommends it.
  • Consider taking an over-the counter probiotic to prevent these symptoms; however if symptoms persist more than 5 days, you will need to consult a gynaecologist for advice and treatment.
  • Reducing sugars in your diet may help prevent recurrence of these symptoms specifically if you have diabetes mellitus.
  • Not sharing bath towels or bathrobes is an important hygiene practice.

Contributed by: Dr Sheila Loh Kia Ee, Obstetrician and Gynaecologist and Reproductive Medicine Specialist.

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