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Common vaginal infections

Vaginal infections occur when bacteria, fungi or viruses grow in and around your vagina.

Certain types of bacteria live naturally inside your vagina. They produce acid to help fight off other bacteria, viruses and fungi that don't normally live in your vagina.

Vaginal infections are common. For example, around three-quarters of women will have thrush in their lives.

Details

  • Symptoms Symptoms of common vaginal infections

    It's normal and healthy for a woman of childbearing age to have vaginal discharge. The amount and colour of the discharge can change during your menstrual cycle, sexual arousal and pregnancy.

    Symptoms of a vaginal infection include:

    • unusual vaginal discharge (this may be unusual in colour and smell unpleasant)
    • irritation and soreness of the vulva (the skin around the outside of your vagina)
    • vaginal itching
    • pain during sex
    • bleeding between periods or after sex
    • low abdominal (tummy) pains
    • lumps, redness, swelling, blisters or ulcers on the vulva or anus
    • pain when passing urine

    It's important that you see your GP or visit a sexual health clinic if you have any of these symptoms.

  • Diagnosis Diagnosis of common vaginal infections

    If you have any symptoms, visit your GP or your local sexual health clinic. Your GP may refer you to a sexual health clinic for specialist treatment.

    There are different ways to test for a vaginal infection. You may be asked to provide a sample of urine. A doctor or nurse may look inside your vagina using a speculum (which is also used for smear tests) and take a swab (similar to a small, round cotton bud). The swab picks up a sample of discharge or cells from your vagina. These samples may be tested or examined under a microscope in the clinic, as well as being sent to a laboratory for testing.

  • Types Types of common vaginal infections

    The main types of common vaginal infection are described below.

    Bacterial vaginosis (BV)

    Bacterial vaginosis (BV) is caused when certain bacteria living naturally inside your vagina grow more than usual (for example, Gardnerella vaginalis). It’s the most common cause of abnormal vaginal discharge in women of childbearing age. The vaginal discharge is usually thin and grey with a fishy smell. Sometimes the fishy odour only occurs after sex, when vaginal secretions are mixed with semen.

    Possible triggers of BV include:

    • perfumed soaps, feminine hygiene sprays or vaginal douching
    • having an intra-uterine system (IUS or coil)
    • taking antibiotics

    BV is not always sexually transmitted, although there may be a link with having a new sexual partner or a high number of sexual partners. If left untreated, BV may increase your risk of:

    Thrush

    Around two in 10 women have Candida albicans growing harmlessly in their vagina. A change in your vaginal environment can mean the yeast grows more than usual, causing vaginal thrush (vaginal candidiasis).

    Common triggers for thrush include:

    • taking antibiotics
    • pregnancy
    • diabetes that is not well controlled

    Using perfumed soap or feminine hygiene sprays, taking the combined contraceptive pill and wearing tight underwear or clothes have also been linked to causing thrush. However, there is not good evidence that these can cause thrush.

    Trichomoniasis

    Trichomoniasis is caused by a parasite called Trichomonas vaginalis. This is usually transmitted during unprotected sexual intercourse.

    Symptoms of trichomoniasis include an itchy or painful vulva with heavy, sometimes frothy, yellow-green, fishy-smelling vaginal discharge. However, half of women with trichomoniasis don't have any symptoms.

    If left untreated, trichomoniasis infection may increase your risk of:

    • premature labour or having a low birth-weight baby
    • becoming infected with viruses including the Human immunodeficiency virus (HIV)

    Chlamydia

    Chlamydia is the most common STI in the UK. It is caused by a bacterium called Chlamydia trachomatis.

    Many people have chlamydia without knowing it. Seven in 10 women and half of men with chlamydia don't have any symptoms.

    In women, chlamydia infection can spread to your womb (uterus), ovaries and fallopian tubes and cause PID. Up to four women in 10 with untreated chlamydia will get PID. PID can damage the fallopian tubes and can increase the risk of:

    Gonorrhoea

    Gonorrhoea is caused by a bacterium called Neisseria gonorrhoeae, which is passed on during unprotected sexual intercourse.

    Half of women with gonorrhoea don't have any symptoms.

    Symptoms of gonorrhoea usually appear within two weeks of infection, and may include:

    • vaginal discharge
    • pain when passing urine
    • bleeding between periods or after sex
    • pelvic or abdominal pain or pain during sex

    Genital herpes

    Genital herpes infection is caused by the herpes simplex virus (HSV) being passed on during sexual contact. Once you’re infected, HSV stays in your body for the rest of your life, although it may not always cause symptoms.

    Symptoms of genital herpes include:

    • painful blisters, or patches of sore, red skin
    • tingling or pain in the genital area
    • pain when passing urine
    • discharge
    • fever and feeling generally unwell

    Genital warts

    Genital warts are the most common sexually transmitted viral infection in the UK, and are especially common in people under 25.

    Genital warts are caused by HPV (Human Papilloma Virus), which makes cells grow unusually. You can catch genital warts by having sex and/or genital skin-to-skin contact with someone who has them.

    Genital warts appear as small, round lumps on or around your vulva, cervix, vagina or anus. It can take several weeks or months after infection for the warts to appear. However, many people with the virus don't develop warts and you may not know you have the infection.

  • Treatment Treatment of common vaginal infections

    Some treatments are available from your pharmacist as well as on prescription from your doctor. Always read the patient information leaflet that comes with your medicine.

    Thrush

    Most infections respond to antifungal treatments such as clotrimazole cream or pessaries (a medicine you insert into your vagina), or antifungal tablets such as fluconazole. These are available from your pharmacist without prescription. The infection clears up completely in most women. If you’re pregnant, see your GP before taking any medicines to treat thrush.

    If your symptoms don't improve within seven to 14 days or symptoms come back, see your GP. He or she may prescribe a different antifungal medicine. If you suffer from repeated infections, a longer course of treatment might be recommended. Male partners don’t need treatment unless they have a rash or a sore penis.

    BV

    Antibiotic treatment clears BV infection in most women. Antibiotics are usually given in tablet form although sometimes, especially in pregnancy, your GP will prescribe a gel or cream. Male sexual partners don't need treatment.

    Trichomoniasis

    If you have trichomoniasis, your GP will usually refer you to a sexual health clinic.

    Trichomoniasis can sometimes get better without treatment, but your doctor will prescribe antibiotics to make sure the infection clears. Antibiotics may be prescribed as a course of tablets for five to seven days or as a one-off larger dose. Sexual partners need to be treated too as symptoms are less common in men and they may not know they are infected.

    Chlamydia and gonorrhoea

    Both Chlamydia and gonorrhoea infections are treated with antibiotics.

    Your doctor will give you antibiotics as a one-off injection and tablets for gonorrhoea, or for chlamydia a course of tablets or a one-off dose. Sexual partners need to be treated too as symptoms are less common in men and your partner may not know he is infected.

    For gonorrhoea, you will be tested again a couple of weeks after you have finished your treatment to ensure that the infection has gone completely. You may also be offered re-testing after chlamydia treatment.

    Genital warts

    Treatment depends on where the warts are, what they look like and how many you have. You may be given creams or liquids, cryotherapy (a freezing procedure), surgery or laser treatment.

    Some women find that the warts go after one treatment, whereas others need several treatments.

    Genital herpes

    Your GP may prescribe antiviral tablets, which can reduce the severity of the attack but don’t eradicate the infection. This means that some women get further attacks. You need to take them for at least five days.

    You may also need to use a local anaesthetic ointment on your vulva to help with the pain.

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  • Causes Causes of common vaginal infections

    Many factors such as having your period, sex without a condom, vaginal douching, or using soap to clean your genital area can upset the levels of bacteria and fungi in your vagina.

    A foreign object, such as a forgotten tampon, can also encourage bacteria to grow and cause an infection. Rarely, it can produce a life-threatening complication known as toxic shock syndrome.

    Vaginal infections can also be caused through unprotected sexual intercourse or skin-to-skin contact. These are known as sexually transmitted infections (STIs).

  • Prevention Prevention of common vaginal infections

    Chlamydia, gonorrhoea, trichomoniasis, genital warts and herpes are passed on by genital skin-to-skin contact or in bodily fluids during sexual intercourse. A condom provides good protection against many STIs. However, genital warts and herpes may still be passed on by contact with skin that is not covered with a condom.

    You can reduce your risk of having BV by:

    • not using perfumed soaps or antiseptic feminine hygiene wash
    • not using vaginal douches – they disturb the natural protective acidity in your vagina

    If you're diagnosed with an STI, it's important to contact your previous partners who may be at risk. This is to prevent them from spreading the infection to others. Sexual health clinics can send anonymous notifications on your behalf if you're willing to provide details.

  • FAQs FAQs

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

    Answer

    The time it takes for a vaginal infection to go will vary. Common bacterial vaginal infections are often treated with a course of antibiotics. Some infections do come back. You can help to prevent this by taking your medicine as advised and finishing the course of treatment.

    Explanation

    The time it takes for the infection to clear up depends on the type of vaginal infection you have. If you still have symptoms after you’ve finished your course of treatment, or you get a repeat infection, talk to your GP or sexual health clinic.

    It's important that you finish your course of treatment even if your symptoms have improved, and always read the patient information leaflet that comes with your medicine.

    Some vaginal infections can be recurrent. For example genital herpes and genital warts may come back after the initial episode has gone away. This is because these viruses are never completely cleared by your body. Other infections such as chlamydia and gonorrhoea will only normally come back if you have been reinfected, for example if you have sex with a partner who has not been treated.

    Is there anything I can do to feel more comfortable when I have a vaginal infection?

    Answer

    There are steps you can take to help ease your symptoms while you're 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 that can be uncomfortable and unpleasant. The following steps may help.

    • Wear loose-fitting, cotton clothes rather than tight clothes, or nylon underwear or tights.
    • Don't use strong detergent to wash underwear.
    • Use plain water to wash – perfumed soaps, bath or shower products, antiseptics or vaginal deodorants can irritate your skin. Don't scrub with a flannel or sponge. Wash your hair over a sink so the shampoo doesn't run down to, and irritate, your genital area.

    If you have pain from genital herpes or warts, the following may help.

    • Take an over-the-counter painkiller, such as paracetamol or ibuprofen.
    • Bathe in salt water (add half a cup of household salt to your bath).
    • Apply petroleum jelly (such as Vaseline) or a mild anaesthetic gel to the infected area – you can buy this from your pharmacy.
    • Pass urine while sitting in warm water or pour warm water over your vulva while you're passing urine on the toilet.

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

    Answer

    'Live' natural yogurt can help to ease symptoms of thrush and bacterial vaginosis (BV), although research shows that it isn't effective as a treatment for either infection. Studies have shown complementary medicines such as tea tree oil don't work and may cause skin irritation.

    Explanation

    Both thrush and BV are thought to be caused by a disturbance in the healthy bacteria and yeasts usually found in your vagina. There isn’t enough research to show whether yogurt is effective at treating either condition, but it may help to ease the symptoms.

    Using yogurt isn't likely to be harmful. So, if you want to use yogurt to ease your symptoms, you can apply it directly to your vagina. Use plain, 'live' yogurt. Eating probiotic yoghurts or drinks containing lactobacillus may also help to prevent bacterial vaginosis if you’re prone to it.

    Some women find that diluted tea tree oil eases symptoms, but it can cause skin irritation. Douching (washing out your vagina with water or special douching fluid) is not effective at treating vaginal infections and may irritate your vagina or spread infections up to your uterus (womb).

  • Resources Resources

    Further information

    Sources

    • Bacterial vaginosis. Medscape. emedicine.medscape.com, published 25 March 2013
    • Candida – female genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published August 2012
    • Simon C, Everitt H, van Dorp F. Oxford Handbook of General Practice. 3rd ed. Oxford: Oxford University Press, 2010:734
    • Vaginal discharge. Patient UK Professional Reference. www.patient.co.uk, published 19 July 2012
    • Chlamydia. Map of Medicine. eng.mapofmedicine.com, published 19 April 2011
    • BASHH (2007) United Kingdom national guideline on the management of anogenital warts, 2007. British Association for Sexual Health and HIV. www.bashh.org
    • Sexually Transmitted Infections in Primary Care. Royal College of General Practitioners. 2013. Available from www.rcgp.org.uk, published 2013
    • Bacterial vaginosis. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published April 2013
    • Bacterial vaginosis. Medscape. emedicine.medscape.com, published 25 March 2013
    • Toxic shock syndrome. Medscape. emedicine.medscape.com, published 30 November 2012
    • Gonorrhoea. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2011
    • Herpes simplex – genital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published September 2012
    • Health Protection Report. Health Protection Agency, 2011, Volume 5 (17). www.hpa.org.uk
    • Genital Human Papillomavirus. Medscape. emedicine.medscape.com, published 20 December 2013
    • Joint Formulary Committee, British National Formulary. London: British Medical Association and Royal Pharmaceutical Society of Great Britain, January 2014.
    • Fungal infections. Medicines Complete. www.medicinescomplete.com, accessed 31 January 2014
    • United Kingdom National Guideline on the Management of Trichomonas vaginalis (2007). Clinical Effectiveness Group, British Association of Sexual Health and HIV www.bashh.org, published 2007
    • Ano-genital warts. Map of Medicine. eng.mapofmedicine.com, published 24 September 2013
    • Warts – anogenital. NICE Clinical Knowledge Summaries. cks.nice.org.uk, published November 2012
    • Antibiotic Resistance Questions and Answers. US Centers for Disease Control and Prevention. www.cdc.gov, published 4 November 2013
    • Mastromarino P, Vitali B, Mosca L. Bacterial vaginosis: a review on clinical trials with probiotics. New Microbiol 2013; 36(3):229¬–238. www.newmicrobiologica.org
    • Jurden L, Buchanan M, Kelsberg G et al. Can probiotics safely prevent recurrent vaginitis? J Fam Pract 2012; 61(06):357–368 www.jfponline.com
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  • Author information Author information

    Reviewed by Jane McQueen, Bupa Health Information Team, April 2014.

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