As discussed in part one of our series on vaginal infections, the most common kind of infections can be more accurately described as imbalances of the vaginal ecosystem--there is an overgrowth of one species that may be naturally present in smaller numbers, and this overgrowth causes symptoms. Less commonly, a new organism is introduced to the vaginal ecosystem through sex and begins to cause damage to the other species (the vaginal wall cells and the healthy bacteria that populate them) present.
Trichomoniasis: trichomoniasis (or trich, pronounced like “trick” for short) is a sexually-transmitted parasite that can cause foul or fishy odor, irritation or itching, burning with urination, and discharge that is white, yellow, or green in color. It can also cause bleeding of the cervix, which may be more noticeable during or after sex. Trichomoniasis can be found using a microscope sample, lab swab test, or even on a Pap test. If found, your provider will prescribe antibiotics; in fact, the same ones that treat BV! Metronidazole (though it may come in a different dose) is an effective treatment for trichomoniasis. Your provider will also recommend your partner(s) be treated for trich as well.
STIs: other sexually-transmitted infections like chlamydia and gonorrhea may cause strange discharge, irritation, burning with urination, or bleeding with sex. However, these same infections can also cause NO symptoms at all. That is why we recommend being tested for STIs regularly (every 3 to 6 months) if you are sexually active, even if you feel fine. Left untreated, STIs can cause a painful condition called pelvic inflammatory disease (PID). People with PID have pelvic pain/cramping from inflammation and infection of the uterus and/or fallopian tubes with bacteria. PID can become a serious infection with high fever, foul-smelling discharge, and debilitating pain which may require hospitalization to treat. PID can lead to chronic pelvic pain, infertility, increased risk of an abnormal pregnancy that grows outside of the uterus (an ectopic pregnancy), changes to the menstrual cycle, and lethal sepsis if not properly treated. If you have pelvic pain, it’s important to see a healthcare provider as soon as possible. If you have pelvic pain and feel really sick with a high fever, please seek emergency medical attention.
Not everything that causes vaginal health issues is an imbalance or infection; certain anatomical differences or injuries, general health conditions, or major body transitions can also change the way a vagina feels, smells, or looks.
Other diseases that can affect vaginal health
Untreated diabetes may cause lots of sugar in the urine, which can in turn make vaginal discharge smell very sweet. A fistula, or opening between the vagina and bladder or rectum, can cause urine or poop to leak into the vagina; this may happen after giving birth or suffering an injury. Cervical and uterine growths can cause irregular bleeding (which may look like brown or pink discharge) and pain; see our upcoming period pain article for more information. Pregnancy (normal or abnormal) can cause bleeding, pain, and an uptick in other vaginal infections because of the massive changes in your hormones. Menopause or perimenopause (the time right before menopause) can also cause unusual discharge (or a lack in usual discharge), irritation or burning, or irregular bleeding (any bleeding after menopause is an urgent medical matter to discuss with your provider). A condition affecting the immune system like HIV or lupus can affect your vaginal health and how well it prevents infection. A skin condition like lichen planus, lichen sclerosus, or hidradenitis suppurativa can hugely alter the vaginal tissue, leading to different discharge, sensations, and appearance. Even an overgrowth of the helpful bacteria (cytolytic vaginosis) can cause excess discharge and irritation!
This has been a lot of information about vaginas! I hope it’s been helpful to you in learning more about a body part that we don’t talk about enough in a factual, straightforward way. As always, if you have specific questions or concerns about your body or you’re experiencing symptoms that are bothering you--please talk to a trusted medical professional. And if you have any personal experiences or questions you’d like to share with us, reach out to us at Dear ReproRants. Happy vagina-having!
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