What is vulvovaginitis and how do I identify it?

Vulvovaginitis is an inflammation or infection of the vulva and the vagina. It is extremely common and affects women of all ages and most women refer to this as "thrush". thrush is an yeast infection caused by Candida albicans.Vulvovaginitis, on the other hand, is a condition caused by various bacteria, viruses, parasites, poor personal hygeine or humid climates. Less commonly vulvovagninitis is an allergic reaction to the chemicals found in soaps, bubble baths and perfumes which causes inflammation of the area. There are instances were the low oestrogen states that occur in menopause lead to vaginal drying and thinning of mucous membranes which cause burning, discomfort and itching that is not caused by infection.

Vulvovaginitis generally occurs when there is a disruption in the vaginal pH. If the environment becomes too acidic it favours the Candida and it tends to overgrow, thus creating symptoms of an infection, and if it becomes too alkaline it favours bacterial overgrowth, resulting in a bacterial infection.

The normal pH of vaginal secretions is 4.0-4.5. The pH is maintained by healthy, naturally occuring lactobacilli (the good bacteria), which produce hydrogen peroxide whch maintains the pH.  Vaginal pH may change with age, phases of menstrual cycle, sexual activity, pregnancy, contraception, presence of foreign bodies, abnormal  carbohydrate metabolism, and use of perfumed hygienic products or antibiotics.  Any of these triggers can disturb the pH and lead to either a bacterial or yeast related infection.

CHILDREN AND PRETEENS

• When young girls get vulval irritations it is generally as a result of diets high in sugar.  In these young girls, the vaginal environment has not yet established its own antimicrobial acid environment, which only occurs in the teen years.  Hence it is easy for these little girls to get vaginal itching and "thrush" symptoms.
• Acidic urine and allergies can also result in inflammation of the vulva and surrounding perinieal area (the space between the vagina and the anus).
• Children playing outside and sitting on freshly cut or wet grass can develop vaginal irritation, and this may be mistaken for an infection.
• Vaginal infections can easily occur from front to back wiping after a bowel movment.  Girls should wipe from front to back to reduce the risk of introducing infections.
• Femiliner is ideal for children as it is a non-invasive way of providing a protective barrier, as well as providing soothing relief from irritations in the perineum area.
• If there is vaginal itching that presents mostly at night, we must suspect a pinworm infection.  Please see your Doctor to establish this.
• Itching, soreness, bleeding,and a  foul-smelling discharge that contains blood may suggest a vaginal foreign body.  Take your daughter to her Doctor to be checked if you suspect that she may have pushed something up.

TEENAGERS

• The normal vaginal lining thickensand grows under the influence of estrogen which rises sharply in the first half of a normal menstrual cycle.  This protects women against infection. A normal vaginal discharge may begin as part of puberty which presents as 3-4 ml of white or transparent and odourless fluid.
• The discharge is noticeable at mid menstrual cycle around the time of ovulation and the voulme can be increased if the girl is on a contraceptive pill.
• The hormonal changes create corresponding changes in the vaginal environment which can predispose young woman to yeast infections. This effectively means the pH levels change and that the internal environment favours the pathogenic (disease causing) phase of the natually ocurring candida or bacteria (called commensals).  This results in an infection and produces symptoms of discharge, pain, inflammation, and irritation.
• Sexual activity can also create risk of infections, as well as STI's. Education to avoid STI’s should be paramount.  In the case of Candida, the male sexual partner can cause re-infection if the vaginal environment is altered, as he is not symptomatic and therefore unknowingly passes the infection along.
• Femiliner provides the ideal solution to Vulvovaginal discomfort resulting from hormonal changes and acidic imbalances within the vagina,  by creating the perfectlty balanced environment in which all the "good" commensals (candida and bacteria)  thrive. Creating a healthy environment restricts the opportunities for potential infections to arise.

ADULTS

• Bacterial vaginosis (BV) is the most important cause of vulvovaginitis. This may be a result of overgrowth of commensal (naturally ocurring) bacteria, or from the introduction of foreign bacteria like Gardnerella vaginalis, and other anaerobic bacteria through sexual intercourse. A change most commonly ocurrs  when there is disruption in the growth of the acid maintaining Lactobacillus (good, natually occuring bacteria), which causes a rise in the pH. This alkalinic pH causes an overgrowth of the anaerobic bacteria and G vaginalis. The role of G VAGINALIS IN BV IS NOT FULLY UNDERSTOOD as it can be recovered from a vaginal swab in 30-50% of asymptomatic women, so it seems factors other than the presence of certain bacteria contribute to the symptoms of BV.  Femiliner is infused with silver ions on specically therapeutic herbs that not only control the bacterial growth, but balance the pH, so that harmony exists between the commensals organisms.
• Candidal vulvovaginitis or candidiasis, ocurrs less commonly than bacterial vaginosis, yet most women consider vaginitis to be a Candida infection. The candida discharge is thick and white, more like cottage cheese than the creamy, yellow, smelly discharge of BV. The problem with misdiagnosis is that many women may use anti-fungal treatments or alkaline douches because they think they have a candida infection, which aggravates the bacterial infection because it creates and alkaline environment, which the bacteria love!  A commone problem with recurrent candidal infections is that many treatments that provide symptom relief are not used long enough to eradicate the recurrence of Candida. The candida fungus goes into a spore (like a seed with a hard protective covering) when a cream or tablet is used to erradicate it, and it will stay like this for up to 21 days.  The recurrent infection when the candida spores hatch, which happens as soon as the cream or tablet used to treat it is no longer being applied.  It is of paramount importance that any thrush treatment be used continuously for the full 21-day life cycle of the spore phase of the  Candida, to prevent reinfection when the spores hatch. If the vaginal environment remains unfavourable for the overgrowth of yeast when the spores hatch, the candida population size will settle down into the normal balance with the commensal bacteria.  This can only occur when the pH is back to 4.0 - 4.5. Femiliner is infused with silver ions on specically therapeutic herbs that not only control the candida growth, but balance the pH, so that harmony exists between the commensals organisms.
• Trichomonis vaginalis affects many women and is considered a sexually transmitted disease. The pain experienced with T Vaginalis are often mistaken for menstrual or endometriosis pain. There is a discharge which is white, frothy or bubbly. The danger of T Vaginalis infections is that it can cause scarring of the fallopian tube which is a major cause of infertilty.  Interestingly we note that 30-40% of men presenting with urethritis contract it through sexual contact with women infected with T Vaginalis.

POST MENOPAUSAL WOMEN

• Due to the drop in oestrogen and progesterone levels during menopause, many women experience thinning of the vaginal wall, a decrease in secretion of lubricating and moisturising fluids which leads to vaginal drying. These changes lead to abrasivef inflammation and irritation of the internal vaginal surfaces.  So when we see vaginitis in postmenopausal women , the cause is far more hormonally than infection driven.

SURVEY FINDINGS

• We recently ran a  survey here in South Africa and we found an alarming figure of 34% of women reported suffering with vulvovaginitis or thrush at least once a month. the survey revealed that most of these women have learned to "live with" their symptoms, and do not find they get consistent relief from any one particular form of treatment.  So the stark reality is that these women live with regular to permanent vaginal symptoms that make them self concious, impact their sex life, afffect their libido in addition to the constant pain and discomfort.
• Femiliner provides the convenience and ease of use like nothing that has been available before.  It has been designed not only to control both bacterial and candida infections, but also to maintain the healthy enviroment that prevents re-occurrance.  It is wonderfully convenient and women can now use Femiliner as part of their regular female hygiene regime. Simply wearing a panty liner to maintains female health. Say "Bye - bye"  to constant, regular pain, discomfort and nasty discharge.

COMMON CAUSES

• Antibiotics are a common cause of yeast infections, because they eradicate most bacteria including the naturally occuring bacteria, and this allows the  yeast to overgrow because the antibiotics have erradicated any controlling opposition from the bacteria.
• Diets high in wheat, sugar and alcohol intake can predispose women to infections because they increase the vaginal acidity.
• Diabetes mellitus is commonly associated with recurrent thrush conditions due to the sugar imbalances.
• A weak immune system allows overgrowth of commensals and leads to recurrent infection.
• Sexual activity may aggravate an existing mild infection to the point where it becomes symptomatic.  A male sexual partner can be a silent carrier of the candida spores, or bacteria, and may reintroduce the infective agent during sexual intercourse.  This will re-ignite the infection. Because most men are asymptomatic they are unaware that theye habour of high levels of a particular microorganism, and unwittingly cause a re-introduction during sexual activity with their partner.

SYMPTOMS

• Abnormal amounts of vaginal discharge
• Discharge that tanges from a slightly watery, white discharge to a thick, white, chunky discharge (like cottage cheese) to a yellow discharge with an unpleasant odour
• Painful intercourse and/pain after intercourse or exageration of symptoms after intercourse
• Painful urination
• Redness and swelling of the vulva
• Vaginal and labial itching, burning

HOW TO DIFFERENTIATE BETWEEN WHICH INFECTION YOU COULD POTENTIALLY HAVE

• The amount discharge is usually moderate to profuse.
• It is thin, creamy-yellow or off-white and sticky vaginal. It is thick and viscous and sticks to the vaginal wall and might not be as noticable as that of a candida infection.  It may only be more noticeable after intercourse because the movement will dislodge it from the walls and bring it down.
• The discharge has a foul, slightly fishy-smell  that is more noticeable after unprotected intercourse.
• Itching and inflammation of the labia are less common in bacterial vaginosis than Candida infection, but it presents with burning after intercourse.

• May be asymptomatic or may produce a profuse, frothy, white discharge.
• When it is symptomatic, redness of the vulva and vaginal area occurs that is worse than in bacterial vaginosis.  Sufferers may complain of an itch, but it is less severe than Candida infection.
• An alkaline environment is suggestive of bacterial vaginosis or T Vaginalis (pH 5-6)

• Is characterised by intense itching which may be temporarily relieved by bathing.
• A thick, odourless, white, cottage cheese like discharge occurs which may also burn. This creates a desire the clean the area regularly as the discharge is very irritating to the skin.
• Redness and swelling of the labia and the labial folds which can become split and cracked.
• The inner part of the labia minora takes on a cobblestoned appearance.
• Painful urination and urinary frequency are occasionally present.
• Candida occurs in women of all ages and does not have to be associated with sexual activity.
• Acidic states are more indicative of candidal vulvovaginitis.

PREVENTATIVE TIPS THAT ENHANCE THE LONG-TERM BENEFITS OF FEMILINER

• Keep your genital area clean and dry. Avoid harsh, heavily fragranced soap and rinse with water only. Sitting in a warm bath that is not too hot may offer some relief.
• Avoid douching. This may remove your healthy bacteria and lead to or aggravate existing candidiasis. Alkaline douches have the ability to aggravate bacterial infections.
• Take a good probiotic during and after any antibiotic course, yoghurt does not contain enough good becteria to be a complete probiotic. Make sure you take a "live" bacterial culture probiotic to replace bacteria erradicated by the antibiotics.
• Use condoms to avoid catching or spreading sexually transmitted diseases. If burning symptoms occur or are aggravated after using condoms, then investigate the potential of a latex allergy, or it may even indicative awakening of a dormant vaginitis.
• Wear cotton underwear only as non-cotton underwear increases sweating but restricts airflow which predisposes women to vulvovaginitis.
• Avoid foods high in wheat, sugar and alcohol while you have an active infection, as it is well known that they aggravate the occurrence of thrush by interfering with the vaginal pH.
• With the health promoting benefits of Femiliner, the use of female hygeine sprays or creams is longer be necessary.  Regular use of Femiliner throughout the 21 day period after symptoms abate if treating a candida infection, will normalise the vaginal envrionment and prevent recurrance, and regular use of Femiliner until symptoms of a bacterial infection are clear will do the same.  If you are prone to this kind of infection, keep one or two discreetly in your handbag and use at the slightest hint of symptoms.  That way you will stay healthy longer.  Always having a Femiliner panty liner handy means that not only are you ready for anything, but you are ready to save a girlfriend who might be with you from agony and distress if she complains and you are ready for the rescue.

Order online directly from us, or check your nearest Dischem, Pharmacy or Health Shop.  Certain practitioners are also stocking Femiliner, so ask your local doc to stock it for you.