by: John Laurusonis, MD
The female reproductive tract is a complex and intricate system. It must stay balanced in order to remain healthy. When the vaginal, ovarian, uterine, and hormonal aspects work to “factory standards” the female tract is a self sustaining, self cleaning, and self regulating milieu that demand nothing more from the patient other than general external hygiene. Internal cleaning, douching, talcum powders, creams and ointments can be detrimental to the balance and actually cause some of the problems that patients are trying to avoid.
I’ve written extensively about the menstrual cycle and problems during cycles in other publications and an in-depth discussion is beyond the scope of this article. Suffice it to say that the hormones that are controlled by the brain, secreted by the ovaries, and that act on the uterus and vagina all work together to keep the environment of the vagina amicable to the needs of the moment where as ovulation and possible fertilization dictates a certain set of pH, lubrication, and mucus consistency and menstruation a different set of variables. An interruption or defection of many of these processes can lead to internal or external pelvic irritation, infection, or worse.
This is a yeast infection in the vagina. Yeast are balls of fungi type material. It occurs commonly after taking antibiotics. It is common in patients with diabetes. Wearing cotton underwear instead of nylon underwear will make it less likely to occur because the fabric breathes and lets water out when you sweat. Symptoms include a thick white cottage cheese type discharge, which is very itchy. The vaginal area is dry and inflamed. During pelvic exam a test can be performed on the discharge to determine if it is yeast. The infection is either treated with Diflucan tablets or Monistat or Clotrimazole vaginal cream. Over the counter preparations can be used but if the yeast infection persists, a doctor should be consulted. A persistent yeast infection can be a sign of other disease and needs further investigation. Yeast infections are not considered sexually transmitted diseases but can be transmitted via partners during intercourse.
This discharge is caused by the trichomonas parasite. Symptoms include a yellow or clear bubbly vaginal discharge with a bad odor. Parasites are visible under the microscope when a specimen of the discharge is obtained. This is a sexually transmitted disease and both partners need to be treated at the same time before resuming intercourse. Trichomonas is found only in the discharge and does not usually cause infection in the uterus and tubes. Like a yeast infection above, trichomonas infection is not considered a true sexually transmitted infection however intercourse and transmission from partner to partner is the most common way this diseases is spread.
Bacterial vaginosis is caused by an overgrowth of Gardnerella and Mycoplasm or other bacteria in the vagina. Symptoms include a white vaginal discharge with a bad odor. This is usually not a sexually transmitted disease. The partner does not always need to be treated. If this occurs during pregnancy, it should be treated as it can cause irritability of the cervix and can cause problems during the pregnancy. Treatment with Flagyl tablets or Clindamycin vaginal cream is usually quite successful. BV can be seen when there is a shift in vaginal flora from the good Lactobacillus bacteria that help the vagina maintain a pH that is not favorable to other organisms which cause infections.
Medications, frequent baths, bad hygiene, and certain medical conditions can impact the general reproductive health of women. Most of these causes are not only treatable but preventable so see your Medical Doctor to discuss any issues you may have.