What Could Be Wrong

IT MIGHT START as a minor irritation, a feeling that something's not right. Probably nothing, you think. But a few days later, the burning, itching or discomfort has gotten worse. Maybe you notice an unusual discharge, pain or the need to urinate more often. This is when the anxiety sets in. It's hard to tell what's worse, the discomfort or not knowing what's wrong.

Determining the Cause

Many women experience irritation in their pelvic region at some point in their lives. The very nature of a woman's anatomy can make it difficult to know what is wrong. Because so many different organs and tissues are located in a woman's pelvic area—the vagina, colon, bladder, and ovaries, to name a few—it may take time to determine exactly what is causing the irritation.

The good news is that most pelvic problems can be successfully prevented or, if necessary, treated. Any woman who experiences discomfort that worsens or does not go away within a few days should seek medical attention. Having regular gynecological checkups is also vital, since many problems, including some sexually transmitted diseases, show no symptoms and can only be detected during an exam.

In the meantime, this guide may help you identify whether you are suffering from one of the more common gynecological infections. These include vaginitis, urinary tract infections, and pelvic inflammatory disease. Vaginitis includes four types of common infections: yeast infections, as well as bacterial vaginosis, trachomoniasis, and atrophic vaginitis.

The vaginal area is where many problems begin. Many factors can upset the natural balance of hormones, acid/alkaline levels, and various microorganisms in this delicate environment, leaving a woman susceptible to infection. These factors may include any of the following:

Certain medical conditions, including diabetes and HIV.
Douches, vaginal sprays, and perfumed or deodorant soaps and products.
Poor hygiene or not adequately washing or drying the genital area.
Damp, restrictive, or synthetic clothing.
Pregnancy.
Certain medications, including antibiotics.
Sex with an infected partner.
Lack of sleep, inadequate diet, illness, or stress.

If you're experiencing:

* An unusual grayish discharge that might smell fishy, particularly after sexual intercourse or washing with soap.

* Burning, itching, and swelling around the vagina.

You May Have

Bacterial Vaginosis
Bacterial vaginosis is a form of vaginitis, caused by an overgrowth of bacteria. Note: Some women experience no symptoms.

Relief may come from…
Antibiotics are usually effective against this condition. If the infection recurs, your partner may also need to take antibiotics.

If you're experiencing:

* A foul-smelling yellow-gray or green discharge.

* Vaginal burning, itching, and redness.

* Discomfort during sexual intercourse.

* Pain during urination.

* Symptoms usually occur four to 20 days following exposure.

You May Have

Trichomoniasis
Trichomoniasis, a form of vaginitis, caused by a parasite that is spread during sexual intercourse.

Note: Women with trichomoniasis frequently have no symptoms.

Relief may come from…
A woman and her partner can be treated with antibiotics.

If you're experiencing:

* Itching and burning.

* A white discharge that looks like cottage cheese. This may have a yeasty, bread-like smell.

* Pain during sexual intercourse.

You May Have

Yeast Infection
A yeast infection, a form of vaginitis, caused by an overgrowth of the fungus Candida.

Relief may come from…
Over-the-counter antifungal creams successfully cure most yeast infections. Seek medical attention if symptoms do not improve, or if you have never had a yeast infection before.

If you're experiencing:

* Dryness and discomfort in the vaginal area.

* Itching and/or burning.

* Pain or discomfort during intercourse.

* A watery yellow or green discharge.

You May Have

Atrophic Vaginitis
Atrophic vaginitis, or vaginal atrophy, caused by a natural decrease in estrogen that occurs after menopause and during breastfeeding.

Relief may come from…
Vaginal lubricants and moisturizers can ease discomfort. Estrogen-containing vaginal creams or oral estrogen may also help.

If you're experiencing:

* The urge to urinate more frequently than usual, often with little urine coming out.

* A painful, burning sensation when urinating.

* Blood or pus in the urine.

* Strong-smelling urine.

* Tenderness just above the pelvic bone.

You May Have

Urinary Tract Infection
A urinary tract infection, which often occurs when bacteria from the anus enter the urethra—the tube that empties urine from the bladder. This often happens after sexual intercourse or from wiping after using the toilet.

These infections can spread to the bladder and to the ureters, which connect the bladder to the kidneys. It can also spread to the kidneys, which is considered more serious.

Signs that the infection has spread to the kidneys include back or side pain, nausea, fever, or chills.

Relief may come from…
Some minor infections clear up on their own within a day or two. Antibiotics are usually effective against more serious cases.

If you're experiencing:

* Pain and tenderness in the lower abdomen.

* Abnormal vaginal discharge.

* Weakness and fever.

* Pain during sexual intercourse.

* Irregular menstrual bleeding.

You May Have

Pelvic Inflammatory Disease
Pelvic inflammatory disease, which is often caused when gonorrhea or chlamydia—sexually transmitted diseases—spread to a woman's upper genital tract, including her uterus, ovaries, and fallopian tubes. Rarely, the disease can result when bacteria travels up the genital tract via an intrauterine device or during an endometrial biopsy, miscarriage, or childbirth.

Relief may come from…
Antibiotics are used to treat women and their partners. About one-fourth of women with pelvic inflammatory disease must be hospitalized to receive intravenous antibiotics.

Healthy Habits Worth Adopting

Many vaginal infections and other pelvic problems can be prevented. These steps may help:

Wash genital and anal areas daily. Consider washing before and after sexual intercourse, particularly if you get frequent urinary tract infections. Always wash from front to back.
Wipe from front to back after using the toilet.
Keep the genital area as dry as possible by avoiding tight clothing and wearing underwear or pantyhose with a cotton crotch. Also, don't wear underwear to bed at night.
Don't douche or use deodorant or perfumed products in the vaginal area.
Drink enough fluid to allow you to empty your bladder every three to four hours during the day. At least half of this fluid should be noncarbonated water.
Drink cranberry juice if you get frequent urinary tract infections.
Eat yogurt every day if you get frequent yeast infections.
Change sanitary napkins and tampons frequently.
Finally, get enough sleep, eat a nutritious diet, and manage stress—these good health measures will help your body fight off infections.