The vaginal lining, also known as the epithelium or mucosa, is a normally thick, moist, folded surface of mucous membranes that collapses on itself. Beneath the mucosa, muscular and fibrous tissue allow the vagina to expand or contract and to connect to pelvic structures. Nerve endings are concentrated near the outside vaginal opening, or introitus. Blood vessels near the surface of the epithelium become engorged during sexual arousal, increasing lubrication of the mucosa. Age, medications, and infections can cause changes in the vaginal lining that may lead to disease conditions.
Vaginal Atrophy
The lining of the vagina may become thin, dry and inflamed due to diminishing estrogen during breastfeeding, menopause, or side effects of some medications, according to the MayoClinic.com. Atrophied mucosa is more vulnerable to injury and resulting fissures, or tears or cracks in the vaginal lining. Information from the Women's College Hospital in Toronto, Canada, says the most common cause of such injuries is sexual intercourse without adequate lubrication. Vaginal atrophy also increases a woman's risk of urinary tract infections. Birth control medications with a high progesterone content may cause or worsen vaginal atrophy, as can antihistamines, tranquilizers, tobacco and marijuana.
Bacterial Vaginosis
In women of childbearing age, the most common cause of odorous vaginal discharge is bacterial vaginosis, according the the Centers for Disease Control and Prevention. BV is associated with altered pH of the bacterial mucosa and an overgrowth of harmful bacteria. Pregnant women and those who have a new partner or multiple partners are most at risk for BV. Pain, burning and itching of vaginal mucosa are other possible symptoms. Bacterial vaginosis can be treated with antibiotics.
Candidiasis
Redness, itching, and irritation of the vaginal lining and external labia indicates infection with yeast organisms, or candidiasis. White clumpy discharge with a yeasty odor is typical. Pregnant women, diabetics, and those with compromised immune systems are most vulnerable to candidiasis infection. Candida is a fungus, part of the normal flora inhabiting a healthy vagina and kept in check by friendly bacteria that compete for space and nutrients. When the balance is disturbed, for example when antibiotic medications kill the friendly bacteria, a fungal overgrowth occurs that produces symptoms. The National Institutes of Health advises women not to douche or to use feminine sprays that can disturb the mucosal balance, and to wear loose fitting porous clothing. Recurrent yeast infections may be linked to more serious underlying conditions and should be evaluated by a health care professional.
Trichomonas
A sexually transmitted infection, trichomonas, is a parasite that invades the vaginal tissues. Symptoms include a green or yellow frothy discharge, itch, and pain on intercourse. The infection is less likely to produce symptoms in men. Treatment of trichomonas during pregnancy is complex; the most effective antibiotics are thought to cause preterm labor. Additionally, treatment may not prevent pregnancy complications, such as premature birth, associated with trichomonas infection. Researchers from the Oklahoma University Health Science Center, in an analysis published in the February 2006 issue of "Expert Review of Anti-infective Therapy", concluded that treatment of trichomonas during pregnancy is controversial.
References
- MayoClinic.com: Vaginal Atrophy
- Women's Health Matters: Preventing Vaginal Fissures
- Centers for Disease Control and Prevention: Bacterial Vaginosis
- National Institute of Allergy and Infectious Diseases: Vaginal Yeast Infection Transmission
- "Expert Review of Ani-infective Therapy"; Trichomoniasis and its Treatment; N. Nanda; February 2006
