Itchy, irritating and often embarrassing, vaginal and urinary tract infections can be quite a pain. Dr Parul R Sheth explains how to deal with them

FOR the past two years, I keep getting either a fungal infection or a urinary tract infection (UTI). In spite of following good hygiene even before and after sex, the problems persist. Do I have to live with them?" questions Lata, 28.

"My husband and I don't want children at present. I have been on an oral contraceptive for a year. I have been getting recurring bladder infections every now and then. Despite following good hygiene and taking medications, I end up with UTIs. I am going crazy," expresses Shruti, 23.

Any woman who has had a UTI or a vaginal infection knows how frustrating it is. Nearly 50 per cent of women have experienced a UTI at some time or other. The urethral opening in women is close to the vagina as well as rectum and because of their proximity, it is easy for the germs to contaminate the urethra and the vagina. With proper treatment, the symptoms resolve quickly but often recur with alarming frequency. Yet, a few preventive measures can save you from recurring infections.

Banish The UTIs
Normally, your pee is free of bacteria, viruses and fungi. It includes waste products from your body. A UTI refers to an infection anywhere in the urinary system - bladder, ureters, urethra or kidneys. The most common occur in the lower tract, which may then spread upward into the upper tract. Once the germs gain access to the urethra, the infection can travel right up through the ureters into the kidneys, giving rise to more serious infections.

Triggers: The main culprits are the E coli bacteria that travel from the rectal opening to the urethral opening. Excessive friction or inadequate lubrication during sex may irritate the area around the urethral opening making it easier for the bacteria to infect it. A higher incidence of UTIs occurs in pregnant women.

The use of diaphragm or spermicides for contraception, conditions such as kidney stone and diabetes, a family history, some sanitary napkins and tampons, a habit of holding urine for long periods of time.

Symptoms: Fatigue, the urge to pee often, pain or burning during urination, cloudy or bloody or foul-smelling pee, lower back pain, fever and chills, nausea and dizziness.

What do I do? A routine urine test helps to confirm the presence of infection. Control the infection while it is still in the bladder. Antibiotics work best. Even if you feel better after two days of the treatment, take the entire course to completely wipe out the infection. Incomplete treatment may encourage drug resistance and a relapse.

Eeky Blues
If you are being troubled with inflammation and infection of the vulva and vagina, you are far from alone. Vulvovaginitis is the most common gynaecological disorder today. Normally, vaginal discharge is clear, slightly milky and slippery and yellowish when dry. But it changes in response to your monthly cycle - for instance, the discharge becomes clear and stretchier at the time of ovulation.

The secretion increases when you're aroused. Bacteria in the vagina helps keep the acidic balance. Vaginitis is caused by vaginal infections, the most common ones being bacterial vaginosis, yeast infection or candidiasis and trichomoniasis. Lab tests, including microscopic evaluation of the vaginal fluid, can confirm the type of infection you have.

Triggers: Low resistance, pregnancy, diabetes, use of birth control pills, etc.

Symptoms: An abnormal, smelly discharge with itching and burning.

What do I do?: There are different types of vaginitis, but all are treated with antibiotics. The most common therapy is metronidazole.

The Yeast Beast
Three out of four women may experience at least one yeast infection at some point; many others may experience recurrent infections. Candida albicans, a fungus causes yeast infection.

Triggers: Stress, poor diet, illness, lack of sleep, use of birth control pills, etc. Pregnant women and diabetics are at a higher risk.

Symptoms: If you experience itching and soreness inside the vagina, you get a thick cheesy vaginal discharge, burning around the vaginal opening, and pain or discomfort during sex, you may be suffering from a yeast infection.

What do I do?: Visit your gynaec, who will most likely suggest anti-fungal medications in the form of tablets, creams, ointments or suppositories.

How Not To Let It Happen
• Drink plenty of fluids
• Avoid caffeine and alcohol; they can irritate the bladder
• Do not hold your pee
• Drinking cranberry juice can help
• Make sure you are lubricated enough during sex
• Wipe from front to back after a pee or a crap
• Keep all your parts down there clean and dry
• Avoid using soaps and douches
• Change sanitary napkins and tampons frequently
• Clean diaphragms, cervical caps and medical applicators after use
• Wear loose cotton underwear
• Do not sit in a wet bathing suit for long