HEALTH CONDITIONS THAT CAN AFFECT THE VAGINACANDIDIASIS(vaginal yeast INFECTION) CHLAMYDIA
Escherichia coliINFECTION GENITAL HERPES
GENITAL TRAUMA GONORRHEA
HUMAN PAPILLOMAVIRUS(HPV) SEXUAL ASSAULT
vaginal cancer VAGINITIS
For further discussion of the vagina within the
context of the structures and functions of repro-
duction and sexuality, please see the overview sec-
tion “The Reproductive System.”
See also AGING, REPRODUCTIVE AND SEXUAL
CHANGES THAT OCCUR WITH; BARTHOLIN’S CYST; COL-
POSCOPY; MENSTRUAL CYCLE; NABOTHIAN CYST; SEXUAL
HEALTH; SEXUALLY TRANSMITTED DISEASES(STDS).
vaginitis INFLAMMATIONof the VAGINA that may
occur as a result of irritation or INFECTION. Com-
mon causes of irritation-based vaginitis include
douches, feminine hygiene products, spermicides,
bubble bath, and soaps. Common causes of infec-
tion-based vaginitis include CANDIDIASIS (yeast
infection) and SEXUALLY TRANSMITTED DISEASES(STDS)
such as CHLAMYDIAand TRICHOMONIASIS. Viruses that
may cause vaginitis include HERPES SIMPLEX2 (HSV-
2), which causes GENITAL HERPES, andHUMAN PAPIL-
LOMAVIRUS (HPV), which may cause clusters of
wartlike growths. Other forms of vaginitis are bac-
terial (called gardnerella) and atrophic (which
may occur after menopause).
Symptoms and Diagnostic PathThe symptoms of vaginitis typically include itch-
ing, burning, soreness, or other discomfort. When
the cause is infection there may be a discharge or
unusual odor. The diagnostic path includes discus-
sion of sexual activity and any history of STDs,
PELVIC EXAMINATIONwith PAP TEST, and laboratory
examination or culture of any discharge to check
for infection.
Treatment Options and OutlookTreatment depends on the identified cause of the
vaginitis and may include ANTIBIOTIC MEDICATIONS
for bacterial infection (including STDs) or ANTIFUN-
GAL MEDICATIONS for yeast infection. When the
cause is irritation, removing exposure to the
source (such as a douche solution or spermicide)
allows the vaginal tissues to heal. The doctor may
prescribe topical CORTICOSTEROID MEDICATIONS to
relieve symptoms. Tepid baths in water containing
baking soda are often soothing. Wearing loose-fit-
ting cotton underwear and avoiding pantyhose are
other helpful measures. Most vaginitis improves
rapidly with appropriate treatment.Risk Factors and Preventive Measures
Vaginitis is very common in women, particularly
women who are sexually active. SEXUAL INTER-
COURSE, particularly with multiple sex partners or
unprotected (without a barrier such as a condom),
increases the risk for vaginitis. Women who use
intrauterine devices (IUDs) for CONTRACEPTIONalso
have increased risk for vaginitis as well as PELVIC
INFLAMMATORY DISEASE(PID). Vaginitis is uncommon
in prepubertal girls (girls who have not yet begun
to menstruate) though may result from
ESCHERICHIA COLIINFECTIONas a consequence of poor
toileting hygiene. Preventive measures include
minimizing exposure to potential irritants and
wearing clothing that allows some airflow
between the fabric and the external GENITALIA.
See also PERSONAL HYGIENE; SEXUAL HEALTH; SEXU-
ALLY TRANSMITTED DISEASE(STD) PREVENTION.varicocele A VARICOSE VEINin the testicle. Vari-
cose veins are dilated, twisted, and often nonfunc-
tioning veins that develop for numerous reasons.
Varicocele affects the BLOODflow that leaves the
TESTICLES. Blood that accumulates in the testicles
can raise the temperature within the SCROTUMhigh
enough to interfere with proper SPERMformation
(spermatogenesis) and maturation, resulting in
INFERTILITY. A man may notice a varicocele as a soft
bulge in his testicle that becomes more prominent
when bearing down. Varicocele is more common
in the left testicle because of the structure of the
veins. The doctor can detect varicocele on palpat-
ing the testicles; Doppler ULTRASOUND, which shows
the flow of blood, confirms the diagnosis.
Treatment is surgery to repair the varicocele.
The OPERATIONis an AMBULATORY SURGERY(the man
goes home the same day). The man may receive
general or regional ANESTHESIA. The most common
operative technique involves a small incision
made into the lower portion of the groin through
which the surgeon can reach and repair the vari-
cocele. HEALINGis rapid and most men return tovaricocele 353