Maxy sez : When Is Low Blood Pressure Too Low?

Some people naturally have low blood pressure, known as hypotension. However, when high blood pressure suddenly becomes low blood pressure, it could be cause for concern.
By Krisha McCoy      Medically Reviewed by Michael Cutler, DO, PhD
Low numbers may be the sign of dehydration or nutrient deficiencies.Alamy
Low blood pressure, or hypotension, may be a sign of good health and of a decreased risk of heart disease. But not always. At times, continually low blood pressure or a sudden drop in blood pressure can lead to worrisome symptoms and even serious health problems.

Understanding Hypotension
A blood pressure reading contains two numbers: systolic pressure and diastolic pressure. Systolic pressure is the top or first number in your blood pressure reading; it indicates the pressure within your arteries when your heart pumps out blood. Diastolic pressure is the bottom number, and shows the pressure in your arteries while your heart is filling with blood.

If your blood pressure is 120/80 millimeters of mercury (mm Hg) or lower, it’s considered normal. Generally, if the blood pressure reading is under 90/60 mm Hg, it is abnormally low and is referred to as hypotension. Some adults regularly have a blood pressure in the hypotensive range, but have no symptoms at all and do not require treatment. In serious cases, though, hypotension can result in a decreased supply of oxygen and nutrients to your brain, which can eventually lead to life-threatening shock.

Anyone can develop hypotension, but certain groups of people are more likely to experience it, and there are different types. For instance, orthostatic (positional) hypotension, which occurs when you stand up after sitting or lying down, is more common in older adults. Typically, “your body has certain compensatory mechanisms to prevent your blood pressure from falling when you stand up,” explains Willie Lawrence, MD, an interventional cardiologist at Research Medical Center in Kansas City, Missouri, and a spokesperson for the American Heart Association. But, he adds, “orthostatic hypotension is a problem for some people because these reflexes that should occur, don’t occur.”

Symptoms of Hypotension
Most doctors do not consider hypotension a problem unless it is associated with certain signs and symptoms, which may include:
Dizziness
Fainting
Fatigue
Problems concentrating
Blurry vision
Nausea
Clammy, pale skin
Shortness of breath
When Low Blood Pressure Can Strike
Some people have naturally low blood pressure, and they don't experience any symptoms. But for those who are used to having high blood pressure, episodes of low blood pressure can signal a problem and can cause the symptoms listed above.

An onset of hypotension is more likely to occur when you:

Are on bed rest for a long period of time, and then resume an upright posture
Are in your first 24 weeks of pregnancy
Have lost a large amount of blood
Are dehyrdrated
Are taking certain medications, such as blood pressure lowering medications; certain heart medications; certain Parkinson's disease medications; tricyclic antidepressants; or medications to treat erectile dysfunction
Have a heart problem, such as a very slow heart beat, heart valve problems, heart attack, or heart failure
Have an endocrine problem, such as hypothyroidism, parathyroid disease, Addison's disease (an adrenal gland disorder), low blood sugar, or diabetes
Have a severe infection that enters your blood stream
Are experiencing anaphylaxis, a life-threatening allergic reaction
Have a neural disorder that affects your blood pressure
Have a nutrient deficiency, such as low vitamin B12 and folic acid levels

When Do You Need Medical Care for Hypotension?
If your blood pressure is always on the low side and you do not have any of the above symptoms, there is usually no cause for concern. Similarly, if you have a single at-home blood pressure reading that is abnormally low without any symptoms, you probably do not need to see your doctor. It is normal for your blood pressure to rise and fall over time, and your body is usually able to get your blood pressure back to normal.

But, says Dr. Lawrence, “when you sense there’s a recurrent problem, or there’s no clear explanation for what’s happened, you need to seek medical advice."

If your blood pressure drops suddenly and you are experiencing symptoms like dizziness, you should call your healthcare provider. They can assess your situation and rule out underlying problems, such as internal bleeding, serious infection, or allergic reaction.

Treatment for hypotension will depend on the cause of the low blood pressure. Immediate steps might include:

Lying with your feet above your heart
Drinking fluids
Avoiding hypotension triggers like prolonged standing
After evaluation by a doctor, recommendations may include:

Avoiding alcohol
Adjusting your diet
Adjusting your medications (possibly lowering dosages)
Taking blood pressure raising medications, such as fludrocortisone (Florinef) and midodrine (ProAmatine)
Wearing compression stockings
People who experience shock related to hypotension will need emergency treatment to restore blood flow to their organs and raise their blood pressure back to normal.

It’s important to determine whether your low blood pressure is “a primary problem or secondary problem,” notes Lawrence. A primary problem means that the body’s reflexes are not working as they should. Secondary causes mean that the low blood pressure is a result of things like dehydration or the effects of certain medications. “Some anti-hypertensive [medications] are more likely to cause hypotension than others, and a lot of it is dose-dependent,” says Lawrence. “In most people, there will be some easily identifiable secondary cause, or some easy solution to what may even be a chronic problem that has no secondary cause, and that’s why it’s important to see your doctor, so they can make an appropriate assessment.”

Keep track of your blood pressure readings, even if you don’t have any health issues, so that you know what your personal “normal” reading is. And if your blood pressure is being monitored, talk to your doctor about the blood pressure target range that’s best for you.

Maxy Sez :The History of Diabetes

People have been aware of diabetes for thousands of years. Learn how discoveries over the ages have led to today's understanding of diabetes.
By Krisha McCoy
Medically Reviewed by Pat F. Bass III, MD, MPH
Scientists and physicians have been documenting the condition now known as diabetes for thousands of years. From the origins of its discovery to the dramatic breakthroughs in its treatment, many brilliant minds have played a part in the fascinating history of diabetes.

Diabetes: Its Beginnings

The first known mention of diabetes symptoms was in 1552 B.C., when Hesy-Ra, an Egyptian physician, documented frequent urination as a symptom of a mysterious disease that also caused emaciation. Also around this time, ancient healers noted that ants seemed to be attracted to the urine of people who had this disease.

In 150 AD, the Greek physician Arateus described what we now call diabetes as "the melting down of flesh and limbs into urine." From then on, physicians began to gain a better understanding about diabetes.

Centuries later, people known as "water tasters" diagnosed diabetes by tasting the urine of people suspected to have it. If urine tasted sweet, diabetes was diagnosed. To acknowledge this feature, in 1675 the word "mellitus," meaning honey, was added to the name "diabetes," meaning siphon. It wasn't until the 1800s that scientists developed chemical tests to detect the presence of sugar in the urine.

Diabetes: Early Treatments

As physicians learned more about diabetes, they began to understand how it could be managed. The first diabetes treatment involved prescribed exercise, often horseback riding, which was thought to relieve excessive urination.

In the 1700s and 1800s, physicians began to realize that dietary changes could help manage diabetes, and they advised their patients to do things like eat only the fat and meat of animals or consume large amounts of sugar. During the Franco-Prussian War of the early 1870s, the French physician Apollinaire Bouchardat noted that his diabetic patients' symptoms improved due to war-related food rationing, and he developed individualized diets as diabetes treatments. This led to the fad diets of the early 1900s, which included the "oat-cure," "potato therapy," and the "starvation diet."
In 1916, Boston scientist Elliott Joslin established himself as one of the world's leading diabetes experts by creating the textbook The Treatment of Diabetes Mellitus, which reported that a fasting diet combined with regular exercise could significantly reduce the risk of death in diabetes patients. Today, doctors and diabetes educators still use these principles when teaching their patients about lifestyle changes for the management of diabetes.
Diabetes: How Insulin Came About

Despite these advances, before the discovery of insulin, diabetes inevitably led to premature death. The first big breakthrough that eventually led to the use of insulin to treat diabetes was in 1889, when Oskar Minkowski and Joseph von Mering, researchers at the University of Strasbourg in France, showed that the removal of a dog's pancreas could induce diabetes.

In the early 1900s, Georg Zuelzer, a German scientist, found that injecting pancreatic extract into patients could help control diabetes.

Frederick Banting, a physician in Ontario, Canada, first had the idea to use insulin to treat diabetes in 1920, and he and his colleagues began trying out his theory in animal experiments. Banting and his team finally used insulin to successfully treat a diabetic patient in 1922 and were awarded the Nobel Prize in Medicine the following year.

Diabetes: Where We Are Today

Today, insulin is still the primary therapy used to treat type 1 diabetes; other medications have since been developed to help control blood glucose levels. Diabetic patients can now test their blood sugar levels at home, and use dietary changes, regular exercise, insulin, and other medications to precisely control their blood glucose levels, thereby reducing their risk of health complications.

Maxy sez : Regaining Your Energy With Type 2 Diabetes: Tips to Prevent Fatigue

Living with diabetes can be tiring, not just from the actual diabetes symptoms but also from managing the condition in general. These simple steps can help fight fatigue from diabetes and boost energy.

 By Barbara Sadick

Medically Reviewed by Bhargavi Patham, MD, PhD

Getting exercise regularly can help you boost energy and maintain a healthy body weight — both important for improving your diabetes symptoms.Getty Images

No, it's not your imagination: Taking care of yourself when you have type 2 diabetes can be exhausting. Diabetes-related fatigue is common, and you may be feeling it from a variety of sources — your type 2 diabetes symptoms themselves, exhaustion from the responsibilities of managing diabetes daily, ineffective diabetes management, or even from other underlying conditions.

Understanding Diabetes-Related Fatigue

There are strong associations between diabetes and testosterone levels, kidney disease, and other health complications, all of which can cause you to become very tired, says Ronald Tamler, MD, medical director of the Mount Sinai Clinical Diabetes Institute at Mount Sinai Hospital in New York City. There’s also a link between diabetes and depression, he adds, and depression is a common cause of extreme fatigue.

According to a study published in June 2014 in the journal Current Diabetes Report, depressive symptoms affect up to one-third of people with diabetes. The research also found that depression not only impairs quality of life but also adds to the difficulties experienced in diabetes self-management.

"The research highlights a wide range of potential explanations for the association between diabetes and depression, which include having a sedentary lifestyle, eating a diet high in refined sugars, sleeping poorly, and experiencing brain dysfunction due to low and high blood sugars, as well as chronic inflammation that is associated with diabetes," says David Lam, MD, associate director of the Mount Sinai Diabetes Center at Mount Sinai Hospital in New York City.

Other causes of fatigue from diabetes include cells being deprived of sugar, high blood sugar, dehydration from increased urination, loss of calories, and sleep apnea. Graham McMahon, bachelor of medicine and bachelor of surgery, the president and CEO of the Accreditation Council for Continuing Medical Education and an adjunct professor of medical education at the Northwestern University Feinberg School of Medicine in Chicago, says that high blood pressure, nerve damage, and other underlying physical conditions can be a direct cause of exhaustion.

Pinpointing a Cause of Fatigue

“Don’t take fatigue for granted,” Dr. McMahon says. “It needs to be investigated.” Some people may need to undergo a sleep study for possible sleep apnea, while others should be tested for anemia, and still others may need to be treated for stress and depression.

Reasons you may be tired from diabetes can be more subtle than you might think. If you’re not getting the energy you need from food, or you’re skipping meals, you’ll be tired. If you’re overweight, you may be at risk for sleep apnea, a serious condition in which breathing problems cause poor-quality sleep that can in turn deplete your energy. These problems can also make diabetes symptoms worse.

Being tired from diabetes is a serious barrier to being active, taking good care of oneself, and properly using medication to stabilize your blood sugar levels. The good news, though, is that a lack of energy doesn’t have to be a permanent way of life.

Boosting Energy

Following these tips to help boost energy may go a long way toward improving your diabetes symptoms and your quality of life:

Be sure to see your doctor regularly.

Eat a healthy, nutritious diet and don’t skip meals.

Move more. Exercise boosts energy and helps you lose extra weight or maintain a healthy weight.

Keep blood sugar levels in control.

Sleep is critical, so get seven to eight hours a night and never less than six hours.

If you’re depressed, get treatment.

If you’re stressed, ask your doctor for ways to manage it.

If you think you may have sleep apnea or other sleep problems, seek treatment.

Adjusting to a Healthier Lifestyle

Because of the great amount of management it takes to live a healthy life with type 2 diabetes symptoms, you’re likely to experience a lack of energy at times. The more complex the diabetes, the more you’ll need to do to keep your blood sugar levels in normal range. And the more work it takes to control blood sugar levels, the more tired you’ll likely become.

But as you continue to become more educated about diabetes — with as much support as you can get from family and friends — you’ll begin to adjust to eating better, exercising more, sleeping better, and keeping your blood sugar levels in check. Once you’ve made the choice to be healthier, you’ll find yourself less fatigued and more energized.

Maxy sez : A Diabetes Diagnosis After Age 50 May Be an Early Sign of Pancreatic Cancer in Black, Latino People

The findings may help doctors identify more people at risk for the potentially deadly cancer.
By Sheryl Huggins Salomon         Medically Reviewed by Kacy Church, MD
A type 2 diabetes diagnosis after age 50, called late-onset diabetes, is a known risk factor for pancreatic cancer, and in Latino and African-American people with diabetes who are diagnosed with pancreatic cancer within three years, pancreatic cancer itself may manifest as diabetes.

That’s what a study published June 18 in the Journal of the National Cancer Institute suggests, and the findings may help doctors identify more individuals at risk for pancreatic cancer, which has poor survival rates because doctors often don’t catch the disease early enough for treatment to be effective. Pancreatic cancer has a five-year survival rate of only 8.5 percent, according to the National Cancer Institute (NCI).

For the current study, authors studied the incidence of type 2 diabetes and pancreatic cancer in nearly 49,000 African-American and Latino people older than 50. From 1993 to 2013, about 32 percent, or about 15,800, of the study participants developed diabetes. During follow-up, researchers identified an additional 408 pancreatic cancer cases.

Over the study period, about 20 years, they found that diabetes was associated with a twofold risk of pancreatic cancer. But when researchers stratified the data, they observed the risk for pancreatic cancer was even higher among participants diagnosed with diabetes in the previous three years (called recent-onset diabetes). Within that time period, Latinos were four times more likely to develop pancreatic cancer, and African-Americans were three times more likely.

“Our results suggest that late-onset diabetes can be used as a marker to narrow down who is in a high-risk group for pancreatic cancer,” says the lead study author, V. Wendy Setiawan, PhD, an associate professor of preventive medicine at the Keck School of Medicine of the University of Southern California in Los Angeles. “Physicians should be aware that while the chance [of developing pancreatic cancer] is low, recent-onset diabetes could be an early sign of pancreatic cancer,” she adds.

The Association Between Pancreatic Cancer and Type 2 Diabetes in Minorities
The pancreas is a gland behind the stomach that secretes digestive enzymes and releases hormones, such as insulin and glucagon, that help to control blood glucose (sugar), according to Johns Hopkins University. According to the NCI, about 1.6 percent of people in the United States will be diagnosed with pancreatic cancer at some point in their lifetime.

The incidence of pancreatic cancer among black people specifically is about 25 percent higher than it is in white people, according to the American Cancer Society. Yet, says Setiawan, “Blacks and Latinos are understudied, and thus very little is known about the relationship between diabetes and pancreatic cancer in these two populations.”

Additionally, both black and Latino people have higher rates of type 2 diabetes than the general population, according to the American Diabetes Association. That’s why her team focused on those groups.

Rahil Bandukwala, DO, an endocrinologist at MemorialCare Saddleback Medical Center in Laguna Hills, California, who wasn’t involved in the research, says the results seem to align with what he’s seen in his nearly 20 years of practicing medicine, but he would be interested in seeing more long-term data. He notes a limitation of the study that the authors acknowledge in their paper: The research relied on self-reporting when determining the diabetes diagnoses, Medicare claims, and hospital discharge records. And so the recorded onset dates may have been imprecise. “It would be good to better understand when the diabetes truly came about and follow the participants out from there — to see who gets pancreatic cancer and who doesn’t.”

But previous research seems to support the current study’s findings. For example, nearly 40 percent of people with pancreatic cancer had also developed diabetes within the three years prior to their cancer diagnosis, according to the findings of a review of 500 medical records that was published in the March 2013 issue of Pancreas.

A Need for Better Pancreatic Cancer Screening Tools
Michael Choti, MD, a surgical oncologist at Banner MD Anderson Cancer Center in Gilbert, Arizona, who specializes in pancreatic cancer, says that study results so far, while interesting, aren’t cause for alarm. “Patients who develop late-onset diabetes shouldn’t panic and think Oh my God, that means I’m going to develop pancreatic cancer,” says Choti, who wasn’t involved in the current research.

But he notes that pancreatic cancer rates are on the rise, and current screenings for the disease fall short. Given that pancreatic cancer can be aggressive and survival rates so poor, he argues that better tools are needed to screen for early signs. “We don’t really have any screening tools, and even imaging [methods] of the pancreas, such as a CAT scan or MRI of the pancreas, are not perfect,” Choti explains. According to the U.S. Preventive Services Task Force, there are no official guidelines for pancreatic cancer screening.

Setiawan agrees with Choti. “There is an urgent need to find better ways to identify patients with early cancer in the group of patients who develop diabetes after age 50,” she says, adding that her team at the Consortium for the Study of Chronic Pancreatitis, Diabetes, and Pancreatic Cancer are “working diligently to develop tests that can better identify patients with recent onset diabetes who actually have pancreatic cancer at its earliest stage.”

“Finding the cancer at an early stage and treating it with surgical removal provides the best chance for a cure of the disease,” she adds.

Wise Advice about Life

1. Have the courage to live a life true to yourself, not the life others expect of you.

2. Never attribute to malice that which can be adequately explained by stupidity.

3. “There is nothing noble in being superior to your fellow man; true nobility is being superior to your former self.” Ernest Hemingway

4. Don’t make decisions when you’re angry. Don’t make promises when you’re happy.

5. “Never argue with a stupid person, they’ll drag you down to their level and beat you with experience.” Mark twain

6. Only pack what you can carry yourself.

7. Remember you’ll always regret what you didn’t do rather than what you did.

8. “You’d worry less about what people think about you if you knew how seldom they do.” David Foster Wallace

9. If you blame it on someone else, don’t expect it to get better.

10. “You can be the ripest, juiciest peach in the world, but there will always be someone who hates peaches.” Dita von Teese

11. If the grass is greener on the other side, there’s probably more manure there.

12. Don’t give up what you want most for what you want now.

13. With regards to the opposite sex: If you look hungry, you’ll starve.

14. “Never let your sense of morals prevent you from doing what is right.” Isaac Asimov

15. Strive to be the man you want your daughter to marry.

16. “Remember only enemies speak the truth. Friends and lovers lie endlessly, caught in the web of duty.” Stephen King

17. Never forget your car keys will change your car from one tonne of inert metal into one of the most deadly killing machines that has been invented.

18. Wait 24 hours before getting mad and reacting about anything. If it doesn’t bother you in 24 hours time, it probably isn’t important enough to get mad over.

19. Never make someone a priority who only makes you an option.

20. Try not to take anything personally. No one thinks about you as much as you do.

21. “If you want to know what a man’s like, take a good look at how he treats his inferiors, not his equals.” Sirius Black

22. Figure out what you love to do, and then figure out how to get someone to pay you to do it.

23. If you treat a woman like a queen, and she treats you like a jester, your princess is in another castle.

24. Whenever something happens that makes you sad, ask yourself whether you’d still care about it when you’re ninety.

25. Be persistent. When knowledge and ability aren’t enough, be persistent.

26. “Life is scary. Get used to it. There are no magical fixes. It’s all up to you. So get up off your keister, get out of here, and go start doin’ the work. Nothing in this world that’s worth having comes easy.” Bob Kelso

27. Smart girls like to hear they’re pretty, pretty girls like to hear that they’re smart.

28. Happiness is a choice and everything else is a matter of perspective.

Maxy sez ::What your pee means ---3 red flags What Your Urine Says About Your Health

BY PATRICK SULLIVAN
Clear as urine. That’s not the expression, but perhaps it should be, at least when urine is healthy. Perfectly normal urine tends to be a pale, straw color or a clear yellow. “A lot of people don’t realize that when you’re well-hydrated, your urine should be close to running water,” explains urologist Arthur Crowley, MD. “People are confused about that. They’ll say it looks great but it’ll be dark.”

Urine gets its yellow color from a pigment called urochrome. “It has to do with the way the kidneys break things down,” says Dr. Crowley. In addition, healthy urine has a slight, mild smell. But what if your pee has a strong odor, or isn’t a mellow yellow? What if it’s pink? Or red? Chances are the cause is innocuous, but there are times when your body may be telling you something about an underlying medical condition.

What’s that smell?
Normal urine should smell unobtrusive, but there are several reasons why you might notice a stronger odor wafting up from the bowl. Dehydration can cast a distinct aroma if your urine isn’t as diluted as usual, signaling that you need to drink up. Vitamins—namely vitamin B6—and certain foods are other common suspects. “Vitamin B6 has a strong odor, almost like old urine,” says Crowley. “It’s more a nitrogen-type smell.” Garlic can make your pee as stinky as your breath, and asparagus is well known for scenting your urine, giving off a sulfur-like smell.

Sometimes, though, the smell may be a sign of trouble. Diabetics often have sweet-smelling urine due to the presence of sugar. A urinary tract infection (UTI) is another condition that brings along a strong smell, “almost like gunpowder,” says Crowley. “The bacteria that causes a UTI will split the urea molecules in urine apart, releasing the smell.”

(Not so) pretty in pink
Red or pink urine could indicate the presence of blood, but don’t panic just yet. Blueberries and rhubarb (did you overindulge in pie recently?) can do it. So can beets. Certain medications, such as senna laxatives or even ibuprofen, can cause blood in the urine. Crowley says if a lab analysis reveals no red blood cells in your urine sample, it’s probably something you ate. If it’s not your diet, blood in the urine may be a symptom of UTIs, bladder stones and cancer of the kidneys or bladder. It may also be due to long-distance running (joggers’ hematuria) or other strenuous exercise. If you haven’t recently chowed down on veggies that may be behind the color change, see your primary care physician and have a sample taken.

Very dark urine
If you’ve thought all along that dark-colored urine is the norm, think again. Severe dehydration is the best-case scenario for urine that’s amber or orange in color. Fortunately, it’s the most common diagnosis, according to Crowley. The fix is easy enough: Drink more water. If your urine is still dark, you might need to replenish your electrolytes as well. Sports drinks and Pedialyte can help.

But if dehydration isn’t causing the dark hue, it could be something more serious. “Cirrhosis of the liver and hepatitis are possibilities,” says Crowley. With liver issues, a pigment called bilirubin is turning the urine dark. “Bilirubin results from the breakdown of old red blood cells and normally can be converted to a water soluble substance by the liver,” Crowley says. If the liver is damaged, the bilirubin does not get broken down and passes through the bladder as a dark discoloration.

Maxy sez : Types of Vaginal Infections

Burning, itching, and an unpleasant odor are just some of the common symptoms of vaginal infections. But treatments vary by condition, so it's important to know which type of vaginal infection you have.
By Beth W. Orenstein
Medically Reviewed by Lindsey Marcellin, MD, MPH
Vaginal infections, or vaginitis, are very common — so much so that most women will experience some form of vaginal infection or inflammation during their lifetime.

“To the gynecologist, vaginitis is a vaginal discharge with or without itching and burning, with or without an odor,” says Gregory R. Moore, MD, MPH, an obstetrician-gynecologist and director of the University Health Service at the University of Kentucky in Lexington.
Some women seem to be more prone to vaginal infections than others for reasons that are not entirely obvious, Dr. Moore says.

What Upsets the Normal Vaginal Balance
A healthy vagina has many bacteria and yeast. However, some things can disturb that healthy balance. These include:
Douches
Hormone level changes
Antibiotics
Vaginal intercourse
Pregnancy and breastfeeding
The Most Common Types of Vaginal Infections
There are three very common types of vaginal infections, says Cynthia Krause, MD, assistant clinical professor of obstetrics and gynecology at Mount Sinai School of Medicine in New York City.

Yeast infections. The most common type of vaginitis, a yeast infection is caused by one of the many species of fungus known as Candida. Candida live naturally in your body in small numbers, including in the vagina, and usually don't cause any harm.

However, Candida thrive in a warm, moist, airless environment and, under those conditions, can grow in number, causing a vaginal infection. Dr. Krause says, “There are many species of yeast or Candida — Candida albicans is the most common.”

Symptoms of a vaginal yeast infection include a thick, white discharge that some women describe as resembling cottage cheese. Yeast infections also can cause vaginal itching and redness of the vulva (the lips of the external female genital area) and vagina.

Bacterial vaginosis. Along with yeast, “friendly” bacteria called lactobacilli live in the vagina. When the number of lactobacilli gets too low, it can trigger a condition called bacterial vaginosis (BV).

Why bacteria levels change is not known, but the normal lactobacilli can be replaced by other infection-causing bacteria. “Gardnerella is the bacteria most often associated with bacterial vaginosis,” Krause says. “It is the lack of lactobacilli and overgrowth with these other bacteria that cause the symptoms of infection.”

With bacterial vaginosis, a woman may see a thick or whitish discharge or one that is slippery and clear. It is not likely to itch or burn. A fishy odor may be noticeable, especially during intercourse.

Trichomonas. “Of the three most common vaginal infections, trichomonas vaginitis is the only one that is a true sexually transmitted infection,” Krause says. Commonly called “trich,” it is caused by a single-celled parasite, trichomonas vaginalis, and is passed from partner to partner during intercourse.

The symptoms of trichomonas vaginitis are similar to other vaginal infections: burning, irritation, redness, and swelling of the vulva, with a yellow-gray or greenish vaginal discharge, possibly with a fishy odor. Some women also experience pain during urination.

Other common vaginal infections and causes of vaginal itching include:

Chlamydia vaginitis. Chlamydia is a sexually transmitted disease that can cause inflammation of the vagina. Some women will have a discharge with chlamydia and some will not. A more common symptom is bleeding, especially after intercourse. “Sexually active women up to age 26 should be tested annually for chlamydia because it so often comes without symptoms and can linger and do a fair amount of damage to fertility,” Moore says.
Noninfectious vaginitis. Noninfectious vaginitis is when the skin around the vagina becomes sensitive to an irritant such as scented tampons, perfumed soaps, or fabric softeners. This is not an infection, and the solution is simple: “Not to be exposed to whatever you are having a reaction to,” Moore says.
Vulvodynia. This is a condition in which women have chronic pain or discomfort of the vulva without a known cause. The symptoms are similar to vaginal infections: burning, stinging, rawness, soreness, and swelling. Symptoms may be constant or occasional.
Viral vaginosis. Viruses also can cause vaginal infections. Most viruses are spread through sexual contact. “The herpes simplex virus is a common cause of viral vaginosis,” Moore says. Symptoms include pain in the genital area from lesions or sores. Most of the time, you can see the sores on the vulva or vagina, but they can also be hidden and seen only during an examination by your gynecologist.
Treatment for Vaginal Infections

All of these infections can be treated, but it is important to know which infection you have so that the right medication is prescribed.

“Yeast medication is available over the counter if you are certain that it is a yeast infection,” Krause says. “Sometimes women think they have a yeast infection and it is actually something else. If you try over-the-counter medications and they don’t work, you should see a doctor.”