Newspaper Page Text
SEPTEMBER 24, 1998 AUGUSTA FOCUS
10A
Vaginitis: .
A common cause of discomfort
By Dr. Miricm Greene
New York University School of Medicine
Women who have an unusual
vaginal discharge accompanied by
itching and burning or pain during
intercourse, may be suffering from
vaginitis. While the symptoms can
be uncomfortable, generally the
situation is not serious. In fact,
vaginitis is one of the most com
mon reasons women between age
18 and 40 visit a gynecologist.
Vaginal infections are not all
alike. Ninety percent fall into one
of four categories: candida (com
monly known as yeast), bacterial
vaginosis, trichomoniasis and atro
phic vaginitis. To treat the patient,
a doctor must first find out the
exact type of vaginitis causing the
discomfort. This means a thorough
history and physical exam, a his
tory of past and current medica
tions taken, including birth con
trol pills, information about sexual
partners and determining whether
the patient is under unusual stress.
The exam should include a smear
that is examined under a micro
scope or sent for study in a certified
laboratory. Once identified, most
infections can be remedied easily
and quickly.
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Candida is the most prevalent
vaginal infection. It is caused by an
overgrowth of yeast. Often, it may
be related toachange in hormones,
which may explain why many
women complain that their symp
toms appear just before their
menses. The relationship to hor
mones also explains why such in
fections are prevalent among those
in childbearing years and even
more so during pregnancy. Birth
control pills, steroids, antibiotics
and diabetes also create an envi
ronment foran overgrowth of yeast.
For relief, some women turn to
alternative methods not necessar
ily approved by the medical profes
sion. They try to restore the nor
mal environment by eating yogurt.
Others use boric acid vaginal sup
positories or boricacid compresses.
These alter the vaginal pH, thereby
suppressing growth of the yeast.
Ice-milk soaks are another home
alternative remedy.
For medically sanctioned solu
tions, there are many over-the
counter drugs commonly used to
treat candida. Azole drugs, such as
the generics lotrimazole,
butoconazole and miconazole, are
usually effective. Many patients
Living Better
know these drugs by brand names,
such as Femstat, Gynelotrimin and
Monostat. Some are used for three
days, and others for seven days.
More often treating the situation
for 6-to-seven days works best.
Bacterial vaginosis is another
very common form of vaginitis. The
primary symptoms are a foul smell
ing discharge and mild vaginal dis
comfort. Some researchers believe
pregnant women in high-risk popu
lations have a greater chance of
pre-term delivery if bacterial
vaginosis is left untreated during
pregnancy. The benefit of treat
ment in these cases far outweigh
the risks of non-treatment.
Nobody knows exactly what
causes vaginosis, but an over
growth of multiple bacteria is the
result. Since this form of infection
may be sexually transmitted,
sexual partners of those who have
the infection should be treated.
Infections from bacterial vaginosis
associated organisms pose a threat
tothe patient’s reproductive health,
80 proper diagnosis and treatment
is essential. Drugs, such as met
ronidazole (Metrogel-Vaginal) or
clindamycin(Cleocin), should clear
up the infection.
Trichomoniasis is the third most
common type of vaginitis. It is
caused by a sexually transmitted
lmngomnim. Symptomsinclude
adischarge, itching and, often, pain
with intercourse. If you have tri
chomoniasis, your partner abso
lutely must be treated. Recommen
dations are a one-time, single dose
of 2 grams of metronidazole taken
orally.
Sometimes problems unrelated
to bacteria or yeast cause similar
symptoms to vaginitis, which can
confuse women treating them
selves with over-the-counter rem
edies. Examples include urinary
tract infections or chemical aller
gies to detergent, soap or bubble
bath, as well as allergies to silk or
nylon. Menopausal women can also
suffer from symptoms of vaginitis
due to low estrogen levels called
atrophic vaginitis. This problem
can be solved by using an estrogen
cream that can be prescribed by a
physician.
Whatever the cause of vaginitis,
it is important to remember that,
although the condition is common,
it is critical to get a correct diagno
sis and treat the problem before it
develops into something more se
rious.
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