Almost all women have the fungus Candida albicans growing harmlessly on and in their bodies. However,when it grows excessively, it causes thrush (vaginal candidiasis). Irritation and soreness of the vulva are the usual symptoms, sometimes but not always, accompanied by a thick, white vaginal discharge. If left untreated, the irritation can spread to the area between the buttocks. Passing urine and intercourse can be painful.
Pregnancy, menstruation, diabetes, wearing tight underwear and antibiotics are all possible triggers of an attack of thrush.
Most thrush infections respond to one of the antifungal treatments such as clotrimazole creams and pessaries (eg Canestan), or fluconazole (Diflucan) tablets, that are available from your doctor. You may also ask your pharmacist for advice. If the treatment doesn’t work or the symptoms return, see your doctor. Antifungal drugs or a longer course of fluconazole tablets may be prescribed. Theres no good evidence that treating a womans partner helps, unless he has a rash or soreness of the penis.
Wearing cotton pants, changed daily, and avoiding harsh soaps, bubble baths and deodorants may help prevent thrush. Vaginal douches are not recommended to treat or prevent vaginal infections, including thrush, as they disturb the natural, and protective, acidity of the vagina.
Bacterial vaginosis (BV) is the commonest cause of vaginal discharge in women of childbearing age. It causes a fishy smell and occasionally vaginal itching and burning. BV symptoms can clear up without treatment before recurring. But, left untreated, the infection can cause miscarriages, premature labour and pelvic inflammatory disease (PID).
Bacterial vaginosis is caused when the bacteria normally found in the vagina (Lactobacillus) are overgrown by others (eg Gardnerella vaginalis), which are normally found in smaller numbers. Any woman with a fishy smelling discharge should seek medical advice, as the effective treatments -- antibiotics in cream, gel or tablet form - are only available on prescription. This treatment is fairly effective in stopping the symptoms, but the condition often returns.
It is not clear how BV is related to sexual activity, although there may be a link with having a new sexual partner and a high lifetime number of sexual partners. The contraceptive coil seems to increase the risk of BV.
The characteristic symptom of trichomonas infection is a heavy, frothy, yellow-green, unpleasant-smelling discharge. It can also cause discomfort during sex, vaginal itching, pain when passing urine and occasionally stomach pains. Research has linked trichomonas infection with infertility, increased risk of transmission of HIV, premature labour, and low-birth-weight babies.
It is caused by a protozoan (a form of parasite) called Trichomonas vaginalis that is transmitted during sex. The treatment is with the antibiotic metronidazole, available only on prescription. Trichomoniasis may cause no symptoms in men, so male partners should also be treated.