Your Privates Problems -- Solved

From the WebMD Archives

By Janis Graham

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Discomfort "down there" doesn't always mean what you think.


Worried you have a yeast infection? Don't be so quick to diagnose -- or treat -- yourself. "About 75 percent of women who believe their symptoms signal a yeast infection have something else," says Jennifer Gunter, M.D., director of pelvic pain and vulvovaginal disorders at Kaiser Permanente San Francisco Medical Center. What's more, improper diagnosis and treatment can have long-term effects: Some vaginal infections increase your risk of infertility, complicated pregnancies, and contracting certain STDs. Use our guide to determine the real source of your troubles -- and the right cure.

Bacterial Vaginosis (BV)

Symptoms: A fishy-smelling, watery discharge that's particularly noticeable after intercourse; itchiness.

How you get it: About 46 percent of women who visit their doctor to treat a vaginal infection have BV. It's caused by an overgrowth of bacteria that normally reside in the vagina. Experts aren't sure what triggers this overgrowth, but douching, using an intrauterine device (IUD), or having a new sex partner can alter vaginal bacteria levels and increase susceptibility.

What to do: See your ob/gyn right away to check for evidence of a bacterial overgrowth. Women with BV are more likely to contract HIV if exposed, and to suffer from pelvic scarring, which can lead to infertility. BV is also linked to low birth weight and preterm birth in pregnant women. The infection is easily treated with antibiotics, but be aware: It returns in up to 30 percent of women within three months. If that happens, you may need a longer course of medication.

Trichomoniasis (trich)

Symptoms: A frothy, yellow-green discharge; a musty odor; bleeding after sex.

How you get it: Trich is the most common curable STD in young, sexually active women and is caused by a parasite that passes from partner to partner. Like BV, the infection is linked to preterm delivery and low birth weight. Men may experience itching or burning after urination or ejaculation but are often asymptomatic, which may be why trich is easily spread.

What to do: See your gyno. Trich can be cured with a single dose of the antibiotics tinidazole or metronidazole. Your partner should seek treatment too.


Noninfectious Vaginitis

Symptoms: Inflamed, itchy genitals.

How you get it: Although an infection is usually the cause of these symptoms, sometimes an allergy or irritation is to blame. Vaginal tissue is delicate and some women are sensitive to sprays, douches, spermicides, or perfumes.

What to do: Skip feminine-hygiene products -- your vagina is self-cleansing -- and stick to gentle soaps. Soothe soreness with Eucerin lotion, A+D Ointment, or Aquaphor ointment. Finally, launder underwear in unscented detergent (nix the fabric softener -- it leaves irritating residue) and rinse them well.

Yeast Infection

Symptoms: itchy, irritated, and sensitive genitals; a white, "cheesy" discharge.

How you get it: Normally, yeast, a fungus, lives harmlessly in your vagina. But certain factors can encourage it to overgrow. For example, oral antibiotics can wipe out the good bacteria that keep yeast in check, and spermicides encourage yeast to stick to vaginal walls, where it multiples. Tight clothes also create a dark, moist environment in which yeast flourishes.

What to do: Self-test with Fem-V, available over-the-counter for $8. You wear a special panty liner for six hours; the indicator strip tells you if you have a yeast infection, which you can treat with drugstore remedies. If it's not a yeast infection, see a doctor -- you could have one of the conditions above.

What Is "Normal"?

Up to 21 percent of women who believe they have a vaginal infection turn out to be healthy. "It's completely normal to experience some itching and changes in wetness or odor," says Paul Nyirjesy, M.D., director of the Drexel Vaginitis Center in Philadelphia. A guide to regular discharge: It's minimal right after your period, opaque and sticky after that, and stretchy and clear mid-cycle. Prior to your next period, it should look tacky and chalky yellow or white.



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