As a doctor, when a woman tells me she has a “toilet infection”, the conditions that readily come to mind are Cholera, Hepatitis A & E infection, Typhoid fever, Poliomyelitis, Helminthic infections (intestinal worms), and so on, until I am dragged back to reality by further explanations pointing to symptoms of a vaginal infection. There is a need to demystify the term “toilet infection” as it does not portray a true picture of vaginitis, the disease of concern. It has also misinformed the layman about the modes of acquiring vaginal infections.
Vaginal infections generally cause a condition called vaginitis. This is an inflammation of the vagina characterized by redness, itching, abnormal discharge, burning sensation, and pain. Some women are asymptomatic i.e. they may be infected but have no symptoms at all. In some cases, the vulva may be affected as well (vulvovaginitis).
How do you know when you have vaginitis?
A normal vagina produces a discharge that doesn't really have a noticeable smell. The quantity and color can vary throughout your menstrual cycle. At one point, you may have only a small amount of a very thin or watery discharge, and at another time of the month, it is thicker and more in quantity and this is pretty normal. However, when you feel any of the symptoms stated below, then it is time to see a doctor.
- If your vaginal discharge changes color (gray, yellow, green, bloody), is heavier, or has a noticeable odor (pungent, fishy, rotten egg).
- If you notice itching, swelling, rashes or soreness around or outside of your vagina.
- If you feel an irritation around the vagina any time of the day, but most often bothersome at night.
- If you have a burning sensation or pain when you pee.
- If sex is uncomfortable or painful and symptoms worsen after sexual intercourse.
- If you have lower abdominal pain
What are the causes of Vaginitis?
For better understanding, they can be divided into 2.
- Infectious causes
- Non-infectious causes.
The 2 commonest infectious causes of vaginitis are Candidiasis (yeast) infection and Bacterial Vaginosis, and they are both related to the normal flora (the healthy bacteria found normally in the vagina that protect against infection and regulate the PH of the vagina). Yeast infection occurs when there is an overgrowth of Candida Albicans (yeasts) while bacterial vaginosis happens when there is an imbalance of the naturally occurring bacteria in the vagina.There is a change in the most common type of bacteria and a hundred to thousand fold increase in total number of bacteria present.
These 2 conditions are not sexually transmitted infections but can cause mild symptoms in men who have sexual intercourse with female sufferers.
The other less common infectious causes of vaginitis are sexually transmitted infections and they include:
- Herpes simplex virus
- Human papilloma virus (HPV) or genital warts
Non-infectious causes include
- Allergic reaction to substances such as vaginal sprays, spermicides, condoms, lubricants, detergents, douches, fabric softeners, perfumed soaps, semen, tampons, sex toys, etc.
- Hormonal changes- Due to poor estrogen support to the vagina, a condition called atrophic vaginitis may occur leading to dryness, soreness, burning and itching of the vagina. It may occur in young girls before puberty, postmenopausal (after menopause) and postpartum women(after birth)
Also, conditions that weaken the immune system may increase risk of having vaginal infections. They include
- Pregnancy state
What are some habits that predispose you to having vaginal infections?
- Bad toilet habits: Wiping from back to front after defecating will introduce bacteria from the anus into the vagina. Also, back splash of water from a dirty water closet has been implicated in few cases of vulvovaginitis.
- Overzealous use of antibiotics: Antibiotics should be taken only when absolutely necessary as they can kill the normal flora that protects the vagina from infections.
- Vaginal douching: women who are in the habit of cleaning the inside of the vagina are more prone to having candidiasis and bacterial vaginosis. Douching with salt water, antiseptic soaps, vaginal washes, etc. are harmful to the vagina as they promote overgrowth and imbalance of bacteria.
- Poor hygiene: Use of nylon underwear causes the vaginal area to sweat thereby creating a moist environment which supports over growth of bacteria. Sharing of underwear and use of dirty underwear/towels also promote infection.
- Habits that reduce immunity such as chronic use of steroids, and excessive alcohol intake makes you prone to vaginitis.
- Use of Oral contraceptive pills increases susceptibility to vaginitis.
How can one ensure a healthy vagina and prevent vaginal infections?
- You are what you eat. Eat nutritious foods and a good balanced diet.
- Keep the body properly hydrated. Fluids will help lubricate the vagina and dilute odors.
- Stay comfy. Keep vaginal area clean and dry.
- Wear cotton underwear. This allows for better ventilation, keeping the vagina moist free and infection free.
- Wipe from front to back after urination or bowel movement to avoid translocation of bacteria.
- Avoid using deodorant pads or tampons or any foreign bodies
- Don't use petroleum jelly or other oils for lubricants.
- Do not douche. The vagina is self-cleansing. Wash only the outer parts with tepid water.
- Use medications (antibiotics and steroids) only as prescribed by your doctor.
- Practice safe sex. Be faithful to an equally faithful partner. New sexual partners must be tested and treated. Avoid sexual intercourse until treatment is completed and you are symptom free.
- Resist the urge to scratch infected areas to avoid further irritation and contamination of other parts.
- Use tampons only when necessary. Do not use tampons when treating an infection. Sanitary pads should be used during menstruation.
- Perfumed or deodorant soaps/body washes can irritate the vagina. Use mild soaps.
The term “toilet infection” does not exist in medicine. Women should be more informed of the possible causes and risk factors of vaginitis, shun bad habits that predispose them to such infections, and learn healthier habits to ensure optimum vaginal health.