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Vaginal Infections

Ewwww, right?

We don’t often talk about vaginal infections but I wish we would because then maybe women wouldn’t feel so bad about them. Vaginal infections can cause significant discomfort and embarrassment, but they are also super common, easily treatable and are not necessarily related to sexual activity.

We all have a certain amount of yeast and good bacteria in our vaginas and they live happily in balance together at a very specific pH (aciditiy). Factors that disrupt that happy ecosystem by affecting the pH or the number of good bacteria present create an environment where infection can thrive. Conveniently, your vagina is self cleaning, so it is not necessary clean inside the vagina. If you must, there are vaginal washes that are matched to the pH of your vagina available from the pharmacy but you can just leave it be.

Below, I cover the two most common vaginal infections: Bacterial vaginosis and thrush.

Thrush

Thrush (or candida) is a yeast infection of the vagina caused by an overgrowth of the yeast that resides there. It is similar to teenagers throwing a rave party when their parents leave town. Thrush is extremely common, 3 out of 4 women will know the joys of thrush and be able to sympathise.

You are more likely to get thrush if you have recently been taking antibiotics, this is because the antibiotics can also kill the natural good bacteria in your vagina allowing the yeast to grow out of control. Thrush is also more common if you have diabetes or conditions that weaken the immune system. Tight clothing can also contribute as they trap moisture which facilitates the growth of infection. Cleaning inside your vagina with soaps or using baby wipes can change the acidity in your vagina and upset the balance of bacteria and yeast that live there.

Thrush symptoms include a sore and itchy vulva, thick whitish discharge (often described as cottage cheese, which has resulted in me never eating cottage cheese), a burning sensation when passing urine and a dry/sore vagina during sex.

Thrush is NOT sexually transmitted (you cannot give it to or get it from your partner) and is NOT a sign of poor hygiene; as such you do not need to avoid having sex.

Thrush is diagnosed by taking a swab from the vagina that is tested in a lab. Usually your GP will also use these swabs to run tests for bacterial vaginosis, Chlamydia and gonorrhoea as they can cause similar symptoms.

Treatment for thrush is simple and involves anti-fungal medication in the form of cream that you insert into your vagina. You do not need a script for this treatment, however, it is still advisable to see a doctor to make sure that your symptoms are due to thrush and not bacterial vaginosis, Chlamydia or gonorrhoea which have different treatments. Chronic thrush infections are uncommon but require different treatment.

Your GP will be able to discuss a treatment plan with you.

Bacterial Vaginosis

Bacterial vaginosis (fondly shortened to BV) is irritation of the vagina due to an overgrowth of the normal bacteria in your vagina. BV is extremely common, it is estimated that 30% of women have bacterial vaginosis at any one time. So think of you and two of your girl friends….one of you probably has BV.

BV symptoms include a sore and itchy vulva, greyish discharge that has a fishy smell (rotten fish smell, not delicious sushi fish smell), and a burning sensation when passing urine.

BV is NOT sexually transmitted this means you CANNOT give it to or get it from your partner; however your own risk of developing BV is related to sexual activity though exactly why is not understood. It is more likely in women who are sexually active, have sex with other women, have a new partner or have sex without a condom.

Cleaning inside your vagina with soaps or using baby wipes can also cause BV as it can change the acidity in your vagina and upset the balance of bacteria that live there.

BV is diagnosed by taking a swab from the vagina that is tested in a lab. Usually your GP will also use these swabs to run tests for thrush, Chlamydia and gonorrhoea as they can cause similar symptoms.

BV is effectively treated with antibiotics in the form of a tablet or cream. Usually treatment only takes a week, rarely infection will persist and treatment may be up to 6 months.

Dr HT