Gynecologic Infections

There are several different types of infections of the female reproductive tract and they present with a range of symptoms.

Vaginitis

The vagina normally contains many organisms and a change in the normal balance of these organisms can lead to an infection in the vagina called vaginitis. Some of the potential causes of vaginitis are the use of antibiotics for an unrelated infection, changes in hormone levels, douching, spermicides, and sexual intercourse.

Vaginitis due to yeast is common and causes itching and burning and is associated with a white, clumpy, non-odorous vaginal discharge. There may also be redness and swelling.

Bacterial vaginitis (BV) presents with a discharge that may have a strong fishy odor. The discharge is usually thin and dark, dull gray or yellow. Trichamonas infection is caused by a parasite that is sexually transmitted. Here the discharge may also have a fishy odor, with a color that is yellow-gray or green.

The symptoms from the various types of vaginitis overlap and it is often best to see us for a definitive diagnosis. There are very effective treatments for vaginitis and symptom relief usually quickly follows the appropriate treatment.

Urinary Tract Infections

Urinary tract infections are among the most common infections that women face- most women will experience such an infection at least once. The most common infection is that of the bladder, called cystitis, which caused by bacteria. These enter the bladder through the urethra, which is the path for urine when you urinate.

Most bladder infections are not dangerous and are easily treated, but occasionally the infection can spread to the kidneys, causing pyelonephritis. This is a more serious infection that is associated with fever, shaking chills, and pain in the flank (lower back) and on occasion requires hospitalization for treatment with intravenous medications. For this reason, and also to relieve the symptoms caused by the infection, bladder infections are important to treat.

The most common symptom associated with a bladder infection is pain while urinating. This usually is accompanied by the need to urinate suddenly and without delay (urgency). Urinary frequency, or the urge to urinate even a very short time after completing urination, is common. A bladder infection may also on occasion present with blood, a foul smell or cloudiness in the urine.

There are several ways to help reduce the chance of infection. These include:

After having a bowel movement or urinating, wipe yourself from front to back, which will help to prevent bacteria from the rectum to reach the urethral area.
Empty your bladder before and after having sex.
Avoid douching or chemical deodorants in the vaginal area.
Drink plenty of water and empty your bladder as soon as you feel the urge.
When showering or bathing, wash the rectal and vaginal area.

While not all infections can be prevented, adopting these healthy practices will dramatically reduce your chance of getting a bladder infection.

If you think you are getting an infection, it is important to contact our office as soon as possible, so that treatment can be started.

Genital Herpes

Genital herpes is a sexually transmitted viral illness that is passed from one to another by vaginal, oral, or anal sexual contact, as well as contact with open sores by the hands. It causes blistering, painful ulcers and these develop at the site of first contact, whether in the vaginal area, mouth, throat, rectum or hands. The symptoms may be mild, but in many women the symptoms are very painful. The initial bout of herpes may last two to four weeks. During that time, sores form that may weep fluid. These eventually crust over and heal without scar.

Unfortunately, there is no cure for genital herpes and while the infection may seem to disappear, the virus stays in the nerve cells of the patient and can become re-activated. Some patients have rare episodes, while others it is frequent. After the first episode, the subsequent attacks are often shorter, typically from 3 to 7 days. Just before the virus reappears, it may cause pain in the lower back, legs or thighs and this is called a prodrome, which signals the onset of an attack.

The virus is most commonly transmitted when it is active and there is direct contact with an active sore. At this time, it is contagious to partners and can even be transmitted from one part of the body to another by the hands if the lesion is touched. This is particularly a concern for the eyes.

While the virus cannot be eliminated from the body, there are oral medications that make the outbreaks shorter and that may reduce the risk of transmission. Many women are treated as soon as they notice symptoms of the prodrome. If you feel that you are about to have a recurrence, it is important to contact us so that appropriate treatment can be started.

The likelihood of spreading the virus can be reduced by avoiding sexual activity or direct contact with active sores by an uninfected partner. It is important to carefully wash the hands with soap and water after contact with an active sore. There is a 1% chance of shedding the virus without an active lesion and use of a condom may help prevent that.

Herpes can be a very serious problem if it occurs in pregnancy. It can cause brain damage or eye damage in the baby. If you have a history of herpes it is important that you tell your obstetrician when your pregnancy is first confirmed. You must be monitored carefully and have any outbreaks treated if they occur during the pregnancy. If you have an active episode of herpes at the time of delivery, you will require a Cesarean section to avoid infecting the baby at birth. We now use antiviral medications starting at 36 weeks to prevent an outbreak before delivery.

Gonorrhea, Chlamydia and Syphilis

While there are many sexually transmitted diseases, two of the most important bacterial infections, gonorrhea and chlamydia, are passed through vaginal, anal, or oral sex. These infections may cause no symptoms, but when they do occur, they can include yellowish vaginal discharge, painful urination, and bleeding between menstrual cycles. The symptoms can appear between two days and three weeks after infection. The diagnosis requires a culture of the affected area.

If untreated, these infections can cause serious long-term complications, including infection of the uterus, fallopian tubes, and ovaries. This infection can cause fever and pain and lead to long-term damage to the reproductive structures by blocking the tubes, leading to infertility. Scarring of the tubes also increases the likelihood of ectopic pregnancy. Infections that occur during pregnancy can be very serious, with possible early delivery, low birth weight babies, infections of the baby’s eyes, birth defects, and even death of the baby.

Syphilis is another type of sexually transmitted infection, but it presents differently from gonorrhea and chlamydia, with a painful sore in the vaginal area. The disease progresses in stages and in its late stages can cause serious heart problems, brain damage, and other serious consequences.

These sexually transmitted infections may be prevented in many cases with proper protection. The use of either male or female condoms reduces the risk of transmission. Limiting sexual partners is important and knowing your partner well will reduce the risk. These diseases can only be transmitted from an infected partner.

All three of these infections can be treated with antibiotics. After a culture is obtained, the appropriate antibiotic can be chosen to provide the best therapy. It is important to remember that all the damage of the infection may not be prevented if the infection is not detected early in its course.

HIV

Human immunodeficiency virus causes AIDS and it is a potentially very serious infection. One may be infected with the virus and have no symptoms and it may be years before the infection results in AIDS. AIDS is a syndrome which extensively damages the body’s immune defenses, and this allows a range of potentially life threatening infections to occur.

The HIV virus is transmitted through contact with various body fluids and can occur during sexual activity, as well as through injuries with contaminated needles. Early in the AIDS epidemic, the disease was associated with homosexual activity and intravenous drug abuse, but currently it is growing most rapidly among women who engage in heterosexual sex.

There are no vaccines currently to prevent infection and there is no cure for an HIV infection. However, modern medical regimens can prevent the onset of AIDS in most patients. The infection can be prevented in many cases by limiting the number of sexual partners, avoiding intravenous drug use and specifically sharing of needles, and using of condoms during sex.