The discharge is irritating to the vagina and the surrounding skin. Atrophic vaginitis or senile vaginitis, usually causes scant vaginal discharge with no odor, dry vagina and painful intercourse. These symptoms usually due to decreased hormones usually occurring during and after menopause. Bacterial vaginitis gardnerella, usually causes a discharge with a fish like odor. It is associated with itching and irritation, but no pain during intercourse. Trichomonas vaginalis, can cause a profuse discharge with a fish like odor, pain upon urination, painful intercourse and inflammation of the external genitals. Lastly, herpes. It usually occurs as water blisters on the genital region, about one week after infection. There is tenderness, swollen glands, and fever. The water blisters are extremely painful and heal in about three weeks. However, herpes is usually an external infection and does not fall under the category of vaginitis. The diagnosis of this disease is made with microscopy and culture of the discharge after a careful history and physical examination have been completed. It may be useful to measure the pH value as with infectious vaginal pH increases. Complication includes persistent discomfort, superficial skin infection, gonorrhea and candida infection. The cause of the infection determines the appropriate treatment. It may include oral or topical antibiotic, antifungal creams, antibacterial creams or similar medications. A cream containing cortisone may also be used to relieve some of the irritation. If an allergy is involved, an antihistamine may be prescribed. For women who have an irritation and inflammation caused by low levels of estrogen, a topical estrogen cream might be prescribed.

CANDIDIASIS

Candidiasis is commonly called yeast infection or thrush, is a fungal infection of any of the candida species of which candida albicans in the most common. In immunocompetent people, candidiasis can usually be found in exposed and moist parts of the body such as the oral cavity, the vagina, folds of the skin in the diaper area, and the nipples while breastfeeding. Candidiasis is the second most common cause of vaginal irritation or vaginitis. The most common symptoms include severe itching, burning, soreness, irritation of the vagina and whitish or whitish- gray discharge, often with a curdlike appearance. Medical professionals use two primary methods to diagnose yeast infections, the microscopis examination and culturing. For the microscopic method, a scraping or swab of the affected area is placed on a microscope slide. A single drop of 10% potassium chloride solution is then also placed on the slide. The potassium chloride dissolves the skin cells but leaves the Candida untouched, so that when the slide is viewed under a microscope. Their presence in large numbers strongly suggests a yeast infection.

For culturing method, a sterile swab is rubbed on the infected skin surface. The swab is then rubbed across a culture medium. The medium is incubated for several days, during which time presumptive diagnosis of the organism causing symptoms. It is important to consider candida is part of the human body’s normal oral and intestinal flora and an infection is more a bloom than the work of a parasite, as in case of some bacterial infections. Despite this, candidiasis is sometimes misdiagnosed by medical personnel as bacterial in nature, and treated with antibiotics. This can lead to eliminating the yeast natural competitors for resources and increase the severity of the condition. Prescription medication is often the only solution to an infection. The antufungal drugs commonly used to treat candidiasis are topical clotrimazole, topical nystatin, fluconazole and topical ketoconazole.

In severe infections generally in hospitalized patients, amphotericin B, caspofungin or voriconazole may be used. Local treatment may include suppositories or medicated douches, gentian violet can be used for breastfeeding thrush. Treating candidiasis solely with medication may not give desired results. If medicated, underlying causes should be considered. As candida originates some strategies may be effective during an infection and to control or prevent outbreaks. The fungus requires processed starches as gluten, as well as sugars to thrive. Dairy products and fermented foods may also contribute to its growth. As such avoiding glutens, sugars, dairy products and fermented foods may help to prevent overgrowth of the organism. It is important to remember that sugars include sucrose, fructose, lactose, maltose, dextrose and others including maltodextrin. All these types of sugars may contribute to candidiasis and may give relief if avoided.

The prognosis is better when the cancer is found early. Possible signs of cervical cancer include vaginal bleeding, unusual vaginal discharge, pelvic pain and pain during sexual intercourse. To detect and diagnose cervical cancer the following procedures are performed. Papsmear, a procedure to collect cells from the surface of the cervix and vagina. A piece of cotton, a brush, or a small wooden stick is used to gently scrape cells from the cervix and vagina. The cells are viewed under a microscope to find out if they are abnormal. This procedure is also called Pap test. Colposcopy, a procedure in which a colposcope is used to check the vagina and cervix for abnormal areas. Tissue samples may be taken using a curette and checked under a microscope for signs of disease. Biopsy, if abnormal cells are found in a Pap smear, the doctor may do biopsy. A sample tissue is cut from the cervix and viewed under a microscope by a pathologist to check for signs of cancer. A biopsy that removes only a small amount of tissue is usually done in the doctors office. The woman may need to go in the hospital for a cervical cone biopsy.

Next is pelvic exam. An examination of the vagina, cervix, uterus, fallopian tubes, ovaries and rectum. The doctor or nurse inserts one or two lubricated gloved fingers of one hand into the vagina and places the other hand over the lower abdomen to feel the size, shape, and position of the uterus and ovaries. A speculum is also inserted in to the vagina and cervix for signs of disease. A Pap test of the cervix is usually done. Lastly, endocervical curettage is a procedure to collect cells or tissue from the cervical canal using a curette. Tissue samples may be taken and checked under a microscope for signs of cancer. Certain factors affect prognosis and treatment which include the stage of the cancer, type of cervical cancer, size of the tumor and patients age. While the treatment of the cervical cancer during pregnancy depends on the stage of the pregnancy depends on the stage of the cancer and the stage of the pregnancy. For cervical cancer found during the last trimester f pregnancy, treatment may be delayed until the baby is born.

The cells in the vagina and cervix can show changes from infections or other irritations. Once these conditions have been treated, the cells go back to normal. But if there is some problem the doctor will tell the patient to undergo biopsy. A biopsy is the removal of a small piece of tissue from all areas that were noted during the examination. There are several different kinds of instrument made to do biopsy. An endocervical curette is used to scrape the endocervical canal and may cause some cramping. The doctor will apply pressure to the cervix using a large cotton swab to stop bleeding from the biopsy areas. If this doesn’t work, a solution called Monsels Solution or silver nitrate will be applied to the cervix.

This will stop the bleeding that is happening. After the procedure is finished, the doctor will explain what he found. The doctor will also tell you to expect a coffee grounds discharge. This comes from the solution used to stop the bleeding. The patient will also be instructed not to put anything into the vagina for two weeks which includes having sex and tampons because of the risk of infection. Patients may have bleeding or infection after biopsy. Bleeding is usually controlled with a topical medication prescribed by the physician or health care provider. If colposcopy is performed on a pregnant patient there is a risk of premature labor.

A patient should call the doctor right away if she notices any of the following symptoms such as heavy vaginal bleeding which is more than one sanitary pad an hour, fever, chills, unpleasant vaginal odor and lower abdominal pain. Abnormal conditions that can be detected using colposcopy and biopsy include precancerous tissue changes or cervical dysplasia, cancer and cervical warts caused by human papilloma virus. Complications associated with colposcopy are extremely rare. There is a risk that the procedure will missed precancerous tissues and thus prolong until the cancer has become advanced.

The patient will take 600-800 mg of Aleve or Advil one hour before leaving for your doctor’s office. If you are allergic to ibuprofen, take two Extra-Strength Tylenol. Make sure you have not started nor will start your period for about two weeks. Do not use anything in the vagina for 24-48 hours before the procedure. This includes spermicides, vaginal medications, douching products or tampons. These all interfere with the accuracy of the test. And do not have vaginal sex 24 – 48 hours before the procedure because this can also interfere with teh test’s accuracy. The patient will lie on the examining table just as in a regular pelvic exam. The colposcope is placed at the vaginal opening in order to examine the genital area, vagina and cervix.

The doctor will use a speculum, the same as used during your regular examination, to separate the walls of the vagina as in a pap smear. The speculum will be moistened with warm water and stays in the vagina throughout the procedure. Upon insertion of the speculum, inspection of the vaginal walls will be done. The speculum will be gently rotated so that the entire vagina can be seen. Next, the speculum is placed so that the cervix is completely visible. While looking through the colposcope, your doctor will do a Pap Smear that will be sent to the lab with any other tissue samples, called biopsies, that may be taken dung your examination. The Pap Smear is done as usual, making sure that cells from the Transformation Zone are included in the smear. The doctor will then look at your cervix under 2 – 3 different magnifications. Any excess mucus or other secretions will be cleaned from the cervix using a large cotton swab.

After this, a cool sensation will be felt. This is the application of acetic acid, a vinegar solution that will enable abnormal cells to be more visible. This may sting a bit. Acetic acid dissolves mucous and accentuates atypical areas by causing cellular dehydration and coagulation of cellular protein. The effect of the acetic acid peaks in approximately 2 minutes and fades in approximately 5 minutes. Because of this, your doctor may need to re-apply the acetic acid solution several times. Areas of the cervix may turn white after the acetic acid has been applied. These areas are called White epithelium. White epithelium is sometimes associated with dysplasia. These areas will be biopsied by the doctor near the end of the procedure.