Cutaneous Manifestations of HIV: Overview, Manifestations by HIV Disease Stage, Manifestations in HIV-Infected ...

Bacterial Vaginosis

Bacterial vaginosis is the most common cause of abnormal vaginal discharge, affecting 23%–30% of reproductive-aged people

Bacterial vaginosis is caused by a disrupted vaginal microbiome balance. Symptoms include itch, dysuria, and a thin, grey discharge with a "fishy" odour, particularly after coitus. Risk factors include smoking and unprotected intercourse, including oral sex.1,2

Bacterial vaginosis is associated with other medical risks

It increases susceptibility to sexually transmitted infections such as HIV, Chlamydia trachomatis, Neisseria gonorrhoeae, Trichomonas vaginalis, human papillomavirus, and herpes simplex virus.1 Bacterial vaginosis in pregnancy increases risks of miscarriage, preterm premature rupture of membranes, preterm labour and delivery, chorioamnionitis, and postpartum infections.3 Screening for and treatment of bacterial vaginosis is recommended in pregnant people at increased risk of preterm birth between 12 and 16 weeks, even if asymptomatic.3 Routine screening in asymptomatic females, pregnant or not, is unnecessary.1,2

Diagnosis is usually made after a culture of vaginal discharge

Vaginosis is presumed with 3 of the following criteria: thin homogeneous discharge; vaginal pH higher than 4.5; positive "whiff test" (a "fishy" odour after application of 10% potassium hydroxide solution to the discharge); and vaginal discharge microscopy showing clue cells (vaginal epithelial cells covered in gram-negative bacteria).3

First-line treatment regimens have comparable cure rates of 70%–80%

Topical treatment options include metronidazole gel 0.75% (5 g/applicator) once per day for 5 days, or clindamycin cream 2% (5 g/applicator) at bedtime for 7 days. Another treatment option is oral metronidazole 500 mg twice daily for 7 days. Avoiding alcohol consumption during treatment is no longer recommended.1,4

Recurrence rates at 6 months after treatment are higher than 50%

Partner treatments have not proven to be preventive. Recommendations for prevention of recurrence based on expert opinion (low level of evidence) include a trial of alternating vaginal and oral treatments; boric acid (contraindicated in pregnancy) 600 mg vaginal capsules nightly for 21 days after antibiotics; vaginal metronidazole gel twice weekly; or intrauterine device removal.1,4,5

Footnotes

Competing interests: Amanda Selk is the past president of the Society of Canadian Colposcopists, past president of the North American branch of the International Society for the Study of Vulvovaginal Disease, and a board member of the International Federation of Cervical Colposcopy and Pathology (all positions unpaid and outside the submitted work). No other competing interests were declared.

This article has been peer reviewed.

This is an Open Access article distributed in accordance with the terms of the Creative Commons Attribution (CC BY-NC-ND 4.0) licence, which permits use, distribution and reproduction in any medium, provided that the original publication is properly cited, the use is noncommercial (i.E., research or educational use), and no modifications or adaptations are made. See: https://creativecommons.Org/licenses/by-nc-nd/4.0/

Vaginal Discharge You Should Have Checked Out Immediately

Remember, early detection and treatment are key to preventing more serious health issues down the line

Vaginal discharge is a normal and healthy part of a woman's reproductive system. It helps to clean and lubricate the vagina and plays a critical role in protecting against infections. However, not all discharges are the same; some can indicate an underlying health issue that needs immediate medical attention. Understanding the types of vaginal discharge you should have checked out immediately is crucial for maintaining your reproductive health and overall well-being.

Types of vaginal discharge Normal vaginal discharge

Before diving into the concerning types of discharge, it's important to understand what normal vaginal discharge looks like. Typically, normal discharge is clear or milky and may have a mild odor. It varies throughout the menstrual cycle, often becoming thicker and more noticeable during ovulation. This type of discharge is a sign that your vagina is functioning correctly and maintaining a healthy environment.

Abnormal vaginal discharge

Abnormal vaginal discharge can be a sign of various health issues, ranging from infections to more serious conditions. The following are types of vaginal discharge that you should have checked out immediately:

Thick, white discharge with itching: This type of discharge often resembles cottage cheese and is accompanied by intense itching and irritation. It is typically a sign of a yeast infection, also known as candidiasis. Yeast infections are common and can be treated with antifungal medications, but it's important to see a doctor to confirm the diagnosis and receive appropriate treatment.

Yellow or green discharge: Yellow or green discharge — especially if it's thick or clumpy — can indicate a bacterial infection or sexually transmitted infection (STI), such as trichomoniasis. This type of discharge is usually accompanied by a foul odor and other symptoms like itching or burning. Prompt medical attention is necessary to diagnose and treat the infection properly.

Gray discharge with a fishy odor: A grayish discharge with a strong fishy odor is often a sign of bacterial vaginosis (BV). BV is an imbalance in the normal bacteria found in the vagina and can cause discomfort, itching and a burning sensation during urination. Left untreated, BV can lead to more serious health issues, so it is important to seek medical advice immediately.

Pink or brown discharge: Pink or brown discharge can be alarming as it often indicates the presence of blood. While this type of discharge can be normal after menstruation, it can also be a sign of more serious conditions such as cervical or uterine cancer, especially if it occurs outside of your regular menstrual cycle. If you experience unexplained pink or brown discharge, it is crucial to consult with a health care provider as soon as possible.

Frothy, yellow-green discharge: Frothy, yellow-green discharge is another symptom of trichomoniasis, an STI caused by a parasite. This discharge is often accompanied by a foul odor, itching and irritation. Trichomoniasis requires medical treatment with antibiotics, so seeking prompt care is essential.

Causes of abnormal vaginal discharge Infections

The most common cause of abnormal vaginal discharge is an infection. These can include:

Bacterial vaginosis (BV): An overgrowth of certain bacteria in the vagina.

Yeast infections: Caused by an overgrowth of Candida fungi.

Sexually transmitted infections (STIs): Including trichomoniasis, gonorrhea and chlamydia.

Hormonal imbalances

Hormonal changes during pregnancy, menopause or due to contraceptive use can also affect the type and amount of vaginal discharge. It's important to monitor these changes and discuss any concerns with your health care provider.

Other medical conditions

Certain medical conditions, such as cervical or uterine cancer, can also cause abnormal vaginal discharge. Regular gynecological checkups are essential for early detection and treatment of these conditions.

When to see a doctor

It's crucial to be vigilant about any changes in your vaginal discharge and seek medical attention if you notice any of the following symptoms:

Persistent changes in color, consistency or odor: If your discharge changes suddenly and doesn't return to normal within a few days, it's time to see a doctor.

Accompanied by other symptoms: If you experience itching, burning, swelling or pain along with the discharge, it could indicate an infection or other health issue.

Unexplained bleeding: Any unexplained bleeding or pink/brown discharge outside of your menstrual cycle should be evaluated by a healthcare provider.

Taking charge of your reproductive health

Understanding the types of vaginal discharge you should have checked out immediately is an important aspect of maintaining your reproductive health. Regular gynecological checkups and being aware of the signs of abnormal discharge can help you catch potential issues early and receive the necessary treatment. If you notice any concerning changes in your vaginal discharge, don't hesitate to contact your health care provider. Taking proactive steps in managing your health ensures your well-being and peace of mind.

By staying informed and attentive to your body's signals, you can effectively manage your reproductive health and address any concerns promptly. Remember, early detection and treatment are key to preventing more serious health issues down the line.

This story was created using AI technology.

How Long Syphilis Is Contagious After Treatment And How It Spreads

Syphilis may still be contagious for a short time after treatment. People can take precautions to help avoid transmission before and after treatment. This can include avoiding sex for at least 1 week.

Syphilis is a sexually transmitted infection (STI). A person with syphilis may have symptoms that come and go and can take time to develop. People can also have no symptoms despite still having the condition.

Syphilis is generally curable. However, the infection can still spread from one person to another for some time after treatment.

This article discusses how long syphilis remains contagious after treatment, including when a person can have sex again. It also discusses how long treatments last, preventing syphilis, and more.

Syphilis can be contagious for a short time after treatment. A person may need to wait for at least 1 week after they finish treatment before having sex, as it may still be possible for the infection to spread during this time.

A person may need syphilis testing around 6 to 12 weeks after treatment. This is to help ensure that the treatment has been effective.

The Centers for Disease Control and Prevention (CDC) recommends people undergo syphilis testing at least 6 and 12 months after treatment, or more often if necessary, to help detect reinfection.

Doctors will typically recommend that a person does not have sex until at least 1 week after they finish treatment for syphilis. They also need to wait until their symptoms resolve.

The CDC recommends people with syphilis notify their sexual partners. Medical professionals also recommend contacting any sexual partners a person has had in the last 90 days. This is so they can also seek testing and treatment if necessary.

The incubation period of syphilis is around 10 to 90 days. It can take 21 days or longer for a person to experience symptoms.

Initial symptoms of syphilis usually include one or more open sores called chancres. They tend to develop in the genital area or inside the mouth.

As chancres feel painless and firm, people may not notice them. They usually heal within 3 to 6 weeks without treatment. However, people may still then be able to pass syphilis on to others. Their syphilis can also develop further, leading to serious complications.

Even if a person's chancres have gone away, they still need to seek professional medical treatment.

Medical professionals usually recommend the antibiotic medication penicillin to treat syphilis. How long a person's treatment lasts depends on the stage of their syphilis.

Early stages: A person usually requires a single dose of penicillin.

Late stages: Medical professionals usually recommend three shots of penicillin, administering one shot per week for 3 weeks.

Syphilis that affects their nervous system: If syphilis affects the nervous system, a person may require penicillin through an intravenous infusion into the veins. They will usually receive this daily for 10 to 14 days.

If penicillin is unsuitable, a doctor may recommend oral doxycycline or ceftriaxone injection. A person's doctor can provide them with more information about what treatment they recommend.

Learn more about the stages of syphilis.

Treatment may completely cure syphilis. However, this treatment will not cure any damage or complications that syphilis may cause if it progresses to later stages.

People with hearing loss due to syphilis will still have hearing loss after syphilis treatment. If the condition has damaged a person's heart, they may still need heart surgery to repair it.

A person's doctor can advise on any additional treatments they may require for complications of syphilis.

The best way to prevent STIs, including syphilis, is by not having oral, anal, or vaginal sex.

There are steps a person can take to reduce the likelihood of syphilis. These include:

using a condom when they have vaginal or anal sex

covering the penis with a condom or the vagina with a latex or plastic square during oral sex

not sharing sex toys, and washing and covering them with a new condom before use

not sharing needles if injecting drugs

Condoms can help prevent contact with sores. However, chancres may occur in areas that condoms do not cover. If a person has contact with these sores, they can still get syphilis.

The CDC also recommends regular testing if a person is sexually active and:

is a gay or bisexual male

has HIV

is taking preexposure prophylaxis (PrEP), a medication for HIV prevention

has a partner who has tested positive for syphilis

A pregnant person with syphilis can also pass it on to their unborn child. Medical professionals should test all pregnant people for syphilis during their first prenatal visit and sometimes at later stages.

Syphilis may be contagious for at least 1 week after completing treatment. This means that, during this time, it is best for a person to avoid having sex.

A person may need follow-up tests to determine if the treatment has been successful. Their doctor can advise on when they may require the tests.

Although it may not be possible to completely prevent syphilis, a person can take steps to reduce the likelihood of reinfection. These include the use of condoms, not sharing sex toys, and not sharing needles.

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