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Q. Are all vaginal infections transmitted sexually?
No, the most common vaginal infections are bacterial vaginosis, trichomoniasis, and vulvovaginal candidiasis. Some vaginal infections are transmitted through sexual contact, but others such as candidiasis (yeast infections) are not.
Q. What is vaginitis?
Vaginal infections are often accompanied by vaginitis, which is an inflammation of the vagina characterized by discharge, irritation, and/or itching. The cause of vaginitis cannot be adequately determined solely on the basis of symptoms or a physical examination. Laboratory tests allowing microscopic evaluation of vaginal fluid are required for a correct diagnosis. A variety of effective drugs are available for treating vaginal infections and accompanying vaginitis.
BACTERIAL VAGINOSIS
Q. What is bacterial vaginosis?
Bacterial vaginosis (BV) is the most common cause of vaginitis symptoms among women of childbearing age. BV (previously called nonspecific vaginitis) can be transmitted through sexual activity although the organisms responsible also have been found in young women who are not sexually active. BV is due to a change in the balance among different types of bacteria in the vagina. Instead of the normal predominance of Lactobacillus bacteria, increased numbers of organisms such as Gardnerella vaginalis, Bacteroides, Mobiluncus, and Mycoplasma hominis are found in the vagina in women with BV. Investigators are studying the role that each of these microbes may play in causing BV. The role of sexual activity in the development of BV is not understood. Additionally, intrauterine devices (IUDs) may increase the risk of acquiring bacterial vaginosis.
Q. What are the symptoms of bacterial vaginosis?
The primary symptom of BV is an abnormal vaginal discharge with a fishy odor, which is especially noticeable after intercourse. However, nearly half the women with clinical signs of BV report no symptoms. A physician observes these signs during a physical examination and from various tests of vaginal fluid.
Q. Is there a treatment for BV infections and do both partners need to be treated?
All women with BV should be informed of their diagnosis, including the possibility of sexual transmission, and offered treatment. BV can be treated with antibiotics. Generally, male sex partners are not treated. However, in cases of BV that do not respond to drug therapy, treatment of male partners may be helpful. Many women with symptoms of BV do not seek medical treatment, and many asymptomatic women decline treatment. Until the long-term consequences of untreated BV are known, routine treatment of all asymptomatic carriers is not necessary.
Q. Are there any complications of BV?
Researchers are investigating the role of bacterial vaginosis in pelvic infections that result in infertility and tubal (ectopic) pregnancy. There is a growing body of evidence suggesting an increase in adverse outcomes of pregnancy such as premature and low-birth-weight infants among women with BV.
TRICHOMONIASIS
Q. What is trichomoniasis?
Trichomoniasis, sometimes referred to as “trich,” is a common STD that affects 2 to 3 million Americans yearly. It is caused by a single-celled protozoan parasite called Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urogenital tract; the urethra is the most common site of infection in men, and the vagina is the most common site of infection in women.
Q. What are the symptoms of trichomoniasis in women?
Trichomoniasis, like many other STDs, often occurs without any symptoms. When symptoms occur, they usually appear within 4 to 20 days of exposure although symptoms can appear years after infection. The symptoms in women include a heavy, yellow-green or gray vaginal discharge, discomfort during intercourse, vaginal odor, and painful urination. Irritation and itching of the female genital area, and on rare occasions, lower abdominal pain also can be present.
Q. What is the treatment for trichomoniasis?
Although symptoms of trichomoniasis in men may disappear within a few weeks without treatment, men can transmit the disease to their sex partners even when symptoms are not present. Therefore, it is preferable to treat both partners to eliminate the parasite. Metronidazole is the drug used to treat trichomoniasis. It is administered in a single dose. People taking this drug should not drink alcohol; mixing the two substances can cause severe nausea and vomiting.
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