What is vulvitis?
Vulvitis is not a disease, but refers to the inflammation of the soft folds of skin on the outside of the female genitalia, the vulva. The irritation can be caused by infection, allergic reaction, or injury. The skin of the vulva is especially susceptible to irritation due to its moistness and warmth.



Who is affected by vulvitis?
Any woman of any age can be affected by vulvitis. Girls who have not yet reached puberty or post-menopausal women may be at higher risk of vulvitis. Their lower estrogen levels may make them more susceptible to the condition due to thinner, dryer vulvar tissues.


What causes vulvitis?
Vulvitis can be caused by many factors or irritants, including:
The use of colored or perfumed toilet paper
An allergic reaction to bubble bath or soap used to clean the genital area
Use of vaginal sprays or douches
Irritation by a chlorinated swimming pool or hot tub water
Allergic reaction to spermicide
Allergic reaction to sanitary napkins
Wearing synthetic underwear or nylon pantyhose without a breathable cotton crotch
Wearing a wet bathing suit for extended periods of time
Bike or horseback riding
Fungal or bacterial infections including scabies or pubic lice
Herpes
Skin conditions such as eczema or dermatitis



What are the symptoms of vulvitis?
The symptoms of vulvitis can include:
Extreme and constant itching
A burning sensation in the vulvar area
Vaginal discharge
Small cracks on the skin of the vulva
Redness and swelling on the vulva and labia (lips of the vagina)
Blisters on the vulva
Scaly, thick, whitish patches on the vulva
The symptoms of vulvitis can also suggest other disorders or diseases of the genitals. If you are experiencing any of these symptoms, you should consult your healthcare provider.

White discharge is a fairly common occurrence for a woman but for some first-time mothers, it became a cause of concern when they start having more of the white discharge during pregnancy in the second trimester.

Why there is a white discharge during pregnancy in the second trimester?
There are many possible causes of having thick white discharge in the second trimester of pregnancy. Most of the time it is normal, but it could also indicate something serious.

Leucorrhoea:
The most common reason woman might experience increased white discharge during pregnancy in second trimester is leucorrhoea. It is a normal part of pregnancy and happens to many women. In fact, this is the same white discharge they might have seen before their periods. The only difference is this time it is thicker and more in amount. Leucorrhoea is a thick white discharge with a mild smell. It is made up of secretions from the cervix and vagina.

When pregnant, the estrogen production in body increases causing a greater flow of blood to vagina. More mucus is produced from cervix glands as a result. This then comes out of vagina as a white discharge.”

This white discharge is important because it helps protect developing baby by maintaining a healthy balance of helpful bacteria in birth canal and vaginal area.

Yeast Infection:
If you experience vaginal itching and a burning sensation during urination along with a thick, white discharge resembling cottage cheese, then it might be the sign of a yeast infection in your vagina. Yeast infection is common in women but its chances of occurring increase during pregnancy. During pregnancy, hormonal changes disrupt the pH balance of the vagina causing yeast infection. It is not dangerous and doesn’t harm the baby.

Sexually Transmitted Infections:
Sexually Transmitted Infections are bacterial or viral infections transmitted through genital, oral or anal sex. It causes a yellow or white discharge but with a foul smell and woman might also experience pain during sex and urination. Sexually Transmitted Infections are harmful to woman and her baby and hence, require immediate treatment. The most common STI is gonococcal infection. In most cases, these infections can be treated with antibiotics. Whenever woman notice that white discharge has a foul smell or is associated with itching then consult the doctor immediately.

Bacterial Vaginosis:
As the name suggests, Bacterial Vaginosis is caused by an imbalance in the normal bacteria existing in a woman’s vagina. It is unclear what causes the imbalance. Bacterial vaginosis is a serious concern during pregnancy. It leads to an increased risk of preterm birth or miscarriage thus needs immediate medical attention.

What is vaginal cancer?
Vaginal cancer happens when malignant (cancerous) cells form in the vagina. It is a very uncommon disease. The vagina, also known as the birth canal, is a hollow channel that goes from the opening of your uterus to the outside of your body.


There are two types of vaginal cancer:
Squamous cell carcinoma: This is by far the more common of the two. It happens when cancer forms in the flat, thin cells that line the vagina. This type spreads slowly and tends to stay close to where it starts. But it can move into other organs including the liver, lungs, or bones. Older women are most likely to get this form of the disease. Nearly half of all cases occur in age group of 60 & more.

Adenocarcinoma: This type starts in the glandular cells in the lining of the vagina. These cells make mucus and other fluids.

Of the two main types, Adenocarcinoma, the more likely to spread to other areas. These include the lymph nodes (organs that filter harmful substances in the body) in the groin area and the lungs.

Clear cell carcinoma: This is an even rarer form of adenocarcinoma. It is been linked with women whose mothers took a hormone called diethylstilbestrol (DES) in the early months of pregnancy. Between 1938 and 1971, doctors often prescribed this medication to pregnant women to prevent miscarriage and other problems. Doctors stopped using it in 1971. But just how long do you remain at risk if your mother was given DES? That remains unknown.

Women who haven’t been exposed to it can still get vaginal cancer, but the chances are very small. If DES isn’t a factor, clear cell carcinoma is most likely to happen after menopause.


Vaginal Cancer and HPV (Human Papilloma Virus):
About nine out of every 10 vaginal cancer cases are linked to human papilloma virus, or HPV, infection. This is the most common STI, or sexually transmitted infection. There are two different vaccines to prevent HPV. But once you have it, it will most often go away on its own without treatment. When the infection lingers, though, it can cause cancer.


Other Causes
The following things can also increase your chances of developing vaginal cancer:
Drinking alcohol
Having cervical cancer or pre-cancer
Having HIV
Smoking
Many cases of vaginal cancer aren’t linked to any specific causes.



What are the symptoms for Vaginal Cancer?
These can include pain or abnormal vaginal bleeding. But the disease often doesn’t come with any warning signs. Your doctor might find it during a routine exam or Pap test.

Other symptoms can include feeling a lump in your vagina, pain in your pelvis, and painful sex.

If you notice any of these things, it doesn’t mean you have vaginal cancer. You could just have an infection. But it’s important to get it checked out.


What are the diagnosis and treatment for Vaginal Cancer?
If a pelvic exam shows there might be cancer, your doctor may want to take a closer look with a procedure called colposcopy. She’ll use a lighted magnifying instrument, a colposcope, to check your vagina and cervix for anything abnormal.

She might take tissue samples at the same time. A specialist will study the samples under a microscope. This is called a biopsy.

If she finds cancer, your doctor will choose a treatment based on many factors. These include how close the cancer is to other organs, which type of cancer is present, how advanced it is, whether you’ve had a hysterectomy, and if you’ve had radiation treatment in your pelvic area.

Most likely, your doctor will recommend one of the following courses of action:

Surgery: This is the most common treatment. Your doctor may use a laser to cut out affected tissue or growths. In some cases, she may need to remove all or part of the vagina. Or she’ll perform a hysterectomy. This is when the uterus is taken out. Sometimes the cervix or other organs need to be removed, too.

Many women can have a normal sex life after surgery. Your doctor will need to tell you what’s safe and when. Sex can increase the chance of infection, and it can cause bleeding or strain the surgical site. How you’re healing and what kind of surgery you’ve had will make a difference in the effect on your sex life, too.

Radiation therapy: This treatment uses high-powered X-rays or other forms of radiation to kill the cancer. It might be performed using a machine that sends X-rays into your body from outside. Your doctor might also place a protected radioactive substance inside your body on or near the cancer.

Radiation treatments in the pelvic area can damage the ovaries. This cuts off estrogen production, which leads to menopause symptoms like hot flashes and vaginal dryness. If you’ve already been through menopause, these symptoms likely won’t happen.

This type of therapy also can irritate healthy tissue. Your vagina might get swollen and tender. Sex may be painful.

Chemotherapy (“Chemo”): This kills or stops the growth of cancer cells using medications. You might take them by mouth or get them through an IV. If you have squamous cell vaginal cancer, your doctor might prescribe a chemo treatment in lotion or cream form.

Many patients lose their sex drive when they get chemo. Plus, the physical side effects, like nausea, hair loss, and changes in body weight can cause feelings of insecurity. Knowing that the physical side effects will improve when treatment stops can help a lot.


Can you Prevent Vaginal Cancer?
The best way to guard against it is to avoid being exposed to HPV. There are two vaccines, Gardasil and Gardasil 9, available to prevent vaginal cancer. Gardasil protects you from the four most common types of HPV. Gardasil 9 covers nine types of HPV.

If you don’t want the vaccine, you might try the following lifestyle changes. Studies show they may help to reduce your risk of vaginal cancer:
Wait to have sex until your late teen years or beyond
Don’t have sex with more than one partner
Don’t have sex with someone who has more than one partner
Use condoms during sex
Get regular Pap exams
If you smoke, stop. If you don’t smoke, don’t start.

Bleeding during pregnancy is relatively common. However, bleeding from the vagina at any time in pregnancy can be a dangerous sign, and you should always contact your midwife or doctor immediately if it happens to you.

Bleeding is not often caused by something serious, but it’s very important to make sure and to find out the cause straight away.

Contact your doctor or midwife if you notice bleeding from your vagina at any time during your pregnancy.

In early pregnancy you might get some light bleeding, called ‘spotting’, when the fetus plants itself in the wall of your womb. This is also known as ‘implantation bleeding’ and often happens around the time that your first period after conception would have been due.

Causes of bleeding
During the first 12 weeks of pregnancy, vaginal bleeding can be a sign of miscarriage or ectopic pregnancy (when the fetus implants outside the womb, often in the fallopian tube). However, many women who bleed at this stage of pregnancy go on to have normal and successful pregnancies.

In the later stages of pregnancy, vaginal bleeding can have many different causes. Some of the most common are outlined below.

Changes in the cervix
The cells on the cervix often change in pregnancy and make it more likely to bleed, particularly after sex. These cell changes are harmless, and are called ‘cervical ectropion’. Vaginal infections can also cause a small amount of vaginal bleeding.

The most common sort of bleeding in late pregnancy is the small amount of blood mixed with mucus that is known as a ‘show’. This occurs when the plug of mucus that has sealed the cervix during pregnancy comes away. This is a sign that the cervix is changing and becoming ready for the first stage of labor to start. It may happen a few days before contractions start or during labor itself.

Placental abruption
This is a serious condition in which the placenta starts to come away from the inside of the womb wall. Placental abruption usually causes stomach pain, even if there is no bleeding. If it happens close to the baby’s due date, your baby may be delivered early.

Placenta praevia
Placenta praevia, sometimes called a ‘low-lying placenta’, is when the placenta is attached in the lower part of the womb, near to or covering the cervix. This can block your baby’s path out of your body. The position of your placenta is recorded at your morphology scan.

If the placenta is near the cervix or covering it, the baby cannot get past it to be born vaginally, and a caesarean will be recommended.

Vasa praevia
Vasa praevia is a rare condition, occurring in about 1 in 3,000 to 1 in 6,000 births. It occurs when the blood vessels of the umbilical cord run through the membranes covering the cervix. Normally the blood vessels would be protected within the umbilical cord. When the membranes rupture and your waters break, these vessels may be torn and this can cause vaginal bleeding. The baby can lose a life-threatening amount of blood and die.

It is very difficult to diagnose vasa praevia, but it may occasionally be spotted before birth by an ultrasound scan. Vasa praevia should be suspected if there is bleeding and the baby’s heart rate changes suddenly after the rupture of the membranes. It is linked with placenta praevia.

Getting your first period is a right of passage for women, and guess what?

So is your first yeast infection. The issue, which doctors also call candidal vulvovaginitis or vaginal thrush, is incredibly common, affecting 3 out of 4 women in their lifetimes. Some even experience it 4 or more times in a year. (Though we really, really hope that doesn't happen to you.)

The health condition is so, err, popular because every woman naturally has yeast (aka candida) brewing in their vaginas. But sometimes an overgrowth can occur, and that's when problems pop up. "Anything that can throw off the environment of your vagina can cause yeast infections, whether it's medication, excess moisture, condoms, IUDs, or even tampons," says Angelique Mason, a family nurse practitioner at Hahnemann University Hospital in Philadelphia. Other common causes: Douching, using vaginal products that have fragrance chemicals, hanging out in wet or sweaty clothing and swimsuits, and wearing underwear that's too tight.

But how do you know if what you're seeing or feeling is actually a yeast infection? These surefire signs signal that it's time to schedule a visit with your OBGYN. That way you'll know if an over-the-counter treatment will actually work, or if you need to grab a prescription for something stronger. Either way, you'll be on your way to a healthy, back-in-balance vagina.

1. Your vaginal discharge looks like cottage cheese.
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It's one of the more gag-worthy comparisons out there, but anyone who's experienced this yeast infection symptom firsthand knows it's accurate. "Generally, women will come in and complain of an odorless discharge something that’s thick, whitish, and looks like cottage cheese," Mason says. Normal discharge is typically somewhere between clear and milky white, so you'll notice a distinct difference.

2. You feel sore for no reason.

It wouldn't be all that surprising to feel general vaginal pain or soreness after an enthusiastic romp in the sack. But if that didn't actually happen and there are no other obvious reasons behind your pain then that could be a sign of a yeast infection, reports the Centers for Disease Control and Prevention.

3. Peeing is super painful.
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One day you're peeing without a care in the world and the next it becomes one of those moments that you dread (and may even try to avoid). Mason says painful urination is one of the most telltale yeast infection symptoms in women. When you're experiencing it, you'll most likely notice other symptoms, including redness and swelling in the vulva, reports the Cleveland Clinic.

4. You're itching like crazy.

One of the most common symptoms is intense itchiness in both the vaginal opening and the vulva, so feeling like you constantly have to scratch is a solid indicator that something isn't right, Mason says. It doesn't help that fungus thrives in warm, moist environments (like your vagina), so it's important that you start treating a yeast infection right away before your symptoms get worse.

5. There's a burning sensation during sex.
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If things are tingling downstairs in a not-so-pleasant fashion, the Mayo Clinic says this is a common symptom of an active yeast infection. But here's a doozy: If you have one, it's possible to spread it to your partner. It’s not overly common, but since men also have candida on their skin, having unprotected sex can cause an overgrowth that results in an infection called balanitis, or inflammation of the head of the penis. Because of that, Mason says they could experience an itching or burning sensation, redness, and small white spots on the skin. If that happens, he'll need to see the doc too so he can be treated with over-the-counter anti-fungal medications.