|Itchiness, soreness and
a vaginal discharge can be signs of infection. However, it is
quite normal and healthy for women of childbearing age to have
a vaginal discharge. The quantity and colour of this can change
during the menstrual cycle, sexual excitement and pregnancy. An
abnormal discharge which is thick and white, green and foul-smelling,
or blood stained suggests possible infection.
|Causes of infection
|Thrush, bacterial vaginosis,
trichomoniasis, chlamydia and gonorrhoea are the most common causes
of vaginal infection. Other infections include genital herpes
and genital warts. Each of these is described below.
A foreign body, such as a forgotten tampon, can also promote infection
and cause an offensive discharge.
In addition to a discharge, itchiness and soreness, other warning
signs of an infection include:
- a fishy smell
- painful intercourse
- abdominal pains
- redness, swelling, lumps, blisters, sore spots
or ulceration of the vulva (the skin around the outside of
the vagina) or anus
- pain when passing urine
|So that a doctor can diagnose
a vaginal infection, he or she may need to examine the outer genital
skin and the inner vaginal lining. An instrument called a speculum,
the same as used for a smear test, is sometimes used. A sample
of discharge may be taken using a swab, which looks like a long
cotton bud. This is sent to a laboratory for analysis.
Almost all women have the fungus Candida albicans growing harmlessly
on and in their bodies. However, when it grows excessively, it
causes thrush (vaginal candidiasis). Irritation and soreness of
the vulva are the usual symptoms, sometimes but not always, accompanied
by a thick, white vaginal discharge. If left untreated, the irritation
can spread to the area between the buttocks. Passing urine and
intercourse can be painful.
Pregnancy, menstruation, diabetes, wearing tight underwear and
antibiotics are all possible triggers of an attack of thrush.
Most thrush infections respond to one of the antifungal treatments
such as clotrimazole creams and pessaries (eg Canestan), or fluconazole
(Diflucan) tablets, that are available from your doctor. You may
also ask your pharmacist for advice. Many women find that applying
plain yoghurt to the area helps relieve symptoms.
If the treatment doesn't work or the symptoms return, see your
doctor. Antifungal drugs or a longer course of fluconazole tablets
may be prescribed. There's no good evidence that treating a woman's
partner helps, unless he has a rash or soreness of the penis.
Wearing cotton pants, changed daily, and avoiding harsh soaps,
bubble baths and deodorants may help prevent thrush. Vaginal douches
are not recommended to treat or prevent vaginal infections, including
thrush, as they disturb the natural, and protective, acidity of
Bacterial vaginosis (BV) is the commonest cause of vaginal discharge
in women of childbearing age. It causes a fishy smell and occasionally
vaginal itching and burning. BV symptoms can clear up without
treatment before recurring. But, left untreated, the infection
can cause miscarriages, premature labour and pelvic inflammatory
Bacterial vaginosis is caused when the bacteria normally found
in the vagina (Lactobacillus) are overgrown by others (eg Gardnerella
vaginalis), which are normally found in smaller numbers. Any woman
with a fishy smelling discharge should seek medical advice, as
the effective treatments -- antibiotics in cream, gel or tablet
form - are only available on prescription. This treatment is fairly
effective in stopping the symptoms, but the condition often returns.
It is not clear how BV is related to sexual activity, although
there may be a link with having a new sexual partner and a high
lifetime number of sexual partners. The contraceptive coil seems
to increase the risk of BV.
The characteristic symptom of trichomonas infection is a heavy,
frothy, yellow-green, unpleasant-smelling discharge. It can also
cause discomfort during sex, vaginal itching, pain when passing
urine and occasionally stomach pains. Research has linked trichomonas
infection with infertility, increased risk of transmission of
HIV, premature labour, and low-birth-weight babies.
It is caused by a protozoan (a form of parasite) called Trichomonas
vaginalis that is transmitted during sex. The treatment is with
the antibiotic metronidazole, available only on prescription.
Trichomoniasis may cause no symptoms in men, so male partners
should also be treated.
Chlamydia can cause pain when passing urine, long-term pelvic
pain and infertility. However, it may produce no symptoms in women.
It's also been associated with low birth weight babies and premature
delivery. Infected male partners often complain of painful urination
Chlamydia is caused by the sexually transmitted bacterium Chlamydia
Treatment is usually with the antibiotics doxycycline, erythromycin
The main symptoms are vaginal discharge and pain passing urine,
but there may be no symptoms in the early stages. Untreated, gonorrhoea
can lead to pelvic infection, with abdominal pain, painful sex,
and a general feeling of being unwell. Damage to the Fallopian
tubes can result in reduced fertility and an increased risk of
ectopic pregnancy (pregnancy in the tube rather than the womb).
The bacterium responsible is called Neisseria gonorrhoeae. Penicillin
used to be the standard treatment, but as resistance is now a
problem newer antibiotics are often used.
Herpes infection can cause spots on the labia, clitoris and pubic
area. These look like blisters, ulcers, or chapped areas. People
often have flu-like symptoms, fever and pain passing urine for
about a week when first infected.
A pregnant women can transmit the infection to her baby during
delivery. Severe damage to the baby's nervous system can result.
The infection is caused by the herpes simplex virus being passed
during sex. The virus lies dormant in the body and it's common
to get repeated attacks. These are generally milder than the first
attack. Sometimes a burning or tingling feeling is felt beforehand.
There's no cure for herpes, but antiviral drugs (such as aciclovir
tablets) can help to shorten the first attack, and reduce the
severity of further episodes. Some people find salt baths, ice
packs and painkillers helpful. Frequent severe attacks may require
regular antiviral treatment for up to a year.
The virus is most infectious during an attack, so avoiding sexual
activity at this time lessens the chance of passing it to others.
These appear as small round lumps on or around the genitals. They're
caused by the human papilloma virus (HPV), which is passed by
skin-to-skin contact. Exposure to HPV increases the risk of developing
Although there's no cure for the virus, a variety of treatments
are available to remove individual warts, including creams, application
of liquid nitrogen, and laser surgery. Removing the warts as they
arise does reduce the chance of passing on the infection.
|Chlamydia, gonorrhoea, herpes
and trichomoniasis are sexually transmitted diseases (STDs) that
can cause vaginal symptoms. However some STDs do not cause symptoms.
As a condom provides good protection against many STDs, one should
always be used unless both partners are entirely sure that they
have not been exposed to infection.
If you suspect you have an STD, or other genital or urinary infection,
see your doctor.
|The Family Planning Association
Brook (info and services for under-25s)
National Women's Health Information Center
National Vaginitis Association
|Healthwise (Health Information Resource
Tel : (852) 2849 2400
Fax : (852) 2849 2900
Email : firstname.lastname@example.org
Homepage : http://www.healthwise.org.hk/
This leaflet is for information only. For a detailed
opinion or personal advice, please consult with your own