Vaginal infections

Vaginal infections arise when the patient’s natural vaginal balance is altered generating an environment prone to the proliferation of excessive fungi, bacteria, and parasites.

Each year 7 to 20% of women experience vaginal infections. It is estimated that 75% of women will have at least one vaginal infection episode during their lives and up to 50% of women will have two or more episodes.

Most common vaginal infections are:

  • Candidiasis or vaginal mycosis: The microorganism responsible for this infection is the fungus Candida Albicans which inhabits the vaginal flora under normal conditions but is considered harmful if it proliferates disproportionately
  • Bacterial vaginosis: This is the most common vaginal infection and occurs whenever Gardenerella Vaginalis bacteria proliferates in the woman’s vagina
  • Trichomoniasis: This is a sexually transmitted disease caused by the unicellular parasite called Trichomona Vaginalis
  • Atrophic vaginitis: This is an vaginal inflammation due to a lubrication lack. This is caused by an estrogen level decrease which, in turn, increases the risk of contracting infections

Women with frequent untreated or poorly handled vaginal infections are more likely to develop infections in the ovaries, fallopian tubes, and the uterus (pelvic inflammatory disease or PID).

These conditions can affect fertility in different ways:

  • Cervical infections can stop the sperm from reaching the uterine cavity
  • Tubal infections can cause hydrosalphynx, which means blockage of one or both fallopian tubes. This will likely stop sperm from meeting the egg and fertilizing it. If it happens, however, it also obstructs the path of the fertilized egg into the uterus thus increasing the risk of ectopic pregnancy
  • When they reach the uterine cavity, infections can cause an insufficient endometrial development which can hinder the correct implantation of the embryo
  • Chronic infections produce inflammatory reactions that can lead to the formation of pelvic adhesions, which interfere with gamete (eggs and sperm) transportation
  • Since infections can cause pain during or after intercourse, many couples are forced to avoid sex during the woman’s most fertile period, which evidently impedes conception

Likewise, frequent untreated vaginal infections can cause serious consequences during pregnancy, such as:

  • Increased ectopic pregnancy risk
  • Increased spontaneous miscarriage risk
  • Threatened miscarriage
  • Premature birth
  • Premature membrane rupture
  • Underweight newborn

Vaginal infection main symptoms

While some vaginal infections may be asymptomatic, others can present the following symptoms:

  • Abnormal vaginal discharge (greenish, yellowish, fetid, lumpy, etc.)
  • Irritation
  • Itching
  • Stinging
  • Swelling
  • Unpleasant smell
  • Painful urination
  • Urinary infections
  • Painful intercourse
  • Chronic pelvic pain

It is necessary for women to learn to recognize vaginal infections symptoms and know when to contact an expert to avoid further complications.

Vaginal infection causes

There are numerous beneficial species of bacteria that naturally live in the vaginal area. These produce acidic substances that prevent other bacteria, fungi, and parasites from settling in the vagina.

Therefore, any factor that decreases the natural vaginal acidity may cause a vaginal infection.

In most cases, vaginal infections reach the cervix, and are therefore known as vaginal infections.

Some factors that increase the probability of contracting vaginal infections include:

  • Pregnancy
  • Uncontrolled diabetes
  • Multiple sclerosis
  • Human immunodeficiency virus (HIV)
  • Endocrine and thyroid disorders
  • Hormonal changes
  • Obesity
  • Corticosteroid, immunosuppressant and antiviral use
  • Some antibiotic treatments over extended periods of time
  • Stress

To avoid vaginal infections, specialists recommend:

  • Wearing cotton-based underwear
  • Frequent sanitary towel change
  • Wearing loose and comfortable clothes
  • Not using vaginal deodorants, talcum powder or perfumed soap
  • Maintaining a healthy diet
  • Avoiding tampon use
  • Avoiding vaginal douche use
  • Avoiding spermicidal use
  • Daily external genital washing
  • External genital washing of both sexual partners before and after intercourse
  • Having protected sexual relations, provided that getting pregnant is not the objective

How are vaginal infections diagnosed?

In addition to an analysis of your medical history and a painless vaginal test that takes a few minutes, it is necessary for your doctor to take a cell sample of your vagina or cervix using a cotton swab to be sent to a laboratory where a culture will be performed to obtain more information.

It is essential the diagnosis is performed by an experienced specialist, since each type of vaginal infection requires a specific treatment.

It is also advisable for women with frequent untreated or poorly handled vaginal infections to have a gynecological vaginal ultrasound.

During this procedure the doctor carefully introduces an ultrasound probe in the woman’s vagina in order to determine the potential damage caused by these infections to her reproductive organs.

Alternatives to achieve pregnancy in patients suffering from vaginal infections

Numerous therapeutic options exist to treat vaginal infections such as candidiasis, bacterial vaginosis and vaginal trichomoniasis.

Treatments take between one and seven days and usually consist on oral (capsules and tablets) or local (creams and vaginal tablets) antibiotics or antimycotics, depending on the infection causes.

As opposed to oral treatments, creams and vaginal tablets are applied directly to the infected area and do not produce gastrointestinal effects.

Meanwhile, atrophic vaginitis is treated with estrogen, which is also available in cream or tablets form.

Some vaginal infections such as bacterial vaginosis may be recurrent, which may make it necessary to the repeat treatment.

If the reproductive organs are damaged (principally in the case of tubal obstruction), In-Vitro Fertilization (IVF) is the recommended treatment to achieve pregnancy.

Since the damage caused by cervicovaginal infections frequently alters the gamete (eggs and sperm) transport or blocks the path of the fertilized egg towards the uterus, In-Vitro Fertilization (IVF) allows us to obtain the eggs directly from the patient’s ovaries.

These eggs are fertilized under controlled laboratory conditions to generate higher implantation potential embryos which are then transferred back into the patient’s uterus.

Therefore, In-Vitro Fertilization (IVF) makes the fallopian tubes no longer indispensable and offering greater pregnancy probabilities when compared to other available treatments.

It is important to treat the infection before beginning In-Vitro Fertilization (IVF) cycle as this may have an adverse effect on the success rates of this procedure.