Vulvovaginitis, a common if little understood problem

Vulvovaginitis, a common if little understood problem

Maria Endah Hulupi, The Jakarta Post, Jakarta

Many women do not know the word vulvovaginitis even though
they may be suffering from its symptoms: It is the most common
cause of inflammation of women's genitalia.

"Most women with vulvovaginitis see doctors to treat this
inflammation and as the infection can reoccur, many of them
become frustrated and see different doctors for a permanent
cure," said Forry Fortuna, an obstetrician with Jakarta Hospital
in Central Jakarta.

"Seeing a doctor for proper diagnosis is highly recommended
because the infection is triggered by different causes, but
seeing different doctors for treating the flare-ups is not wise
as this would hamper efforts to trace other possible factors that
may trigger the condition."

Vulvovaginitis is inflammation of the vagina and vulva,
commonly affecting women aged between 18 years to 40 years
because this is the period when the cervix is more active in
producing vaginal fluid.

The inflammation, which is not a sexually transmitted disease,
can be caused by the fungus candida, bacterial and parasitic
infections.

The normal, healthy vagina is a living environment for various
good and bad bacteria and candida existing in balance.

Bacterial vulvovaginitis occurs after the balance in this
environment is disturbed and gardnerella vaginalis outgrows
"good" bacteria to trigger infections, while candida
vulvovaginitis infection (also known as vaginal yeast infection)
occurs because of an overgrowth of Candida albican or other types
of candida.

Another cause of vaginitis is trichomoniasis, which can be
spread through sexual contact.

Other factors that can trigger vulvovaginitis include failure
to keep the vagina clean, allergic reaction, pregnancy, certain
diseases (like diabetes mellitus), stress, certain types of
contraception and antibiotics.

Overuse of spermicide and antiseptic douches also can kill
good bacteria and enable candida to flourish.

Women with multiple sexual partners (or whose partner is
promiscuous) are especially prone to bacterial vaginitis.

Forry also said that wearing tight clothing and pantyliners
can encourage the growth of unaerobe bacteria (bacteria that live
in the absence of oxygen), leading to vaginal inflammation as
well.

Vulvovaginitis can lead to abnormal vaginal discharge, itching
and irritation in the genital area, leaving the vagina and vulva
with a reddish color. This condition is usually accompanied with
pain during sexual intercourse and urination.

A change in vaginal pH can indicate the cause of the
infection, pH lower that 4.5 indicates candidal infections, while
5-7 indicates bacterial infections.

Each infection may be indicated with different characteristics
of the vaginal discharge.

Candida vulvovaginitis causes a milky white discharge of a
thick consistency with a yeasty smell; Trichomoniasis is usually
accompanied by a copious, foul-smelling yellowish or greenish
discharge, while bacterial vaginitis causes a greenish discharge
that sticks to the vagina lining.

"To determine the exact cause of the infection, a sample of
vaginal discharge must be taken for further laboratory analysis,"
said Forry.

As a prevention, he advised women to be careful to maintain
personal hygiene, particularly in the vaginal area, but not to
overuse the antiseptic or vaginal solutions as there was the
potential to disturb the balance of the vaginal flora.

He explained that it is better to change underwear more often
and rinse the area with water three times everyday.

After defecating, clean the area by wiping from front to back
to prevent transfer of bacteria from the anus to the vagina.
Properly drying oneself after bathing and swimming as well as
avoiding wearing tight clothing can also help prevent problems.

It is also important to balance a stressful routine with
adequate sleep and hobby.

As abnormal vaginal discharge may also indicate another more
serious illness, like cervical cancer, for example. Forry advised
women aged 35 years old or older to undergo a pap smear to
determine what was wrong with them.