Gynecological infections

The most frequent causes

• Candidiasis: itching, thick white discharge, sometimes odorless.
• Bacterial vaginosis: thin discharge with a fishy smell, often without itching.
• Sexually transmitted infections, such as chlamydia, gonorrhea, trichomoniasis.

Symptoms overlap, so they cannot be told apart with certainty from the complaint alone. New discharge with odor, blood or pain needs assessment.

Pelvic inflammatory disease and ectopic pregnancy

Untreated infections, especially chlamydia and gonorrhea, can ascend to the uterus and tubes (pelvic inflammatory disease). It causes pelvic pain, fever and discharge, and can leave adhesions that reduce fertility and raise the risk of ectopic pregnancy. Early diagnosis and treatment with antibiotics protect fertility. Partners are treated when the infection is sexually transmitted.

Prevention, correct behavior and common mistakes

The vagina has a normal microbial ecosystem, dominated by lactobacilli, which maintains acidity and prevents the growth of harmful microbes. Vaginal douching, perfumed soaps, excessive intimate hygiene and frequent use of antibiotics weaken this balance and raise the risk of bacterial vaginosis or candidiasis. External washing with warm water and mild soap is enough; cotton underwear and avoiding tight, damp clothes during the day help. If you have diabetes, glucose control reduces recurrent candida infections.

The most frequent mistake is self-treating every discharge with an antifungal without confirmation: candidiasis is the cause in only some cases, while bacterial vaginosis and trichomoniasis require other medicines and may worsen or recur. If symptoms do not clear within a few days, if they recur more than four times a year, or if they have accompanied a new partner, assessment is needed. During treatment avoid intercourse or use a condom, and complete the full course even when symptoms disappear.

Sexually transmitted infections and pregnancy

Chlamydia and gonorrhea often cause no symptoms in women, so they can go unnoticed and cause damage to the tubes. For this reason sexually active people with new or multiple partners, especially under 25, do well to be tested regularly and to inform partners so they can be treated. Any symptom such as pain during intercourse, bleeding after intercourse or persistent pelvic pain is a reason for assessment. Testing is done with vaginal or urine samples and blood tests for infections such as HIV, syphilis and hepatitis B when indicated.

In pregnancy, abnormal discharge and genital infections are assessed carefully, because some are linked to preterm birth and to infections in the newborn; medicines are chosen only by the doctor. The HPV and hepatitis B vaccines are part of prevention. Abdominal pain in early pregnancy with bleeding is an emergency and should not be waited out.

Diagnosis and treatment

The doctor asks about symptoms and sexual contacts; vaginal samples and urine or blood tests are done as suspected. Antibiotics or antifungals are chosen by cause, not for every discharge. Recurrent infections require reassessment of the cause (diabetes, frequent antibiotics, hormonal changes). Condom use reduces the risk of sexual infections. Distinguish it from urinary infections, which cause burning when urinating.

Care at Tirana Polyclinic: we offer gynecology consultation and interpretation of tests. Special samples and imaging examinations may be performed at other centers. Reviews are as needed, every 6 months to a year for recurrent infections, or sooner when the doctor considers it reasonable.