Vaginal Discharge and Irritation

Although makers of feminine hygiene sprays and douches would like you to believe otherwise, a healthy vagina cleans itself naturally. A clear or opaque vaginal discharge is part of this cleansing process.

Causes

Several conditions can cause irritation around the vagina and changes in the color, smell, amount, or consistency of the vaginal discharge. These include vaginal yeast infections, bacterial vaginosis, trichomoniasis, and sexually transmitted diseases, such as the herpes simplex virus type 2.

Yeast infections are usually marked by a thick, white discharge like cottage cheese. The vagina and labia (the lips of the vagina) may be red and swollen. Yeast infections also cause intense itching and burning in the genital area.

An overgrowth of a normal fungal organism, Candida albicans (Monilia), is the usual culprit. This type of infection is more likely during pregnancy, after taking antibiotics, when using birth control pills, or if you have diabetes. Spreading it through sex is rare, but if your partner has genital itching and a rash, an over-the-counter antifungal  cream may be used topically. Yeast infections can usually be treated safely with self-care steps.

Bacterial vaginosis is a condition that occurs when there is excessive growth of the wrong bacteria in your vagina. Symptoms include a yellow or white fishy-smelling vaginal discharge, itching, burning during urination, and pain in the vaginal area following intercourse. Bacterial vaginal infection is usually treated with specific prescription antibiotics.

Trichomoniasis is caused by a tiny one-celled parasite. Symptoms include a yellow-green frothy discharge from the vagina, itching, and sometimes pain. The discharge may have a bad odor but doesn't always. Because the Trichomonas parasite can live in the male prostate gland, your partner should also be treated to prevent reinfection. See your doctor or nurse practitioner if you have symptoms of Trichomonas infection. He or she can prescribe drugs. Take your medication exactly the way it is prescribed.

Sexually transmitted diseases also may cause vaginal itching, pain, and discharge.

Self-Care

• If you think you are having your first infection, see your doctor before trying self-care. Your doctor can make sure you do not have a more serious infection.

• Use an over-the-counter antifungal vaginal cream or suppository (such as Monistat, Gyne-Lotrimin, or Mycelex). Follow the package directions and be sure to use all the medicine. Don't stop treatment just because the symptoms are gone. Medication can be used while menstruating, but you may also wait and use afterward if symptoms continue.

• Expose the area to air when possible.

• Apply cool compresses to the area between the vagina and rectum or soak in an oatmeal bath product (Aveeno bath treatment).

• Avoid bubble baths, vaginal sprays, and douching (unless prescribed). Soaking in a tub of plain, lukewarm water, however, may be helpful.

• Avoid sexual intercourse until you finish the medicine. This will prevent further irritation.

• If self-care doesn't relieve your symptoms or if symptoms get worse, see your doctor. It is preferable to be off the vaginal cream for 48 hours before evaluation.

• Skin changes during perimenopause and menopause may cause thinning of the vaginal and vulvar tissue, which may result in vaginal dryness, burning, itching, painful intercourse, and urinary frequency. Estrogen creams are often helpful for these symptoms. Make an appointment to discuss treatment with your doctor.

Prevention

The following are basic hygiene practices that may help prevent vaginal irritation and discharge:

• Wear cotton underwear.

• Avoid tight-fitting jeans and pantyhose.

• Avoid deodorant tampons or douches.

• Use adequate lubrication during intercourse.

• Avoid scented or deodorant soaps, laundry detergents, or fabric softeners that cause irritation.

• Thoroughly clean spermicide applicators and diaphragms after use.