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Common vaginal infections

Itchiness, soreness and a vaginal discharge can be signs of infection. However, it is quite normal and healthy for women of childbearing age to have a vaginal discharge. The quantity and colour of this can change during the menstrual cycle, sexual excitement and pregnancy. An abnormal discharge which is thick and white, green and foul-smelling, or blood stained suggests possible infection.

This information was published by Bupa's health information team and is based on reputable sources of medical evidence. It has been peer reviewed by Bupa doctors. The content is intended for general information only and does not replace the need for personal advice from a qualified health professional.

It's normal and healthy for women to have some discharge from their vagina. 

The amount and colour of this discharge can change during your menstrual cycle, when you take the contraceptive pill and when you’re pregnant. 

Symptoms of a vaginal infection include:

 

  • an unusual vaginal discharge – it may be an unusual colour and smelly
  • an irritated and sore vulva (the skin around the outside of your vagina) 
  • feeling itchy in your vagina
  • pain when you have sex
  • bleeding between your periods or after you have sex
  • pain in your lower abdomen (tummy) or pelvis
  • lumps, redness, swelling, blisters or ulcers on your vulva or anus
  • pain when you pass urine 


If you have any of these symptoms, see your GP or go to a sexual health clinic.

Here are the main types of common vaginal infections. It’s important to get treatment for vaginal infections so you don’t develop any complications. These potential risks are listed in the last column of the table.

Infection
Main symptoms (if you get any)
Sexually transmitted?
Treatment
Risks (if you don’t get treatment)
Bacterial vaginosis (BV)
  • Vaginal discharge that’s usually thin and grey with a fishy smell
There may be a link
Antibiotics
  • Pelvic inflammatory disease
  • Miscarriage
  • Premature labour

Chlamydia
  • Cloudy or yellow vaginal discharge
  • Bleeding from your vagina after you have sex or between periods
  • Pain in your lower abdomen (tummy) or pelvis
  • Pain when you pass urine
  • Pain when you have sex

Yes Antibiotics
  • Pelvic inflammatory disease
  • Infertility
  • Ectopic pregnancy

Genital herpes
  • Tingling or pain in your genital area
  • Painful blisters, or patches of sore, red skin on or around your vagina and bottom
  • Pain when you pass urine
  • A fever and feeling generally unwell

Yes Antiviral tablets and cream
Genital warts
  • Small, round lumps on or around your vulva, cervix, vagina or anus

Yes Creams, liquids, cryotherapy (a procedure to freeze off the warts), surgery or laser treatment
Gonorrhoea
  • Yellow vaginal discharge that may have pus in it
  • Pain when you pass urine
  • Bleeding between your periods of after sex
  • Pain in your pelvis or tummy when you have sex
  • Heavy periods

Yes Antibiotics
  • Pelvic inflammatory disease
  • Becoming infected with viruses such as HIV

Thrush
  • Feeling itchy and sore around your vagina and vulva
  • Thick, white vaginal discharge (that looks like cottage cheese)
  • Pain when you have sex and when you go to the toilet to pass urine

Not usually Antifungal tablets, creams or pessaries (which you put into your vagina)
Trichomoniasis
  • An itchy or painful vulva with heavy, sometimes frothy, yellow-green, fishy-smelling vaginal discharge

Yes Antibiotics
  • Premature labour
  • Low birth-weight baby
  • Men becoming infected with viruses such as HIV

Your GP or doctor at a sexual health clinic will ask about your symptoms and your medical history. Your GP may refer you to a sexual health clinic for specialist treatment. 

 

There are different ways to test for a vaginal infection. You may be asked to provide a sample of urine. A doctor or nurse at the clinic or surgery may ask to look inside your vagina using a speculum. This is an instrument to gently open your vagina; it is also used for smear tests. They’ll use a small, round cotton bud to take a swab of a sample of discharge or cells from your vagina.

 

These samples may be tested or examined under a microscope in the clinic, and also sent to a laboratory for testing.

 

Bacterial vaginosis

 

Bacterial vaginosis (BV) is an infection that can happen when certain bacteria (Lactobacillus) living naturally inside your vagina grow more than usual, or are overgrown by others (eg Gardnerella vaginalis). It’s the most common vaginal infection, and up to half of women don’t get any symptoms.

Possible triggers of BV include:

 

  • perfumed soaps, feminine hygiene sprays or vaginal douching
  • having a copper intra-uterine system (IUS or coil)
  • smoking

 

People don’t always get BV through having sex, although there seems to be a link with being sexually active, and having a new sexual partners.

Any woman with a fishy smelling discharge should seek medical advice, as the effective treatments -- antibiotics in cream, gel or tablet form - are only available on prescription. This treatment is fairly effective in stopping the symptoms, but the condition often returns.

 

Chlamydia

Chlamydia can cause pain when passing urine, long-term pelvic pain and infertility. It has also been associated with low birth weight babies and premature delivery. However, lots of women have chlamydia without knowing it: seven in ten women and half of men with chlamydia don’t have any symptoms.

Chlamydia is caused by the sexually transmitted bacterium Chlamydia trachomitis and is treated with antibiotics (doxycycline, erythromycin or azithromycin). Your doctor will give a course of antibiotic tablets or a one-off dose. Any recent sexual partners will also need to be tested and treated if necessary.

Your doctor may offer to re-test you three to four months after you’ve finished your treatment to check the infection has gone completely. \

Genital herpes

Genital herpes is caused by the herpes simplex virus (HSV), which can be passed on through sexual contact. Once you’re infected, HSV stays in your body for the rest of your life, although it doesn’t always cause symptoms.

Herpes infection can cause spots on the labia, clitoris and pubic area. These look like blisters, ulcers, or chapped areas. People often have flu-like symptoms, fever and pain passing urine for about a week when first infected.

Pregnant women can transmit the infection to her baby during delivery. Severe damage to the baby’s nervous system can be a result of the infection.

Your GP may prescribe antiviral tablets, which can reduce the severity of the attack, but won’t eradicate the infection as there is no cure. This means you may still get further attacks. You may also be given a local anaesthetic ointment to use on the affected area, to help with any pain.

The virus is most infectious during an attack, so avoiding sexual activity at this time lessens the chance of passing it to others.

Genital warts

Genital warts are caused by HPV (human papilloma virus), which makes cells grow unusually. You can catch genital warts by having sex or genital skin-to-skin contact with someone who has them. Exposure to HPV increases the risk of developing cervical cancer.

Genital warts appear as small, round lumps on or around your vulva, cervix, vagina or anus. It can take several weeks or months after you get infected for these to appear. Once you’re infected, HPV stays in your body for the rest of your life, although it doesn’t always cause symptoms.

Treatment depends on where the warts are, what they look like and how many you have. You might be offered creams or liquids, cryotherapy (a freezing procedure), surgery or laser treatment. You might find that the warts go after one treatment, or you may need to have several treatments.

Gonorrhoea

Gonorrhoea is caused by a type of bacteria called Neisseria gonorrhoeae, which you can get if you have unprotected sex.

Half of women with gonorrhea don’t have any symptoms. If you do have symptoms, they’ll usually appear within 10 days of getting infected. The main symptoms are vaginal discharge ad pain passing urine.

Gonorrhoea is treated with antibiotics. Your doctor will give you antibiotics as a one-off injection and tablets. Any recent sexual partners will also need to be tested and treated if necessary. If left untreated, gonorrhea can lead to pelvic infection, with abdominal pain, painful sex, and a general feeling of being unwell. Damage to the Fallopian tubes can result in reduced fertility and an increased risk of ectopic pregnancy (pregnancy in the tube rather than the womb).

Thrush

Up to half of women have the yeast Candida albicans growing harmlessly in their vagina. However, when it grows excessively, it causes thrush (vaginal candidiasis).       Irritation and soreness of the vulva are the usual symptoms, sometimes but not always, accompanied by a thick, white vaginal discharge. If left untreated, the irritation can spread to the area between the buttocks. Passing urine and intercourse can be painful.                                                                                                                                                                                          

Common triggers for thrush include:

  • Taking some types of antibiotic
  • Being pregnant
  • Having diabetes that’s not well controlled

Perfumed soap or feminine hygiene sprays, taking the combined contraceptive pill and wearing tight underwear or clothes have also been linked to thrush. But there isn’t any strong evidence to prove it.

Most infections get better if you take antifungal tablets, or use antifungal creams or pessaries (which you put into your vagina). Examples of medicines include fluconazole and clotrimazole. You can get these from a pharmacist without a prescription. In addition, many women find that applying plain yoghurt to the area helps relieve symptoms. If you’re pregnant, see your GP before you take any medicines to treat thrush.

Wearing cotton pants, changed daily, and avoiding harsh soaps, bubble baths and deodorants may help prevent thrush. Vaginal douches are not recommended to treat or prevent vaginal infections, including thrush, as they disturb the natural, and protective, acidity of the vagina.

Pre-eclampsia (Trichomoniasis)

Trichomoniasis is caused by a parasite called Trichomonas vaginalis, which you usually get through having unprotected sex.

Up to half of women with trichomoniasis don't have any symptoms. But, the characteristic symptom of trichomonas infection is a heavy, frothy, yellow-green, unpleasant-smelling discharge. It can also cause discomfort during sex, vaginal itching, pain when passing urine and occasionally stomach pains. Research has linked trichomonas infection with infertility, increased risk of transmission of HIV, premature labour, and low-birth-weight babies.

Trichomoniasis can sometimes get better without any treatment, but your doctor will usually prescribe some antibiotics to clear up the infection. They may prescribe a course of antibiotic tablets lasting five to seven days, or it may be a one-off larger dose. Your partner will also need to be treated, even if they don’t have symptoms of the infection.

Safer sex

Chlamydia, gonorrhoea, herpes and trichomoniasis are sexually transmitted diseases (STDs) that can cause vaginal symptoms. However, some STDs do not cause symptoms. As a condom provides good protection against many STDs, one should always be used unless both partners are entirely sure that they have not been exposed to infection.

If you suspect you have an STD, or other genital or urinary infection, see your doctor.

Self help

Other things you can do to reduce your risk of getting a vaginal infection include: 

  • not using perfumed soaps or antiseptic feminine hygiene wash
  • not using vaginal douches – they disturb the natural protective acidity in your vagina

1. Is there anything I can do to feel more comfortable when I have a vaginal infection?

Things you can do to help ease your symptoms while you're having treatment include wearing loose-fitting clothes and underwear and taking painkillers. Also, don’t use perfumed bath and shower products.

If you do the following, it may help you feel more comfortable. 

  • Wear loose-fitting, cotton clothes rather than tight clothes, or nylon underwear or tights.
  • Use plain water or an emollient such as E45 to wash – perfumed soaps, bath or shower products, antiseptics or vaginal deodorants can irritate your skin.
  • Don't scrub with a flannel or sponge. And wash your hair over a sink so the shampoo doesn't get to the affected area.


If you have pain from genital herpes or warts: 

  • take an over-the-counter painkiller, such as paracetamol or ibuprofen
  • have a bath in salt water 
  • put petroleum jelly (such as Vaseline) or a mild anaesthetic gel on the infected area – you can buy this from a pharmacy
  • pass urine while you’re sitting in the bath, or pour warm water over your vulva while you're on the toilet

 

2. How long will it take for a vaginal infection to clear up and will it come back?

This can vary. Common bacterial vaginal infections are often treated with a course of antibiotics but some infections do come back. You can help to prevent this by taking your medicine as directed and finishing the course of treatment.

The time it will take for the infection to clear up depends on the type of vaginal infection you have. If you still have symptoms after you’ve finished your treatment, or you get it again, talk to your sexual health clinic or GP.

It's important that you finish your course of treatment even if your symptoms have improved. Always read the patient information leaflet that comes with your medicine. If you have any questions, ask your pharmacist or GP for advice.

Some vaginal infections, such as genital herpes and genital warts, can keep coming back. This is because these viruses are never completely cleared from your body. Other infections such as chlamydia and gonorrhoea normally only come back if you get infected again, which can happen if your partner doesn’t get treated.

3. Can I use yoghurt or tea tree oil to treat a vaginal infection?

'Live' natural yoghurt may help to ease symptoms of thrush and bacterial vaginosis (BV) but it won’t cure either infection. Studies haven’t shown that the complementary medicine, tea tree oil, can treat thrush.

Both thrush and bacterial vaginosis are thought to be caused by a disturbance in the healthy bacteria and yeasts usually found in your vagina. There isn’t enough research to show whether yoghurt is effective at treating either condition, but it may help to ease your symptoms.

Yoghurt isn't likely to be harmful so if you want to ease your symptoms, you can put it in and around your vagina. Use plain, 'live' yoghurt. If you use a probiotic yoghurt that contains lactobacillus, it may help to prevent bacterial vaginosis if you’re prone to it.

This information was published by Bupa Group's Health Content Team and has been reviewed by appropriate medical or clinical professionals. To the best of their knowledge the information is current and based on reputable sources of medical evidence, however Bupa (Asia) Limited makes no representation or warranty as to the completeness or accuracy of the Content.

The information on this page, and any information on third party websites referred to on this page, is provided as a guide only.  It should not be relied upon as a substitute for professional medical advice, nor is it intended to be used for medical diagnosis or treatment. Bupa (Asia) Limited is not liable for any loss or damage you suffer arising out of the use of, or reliance on, the information.

Third party websites are not owned or controlled by Bupa and any individual may be able to access and post messages on them. Bupa is not responsible for the content or availability of these third party websites.

 

 

Further Information

The Family Planning Association (UK) 
http://www.fpa.org

Brook (info and services for under-25s)
www.brook.org.uk/

National Womens Health Information Center 
http://www.4woman.gov/faq/Easyread/vi-etr.htm

National Vaginitis Association 
http://www.vaginalinfections.com/

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