Burning, itching and discomfort in the intimate parts are among the problems that bother women in summer. Why do these symptoms appear and what should women and their partners watch out for when going to the sea or pool, comments Dr. Elena Bangeeva. Doctor Elena Bangeeva graduated in medicine in 2012 at Medical University – Sofia, with excellent results. Since 2013, she has been working and specializing in PSAGBAL “Sveta Sofia” EAD – in the departments “Pregnancy at risk” and “Maternity”. In 2014, he specialized in “Endoscopic gynecological surgery”, acquiring international certificates in Belgium and France. In 2016 began working in the field of “Assisted Reproductive Technologies” at MC “Aphrodite” and acquired Bulgarian and European certificates. Attended the largest world and European congresses in “Obstetrics and Gynecology”. A year later acquired a master’s degree in the specialty “Health management and public health”. – Dr. Bangeeva, what are the most common vaginal infections that women suffer from in the summer? Summer is the season of sun, sea and holidays. It is also the most favorable time for the development of vaginal infections. Fungal infections are one of the most common, they love a moist, warm environment, and summer generously offers it to them. Interest in swimming pools has also increased, and poorly chlorinated ones can bring us unpleasant sensations. With warmer weather and holidays, sexual temptations become more frequent. The other large group is the bacterial colpitis with the most common representative of bacterial vaginosis, chlamydia and other sexually transmitted infections. – What is the difference between viral, bacterial and fungal infections? First of all, the different causes and the clinical picture. Viral infections – for example HPV, are divided into two groups – benign skin-mucosal changes and pre-cancerous and cancerous changes, the most common being representatives of HPV 16 and 18. Patients seek medical help when changes appear on the skin and mucous membrane of the external sexual organs. Some viral infections are asymptomatic. Genital herpes, which is also caused by a virus, presents with painful blisters and sores. Bacterial infections are caused by different types of bacteria and occur most often with increased vaginal discharge and discomfort. Rarely, they have chronic, asymptomatic carriage. Fungal infections are caused by different types of fungal microorganisms. Asymptomatic carriage and recurrent forms after local treatment are important for them. When the infection is acute, it is characterized by a discharge resembling curdled milk and severe itching. – What are the symptoms of bacterial vaginosis? Bacterial vaginosis is the most common form of vaginal disease. It is a polymicrobial infection. The main cause is the anaerobic microorganism – Gardnerella vaginalis, which reduces the amount and changes the type of lactobacilli and creates an environment for the growth of anaerobic microorganisms.It is characterized by weak to moderate vaginal fluorine with the presence of a specific odor, especially after sexual contact, burning and redness that disturb the personal comfort of the woman. – How is it treated in women and what should be the therapy for their partners? The treatment is with preparations from the group of metronidazole derivatives, and it is general and local. An alternative for people with allergies is an antibiotic from the lincosamide group. Treatment of the partner is mandatory if the woman has clinically evident or recurrent infection, although in most cases he has no complaints. – What complications do vaginal infections lead to? There are different types of complications. Precancerous and cancerous diseases of the cervix can develop from viral ones. Bacterial infections can ascend from the vagina and infect the uterus and fallopian tubes, which can lead to the development of pelvic inflammatory disease and in turn lead to infertility. Most often, chlamydia infections make such passions. Complications can also occur in pregnant women. Bacterial infections may lead to miscarriage, premature birth, increased risk of infection of the fetus and uterus in the postpartum period. HPV can be transmitted from the mother to the newborn with an increased risk of laryngeal papillomatosis. That is why timely diagnosis and treatment of these infections is extremely important. – How are they treated? Treatment depends on the causative agent and the microbial count in bacterial and fungal infections. Viral infections are treated with general antiviral agents, destruction of the changes or medically with various chemical agents, but always after consultation and on the recommendation of a doctor. For bacterial ones, antibiotics and/or metronidazole derivatives are used, and it is best after an antibiogram. Treatment of vulvovaginal candidiasis, for example, is with various imidazoles and triazoles in the form of creams, pessaries, vaginal globules and oral tablets for single or long-term use. Combinations between the preparations are also used in polomicrobial infections. NEWS_MORE_BOX – Can poorly washed underwear cause an infection? Underwear is extremely important in a woman’s intimate hygiene. It should be cotton and not too tight. It is recommended after a bacterial and fungal infection not only to wash, but also to iron well. Sometimes, especially fungi, they are quite stubborn and can survive after washing at a low temperature. – Give some tips to improve “vaginal immunity” in the summer. What should women avoid while on vacation to protect themselves from infections? There is a great variety of products to restore the normal flora – intimate gels, globules, vaginal douches, but they should be used with measure, so as not to disturb the normal microflora of the vagina. My advice is to observe good personal hygiene of the external genitalia, without scrubbing roughly, and to dry carefully with a towel.At the appearance of the slightest symptoms, women should consult a doctor and not self-medicate, because this leads to the chronicity of the infection and the creation of resistant strains. If they use tampons during a cycle, change them every 3 hours or immediately after leaving the sea or pool. Fungi love moist environments. Swimwear should be changed into dry ones after bathing (especially for pregnant women). Women should also be careful when visiting public pools, because some of them are not always well cleaned. My advice is to use a moisturizing gel (if needed) or cream during intercourse to avoid chafing, which can be a gateway to infections. The use of condoms is also very important because it protects against sexually transmitted infections. Healthy nutrition and strengthening the body also improve the local immunity of the vagina. Be healthy!