Counseling Sheet

Agatha M. Thrash, M.D.

Preventive Medicine

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Vaginitis is the cause of itching, burning, and vaginal discharge. It is a common problem among women, becoming more and more common with the use of panty hose and synthetic pants and panties and with the greater sexual activity of women. Mechanical irritation, such as that from wearing tampons, can cause vaginitis. The use of birth control pills and many other drugs are common offenders. The ovarian hormones cause a hardening of the lined surfaces of the vagina, allowing it to perform its function better during the childbearing years. Because of the thinner vaginal lining of young girls and post-menopausal women and the greater proneness of diabetics to get infection, there is a greater likelihood of irritation and infection. In the past, young girls, diabetics, and post-menopausal women were those principally suffering from vaginitis. Recently, there has been an increase in vaginitis in healthy menstruating women.

Vaginitis should be treated vigorously as it can become chronic and more difficult to eradicate.

Three kinds of microorganisms can cause vaginitis:

• Ordinary bacteria or the special bacteria of venereal diseases
• A yeast-like organism called monilia
• A protozoan called trichomonas

Since the treatment of the three types is slightly different, it is desirable but not essential to know the kind of organism causing the vaginitis. In the absence of that information, a treatment routine can be tried against one type and then changed, if the treatment is not at once effective.

When vaginitis occurs, a woman should treat it by proper diet, proper dress, and various simple remedies using water.

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Diet

The diet should not contain free fats or free sugars for one month. That means no margarine, mayonnaise, fried food, cooking fats, honey, sugar, molasses, and similar foods. All of these foods tend to inhibit the activity of white blood cells and to make the body less able to defend itself against the spread of vaginitis.

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Clothing

Chilled extremities, especially feet, cause a reduction in blood flow to the vagina and other pelvic organs. The feet and hands should always be kept warm by proper clothing, such as the use of pants, long johns, and protective stockings as needed. Nylon underpanties, panty hose, or synthetic pants should not be worn. Only cotton panties should be worn—those entirely of cotton, not just cotton crotch. Panty hose and pants are less objectionable, if they are opened in the seams about 6 to 10 inches so that air can circulate. Synthetic fabrics promote the build-up of moisture and heat, making ideal conditions for the growth of microorganisms.

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Water Treatments

• Hot Foot Bath

Since chilled feet cause vaginitis to be worse, especially in young girls and in postmenopausal women who have reduced circulation to the lower extremities, a hot foot bath is recommended. In diabetics the hot foot bath should not exceed about 102 degrees, if there is a suspected hardening of the arteries to the lower extremities. Showers are preferred over tub baths as the bath water containing impurities and soap can enter the vagina and cause an increase in the problem.

• Hot Soda Water Douche

The water treatments should begin with a hot soda water douche (1-3 teaspoons of soda per quart of water) taken twice daily for 7 days, and once daily for 30 additional days. If there is not prompt relief with the soda water douche, switch to hot vinegar water (1-4 tablespoons per quart) taken twice daily for 7 days and once daily for 30 additional days. Any kind of vinegar is satisfactory. The soda water douche is better for monilia and the vinegar water is better for trichomonas.

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Distinguishing Monilia Vaginitis vs Trichomonas Vaginitis

Monilia vaginitis can be distinguished from trichomonas vaginitis by the cottage cheese appearing exudate seen in the vagina in monilia as compared to a foamy exudate seen with trichomonas. To see the exudate you will need a hand mirror, a kitchen spoon and a flashlight. Insert the spoon into the vagina and press down gently to open the vagina. Use the mirror and flashlight to see the interior of the vagina. An assistant is very helpful.

• Hot Vinegar Water or Hot Garlic Douche

If a vaginal infection with an ordinary bacterium is suspected, the hot vinegar water may be effective, or a hot garlic douche may be just the thing. The garlic water is made by boiling a quart of water and blending part of it with a single clove of garlic, until the garlic is entirely smooth. Add the rest of the hot water and allow to stand for one minute to denature the enzyme of the garlic. Pour sufficient cold water with the garlic water to make the resultant temperature reduced to about 110 degrees or about as hot as can be tolerated for a douche. Use the garlic douche on the same schedule as the soda or vinegar water.

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Avoid Sex

Sexual relations should be avoided during the treatment period, since germs can be transferred between husband and wife.

• Hot Sitz Bath

The marriage partner should take a hot sitz bath at 110 degrees for 20 minutes, cleansing the genitals well with ordinary soap during the bath. Follow the bath with a brief rinse off with cold water and a dry rub down. Continue the sitz bath twice daily for 3 days and once daily for 7 days. This treatment can be very beneficial in eradicating such microorganisms as trichomonas and ordinary bacteria from the marriage partner.

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Baking Soda Dusting

A fine dusting of baking soda left on the skin of the genital area helps with monilia.

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Avoid Long-Term Douching

Once the vaginitis is well, douching should be discontinued, as there is an apparent relationship between long-term douching over a number of years and the development of cancer of the cervix.

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Postmenopausal Women and Vaginitis

Postmenopausal women who have vaginitis should also follow a special routine for menopausal symptoms given in a separate article.

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Avoid Scratching and Chemicals

Whatever the type of vaginitis, carefully avoid scratching and bear in mind that the use of any of several chemicals can make vaginitis worse: contraceptives, deodorants, soaps, and even dusting powder.