Vaginal Infections: Treatments and Prevention

Vaginal infections are uncomfortable and frustrating to deal with. Symptoms like burning, itching, and pain are common for most women.

Thankfully, the most common types of infections have straightforward treatments that can resolve any issues in a relatively short period of time so you can get back to regular life.

Rachel Houghtling, PA-C, serves as a virtual OB/GYN urgent care provider with Rochester Regional Health and explains some of the most common vaginal infections, how to treat them, and the best ways to prevent them.

Bacterial vaginosis (BV)

One of the most common vaginal infections is bacterial vaginosis (BV). This infection stems from an overproduction of vaginal bacteria. The most common bacteria is called gardnerella vaginalis.

Symptoms of BV may include:

• Thin, white-gray milky discharge
• Fishy or unpleasant odor
• Itching/burning (vaginal or urinary)

“There is good evidence that diagnosing BV on symptoms alone is not accurate,” Houghtling said.” It’s good to also get a vaginal test or swab to confirm.”

Treatment for BV

Patients will typically be prescribed an antibiotic (metronidazole). This can be taken orally twice a day for 7 days or administered nightly as an intravaginal gel for 5 days.

Yeast infection

A vulval vaginal candida infection, more commonly referred to as a yeast infection, is another one of the most common vaginal infections.

Symptoms of yeast infections include:

• Itching (outside or inside the vagina)
• Pain with urination and/or sex
• Redness or swelling
• Thick white discharge (appearance of cottage cheese)

Providers will confirm a yeast infection with a vaginal swab test.

Treatment for yeast infections

Since yeast infections are a fungal infection, they are treated with an antifungal medication. This can be either oral or creams.

Fluconazole, the oral antifungal medication, is available as a single-dose prescription. Antifungal creams such as miconazole and clotrimazole are available over the counter. Providers may also prescribe terconazole as an antifungal cream.

Trichomonas

Trichomonas is also common, but is a parasitic vaginal infection caused by a protozoa called trichomonas. This infection can only occur in individuals who are sexually active, which classifies it as a sexually transmitted infection (STI).

People who have trichomonas typically experience no symptoms. Some patients may have a yellowish-green frothy discharge, redness, swelling, pain with urination or sex, but a lack of symptoms is generally more common.

Instead, this vaginal infection is diagnosed during a routine screening or by someone who comes in requesting a screening.

“If someone is swabbed for bacterial vaginosis and yeast infection, we will screen for trichomonas so we can test for all 3 at the same time,” Houghtling said.

Treatment for trichomonas

Providers will usually prescribe an oral antibiotic (metronidazole) for 7 days to kill the parasite. Treatment for any sexual partner(s) is recommended.

Generally, OBGYN providers recommend using over-the-counter products and prescribed medications to treat vaginal infections.

“There have not yet been any natural remedies for vaginal infections that are clinically proven to be effective,” Houghtling said. “Some patients may eat yogurt or take probiotics. There are a lot of herbal suppositories and none of them have been shown to reduce recurrence in individuals.”

Preventing vaginal infections

Maintaining good general vaginal health helps to prevent most infections. Good vaginal hygiene means:

• Avoiding harsh fragrant products directly on the genital area (detergent, lotions, body wash)
• Avoid using douches
• Drinking lots of water
• Wearing breathable clothing to avoid excess moisture

If you are not finding relief from vaginal infection symptoms within 72 hours of completing any prescribed treatments, contact your OBGYN provider and let them know so you can be re-tested. There may be on ongoing infection or a new infection.

If the symptoms go away and then return within a few weeks, call a provider if those symptoms return.

“Symptoms alone aren't always a good source of knowing whether you have an infection,” Houghtling said. “Getting tested is going to be the most helpful way to provide you with the best and safest care.”