I am typing all of this up from my Merck's Medical Manual, which I constantly read while on the toilet.
What causes an abnormal vaginal discharge?
Infection:
* Bacteria, such as chlamydiae (the clam chowder) and gonococci (the guacamole splatters)
* Fungi, such as Candida (especially among women who have diabetes, are pregnant, or are taking antibiotics)
* Protozoans, such as Trichomonas vaginalis
* Viruses, such as human papillomavirus (HPV) and herpesvirus
Irritation:
* Spermicides, lubricants, condoms, diaphragms, cervical caps, and sponges
* Laundry soaps and fabric softeners
* Deodorant sprays and soaps
* Bathwater additives
* Frequent douching
* Foreign objects in the vagina
* Tight, nonporous, nonabsorbent underpants
* Stool (feces, not the thing you sit on at the bar)
Tumors or other abnormal tissue
* Cancer of the vulva, vagina, cervix, or uterine lining
* Radiation therapy necessitized by said tumors
TREATMENT:
For a normal discharge, occasional douching with water may reduce the amount. However, a discharge caused by vaginitis requires specific treatment according to its cause. If the cause is an infection, treatment consists of an antibiotic, antifungal, or antiviral drug, depending on the infective organism. Until the infection has been cured, a premeasured vinegar and water douche can be used briefly to control symptoms. However, douching frequently and using medicated douches are discouraged because they increase the risk of pelvic inflammatory disease. If the labia (folds of skin skin around the vaginal and urethral openings) are stuck together because of previous infections, applying a vaginal estrogen cream for 7 to 10 days usually opens them.
In addition to an antibiotic, treatment of a bacterial infection may include propionic acid jelly to make the vaginal secretions more acidic - which discourages bacterial growth. For sexually transmitted infections, both sex partners are treated at the same time to prevent reinfection.
Thinning of the vaginal lining after menopause (atrophic vaginitis) is treated with estrogen replacement therapy. Estrogen can be given by mouth or through a skin patch or applied as a cream directly to the vulva and vagina.
The drugs used to treat vulvitis depend on its cause and are the same as those used to treat vaginitis. Additional measures include wearing loose, absorbent clothing that allows air to circulate, such as cotton or cotton-lined underpants, and keeping the vulva clean. Glycerine soap should be used because many other soaps can irritate the area. Occasionally, placing ice packs against the vulva, sitting in a cool sitz bath, or applying cool compresses may reduse soreness and itching. Corticosteroid creams or ointments, such as those containing hydrocortisone, and antihistamines taken by mouth may also reduce itching that's not caused by an infection. Acyclovir applied as a cream or taken by mouth may reduce symptoms and shorten the course of a herpes infection. Analgesics taken by mouth may help reduce pain.
If chronic vulvitis is caused by poor personal hygiene, instruction in proper hygiene is the first step. A bacterial infection in the area is treated with antibiotics. Skin conditions such as psoriasis may be treated with corticosteroid creams. Substances that may be causing persistent irritation, such as creams, powders, and some brands of condoms, should not be used.
COMMON TREATMENTS FOR VAGINAL and VULVAR INFECTIONS
Candidal (yeast): Miconazole, clotrimazole, butoconazole, or terconazole (as a cream, vaginal tablets, or suppositories); fluconazole or ketoconazole (by mouth)
Bacterial: Usually, metronidazole or clindamycin (as a vaginal cream) or metronidazole (by mouth); if due to gonococcus, usually ceftriaxone (by intramuscular injection) plus doxycycline (by mouth)
Chlamydial: Doxycycline or azithromycin (by mouth)
Trichomonal: Metronidazole (by mouth)
Viral:
Human papillomavirus: Trichloroacetic acid (directly on the warts); liquid nitrogen or fluorouracil (directly on the warts) for severe infections
Herpesvirus: Acyclovir (by mouth or as an ointment)
What causes an abnormal vaginal discharge?
Infection:
* Bacteria, such as chlamydiae (the clam chowder) and gonococci (the guacamole splatters)
* Fungi, such as Candida (especially among women who have diabetes, are pregnant, or are taking antibiotics)
* Protozoans, such as Trichomonas vaginalis
* Viruses, such as human papillomavirus (HPV) and herpesvirus
Irritation:
* Spermicides, lubricants, condoms, diaphragms, cervical caps, and sponges
* Laundry soaps and fabric softeners
* Deodorant sprays and soaps
* Bathwater additives
* Frequent douching
* Foreign objects in the vagina
* Tight, nonporous, nonabsorbent underpants
* Stool (feces, not the thing you sit on at the bar)
Tumors or other abnormal tissue
* Cancer of the vulva, vagina, cervix, or uterine lining
* Radiation therapy necessitized by said tumors
TREATMENT:
For a normal discharge, occasional douching with water may reduce the amount. However, a discharge caused by vaginitis requires specific treatment according to its cause. If the cause is an infection, treatment consists of an antibiotic, antifungal, or antiviral drug, depending on the infective organism. Until the infection has been cured, a premeasured vinegar and water douche can be used briefly to control symptoms. However, douching frequently and using medicated douches are discouraged because they increase the risk of pelvic inflammatory disease. If the labia (folds of skin skin around the vaginal and urethral openings) are stuck together because of previous infections, applying a vaginal estrogen cream for 7 to 10 days usually opens them.
In addition to an antibiotic, treatment of a bacterial infection may include propionic acid jelly to make the vaginal secretions more acidic - which discourages bacterial growth. For sexually transmitted infections, both sex partners are treated at the same time to prevent reinfection.
Thinning of the vaginal lining after menopause (atrophic vaginitis) is treated with estrogen replacement therapy. Estrogen can be given by mouth or through a skin patch or applied as a cream directly to the vulva and vagina.
The drugs used to treat vulvitis depend on its cause and are the same as those used to treat vaginitis. Additional measures include wearing loose, absorbent clothing that allows air to circulate, such as cotton or cotton-lined underpants, and keeping the vulva clean. Glycerine soap should be used because many other soaps can irritate the area. Occasionally, placing ice packs against the vulva, sitting in a cool sitz bath, or applying cool compresses may reduse soreness and itching. Corticosteroid creams or ointments, such as those containing hydrocortisone, and antihistamines taken by mouth may also reduce itching that's not caused by an infection. Acyclovir applied as a cream or taken by mouth may reduce symptoms and shorten the course of a herpes infection. Analgesics taken by mouth may help reduce pain.
If chronic vulvitis is caused by poor personal hygiene, instruction in proper hygiene is the first step. A bacterial infection in the area is treated with antibiotics. Skin conditions such as psoriasis may be treated with corticosteroid creams. Substances that may be causing persistent irritation, such as creams, powders, and some brands of condoms, should not be used.
COMMON TREATMENTS FOR VAGINAL and VULVAR INFECTIONS
Candidal (yeast): Miconazole, clotrimazole, butoconazole, or terconazole (as a cream, vaginal tablets, or suppositories); fluconazole or ketoconazole (by mouth)
Bacterial: Usually, metronidazole or clindamycin (as a vaginal cream) or metronidazole (by mouth); if due to gonococcus, usually ceftriaxone (by intramuscular injection) plus doxycycline (by mouth)
Chlamydial: Doxycycline or azithromycin (by mouth)
Trichomonal: Metronidazole (by mouth)
Viral:
Human papillomavirus: Trichloroacetic acid (directly on the warts); liquid nitrogen or fluorouracil (directly on the warts) for severe infections
Herpesvirus: Acyclovir (by mouth or as an ointment)