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Vaginal Infections (Vaginitis)

 

Common vaginal infections are among the most frequent disorders for which patients seek care from gynecologists, and comprise over 95% of lower female genital tract infections. These infections, encountered during the life time of women in some periods and disturbing the patients' quality of life, affect 75% of the woman world-wide.

What are the signs and symptoms of vaginal infections?

Most common symptoms of vaginal infections are as following:

  • Increase in vaginal discharge
  • Changes in colour and consistency
  • Unpleasant odour
  • Vaginal and vulvar itching, burning, irritation and discomfort
  • Pain on urination and pain during sexual intercourse

Unfortunately, although each of the most common vaginal infections has its own characteristic signs and symptoms, distinguishing one infection from another is often difficult for clinicians. Symptoms may be similar for different infections, and characteristic symptoms may be absent in some patients.

 

Types of vaginal infections

The most common causes of vaginitis are candidiasis, bacterial vaginosis, trichomonal vaginitis and vaginitis due to mixed pathogens.

Candidial vaginitis (fungal infection):
The most common pathogen is Candida albicans, which accounts for 80% of infections. The majority of the remaining 20% are due to Candida glabrata and Candida tropicalis. Typical symptoms are itching, thick (cottage-cheese) vaginal discharge and generalized genital irritation.

Bacterial vaginosis:
Bacterial vaginosis is a complex, polymicrobial infection characterized by an overgrowth of anaerobic microorganisms. Gardnerella vaginalis is one of the key pathogens in bacterial vaginosis, but other anaerobic bacteria, as well as genital mycoplasmas, also contribute. Most patients with symptomatic bacterial vaginosis have discharge (white-grey) and foul odour.

Trichomonal vaginitis:
The infection is caused by a protozoan called Trichomonas vaginalis. This is a sexually transmitted disease and its most important symptoms are yellow-green, profuse purulent discharge and unpleasant odour.

Mixed infections:
Approximately 30% of patients with common vaginitis may have mixed vaginal flora; e.g. vaginal candidiasis may be accompanied by bacterial vaginosis, or trichomonal vaginitis.

Risk factors for vaginal infections:

  1. Pregnancy
  2. Diabetes mellitus
  3. Use of broad-spectrum antibiotics, corticosteroids
  4. Use of an intrauterine device
  5. Tight-fitting clothing (e.g. synthetic panty hose, jeans)
  6. Metabolic diseases
  7. Sexual activity (particularly involving multiple sexual partners)
  8. Inappropriate hygiene

 

Prevention measures:

  1. Proper hygiene. Avoid long term use of sanitary protection especially vaginal tampons
  2. Avoid wearing tight-fitting, synthetic underwear
  3. Use condoms during sexual intercourse
  4. Avoid excessive vaginal douching

 

Treatment recommendations:
Consulting a physician as soon as possible without ignoring complaints associated with vaginal infections is very important.
Cure of vaginal infections are related to the drug used as well as to compliance. To discontinue the drug before completing the treatment will decrease the compliance, reduce the success rate and may lead to re-infection and increased treatment cost.
Therefore, follow your physician's instructions and apply strictly the treatment recommended.