Woman Genital Helath (2)
Common genital problems
A variety of bacteria, yeasts and other micro-organisms occur naturally in the vagina. Specific bacteria (lactobacilli) normally keep the vagina slightly acidic, keeping the growth
of other bacteria under control.
The vaginal balance can be upset by external factors. This can lead to a change in the balance of the natural bacteria in the vagina, causing problems. Some women are more prone than others to disturbance of the vaginal environment.
A course of antibiotics may reduce the numbers of bacteria that the vagina needs to keep
its normal acidic balance. Stress, illness and hormone changes can also alter the vaginal environment.
Signs of a vaginal problem may be:
• itching, irritation or soreness around the vaginal opening
• a burning sensation when urinating
• increased or unusual discharge
• swelling of the labia
• abnormal bleeding
• uncomfortable or painful sex
• an unpleasant odour
If you are experiencing any of the above problems, see a doctor or FPWA clinician.
Genital itch is a common problem among women. Many assume that any genital itch is due to thrush (see below for more information), but there are other conditions that can cause itching and soreness, such as eczema (dermatitis).
If you are experiencing persistent genital itch, it is important to see a doctor or FPWA clinician to get an accurate diagnosis, so that you can be given the right treatment.
Vulval pain is a problem for many women, and can be caused by both physical and psychological factors. It can make inserting tampons or having sex difficult or impossible. Some women find the area too painful to even touch.
Some vulval problems have noticeable signs, such as a growth, sore or rash on the vulva. These can often indicate an infection or skin condition such as eczema or dermatitis, and need to be checked by a doctor.
Some women experiencing vulval pain have no other physical symptoms but experience pain some or all of the time, in particular when urinating or sitting for long periods.Because of the lack of other symptoms, these problems can be difficult to diagnose. Physical therapy is often used to treat vulval pain, but avoiding intercourse, wearing loose clothing and using cold packs can help. Your doctor may prescribe antidepressants or anti-epileptic medication to reduce the pain, or a special cream to apply to the area. Counselling or therapy may be beneficial if the pain is due to psychological causes.
Although not usually an indication of a serious condition, if you are experiencing recurring vulval pain it is important to see a doctor – don’t try and treat the problem yourself. Occasionally however, pain can be related to conditions such as cancer.
Infection can be avoided by:
• wiping from front to back when using toilet paper
• being particularly careful with hygiene if you have a bowel upset e.g. washing rather than wiping
• eating a healthy, well balanced diet
• not douching (flushing liquids into the vagina)
Common vaginal infections
This infection is also called monilia or candida. The organism is a yeast which is commonly found in the body without causing any problems. At times a woman may notice symptoms, particularly during pregnancy, or when she is on antibiotics or some other medication. Women who are diabetic or who have other illnesses may have recurring problems with thrush.
Common symptoms of thrush can include itchiness, burning, soreness, a thick white or yellow discharge, discomfort during intercourse and pain when urinating. Sometimes men may also notice irritation and redness of the penis after sex if their partner has thrush, but it is not considered to be a sexually transmissible infection (STI).
Thrush is diagnosed by examination and confirmed by taking swabs.
It may also be detected on a routine Pap smear.
Thrush does not have to be treated if it is not bothering you. Some women find their symptoms can be relieved by sitting in a warm salty bath or by using cold compresses.
If you are certain that thrush is the cause of your symptoms, antifungal vaginal creams and pessaries are available over the counter at pharmacies. If you are finding that thrush is a frequent problem it is advisable to visit your doctor or the FPWA clinic. Your doctor will examine you to confirm that thrush is the cause of your symptoms and may prescribe other treatments such as oral antifungal tablets. The doctor may take this opportunity to rule out the possibility of STIs, which can also cause irritation.
Putting yogurt on an irritated vulva will not get rid of the infection.
This is a common condition in women and is caused by an overgrowth
of bacteria that normally live in the bowel but may be found in the vagina. The organisms often multiply in the vagina when the acid level falls.
Bacterial vaginosis may cause a white to grey discharge with an unpleasant ‘fish‘ or stale odour. Vulval irritation can occur and sex may be uncomfortable. Bacterial vaginosis is diagnosed by an examination testing the acidity of the vaginal fluid, and confirmed by swabs.
Bacterial vaginosis does not have to be treated if it is not bothering you.
If it is a problem your doctor may prescribe antibiotics in the form of tablets or vaginal cream. The FPWA clinic or your doctor may also recommend treatment if you are planning to have an intrauterine contraceptive device fitted or any gynaecological operation.
It is a good idea to talk to your partner if you have a vaginal infection or are experiencing vulval pain, even though it can be embarrassing. They may find it helpful to read this pamphlet. It is generally better to avoid sexual intercourse if you have an infection, particularly if you have pain or discomfort, to prevent ongoing problems.
Ways of coping
Vaginal infections and vulval pain are very common, but can be a real problem for some women. If you are feeling distressed, it is important to talk to your doctor, nurse or a counsellor for further information and support. If you are experiencing pain, relaxation and stress management techniques may be of help.