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Common vaginal infections Q&As

Published by Bupa's health information team, September 2008.

Answers to questions about common vaginal infections

This section contains answers to common questions about this topic. Questions have been suggested by health professionals, website feedback and requests via email. This section will expand over time.

How long will it take for an infection to clear up and is it likely to come back again?

The time it takes for an infection to go will vary. Many infections are treated with a course of tablets which usually lasts for about a week. Some infections do come back. You can help to prevent this by taking your medicine as you have been advised and finishing your course of treatment.

Explanation

How long it takes for any infection to clear up will depend on what the infection is and the kind of treatment you have for it. It's important that you take the treatment as you have been advised. Always ask your doctor for advice and read the patient information leaflet that comes with your medicine. It's important that you finish the course of treatment even if you think the symptoms and infection have gone. This will give you the best chance of a complete cure.

If you have bacterial vaginosis, you are likely to be prescribed an antibiotic called metronidazole. It can be taken in different ways - as a course of tablets for five or seven days, as a one-off large dose, or as a gel that you apply directly to your vagina for five days. It's possible that you will be prescribed other antibiotics called clindamycin or tinidazole instead. Clindamycin can be prescribed as a tablet or as a vaginal cream that you apply for seven days. Tinidazole is taken once as a single large dose.

After this treatment about three out of four women will be cured of the infection. However, some women find that the vaginosis comes back. If this happens to you, you are likely to be prescribed more metronidazole. This will mean either taking tablets for three days before and after your period every month or applying a vaginal cream twice a week for between four and six months.

If your infection keeps coming back, it's important not to use any perfumed bath products, shampoos or antiseptics as these can irritate your skin. Don't use vaginal douching. Douching means washing out your vagina - usually with water or a special douching liquid - to clean it and prevent infection. However, douching actually has the opposite effect. It destroys the healthy bacteria in your vagina and leaves you more open to infection.

Thrush (candidiasis) is treated with anti-yeast medicines. These are available as tablets, creams and pessaries which can be used on their own or in combination. Treatments for thrush are available from your pharmacist as well as on prescription from your GP. Always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice.

Tablets are usually taken just once as a single dose, whereas pessaries and vaginal creams need to be used over a longer period. This can be for between three and 14 days. Your GP or pharmacist can advise you for how long you need to take your treatment. The symptoms should start to ease quite quickly after you start the treatment, especially if you are using a cream as well as taking tablets or pessaries. See your GP if your symptoms haven't gone after one or two weeks.

If treatment is used properly, the infection clears up completely in eight out of 10 women. However, some women find that thrush keeps coming back. If you have more than four episodes of thrush in a year, this is known as recurrent thrush and you will need long-term treatment to control your symptoms. You may need to take medicines for months or even years to keep the symptoms at bay. Your GP will arrange for you to have a swab taken to check for other infections and to make sure that it's definitely thrush. Infection that keeps coming back can be very upsetting and some women find that it affects their sex life and how they feel about themselves. Talk to your GP if you are concerned.

Trichomoniasis is another infection that can be treated with the antibiotic metronidazole. It can be taken as a course of tablets for five or seven days or as a one-off large dose. About nine out of 10 women find that their infection goes completely after treatment. If your infection doesn't get better, your GP may prescribe another course of metronidazole or a different antibiotic. If this doesn't work, your GP will probably refer you to a specialist for further treatment.

Antibiotics are used to treat both chlamydia and gonorrhoea. You might be asked to take a one-off dose of antibiotics or for chlamydia you may be given a week-long course. You shouldn't have sex while you are taking the treatment. If you had a one-off dose, you shouldn't have sex for the following seven days. If the infection comes back, you can have further treatment. As chlamydia and gonorrhoea are both passed on by having sex, it's important to make sure that your partner is also treated.

Genital herpes can be treated very successfully although there is no cure. Genital herpes is a virus so it's treated with medicines called antivirals such as aciclovir. Usually you will be prescribed an antiviral medicine for five days. Your GP might also prescribe you a local anaesthetic ointment to use on your vulva to help with the pain. These can cause your skin to become very sensitive so don't use them for longer than seven days.

Genital herpes may keep coming back, though usually with less severe symptoms than the first time you have it. Your GP may offer you more antiviral medicines or suggest steps you can take to feel more comfortable. These may include painkillers, salt baths and drinking plenty of fluids to help you pass urine more comfortably.

Genital warts are only treated if they can be seen. The kind of treatment you are offered and how well it works will depend on how many warts you have, where they are and how big they are. As well as removing the warts that can be seen, treatment aims to help your immune system fight the virus. Warts can be removed by surgery, laser treatment or applying heat. All of these treatments are done using local anaesthesia. This completely blocks feeling from the area being treated and you will stay awake during the procedure. You can also have warts frozen or you can apply a cream or liquid to them at home. You may have to do this for several weeks. Some women find that the warts go after one treatment whereas for others it takes several to get rid of them.

Further information

Sources

  • Vaginal infections: thrush and bacterial vaginosis. Family Planning Association (fpa). www.fpa.org.uk, accessed 18 June 2006
  • Faculty of Family Planning and Reproductive Health Care Clinical Effectiveness Unit. The management of women of reproductive age attending non-genitourinary medicine settings complaining of vaginal discharge. J Fam Plann Reprod Health Care 2006; 32(1):33-42
  • Vaginal douching. Bandolier. www.jr2.ox.ac.uk/bandolier, accessed 9 June 2008
  • National Prescribing Centre. An update on vulvovaginal candidiasis. MeReC Bull 2004; 14(4):13-16
  • Candida - female genital management. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 9 June 2008
  • Chlamydia - uncomplicated genital management. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 9 June 2008
  • Treatment of gonorrhoea. GP Notebook. www.gpnotebook.co.uk, accessed 9 June 2008
  • Herpes simplex - genital - management. Clinical Knowledge Summaries. http://cks.library.nhs.uk, accessed 9 June 2008
  • Genital warts. Family Planning Association (fpa). www.fpa.org.uk, accessed 9 June 2008
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Is there anything I can do to feel more comfortable?

There are a number of things you can do to help ease your symptoms while you are having treatment. These include wearing the right clothes and underwear, not using perfumed bath and shower products and taking painkillers.

Explanation

Some vaginal infections cause symptoms which can be uncomfortable and unpleasant. As well as following any treatment you have been given, there are several things you can do which may help you to feel more comfortable. Some of the main ones are listed here.

  • Wear loose-fitting, cotton clothes rather than tight clothes such as jeans, or synthetic materials such as nylon underwear or tights.
  • Use plain water to wash rather than perfumed soaps, bath or shower products, antiseptics or vaginal deodorants as these can irritate your skin and the sensitive area of your vulva. Don't scrub with a flannel or sponge. Wash your hair over a sink rather than in the shower or bath so that the shampoo doesn't come into contact with your vulva.
  • If you are itching, try applying aloe vera juice or gel around your vagina. Cold water or ice cubes wrapped in a cloth can also soothe itching. You shouldn't apply ice directly to your skin as it can damage your skin.
  • If you have sex, you may need to use a lubricant during intercourse. If you have a sexually transmitted infection (STI), always use a condom or don't have sex at all until the infection has been treated. Be aware that some treatments for vaginal infections can affect the latex in condoms, caps and diaphragms which can make them unsafe for contraception. Speak to your GP or pharmacist for advice.

If you have pain in your vagina or vulva from genital herpes or warts, the following may help:

  • painkillers such as paracetamol or ibuprofen - always read the patient information leaflet that comes with your medicine and if you have any questions, ask your pharmacist for advice
  • salt water baths - use half a cup of ordinary salt in your bath water
  • passing urine while you are sitting in warm water - in the bath or shower, or pour warm water over your vulva while you are passing urine on the toilet
  • using a local anaesthetic gel - you can buy this from your pharmacy
  • drinking lots of fluids as this can make passing urine less painful
  • keeping the area as dry as you can - dry yourself well after a bath or shower, or use a hairdryer on a cool setting

Further information

Sources

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Can I use yogurt or complementary therapies to treat a vaginal infection?

Some women use 'live' natural yogurt to treat thrush and bacterial vaginosis. Although research shows that it isn't effective as a treatment for either infection, it can help to ease your symptoms. Some women also use complementary or herbal medicines such as garlic and tea tree oil to treat thrush. None of these have been shown to work and may actually be harmful.

Explanation

Both thrush and bacterial vaginosis are thought to be caused by a disturbance in the healthy bacteria and yeasts usually found in your vagina. Some women believe that by using a yogurt that contains bacteria ('live' yogurt) they can help to restore the natural balance of bacteria and yeasts in their vagina. This in turn helps to reduce the symptoms and treat the infection.

Research has shown that using yogurt in this way isn't an effective treatment for either condition, but it may help to ease the symptoms. Using yogurt isn't likely to be harmful. Yogurt isn't used to treat any other vaginal infection or to ease the symptoms of other conditions.

If you want to use yogurt to ease your symptoms, you can eat it or apply it directly to your vagina. To do this either cover a tampon with it and put it high up in your vagina or fill a plastic syringe with yogurt and squirt it high up into your vagina. Do this once a day for a week - most women find it easiest to do this before they go to bed. Always use plain, unsweetened, 'live' yogurt.

Some women use other complementary treatments or herbal medicines to treat thrush including:

  • garlic
  • tea tree oil
  • douching - washing out the vagina with water or special douching fluid

None of these have been shown to be effective at treating thrush and they may be harmful. Tea tree oil and garlic can both cause skin irritation and douching may increase the risk of infections. For these reasons you shouldn't use them to treat thrush.

Further information

Sources

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This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

Publication date: September 2008

 

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