Vaginal and Vulvar Problems

The vagina is a muscular canal that:

• Connects the uterus to the vulva
• Funnels your menstrual flow
• Allows for penetration during sex
• Provides a pathway for childbirth

The vagina resides in a warm, dark place loaded with lymph nodes and glands. It has its own delicately balanced ecosystem. Good bacteria help keep your vagina healthy by producing lactic acid, hydrogen peroxide, and other substances to keep harmful bacteria at bay. They help maintain your vaginal pH levels by keeping it on the acidic side to ward off the overgrowth of yeast and other harmful bacteria.

Common Vaginal Problems

Unusual Vaginal Discharge

The amount of vaginal discharge you experience typically changes with your menstrual cycle. If you are experiencing discharge that is clear with either no scent or a light musky odor, you are likely ovulating, and the discharge is normal. However, other types of discharge typically signal an infection and should be checked out by your provider. Learn more below about vaginal infections below.

Vaginal Odors

Your vagina comes complete with its own unique, odor-producing bacterial flora. You may not notice your vaginal odor, and even when you do pick up a scent, it may be because of your period, because you’ve just had sexual intercourse or a host of other normal odor-producing reasons.

But if you notice a strong, not-so-normal odor—especially if it’s accompanied by itching or burning—it may be an indicator of something more serious.

Vaginal Infections

When your normal pH levels are upset, a vaginal infection may occur. The three most common types of vaginal infections are discussed below.

• Bacterial Vaginosis (BV) is a bacterial infection that occurs when your healthy lactobacilli are outnumbered by unhealthy bacteria, causing an imbalance. Symptoms include thin vaginal discharge that has a strong fishy smell and a little itching or burning when you urinate. BV is diagnosed by your OB-GYN and is treated with an antibiotic.
• Yeast infections are caused by an overgrowth of a fungus, Candida, that normally exists in the mouth, throat, gut, and vagina in small amounts. Factors that can promote yeast to over-produce include antibiotics, pregnancy, diabetes, or a weakened immune system. Yeast infections are treatable with antifungal medication.
• Trichomoniasis is a sexually transmitted infection caused by a parasite. Women with trichomoniasis may notice a clear, white, yellowish, or greenish vaginal discharge; a heavy fishy vaginal odor; genital itching; burning, redness or soreness; and urinary discomfort. Trichomoniasis is treatable with antibiotics.

A forgotten tampon could also be the cause of a vaginal infection. (It happens more than you realize.) In addition to a putrid-smelling vaginal discharge that’s yellow, green, pink, gray, or brown, you may experience additional symptoms, including fever, vaginal itching, pain urinating, pain around your pelvis or abdomen, redness around the genital area, and vaginal swelling. If you’re unable to easily retrieve the tampon and if you are experiencing these symptoms, call your Moreland OB-GYN provider.

If you are pregnant and have symptoms of a vaginal infection, schedule an appointment with your Moreland OB-GYN provider. Conditions like bacterial vaginosis could affect your pregnancy.

Common Vulvar Problems

Some skin disorders that affect the vulva include:

• Folliculitis. Folliculitis appears as small, red, and sometimes painful bumps caused by bacteria that infect a hair follicle. It can occur on the labia majora. This can happen because of shaving, waxing, or even friction. Folliculitis often goes away by itself. Attention to hygiene, wearing loose clothing, and warm compresses applied to the area can help speed up the healing process. If the bumps do not go away or they get bigger, see your healthcare provider. You may need additional treatment.
• Contact dermatitis. Contact dermatitis is caused by skin irritation by things such as soaps, fabrics, or perfumes. Signs and symptoms can include extreme itching, rawness, stinging, burning, and pain. Treatment involves avoidance of the source of irritation and stopping the itching so that the skin can heal. Ice packs or cold compresses can reduce irritation. A thin layer of plain petroleum jelly can be applied to protect the skin. Medication may be needed for severe cases.
• Bartholin Gland Cysts. If the Bartholin glands become blocked, a cyst can form, causing a swollen bump near the opening of the vagina. Bartholin gland cysts usually are not painful unless they become infected. If this occurs, an abscess can form. If your cyst is not causing pain, it can be treated at home by sitting in a warm, shallow bath or by applying a warm compress. If an abscess has formed, treatment involves draining the cyst in a health care provider’s office.
  
• Lichen simplex chronicus. Lichen simplex chronicus may be a result of contact dermatitis or other skin disorder that has been present for a long time. Thickened, scaly areas called “plaques” appear on the vulvar skin. These plaques cause intense itching that may interfere with sleep. Treatment involves stopping the “itch-scratch” cycle so that the skin can heal. Steroid creams often are used for this purpose. The underlying condition should be treated as well.
• Lichen sclerosus. Lichen sclerosus is a skin disorder that can cause itching, burning, pain during sex, and tears in the skin. The vulvar skin may appear thin, white, and crinkled. White bumps may be present with dark purple coloring. A steroid cream is used to treat lichen sclerosus.
• Lichen planus. Lichen planus is a skin disorder that most commonly occurs on the mucous membranes of the mouth. Occasionally, it also affects the skin of the genitals. Itching, soreness, burning, and abnormal discharge may occur. The appearance of lichen planus is varied. There may be white streaks on the vulvar skin, or the entire surface may be white. There may be bumps that are dark pink in color. Treatment of lichen planus may include medicated creams or ointments, vaginal tablets, prescription pills, or injections. This condition is difficult to treat and usually involves long-term treatment and follow-up.
• Vulvodynia. Vulvodynia means “vulvar pain.” The pain can occur when the area is touched, or it can occur without touch. There are two types of vulvodynia: generalized and localized. 
• Generalized vulvodynia: Pain occurs over a large area of the vulva. 
• Localized vulvodynia: Pain is felt in a smaller area, such as the vestibule.

Gentle Care for Your Vagina and Vulva

Cleanliness and comfort can help alleviate vulvar and vaginal issues. The good news is, vulva and vaginal care is pretty simple and doesn’t involve drastic lifestyle changes.

Cleaning your Vulva and Vagina 

• Wash your vulva daily with warm water —soap is optional, but use a gentle soap like Dove-Hypoallergenic, Neutrogena, Basis, or Pears. Use your fingers instead of a washcloth.
• Do not wash inside your vagina. The vagina cleans itself with discharge to maintain a consistent pH balance.
• Avoid using any vaginal scrubs, scented soaps and douching. The use of these products can throw off your natural pH balance and increase the chance of infection.
• After you go to the bathroom, wipe from the front to the back. Doing the reverse could transfer bacteria to the urethra and cause a urinary tract infection.

More Good Practices for Caring for Your Vulva and Vagina

Clothing

Choose clothing that will ensure your vulvovaginal area can breathe easy and stay dry. Moisture can promote the growth of bacteria, which can lead to a yeast infection.

• Wear cotton underwear. Cotton offers breathability and makes it more difficult for smell-producing bacteria to build up. Avoid the use of thongs because they can collect fecal matter that can reach the vagina and cause infections.
• Avoid tight-fitting clothing.
• Change your clothes and underwear after working out. 
• Avoid wearing a damp swimsuit all day.
• If you experience heavy vaginal discharge, change your underwear twice a day.
• At night, reduce sweat being trapped around the vulva by forgoing underwear.

A few more tips regarding good vulvovaginal health 

• Avoid scented tampons, pads, and liners.
• During your period, change your tampon 4 to 5 times a day. That goes for pads and liners, as well.
• Wash or wipe the area regularly during your period. 
• Consuming probiotics like yogurt can help prevent yeast infections and reduce vaginal odor by keeping your vagina’s pH levels in order. 
• Stay well-hydrated because it helps to keep bacterial overgrowth and stress-related sweat in check.

When To Call Your OB-GYN Doctor

See your Moreland OB-GYN provider annually for your wellness visit and in between if you have any concerns and questions about the health of your vulva and vagina.

Pay attention to unusual vaginal discharge and odors, especially when those symptoms are accompanied by:

• Fever
• Bleeding not associated with your period
• Itching
• Burning
• Vaginal swelling
• Genital rash or redness

If you notice any unusual vaginal symptoms, contact your doctor and schedule an appointment. 

The providers at Moreland OB-GYN are dedicated to providing women with compassionate OB-GYN care throughout life. This includes complete obstetrical care, gynecology, gynecologic and obstetric surgery, fertility services, preventive health care, and more. Learn more about our services and contact us online to request an appointment.