VAGINAL DISCHARGE

A vaginal infection may occur when there is a change in the normal balance of organisms in your vagina.

The most common types of vaginal infections are:

• Candida vulvovaginitis (yeast infections). This is due to the overgrowth of yeast in the vagina because of antibiotic use or other factors.  Discharge appear thick and white like a cottage cheese, and odorless.  Other symptoms include burning, soreness, and pain during urination or sexual intercourse.
• Bacterial infections (bacterial vaginosis). This is the imbalance of the growth of bacteria that are normally present in the vagina.  Discharge appear thin and grayish-white, accompanied by fishy smell.
• Parasitic infections (trichomoniasis). This sexually transmitted infection is caused by the parasite Trichomonas vaginalis.  Discharge appear frothy, yellow-green discharge with a strong smell.
• Chlamydial infections (chlamydia). This sexually transmitted disease is caused by Chlamydia trachomatis and may not manifest any symptom to women, but a vaginal discharge is apparent.

Common symptoms of vaginal infection include:

• Increase or change in the vaginal discharge, including gray, green, or yellow discharge.
• Vaginal redness, swelling, itching, or pain.
• Vaginal odor.
• Burning with urination.
• Pain or bleeding with sex.

DIAGNOSIS

After reviewing your symptoms and medical history, the health care practitioner will likely perform a pelvic examination, which includes examination of the external genital area and the insertion of a speculum to examine the vaginal walls and cervix.

Depending upon the examination, the health care practitioner may take swabs of the vaginal discharge for culture or for examination under a microscope to help define the cause of the vaginal discharge.

RECOMMENDED MEDICATIONS

Self-care at home

A vaginal infection may clear up without treatment in 2 or 3 days.

• If you could be pregnant, do a home pregnancy test. Any pregnant woman with abnormal vaginal symptoms should talk with her doctor about her symptoms before considering using any home treatment measures or nonprescription medicines.
• Avoid sex so that irritated vaginal tissues can heal.
• Do not scratch the vaginal area. Relieve itching with a cold water compress or cool baths. Warm baths may also relieve pain and itching.
• Make sure that the cause of your symptoms is not a forgotten tampon or other foreign object that needs to be removed.
• Wear loose-fitting, cotton clothing. Stay away from nylon and synthetics, because they hold heat and moisture close to the skin, which makes it easier for an infection to start. You may want to remove pajama bottoms or underwear when you sleep.
• Do not douche unless your doctor tells you to.
• If you have gone through menopause, try using a vaginal lubricant, such as Astroglide, to reduce irritation caused by having sex.
• Vaginal yeast infections
• If you have symptoms of a vaginal yeast infection and have been diagnosed and treated by your doctor for this condition in the past, you may want to try treating it at home using a nonprescription medicine, such as tioconazole (for example, Vagistat), clotrimazole (for example, Gyne-Lotrimin), or miconazole (for example, Monistat) to treat your symptoms.

If your symptoms do not improve with home treatment, contact your doctor. Vaginal symptoms that may be related to another type of vaginal infection or a cervical infection need to be evaluated.

Medications

Oral, injectable, and topical medications are used to treat the various causes of vaginal discharge.

• Trichomonas infection: A number of medications may be effective in the treatment of bacterial vaginosis, including metronidazole, tinidazole, and clindamycin
• Gonorrhea: Treated by an injection of ceftriaxone intramuscularly or by oral cefixime. Other antibiotics may also be used.
• Chlamydia: is typically treated by oral azithromycin or doxycycline
• Vaginal yeast infections can be treated by topical creams such as butoconazol, clotrimazole, miconazole, and terconazole. Nystatin is also available in vaginal tablet form. Oral medications such as fluconazole can also be used if necessary.