How to deal with common vaginal infections

Dear Doctor,
please enlighten us about fungal and bacterial vaginal infections that are all too common

Vaginal infections are pretty common. They occur on both the vagina and the vulval area, hence the medical descriptive term vulvo-vaginitis or vulvo-vaginal infections (VVIs). Women and girls of all ages can be affected. Yeast (or fungal) infection is the commonest cause of VVIs. About 75% of women will get a yeast infection at some point in their lifetime. Bacterial infections will affect a further 30% of women. A host of viruses and other parasites can also cause VVIs.

The vagina contains both ‘good’ and ‘bad’ bacteria. The good bacteria maintain an acidic environment that protects against multiplication of bad bacteria. Infections will occur spontaneously when the natural balance of vaginal bacteria is affected. This can be caused by many things that include decreased hormone levels, improper use of antibiotics and poor genital hygiene. External irritants like perfumed soaps, lotions and sprays can also predispose to inflammation and subsequent infections. And ofcourse there are also sexually transmitted infections that can be spread by infected sexual partners.

Common symptoms are irritation in the genital area, and an accompanying abnormal vaginal discharge. There may also be a feeling of intense itching and irritation while passing urine. The vulval area may also appear red with inflammation. Some infections may also cause small lesions on the vulva which may be painful.If you suspect that you may have a VVI, it’s best to get checked out and treated appropriately. Your symptoms will provide a clue as to the most likely cause of the infection. A thick white discharge, usually described like cuddled milk, with associated itching, is commonly the result of a yeast infection. There may be an accompanying odor, which may signify infections with specific organisms. Your doctor may do an examination, and take a sample of the discharge for laboratory testing. Additional tests are usually not required, unless there’s suspicion of other contributing factors. If a sexually transmitted infection is suspected, you will be advised on specific testing.

Treatment of VVIs is usually simple and straight forward. Yeast infections require anti-fungals, which can be given via various routes. If a bacterial infection is suspected or confirmed, an antibiotic will be required. Other infective organisms like viruses and parasites will have specific treatments. Some may have recurrent VVIs, and may be put on longer-term preventive medication. If a vulval irritant is identified, its discontinuation will usually lead to gradual resolution of symptoms.

You can take various steps to reduce your chances of getting a VVI. Wear loose cotton underwear that allows circulation of air, and limits trapping of moisture within the genital area. Avoid irritants like heavily scented and perfumed soaps, sprays, or even bubble baths. Most importantly, never douche. This just disturbs the delicate balance of vaginal bacteria and predisposes to more infections.

Dr Alfred Murage is a Consultant Gynecologist and Fertility Specialist. amurage@mygyno.co.ke