Screening for Vaginitis

WHY this test is done

A vaginitis screen is performed if someone has an unusual discharge, vulvar irritation, vaginal odor, or vaginal bleeding that may be from a vaginal infection.

WHAT you should do to prepare

Do not douche, use any vaginal medications, or have intercourse prior to this test.

WHAT to expect during the procedure

A swab will be used to collect discharge from the vagina. This is usually done using a speculum, but on occasion may be collected by inserting a q-tip in the vagina without using a speculum.

RESULTS

We will have results within 24 hours. If you require medication we will call a prescription in to your pharmacy if you have given us a pharmacy number.

Ninety percent of vaginal infections are due to yeast, bacteria vaginosis, or trichomonas. The vaginal swab (also called a DNA probe) was used to test for the presence of each of those infections. Vaginitis DNA probes do not test for HIV, Syphilis, Chlamydia, herpes, or other sexually transmitted infections. If you are concerned you might have other infections, please discuss it with your doctor.

The following is a brief description of the most common types of vaginitis. Don't hesitate to let us know if you have questions. An excellent source for additional information is The V Book, by Elizabeth Stewart, M.D.

• Yeast (Candida)
  Yeast infections account for 1/3 of cases of vaginitis and are almost always caused by a fungus known as Candida Albicans. Vulvar itching is the most common symptom, but many women also complain of a thick white cottage cheese discharge, pain with urination, soreness, irritation, or painful intercourse. It is not unusual for the vulva to be extremely red and irritated. While often associated with antibiotic use, most yeast infections are not related to antibiotics.
  • Treatment of Yeast Infections
    Both oral and vaginal medications can be used to treat yeast infections.
    
    Vaginal creams or suppositories have few side effects and are considered to be the first treatment for vaginal yeast infections. Many over the counter preparations are available such as Monistat and Femstat. Some medications are prescription only and have a wider range of efficacy.
    
    Fluconazole (diflucan) is a single oral pill which has almost the same success rate as most vaginal preparations but some women experience headaches, rashes, or gastrointestinal upset.
• Bacterial Vaginosis
  Bacterial vaginosis is the most common cause of vaginitis in women of childbearing age and is a result of an imbalance of vaginal bacteria. Multiple (or new) sexual partners, douching, cigarette smoking, use of an intrauterine contraceptive device or vibrators can increase the risk of acquiring bacterial vaginosis. Although sexual activity is a risk factor for the infection, bacterial vaginosis can occur in women who have never had vaginal intercourse and who do not have any of the above risk factors.
  
  Symptoms usually include a watery grayish vaginal discharge that has an unpleasant fishy odor. The odor is often stronger after intercourse or menstruation.
  • Treatment of Bacterial Vaginosis
    Treating bacterial Vaginosis is often frustrating due to a high recurrence rate. 30% of women get a recurrence within 3 months. Metronidazole or clindamycin administered either orally or intravaginally results in a high rate of cure. Oral medication is more convenient but has more side effects than vaginal treatments. Oral metronidazole has a higher cure rate than clindamycin, but has more side effects. In addition, taking metronidazole requires avoiding alcohol. Many women who take metronidazole experience a metallic taste in their mouth and nausea.
    
    Topical vaginal therapy with two percent clindamycin cream (5 g once daily for seven days) is less effective than the metronidazole regimens, but is an option for women who don’t tolerate Metronidazole or feel that they will not be able to avoid alcohol during treatment. Clindesse, a recently released, single dose clindamycin vaginal cream has cure rates similar to the 7-day creams.
• Trichomonas
  Trichomonas is the third most common cause of vaginitis. Unlike bacterial vaginosis and yeast, trichomonas is virtually always sexually transmitted. While many women have no symptoms, 70 % of women have a malodorous, thin discharge along with burning, itching, urinary frequency and discomfort during intercourse. The vulva and vagina are often red. The discharge, when present, generally has a greenish-yellow tint.
  • Treatment of Trichomonas
    Metronidazole (Flagyl) is the most common treatment for trichomonas. Oral therapy is recommended over vaginal therapy since pills also treat other tissues such as the urethra and periurethral glands, which serve as sources for recurrence. All sexual partners should be treated; there is no need for the male partner to be checked prior to treatment. Sexual intercourse should not be resumed until both partners are treated.

FAQ

What does it mean if my DNA probe is negative, but I still have a discharge?
Normal vaginal discharge can increase, have a slight odor, or be irritating due to ovulation, birth control pills or hormonal changes. If your discharge persists and appears to be abnormal, other problems should be checked for. Keep in mind that non-infectious irritants such as douching, creams, perfumes, latex condoms or spermicide may be responsible for symptoms and should be avoided. Acigel might be recommended to reduce inflammation. Rephresh (available over the counter) is another helpful product that helps reduce odor by restoring normal pH balance.