Most Common Female Genital Infections

By Dr. Addo Yobo

Introduction

Every female is conversant with infections of the lower genital tract, most frequent and infrequent.

Mothers should never forget how to teach their young girls as to cleansing in the right direction after fecal movement as well as urination.

Nature had endowed the female genital tract with variety of bacteria, fungus and viruses which live in harmony and protect the environment from virulent organisms. This harmonious echo environment when disturbed by individuals, by chemicals or bacteria, may bring about infections and super infections with resultant unpleasant discharge and even pains and swelling of the vulva. Male partners also contribute significantly.

The best advice is to contact your general Medical practitioner for treatment and advice.

Infectious areas to be discussed will be:

I. Vagina

II. Fallopian tubes, which may extent to ovaries

III. The womb


Consequences

I. Other constitutional symptoms accompany such ailment. Severity of the disease can destroy the fallopian tubes and ovaries with resultant infertility.

II. The annoying reoccurrence of unpleasant vaginal discharge could even lead to economic loss-due to frequent hospital visits and absenteeism from work.

III. Disruption of relationship from male partners and sometimes divorce.

IV. Psychological disturbance with mood swings and depression had been recorded by some health care providers.

V. The frustration of the health care providers is another factor, because of unsuccessful treatment.

VI. The financial cost can be astronomical, with purchases of medications including none traditional douches and creams etc.

VII. HIV/AIDS via sexual contact is even another TABOO with final condemnation as is being perceived by society.
 

Most Affected feel ostracized and discriminated against.

VAGINITIS

This is most common gynecological problem encountered by the health care provider. It affects all age groups.

Resistant infections are difficult to treat. As mentioned before it may result from bacterial infections, chemical devices, allergic reactions, and dryness of the vagina due to hormonal changes in the individual such as atrophic conditions during or peri-menopause.

Other contributing factors are Anti-biotic, Hormones, Stress, change in partners. The above may bring about overgrowth of yeast and other unfriendly bacteria in the vagina. The friendly acid producing bacteria in the vagina may be destroyed or diminished (Lactibacillus acidophilus).

Some of the common pathogens may be mentioned here and some remedies which could be applied.

Be advised –that self treatment is not the best approach. Do contact your doctor for proper assessment and treatment.

Sexually Transmitted Diseases such as gonorrhea and tricomoniasis; could be treated with the appropriate antibiotics.

I. Candidiasis (Fungus) is the most troublesome of all vaginal infections. About 30% of all women harbour this yeast Candida in the vagina.

They are harmless if not not triggered by other conditions such as frequent douches with chemical; trauma, excessive use of antibiotics. The echo-balance in the vagina will be disturbed with resultant excessive discharge and itching and even swelling of the vulva. The PH of the vagina at about 4.5 when disturbed has uncomfortable consequences. Patients with diabetes and HIV are at increased risk for Candida vaginitis. Candida vaginitis is usually thick adherent white vaginal discharge that is “cottage cheese-like” in appearance.

1. It is very frequent in the Diabetics.

2. Malodours might be due to coexisting bacteria. Please do contact your health care provider for proper evaluation. Avoid over the counter medications. Some of the yeasts are very resistant to treatment (Candida tropicalis, Candida globate).

3. Check your blood sugar levels at the health care facility.


BACTERIAL VAGINOSIS

Recent studies have demonstrated a variety of organisms appear to be associated with this condition.

Women with bacterial vaginosis experience malodours -  fishy vaginal discharge. This may be exaggerated following menstruation; or after sexual intercourse. The vaginal discharge is thin, dark or dull grey. Vulva swelling is less common.

I. The male semen is slightly alkaline; may shift the vaginal acidity to more than 4.5 PH.

Some simple tests would be conducted by your doctor at the clinic to determine the accuracy of the diagnosis and start with treatment (Metronidazole and Clindanycin). You may ask or remind your health care provider to conduct simple tests as (WHIFF/AMINE Test) vaginal creams are treatment of choice. Recently Zithromycin oral medications are quite successful.

TRICHOMONAS

Trichomonas vaginitis is considered sexually transmitted disease with wide range of smptoms 25%-50% may not have any significant symptoms, usually yellow-grey or green-malodorous, or foul odour and occasionally burning urination. Your doctor will contact cultures etc for diagnosis. Incidentla diagnosis could be made on a PAP smear.

Metranidazole (flagyl is the treatment of choice) Male partners should also be treated. Metranidazole is not to be given during 1-3 months of pregnancy.

SUMMARY OF CLINICAL MANIFESTATIONS OF VAGINITIS AREA

I. CANDIDA VAGINITIS

None malodorous, thick white, cottage-cheese-like discharge that adheres to vaginal wall.

- Pruritis or itching

- Microscopic examination of buddies

- Hyphae of the discharge.

2. TRICHOMONAS VAGINITIS

- Vulva vaginal irritation

- Painful urination

- Copious yellowish-green or grey discharge. Fishy or homogenous-high PH above 4.5

- Presence of mobile flagellated organisms under microscopic examination.

3. BACTERIA VAGINOSIS

- Thick dark or dull grey discharge

- Homogenous, malodorous discharge that is adherent to the vaginal walls. Positive amine test, clue cells on wet microscopic mount.

4. ATOPHIC VAGINITIS

- Vaginal dryness or burning usually experienced during per-menopause/menopause.



5. VULVAVAGINITIS OF CHILDREN

Mothers or care takers in day care nurseries should be vigilant and help with proper hygiene training of the young girls.

Send them to their pediatric doctors for evaluation and prompt treatment if need be.

NB:

A word of caution-avoid the use of douches with chemicals etc. You can just dip gauze in a warm salt solution and cleanse your inside with two fingers preferably with a pair of clean sterile gloves.

6. WOMB AND ADNEXTAL INFECTIONS (TUBES AND OVARIES)

A womb infection is a gynaecological emergency, accompanied by chills and fever. The septicaemias may be very grave with adverse consequences. Surgical procedures may be resorted to for prompt treatment.

Womb infections may spread to both fallopian tubes and ovaries. Womb infection may result mostly from;

i. Sceptic D&C abortion

ii. Occasional post cesarian section.

iii. Retained placental tissues after normal vaginal deliveries.

Please don’t be a victim of “physician heal thyself”. Contact your doctor for proper healthcare provider. Chronic pelvic infection can destroy your fallopian tubes and ovaries resulting in infertility.