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Öznur KARAER BOZKURTwas born in 1972 in Mut-İçel. She graduated from İçel Anatolian High School in 1990 and Hacettepe University Faculty of Medicine in 1996. She completed her residency at Manisa Celal Bayar University Faculty of Medicine in 2001 and received the title of Obstetrician and Gynecologist.

She carried out scientific research studies at Turku University in Finland with a scholarship of the Ministry of National Education. After completing her residency, she worked at the same university for 2.5 years as a specialist and assistant professor. She started to work at Private Yenişehir Hospital in April 2017.

Dr. KARAER BOZKURT has many articles published in national and international scientific journals and he has good command of English. She is married and has two sons named Alp and Emre.

Article: Vaginal Infections

Vaginal discharge is the most common condition that causes women to consult gynecologists and obstetricians. Vaginitis namely Vaginal Infections occurs due to infections of the vagina, fungal, parasitic or bacterial infections. In some cases, two or all of these factors cause the infection.

Approximately 75% of women have at least one vaginal infection attack in their lives, and a significant portion of them have two or more per year. Vaginal fungal infections increase as the genital area remains moist due to sweating in summer. Normally, mycosis is present in vaginal flora, as they are in equilibrium with the lactobacillus (Döderlein bacillus-beneficial bacteria), which provide an acidic environment in the vaginal region, no infection occurs.

In case of antibiotic use, pregnancy, diabetes and a number of diseases that cause suppression of the immune system, the number of lactobacillus reduces and the risk of vaginal fungus increases. Especially in summer, synthetic clothes and tight pants that cause the genital area to remain moist increase the risk of fungal infection. Apart from these, it is seen that these complaints increase in summer months and especially after the pool. Contrary to popular belief, fungal spores are activated as a result of killing of beneficial bacteria in vaginal flora by chlorine in the pool water.

The most common symptom of vaginal fungal infection is itching and burning sensation in the vagina. In this case, redness and edema occur in the external genital organs. Itching in fungal diseases is usually very severe. Sometimes abrasions and minor bleeding may occur on the skin of that area due to scratching. Generally, patients may have a white, odorless, milk-like discharge. In addition to these symptoms, severe fungal infections may cause burning during urination, tingling in the areas where the urine touches, and pain during intercourse.

Such infections, which are quite common in women, may be treated by vaginal topping, creams and oral medications. The symptoms may relieve within 1-2 days. A few simple measures can be useful to prevent this infection that may cause the patient suffer. First of all, synthetic clothes and tight clothing should be avoided to prevent the genital area to remain wet and damp and cotton and comfortable underwear should be preferred.

In addition, instead of the cleaning of the genital area with cleaning products that may cause irritation such as normal soap, perfumed cosmetic products, the soaps produced specifically for this region should be used. In addition, in order to keep the genital area dry during the summer months, women should not stay in wet swimsuits or bikinis and take a shower after the pool to remove chlorinated water. Women should take the complaints such as discharge, itching and burning arising at any time seriously and should consult a gynecologist and obstetrician in case of any problems.
Trichomonas infection is a parasitic sexually transmitted disease. Although it is frequently associated with vaginitis and cervical infection, it has recently been mentioned in premature birth, premature opening of the membranes during pregnancy, and the formation mechanisms of postoperative infections in the upper genital system.  Having a large number of sexual partners or not using barrier or hormonal control methods, and having previous sexually transmitted diseases increase the risk of infection. The transmission rate is 85% for females and 70% for males within 48 hours following the intercourse. The infection is asymptomatic in 50% of the cases. 50-75% of infected women has discharge. The foamy yellow-green discharge described typically is observed in less than half of these patients. No immunity acquired against the discharge. Vaginal PH is increased in 90% of the cases. The diagnosis of the infection is made with a fresh preparation or pap smear. Because it is a sexually transmitted disease, it requires treatment of the couples.

Atrophic vaginitis is a clinical condition characterized by a decrease in the secretions of the superficial glands, thinning of the vaginal epithelium, and a decrease in elasticity and slippery caused by the lack of estrogen hormone in menopausal women. Over the time, vaginal dryness, pain during intercourse, tenderness may develop. Secondary infections are common in vaginal tissue that has lost its hormonal support. Topical estrogenic creams or tablets and vaginal lubricants are used for the treatment.

Mycoplasmas are different organisms that do not fall into the category of bacteria or viruses. Genital mycoplasma infections occur due to increase and colonization of mycoplasmas after intercourse, which is available in small numbers in normal throat and genital flora. It is considered that they may be available in habitual abortions.  Cervical culture is used for diagnosis. The treatment is applied to the couples with doxycycline for two weeks.

The most important matter about discharges is to recognize normal and abnormal discharge and to get rid of personal habits and hygienic errors that may cause. Followings should be done to avoid diseases with discharge;

• After intercourse and after menstruation, the inside of the vagina should not be washed (vaginal douche).
• The cleaning in the toilet should be made from front to back.
• Wet, sweaty clothes or swimsuits should not remain on the body for a long time after bathing, swimming pool, sauna and exercise.
• It should be ensured that the common areas such as swimming pool, Turkish bath, sauna, bathtub are clean.
• If you have a polygamous sex life, condom should be used for protection.
• Underwear should be made of natural (cotton) materials.
• Vaginal tampons and pads should be changed frequently.
• Deodorants, perfumes or soaps (except those with neutral pH and those used on doctor's advice) should not be used at the vaginal opening for odor.
• Tight pants, tight underwear should not be used.
• Regular pap-smear test should be performed.
• Diabetes should be under control. Fungal infections are reported to be more frequent due to the use of sweeteners. However, this can often be due to the cause of diabetes.
• Vaginal discharge may be more common in summer, as it is difficult to follow the  recommendations above in summer and holidays. Therefore, hygienic rules must always be obeyed with great care.