That uncomfortable itching

Sunanda has been feeling extremely uncomfortable for the past two days. She has developed a small amount of vaginal discharge but what is really distressing is the intense itching she has developed along with it. The itching is particularly worse at nights. The skin outside seems to be inflamed and there is burning when water touches the area.

Sunanda is not alone. As many as one third of women will develop a vaginal infection (vaginitis) sometime during their lives. Vaginitis is an inflammation of a woman's vaginal lining. Vaginitis affects women of all ages but is most common during the reproductive years. There are many possible causes, and the type of treatment depends on the cause.

It is normal to have a small amount of white discharge from the vagina. This keeps the tissue moist and healthy. Organisms, such as bacteria and Candida (a type of fungus), are always present in the vagina. Vaginitis results when there is an overgrowth of these organisms. Some factors that can precipitate an infection are antibiotics, changes in hormone levels, pregnancy, breastfeeding, and menopause. Vaginitis may cause itching, a bad odour, or a variable amount of discharge.

Diagnosis

The exact cause of the vaginitis is diagnosed by a direct examination and from smears of the discharge. The common causes of vaginitis are fungal overgrowth (candidiasis), trichomonas infection or bacterial vaginosis.

Types of vaginitis

Fungal infection

Fungal infection is also known as candidiasis. It is one of the most common types of vaginal infection. A fungus called Candida is found in small numbers in the normal vagina. However, when the balance of bacteria and Candida in the vagina is altered, the Candida may overgrow and cause symptoms. Some types of antibiotics increase the risk of a fungal infection. A woman is more likely to get fungal infections if she is pregnant or has diabetes. The vaginal discharge usually is white, lumpy, and has no odour.

Fungal infections can be treated either by placing medication into the vagina or by taking an oral antifungal medication like fluocanozole. Antifungal ointments containing a small amount of steroids may also be prescribed to decrease the intense itching associated with a fungal infection. An antifungal powder may be prescribed for use in the groin area.