The most common causes of vaginitis are bacterial vaginosis, candida (yeast) infection and trichomonas infection. They account for 90 percent of cases. Less common but significant causes of vaginitis are infections caused by sexually-transmitted organisms such as chlamydia, gonorrhoea and herpes.
Not all cases of vaginal discharge are due to infection. Vaginal discharge can be normal (‘physiological discharge’). It can also be caused by presence of foreign objects in the vagina, allergic reactions, cervical conditions and rarely genital tract cancer. In postmenopausal women, vaginal discharge is commonly due to atrophic changes (‘atrophic vaginitis’).
* Cervical ectropion is a condition in which the inner cervical cells are found on the outer part of the cervix.
The normal vaginal environment is a delicate ecosystem of ‘healthy’ bacteria and small amounts of candida (yeast). The normal pH of the vagina is usually acidic in nature. Lactobacillus is the main regulator of vaginal pH by making lactic acid. Maintaining the vaginal pH at an acidic level inhibits overgrowth of ‘healthy’ bacteria and yeast and prevents infections from bad bacteria and viruses.
Discharge flows from the vagina daily
as the body’s way of maintaining a
normal healthy environment. Normal
physiological vaginal discharge
consists of cervical and vaginal cells,
bacteria, water, electrolytes and other
chemicals. Normal discharge is usually
clear or white, thick and mucouslike.
There may be a slight odour.
Vaginal discharge may become more
noticeable near ovulation and in the
week before the menstrual period.
The vaginal pH can change under the
influence of various factors:
Disturbance of the normal vaginal pH
can alter the composition and balance
of the vaginal ecosystem. This leads to overgrowth of ‘healthy’ organisms
and infections from bad organisms,
resulting in vaginitis.
Although vaginal discharge can
be physiological, it is advisable to
seek medical advice under any of
the following circumstances:
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