What is Toilet Infection?
“Toilet Infection does not actually exists as a disease in Medicine“; Any non-medical person will refer to an infection around the Vagina as toilet infection. This article is to enlighten women especially non-medical women on what they refer to as “Toilet infection”, and also for its prevention and care.But before I continue, it is good we get some common terminologies clearly.
Common Medical Terms used to differentiate types of Toilet infections and Sexually Transmitted Diseases (STDs)
- Toilet Infection: This term does not exist in the medical field. If someone says I have toilet infection they could be referring to infection affecting the Vagina, or Sexually Transmitted Infections.
- Sexually Transmitted Infection (STI): This refers to infection that is transmitted mainly by sex. But it must not affect the Vagina only. It can affect anywhere in the body and can affect both male and female. I said “mainly by sex” because sexually transmitted infections can be gotten even without sex such as Hepatitis, Human Papilloma Virus infection and HIV; also Gonorrhea can be transmitted to a baby from the mother through child birth.
- Vaginal Infections: These are infections that affect the Vagina and could be cause by three major types of germs or agents. They are transmitted “mostly” by carelessness, or poor personal hygiene rather than sex.
- Vaginitis: This refers to the redness, soreness, and pain experience in the Vagina when you have Toilet Infections.
I will continue to use the term Toilet Infection to refer to the correct term Vaginal Infections becauseMedically, We know Vaginal Infection, but people are used to “Toilet Infection”. So for the sake of clarity, “Toilet Infection” will be use through out.
Types of Vaginal Infections and Microorganisms that CauseToiletInfections
This is the number one cause of all Toilet infections and out of 100 women that you will find with toilet infections, 50 of them will have Bacterial Vaginosis.This infection is caused by a change in the type of bacteria normally found in the vagina and causes an overgrowth of organisms such as Gardnerella vaginalis in the vagina.
You can get bacterial vaginosis if you do vaginal douching or you insert intrauterine device (IUD)[the type of material inserted into the uterus(womb) to prevent pregnancy] or if you are pregnant or if you recently got a new sexual partner or if you have multiple sexual partners. Any of these can make you get bacterial vaginosis and you can see now that it is NOT cause by Toilet, or Swimming pools; But it affects the Vagina. Hence it is a Vaginal Infection and not Toilet infection.(This should make you understand it more.)
This is also called: Candidiasis, Genital candidiasis, or Vulvovaginal candidiasis (VVC) or simply Vaginal Yeast infection.
This type of Toilet infections is caused by a fungus called Candida albicans.
This infection is not restricted to the Vagina alone because it can spread to other parts of the body such as skin, mucous membranes, heart valves, oesophagus, and other areas.
It can cause serious and life-threatening systemic infections in people that their immunity is not strong (such as pregnant women,HIV positive individuals, people with Diabetes mellitus, or people who are taking Steroids like prednisolone for other diseases).
Out of 100 women, you will find about 75 of them have had Yeast infection(Candidiasis) at some point in their life. Which means that, though Bacterial vaginosis causes half of cases of Vaginal infections in women coming to the hospital with vaginal infections; Yeast infection has affected most women (whether treated or untreated).
We do not see Vaginal yeast infection as a sexually transmitted disease, but about 15 men out of 100 will develop symptoms such as itching around their penis or rashes following sexual intercourse with an infected Woman, but that does not mean it is a sexually transmitted disease.
Yeast infections or Candidiasis is caused by an overgrowth of normally growing fungi (that are found in the vagina but not have decided to be harmful). These overgrowth creates unpleasant symptoms.
Signs and Symptoms of Yeast infections
- Burning sensation around the vagina
- Whitish gray and thick vaginal discharge, but may sometimes be watery
- Painful intercourse (commonly called dyspareunia, medically).
- Rashes around the vagina.
Normally, the yeasts are harmless because they are controlled by the good bacteria in the body. If the natural balance of microorganisms is disrupted(The reasons are explained below), the yeast that were harmless now become very harmful and out of control.
This is not seen as a Sexually Transmitted Disease because the yeast are part of your normal body micro-organisms, but they have accelerated their growth rate(Not because of sexual intercourse).
The explanation for this is explained below under “Harmful Habits that cause Toilet infections”.
Toilet Infection Symptoms: What are the Signs of Toilet Infection?
The general signs and symptoms of toilet infections are:
- Itching: This is the commonest sign and it can occur at anytime. This itching can be so intense that it can make a woman to feel like crying especially if you are in the public. The bad side of it is that, in some women, the itching comes with pain whenever you try to scratch or rub the area. This is very discomforting.
- Pain on Urination: Some people experience severe pain especially when urinating or when having sex. It is usually burning pain or itis peppery in nature as described by many women.
- Abnormal Vaginal Discharge: There could be a discharge from the vagina that is not normal from the normal fluid secreted in the vagina that helps to keep it moist. This abnormal discharge is usually noticed when it becomes much, or when it starts smelling or when the color is abnormal. The color and smell of the discharge helps in knowing to some extent what type of organism is causing it. So always note the color when you want to go and see your doctor. The differences are explained below.
- Abnormal Menstrual flow: When this becomes too much, it could affect the number of days it takes for your flow to end. It could also affect the Amount and the timing.
- Abdominal Pain: Toilet infections may also cause severe lower abdominal pain in some women that may be mistaken for menstrual pains. Vaginal infections areimportant causes of chronic (long) lower abdominal pain.
How do we get Toilet infections? Some Habits that make you have Toilet Infection
- Vaginal Douching: This refers to the various ways that women clean their vagina with the feeling that it makes it clean. The truth is that, this is harmful.
-Some women make use of salt and warm water with the thinking that it will clean and kill the microorganisms causing the vaginal discharge without knowing that they are making it worst
-Others use Antiseptics to wash it together with water
– Others use Medicated Soaps
All these lead to the killing of some bacteria that are helpful to the vagina. These good bacteria have been living in the vagina and they help to protect it from harmful bacteria or fungi.
The good ones are referred to as normal flora in medicine.
So when you use medicated soap or salt with warm water or antiseptics, or Antibiotics, you are actually killing the good bacteria that are in the vagina and you create more space for the bad ones to live in it. And trust me, these bad ones have develop resistance to so many drugs.
- Method of cleaning the anus: The method that is recommended for women to clean the anus after using the toilet is by cleaning it from front to the back. The wrong way is cleaning it from the back to the front.When you clean it from back to the front, you can mistakenly wipe the faecal matter on the vagina and that will carry all the germs of the faecal content into the vagina and you are in for it. So to avoid this, simply wipe from front to the back to avoid introducing harmful microorganisms into the vagina.
- Use of dirty Toilet: They commonest means by which women get infected is through this means, and I think it is the reason why women refer to it as Toilet Infection. But the toilet is not the only way you can get infected as explained above and in fact, some are actually sexually transmitted.Some ways in which women use the toilet wrongly are explained below:
Squatting: Most women get infected by squatting to urinate. This is not good because someone might have used the same place and that person might have been infected already, so by squatting to urinate, you get infected when your urine touches the ground, picks up the micro-organism in the infected persons urine and then splash back and touches the vagina. And believe me, you just need a single drop to be infected because millions of these organism exist in just a drop.
Water System Toilet: – If you are using the water system of toilet for defecating, I advise you use enough tissue paper(toilet paper) inside the seat before using the toilet. This is because the water mostly splash and touches the vagina. And remember the vagina is expose directly to the toilet sink. This will get you infected easily. The best way is just to put enough toilet tissue in the water so as to prevent the splashing.
- Use of some Perfumes and Soaps: Some women use perfumes and spray on the vagina in order to make it smell nice. Wow, that is serious, who is suppose to come and smell it? (Answer the question if you are involve in it). But the fact is that, perfumes, or scented soaps are very good source of growing germs. Germs love to grow on things that are sweet or scented, so stop using any perfume or scented soap on your vagina. If you do not want it to smell, simply wash with ordinary clean water while bathing.
- Use of WetUnder-wears: It is surprising that some women use the same pant or “Skin Tight” day in day out for many days before changing. This will make germs to grow on it and they will infect the vagina. These germs do not grow like maize or beans that you think it will take a long time before the grow. Bacteria grow in minutes and some, in hours. So just give them 6 hours and they can grow to millions. Their growth is the cause of that bad odour from your mouth when you wake up in the morning and you will want to brush. So how many hours are there from night to morning? -Use of Nylon Under wears make you sweat easily and hence germs can grow easily too.
- Weakened immune system: When your immune system (which is just like a soldier that fights diseases in your body) becomes weak and unable to fight infections, then normal micro-organisms that were not harmful becomes harmful because there is nothing to control their actions. The immune system can become weak due to the following: having HIV/AIDS, taking Steroids, Excessive Alcohol, having Diabetes, Pregnancy and many other diseases.
- Use of Antibiotics: Some people misuse drugs so much that whenever they have a tiny boil on the hand, they will take antibiotics. When you use Antibiotics inappropriately just because you think you know drugs, or may be you feel people are using it; I am sorry to tell you that you are causing harm to yourself because it can cause different diseases and not just Toilet (Vaginal) Infection.
Antibiotics do not just destroy the Harmful microorganisms in the body but they also attack the protective bacteria in the vagina. These protective bacteria are the ones that normally stop the harmful organisms from overgrowing. Remember that Yeast infection may occur even after you have taken a course of antibiotics for another condition such as sore throat. It is therefore advisablethat you should never use any drug without a prescription from your doctor.
- Birth control pills: Many Changes in the female body occur as a result of hormones and the vagina is not an exception; Hence, with increased hormonal levels from oestrogen-containing birth control pills, the Vaginal environment becomes disturbed. These changes create an environment for the candidal fungus and the bacteria to grow and cause Toilet (Vaginal) infections.
- Hormonal changes: Changes such as ovulation and menopause can cause Toilet Infections too because of the change in the environment of the Vagina as explained above. These changes are often marked during menstruation and hence some women can experience similar symptoms during their monthly flow.
Prevention of Toilet Infections
I have written on the various ways you can get infected. You can prevent infection by the following ways:
- Stop Vaginal douching: Just use clean water to wash your vagina when bathing if you feel dirty. Because medicated soap, antiseptics and salt, harm the good bacteria living in the vagina. So in order not to kill them, simply use ordinary clean water. After all, the vagina normally secretes fluid that makes it moist and continually clean the vaginal environment, so you just need a bath and not to be involve in douching.
- Always change your inner-wears : ATLEAST change your inner wear everyday and if you live in places that are hot, you need to change, ATLEAST twice. But the recommended way is to change whenever you come back from work or whenever you’ve sweat much.
- Always stand or just bend while urinating: By bending to urinate, it prevents you from getting infection through splashing of the urine. I know it may seem difficult, but after you finish, just wash your legs with water. This will help you a lot than the stress and discomfort of having infections.
- Do not share inner-wears: Some ladies share inner wears! It is the truth but if you do this, simply stop it. Some may say she is my friend, some say she is my sister. I wonder if your sister or friends cannot have infections. After all, everyone that has the infection is a friend or sister to someone. So STOP sharing inner-wears.
- Stop using Perfume on the vagina: Stop the use of perfume or scented soap on the vagina.
–Use Cotton Inner-wears: Cotton can absorb moisture easily than nylon, so using cotton will help absorb moisture and prevents irritation of the vaginal environment.
–Care in Intercourse: Whenever you have sex, make sure you are not wounded in the process, because some people tend to use some unimaginable means. So always try not to harm yourself either through abrasion or through the use of some objects because a tear, scratch or injury breaks the natural barrier of the skin and hence infection ensues.
When you abide by these principles, you will help yourself so much. But if you fail to follow them, then I can assure you that no amount of Drug can help you because when you treat it with a drug, just give it two or three weeks and it will be back again because you are expose to so many ways of getting infected.
Women should also note that the methods of prevention above are far more important than drugs. Because you can still be RE-Infected even after treatment, and that is the reason why these infections are so common in women that some women have thought it is normal, but it is not. Another fact is that these germs are beginning to develop resistance to the Drugs previously use for treating them, so prevention is the goal. If you think you have Toilet Infection, just see your doctor rather than going to google because google is a search engine and not a Medical doctor. You will reduce the rate of resistance of these germs to the drugs whenever you go to a doctor than treating yourself because when you use the wrong drug, the organisms tend to resist treatment even when the correct drug is later used, and you will not kill yourself by self medication too.
Treatment of Toilet Infections
Like I said earlier, google is not a doctor so go and see your doctor for expert management.
I am going to outline the treatment here but know it that your doctor understands your health condition better; because some drugs do not work well in the body especially if you are taking it with other drugs (This is called “Drug Interaction”) – which means that the presence of another drug can cause another one to either become more powerful, or more harmful or less harmful or less powerful. Because of the drug interactions, you may be on one drug currently that may hinder the efficiency of the drugs I am going to mention below, hence the reason why we say your doctor knows best on how to treat you when you are asked questions related to your health. Another Important thing to note when treating yourself for Toilet infections is that the drug you may use for treatment of the infection may not be good for some medical conditions that you may have, therefore always take note on the Contra-Indications(these are exceptions that prevent you from taking the drug compared to another person with the same disease) that will be mention below.
Ok, all the DOs and DON’Ts have been said, let us move to the treatment now:
Treatment of Bacterial vaginosis
For the treatment of Bacterial Vaginosis, the following antibiotics drugs are used,such as:
If you are taking alcohol, stop and finish the treatment with Metronidazole first, because alcohol increases the side effects associated with Metronidazole.
If your pregnancy has not pass 3 months, do not take metronidazole because it can be harmful to your baby’s mental health.
It is recommended that you treat it because the infection will not go on its own unless you treat it and it keeps increasing in severity the more you refuse treating it.
Clindamycin or Metronidazole may cause vaginal itching or discharge so take note.
If you have Bacterial Vaginosis, there is no need for you to treat your male partner because it is not a Sexually transmitted disease and the bacterial love living in the vagina and not in the penis. (This is only applicable to Bacterial Vaginosis and not to all Toilet(Vaginal) Infections.)
Drug Treatment of Trichomoniasis infection
The drug of choice in treating Trichomoniasis is Metronidazole.
A single dose is usually Ok for treatment but you should avoid Alcohol to prevent severe nausea and vomiting. You and your sex partners are required to be treated with the medicine even if they do not have signs of the disease because it can be transmitted from a woman to the male partner and not just women. It is a sexually transmitted infection. SO, this one is not from toilet seats or anything related to Toilets. The organism responsible for this is called Trichomonas vaginalis. Trichomoniasis is primarily an infection that affects the sexual organs of reproduction and urination. The Vagina of the women is affected mostly whereas the urethra is most commonly affected in Males(So this means that Men can also have ‘Toilet Infections’ too because this type is a sexually transmitted infection, So I still insist that the word “Toilet Infection” is not appropriate).
Drug Treatment of Yeast infection
Yeast infections are treated usually but not always with vaginal creams and vaginal applications rather than oral medication; and Pregnant women are usually treated for a longer period than non-pregnant women(because pregnant women have low immunity compared to their non-pregnant counterparts) and must be closely monitored.
Severe infections(when the infections prevent you from doing your daily activities or affecting your social life) are treated with Oral single dose of anti-fungal drug which could include:
– Fluconazole (Diflucan) or
– Itraconazole (Sporanox).
These drugs like I said are taken once or for 3-5 days with the same cure rates.
However, care must be taken because they might cause liver problems and the symptoms of liver problems may manifest with yellowish skin, yellowish eyes, and/or pale stools.
If you begin to notice any of these signs, STOP taking the drug and see your doctor immediately.
Less severe infections, are treated with drugs such as:
Vaginal tablet: in which the tablet is inserted into the Vagina and has been found to be effective or Cream application using an applicator stick: in which a cream is used for 7 to 14 days. Your choice of tablet or cream depends on your convenience or availability of the drug.
Please note that even if the symptoms disappear after the first day, continue with the drug for about 7 days or till 14 days depending on your doctors prescription so as to properly and completely treat the infection and to prevent it from re-surfacing again.
Examples of these drugs are:
– Nystatin (Mycostatin) – can be tablet or cream.
– Miconazole (Monistat-7, M-Zole) – can be tablet or cream and
– Clotrimazole (Mycelex, Gyne-Lotrimin) can be tablet or cream – This is more effective.
In some cases, a single dose of medication has been shown to clear up yeast infections, (but continue with treatment for atleast 7days). In other cases, a longer course of medication (3 days or 7 days) might be prescribed .
For individuals that keep having infections(more than 4 times in a year) even after treatment, this is termed as “Recurrent infection”. This type is treated with oral Fluconazole and Itraconazole or vaginal clotrimazole might be needed for a period of six(6) months.
Complications of Toilet Infections
When not treated immediately, or even when treatment seem not to work (mainly because prevention of Re-infection is not taken seriously), complications do arise that may lead mainly to Infertility.
But just like I said above that when the Immune system is not strong either due to HIV, Diabetes, Pregnancy, or use of Steroids, the infection can be so severe that it can cause Death.
For pregnant women with toilet(vaginal) infections, without treatment, it can affect your baby to be born with low birth weight and may be born prematurely.
What are some of the questions your doctor may ask?
This is to give you an overview of what the doctor may ask and not for you to think as if this is all in all. Or even for you to think the doctor does not know as much as you do.
In fact, they have spent nothing less than 7years before they start treating you, so they know more than you do.
But always feel free to ask them any questions because they are ready to help.
So in order to diagnose a Toilet(Vaginal) infection, your doctor may ask the following questions and also perform physical examination to check for changes around the vagina.
A laboratory test for Urine and Vaginal discharge or swap may also be done.
These are the likely questions:
1. When did this condition begin?
They ask this to know the extent to which it has stayed in your body and to know the mode of treatment and duration of treatment.
2. Has the discharge been the same throughout the month or has it change?
They want to if it is associated with your period of menstruation, so as to know whether hormonal changes are the cause.
3. What does the discharge look like? What color and consistency? Is there an odor?Do you have pain, itching, or burning sensation?
Doctors ask this so as to the likely cause of the infection as seen below:
Signs and symptoms ofBacterial vaginosis
- Thin and grayish white (like Pap).
- Foul-smelling vagina like Fish, especially after having sex.
- Vaginal itching.
- Burning sensation like pepper during urination.
Symptoms and signs of Trichomonas infection(for males)
- Itching inside the penis
- Burning sensation AFTER urination or ejaculation.
- Penile discharge.
Symptoms and signs of Trichomonas infection(for females)
- Itching or redness of the vagina.
- Uncomfortable urination
- Vaginal discharge which can be clear, white, yellowish, or greenish.
- Foul smelling Vaginal odor.
Symptoms and signs of Vaginal Yeast infections
- Thick White discharge and having a cottage cheese appearance.
- Intense itching, swelling, and irritation of the Vagina.
4. Does your sexual partner, if you have one, have discharge from his penis? Do you have many sexual partners? Do you use condoms?
This will enable the doctor to know how you got the infection and to know if it is a sexually transmitted infection or Bacterial Vaginosis
5. What helps relieve the discharge?
To know what works for you and to see if it is correct practice or harmful practice
6. Do you take frequent baths?
To know if it is cause by poor personal hygiene
7. Have you tried over-the-counter medications?
To know the drugs you might have taken so as not to repeat the same thing or even to know if it were the wrong ones that you have been taking. They can ask this to also know if you have been on some drugs before getting the infections
8. Have you been Douching?
I told you earlier that this practice is bad and you should just stop. So a doctor normally ask of this to know if you have been doing this because it causes Toilet(Vaginal infections).
9. What other symptoms do you have?
To know if you have other associated diseases
10. Do you often wear tight underwear or pants/jeans?
I have told you the reason for this above
11. Have you change your soap recently? and what soap are you using?
This is to know the type of soap you use whether it is antiseptic or not. Because using antiseptic soap on the Vagina is harmful.
Physical Examination tp help in Management of Vaginal Infections
The doctor will also check your vaginal canal and also your cervix for any discharge,sores, pain or abnormal swelling.
During this examination, a vaginal swab will be taken of any discharge and tested in the laboratory to determine if the infection is fungal (yeast), protozoan (trichomoniasis), or bacterial (bacterial vaginosis).
In some cases, a Pap test is also done to exclude the possibilities of cervical cancer.
A colposcopy or biopsy might be recommended if your cervix appears abnormal. Colposcopy is a technique that uses a microscope to see the magnified view of your cervix. In a biopsy, a small tissue sample is taken for testing in the laboratory to check if it is turning into a cancer or if it is a normal cell.
If any sexually transmitted infection is present, and confirmed by laboratory tests, then more tests for other sexually transmitted diseases (STDs) may be required so as to treat them at once.