Top vaginal issues you are afraid to ask your doctor about.
MMany women experience vaginal problems at some point in their lives. Dr Regina Zuzarte-Ng, obstetrician and gynaecologist at GynaeMD Women’s Clinic, breaks down common complaints and shares tips on how to tackle them.
Itchiness and cottage cheeselooking discharge
This is most likely caused by a yeast or fungal infection, commonly known as thrush. DEAL WITH IT… Head to a pharmacy and grab some over-the-counter or pharmacistdispensed antifungal creams and vaginal pessaries. Taking probiotics can also help. If the infection does not go away even after you’ve taken the above measures, or if you keep getting the infection, pay the doctor a visit.
Watery white, grey or yellow discharge with a fishy smell
This is most likely a symptom of bacterial vaginosis (BV), an infection caused by an overgrowth of abnormal bacteria, which can be induced by anything that changes your natural vaginal pH balance, such as douching, sex or antibiotics. DEAL WITH IT… Avoid scented soaps and bubble baths, and make time for a medical consult. While BV can sometimes clear up on its own, it’s best to always see a doctor and get treated with medication (oral or vaginal). This is especially important if you’re pregnant as it can trigger preterm labour, or if you’ve recently undergone gynaecological surgery.
Frothy yellow or greenish discharge with a foul smell
This could be indicative of trichomoniasis, a sexually transmitted infection (STI) caused by a parasite known as trichomonas vaginalis. DEAL WITH IT… Talk to your doctor, who will examine your vaginal discharge for evidence of the parasite and also screen for other STIs. Trichomoniasis is easily cured with antibiotics, which you and your sexual partner will need to take. You will also need to refrain from sex during treatment.
Bleeding or spotting outside of your period
There are many reasons for this, including rough sex; hormonal imbalance; abnormal growths such as fibroids, endometrial polyps and ovarian cysts; ectopic pregnancy or miscarriage; infections of the vagina or cervix; and cancer. DEAL WITH IT… Make a note of when it occurs. Spotting is totally normal if you’re on a low-dose birth control pill, but bleeding after sex could be a symptom of cervical cancer. See a doctor if you notice persistent spotting.
Cloudy or yellow discharge
This could point to an infection, but it could also be part of the normal physiological changes (in colour, texture and/or amount of the vaginal/cervical mucus) that occur during the menstrual cycle. DEAL WITH IT… Monitor the discharge throughout an entire menstrual cycle. If the discharge is foul-smelling and accompanied by pelvic or abdominal pain or itchiness, see a doctor immediately.
Bumps, lumps or blisters in the genital area
These are commonly caused by STIs, although they could also be the result of skin disorders and other infections. The bumps or lumps could be genital warts, an STI caused by certain strains of the human papillomavirus (HPV). Of course, they could be completely benign: a sign of skin irritation; ingrown hairs caused by shaving or waxing; or sebaceous cysts, which develop when the sebaceous gland – which
produces the oil that lubricates the hair and skin – or duct is blocked or damaged. Blisters are usually symptomatic of STIs such as genital herpes and syphilis, caused by the herpes simplex virus and the bacterium Treponema pallidum respectively. DEAL WITH IT… See a doctor as soon as possible; it is vital that you get tested and treated. Meanwhile, keep the genital area clean and dry. If an ingrown hair is the culprit, applying a warm compress should do the trick. If you are sexually active, take precautions so that you don’t pass anything to your partner.
Hormonal changes that occur during childbirth, breastfeeding or menopause can cause this, as can overzealous douching. If you experience vaginal dryness during sex, it’s usually due to inadequate foreplay and/ or natural lubrication. DEAL WITH IT… Avoid douching, and use a good lubricant for sex. Consult a physician if you suspect the dryness may be caused by hormonal changes.
Extreme vaginal itchiness, burning or irritation (with no discharge)
This could be caused by a number of things, such as an infection and eczema. It could also be due to the hormonal changes during menopause, or simply a reaction to an irritant such as strong, scented soap. DEAL WITH IT… Avoid using perfumed toilet paper, and bath and female hygiene products. To prevent further irritation, do not douche for the time being. If the itching, burning, redness or irritation persists, or if you suspect it’s due to menopause, see a doctor.
A spot that’s always itchy and irritated
An infection or eczema could be the cause. In rare cases, this could be a symptom of vulva cancer. DEAL WITH IT… Stay away from all things that would make the itch and irritation worse, such as bath salts, bubble baths, and scented oils, bath and female hygiene products. Avoid scratching or rubbing the spot, as this would make the itch worse. Consult a doctor if the itch persists despite the above actions, or if the spot on your vulva looks different than usual.
Deep, internal vaginal pain
This type of pain can stem from a variety of conditions. These include endometriosis, a painful disorder in which tissue that normally lines the inside of the womb grows outside it and can cause ovarian cysts or pelvic adhesions (internal scars); pelvic inflammatory disease, which is an infection of the female reproductive organs; uterine fibroids, non-cancerous growths of the uterus; irritable bowel syndrome, a chronic condition of the large intestine that causes cramping, abdominal pain, bloating, gas, diarrhoea and constipation; scars from previous abdominal or pelvic surgery, chemotherapy or radiation; and emotional stress. DEAL WITH IT… See a doctor if the pain persists for more than a day or two, especially if it is accompanied by discharge or fever. Your physician will likely conduct a pelvic exam or an ultrasound to find out what exactly is causing the pain.
Painful and frequent urination
Common causes include a urinary tract infection (UTI), kidney stones, menopausal changes and interstitial cystitis (a chronic condition in which the bladder becomes inflamed). DEAL WITH IT… Wipe from front to back after urinating or bowel movements, so faecal bacteria isn’t introduced into the urinary tract, worsening existing symptoms. Also, up your fluid intake, especially plain water. In the case of a UTI, drinking more water increases urination, which flushes out the infection-causing bacteria from the urinary tract, helping to eliminate the infection faster. In the case of relatively small kidney stones, the increased urination will help speed up the process of passing a stone naturally.
A medical consult may be best if you suspect it’s a UTI (which can be easily treated with antibiotics), if the problem persists or if it occurs repeatedly. If it’s a UTI, refrain from having sex until the infection has completely cleared up (a week or so), as the act may further irritate the affected tissues. See a doctor immediately if blood is present, or if the painful urination is accompanied by fever or a backache, which may signal a kidney infection rather than just a bladder infection.
Pelvic pain, accompanied by discharge or fever or both
This could indicate pelvic inflammatory disease. DEAL WITH IT… It’s best to see a doctor immediately, especially if the pain is persistent and accompanied by fever. You will most likely need a course of antibiotics. Severe cases may even require surgery to drain the pus inside the pelvis.
Having sex is always very painful, as is using tampons
If you find sex painful and it isn’t because of inexperience, anxiety or a lubrication issue, it could be due to endometriosis, an infection, pelvic inflammatory disease or vaginismus, a rare but painful condition where the vaginal muscles get so tight, they basically close off the opening of the vagina. DEAL WITH IT… Try extended foreplay or different positions to see if that alleviates the pain. If the pain persists, or if there is abnormal bleeding, consult a physician for a diagnosis.
Having sex is suddenly painful – and you used to enjoy it!
Pain during what’s usually a pleasurable experience could have many causes, including endometriosis, an infection, and abnormal growths such as fibroids and ovarian cysts. DEAL WITH IT… If the pain is persistent or there is any bleeding, abstain from sex until you consult a doctor, who can help shed light on the cause. Be as exact as possible in describing your discomfort so that your physician can pinpoint the underlying cause and prescribe the right treatment.
This could be caused by menopause, hormonal changes or frequent bike riding. DEAL WITH IT… If you feel it’s bike-related, invest in a padded seat or padded shorts. If you suspect it’s due to menopause or hormonal changes, see a doctor.