[Brandye]

So, what are the potential problems and their indicators? The common infections are either bacterial or fungal. First, urethritis results from bacteria getting into your urethra in sufficient numbers to colonize and irritate the lining of the urethra. It burns when you pee and there is often a frequent urge to pee with little coming out. Sometimes, the area immediately around the urethra will be irritated and bright red. SEX DOES NOT CAUSE URETHRITIS! It does irritate the urethral opening and make it seem worse but the cause is the bacteria that have most likely migrated from your anus. Your urine will have a particularly foul smell. We all know what our urine usually smells like, so this is your baseline. Urethritis does require prescription anti-biotics and an appointment will be required.

Bacterial vaginitus is also caused by bacteria. The first indication is a foul smell. I am not talking about a strong “female odour,” but a truly foul smell. At the end of each day or after exercise, we all have a strong female odor and we all recognize this. The bacterial infection gives a different odour that is very characteristic. Fungal vaginitis (thrush, yeast) can also smell bad but not as strong or characteristic as the bacterial. Baterial vaginitis can be treated topically, with creams, or, sometimes, with oral medication as well. Both meds need a prescription and doctor’s visit.

Yeast infections can be treated with over the counter potions usually next to the feminine hygiene products. The first indicators of these infections are itching and burning of the area around the entrance to the vagina. It also exists in the vagina but you cannot feel that because there are no nerve endings in the vagina. Treatment must be internal as well as external but will be a topical application – either OTC or, in worse cases, by prescription. The inner lips will be angry and red – this extends internally when examined with a speculum.

An interesting side bar on yeast infection is that the yeast grows well in the human mouth. One patient had a yeast infection which would recur a few weeks after each “cure.” I finally suggested that her husband use a particular mouthwash twice a day. She turned beet red, which I ignored. At her next annual exam she had had no recurrence and we did not talk about that.

We women have several parts that secrete nutrient filled fluids and a major source of bacteria all located along the few square centimeter area described. Urine and semen are both nutrient rich for bacteria. So your natural urine and your partners semen serve to support and encourage bacteria to set up housekeeping. The result is urethritis or vaginitits.

Women make their vaginitis worse through douching. The vagina, indeed the entire pudenda, is a very delicately balanced ecosystem. There is a balance between the good and the bad. Douching removes all the bacteria and fungus – good and bad. If you douche to remove the smell, for instance, you may be successful in the short term but a day or so later, the infection is worse than in the beginning. The only reason I can think of for douching is that you have too many dates too close together! Then, do not use the commercial douches that have perfumes, dyes and unknown stuff. Mix one part white vinegar to two parts tepid water and flush the one guy out before the next. Better he taste vinegar (he won’t) than your earlier date (he will).

The lips and area described can sometimes become irritated because of an accumulation of smegma. It irritates the clitoris and if not cleansed well can irritate the rest of your specifically female parts.

Bottom line (unintended but good pun) is to keep clean. At least twice a day the area described should be thoroughly cleansed with mild soap. Sera recommends Ivory. OK, I recommend clear liquid soap – preferably not anti-bacterial. The clear soap (shampoo is fine) rinses more easily and avoids the irritation from the soap. The antiseptic or anti-bacterial soap adds some chemicals and does no better at cleansing. Wash well; rinse well. I like bidets but they are not generally available in N. America and are less common than they once were in Europe. In the shower is a natural; washing at a sink makes rinsing more difficult.

If your tissues are an angry red, you smell really bad or it burns and itches see, the doctor and do not cleanse more than a surface wash. The doctor needs a collection of the stuff that is irritating you to determine how to get rid of it. Never douche before a doctor’s appointment. I often diagnose by smell as much culture.