GynoFiles

Vaginitis is the official term for vaginal infections, and there are many causes, but most are due to yeast, bacterial vaginosis or trichomoniasis.So far the study of vaginal infections has focused on the presence or absence of organisms. Eventually this may expand to the study of other molecules. The study of various compounds of metabolism in the cervix has just identified 313 biochemicals with in cervial and vaginal fluid, and the activity of the fluid probably has to do with what infections actually take hold, as was reported in a June 2015 article by Dr Jeny Ghartey and her coworkers in American Journal of Obstetrics and Gynecology. Most of vaginal infection conditions are straight forward, easy for your gyno to diagnose, and they resolve promptly, and do not need fancy analysis to determine the cause. On the other hand, there are those who seem to pop up with one infection after another and either fail to find a cause or a treatment, and this was the subject of a review in the ...

For women with their first yeast infection, the recommendation is to see your health care provider for a firm diagnosis. For women familiar with the symptoms and therapy, self diagnosis is recommended as a first line therapy. Cream therapy with soothing components is available OTC and thus the go to therapy for a quick resolution of simple yeast infections. Some patients prefer to get quicker relief call us for a pill. However, what the research says about yeast infection resolution may surprise some women. For those women who generally though that vaginal creams were just a bit messy getting the prescription for an oral medication is a good alternative but does require interacting with your provider. For faster therapy it was shown in a new study from the Robert Wood Johnson institute that actually for faster initial relief of itching and burning and irritation the cream works in an hour, whereas the pill taken orally works in 4 hours. Creams can provide 4 hours of complete relief, a...

Factors leading to chronic vaginal infections have been discussed in many posts. Bacterial Vaginosis (BV) is not necessarily a serious disease,and for those who are completely asymptomatic they do not always need treatment. Often there is a striking odor that is bothersome as well as  intense vaginal itching and burning it can cause is very distressing. BV can lead to the actual real concerns of pelvic inflammatory disease or preterm labor. and for some women these infections can become chronic. An interesting study now shows that taking oral contraceptives actually protects against BV. Some gynos think this is contrary to yeast infections, which are thought to be more common in oral contraceptive users. So if you think you have chronic BV infections, don't give up, come in and be tested. Look for confounding infection problems. And there may be a need to treat the guy too. Time to gab with the gyno.

Bacteria The vagina is a very complicated place, in fact containing 1,000,000,000 bacterial colony forming units per gram of secretions. So keeping the healthy mix of just bacteria, let alone the fungal and other organisms healthy is tricky business! When it comes to infections we first to establish whether this is a new infection or truly the same organism that is not treated from your last gyno visit. Then it's whether the treatment was effective to begin with, and finally, should we look into health factors or medication factors that cause the problem. With birth control pills, there has been a lot of conflicting data, some studies say yeast  infections are caused by birth control pills, others have no link, and others say fewer infections. We also think that being on the birth control pills actually decrease episodes of bacterial vaginosis.

Most women worry about their pap smears showing cancer. We worry the most about a pap that shows high grade squamous intraepithelial neoplasia (HGSIL), but of women who have the low grade form, LGSIL about a third will still have serious precancer. And pap tests do show more than just cancer or precancer, they can help figure out infection or precancer. If you have culture tests, often they are the best check of infection. There are ways to detect infection, including tests on the pap cells themselves, or on the liquid that the pap cells are suspended in after collections. So if you get a pelvic exam, find out what types of infection tests. Years ago the only time we could identify an infection would have been to culture for it. Now tests of the organism with tests called PCR are actually done. With these PCR tests, technically we cannot say if it is still an active infection, or a newly treated infection, but eventually all tests go to negative if some one is treated. Infections ...

To those with intimate gyno knowledge, the Clue cell is a nick name for vaginal wall cells, seen on a smear, that have bacteria on their surface. Your gyno will see these when you come in to be evaluated and she looks at a smear under the microscope. In actuality that is all that is needed for a fairly firm diagnosis of bacterial vaginosis, and it's a quick and relatively cost effective way of making that diagnosis too. These cells can be detected on smear when women have  Bacterial Vaginoisis (BV). This infection gets started when you loose the normal vaginal lactobacilli that produce the hydrogen peroxide discharge that keeps the vagina very acidic. If the pH changes, becomes too basic, other bacteria will overgrow. And those there are normally over 100,000 colonies of bacteria growing in the vagina, and those that produce BV are only 1%, a slight increase in that 1% can cause the infection. Vaginal itching is very common in with these infections, and it can occur in women of ...

Some women get vaginal infections over and over. and the Should you blame your birth control pill for all your vaginal infections? Should you stop your pill if you get many vaginal infections? Should you change your pill if you get vaginal infections? All such good questions! When we say women are getting vaginal infections on the pill usually it is either  a chronic yeast infection or chronic BV infection . We no sooner get one cleared, they have another. It has been tempting to blame many factors for the recurrence of any infection. The vagina is a very complicated place, in fact containing 1,000,000,000 bacterial colony forming units per gram of secretions. So keeping the healthy mix of just bacteria, let alone the fungal and other organisms healthy is tricky business! When it comes to infections we first to establish whether this is a new infection or truly the same organism that is not treated from your last gyno visit. Then it's whether the treatment was effective to begin...

If you are around the age of menopause or beyond and you have painful intercourse you may have post-menopausal vaginal syndrome . Estrogen during the premenopausal years is important for walls of the vaginal and the tissues of the vulva to remain healthy. It is important for the whole urogenital tract to remain healthy, so even the urethra and the tissues near the anus can become affected when the levels of estrogen decline as women get older. With post-menopausal vaginal syndrome women may experience vaginal dryness, vaginal discharge, burning with urination, itching of the vaginal area, and itching of the area of tissue between the vagina and the rectum known as the perineum. In severe cases women will report bleeding after sex, bleeding after exercising or spot bleeding unexpectedly. If you have a pelvic exam you may be told by your gyno that you have vaginal atrophy which is a thinning and dryness of the vaginal walls. Lack of estrogen and the post-menopausal vaginal sy...

Clear vaginal discharge if you are on or off birth control pills. may mean ovulation, or an estrogen effect on the cervical mucus. A physician can test your cervical mucus midcycle to see if you are showing that ovulatory effect. Although the studies all talk abut changing the mucus of the cervix such that it is a block to sperm, the recent studies looking at ovulation rates do not use this measurement as clinical evidence of ovarian suppression, but we definitely could. You could have a check up that determines if your regular clear discharge is ovulation or if your discharge is actually a vaginal infection. If you are ovulating on the birth control pill then you may need to be evaluated to see if this is the right birth control pill for you.

Preterm birth is most often caused by infections says a group looking at ways to prevent all preterm births . But one thing they have not gotten is a way to prevent these infections. Research still has to answer how we can prevent these pregnancy associated infections. Back in the early days of the bacterial buggy squads, they plodded along, looking at one bacteria at a time. New studies point out that they can now look at hundreds . The Canadians have had serious birthing issues and the problem required not just mounted police, it required the Microbiome squad to come and investigate what was causing an alarming rise in the rate of premature births in the country. The Canadian project work has just begun, and they will likely have many a ream of publications for us to review before they are done. The NIH has launched it's Microbiome project as well. This is the most exciting progress in understanding vaginal physiology that has come around in a long time. We will watch these P...

One in 20 women with a yeast infection will develop chronic and recurrent infections. As our prior post said: gynos define recurrent and chronic as more than 4 a year. Most yeast infections are due to pesky and pervasive Candida albicans. Some experts say albicans are 95% of those infections we see, others knock that percentage down to only 75%. And random healthy women sampling find that 25% of those women walking into any office at any time will culture positive for yeast. If you have that yeast infection, you may or may not rate with Dr. House on the medical diagnostic accuracy scale. And women are not encouraged to self treat if you have never been to a gyno for evaluation of a vaginal yeast infection.If you try to self diagnose, you’re probably right somewhere between 1/3 and 50% of the time. So if your symptoms don’t resolve promptly with your goo of choice, inaccurate diagnosis can be the culprit as often as inaccurate treatment. I like to point out that hormone levels and c...

Dr. Charles Penrose of the Gynecean Hospital published his Textbook of Disease of Women in 1900 and eloquently described effective treatments for vulvar itching or other discomforting diseases of the external genitalia that included mercury, bitter almonds, lead or just a solution of pure cocaine used locally. Often copious powders, opium or morphene, all used topically, were employed as well. Exciting reading in those old texts!

Some women cannot exactly differentiate yeast infections from bladder infections. If a patient has recurrent infections of either there are various signs that can be confusing. Symptoms such as pain with intercourse (could be either), thick white discharge (yeast), burning with urination (bladder infection). Other signs you might want to look for, is "splash dysuria" this is pain as you urinate and some urine touches the outside of your skin, but its not specifically painful to just urinate. But ultimately, an examination, and medical tests, such as cultures have to be done to determine what is going on.For those who have multiple infections, i t's time to see the gyno and not continue to rely on self diagnosis. Recurrent yeast infections are defined as four or more infections per year. Solutions have varied from the bizarre: garlic inserts? Does the series Twilight factor too prominently in your life? To effective: weekly prescribed fluconazole oral tablets. But...

This can be a trick question. Did you know what the studies show