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VAGINITIS

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WHAT IS IT?
If you’re bothered by sore genitals and perhaps an unusual discharge from the vagina-the ailment called vaginitis-the cause may be an infection, a medicine you’re taking, or something else.
Yeast infection, the most common of three infections, occurs when a fungus that always lives in the vagina grows out of control. Bacterial vaginosis occurs when bacteria that always live in the vagina grow out of control, or when bacteria in the rectum spread to the vagina. Trichomoniasis is a sexually transmitted disease (STD) caused by a parasite.
Vaginitis can also stem from something like a chemical or tight clothing that inflames the vulva or the vagina. This type of vaginitis is not an infection.
Vaginitis affects women of all ages, but it is most common between the teen years and the forties. It can be painful and can keep coming back, but it is not likely to be a major threat to your health. You and your doctor can take steps to cure vaginitis if you have it, and you can do a lot to prevent the problem from coming back.
WHAT IS HAPPENING?
Every woman’s vagina-the canal leading from the uterus to the outside of the body-contains bacteria and small amounts of yeastlike fungus. Most of the time they are helpful: By keeping the vagina slightly acidic, they defend against infection.

Some conditions, though, make the vagina less acidic-for instance, diabetes, pregnancy, or practices such as frequent douching. Then bacteria and fungi can grow out of control and infections can get started.

Contact dermatitis happens when chemicals in some products-the scents added to deodorant tampons and other products, for instance-inflame the vulva (the entrance to the vagina). These can make tissues around the vagina swell, itch, and redden. Friction caused by wearing tight pants can also be a problem. Women often get atrophic vaginitis after menopause; lowered estrogen levels make tissues in the vagina thinner (atrophy means shrinking), drier, and easy to inflame.
WHAT CAUSES IT?
Many things can increase your risk of vaginitis. Some, such as aging or diabetes, are outside your control. But you can change others.

THINGS YOU CAN’T CHANGE

Being a woman
Of course, only women get vaginitis. But the Trichomonas parasite that causes one form of vaginitis can be passed back and forth between sex partners. For men, the infection most often appears in the urethra, the tube that carries urine from the bladder to the end of the penis.

Your age
If you’re in your childbearing years, you are more likely to get bacterial vaginosis and yeast infections than when you’re older. This may be because of changing hormone levels, tampon use, and sexual activity. Women who have gone through menopause are more prone to atrophic vaginitis brought on by lower levels of female hormones.

Diabetes
Women who have diabetes are more likely to get yeast infections. That’s because diabetes makes the vagina less acidic and less able to fight off the growth of fungi.

Being pregnant
When you are pregnant, the vagina becomes less acidic and less able to fight off yeast infections.

THINGS YOU CAN CHANGE

Hygiene
Not washing your vulva well or spreading bacteria from the rectum to the vagina can lead to bacterial vaginosis.

Some medicines
Certain drugs such as birth control pills and antibiotics may allow yeast to grow out of control in the vagina. Birth control pills can also change your levels of hormones and bring on mild atrophic vaginitis.

Using scented vaginal products
Chemicals in these can inflame the vagina with contact dermatitis.

Clothing
Polyester clothing or tight pants that don’t allow the skin to breathe can cause contact dermatitis, and they can promote the growth of fungi and bacteria that cause other types of vaginitis.

Sexual habits
Researchers are unsure whether you can catch bacterial vaginosis and yeast infections by having sex, but using a condom and spermicide will protect you against any sexually transmitted disease. On the other hand, some people find that spermicides, or the latex in condoms and diaphragms, can cause soreness or itching.
WHAT YOU CAN DO FOR YOURSELF
You can do a lot at home to treat vaginitis. You can also prevent it by making smart choices about such things as diet, sex habits, and even your clothing.

For yeast infection or bacterial vaginosis

For a yeast infection, try an over-the-counter antifungal cream that contains miconazole or clotrimazole.
If your skin burns when you urinate, cut the bottom out of a plastic cup and hold against your vulva when you use the bathroom. This keeps urine from touching inflamed skin. Or use a squirt bottle to spray warm water over your vulva after you urinate.
Dry gently and thoroughly around your vulva after your urinate or shower. Towels may hurt your skin. If they do, try using a hair dryer set on low to blow warm, dry air on the sore area-just be careful not to burn yourself.
For contact dermatitis
To ease itching, apply a cold, wet washcloth soaked in cold water or try putting hydrocortisone cream on the itchy places.
Use calamine lotion, sold in drugstores, to ease itching. A warm soak with Aveeno colloidal oatmeal bath also soothes inflamed tissues and eases itching.
For atrophic vaginitis
Use a lubricant such as K-Y jelly to moisten the vulva and vagina.
Stay clean
After a bowel movement, wipe from front to back to avoid spreading bacteria from the rectum to the vagina. Clean diaphragms, cervical caps, and spermicide applicators after each use. Change tampons and sanitary pads every four to six hours at least.

Avoid chemicals
Don’t use scented toilet paper or perfumed soaps, feminine hygiene sprays, or deodorant tampons. Wash all underwear in mild, fragrance-free soap or detergent (soap made for baby laundry is good) and rinse twice. Don’t use fabric softener or bleach.

Eat live yogurt cultures
If you are taking antibiotics or have repeated yeast infections, try eating a cup of yogurt every day. Read the label to be sure it says “live cultures.” Studies show yogurt may prevent yeast infections.

Avoid tight clothes
Don’t wear tight underwear, shorts, leotards, swimsuits, or slacks. Also, always wear underwear with a cotton crotch-or none under your nightgown or pajamas at night.

Adopt good sex habits
Some types of vaginitis such as trichomoniasis can infect sex partners. Doctors have doubts about whether some other types, such as bacterial vaginosis and yeast infection, are spread sexually. But if you have vaginitis, ask your doctor whether your partner should be treated for any infections and tested for STDs. Ask when it’s okay to have sex again, and don’t do it until all soreness is gone. Also ask your doctor if you should use a latex condom and nonoxynol-9 spermicide to guard against the chance of a sexually transmitted disease. If these inflame your vagina, use a soothing water-based gel such as K-Y jelly instead of the spermicide, and ask your doctor if you should use another form of birth control as well.

Think twice about the Pill
If you take birth control pills and think they might be causing your vaginitis, ask your doctor about other methods of birth control.

Control diabetes
If you have diabetes, follow your doctor’s advice about treating it. This may help you avoid yeast infections.

Stay alert
Check your vulva monthly for discharge, redness, or blisters, or for other symptoms of vaginitis.
WHAT YOUR DOCTOR CAN DO FOR YOU
For yeast infection
If you know you have a yeast infection, try an over-the-counter tablet or cream that you insert into the vagina. If you’re not sure, or this is the first time you’ve had symptoms of the infection, see your doctor. He or she may advise you to try the same over-the-counter treatment. If that doesn’t work, your doctor may prescribe an oral antifungal drug called Diflucan. Just one pill replaces many doses of pills or creams. Diflucan must be prescribed by a doctor.

For bacterial vaginosis
Your doctor can prescribe antibiotics that you take as pills or in vaginal cream. If the problem comes back, the doctor can treat your sex partner, too.

For atrophic vaginitis
You may get a prescription for a vaginal cream or suppository that contains estrogen, or estrogen replacement pills. Doctors often prescribe progesterone tablets along with estrogen creams, suppositories, and pills to reduce the risk of uterine cancer.

Estrogen replacement pills ease the symptoms of menopause, such as atrophic vaginitis, and also protect against heart disease, thinning bones, and bone fractures. But many women decide against hormone therapy because some studies have linked it to breast cancer if a woman takes the pills for more than five years. Other studies say the risk has more to do with aging. If you are thinking about taking hormone therapy pills for more than a few years, be sure to talk to your doctor.

For contact dermatitis
Your doctor will help you figure out what is inflaming the tissues. Home care should take care of the problem.

For a sexually transmitted disease
If your symptoms of itching and burning are caused by herpes, not vaginitis, your doctor will prescribe acyclovir, a drug that fights the virus that causes herpes. While acyclovir can’t cure herpes, it keeps it under control.


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