Neither of you wants to make the first move. You're embarrassed. He's nervous. But it's not doing wonders to your relationship. Vaginal infections can be uncomfortable in more ways than one. And they are far more common than you think. So, don't feel too bad about it, and don't hold on to the pain and discomfort for as long as you possibly can before talking to your doctor.

What's behind it?

Healthy women have vaginal secretions too. It's just that they are in small amounts and vary at different times in the month. The amount and thickness depend on the two female hormones - oestrogen and progesterone. Normally, after a period is over, there is no discharge. Some women do however, have this feeling of dryness and itchiness but there is no discharge. About six days before ovulation (about 14 days after the first day of the period) a thick, opaque, sticky, non-stretchy discharge appears. As the oestrogen level rises further, the discharge becomes cloudy, then clear, watery, and slippery, and produces a feeling of wetness. This is when ovulation occurs. After ovulation, the oestrogen level drops and the progesterone level rises making the discharge thick, opaque, and sticky again. But this is natural and healthy.

The whitish coagulated material in the vaginal discharge is cells shed off the inner vaginal wall. It also has some bacilli in it which are harmless and are normal inhabitants of the vagina. The vaginal wall has a lining with cells that contain glycogen. This glycogen is affected by the enzymatic action in the bacilli to produce lactic acid, which maintains a healthy pH in the vagina.

When the oestrogen activity is low, as during a period, immediately after delivery, or in a woman who takes contraceptives, the pH changes making this level susceptible to infection. Of these yeast infections are the most common.

What is a fungal or yeast infection?

It is an infection caused by the fungus Candida Albicans, transmitted by microorganisms found almost anywhere, even in the vagina (but they do not causes a problem as long as the pH is not disturbed).

Caution: Do not take contraceptive pills without consulting your doctor. Because if the Pill is high in progesterone, it will change the pH and you could be heading toward a fungal infection.

Taking antibiotics could affect the level of the bacilli in the lining and this could in turn affect the pH level. The amount of carbohydrate available to the tissues also affects the levels. For instance, in diabetes mellitus, when the carbohydrate/sugar metabolism of the body is affected, yeast can thrive, even if the pH balance is right.

How do you know you've got a fungal infection? The only way is with a vaginal examination.

Okay, so it's confirmed. I have a vaginal infection. Now, what do I do?

• Most doctors prescribe a fungicidal cream that needs to be applied locally. Or a tablet/suppository is inserted into the vagina with the drug Nystantin or Mycostatin as the base. This acts locally and the treatment continues for 10-15 days. For persistent infections, a repeat course could be done, but consult your doctor first. There are other drugs too- Micanazole, Clotrimazole etc, but do not take anything without consulting your physician first. Unnecessary or frequent use without medical supervision can lead to the infection becoming less sensitive to the drug.
• A remedy that is making a comeback is the use of one per cent Gentian violet (used to treat boils). It is messy, yucky, and can stain clothes, but it is effective. Add a tsp of Gentian violet to a quarter litre of water. Rotate a swab stick in it and remove. Place an old towel under you as you apply it. Wait for it to dry before wearing your panties.
• Here's another home remedy: Add two tsps of vinegar or lemon juice to one litre of boiled but cooled water. This helps restore the right pH level of the vagina. Try not to overdo this because you could end up eliminating all the lactic acid producing bacillus. And never do this when you are pregnant.
• Itching can be relieved using a cream with camomile or calendula. Add it to half a cup of water and apply locally. It is very soothing.
• Try and avoid active sex during treatment. Remember, your vagina is most susceptible to infection during your period.
• Cotton may be blase but it's healthier than its sexier nylon version.
• And before you indulge in any foreplay, or masturbation, make sure nails are clipped.
• Just clean water is enough to clean your vaginal area. Clean from front to back.
• Opt for condoms instead of oral contraceptives unless you have consulted your doctor.
• For heaven's sake, do not share underwear.

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