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Diagnosing vaginal infections

There are six major types of vaginal infections, and as most of them have similar symptoms, they can be difficult to diagnose.

Three in every four women will have a thrush infection during their lives. Bacteria occur naturally in every woman’s vagina. They produce acid to fight off other bacteria, viruses and fungi that aren't usually found in the vagina. If something happens to change the vaginal environment, these usually harmless bacteria could multiply and cause a thrush infection. But thrush, while common, is by no means the only vaginal infection doing the rounds.

The six most common types of vaginal infections are the following:

• Bacterial vaginosis
• Candida or so-called "yeast infections"
• Trichomoniasis vaginitis
• Chlamydia vaginitis
• Viral vaginitis
• Non-infectious vaginitis

The term "vaginitis" is commonly used to describe infections or inflammation of the vagina. There are several different things that can cause vaginal infections. These include bacteria, viruses, yeast (fungi) and irritants, such as those found in sprays and creams, and even from wearing tight clothing. Organisms can also be spread between sexual partners during intercourse.

The symptoms of a vaginal infection usually include burning during urination, itching on the outside of the vagina (the vulva), an abnormal vaginal discharge that could have an unpleasant odour and discomfort during intercourse. Some women may also experience pain when urinating, and could suffer from abdominal pains. Sometimes, when you have a vaginal infection, you could bleed after sex, or between periods.

It isn’t always easy to diagnose which vaginal infection someone has. It is advisable to go to the doctor and not just self-diagnose the problem, as you might very well get it wrong.

There are four things that should happen when you go to the doctor with a vaginal infection: the doctor will ask you questions, he/she will do a physical exam of the vaginal area, a urine test will be done, as well as tests on samples of the discharge.

Questions the doctor may ask you could include the following:

• What is the colour and consistency of the discharge?
• Does the discharge have an odour?
• How long have you had this condition?
• Has it been the same throughout your menstrual cycle?
• Do you have a sexual partner? Does he have a discharge from his penis?
• Do you have more than one sexual partner?
• Are you experiencing itching, burning or pain?
• Have you tried any over-the-counter medications to relieve the itching and the burning?
• Do you wear tight underwear or pants?
• Have you changed anything in your personal hygiene routine, such as trying a different type of soap?

For the physical exam, the doctor will put a speculum into your vagina in order to see the cervix. Swabs (which is similar in appearance to an earbud) will be taken of any discharge on the lining of the vagina. Sometimes the swabs can be examined in the doctor’s surgery, but sometimes they need to be sent to a pathology laboratory to be tested. Tests can determine which type of vaginal infection you may have. It is important not to use douches or vaginal creams before a physical exam, as this can make it hard to diagnose the particular vaginal infection.

The doctor may also need to do a bimanual examination in order to feel inside you. Your doctor could also test for sexually transmitted infections (STIs), such as gonorrhoea or chlamydia, if you are sexually active. If any abnormalities are detected on the cervix, the doctor can do a Pap test to check for the possible presence of cervical cancer.
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