What we can do for you

• Our doctor will take a detailed history and perform an examination
• It may be necessary to send swabs to a local laboratory for confirmation of the cause
• Results will be discussed with the patient usually by telephone and any treatment required will be provided on prescription
• The nature of the problem will be explained and any lifestyle or dietary changes needed to prevent recurrence will be provided
• The cost of this service is €60 with swabs an extra €20 each (maximum of two swabs done if indicated)

Vaginal infections

Vaginal infections are extremely common. Approximately 50-75% of women will have thrush at some point and 10-30% will have bacterial vaginosis. This section will deal only with these two infections. Chlamydia, gonorrhoea and trichomonas are dealt with in the section called STI screening.

Thrush

This is a very common cause of vaginal infection. It is caused by a fungus species called candida. The most common type of candida infection is known as candida albicans. Almost all women have candida albicans growing harmlessly on and in their body. When the balance of the vagina is disrupted for a variety of reasons the fungus overgrows, causing symptoms known as thrush.

Well recognised causes of thrush include:

• Antibiotic use
• Diabetes
• Wearing tight underwear
• Taking the contraceptive pill
• Periods
• Pregnancy

Symptoms of thrush include vaginal and vulval soreness, itch and discharge. Sometimes only one of these symptoms may be present. Often the patient diagnoses thrush herself and some treatments are available in the pharmacy without needing a prescription.

However if the symptoms do not improve within two weeks or they recur your doctor usually prescribes vaginal or oral treatment. The male partner should also receive treatment if they are symptomatic. Your GP will arrange for you to have a swab taken to check for other infections and to make sure that it’s definitely thrush.

If treatment is used properly, the infection clears up completely in 8 out of 10 women. However, some women find that thrush keeps recurring. If you have more than four episodes of thrush in a year, this is known as recurrent thrush and you will need to approach the problem in a different way. More long-term measures may be required to try to eliminate the problem of recurrent thrush, such as diet modification, changes in clothing type and a new approach to personal hygiene. Ironically excessive washing of the vaginal area is associated with recurrent thrush. Infection that keeps coming back can be very upsetting and some women find that it affects their sex life and how they feel about themselves. Talk to your GP if you are concerned.

Bacterial Vaginosis (BV)

Bacterial vaginosis is the most common cause of vaginal discharge in women of child bearing age. It happens when the balance of the vagina is disrupted. A large overgrowth of a bacteria called gardnerella vaginalis occurs which produces the symptoms. Occassionally BV infection is detected in swabs taken from women who have no symptoms. Usually women complain of a thin, grey or green discharge with an unpleasant fishy smell. There can be associated vaginal soreness and irritation, particularly after sex.

If left untreated there is an association between BV and miscarriage. It is treated with a course of metronidazole (flagyl). After this treatment about three out of four women will be cured of the infection. However, some women find that the vaginosis comes back. If this happens to you, you are likely to be prescribed more metronidazole. Alternatively a vaginal preparation designed to lower the Ph of the vagina and therefore restore a healthy balance can be used. These include Relactagel and Aci-Jel. They have been shown to be less effective than antibiotics in treating BV but will still treat BV in approximately 50% of cases successfully. Male partners do not need to be treated.

If your infection keeps coming back, it is important not to use any perfumed bath products, shampoos or antiseptics as these can irritate your skin. Do not use vaginal douching. Douching means washing out your vagina – usually with water or a special douching liquid – to clean it and prevent infection. However, douching actually has the opposite effect. It destroys the healthy bacteria in your vagina and leaves you more open to infection.

Is there anything I can do to feel more comfortable?

There are a number of things you can do to help ease your symptoms while you are having treatment. These include wearing the right clothes and underwear, not using perfumed bath and shower products and taking painkillers.

Some vaginal infections cause symptoms which can be uncomfortable and unpleasant. As well as following any treatment you have been given, there are several things you can do which may help you to feel more comfortable. Some of the main ones are listed below:

• Wear loose-fitting, cotton clothes rather than tight clothes such as jeans, or synthetic materials such as nylon underwear or tights.
• Use plain water to wash rather than perfumed soaps, bath or shower products, antiseptics or vaginal deodorants as these can irritate your skin and the sensitive area of your vulva. Don’t scrub with a flannel or sponge. Wash your hair over a sink rather than in the shower or bath so that the shampoo doesn’t come into contact with your vulva.
• If you are itching, try applying aloe vera juice or gel around your vagina. Cold water or ice cubes wrapped in a cloth can also soothe itching. You shouldn’t apply ice directly to your skin as it can damage your skin.
• If you have sex, you may need to use a lubricant during intercourse. Be aware that some treatments for vaginal infections can affect the latex in condoms, caps and diaphragms which can make them unsafe for contraception. Speak to your GP or pharmacist for advice.