Expert corner

04.11.2019

Vaginal infection: What to do when bacterial vaginosis or yeast infection occur

 

There is certainly no woman who has not experienced vaginal infection at least once in a lifetime. The term Vaginal infection presents a wide range of various infections of the vagina and surrounding structures. Unfortunately, due to a wrong self-diagnosis and inadequate treatment, it often persists uncured with the disease recurrence.

Vaginal flora is the term for vaginal microflora which includes approximately 50 types of microorganisms, so-called good bacteria, mostly from the Lactobacillaceae family, secreting lactic acid and hydrogen peroxide, preventing thus the growth of pathogenic bacteria and excessive growth of fungi. The natural pH value of the Vagina is from 3.8 to 4.2.

Various factors can cause vaginal microflora imbalance and vaginal infection occurrence, including: 

 

  • drug application, eg. antimicrobial and contraceptive drugs
  • hormonal changes such as ovulation, menopause, pregnancy
  • Weakened immune system
  • some diseases such as diabetes
  • frequent use of inadequate products for intimate area hygiene
  • wearing tight underwear made of synthetic, non-absorbable material
  • use of daily panty liners on a daily basis 
  • frequent changing of sexual partners 

 

 

Symptoms of vaginal infections generally include excessive discharge of changed color (whitish, greenish or cheese-like), unpleasant odor, itching, burning and vaginal discomfort, burning during urination, pain and cramps in the lower part of the abdomen and pain during sexual intercourse.

The most common vaginal infections according to infectious agents :

  • bacterial infections (Gardnerella vaginalis)
  • yeast infections (Candida albicans)
  • parasitic infections (Trichomonas vaginalis)
  • viral infections (HPV, genital herpes)

Difference between fungal and bacterial infection

Symptoms of vaginal infections can sometimes be similar, but the treatment depends on the infectious agent. The problem appears because fungal and bacterial infection can sometimes occur simultaneously and symptoms of bacterial infection can even be completely absent. 

The both infections cause changed vaginal discharge, but the appearance is different. Yeast infections cause characteristic thick, whitish, cheese-like discharge of mild odor, while bacterial infections cause characteristic rare, watery, white or grayish discharge of characteristic fishy odor.

Unlike bacterial infection, yeast infection causes intense itching and irritation and vulvar skin is pink or red.

The difference lies in vaginal pH value as well, because bacterial infection causes alkalinity, where yeast infection causes unchanged vaginal pH value.

 

What is yeast infection?

Yeast infections as mostly caused by Candida albicans fungus, which is a normal inhabitant of the vagina and does not cause discomforts when present in a smaller number, that is if the vagina has normally balanced flora with dominant good bacteria and normal, acidic vaginal pH value.  

 

Symptoms of yeast infections

Vaginal itching is a dominant symptom occurring along with burning, sensitivity, irritation. Pain can also occur during urination or sexual intercourse. The vagina and vulva are usually swollen and red, but bruises and lacerations can occur as well. Characteristic whitish, cheese-like discharge without odor is usually present.

 

How is the yeast infection to be treated? 

Fungal vaginal infection is diagnosed by gynecologist examination, vaginal pH measurement and microscopic verification of infectious agent. Drug of choice and duration of therapy depend on whether yeast infection is simple or complicated. Complicated yeast infections are those with pronounced symptoms (excessive redness, swelling and itching which can lead to ulcer or laceration development), caused by other types of Candida (except for albicans), which occur in patients with uncontrolled diabetes or during pregnancy.

Treatment includes:

  • Antifungal creams and vaginal suppositories (clotrimazole, miconazole, nystatin). Some of these products may be purchased without a prescription.  
  • Oral antifungal medications (fluconazole) usually applied as a single dose. These medications are to be prescribed by a physician. 

 

What is bacteria vaginosis?

Bacterial vaginosis is an inflammation of the vagina characterized by disturbed vaginal flora that is, increased growth of harmful bacteria. There is no clearly defined infectious agent, but it is usually caused by Gardnerella vaginalis.

It is not considered a traditional sexually transmitted disease, but it has been noticed that it usually occurs in sexually active women, especially in women having several sexual partners or those who have a new partner, although it may occur in young women who have not been sexually active as well. 

 

Symptoms of bacterial vaginosis

Women with bacterial vaginosis often do not experience pronounced symptoms, so they are not aware of having an inflammation. For that reason, it is very important to undergo regular gynecologist examinations. 

In case of certain symptoms, white and grayish watery homogenous vaginal discharge of unpleasant fishy odor usually occurs, especially pronounced after sexual intercourse and period. Vaginal irritation and itching may occur as well.

 

How is treat bacterial vaginosis to be treated?

Untreated bacterial vaginosis can cause infertility or lead to ectopic pregnancy, or even cause preterm labor in pregnant women. It is treated with oral antimicrobial drugs and topical medications (vaginal suppositories and creams) exclusively prescribed by a gynecology specialist, along with oral and/or vaginal application of Lactobacillus.

It is important to emphasize that when STDs such as Chlamydia, Gonorrhea, Ureaplasma, Mycoplasma are concerned, both partners are to be treated, but bacterial vaginosis usually does not require a treatment for male partners.  

Sexual intercourse should be avoided during the treatment, or partners are to use condoms. Microbiological analysis is recommended after the therapy is completed, because the therapy completed is no guarantee for successful treatment.   

Vaginal suppositories for the treatment and prevention

Since vaginal infections reoccur in some women very often, it is important to take preventive measures.

There are numerous products for vaginal application which can be purchased without a prescription in pharmacy markets that help in treatment of vaginal infections, are used as a continuation therapy after a prescribed drug therapy or as a preventive therapy.

Some of the ingredients in such vaginal suppositories include:

 

  • hyaluronic acid – has an anti-inflammatory and calming effect and forms a protective film 
  • probiotics – help establish normal vaginal microflora faster, are recommended as a preventive therapy in patients using oral antimicrobial drugs, are used as a continuation therapy after the application of vaginal antimicrobial of antifungal drugs, where women with recurrent vaginal infections are advised to use probiotics occasionally as a preventive therapy
  • lactoferrin – a broad spectrum of antimicrobial, antiviral and antifungal activities 
  • microporous silver – antimicrobial and anti-inflammatory effect
  • lactic acid – restores normal vaginal pH value
  • glycogen – supplies good bacteria with nutrients and allows their growth
  • tea tree essential oil – along with antifungal and antimicrobial effect, it is used to treat HPV infections owing to its antiviral and immunostimulatory effect
  • thyme, sage, immortelle, marigold essential oils
  • John’s wort essential oil – antimicrobial and anti-inflammatory effect

 

Maintaining slightly acidic vaginal pH value plays an important role in prevention of vaginal infections. This is ensured by using adequate hygiene products. When cleaning the external genitalia, scent and preservative free products of acidic pH value should be used and vaginal irrigation is to be completely avoided.   

In maintaining women’s health it is necessary to lead a healthy lifestyle, including healthy nutrition with more natural and less processed foods, be sexually responsible, undergo regular gynecologist follow ups and listen to your body.