As a Community Pharmacist, I come across different women frequently complaining about toilet infections with symptoms ranging from itching, soreness of the vulva, vulva itching and vaginal discharge with a very bad odor (rotten egg-like or fish-like smell).

But the fact is that, the so-called toilet infections are not infections gotten from toilets. It is medically not true. The truth is that it was given that name by people to make it sound well in public.

Some of these so-called toilet infections are sexually transmitted. These infections are common in females, roughly about 80% of ladies will have at least a yeast infection in their lifetime. Examples are

Candidiasis (fungal infection)

Bacterial vaginosis (bacterial infection)

Trichomoniasis ( protozoan infection)

Vaginal infection is an inflammation of the vagina that creates discharge, odor, irritation or itching. It might be very stressful to diagnose because it has many causes ranging from over the counter medications like antibiotics, hormones, contraceptives (oral and topical) douches, vaginal medication, sexual intercourse, sexually transmitted infections, stress and change in sexual partners. All these can the vaginal ecosystem which will lead to mass increase in the number of these normal vaginal organisms.

Now, I will briefly talk on the common toilet infections as mentioned above.

CANDIDIASIS: Vaginal yeast infections are caused by a fungus mainly by Candida albicans. This is also called candidiasis, genital candidiasis, or vulvovaginal candidiasis (VVC). Yeast infection can spread to other parts of the body including skin, mucous membranes and other areas. In rare circumstances, it can cause life-threatening systemic infections mostly in people with weakened immune defenses such as Pregnancy, HIV positive patients, diabetes and people on steroids.

Candidiasis cause a thick, whitish-gray cheese” type of vaginal discharge and may be itchy. You may have intense itching in your genital area. Painful urination and intercourse are common. You may not always have a vaginal discharge. Men with genital candidiasis may have an itchy rash on the joystick. Most male partners of women with yeast infection do not experience any symptoms of the infection.

Vaginal yeast infection is not considered a sexually transmitted infection, but some men will develop symptoms such as itching and penile rash following sexual contact with an infected partner.

Yeast infections are caused by an overgrowth of normally growing fungi in the vagina that creates unpleasant symptoms. The yeast are normally kept under control by naturally occurring bacteria in the body. If the natural balance of microorganisms is disrupted, the yeast grow out of control.
Diabetes or pregnancy: Diabetes and pregnancy make the vagina better suited for fungal growth. These conditions lower the glycogen store in certain vaginal cells. They may also raise the sugar content and the pH of the vagina and increase the risk of yeast infection
Birth control pills: Changes in the vaginal environment occur with increased hormonal levels from estrogen-containing birth control pills. This change creates an environment for the fungus to grow and cause symptoms
Antibiotics: Antibiotics destroy protective bacteria in the vagina. These bacteria normally stop the candida organisms from overgrowing. Yeast infection may occur after taking a course of antibiotics for another condition of bacteria origin.

TRICHOMONIASIS. This is a protozoan infection, which is a sexually transmitted disease caused by the parasite Trichomonas vaginalis. Trichomoniasis is primarily an infection of the urinary and genital tract. For women, the vagina is the most common site of infection. For men, the urethra is most commonly affected. It causes a frothy vaginal discharge with a rotten egg-like smell that may be yellow-green or gray, itching and irritation of the genitals, burning with urination, but sometimes confused with a urinary tract infection. Discomfort during intercourse could also be noticed.

Because trichomoniasis is a sexually-transmitted disease, symptoms may appear within 4-20 days after exposure. Men rarely have symptoms, but if they do, they may have a thin, whitish discharge from the joystick and painful or difficult urination.

If your vaginal discharge is abnormal in color such as green, has a foul smell (rotten egg-like) changes consistency, or is significantly increased or decreased in amount, you may be developing a form of trichomoniasis.

BACTERIA VAGINOSIS: Bacterial vaginosis is common and causes a vaginal discharge, often with a noticeable fish-like smell. Bacteria Vaginosis is not a sexually transmitted infection. It is caused by an overgrowth of normal bacteria flora in the vagina. Symptoms are often mild, and it may clear without treatment.

Other cases can be treated with antibiotic medication. Bacteria Vaginosis can affect any woman, including those who do not have or who have never had sex.

However, Bacteria Vaginosis is more common amongst sexually active women than amongst non-sexually active women. No germ (bacterium) is passed on between sexual partners to cause this condition. Sexual partners of women with bacteria vaginosis do not need any treatment. However, some cases of bacteria vaginosis seem to be sexually related. It may develop after a change in sexual partner. In these cases, the infection is not caught from anyone. But a change in sexual partner may affect the balance of normal germs (bacteria) in the vagina. Bacteria vaginosis is also more likely in women in same sex relationships who have had a change of partner.

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