Vaginitis: What’s going on “down there”?

VaginitisEver felt itchy “down there”?

Or had some “weird” discharge?

Or both???

 

Most of us have had some of these symptoms at some point or another, right?

In my practice, I have a special interest in women’s health, including naturopathic gynecology, so I see A LOT of female patients who want help with symptoms like:

  • Itching
  • Burning (oh the burning!)
  • Chronic discharge
  • “Funky” smelling discharge

Today I’m going to break down the most common reasons for vaginitis, aka vaginal discomfort and vaginal discharge.

What is vaginitis?

The Mayo Clinic defines vaginitis as “an inflammation of the vagina that can result in discharge, itching and pain.”

Most of my patients find that eliminating symptoms is not difficult using conventional medical treatment or even over-the-counter treatments, some issues come back over and over or go on and on and on and on…

Actually RESOLVING the problem depends on accurate diagnosis of the cause and often requires more holistic treatment that addresses any underlying issues that are preventing healing.

Naturopathic gynacologyNaturopathic Medicine to the rescue!

I don’t know about you (but I can probably guess…), but I’m interested in long-term resolution, also known as CURE.

To treat correctly and achieve resolution, it is so important to determine the true cause (or causes) of vaginitis as accurately as possible, including whether an infection of some sort is causing vaginitis as well as what is going on with the individual that is preventing the body from healing itself (as it is so great at doing most of the time).

The following are the most common causes of vaginitis and their characteristic signs and symptoms, including one cause you’ve probably never heard of (but should definitely be aware of):

1. Chlamydia or gonorrhea

What is it?

  • Both are sexually transmitted infections
  • May be asymptomatic or present with mildly odourous, white or yellow, mucopurulent scant to moderate discharge
  • If left untreated, can lead to pelvic inflammatory disease which can cause chronic pelvic pain and infertility
  • Diagnosed via urine test or endocervical swab

Treatment:

  • Conventional medical treatment is antibiotics
  • Naturopathic treatment can be used to support healing and preventing adverse effects of using antibiotics

2. Trichomonas

What is it?

  • Another sexually transmitted infection
  • May present with vaginal irritation
  • Profuse discharge that is white, green, or yellow, odourous (may be “fishy” smelling), and watery, frothy, or foamy
  • Diagnosed via vaginal culture

Treatment:

  • Conventional medical treatment is specifically metronidazole
  • Naturopathic treatment can be used to support healing and preventing adverse effects of using antibiotics

3. Bacterial vaginosis (BV)

What is it?

  • Caused by depletion of Lactobacilli bacteria, which leads to overgrowth of other types of vaginal bacteria
  • Risk factors include: antibiotic use, douching, use of creams/suppositories/lubricants, unprotected sex
  • Moderate to profuse discharge that is white or grey, odourous (may be “fishy” smelling)
  • Diagnosed via vaginal culture

Treatment:

  • Conventional medical treatment is antibiotics but sometimes the symptoms will return when antibiotics are completed
  • Naturopathic treatment is a great option instead of or in addition to conventional treatment and may include:
    • Antimicrobial herbs orally and/or locally
    • Probiotics to restore normal vaginal flora both systemically and locally
    • Personalized treatment to address underlying causes, such as immune dysfunction, hormone balance

4. Candida (aka yeast)

What is it?

  • Caused by overgrowth of Candida spp.
  • Risk factors include: antibiotic use, pregnancy, exogenous estrogen (via oral contraceptive pill or hormone replacement therapy), unprotected sex
  • Itching, burning, and irritation of the vulva
  • Scant to moderate discharge which is usually white, thick, and adherent and may or may not have a “cheesy” odour
  • Diagnosed via vaginal culture

Treatment:

  • Conventional medical treatment is antifungals but sometimes the symptoms will return when treatment is completed
  • Naturopathic treatment is a great option instead of or in addition to conventional treatment and may include:
    • Dietary changes to eliminate systemic yeast overgrowth
    • Antifungal herbs orally and/or locally
    • Probiotics to restore normal vaginal flora both systemically and locally
    • Personalized treatment to address underlying causes, such as immune dysfunction, hormone balance

5. Cytolytic vaginosis

Also known as “Lactobacillus overgrowth syndrome” or “Doderlein’s cytolysis.”  Most people have never heard of this, including most medical doctors!  It is usually MISDIAGNOSED as Candida (you can see why, right?) but does not respond to treatment for Candida.  Here is a great article that goes into more detail if you’re interested: Cytolytic vaginosis: a review.

What is it?

  • Caused by overgrowth of lactobacilli bacteria, resulting in acidity and irritation
  • Moderate to profuse discharge which is usually white, thick, pasty, and odourless
  • Often worse before the menstrual period (relief with the flow), and can be worse from using vaginal probiotic suppositories

Treatment:

  • There is no conventional medical treatment that I’m aware of since this condition is usually misdiagnosed as Candida
  • Naturopathic treatment is a great option and may include:
    • Probiotics to restore normal vaginal flora systemically (however, avoid using locally as vaginal probiotic suppositories may exacerbate the condition!)
    • Local treatments to neutralize the overly acidic vaginal environment (such as baking soda sitz baths)
    • Personalized treatment to address underlying causes, such as immune dysfunction, hormone balance

Trackbacks/Pingbacks

  1. The other vaginosis: Cytolytic vaginosis case - Kate Whimster, ND - September 9, 2015

    […] In my practice, I find that vaginitis is usually caused by a sexually transmitted infection (such as Chlamydia, Gonorrhea, or Trichomonas), bacterial vaginosis (aka BV), or yeast (aka Candida). For more details on signs, symptoms, and treatment options for these causes, see my article Vaginitis: What’s going on “down there”? […]

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