What is Normal?
The normal environment of a woman’s vagina has various types of micro-organisms such as bacteria or fungi (yeast) found in the vagina. In a healthy vagina, the balance of good bacteria (lactobacilli) greatly outnumbers the bad bacteria and yeast. The lactobacilli produce lactic acid, which creates an acidic environment and keeps the bad bacteria in check.
All women have a natural vaginal scent, which can change throughout the menstrual cycle, becoming stronger or milder at times. This is normal. However, if you notice that your scent suddenly changes and becomes stronger or smells fishy, it can be a sign of a vaginal infection or a vaginal problem.
The balance of the vagina can be disrupted by several reasons:
- Chemical douches (they kill off the lactobacilli and allow the bad bacteria to overgrow)
- Growth of bad bacteria due to poor hygiene
- Exposure to semen (semen causes the pH levels to rise and encourages bad bacteria to grow)
- Wearing tight clothing for long periods, damp or moist clothing can encourage yeast to grow faster than lactobacilli.
- Incorrectly treating a vaginal infection (using yeast medications for a bacterial infection)
Common Vaginal Infections:
Bacterial vaginosis (BV) is one of the most common (and frustrating!) vaginal infections. Symptoms can include itching, burning, vaginal odor (fishy) and abnormal discharge (usually a milky white). Sometimes BV can occur without symptoms.
BV has been linked with increased incidence of cervical cancer and increased risk of sexually transmitted infections/diseases, including HIV infection. BV is treatable with antibiotics, but can reoccur. Some studies show current medications only work ~ 50% of the time, so prevention is very important.
Fungal /Yeast Infections are also very common. Yeast organisms are present in small amounts in a healthy vagina. Sometimes overgrowth of yeast causes vaginal itching, burning, and abnormal discharge (usually a clumpy white), although sometimes very little discharge is present.
Patients often assume most vaginal infections are caused by yeast overgrowth and use over-the-counter antifungal medications. If it is not a true yeast infection, the medication can cause the good bacteria to be eliminated, which in turn causes the underling bacterial infection to become more severe.
We encourage office visits for vaginal infections so that you can be properly diagnosed and treated. One study found that a telephone diagnosis of vaginal infections were incorrect 50% of the time!