​Vaginal Infection: Ask the Doctor

Candida is one of the most common types of vaginal infection, affecting at least 75 per cent of women at least once. All women have some fungus in the vagina, but a change in the environment in the vagina can lead to an overgrowth and, subsequently, candida infection. This type of infection causes a cottage cheeselike discharge and itching. Occasionally, the vulva can also become red and infected.

Another common infection is bacterial vaginosis. As with candida, the cause is not known, but it is probably due to an imbalance in the “good” and “harmful” bacteria in the vagina. The discharge has a fishy smell, especially after sex.

Trichomonas is a parasite that is sexually transmitted and can cause vaginal discharge, itching, burning, redness or soreness in the genital area. Some women experience discomfort when urinating. The discharge has an unusual smell and can be clear, white, yellowish or greenish. Sometimes, these infections have no symptoms.

Physiological changes during pregnancy or ovulation can cause some vaginal infection, but these typically do not cause much irritation.

Infection is most common among women in the sexually reproductive age group, while trichomonas tends to affect older women.

Candida infections are more common in pregnant women (because of a change in the hormonal environment during pregnancy), women who are on a longterm course of antibiotics (which alter the balance of vaginal flora) and those who have diabetes and are on long-term corticosteroids (which depress immunity).

Bacterial vaginosis is more common in women who have a new sex partner, multiple sex partners or an intrauterine contraceptive device inserted, and those who douche. Trichomonas occurs only in women who have sex.

To make a clear diagnosis, a swab is taken from the vagina and the fluid examined under a microscope for hyphae (in cases of candida infection), clue cells (in cases of bacterial vaginosis) and trichomonas. There are other more sensitive laboratory tests, such as VP3, that can aid diagnosis.

The role of sexual activity is not clear in candida and bacterial vaginosis infections, but trichomonas is a sexually transmitted infection.

Generally no, but it can be transmitted to a sex partner in the case of trichomonas. If you are pregnant and have bacterial vaginosis and/or trichomonas, you are more likely to have a premature birth and an underweight baby. You are also more susceptible to other sexually transmitted diseases – like HIV, chlamydia, gonorrhoea and herpes simplex – if you have these two infections.

Ref: T12