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Vaginitis is an inflammation of the vagina that can cause discharge, itching, and pain. Vaginitis often results from irritation, infection, or hormonal changes, such as low estrogen levels in menopause. Most women will experience vaginitis at some point in their lives, and while it is unpleasant, it can be dealt with effectively with both conventional and natural approaches.

There are many different types of bacteria and yeast normally present in the vagi­na. However, when the numbers of these organisms become out of balance, infection can occur, causing vaginitis.

The most common cause of vaginitis is an overgrowth of the naturally occurring yeast Candida albicans. An estimated three out of four women will have a yeast infec­tion in their lifetime. A yeast infection isn’t considered a sexually transmitted disease because this yeast is naturally occurring in a woman’s body, but it can spread from one partner to another.

Bacterial vaginosis is another common cause of vaginitis. There are several bacteria that can cause these infections, most commonly, Gardnerella. These infections can spread during sexual intercourse, but it also occurs in people who aren’t sexually active.

Trichomoniasis is an infection caused by a parasite, which is commonly transmit­ted by sexual intercourse.

Vaginitis can also result from reduced estrogen levels after menopause, which causes the vagina to become thinner and drier, which may lead to itching, burning, or pain. Use of vaginal sprays, douches, perfumed soaps, and spermicidal products can also cause vaginal irritation, burning, and itching.

SIGNS & SYMPTOMS

•   Change in your normal vaginal discharge and odour

•   Light vaginal bleeding

•   Pain during intercourse or urination

•  Vaginal itching or irritation

Bacterial vaginosis typically causes a greyish-white, fishy-smelling discharge. Yeast infections cause a thick, white discharge that resembles cottage cheese. Trichomoniasis causes a greenish-yellow, sometimes frothy discharge in women while men often have no symptoms.

RISK FACTORS

Risk factors vary depending upon the type of vaginitis. Yeast infections

•   Hormonal changes (pregnancy)

•   Medications such as antibiotics, steroids, and birth control pills

•   Stress, lack of sleep

•  Uncontrolled diabetes

•  Use of vaginal contraceptives or feminine hygiene products

•  Weakened immune system (HIV, chemotherapy, diabetes)

•  Wearing damp or tight-fitting clothing Bacterial vaginosis

•  Douching

•  Use of an intrauterine device (IUD)

•  Women with new or multiple sex partners Trichomoniasis

•  Sexual contact with an infected partner

Women who have diabetes are at greater risk of developing vaginitis caused by Candida albicans due to impaired immune function.

DOCTOR’S ORDERS

There are various medications for vaginitis, depending on the underlying cause. Bac­terial vaginosis is treated with metronidazole (Flagyl) or clindamycin (Dalacin). The latter drug is also used to treat Trichomoniasis.

Yeast infections are usually treated with miconazole (Monistat) or clotrimazole [Canesten) creams or vaginal suppositories, which are available over the counter. Your doctor may also prescribe a drug called fluconazole (Diflucan), which is a single-dose oral treatment. Many women prefer this as it is easy and provides rapid relief. However, it requires a prescription and is more expensive than the other products.

For women with vaginitis in menopause, doctors sometimes prescribe estrogen vaginal creams or rings, which help to thicken the vaginal area. Some estrogen still gets absorbed into the bloodstream, so these products should not be used by women with a history of breast cancer or who are at high risk.

Dietary Recommendations

Foods to include:

•  Eat natural (organic) yogurt with live cultures daily. Studies have shown that daily con­sumption of yogurt can reduce the occurrence of BV and yeast infections.

•  Garlic and onions have antifungal properties.

Foods to avoid:

•  Alcohol, aged cheese, and fermented foods (vinegar and soy sauce) contain yeast and moulds, which can be a problem.

•  Sugar allows yeast to thrive, and can increase the likelihood of yeast infections in suscep­tible women. Cut down on all sugar-containing foods.

Food allergies are believed to be a contributory factor in some cases of recurrent irritant vaginitis. See Appendix D for more information on food allergies and the elimination diet.

Lifestyle Suggestions

•  Wear cotton underwear and minimize or avoid wearing pantyhose. Do not wear pants that are tight at the crotch.

•  Do not use deodorized products, such as tampons, douches, and feminine deodorant sprays.

•  Wash the vaginal area with a mild, unscented soap.

•  Douche with 2 tsp of powdered acidophilus in a quart of warm water daily.

Top Recommended Supplements

Aged garlic extract: Supports immune function and has antibacterial and antifungal proper­ties. Studies have shown that it can reduce Candida albicans. Dosage: Two capsules twice daily.

Boric acid: A substance with antiseptic and antifungal properties. One study found signifi­cant benefits with use of 600 mg boric acid capsules inserted into the vagina twice per day for two to four weeks. It is available at compounding pharmacies. Boric acid suppositories should not be used during pregnancy, and it is very toxic if taken orally.

Lactobacillus acidophilus: A type of friendly bacteria (probiotic) that is part of the normal vaginal flora and helps prevent overgrowth of Candida. Many supplements contain another probiotic called Bifidobacterium. Dosage: Two or three capsules daily of a product that pro­vides at least one billion vaible cells per capsule, such as Kyo-Dophilus. Capsules can also be inserted vaginally at bedtime.

Complementary Supplements

Tea tree oil: Has antibacterial and antifungal properties. Studies have found topically ap­plied tea tree oil helpful for Trichomoniasis, Candida albicans, and other vaginal infections. This should only be done under a doctor’s supervision. Tea tree oil must be diluted to a 5 percent solution when used as a douche.

Vitamin C: Helps support immune function. One study found vitamin C vaginal tablets helpful for vaginitis. Dosage: 250 mg vaginally or 1,000 mg orally daily.

Vitamin E: When used orally or vaginally, it may help relieve itching and irritation and soothe the delicate vaginal tissue. Dosage: 400 IU orally, or apply the oil topically.

FINAL THOUGHTS

To reduce the risk and promote healing of vaginitis, consider the following:

1. Eat yogurt with live cultures daily; reduce sugar, alcohol, and fermented foods.

2. Wear cotton underwear and loose-fitting pants.

3. Avoid using deodorized feminine hygiene products.

4. Take a probiotic supplement and aged garlic extract daily.

5. Consider supplements of vitamins C and E