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Common vaginal conditions What are common vaginal conditions? A number of conditions result in inconvenient or unpleasant vaginal symptoms. Thrush and bacterial vaginosis (BV) are two very common causes of an abnormal vaginal discharge. Some infections may cause sores, swelling or pain in the vaginal area and changes after the menopause can give troublesome symptoms. Other vaginal conditions include genital warts and herpes, which are caused by viruses, and Trichomonas, a type of organism called a 'protozoan'. What causes common vaginal conditions and who is at risk? Thrush and BV are not sexually transmitted infections, although their effects may be worse after sexual intercourse. Thrush is caused by an organism called Candida, which is a type of yeast and is usually harmless. However, it may cause symptoms during pregnancy, after taking a course of antibiotics for another illness, or for women who take the pill and for women who have diabetes. Some women tend to suffer thrush every month just before their period. BV is caused by a mixture of bacteria that multiply in the vagina when the natural acidic vaginal secretions are disturbed, but the reason for this is unclear. Genital warts, herpes, and Trichomonas infections may be transmitted when the organisms come into direct contact with the vaginal area, usually during sexual intercourse. Chlamydia and gonorrhoea are infections that can only be acquired by sexual contact. The biggest risk factor for all sexually transmitted infections is to have unprotected sex (not using condoms). Thinning of the vaginal skin can occur after the menopause and is known as 'atrophic vaginitis'. Cancers in this area do occur, but are very uncommon.  What are the symptoms and complications of common vaginal conditions? A healthy vaginal discharge is clear or white and does not smell unpleasant. It may change at puberty, pregnancy and menopause, and there is a cyclical pattern to its thickness. There should be no blood in the discharge between periods and no bleeding with intercourse. Thrush causes a thick, white discharge, which is likened to cottage cheese. It causes intense itching, vaginal soreness and redness. Unlike thrush, BV does not usually cause soreness. The discharge is grey and watery, and has a strong, unpleasant fishy smell, which is its most characteristic feature. Both thrush and BV have a tendency to occur more than once over a period of time. Genital warts and herpes may be found on the genital area and around the anus. They can also grow inside the vagina and on the cervix (neck of the womb). Warts are painless, fleshy swellings. They are unsightly and may irritate. Herpes causes tiny blisters that burst to leave ulcers that resemble cold sores. They cause severe burning or stinging pain and swelling. The glands in the groin may swell and pain can occur in the legs or back. The symptoms of other sexually transmitted infections may include vaginal discharge, pain on passing urine or pain during intercourse, or such infections may be symptomless. They have the potential to spread upwards into the womb, tubes and ovaries and cause serious illness and infertility. Bartholin's glands are situated on either side of the vaginal opening. If a gland becomes blocked, it may cause a cyst (a painless soft swelling). If the gland is infected, the swelling becomes painful and red, and pus may drain out. Atrophic vaginitis decreases the normal vaginal secretions and can result in soreness and problems with intercourse. How do doctors recognise common vaginal conditions? Your doctor will examine your vagina, cervix and any discharge, perform an internal examination, and take a cervical smear. You may also have swabs taken to test for thrush and any other infections that are suspected. You may be asked for a urine sample. If the doctor is concerned about an internal infection, you will need an ultrasound scan. If a sexually transmitted infection is possible, your partner also needs to have an examination and swab tests. What is the treatment of common vaginal conditions? Self-care action plan You may be familiar with the symptoms of thrush and make your own diagnosis. If you have used a thrush treatment with no improvement, there may be another cause for the discharge and you should see your doctor. You should also see your doctor if you find any swellings, sores or skin changes, if you have any unexpected bleeding or you have been at risk of an infection. Bubble bath, perfumed soap, vaginal douches or the use of disinfectant all destroy the natural acidic vaginal secretions that protect against thrush and BV. Avoiding use of these items helps to prevent the problem arising. You should keep the area cool by wearing cotton underwear and loose clothes. Many women find that a live 'bio' yoghurt or a very dilute solution of vinegar can restore the healthy vaginal bacteria sufficiently to treat thrush. Creams and vaginal pessaries (tablets placed in the vagina) for thrush and acidifying gel to prevent BV can be bought from the chemist. The most effective way to protect yourself from all sexually transmitted infections is always to use a condom during sex. It is important to complete any treatment and make sure your partner is also treated to prevent him from passing the infection back to you. Medicines Women who have recurrent thrush may need to take tablets. Trichomonal, chlamydial and gonorrhoeal infections can only be treated with antibiotics, and BV may require antibiotic treatment. Warts can be treated with a solution that is painted on or with cryotherapy (freezing). Recurrent attacks of herpes can be controlled with tablets if they are very frequent or severe. Post-menopausal changes are often helped by an oestrogen-containing cream or hormone replacement therapy (HRT). Surgery may be necessary for infected Bartholin's glands and occasionally for severe skin changes or cancers. What is the outcome of common vaginal conditions? Thrush causes no long-term complications, but women with BV have a higher incidence of infection in the reproductive organs and pregnant women with BV have a greater risk of a premature labour. The reasons for this are not fully understood. Warts do not cause any serious complications, but the virus that causes them has been linked to cancer of the cervix. Therefore it is important to have them treated. Herpes can recur and often causes repeat attacks. The virus can affect the development of the unborn baby.  Download Acrobat PDF version
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