Love Thyself: Summer Health - Vaginitis & Yeast Infections 

 

by  Andrea N. Price, M.D.   

(c) Copyright, 2001, Dr. Andrea N. Price

Well sisters, summer is upon us.  The time has come for cookouts, swimming, jazz in the park, hot summer nights and …VAGINITIS!  One hour too many spent in a wet swimsuit or sweaty work out clothing, and you'll soon find yourself frantically searching for a drugstore open after midnight.   Even worse (from my perspective anyway), you'll page your OB/GYN, awakening him or her from a peaceful slumber around 2:00 A.M.  You tell the answering service, "No it's not a life or death emergency", but the intense itching and burning in your nether regions sure feels like an emergency.   

Things your mother never told you

 There are several types of vaginitis and each has it's own specific causes and treatments.  But before we get into that, here are some things that your mother never told you.  In general, a healthy vagina is slightly acidic, with a small to moderate amount of discharge which may range in color from clear to white, and in consistency from very thin to very thick and tenacious.  The color and consistency of your discharge is dependant on hormone levels and where your are in your monthly cycle.  A normal vagina does have a distinct smell, however there should not be an unpleasant odor.   Normally, many different types of bacteria (in very small quantities), as well as yeast (candida) can be present in the vagina.    The predominant bacteria that is critical to vaginal health is called "lactobacillus".  This "good" bacteria along with acidity, keep harmful bacteria and yeast from multiplying.  When vaginitis is present, the vagina loses it's acidity and the number of lactobacillus decreases.  This gives the yeast and/or "bad" bacteria opportunity to grow, ultimately leading to odor, discharge and vaginal irritation.  Your doctor can diagnose vaginitis by obtaining a sample of your vaginal discharge called a "wet mount".  She then checks the acidity of the discharge, tests for a characteristic odor, and examines it under a microscope looking for yeast, bacteria, inflammation etc. 

Three Primary Types of Vaginitis:

q       Yeast Infection (vaginal candidiasis)

Causes:  Frequently seen following antibiotic or steroid treatment and in diabetics.  More common following menses. 

Symptoms:  A white cottage cheese like discharge, itching of the vulva and vagina may be quite intense. Generally no unpleasant odor is present. 

Treatment:  Vaginal creams and suppositories. These are available over the counter or by prescription as one day, three day or seven day treatments.  There is also a one dose tablet available obtainable by prescription.  You can treat yourself if you have been previously diagnosed by a doctor for yeast and recognize the symptoms.  However, if you have never had a yeast infection before, or are uncertain, then always contact your physician.  Also consult your doctor if the over the counter medication doesn't cure your symptoms or you experience recurrent yeast infections.  It may not be yeast!

q       Bacterial Vaginosis

Causes:  Decreased lactobacillus "good bacteria" and increased "bad bacteria" and decreased vaginal acidity.  This infection may also be sexually transmitted and is quite common after intercourse with a new sexual partner whose bacteria differ from your own.

Symptoms:  Thin grey/white vaginal discharge, a fishy odor that is more detectable after intercourse, and/or vaginal irritation. This infection is often asymptomatic (sometimes no recognizable symptoms).

Treatment:  Antibiotic vaginal cream called Metrogel or Cleocin , or an oral antibiotic metronidazole (Flagyl). Generally it is not necessary to treat partners.

q       Trichomonas (trich)

Causes:  A sexually transmitted infection caused by a small organism that swims and multiplies in the vagina.

                Symptoms:  Yellow/green frothy vaginal discharge accompanied by vaginal odor and irritation.

Treatment:  Oral antibiotic metronidazloe (Flagyl). It is crucial that your partner is also treated, and that you abstain from intercourse until both partners have completed treatment, otherwise you will be re-infected.  There after always wear condoms.

Let's debunk two popularly held myths in women's circles:

Myth #1 - "It" Should Smell Like Flowers

 Somehow, somewhere, many of us have picked up the mistaken belief that we should smell like a flower garden "down there".  Never mind those ridiculous fish jokes. We are needlessly supporting an entire industry of douches, vaginal washes, deodorant tampons and suppositories all predicated on the myth that a woman's natural odor is unpleasant.  Is a man expected to smell like flowers around his groin at all times?  Many of my married patients will testify to the contrary.  Humor aside, the truth is, most of  these feminine hygiene products actually cause odor by upsetting the vagina's natural pH balance which encourages bacterial growth.  They are equally notorious for causing allergic type reactions, vaginal irritation and itching. "It" should smell like YOU.  If odor is an issue, you need to see your gynecologist as you may have an infection.  Ignore those magazine ads and television commercials promoting paranoia about your natural scent, and save your money for that new pair of strappy sandals you have been wanting.

Myth #2 - Always Douche After Your Period or After Intercourse

Yes, I know you grew up hearing this, but routine douching is completely unnecessary and in fact can again, promote odor and bacterial growth.   The vagina secretes its own fluid and does a much better job of cleansing itself after your menstrual period or intercourse than any douche ever could.  If you insist on douching, limit it to once a month and use plain vinegar and water.    

Prevention

Maintaining a healthy vaginal environment is a relatively simple matter. Keep yourself clean and dry as much as possible.  Wash with a mild antibacterial soap like Dial or Lever 2000, especially after an intense workout.   Avoid staying in wet swimsuits and damp workout clothes too long.  Wear breathable cotton underwear (preferably white) and pantyhose with cotton crotches. Don't be a slave to fashion trends and only wear those super tight jeans, daisy dukes or capri stretch pants occasionally.  Finally, if your mother told you as a little girl, not to sleep with underwear on at night, she was right - ventilation is your friend. [smile]  It goes without saying, if any of these symptoms do not respond to treatment, you may have a more serious STD such as chlamydia or gonorrhea.   As always, consult your physician.

Enjoy the fun and comfort of the summer months.  Be safe, be happy, be blessed and love thyself!

 

Andrea N. Price M.D.,  F.A.C.O.G.

andi@womenofcolorobgyn.com

www.WomenOfColorOBGYN.com