Vaginal problems

Whatever their cause, vaginal problems can be very distressing, not only because ihey concern such an intimate pan of the body, bin also because they can be very painful and may interfere with sexual enjoyment. But these troubles are really quite common. About one woman in even’ two experiences some such disorder in the course of her life.

Vaginal secretions keep the vagina and womb (lean and free of germs the body secretes a protective mucus, so a certain amount of discharge from the vagina is absolutely normal. You have probably noticed how it varies in consistency and quantity during the course of the month, becoming heavier mid-way between your periods or just before one is due.

The discharge is quite bland- ii doesn’t smell unpleasant or itch – although ii leaves a slight stain on underwear. Hut if von have contracted an infection von may notice the first signs when the secretions change and perhaps give oil an offensive odour. Often this is accompanied b itchiness or tenderness.

Vaginal thrush

One of the most common infections of the vagina is caused by a tiny organism (ailed which often lives on die skin, quite harmlessly. Bui this tiny germ, related to the yeast familv, grows well in any warm, dim and moist area, so the vagina is particularly inviting. Once ii lakes hold here it quickly becomes a nuisance, causing intense irritation round the vagina and changing the normal mucus into a thick, white discharge which can be very profuse. Lithe infection is mild, there may be irritation with very little discharge, but ifii gets worse and is left untreated, the discharge takes on a curdlike consistency and yellower hue and the irritation can spread down the inside of the legs and even to the buttocks.

What causes thrush?

Thrush affects both men and women, and even children (since it lives happily in the mouth as well) and although it may appear quite spontaneously, it’s also sexually transmitted. So if vour partner has this infection, you may also get it, and if you don’t receive treatment you may keep re-infecting each other.

The environment inside the vagina is always attractive, but it becomes more so if the acidalkali balance of the secretions changes and become too alkali. This is why many women tend to develop thrush just before they menstruate, when they are on the Pill or during pregnancy. A prolonged course of antibiotics may also lav you open to this organism. This is because the antibiotics can affect the harmless bacteria in the vagina which form part of the body’s natural defences against infection:

The fact that men can carry the germ responsible for thrush is a fairly recent discovery. They often have no symptoms at all, but the infection may show itself as a slight irritation around the fore-skin or even a discharge. Men who have not been circumcized are much more vulnerable r-. to thrush.

Thrush may give you trouble just once, and never return, but often it recurs again and again. If you have it in a mild form, paying special attention to vaginal hygiene may be enough to banish it. A daily soak for 15 minutes in a bath containing a handful of cooking salt will help the irritation, while a coating of natural yogurt may prove very effective in getting rid of it altogether.

If the thrush doesn’t clear up within a couple of days, or if the discharge is very heavy, go and see your doctor. He will give you an internal examination, and may take a sample of the discharge from the inside of your vagina for laboratory testing.

Treatment consists of an antibiotic specially formulated to attack the thrush and it comes in the form of creams or ‘pessaries’. These are cone-shaped tablets which are inserted as high into the vagina as possible. It’s quite safe to push these up with your fingers, but often there’s a plastic inserter to help you position them correctly. If the infection is confined to an area round the opening of the vagina, the cream may be all that’s necessary. But often, both the cream and the pessaries are used together. The pessaries are usually put in at night but in some cases they may be prescribed for day-time use as well.

During the day ordinary sanitary pads will protect your clothes from any staining. The treatment can last for anything from two to 14 days, depending on the type of antibiotic.

Because thrush can be transmitted sexually from one partner to another, it’s important that both of you receive treatment, so that you’re not constandy passing the infection backwards and forwards between you; men should use the antibiotic cream on the penis. As long as you’re both receiving treatment, there’s no need to abandon sex at all, although you may find you are too sore to enjoy it for a couple of davs until the irritation dies down.

Vaginal trichomoniasis

Commonly known as ‘trich’ or ‘TV, the germ also causes an intense irritation in the area around the vagina, and you will notice that secretions then take on a rather unpleasant odour and a greenish tinge.

The infection is usually spread by sexual contact, but an old infection can sometimes become active again for no particular reason. This germ can actually survive outside the body for a short time, so it’s possible to pick it up by contact with infected articles, such as unwashed towels – but this is quite unusual. Although men are infected – and so pass it on – they seem to escape any symptoms.

Unless the proper treatment is given, the condition will not clear up, so doctors have to be careful to make an accurate diagnosis. If vour doctor has any doubts – and vaginal infections tend to share similar characteristics – he will take a sample ‘swab’ for testing in the laboratory. (Treatment is with tablets – usually of a drug called metronidazole – and it’s essential that both partners are treated at the same time to prevent re-infection. It’s best to avoid intercourse until the treatment is complete; usually about a week.

Cervical erosion

Sometimes a discharge that is heavier than usual can be a sign of cervical ‘erosion’. This is not nearly as alarmingas it sounds, and in fact the so-called erosion is quite harmless. It’s only the discharge which may be a nuisance, especially as you become more prone to infections.

What happens is that the normal smooth covering of the neck of the womb is replaced by roughened skin which ‘moves’ downwards from its normal position in the cervical canal. This roughened skin at neck of womb ‘Eroded cervix’ of cervix containing many glands rough skin of cervix ‘moves’ down to cover neck of womb skin secretes much more mucus than the smooth skin, so the discharge increases. The shift of skin covering may be completely spontaneous, but pregnancy or the Pill ean increase the tendency. [f infection does sei in, the discharge will take on a yellower hue, and mavgive off an unpleasant odour. You may notice _rSomc spotting or bleeding. Your doctor will prescribe any neces-sary creams or pessaries if an infection is present, but often the erosion rights itself of its own accord. However, if it’s severe or the infection doesn’t clear up, vour doctor may suggest surgical treatment. This consists of’freezing’ the area, so that the skin can shed its old lining and build a new one. The process is very straightforward, and may not even need a general anaesthetic.

Swellings in the vagina

Sometimes, ordinary skin conditions, such as eczema, can affect the vagina. :

There may also be infections which may cause little boils around the vaginal opening which are lender and painful. As a rule, they settle down without any specific treatment, but il they become rather large, you should visit your doctor for an examination.

Treatment

He will probably prescribe a course of antibiotic tablets, or, in extreme cases may recommend surgery, but this is unusual.

Occasionally, one of the glands on either side of the vagina called ‘Bartholin’s Glands’ becomes infected and swells up like a very large boil. A simple operation is all that’s necessary to put this right.

Treatment

Small painless lumps may be caused by warts. These are transmitted by a virus and you can catch them from a sexual partner. Unfortunately, they tend to spread very rapidly, and it’s wise to see a doctor fairly quickly. If there are only a few, he can treat them with special caustic ‘paint’ which has to be applied very carefully so as not to damage the surrounding skin. Thcy may need one or more sessions until they disappear. Larger warts may surgery in order to remove them.

Prolapse of the womb

A large painless swelling in the vagina may be due to a prolapse, when either the side of the vagina or the neck of the womb drops down into the vaginal entrance, see but this can be corrected by surgery.

Vaginal dryness

Many women find that vaginal dryness becomes a problem alter menopause, the reason being that the hormones which keep the vagina moist are no longer present in such high quantities once your periods stop. If there isn’t enough of the secretion to keep bacteria at bay, infection p- and an irritating discharge may lollow.

It’s well worth consulting the doctor, since the condition is easy to cure with the aid of creams or pessaries containing the hormone oestrogen.

If you find that vaginal dryness is a problem during intercourse, use an artificial lubricant to help, available from any pharmacist.

Bleeding from the vagina

Periods can vary enormously from one woman to another. Many women have them regularly even- four weeks, but some will have one every three weeks while others once every three months or so. As long as the periods are fairly regular, there is no need to worn. But irregular periods may be a sign ihai something is wrongan infection of the vagina or an inflammation in the womb or around the neck of the womb. Occasionally, it may indicate a growth (usually quite harmless).

The signs to watch for are: ? bleeding alter intercourse D bleeding or’spotting between periods p. ? bleeding after the menopause. Go to vour doctor if any one of these ‘-Zoccurs. He will take a smear test and give you an internal examination. Often the cause will turnout to be quite simple, but otherwise further tests in hospital maybe arranged.

Any bleeding from the vagina during pregnancy may be a sign of complications. In this case it is best to go straight to bed, and ring the doctor for advice rather than waiting for an appointment or walking long distances to the surgery.

Of course, spotting or breakthrough bleeding may occur ifyou are on the Pill. This is quite common and there is usually no cause for alarm, bin it is still worth checking with your doctor if it happens more than a couple of months running.

Internal tampons

Forgotten tampons are a common problem. If they are left in for more than a day or two, you may have a very unpleasant discharge.

Sec vour doctor as soon as possible, so that he can remove it, and it should quickly clear up. Ifyou leave it longer, a more serious infection may build up.

Vaginal problems in children

In small girls, the area round the vagina can easily become sore and inflamed, and this may be due to irritation from soaps used for washing, or to the fact that bacteria has been allowed to build up fxinstead of being washed away.

A cream prescribed by the doctor and simple attention to cleanliness should clear this up, although it can be very painful while it lasts.

If you notice any kind of discharge, alwavs see vour doctor. No child should have a discharge before puberty. It may be caused bvan infection, but sometimes by something in the vagina. Unfortunately small girls sometimes push beads or other little tovs into their vaginas, but a visit to the doctor should get this sorted out.

How to keep problems at bay

There’s no question that regularwashing with a mild soap helps keep infections at bay. But if you’re overenthusiastic, you may actually do more harm than good. There is no point in putting household antiseptics into bath water; they do nothing to stop infections. But they can cause soreness, and some people can be allergic to them. Bubble baths and vaginal deodorants should also be used with caution – especially if you are already prone to infections such as thrush. In the past, many women used douches – which squirt water into the vagina and ‘rinse’ it out- in the hope that this would help prevent infections. But this routine can actually be the cause of trouble, since it removes the vagina’s natural protective secretions.

If you suffer from recurrent thrush, following a few basic rules may help prevent it. ? Avoid tight-fitting jeans or trousers. Which don’t allow air to circulate. ? Always wear cotton underpants and use stockings or ‘one-leg’ tights instead of normal tights. Avoid nylon underpants. ? Wash twice a day using plain soap and water only. ? Do not use bubble baths, vaginal deodorants or perfumed tampons. ? If you develop itching around the vagina, take a daily salt bath or try a ‘coating’ of natural yoghurt around the area. If the itching doesn’t settle, see your doctor.

Sexually transmitted diseases (STD) are a group of infections passed on from one-person to another by sexual contact. This may be genital to genital, mouth to genital or or genital to anus. STD can also be transmitted by kissing, but this is rare.