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Discharge, itching, burning, pain while urinating – these are typical symptoms of intimate infections. Most of us women experience them at least once in their lives. And although we do not like to talk about the “unpleasant side of femininity”, the awareness of the intimate health of many of us will make life easier …
A shameful problem …
The very term “intimate infections” refers to infectious diseases affecting the genitals. Although, due to the anatomical structure and the close proximity of the vagina to the anus, intimate infections mainly affect women, men are also at risk of their occurrence.
Due to the factor causing intimate infections, we can divide into:
- bacterial,
- fungal,
- mixed,
- viral,
- parasitic.
According to statistics, fungal and bacterial infections are among the most frequently diagnosed intimate infections in women, while about 1/3 of all cases are inflammations of mixed etiology.
Bacterial intimate infections are mainly caused by anaerobic bacteria, e.g. streptococci, coliform, Chlamydia trachomatis, Gardnerella vaginalis. On the other hand, yeast is one of the most common causes of intimate fungal infections. The most popular of them are Candida albicans, responsible for 90 percent. cases of vaginal mycosis [1], but the following are also pathogens: Candida krusei, Candida glabrata, Candida kefyr and some others.
Intimate viral infections are mainly caused by the human papillomavirus (HPV) and the HSV-2 virus, which causes genital herpes. In the case of parasitic intimate infections, the most common causative agent is a protozoan from the group of flagellates – vaginal trichomes. In women, it is found in the vagina, urethra and bladder, in men it is usually in the urethra, but it can also pass into the prostate and seminal vesicles.
Importantly, regardless of the type, each intimate infection requires treatment. Neglected not only causes discomfort in everyday life, but can lead to serious complications, including infertility.
Warning signals
The symptoms of intimate infections may vary depending on the etiological factor and the duration of the infection. The most common ones include:
- pain and itching in the genital area
- redness of the genital area,
- vaginal burning
- pain or discomfort when urinating,
- pain during intercourse,
- feeling of dryness in the vagina
- vaginal discharge.
It is worth noting that in the first stage of the development of a bacterial or mixed infection, the infection usually does not make itself felt, and disturbing symptoms appear only as the disease develops. Moreover, in 10-20 percent. women in the childbearing period and in 40 percent. in pregnant women, yeast carrier may be asymptomatic [2]. Likewise, 50 percent. people struggling with a bacterial infection do not feel any symptoms of infection [3]. Hence, regular check-ups by a gynecologist are so important to maintain intimate health.
When it comes to intimate infections in men, the most commonly reported symptoms include:
- redness and itching of the glans,
- the appearance of a rash or skin eruptions
- soreness and burning sensation when urinating,
- pain when ejaculating.
Unfortunately, also in the case of men, some infections are asymptomatic, making it difficult to recognize and implement appropriate treatment. Ongoing and untreated intimate infection not only can lead to serious complications, including prostatitis, epididymitis or testicular inflammation, and infertility, but also cause health problems in the partner. Chronic intimate infections are especially dangerous for pregnant women, posing a threat to the health of the mother and the unborn child.
Bacterial or fungal?
Given that mycosis of the vagina and vulva and bacterial vaginosis are the most common “nightmare” of women, it is worth considering how to distinguish one from the other?
Let’s start with the risk factors, women with hormonal imbalance are exposed to fungal infections, most often caused by Candida albicans. This is the case, for example, during pregnancy, when the acidity of the vagina decreases and the swollen tissues of the reproductive organs become more saturated with glycogen (the sugar that yeasts feed on). The risk of ringworm in women also increases during the menopause, when estrogen levels decline and the vaginal epithelium becomes dry, thinner and more susceptible to injury.
Fungal infections are also more often diagnosed in women with diabetes, anemia, atopy, allergies, weakened immunity or taking antibiotics, contraceptives, steroids or immunosuppressants. It is also believed that vaginal candidiasis is promoted by prolonged stress that significantly weakens the immune system, a diet dominated by fatty, sweet and highly processed products, and hygiene errors.
Symptoms that may or may not indicate a fungal infection include profuse vaginal discharge. The vaginal discharge resembles cottage cheese, i.e. a watery suspension with lumps, in appearance and structure. Its color depends on the type of pathogenic fungus – it can be whitish or yellowish. The smell, on the other hand, is neutral or resembles a sweet yeast odor. The fungal infection is very often accompanied by redness, itching, pain and swelling of the intimate parts.
In the case of a bacterial infection, vaginal discharge can also appear, but it is yellow or green-gray in color and has an unpleasant “fishy” smell. Accompanying symptoms such as pain, itching or burning around the vagina and urethra are relatively rare. What distinguishes vaginal and vulvar candidiasis from bacterial vaginosis is the pH of the vagina, which is its natural protective barrier. Normal pH is acidic and ranges between 3,5 and 4,5. And while in the course of mycosis no changes in the pH value are observed, the vaginal reaction is normal (below 4,5), then in the case of bacterial infection it is elevated (above 4,5).
To confirm which pathogen caused the infection, it is sufficient to perform a pH test with a litmus paper. The presence of bacteria or fungi in the perineum can also be confirmed by laboratory tests such as smear, culture, PCR, antibiogram or antimycogram. It is worth remembering that the correct assessment of the test results rests with the doctor. Choosing the right preparation by him is also the key to recovery.
From diagnosis to treatment
Treatment of intimate infections depends primarily on the etiological factor that caused inflammation in the genital area. Regardless of whether the infection appeared for the first time or we had a similar problem before, the best solution in such a situation is always to go to a specialist doctor who will identify the source of the problem and prescribe the most effective drugs possible. And although the Internet is buzzing with home remedies for the “unpleasant side of femininity”, some of them are not only ineffective, but can harm us.
In the case of bacterial infections, oral or vaginal antibiotics containing metronidazole or clindamycin are most often used. Therapy usually takes about a week. However, in the case of intimate fungal infections, the basis of treatment are the so-called azole preparations, incl. fenticonazole. The mechanism of action of this group of drugs is based on the inhibition of the enzyme responsible for the biosynthesis of ergosterol, one of the components that build the fungal cell membrane. This leads to an increase in the permeability of the cell membrane, the loss of its protective functions, inhibition of growth and, consequently, the death of the fungus.
Azole, including fenticonazole, is recommended especially in uncomplicated infections with mild and moderate symptoms. The rate of healing of vaginitis and vulvitis with their help oscillates between 75-100%. [4].
Fenticonazole can be found in the over-the-counter Gynoxin drug, which is distinguished by a very short application pattern. Vaginal therapy is limited to only 3 days for Gynoxin Optima, vaginal capsule and Gynoxin OPTIMA vaginal cream, and even a single administration for Gynoxin UNO, vaginal capsule. With recurrent inflammation, maintenance treatment for 3-6 months may be necessary to restore the natural vaginal flora. As an adjunct in the therapy and prevention of mycosis, probiotics are used to provide beneficial Lactobacillus bacteria that protect female reproductive organs against infections.
Many experts point out that in the case of recurrent episodes of vulvovaginal candidiasis, treatment of the sexual partner is justified [5, 6]. Especially since the partner may not feel any symptoms of the infection or not at all, and may be a reservoir for the fungal colony. In this situation, we are dealing with the so-called ping-pong infection, in which a man infects a healed patient. The partner’s therapy is also initiated whenever there are symptoms of infection. Medicines in the form of a cream will work best for this.
Prevention is the basis
It is true – just as we care for our mental and physical health, so does intimate health require care. By following a few simple rules, we can minimize the risk of intimate infections.
The key is proper intimate hygiene – and attention, just like in everything else, is moderation. Both insufficient and excessive intimate hygiene, which may disturb the delicate battery microflora of intimate places, are not recommended. Washing with running water 1-2 times a day is enough to feel comfortable and reduce the risk of infection. When washing the intimate zone, it is very important … the direction. Always front to back, never the other way around! All this so as not to transfer bacteria into the vagina that will disrupt its natural microflora.
We should also not underestimate the importance of products used for hygiene every day. It is worth choosing delicate intimate hygiene liquids with a pH of 5,5. Preparations containing lactic acid will also work well. Soap, gels or bath lotions can disturb the correct pH of intimate parts. These are overly strong detergents that often contain chemicals that irritate delicate areas. Perfumed panty liners, scented toilet paper or deodorants for intimate places are also not recommended. For preventive purposes, it is also worth giving up the use of sponges and washers.
Another thing to keep in mind is choosing the right underwear. It should be comfortable and made of natural fabrics, preferably cotton, which will provide our skin with the greatest comfort. On a daily basis, it is better to give up thongs, lace, polyester and other synthetic fabrics that can cause irritation and spread infection-causing bacteria.
Considering that the use of saunas, solariums, bathing areas or municipal swimming pools is conducive to intimate infections, special care should be taken in these places. It is also inadvisable to sit on the toilet seat in public toilets without first securing it.
It is equally important to take care of a proper diet. Our plate should contain silage and fermented milk products (kefir, buttermilk, yoghurt) as often as possible, which will enrich the natural intestinal and vaginal microflora with beneficial symbiotic bacteria. In the daily menu, it is worth limiting the amount of sugar and fat and eating highly processed foods as little as possible.