Vaginal Infections: Symptoms, Treatments, and Concerns

Vaginitis and issues related to the perineum and contraceptive pills?

Hello Doctor: For the past couple of months, I have been experiencing recurrent vaginal infections.
During the first and second visits, the doctor diagnosed it as a mild infection but did not specify the type of infection.
I was given a three-day course of suppositories and ointment.
My symptoms include: unbearable itching, no unusual odor, and no abnormal discharge.
The infections occurred approximately one month apart, and I had sexual intercourse before seeing the doctor each time.
After intercourse, I experience severe pain in the perineal area (just below the vaginal opening).
During the internal examination, the doctor said there was no significant issue and no wounds, but mentioned it could be related to insufficient moisture.
However, we did not have any issues with lubrication during intercourse.
I have searched extensively online but still cannot find relevant answers.
During the third visit, the doctor diagnosed vaginal inflammation, but the symptoms were generally the same, with one difference: during intercourse, I felt a sharp pain upon insertion, and my boyfriend had white flakes on his genitalia.
I am also taking the oral contraceptive pill (Alesse).
The first and second visits were with the same doctor, while the third visit was with a different doctor.
After researching a lot of information online and reading many questions from others on this site, I would like to confirm the following questions.
Thank you for your assistance.
1.
What are the specific differences in symptoms between a vaginal infection and vaginal inflammation?
2.
I found information online stating that irregular lifestyle and decreased immunity can lead to infections, but does long-term use of contraceptive pills also increase the risk of infection?
3.
During the third visit, I asked the doctor about the pain in the perineal area, and the doctor responded that it might be due to secretions irritating the outside, which could cause pain.
The pain is so severe that even urinating or slight contact causes extreme discomfort, yet both doctors said there was no significant issue?
4.
Besides insufficient lubrication, what other factors could cause dyspareunia in the perineal area? What should I pay special attention to?
5.
How can I confirm that this treatment has been effective? Should I follow up if I no longer feel pain after finishing the medication?
6.
If I encounter my menstrual period during the treatment, should I continue using the suppositories, or should I wait until after my period to resume?
Thank you, Doctor, for taking the time to answer these questions.
I appreciate your help.

Niming, 20~29 year old female. Ask Date: 2018/04/27

Dr. Cai Yonglong reply Obstetrics and Gynecology

1.
Vaginal infections or severe vaginitis can cause pain and itching, and a visit to a gynecologist is necessary.
2.
Suppositories should not be used during menstruation; they should be used after the period ends.

Reply Date: 2018/04/27

More Info

Understanding vaginal infections and their symptoms, treatments, and concerns is crucial for maintaining reproductive health. Based on your detailed description, it seems you are experiencing recurrent vaginal infections, which can be frustrating and concerning. Let’s address your questions systematically.

1. Differences Between Vaginal Infection and Vaginal Inflammation: Vaginal infections typically present with specific symptoms such as abnormal discharge, odor, itching, and irritation. Common types include yeast infections (often characterized by thick, white discharge and intense itching) and bacterial vaginosis (which may produce a fishy odor). Vaginal inflammation, on the other hand, may occur without an infection and can be due to irritants, hormonal changes, or insufficient lubrication during intercourse. Symptoms may overlap, but inflammation may not always involve an infectious agent.

2. Impact of Birth Control Pills on Infection Rates: Long-term use of hormonal contraceptives, such as birth control pills, can affect the vaginal flora and pH balance. While they are generally safe, some studies suggest that hormonal changes can lead to an increased risk of yeast infections or bacterial vaginosis. This is due to alterations in the natural balance of bacteria and yeast in the vagina. However, the relationship is complex and varies among individuals.

3. Pain in the Perineal Area: The pain you are experiencing during intercourse could be attributed to several factors, including insufficient lubrication, which can lead to friction and irritation. Additionally, if there is an underlying infection or inflammation, this could exacerbate discomfort. The presence of white flakes on your partner's genitalia may indicate a fungal infection, which could also contribute to your symptoms. It’s essential to ensure both partners are treated if an infection is suspected.

4. Causes of Dyspareunia (Painful Intercourse): Besides insufficient lubrication, other factors can contribute to dyspareunia, including hormonal imbalances, infections, allergies to products (such as soaps or lubricants), and psychological factors such as anxiety or stress. It’s important to communicate openly with your partner and consider using water-based lubricants to alleviate discomfort during intercourse.

5. Confirming Treatment Efficacy: To determine if the treatment has been effective, monitor your symptoms closely. If the pain subsides and you no longer experience discomfort during urination or intercourse, it may indicate that the treatment is working. However, if symptoms persist or worsen, a follow-up appointment is advisable. Regular check-ups can help ensure that any underlying issues are addressed promptly.

6. Managing Treatment During Menstruation: If you are in the middle of a treatment regimen and your period begins, it is generally advisable to continue with the treatment unless otherwise directed by your healthcare provider. However, some medications may be less effective during menstruation, so it’s best to consult your doctor for personalized advice.

In conclusion, recurrent vaginal infections can be a sign of underlying issues that may require further investigation. It’s essential to maintain open communication with your healthcare provider and seek a thorough evaluation if symptoms persist. Lifestyle factors, such as stress management, proper hygiene, and safe sexual practices, can also play a significant role in preventing future infections. If you have any further questions or concerns, don’t hesitate to reach out to your healthcare provider for guidance tailored to your specific situation.

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