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Vaginal infections (also called vaginitis) are an issue affecting many women at some point in their lives. This bothersome ailment, while not life-threatening, has many undesirable symptoms that can leave women frustrated, embarrassed and uncomfortable.

There are several types of vaginitis, but the two most common are bacterial vaginosis (or BV) and yeast infections.

Bacterial vaginosis infections occur when too much of a particular type of bacteria disrupts the balance in the vagina. All vaginas have some levels of bacteria in them. BV is the result of those levels becoming unbalanced. It is the most common vaginal infection for women aged 15-44.

Bacterial vaginosis typically presents with thin, whitish, fishy-smelling discharge, especially after sexual activity. Some people feel little to no itching while others have burning and discomfort.

A yeast infection is an overgrowth of a naturally occurring fungus, Candida, in vaginas. All vaginas have a small number of yeast cells, but when the number of these cells grows too high, it can cause an uncomfortable infection. Yeast infections often present with odorless, cottage cheese-like discharge accompanied with itchiness, redness, and sometimes burning.

The treatments for both bacterial vaginosis and yeast infections are quite easy and effective, but only if they are used for the correct infection. That is why it important to see a doctor to determine which kind of infection it is or whether both are present. The sooner a woman has a diagnosis, the sooner she can begin treatment.

Bacterial vaginosis is typically treated with metronidazole either orally or vaginally. Both of these treatments have a 70-80 percent rate of effectiveness. Clindamycin can be an alternative treatment, as well. Unfortunately, more than 50 percent of women will have a recurrence within the next 12 months. They may need to be treated again or put on a medication that suppresses the infection.

Uncomplicated yeast infections can be treated either orally or vaginally with antifungal medications. Many vaginal treatments are available over the counter, while oral treatments and some vaginal creams are prescription only. While both are equally effective (at 80-90 percent), the oral version tends to be less messy but may take slightly more time to alleviate the symptoms. Also, the vaginal treatment has fewer potential side effects and interactions with other medications.

If a woman has repetitive bouts of BV or yeast infections, there may be alternative treatments to consider, such as vaginally inserted boric acid (can be lethal if ingested orally) and Gentian Violet dye applied vaginally by a provider. There are also recurrent protocols of prescription medications used for both infections that treat patients over a longer period of time. Doctors can help guide patients through these options.

The best way to deal with occurrences of vaginitis is to try to prevent them in the first place. Here are a few easy ways to do that:

  • Use soaps and detergents without fragrances. Sometimes vaginas have reactions to chemicals that make up those scents.
  • Use condoms during sexual activity. However, be careful with spermicides because some can cause irritation.
  • Avoid tight, non-breathable clothing.
  • Wear cotton (not nylon) underwear. When wearing pantyhose, choose the kind with the cotton panel.
  • Do not douche. This can upset the balance of good and bad bacteria in the vagina.
  • Avoid scented pads and tampons.
  • Practice good hygiene – be sure to clean the inside folds of the vagina where yeast grows and then dry well.
  • Women who have recurrent bouts of vaginitis may consider taking probiotics, although research studies have not proven this effective. While some organic yogurts with live cultures have probiotics, the pill version taken orally or inserted vaginally probably is more effective. Look for Acidophilus, which is the most common species of good bacteria and can help offset the overgrowth of bad bacteria in the vagina.

Women do not need to suffer with vaginitis. A visit to the doctor can diagnose the problem and effectively treat the infection so women can go back to enjoying a healthy mind, body and spirit.

Dr. Jennifer Shinners is an obstetrician/gynecologist at Coastal Women’s Healthcare in Scarborough. She can be reached at 885-8400 or at jshinners@coastalwomenshc.com.

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