Find out EVERYTHING about vaginal infections: what they are, why they occur and how they can be treated

Vaginal infections are so common that, according to estimates, up to 75% of all women experience one at least once in their lifetime. They can cause itching, redness and changes to vaginal odour and discharge. They don't clear up on their own – and without the right treatment, they can affect the reproductive system.

Read on to find out what types of vaginal infection there are, how they present, how each one is treated and – most importantly – what choices you can make to prevent all this discomfort in the first place.

What are vaginal infections? 

The vaginal flora is naturally home to billions of bacteria. These are beneficial bacteria known as lactobacilli, which maintain the balance of the vaginal flora and prevent fungi and harmful bacteria from spreading.

When this balance is disturbed, the vaginal pH changes and the number of lactobacilli falls. This is how vaginal infections arise – inflammation of the vagina and vulva that can cause itching, pain, redness and other forms of discomfort.

Types of vaginal infection

There are several types of vaginal infection, but the most common – depending on what causes them – are bacterial infections (caused by bacteria) and fungal infections (caused by yeasts).

Depending on their severity, vaginal infections may also be acute or become chronic if they aren't treated in good time. It's also possible for several types of infection to occur at the same time.

Bacterial vaginal infection 

When certain bacteria or germs multiply excessively in the vagina, the natural balance of the vaginal flora is disrupted. This gives rise to bacterial vaginal infection, which is usually caused by an overgrowth of the bacterium Gardnerella vaginalis.

Vaginal fungal infection

Fungal infections (mycoses) are another common form of vaginal infection and are triggered by yeasts such as Candida albicans. Fungi are normally present in small amounts in the mouth, the digestive system and the vagina. If they multiply excessively, however, they can cause itching and vaginal infections.

Causes of vaginal infections 

Vaginal infections can be caused by bacteria, fungi, parasites or viruses. According to the WHO, 90% of cases are triggered by either the bacterium Gardnerella vaginalis, the yeast Candida albicans or the parasite Trichomonas vaginalis. There are, however, other causes too, particularly sexually transmitted infections such as chlamydia, gonorrhoea or genital warts.

Risk factors that can upset the balance of the intimate flora and increase the risk of infection include:

• Detergents: these may contain fragrances and other substances that irritate the intimate area.
• Underwear made from unsuitable materials: synthetic fabrics encourage the build-up of sweat and bacteria, as they don't allow the skin to breathe, creating an environment in which bacteria can thrive.
• Unsuitable hygiene products and excessive or incorrect intimate hygiene: it's recommended that you wash only the vulva externally and avoid douching as well as soaps containing fragrances and parabens, so as not to disturb the vaginal pH. Use only water and Enroush Intimate Gel, with 95% natural ingredients and 87% efficacy against candidiasis.
• Certain contraceptive methods, such as the coil
• Hormonal imbalances and fluctuations: for example, falling oestrogen levels during the menopause can alter the vaginal pH and increase the risk of infection.
• Long-term treatment with antibiotics or steroids
• Sexual activity, particularly with a new partner
• Other conditions that weaken the immune system, such as diabetes or HIV

Symptoms of vaginal infections 

There are cases in which infections cause no symptoms at all – often, though not exclusively, with sexually transmitted diseases. This is precisely why regular gynaecological check-ups are so important: they can detect infections even when there are no complaints.

Often, though, vaginal infections do present with symptoms – depending on the cause and severity – such as:

• Itching/burning in the vagina: many factors can trigger vaginal itching, and infections are just one of them. HERE you can find out what other causes may be involved
• Vaginal pain and discomfort: this may even be accompanied by pain in the lower abdomen
• Inflamed, red or swollen skin: around the vagina and vulva
• A change in the amount of vaginal discharge: very heavy discharge can be a sign of a vaginal infection, but it may also have other causes, which we've covered HERE
• Changes to the discharge in terms of colour, consistency and smell: discharge may become yellow-green or bloody, with a lumpy consistency and an unpleasant odour
• Pain or burning when passing urine: this can also occur with a urinary tract infection, so a specialist examination is needed to determine the exact cause
• Pain during intercourse: during or after sex, because the vaginal tissue is inflamed
• Vaginal bleeding or spotting: this can be a symptom, but doesn't automatically indicate a vaginal infection. Spotting can be perfectly normal, particularly just after your period ends, while the vagina is still cleansing itself. If you'd like to know more about what is and isn't normal when it comes to spotting and brown discharge, read our article.

Diagnosing vaginal infections 

Your doctor will make the diagnosis during a gynaecological examination, first asking you about your symptoms and medical history. To determine the cause, the type of infection and the appropriate treatment, the following steps may also be necessary:

Examination of the genital area, both the vulva and the vagina, to identify signs of infection

Taking a sample of vaginal discharge for laboratory testing

Sending a urine sample to the laboratory to establish whether you are pregnant and whether there's a risk of a urinary tract infection

When to see a doctor 

As a general rule, as soon as you notice unusual symptoms or persistent discomfort in the intimate area, you should see a specialist. So book an appointment as soon as possible if you experience the following:

• Itching in the intimate area
• Heavy vaginal discharge with a change in colour
• An unpleasant, unusual smell in the intimate area
• Vaginal pain during or after intercourse, or when passing urine
• Pain in the lower abdomen
• A temperature above 38.5 ℃

It's also advisable to see a doctor if you've had unprotected sex with a partner who has a sexually transmitted disease.

Risk factors and complications of vaginal infections

The most common factors that can trigger vaginal infections include unprotected sex with multiple partners, courses of antibiotics and taking the contraceptive pill. Diabetes mellitus, the use of intimate care products containing fragrances and harmful substances, and the use of menstrual products containing bleaching agents, plastic and perfume are also risk factors.

It's very important to start treatment as early as possible, because these infections don't clear up on their own and can lead to complications such as infections following a hysterectomy, pelvic inflammatory disease (PID), infertility or, in pregnant women, premature birth.

Treating vaginal infections

Treatment is prescribed by your gynaecologist once a diagnosis has been made. Depending on the type of infection, the following may be recommended:

Antibiotics to treat bacterial infections, but also gonorrhoea, chlamydia or trichomoniasis. These can be given as oral antibiotics or as a cream or ointment applied in the vagina.

Antiviral medication for genital herpes. These don't cure the virus, as it remains in the body once you're infected, but they do help the blisters to heal.

Creams and ointments to relieve symptoms.

Antifungal pessaries for topical use in treating fungal infections.

Vaginal fungal infections during pregnancy

Vaginal fungal infections are more common in pregnancy, as raised oestrogen levels alter the vaginal pH and intimate balance. Treatment is especially important in these cases, because the infection can also cause complications for the baby (including delivery before or after the due date).

As a rule, oral treatments or pessaries containing boric acid are contraindicated, which is why mums-to-be are advised to use topical medication.

Acute vaginal fungal infections 

Occasional vaginal fungal infections can be treated with over-the-counter medicines. In patients with a weakened immune system, however, oral treatment isn't always effective, so the doctor will recommend topical therapies.

Recurrent vaginal fungal infections

Vaginal infections are described as recurrent when they return within 60 days or occur at least four times in the same year. Further tests and even a change of treatment may be needed to prevent another relapse.

Vaginal fungal infections – treating sexual partners

Vaginal fungal infections are not sexually transmitted infections. They arise from an overgrowth of fungi in the vaginal flora, not from a virus. For this reason, treating sexual partners isn't generally recommended – nor can it prevent reinfection.

Only if your partner is at increased risk of carrying a fungal infection (for example, if he is uncircumcised, has diabetes mellitus or a weakened immune system) might the doctor recommend treatment for him too.

How to prevent vaginal infections

Vaginal infections stem from an imbalance in the vaginal flora. The best protection, therefore, is to preserve the vaginal microbiome and avoid anything that can disturb the intimate pH. A few simple steps will do the trick:

Avoid douching, as it can throw your natural pH out of balance.

Don't use gels, soaps, sprays or intimate deodorants containing fragrances and allergens; instead, opt for an intimate gel made from natural ingredients, such as the one from Enroush.

Wipe from front to back after using the toilet to stop germs entering the vagina.

Wear loose-fitting, breathable underwear made from natural fibres, so that moisture and sweat don't build up in the intimate area.

Choose organic menstrual products, such as Enroush's 100% organic cotton pads, which contain no plastic, fragrances, bleaching agents or synthetic fibres and won't expose your intimate area to irritating substances.

Eat a balanced diet rich in prebiotics and dairy products to maintain the balance of micro-organisms and the lactobacilli that are essential to the vaginal flora.

Avoid taking too many antibiotics, as they can increase the risk of imbalances in the vaginal flora.

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