The vagina is not a sterile environment and contains good and bad micro-organisms most of the time. The ecosystem is in place when more than 90% of the organisms in the vagina are good bacteria. The good bacteria are called probiotics and must specifically be of the Lactobacilli species. Some lactobacilli keep the vagina acidic by excreting lactic acid while others excrete hydrogen peroxide to prevent the growth and/or kill bacteria, Candida and viruses, including the HIV virus.
The Lactobacilli in the vagina are therefore essential to maintain the vaginal ecosystem. To help prevent vaginal infections due to a disrupted ecosystem, measure the vaginal pH on a regular basis (Vianalyse™) and correct if the pH is disrupted (MonoginTM gynaecological solution)
VAGINITIS
Definition
Vaginitis: Inflammation of the vagina. The vagina is the muscular canal extending from the cervix to the outside of the body. Vaginitis is caused by a bacterial or fungus overgrowth. A woman with this condition may have itching or burning and may notice a discharge. Vaginitis is a common condition. There are many factors that predispose a woman to develop Vaginitis such as douching (washing out all the good and bad organisms), stress, diet, and others.
90% of Vaginitis is one of the following 3 vaginal infections:
Candida is often mistaken as being the most prevalent
Candida
Candida albicans: A yeast-like fungal organism found in small amounts in the normal human intestinal tract, normally kept in check by the body's own helpful bacteria. Candida albicans can increase in numbers when this balance is disturbed to cause candidiasis of the intestinal tract, or yeast infections of other parts of the body. C. albicans causes thrush. Also called Monilia albicans.
Candida: Symptoms
Signs and symptoms of a vaginal yeast infection are a white cheesy discharge that typically itches and irritates the vagina and surrounding outer tissues. On occasion there may be pain with sexual intercourse or burning with urination.
Candida: Diagnosis
When feeling some of these symptoms, use Vianalyse™ to indicate whether the symptoms felt are indeed the result of a Yeast/Thrush/Candida infection and not a Bacterial or other potentially harmful infection.
Candida: Treatment
Obtain an OTC product at your local Pharmacy.
Bacterial Vaginosis
Bacterial Vaginosis (BV) is the most common vaginal infection to affect women in their reproductive age. Recent data (2007) shows that nearly one third (29%) of the female population in America between the age 14 and 49, and as many as 16% of pregnant women have BV1.
BV has been diagnosed in virgins and females that are not sexually active and is therefore not a sexually transmitted disease.
The cause of BV is not fully understood. BV is defined as a shift in the ecosystem of the vagina where the dominant Lactobacilli concentration (good bacteria) is replaced by different other types of bacteria (harmful bacteria) which causes a chemical imbalance within the vagina. This increases the pH of the vagina to above 4.5 and has a negative effect on the vagina’s defense mechanism. The vagina is now exposed to harmful bacteria, viruses, fungus, toxins and enzymes produced by these organisms.
If a female is of the black race, smokes, douches, uses an intrauterine device (IUD), has a new sexual partner or several sexual partners (including lesbian partners), she will have a higher risk of developing BV.
Bacterial Vaginosis: Symptoms
1. Vaginal discharge
The main symptom of BV is an abnormal, foul-smelling (fish-like odour) vaginal discharge. The vaginal discharge is thin and white or gray in colour. The odour may be more noticeable after sex.
Nearly half of the women will have no symptoms. A study performed in Birmingham, Alabama showed that 75% of women with and 82% of women without BV never noted any vaginal odour. Furthermore 63% with and 65% without BV never noted any vaginal “wetness” during the last 6 months.
2. Dysuria
Some patients may experience pain during urination.
3. Minor itching, if any.
Complications
BV is not the innocent infection as it was thought to be in the past. BV is associated with several gynaecological and obstetric risks:
Gynecological risks
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Increase the woman’s susceptibility of HIV if exposed to the HIV virus.
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Increase the chances that an HIV infected woman can pass HIV to her sex partner.
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Increase the women’s susceptibility of other Sexually Transmitted Diseases (STD’s) such as Chlamydia and Gonorrhea.
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Increase the development of Endometritis, Pelvic Inflammatory Disease (PID) (Inflammation of the uterus/womb and fallopian tubes) and Vaginal Cuff Cellulitis after invasive procedures. PID can cause infertility (blocked tubes) or cause damage to the fallopian tubes to increase the future risk of ectopic pregnancy. It is a life threatening condition when the fertilized egg grows in the fallopian tube and not in the uterus.
Obstetrics risks
The complications above are quite serious and could have long term implications for any female, mother and child.
Bacterial Vaginosis: Diagnostics
It is difficult for a woman to diagnose a specific vaginal infection and often women go to the pharmacy for treatment.
A new diagnostic product, Vianalyse™, is available which will enable women to make the correct decision in the privacy of her own home. if the Vianalyse diagnostic test turns blue, then get an appropriate product to correct the disrupted vaginal ecosystem.
The doctor might utilize the following to diagnose BV:
1. Amsel or Clinical criteria
The doctor will evaluate the following:
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Discharge
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Vaginal pH - After taking a vaginal swab:
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Whiff test (smell if discharge has a fish-like odour)
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Investigate under a microscope.
2. Gram stain test
The doctor will take a vaginal swab, smear it on a slide and forward it to a laboratory where a specialized person will investigate the slide. They use a Nugent score to quantify the infection. Although it takes time to perform this test, it is the most accurate test.
The following test should not be used for the diagnosis of Bacterial Vaginosis.
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PAP Smear
Although BV is not a sexually transmitted disease, it is included in the Sexually Transmitted Disease Treatment Guidelines 2006 of the Centers for Disease Control and Prevention in the USA. These guidelines specify that a PAP smear has no clinical utility for the diagnosis of BV because of low sensitivity.
The 2006 National Guidelines for the Management of Bacterial Vaginosis of the British Association for Sexual Health and HIV recommends only the Amsel criteria and the Gram stain test.
Bacterial Vaginosis: Treatment
The aim of the treatment is to normalize the vaginal ecosystem. The ideal product should preferably be a single dose, kill the bad bacteria, normalize the vaginal pH, lactobacilli sparing (not kill good bacteria) and safe to use during pregnancy.
Treatment during Pregnancy
Treatment is especially important for pregnant women due to the fact that BV is highly associated with early miscarriage, late abortion and preterm labour/birth. The focus must be on prevention and women should be screened and treated for BV before becoming pregnant to ensure that they have a normal healthy vaginal ecosystem. Maintaining a healthy ecosystem during pregnancy is important and Vianalyse is an ideal product to monitor the vaginal ecosystem during those months.
Treatment before surgical procedures
Fifty percent of patients are asymptomatic and some physicians recommend that patients due for surgical procedures, for example hysterectomy or abortion etc., should be screened and treated for BV to reduce their risk of developing PID.
Trichomonas
Trichomonas is the most common sexually transmitted disease (STD). The vagina is the most common site of infection in women, and the urethra (urine canal) is the most common site of infection in men. The parasite is sexually transmitted through penis-to-vagina intercourse or vulva-to-vulva (the genital area outside the vagina) contact with an infected partner. Women can acquire the disease from infected men or women, but men usually contract it only from infected women.
Trichomonas: Symptoms
Many women have signs or symptoms of infection which include a frothy, yellow-green vaginal discharge with a strong odor. The infection also may cause discomfort during intercourse and urination, as well as irritation and itching of the female genital area. In rare cases, lower abdominal pain can occur. Symptoms usually appear in women within 5 to 28 days of exposure.
Trichomonas: Diagnosis
If you experience any of the symptoms above or had a new sex partner in the last 6 months, test with Vianalyse™ to see whether the pH of your discharge is elevated. If Vianalyse™ turns blue, consult your doctor or healthcare provider.
Trichomonas: Treatment
Please contact your healthcare provider for appropriate treatment.