Dear Doc,
Whenever I have sex there is always an itching which lasts a few days and there is pain sometimes. What's happening?

Dr Sharmaine Mitchell

Disturbed

Dear Disturbed,
Vaginal itching after intercourse may be secondary to inflammation and irritation of the vagina and vulva commonly caused by a fungal or bacterial infection. Usually the infection originates in the vagina. There may be an associated abnormal odour and increased discharge.

Atrophic vaginitis - a skin condition of the vulva and vagina which happens when a hormone called oestrogen is lacking in the body - may also be a problem in post-menopausal women. This is secondary to oestrogen deficiency. Rarely irritation of the vaginal walls may result from an allergic reaction to the male condom or spermicidal cream if one is used.
Three common causes of vaginitis are

. Candida (yeasts Monilia)
. Trichomonas vaginalis
. Bacterial Vaginosis

When there is a yeast infection, the discharge is usually white, thick and curdy (cottage-cheese appearance). Trichomonas vaginitis produces a profuse, usually foul-smelling vaginal discharge that is greenish-grey in colour and has a frothy appearance.

Bacterial vaginosis usually presents with a slightly increased discharge with an odour. The discharge is usually grey in colour. The organism responsible for this is gardeneralla vaginalis.
These infections can be effectively treated with antifungal cream, vaginal pessaries or tablets by mouth.

In the case of trichomonal vaginitis, this is a sexually transmitted disease, and both you and your partner will need treatment. If bacterial vaginosis is recurrent, treatment of your sexual partner is definitely recommended.

If a yeast vaginitis is suspected and this is recurrent, work-up should include a screening for diabetes mellitus and an HIV test. You should consult your gynaecologist who will examine you, do appropriate cultures if necessary and manage your problem appropriately.

Encourage your partner to be evaluated also, as this may help to reduce this recurrent problem. Invite him to be a part of the first consultation with your gynaecologist.

Dr Sharmaine Mitchell is an obstetrician and gynaecologist. Send your health queries to Dr Mitchell at mclymonti@jamaicaobserver.com or Dear Dr Mitchell, c/o all woman, Jamaica Observer, 40-42 1/2 Beechwood Ave, Kgn 5.

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