A Healthy Vagina is Our Friend

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People with vaginas know—from the time that you realize what it is and what it does, you have a love-hate relationship with it. Vaginal discomfort can cause a lot of distress for people. 

The vagina is a carefully crafted ecosystem with a healthy mixture of bacteria (some harmful, some good) and yeast coexisting together. It is important to maintain a healthy balance of all these factors to avoid vaginal infection. A normal vaginal pH is acidic, somewhere between 3.8 and 4.5. A lay person does not need to keep track of that; however, it is important to know that when the vaginal balance is disrupted, it will result in an odor or a discharge. Having these symptoms is your body’s way of telling you that your vaginal pH may be off. This blog post provides an overview of common vaginal symptoms, treatments, and helpful tips for prevention.

Vaginal Odor

All vaginal odor is not abnormal. The vagina has a natural scent.  Signs that the vaginal odor may be abnormal include an accompanying discharge, stronger odor with sexual activity, or irritation and itching in the outer vaginal area—which is called the vulva.

Sometimes foreign objects left in the vagina can be the cause of vaginal odor. For example, “lost” tampons have been a cause I have encountered several times over the course of my career. Another thing that can be left behind is a condom. It is important to remember to account for the condom after sexual activity when a condom is used. If a condom remains in the vagina it can cause an odor, eventually irritation, and possibly infection if it's been there for some time. 

Vaginal Discharge

Normal vaginal discharge is usually clear or milky and may have a subtle scent that is not unpleasant or foul smelling.  Vaginal discharge changes over the course of your menstrual cycle and changes in color and thickness are associated with ovulation and are natural. An abnormal vaginal discharge can also be milky, in addition to, gray, foamy or watery.  When we're thinking about abnormal vaginal discharge, there are two conditions that come to mind: bacterial vaginosis and vaginal yeast infections. The symptoms for these problems are actually very similar and may include burning, itching, swelling, irritation, and pressure in the vulvar area, painful urination, and pain during sexual activity.

Chronic/Recurring Infections

Vaginal infections, also called “vaginitis”, are treated with antibiotics prescribed by a health care provider. Making an accurate diagnosis aids in determining the appropriate therapy. It is possible to have an ongoing persistent infection if the treatment doesn’t completely resolve the symptoms. Alternatively, you may have some resolution of symptoms and then they return. This is called a recurrent infection. Completing your prescribed course of therapy minimizes the chance of having an inadequately treated infection. If you find that you're having vaginal infections four to five times a year, then you may benefit from having a prolonged course of treatment to make sure that the infection is completely resolved.  

Vaginal symptoms can sometimes become cyclical in relation to one’s menstrual cycle. This means that you might notice that you were having a little bit of irritation, discharge, or itching, but then your period comes and after that, the symptoms go away. This is sometimes the case because the hormonal changes that occur over the course of your menstrual cycle aids in the natural cleansing of the vagina. The vagina is self-cleansing, and you don't have to do very much to help it out. In some instances, I've had people come see me after having these cyclical symptoms for months. On evaluation, I occasionally see evidence of an overgrowth of both bacteria and yeast. This occurs because your body has been cycling through varying pH levels over time and now you have a mixed infection. Both must be treated to alleviate the symptoms. 

People may exhibit different signs and symptoms of infection. For example, we often think of a yeast infection as being accompanied by a very, very intense itching and irritation of the vulva. That is not always the case. Without the irritation, people often don't notice that they have a yeast infection until they get evaluated for a discharge. They often ponder, “Why wasn’t I itching?” Bacterial vaginosis is typically associated with a watery, milky white discharge and “fishy” odor. The associated discharge may be gray, or foamy, or just like water. A foul odor does not always accompany bacterial vaginosis. Attempts at self diagnosis are often inaccurate. 

Recurrent yeast infections may be a sign of another medical condition. Diabetes can increase your risk of developing recurrent and chronic yeast infections. People with compromised immune systems from HIV, autoimmune conditions like lupus, or other conditions, have an increased risk of recurrent yeast infections as well. A healthcare professional can screen you for other medical conditions that may put you at risk for recurrent vaginal yeast infections. 

Preventing Vaginal Infections

Vaginal infections are not fun to have or treat, and are even more distressing when they recur or become chronic. Here are some tips you can incorporate to improve your vaginal health.

  1. Clothing: If you have recurring issues with vaginal yeast infections or bacterial vaginosis, it is very important to wear cotton undergarments and loose fitting clothing. Wearing fabrics that trap moisture in the vaginal area may alter your natural pH balance. 
  2. Cleansing: Remember that the vagina is self-cleansing—so, you never want to put anything inside the vagina to clean it. The only thing that you need to do is clean the outside of the vagina, the vulva, with warm water only. Even mild soaps can be irritating to the vaginal tissue and increase your chance of infection. 
  3. Diet: If you find that you're having a lot of problems with vaginitis, evaluate your sugar intake. Reducing your dietary sugar will sometimes help to alleviate your symptoms.
  4. Menstruation: You don't necessarily have to avoid tampons. However, if you are having recurring issues with vaginitis, it is a good idea to use pads instead of tampons. Impeding menstrual blood flow may be impacting your vagina's ability to cleanse itself. If you find that you are having irritation from pads you can switch to cotton pads. Also avoid scented pads and tampons and powders and sprays, because those may also alter your balance and increase your risk of infection.
  5. Douching: Oftentimes, people are douching because they are trying to eliminate an odor. If you are concerned by a vaginal odor, make an appointment with a healthcare professional to have it evaluated. Another misconception people have is the idea of douching after sex to avoid pregnancy. Douching after sex does not prevent pregnancy. 
  6. Sexual Activity: Sexual activity should be avoided when you are having symptoms of a vaginal infection. Sex while experiencing symptoms of a vaginal infection may make your symptoms worse and can be very uncomfortable.  Your health care provider will let you know when it is safe to resume sexual activity after treating an infection. 

Your vaginal health can be a reflection of our overall health. Empower yourself with the tips discussed here to practice good vaginal health and avoid infection. Have those awkward conversations about what you’re experiencing with your healthcare provider to get to know your body better and give yourself some peace of mind. Please like and share if you found this information helpful.

Follow Desert Star Family Planning on Instagram and Facebook for Dr. Taylor’s LIVE series “Well Woman Wednesdays” where she discusses hot topics in women’s health Wednesdays at noon. Dr. DeShawn Taylor M.D. is a board-certified Gynecologist and Family Planning Specialist who is the owner of Desert Star Family Planning clinic in Phoenix, Arizona. She is accepting new patients and would love to partner with you in your health and wellness. Please visit www.desertstarfp.com or call 480-447-8857 to learn more and schedule an appointment. 


This content is also available via video on Instagram and Facebook.

Author
DeShawn Taylor, MD Dr. DeShawn Taylor, MD, MSc, FACOG, is a gynecology physician, clinical professor, and reproductive rights advocate, who founded and owns Desert Star Family Planning clinic, as well as Desert Star Institute for Family Planning, a nonprofit organization in Phoenix for which she is the president and CEO.

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