Feminine hygiene

A HEALTHY VAGINA
The vagina is a tube-like, muscular elastic organ about 10 cm long. It is an internal genital organ that connects the outer genitalia to the uterus. The vagina provides a passageway for sperm, menstrual bleeding and childbirth. The vagina is kept moist by fluids produced by cells and glands inside the vagina.

A healthy vagina

The role of lactobacilli
The vagina is lined with epithelial cells, which store and release glycogen (sugar). Bacteria (also known as lactobacilli) metabolise glycogen to lactic acid, which keeps the vaginal pH below 4.5 (acidic).
This inhibits growth of other bacteria and fungi, and limits the time in which sperm can survive in the vagina. Lactic acid, in combination with other vaginal secretions, makes the vagina a self-cleansing organ.

The role of oestrogen
Oestrogen helps maintain the glycogen-rich epithelial cells. With adequate glycogen, the lactobacilli can produce enough lactic acid to keep the vaginal pH acidic. Oestrogen also ensures adequate blood flow to the vagina, keeps the vagina wall elastic and maintains adequate lubrication of the vagina.

The importance of vaginal pH
The vaginal pH in a healthy female is 3.8 to 4.5. A number of factors can change the vaginal pH, leading to overgrowth of organisms such as bacteria or yeasts inside the vagina. These factors include antibiotics, contraceptives, scented detergents and soaps, sexual intercourse, feminine sprays, low oestrogen levels, poor hygiene and stress.

Vaginal infections

An overgrowth of bacteria or yeasts can result in vaginal infections such as bacterial vaginosis or thrush. Other infections, such as Trichomonas vaginalis, are sexually transmitted.

Vaginal infections are usually associated with some form of discharge, itching and redness, burning pain and odour.

Bacterial vaginosis (BV)

BV occurs when the balance of healthy bacteria in the vagina changes, leading to a decrease in protective lactobacilli and an overgrowth of a bacteria such as Gardnerella vaginalis and Peptostretptococcus. BV is the most common cause of vaginal infections. This type of infection can occur regularly, repeatedly and is not a sexually transmitted disease. Symptoms include a thin white/grey and profuse discharge with a fishy odour. Itching is not common. Treatment is with antibiotics.

Candidiasis (thrush)

Thrush is the second most common cause of vaginal infections and is caused by the overgrowth of a yeast called Candida (usually Candida albicans). Candida is common in pregnancy, women who use intrauterine contraceptive devices, diabetics, prior to menstruation and following antibiotic use. Symptoms include a thick, white discharge, a burning and itchy vulva and vagina, and a red and swollen genital area. Treatment is with antifungals.

Trichomonas vaginitis

Trichomonas vaginitis is a sexually transmitted infection caused by Trichomonas vaginalis. Symptoms included a green or yellow, profuse, frothy discharge with a fishy odour, itching, redness, tenderness, painful intercourse and urination. Both partners should be treated with antibiotics, and condoms should be used to prevent further transmission of the infection.

Menopause

Menopause happens when the ovaries stop producing oestrogen and progesterone. This leads to cessation of menstrual periods and the onset of other symptoms, such as hot flushes, breast tenderness, moodiness, headaches, depression, irritability, anxiety and disturbed sleep. A lack of oestrogen causes the vaginal wall to become thinner, drier and less elastic (known as vaginal atrophy). These changes can make sexual intercourse painful.

Vaginal dryness

Vaginal dryness may be a problem for women of any age, though it is more common in older women, especially after menopause. In a survey, 50% of South African post-menopausal women complained of vaginal dryness. Vaginal dryness can be very uncomfortable and accompanied by itching, burning, and painful intercourse. This may affect sexual relationships and lead to negative feelings and low self-esteem. Despite this, 40% of women are not treated.

Vaginal dryness can also occur following childbirth and breastfeeding, after chemotherapy or radiation treatment for cancer, or after surgical removal of the ovaries. Other causes of vaginal dryness include certain allergy and cold medications, certain anti-depressants, douching and lack of adequate foreplay before sexual intercourse.

Despite this, 40% of women were untreated13

Treatment includes oestrogen gels, creams or tablets.

The following GynaGuard products are also helpful, e.g.:

  • GynaGuard Daily Control Intimate Comfort Gel
  • GynaGuard Vaginal Capsules
  • GynaGuard Lubricating Moisturising Gel