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Vaginitis, inflammation of the vagina, is responsible for an estimated 10% of all visits by women to their healthcare practitioners. The three general causes of vaginitis are hormonal imbalance, irritation, and infection. Hormone-related vaginitis includes the atrophic vaginitis generally found in postmenopausal or postpartum women, and occasionally in young girls before puberty. Irritant vaginitis can result from allergies or irritating substances. Infectious vaginitis is most common in reproductive-age women and is usually from bacterial vaginosis, trichomoniasis or vulvovaginal candidiasis. Some vaginal infections are transmitted through sexual contact, but others such as candidiasis (yeast infections) are not.
Vaginal infections are often accompanied by vaginitis, which is an inflammation of the vagina characterized by discharge, irritation, and/or itching. The cause of vaginitis cannot be adequately determined solely on the basis of symptoms or a physical examination. Laboratory tests allowing microscopic evaluation of vaginal fluid are required for a correct diagnosis.
Trichomoniasis, sometimes referred to as "trich", is a common STD that affects 2 to 3 million Americans yearly. It is caused by a single-celled protozoan parasite called Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urogenital tract; the urethra is the most common site of infection in men, and the vagina is the most common site of infection in women.
Symptoms. Trichomoniasis, like many other STDs, often occurs without any symptoms. When symptoms occur, they usually appear within 4 to 20 days of exposure, although symptoms can appear years after infection. The symptoms in women include a heavy, yellow-green or gray vaginal discharge, discomfort during intercourse, vaginal odor, and painful urination, or no symptoms at all. Irritation and itching of the female genital area, and on rare occasions, lower abdominal pain also can be present. The symptoms in men include a thin, whitish discharge from the penis and painful or difficult urination. However, most men do not experience any symptoms.
Diagnosis. Trichomoniasis is usually diagnosed in women by examining vaginal fluid under the microscope for evidence of the parasite; in some cases it can be detected on a Pap smear. Because only small numbers of parasites may be present during infection in a male, microscopic examination of discharge from the penis often does not reveal the presence of parasites. However, a sample of fluid from the penis may be taken from which the parasite can be grown in culture in the laboratory. Cultures may be required to establish the diagnosis in women who have no symptoms but are at high risk of infection. Cultures can also confirm the diagnosis in symptomatic women whose microscopic examinations are negative.
Treatment. Although symptoms of trichomoniasis in men may disappear within a few weeks without treatment, men can transmit the disease to their sex partners even when symptoms are not present. Therefore, it is preferable to treat both partners to eliminate the parasite.
Prevention. Condoms and diaphragms may be helpful in preventing the spread of trichomoniasis. Although there is some laboratory evidence that spermicides can kill STD organisms, scientists are still evaluating the usefulness of spermicides in preventing STDs. Some studies have found that frequent use of spermicides (more than three times a week) may cause vaginal inflammation.
Vulvovaginal candidiasis (VVC), sometimes referred to as candidal vaginitis, monilial infection, or vaginal yeast infection, is a common cause of vaginal irritation. It has been estimated that approximately 75% of all women will experience at least one episode of VVC during their lifetime. VVC is caused by an overabundance or overgrowth of yeast cells (primarily Candida albicans) that normally colonize in the vagina. Several factors are associated with increased rates of VVC in women, including pregnancy, uncontrolled diabetes mellitus, and the use of oral contraceptives or antibiotics. Other factors that may increase the incidence of VVC include the use of douches, perfumed feminine hygiene sprays, topical antimicrobial agents, and tight, poorly ventilated clothing and underwear. There is no direct evidence that VVC is transmitted by sexual intercourse.
Symptoms. The most frequent symptoms of VVC in women are itching, burning, and irritation of the vagina. Painful urination and/or intercourse are common. Abnormal vaginal discharge is not always present and may be minimal. The discharge is typically described as cottage-cheese-like in nature, although it may vary from watery to thick in consistency. Most male partners of women with VVC do not experience any symptoms of the infection. However, a transient rash and burning sensation of the penis have been reported after intercourse if condoms were not used. These symptoms are usually self-limiting.
Diagnosis. Because few specific signs and symptoms are usually present, this condition cannot be diagnosed by the patient's history and physical examination. VVC is usually diagnosed through microscopic examination of vaginal secretions for evidence of yeast forms.
A sufficient intake of probiotics or friendly bacteria can help keep yeast regrowth to a minimum. Other treatments include the application of a very weak vinegar douche; application of dilute tea tree oil solution. Since oral consumption of live acidophilus cultured yogurt has been proven beneficial, acidophilus suppositories should have the same or a more rapid effect. If candida is suspected of being more than a local problem, more systemic anti-candidal treatments will need to be utilized.
Other Causes of Vaginitis
Although most vaginal infections in women are due to bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis, it is clear that there are other possible causes. These causes may include allergic and irritative factors or other STDs. Noninfectious allergic symptoms can be caused by spermicides, vaginal hygiene products, detergents, and fabric softeners. Cervical infections are also often associated with abnormal vaginal discharge, but these infections can be distinguished from true vaginal infections by appropriate tests. Finally, in uninfected women, vaginal discharge may be present during ovulation and may become so heavy that it raises concern.
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Acidophilus: A microflora (good bacteria) that acts as a digestive aid and lives in your intestines helping your body fight disease.
AIDS: Acquired Immune Deficiency Syndrome. An immune system deficiency disorder that suddenly alters the body's ability to defend itself. The AIDS virus invades the T4 helper/inducer lymphocytes and multiplies, causing a breakdown in the body's immune system, eventually leading to overwhelming infection and/or cancer, with ultimate death.
Allergy: Hypersensitivity caused by exposure to a particular antigen (allergen), resulting in an increased reactivity to that antigen on subsequent exposure, sometimes with harmful immunologic consequences.
Antimicrobial: Tending to destroy microbes, hinder their multiplication or growth.
Antiseptic: Inhibiting growth of infectious organisms.
Asymptomatic: Not showing symptoms.
Bacteria: Microscopic germs. Some bacteria are "harmful" and can cause disease, while other "friendly" bacteria protect the body from harmful invading organisms.
Candidiasis: Infection of the skin or mucous membrane with any species of candida, usually Candida albicans. The infection is usually localized to the skin, nails, mouth, vagina, bronchi, or lungs, but may invade the bloodstream. It is a common inhabitant of the GI tract, only becoming a problem when it multiplies excessively and invades local tissues. Growth is encouraged by a weakened immune system, as in AIDS, or with the prolonged administration of antibiotics. Vaginal symptoms include itching in the genital area, pain when urinating, and a thick odorless vaginal discharge.
Chronic: Usually Chronic illness: Illness extending over a long period of time.
Corticosteroid: Steroid hormone produced by the adrenal cortex.
Diabetes Mellitus: A disease with increased blood glucose levels due to lack or ineffectiveness of insulin. Diabetes is found in two forms; insulin-dependent diabetes (juvenile-onset) and non-insulin-dependent (adult-onset). Symptoms include increased thirst; increased urination; weight loss in spite of increased appetite; fatigue; nausea; vomiting; frequent infections including bladder, vaginal, and skin; blurred vision; impotence in men; bad breath; cessation of menses; diminished skin fullness. Other symptoms include bleeding gums; ear noise/buzzing; diarrhea; depression; confusion.
Ectopic: Located outside normal position, e.g., location of fetus in pregnancy.
Essential Oil: Volatile terpene derivative responsible for the odor or taste of a plant.
Estrogen: One of the female sex hormones produced by the ovaries.
Gonorrhea: A sexually-transmitted disease that is often without symptoms. If there are symptoms in the female, they include frequent and painful urination, cloudy vaginal discharge, vaginal itching, inflammation of the pelvic area, and abnormal uterine bleeding. If the male has a purulent (pus-like) urethral discharge, he should assume he has gonorrhea until proven otherwise.
HIV: Abbreviation for human immunodeficiency virus, a retrovirus associated with onset of advanced immunodeficiency syndrome (AIDS).
Hormones: Chemical substances secreted by a variety of body organs that are carried by the bloodstream and usually influence cells some distance from the source of production. Hormones signal certain enzymes to perform their functions and, in this way, regulate such body functions as blood sugar levels, insulin levels, the menstrual cycle, and growth. These can be prescription, over-the-counter, synthetic or natural agents. Examples include adrenal hormones such as corticosteroids and aldosterone; glucagon, growth hormone, insulin, testosterone, estrogens, progestins, progesterone, DHEA, melatonin, and thyroid hormones such as thyroxine and calcitonin.
Microgram: (mcg): 1/1,000 of a milligram in weight.
Pap Test: Papanicolaou test. Microscopic examination of cells collected from the vagina and cervix to test for uterine cancer or dysplasia.
Parasite: An organism living in or on another organism.
Pelvic Inflammatory Disease: (PID) A Purulent (pus-like) vaginal discharge with fever and lower abdominal pain.
Peroxides: Free radicals that are by-products formed in our bodies when molecules of fat react with oxygen.
Postmenopause: The postmenopausal phase of a woman's life begins when 12 full months have passed since the last menstrual period and any menopausal symptoms have become milder and/or less frequent.
Postpartum: After childbirth.
Protozoan: (Plural: Protozoa) Any one of a large group of one-celled (unicellular) animals, including amoebas. They are microorganisms that differ from bacteria in that they are larger and possess a nucleus surrounded by a membrane. Several species of protozoa can be transmitted through water and cause disease in humans, including Giardia, Cryptosporidium, Cyclospora, Entamoeba and Isospora. One distinguishing characteristic of protozoa is that when released from the human body through feces they are present in an encysted (dormant) form. These cysts have a protective layer that surrounds them and keeps chemicals from penetrating them. Therefore, chlorine disinfection does not kill the protozoan cysts.
Tablespoon: (Tbsp) Equivalent to 15cc (15ml).
Teaspoon: (tsp) Equivalent to 5cc (5ml).
Thyroid: Thyroid Gland: An organ with many veins. It is at the front of the neck. It is essential to normal body growth in infancy and childhood. It releases thyroid hormones - iodine-containing compounds that increase the rate of metabolism, affect body temperature, regulate protein, fat, and carbohydrate catabolism in all cells. They keep up growth hormone release, skeletal maturation, and heart rate, force, and output. They promote central nervous system growth, stimulate the making of many enzymes, and are necessary for muscle tone and vigor.
Topical: Most commonly 'topical application': Administration to the skin.
Trichomonas: Also known as Trichomonas vaginalis or "Trich", this is one of the most common sexually-transmitted diseases. It is caused by a parasite that thrives in the vaginal environment, usually transmitted by sexual contact but also in warm moist environments such as hot tubs. Trichomonas may affect not only the vagina but also the urinary tract of both women and men. Signs include: Vaginal irritation; a fishy odor; a greenish/yellow vaginal discharge; pain with intercourse and/or with urination. Some women may have no symptoms at all.
Trichomoniasis: Trichomoniasis is a sexually-transmitted infection caused by the single-cell protozoan parasite Trichomonas vaginalis. Symptoms include vaginal itching and pain, with a watery foamy greenish or yellow odorless discharge being frequently present. A clear urethral discharge is an early sign in the male.
Virus: Any of a vast group of minute structures composed of a protein coat and a core of DNA and/or RNA that reproduces in the cells of the infected host. Capable of infecting all animals and plants, causing devastating disease in immunocompromised individuals. Viruses are not affected by antibiotics, and are completely dependent upon the cells of the infected host for the ability to reproduce.
Yeast: A single-cell organism that may cause infection in the mouth, vagina, gastrointestinal tract, and any or all bodily parts. Common yeast infections include candidiasis and thrush.