Stop Bacterial Vaginosis Naturally
There have long been indications that the incidence of Candida vaginitis is hormone dependent (2,33). Thus, a Candida infection is observed more frequently in pregnant women than in nonpregnant women. The use of ovulation inhibitors, in particular, those with a high estrogen content, also increases the risk of an infection. In postmenopausal women who do not use estrogen replacement therapy, the incidence is low. Relapses of a Candida infection with pruritus vulvae occur frequently in the luteal phase prior to the onset of menstruation. Kalo-Klein and Witkin demonstrated an inhibition of the cellular immune response to C. albicans during this phase, which they attributed to variations in the progesterone and estradiol levels (33). However, even independent of the menstrual cycle, patients with relapsing Candida vaginitis were shown to have a reduced Candida-specific T cell reaction. In vitro, both a reduced T cell proliferation and a reduced interferon-gamma secretion were...
Atrophic vaginitis is a condition that occurs when the vulvar vaginal tissue lacks estrogen. It occurs most commonly in postmenopausal females, but can also occur in situations that induce a hypoestrogenic state, such as when women are breastfeeding or taking medications such as depomedroxyprogesterone or tamoxifen. Atrophic vaginitis does not affect all women. Typically, women with atrophic vulvovaginitis experience burning that can range from intermittent to constant. Symptoms can be exacerbated with urination or with wiping after urination. In addition, some patients experience urinary urgency, frequency, and nocturia, and some patients also experience vaginal dryness and pain with Figure 5 Atrophic vaginitis thin, pale erythematous tissue. (See color insert pp. 4 and 5.) Treatment for atrophic vaginitis is estrogen replacement. Intravaginal topical estrogen, either prescribed as vaginal cream or vaginal tablet, is effective. Systemic estrogen replacement, prescribed as either an...
Bacterial vaginosis one of three major causes of vaginal discharge. (The others are Candida and Trichomonas species.) Bacterial vaginosis produces a change in the normal bacterial flora of the vagina. The direct cause of the change is not known, and it is unclear whether it is contagious. The condition is called vaginosis instead of vaginitis because there is no apparent inflammation. Bacterial vaginosis causes a discharge that is often malodorous but does not typically cause itching. This problem has led to slang terms that refer to women as fish or statements about fishy odors of the vagina. Treatment typically employs metronidazole.
Reported rates of gonococcal infection range from 3 percent to 20 percent among sexually abused children. A gonococcal infection may be diagnosed in the course of an evaluation of a medical condition such as conjunctivitis, in which no suspicion of abuse existed, or it may be diagnosed during an assessment for possible sexual abuse. In preteens, gonococcal infection usually occurs in the lower genital tract, and vaginitis is the most common symptom. pelvic inflammatory disease occasionally occurs. Infections of the throat and rectum typically do not have symptoms and may go unrecognized.
Malnutrition Any disorder of nutrition specifically, either the deficit of efficient or substantive food substances in the body or the inability of the body to properly absorb food substances. Physical signs of malnutrition and deficiency state in adolescents and adults include nasolabial sebaceous plugs sores at the corners of the mouth Vincent's angina red, swollen lingual papillae glossitis papillary atrophy of tongue stomatitis spongy, bleeding gums muscle tenderness in extremities poor muscle tone loss of vibratory sensation increase or decrease of tendon reflexes hyperesthesia of skin bilateral symmetrical dermatitis purpura dermatitis thickening and pigmentation of skin over bony prominences nonspecific vaginitis follicular hyperkeratosis of extensor surfaces of extremities rachitic chest deformity anemia not responding to iron fatigue of visual accommodation vasculariza-tion of cornea and conjunctival changes.
Pap smear screening The need for rigorous surveillance in HIV infection has given rise to the argument for routine Pap smear screening in HIVpositive women. At the time of screening, it is equally important to examine the vulva and vagina, culture the cervix for STDS (gonorrhea and chlamydia), and diagnose and treat any vaginitis present, including atrophic vaginitis. Management strategies also include liberal referrals for colposcopic evaluation, particularly for vulvar and vaginal lesions that cannot be definitively diagnosed, so that colposcopically directed biopsies can be obtained.
It often bleeds when touched with a cotton applicator or cervical spatula. A purulent exudate is often observed. cervical cancer can also give this appearance. Most infectious cervicitis is due to sexually transmitted infection, often chlamydia, gonorrhea, or trichomonas. In HIVpositive women, viral infections may be isolated from cervical secretions and may cause local infections including cytomegalovirus, herpes simplex virus, and even HIV itself. All vaginal infections should be treated and followed up.
In 1959, investigators examined a group of 113 New York City women, an unknown number of whom showed evidence of cervical or vaginal infection (19). The researchers quantified the discharge by swabbing the entire vagina during the course of an examination and measuring the weight change in the swab. The mean vaginal discharge was 0.76 g for all patients, 1.0 g for women with vaginal infection, and 0.50 g for women who had douched the day before the examination. The mean weight of vaginal discharge increased among women who were periovulational.
Capsules or suppositories have shown some efficacy for the treatment of C. (T.) glabrata vaginal infections (boric acid 600 mg, in either a gelatin capsule or suppository, inserted intravaginally twice daily for 14 days). The application of 1 or 2 gentian violet intravaginally prior to initiation of the boric acid capsules has been helpful for some women. A single course of boric acid capsules may not be curative and, therefore, retreatment may be required. Other treatment regimens for C. (T.) glabrata cited in the literature include boric acid with flucytosine or combined with flucytosine and amphotericin B topically (12-14).
In some cases, superficial C. albicans infections may be particularly severe and recalcitrant to treatment, producing the uncommon disorder known as chronic mucocutaneous candidiasis. This condition consists of persistent and recurrent infections of the mucous membranes, skin, and nails, along with a variety of other manifestations. The superficial infections last for years in affected patients unless they are properly treated, although deep candida infections are very rare in this situation. Oral thrush and candida vaginitis are fairly common in patients with chronic mucocuta-neous candidiasis. There is often infection of the esophagus, although further extension into the viscera is unusual. Epidermal neutrophilic microabscesses, which are common in acute cutaneous candidiasis, are rare in the lesions of chronic mucocutaneous candidi-asis. The oral lesions are generally tender and painful. A number of other disorders are associated with the syndrome of chronic mucocutaneous...
TEWL was assessed in 58 women 18 to 35 years of age, with regular menstrual cycles (25 to 35 days) and a menstrual flow of five or less than five days. Exclusion criteria were the use of immunosuppressive drugs, chemotherapy, anti-inflammatories, antihistamines, or steroids an active vulvar vaginal infection high blood pressure cardiovascular disease, and pregnancy. Prior to treatment, the participants completed a medical questionnaire that included an atopic dermatitis self-assessment (Table 1) (17) and had their weight and height recorded. Participants received a set of standard cotton panties to wear during the study period and an oil-free, personal cleansing body wash to use in lieu of their normal cleansing product. Participants were asked to refrain from body cleansing within two hours of their clinical visit, from intercourse during the
Gynecological problems are common early symptoms of immunocompromise in HIV-positive women. These may include gynecological infections (most commonly vaginal candidiasis, bacterial vaginosis, trichomoniasis), as well as genital ulcers, vaginitis, simple urinary tract infections, postpartum endometritis, and pelvic inflammatory disease and cervical neoplasia. These problems may become chronic, less responsive to conventional therapies, and tend to progress as immunocompromise worsens. Specific protocols are needed for the treatment of gynecological problems in HIV-positive women that are appropriate to the degree of immunocompromise. Women who receive gynecological services in the same primary care clinics where they receive care for HIV infection are less likely to be lost to follow-up, and treatment plans can be initiated earlier. and, rarely, lymphogranuloma venereum (LVG), and granuloma inguinale (donovanosis). Other genital lesions that may accompany HIV infection include genital...
Torulopsis glabrata vaginitis clinical aspects and susceptibility to antifungal agents. J Obstet Gynecol 1990 76 651. 11. Sobel JP, Chaim W. Treatment of Torulopsis glabrata vaginitis retrospective review of boric acid therapy. Clin Infect Dis 1997 24 649. 13. Sobel JD et al. Treatment of vaginitis caused by Candida glabrata use of boric acid and flucytosine. Am J Obstet Gynecol 2003 189 1297. 14. Baum SE, Morris JT. Amphotericin B douche for highly resistant Candida (Torulopsis) glabrata vaginitis. Infect Med 2001 18 114. 19. Kent HL. Epidemiology of vaginitis. Am J Obstet Gynecol 1991 165 1168. 32. Klebanoff MA et al. Vulvovaginal symptoms in women with bacterial vaginosis. Obstet Gynecol 2004 104 267. 33. Brand JM, Galask RP. Trimethylamine the substance mainly responsible for the fishy odor often associated with bacterial vaginosis. Obstet Gynecol 1986 68 682.
All of the fluoroquinolones are effective in single-dose treatment of uncomplicated urethral, anal, and oropharyngeal gonorrhoea 51 , although such regimes are ineffective for chlamydial disease. Ofloxacin for 7 days is reliably effective in chlamydial urethritis in men, although possibly less so in women, but there are little data on genital Mycoplasma infection. Preliminary data on trovafloxacin suggest high efficacy at low single doses in gonorrhoea 52 and, after multiple dosing, for chlamydial sexually transmitted diseases (STDs). However, fluoroqui-nolones are not indicated in syphilis, and results in bacterial vaginosis suggest only a secondary role.
Vaginitis An inflammation or infection of the vagina. Vaginitis occurs when the normal environment of the vulva and vagina is disturbed, usually by common bacteria. Although the vagina resists disease as well as the rest of the body, vaginal imbalance and lowered resistance to infection can be caused by poor diet lack of sleep, exercise or cleanliness and stress. Causes of vaginitis include trichomona virus, candida, bacterial vaginosis, and several other possibilities. The presence of vaginal pathogens may predispose women to increased frequency of herpes outbreaks or recurrences of vaginosis See bacterial vaginosis.
It is troubling that these conclusions challenge some of what is written in textbooks. Physicians who are misinformed about the nature of vaginal wetness, odor, and irritation may impose the diagnosis of vaginitis on healthy women who would then be subject to needless worry and unnecessary medication. If true, this would be consistent with medicine's historical tendency to interpret the normal functions of the female reproductive system as diseased (29).
Note too that if a patient's most recent sexual contact occurred more than 60 days before the onset of symptoms, her most recent sexual partner should be treated. Intercourse should be avoided until treatment is completed and symptoms have been resolved. It is generally recommended that the initial medical evaluation of HIV-positive women include screening for chlamy-dia as well as for vaginitis, urinary tract infection, syphilis, and gonorrhea along with a complete menstrual, sexual, obstetrical, and gynecological history and breast and pelvic exams. Some evidence suggests that sexually transmitted infections, including gonorrhea and chlamydia, are more common in HIV-positive women, but it is not clear yet whether this is a result of HIV infection or of high-risk behavior that is also responsible for acquisition of HIV infection itself.
Several hypotheses have been proposed to identify etiological factors for vulvodynia. A high concentration of calcium oxalate crystals in the urine (27), allergies (28), hormonal relationships (29), history of abuse (30), genetics (25), psychological conditions (11), and recurrent infections (e.g., Candidiasis yeast, human papilloma virus, and bacterial vaginosis) (20,31,32) have been thought to play a role in disease development. Yet, there is no agreement in the literature regarding these and other theories. Moreover, these issues have been described primarily in small, uncontrolled studies, and there is a lack of systematic, large-scale studies that explore them in greater depth (33).
A history of genital infections is a risk factor for VVS (34). Early etiologic hypotheses focused on epidemiologic links to vulvovaginal candidiasis and genital human papilloma virus (HPV) infection. One study reported a history of recurrent candidiasis in 80 of VVS cases (35) others found the prevalence of Candida infection to be within the range found in normal subjects (36). The diagnosis of candidiasis in the aforementioned studies was often presumptive hence, early misdiagnosis of VVS as candidiasis could have contributed to the observed statistical linkage. More recent investigations, which corroborated referring physicians' statements or prior laboratory results with patient reports, found VVS risk to be associated with a history of bacterial vaginosis, Candida albicans, pelvic inflammatory disease, trichomoniasis, and vulvar dysplasia (34).
Infections, including vulvovaginal candidiasis, bacterial vaginosis, genital herpes simplex, human papillomavirus, syphilis, cytomegalovirus, toxoplas-mosis, hepatitis B, and hepatitis C. These infections may be associated with pregnancy complications or perinatal infection.
Common sense dictates that establishing good hygiene habits is desirable and healthful, but research on the contribution of hygiene to premenarchal vulvo-vaginitis has produced mixed results. A case study of 54 patients, drawn from a North American population of low socioeconomic background, concluded that most noninfectious cases of vulvitis in young girls were caused by improper
Douching has a long and ancient history, reaching as far back as 1500 B.C., when an Egyptian papyrus recommended a garlic and wine douche for the treatment of menstrual disorders. In the days of Hippocrates, vaginal rinsing was thought to be the only method of curing vaginal infections. Different ethnic groups have used douching off and on throughout history, but in America, douching had its heyday beginning in the early 1920s and carried on through the 1950s, when women's magazines regularly featured advertisements for douche brands such as Lysol (Lehn and Fink Products Company, Montvale, New Jersey, U.S.A.), Sterizol (Sterizol Company, Ossining, New York, U.S.A.), and Zonite (Lee Pharmaceuticals, El Monte, California, U.S.A.). As recently as the early 20th century, the medical community recommended douching for the treatment of specific gynecological conditions (9). Bacterial vaginosis effects, an increase in the occurrence of sexually transmitted diseases (STDs) and pelvic...
The fluconazole vaginitis study group, single oral dose fluconazole compared with conventional clotrimazole topical therapy of Candida vaginitis. Am J Obstet Gynecol 1995 172 1263. 67. Isaacs JH. Nystatin vaginal cream in monilial vaginitis. Illinois Med J 1973 3 240. 69. Palacio-Hernanz A, Sanz-Sanz F, Rodriquez-Noriega A. Double-blind investigation of R-42470 (terconazole cream 0.4 ) and clotrimazole (cream 1 ) for the topical treatment of mycotic vaginitis. Chemioterapia 1984 3 192. 70. Slavin MB et al. Single dose oral fluconazole vs intravaginal terconazole in treatment of candida vaginitis. J Florida Med Assoc 1992 79 693. 71. Sobel JD. Vaginitis. N Engl J Med 1997 337 1896.
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Bacterial Vaginosis Facts
This fact sheet is designed to provide you with information on Bacterial Vaginosis. Bacterial vaginosis is an abnormal vaginal condition that is characterized by vaginal discharge and results from an overgrowth of atypical bacteria in the vagina.