• February 16, 2016
  • by White Pharmacy under 
  • Wellbeing, White Pharmacy, Bacterial Vaginosis, Thrush, STI
  • This blog concludes our series on vaginal discharge and sexually transmitted diseases.

    Is vaginal discharge normal?

    It is quite normal and healthy to have a clear or white discharge from your vagina.

    This mucus is produced naturally from the neck of the womb, known as the cervix.

    The amount of vaginal discharge varies throughout your menstrual cycle (brown discharge is usual towards the end of your period) and most pregnant women will get a ‘pregnancy discharge’.

    Healthy discharge does not have a strong smell or colour. You may feel an uncomfortable wetness, but you should not have any itching or soreness around your vagina.

    How do I know if my discharge is unhealthy?

    Any sudden change to your discharge may indicate a vaginal infection. There will be a recurring pattern of how your discharge varies throughout your cycle – if you are concerned by any possible changes contact your GP or GUM clinic. Obvious warning signs of infection are:

    • A change in colour or consistency

    • A sudden bad smell

    • An unusually large amount of discharge

    • Another symptom alongside the discharge, such as itching on the outside of your vagina or pain in your pelvis or tummy

    • Unexpected bleeding from the vagina

    Common causes of abnormal discharge

    There are many possible causes of abnormal vaginal discharge, but it is usually a sign of infection. The infection is often caused by something that upsets the natural balance of bacteria or yeast in your vagina, such as washing inside the vagina, or it may be sexually transmitted.

    The most common causes are:

    Thrush – a fungal infection that commonly affects the vagina

    Bacterial vaginosis – a bacterial infection of the vagina

    Trichomoniasis – a sexually transmitted infection (STI) caused by bacteria

    Genital herpes – an STI caused by the herpes simplex virus

    The guide below may help you identify the cause of your discharge:

    Watery or white vaginal discharge with intense itchiness

    If your discharge is thin and watery, or thick and white (like cottage cheese), you may have thrush. This common fungal infection causes a high level of itching and soreness around your vagina. The discharge may smell slightly yeasty, but doesn’t have a strong smell.

    Almost all women get thrush from time to time and it is NOT sexually transmitted. It is easily treated with antifungal medicine, which can be bought over the counter from your pharmacy or via White Pharmacy.

    White or grey, fishy-smelling discharge

    If your vaginal discharge is grey or develops a strong fishy smell, particularly after sexual intercourse, you could have bacterial vaginosis (BV). BV is an imbalance in the normal bacteria found in your vagina. It doesn’t usually cause itching or irritation.

    Like thrush, BV is very common and isn’t sexually transmitted. It is easily treated with antibiotics prescribed by your GP or from White Pharmacy.

    Green, yellow or frothy discharge

    Trichomoniasis is a common STI caused by a tiny parasite. It can make your vaginal discharge frothy, yellow or green. You may have a lot of discharge, which may also have an unpleasant fishy smell. Other possible symptoms are soreness, swelling and itching around the vagina and pain when passing urine.

    Trichomoniasis is effectively treated with an antibiotic called metronidazole, which your GP or the White Pharmacy doctors can prescribe. If you have Trichomoniasis you should also consider visiting a local GUM or sexual health clinic, as it can exist alongside other STIs.

    Abnormal discharge with pain or bleeding

    See your GP or go to a genitourinary medicine (GUM) clinic as soon as possible if your vaginal discharge is abnormal and you have:

    • Pain in your pelvis

    • Pain when you urinate

    • Bleeding between periods or after sex

    You may have chlamydia or gonorrhoea (both STIs). Gonorrhoea can make your discharge turn green, although often the pain or bleeding is more noticeable. Both conditions are treated with antibiotics.

    Untreated gonorrhoea or chlamydia may spread upwards and lead to pelvic inflammatory disease: a serious infection of the womb, fallopian tubes or ovaries. This, in turn, can cause infertility.

    Abnormal discharge with blisters around the genitals

    Genital herpes can cause painful, red blisters or sores to appear around your genitals, as well as an abnormal vaginal discharge. See your GP or go to a genitourinary medicine (GUM) clinic as soon as possible. You may be offered a course of antiviral tables, which stop the herpes virus multiplying, but the symptoms have a tendency to return.

    Young girls and post-menopausal women

    It is unusual for young girls to have abnormal vaginal discharge before they have gone through puberty. If this happens, they should see a GP. A common cause is a type of vulvitis (inflammation of the vulval area), caused by a streptococcal infection.

    Abnormal discharge is also unusual in older women. If you have gone through the menopause and suddenly notice an abnormal vaginal discharge, see your doctor as soon as possible. Possible causes include:

    • A sexually transmitted infection (STI)

    • Cervical polyps – non-cancerous growths in the womb or lining of the cervix (neck of the womb).

    • An intrauterine device (IUD)

    It is also important for the doctor to be able to rule out cervical cancer or endometrial cancer.

    Should I wash my vagina?

    The vagina is self-cleansing, so there is no need to wash inside it (called douching). Douching can upset the natural balance of bacteria and fungi in your vagina and lead to thrush or bacterial vaginosis.

    Overusing perfumed soaps, bubble baths and shower gels can also cause vaginal soreness and abnormal vaginal discharge. Never clean your vagina with anything strongly perfumed. Use a mild soap and warm water to gently wash around the outside of your genitals.

    If your symptoms are not on this list but you are concerned about your sexual health, visit a doctor or GUM clinic as soon as possible. Remember, the longer symptoms persist the more chance there is of lasting damage.

  • December 22, 2015
  • by White Pharmacy under 
  • Wellbeing, White Pharmacy, Thrush
  • Thrush is a yeast infection caused by an increase in the growth of fungi: usually Candida albicans. Yeast typically lives in harmony with normal healthy bacteria in the gut and mucous membranes such as the vagina. However, under certain conditions, this balance is disrupted and it can multiply and cause symptoms.

    Three out of four women will experience vaginal thrush at some point in their lives and up to half of these will see repeated attacks, particularly when they first start having sex.

    A third of women will get a vaginal yeast infection following a course of antibiotics as the helpful bacteria that normally keep yeast under control are killed off. A weakened immune system can encourage the fungus, as can diabetes due to the presence of glucose in the urine. Sometimes a contraceptive pill will predispose to yeast overgrowth leading to recurrent thrush in some women. Although the two are often confused, thrush is quite different from cystitis, which is an inflammation of the inner lining of the bladder and urethra.

    Your chances of getting thrush are higher if you:

    • Wear lycra shorts or tight nylon clothes

    • Take antibiotics, (thrush can develop in about a third of women who take antibiotics)

    • Take steroids or immunosuppressive drugs

    • Use too much vaginal deodorant or perfumed bubble bath or shower gel

    • Are pregnant

    • Damage the vaginal walls due to vaginal dryness during sexual intercourse or the excessive use of tampons

    • Have sex with someone who has a thrush infection

    Symptoms of vaginal yeast infection

    • A lumpy, white vaginal discharge ‘like cottage cheese'

    • Painful sex (but not always)

    • Itching, pain or burning in the vulva especially when wiping after urination

    • Pink vaginal discharge

    • Needing to urinate frequently

    Oral thrush

    Thrush can also affect other internal areas, for example the mouth. This is less common and may indicate that the immune system isn't working properly. In this case it is important to contact a doctor.

    When babies develop oral thrush, it can lead to sore nipples for mothers and an angry looking nappy rash.

    Yeast infection in men

    Thrush can also affect men usually in the groin area and this is referred to as Jock itch or Dhobi’s itch. It is caused by a different fungus called Tinea cruris that can also produce athlete's foot resulting in cheesy, itchy and soggy skin between the toes.

    Is thrush contagious?

    Thrush is not contagious in the usual sense of the word, but it can pass between partners. If a woman has thrush it is advised that any male sexual partner apply some Canesten HC cream to the penis for five days and avoid sex whilst having treatment.

    One consequence of Candida on the skin and vaginal tissues is an allergic response to the yeast itself, such that even after getting rid of the yeast you're still left with an unpleasant irritation.

    Available treatments

    Treatment for uncomplicated thrush is available without a prescription at any pharmacy and consists of a tablet of fluconazole taken orally or a pessary, containing clotrimazole that is inserted into the vagina. This is often used in combination with Canesten cream, which also contains clotrimazole.

    Unfortunately, in some cases, this treatment is not effective and then you should consider seeing a doctor.

    The doctor will probably provide a prescription that includes Canesten HC cream as well as a single dose of fluconazole (Diflucan). The 'HC' stands for hydrocortisone, a type of steroid that treats the inflammation that inevitably occurs in the delicate vulval and vaginal skin.

    Persistent or recurrent thrush, which is defined as getting four or more outbreaks a year, can be a real nuisance. Around one in ten women may have recurrent thrush and up to one in one hundred may have it almost all the time. Various things predispose to recurrent thrush, such as diabetes and pregnancy.

    To control recurrent thrush a doctor will probably advise you to take a six month course of treatment with the antibiotic fluconazole in combination, initially, with a clotrimazole pessary and five day’s use of Canesten HC cream.

    How to avoid getting thrush

    • Drink lots of water

    • Do not douche or clean inside of vagina

    • Avoid vaginal deodorants, bubble baths or perfumed soaps and shower gels

    • Try not to wear nylon underwear, tights, or tight fitting trousers

    • Change to a non-biological washing powder

    • Take care with genital hygiene and wipe from 'front to back'

    • Consider using pads and panty liners rather than tampons

    • Avoid intercourse until all symptoms have disappeared as this will encourage healing of the lining of the vagina

    Thrush is a fairly harmless, though irritating, condition. Occasionally the symptoms can be a sign of a more serious disorder, so see your GP if you also have a fever, there’s blood in your urine, you are pregnant, or have been experiencing vomiting. Also bear in mind that thrush is more likely if you have diabetes.