Am seated in the consultation room of a certain community health facility that I volunteer regularly. A young lady gets in looking timid and doleful. I try my level best to smile at her but she opt to maintain the status quo. It’s obvious that there is something that is seriously bothering her. Finally she agrees to share with me her concerns after spending close to ten minutes creating rapport with her. She narrates to me how she has been experiencing vaginal discharge and continuous itchy pubic irritation for the last two days. She is convinced that she has an STI. However what puzzles her is the fact that she is not sexually active. She explicitly reveals to me that she is a virgin. I go ahead and request her to allow me to examine her and am glad she agrees.

I note the semiliquid discharge which is white in color and although I cannot see the spores with my bear eyes, I can tell from experience and her medical history that she is suffering from vaginal candidiasis. Although it can be transmitted through sexual intercourse, it is not regarded as an STI.There are so many other factors that can contribute to this curable condition.

Vaginal candidiasis is a fungal infection that is caused by various strains of candida, candida albican being the major cause of most candidiasis cases. Candida is found in the vagina and coexists with other vaginal bacteria (lactobacilli) also known as the good bacteria without causing any symptoms. Disease process takes place when this equilibrium is destabilized. Any agent that kills the good bacteria gives candida an opportunity to multiply and that is how candidiasis occurs.

I reassure her that she does not have an STI. I further inquire from her if she has been on antibiotic therapy recently because it may contribute in killing of lactobacilli (good bacteria) enabling candida albican to thrive. Oral contraceptive can also favour the growth of Candida. Certain clinical conditions such as Diabetes and Human Immunodeficiency Virus (HIV) tend to aggravate this condition. Pregnancy may also lead to recurrent vaginal candidiasis.

Well according to her she has not been on any medication. I probe further to find out if she douches i.e. washing the inner cavity of the vagina with water and soap. My clinical diagnosis is further reaffirmed when she tells me that she does it regularly with deodorants. Many women tend to douche without knowing the potential dangers of this practice. Apart from causing vaginal candidiasis, research shows that it can predispose one to cervical cancer, vaginitis and inflammation of the uterine wall (endometriosis). This topic will be discussed in details at a later post.

I advise her to stop douching immediately to prevent altering the ecosystem of the vagina. Vaginal antifungal pessaries are prescribed for three days. I instruct her to come back for a review after five days to check the progress.

Antifungals are very effective in treating this condition and they can be given either orally, as a cream or pessarries.

It’s very important to seek medical advice whenever you notice any form of abnormal vaginal discharge which sometimes is foul smelling for early diagnosis and treatment.

PREVENTIVE MEASURES

  • Don’t douche.
  • Don’t wear tight pants.
  • Don’t wear nylon pants. Cotton pants are the best.
  • Don’t wear wet pants.
  • Don’t use pads with deodorants. Vagina will always have odour and it’s rare for the third party to smell it unless your hygiene is wanting and there is another underlying condition.

Author: Eliud Kigotho. KRN, HTC Counsellor.

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