5. Thrush

Most women will experience at least one bout of thrush so this is a common complaint. Thrush is usually caused by the Candida fungus, which usually lives harmlessly in the vagina. Under some circumstances though, an imbalance can occur and this results in symptoms such as itching (inside the vagina and around the vulva), soreness and a vaginal discharge that looks a lot like cottage cheese. Some of the factors that can trigger a bout of thrush include:

• Medical factors. There are some health problems that can be a factor in developing thrush, especially if it is a recurring problem. "It is more likely to occur in women who have uncontrolled diabetes mellitus," says Dr. Sarah Brewer, author of The Essential Guide to Vitamins, Minerals and Herbal Supplements. "Some women suffer repeated bouts of thrush, which may be due to slightly reduced levels of iron (which is needed by the white blood cells to make the chemicals used to destroy opportunistic infections such as this). This can be diagnosed by a blood test that measures serum levels of ferritin -- an iron-binding protein. An inborn error of biotin metabolism may also be involved."
• Antibiotics. A course of antibiotics can sometimes result in thrush. "Candida often occurs after taking antibiotics which kill off the healthy bacteria (e.g. Lactobacillus acidophilus) naturally found in the vagina which help to keep disease-causing organisms such as candida yeasts at bay," explains Dr. Brewer.
• Hormonal changes. Hormone changes (including an increase in estrogen) can pave the way for attacks of thrush. "Candidiasis is more likely to occur around the time of a period due to changes in the acidity of vaginal discharge," says Dr. Brewer. "It is also more common in women who are pregnant, or who use high dose oral contraceptives (although the latter is rare with modern low dose pills)."
• Wearing tight-fitting clothing. The lack of air flow can be a trigger for vaginal infections. "Candida spores thrive in warm moist places," says Dr. Brewer. "Getting hot (for example, wearing tight trousers or nylon tights) may trigger a vaginal infections if you are susceptible or run down."
• Sex. Although it's not classed as a sexually transmitted infection, Dr. Brewer warns that this can be a factor as spores may be passed to and fro through intercourse.
• Sunbeds. You might not associate sunbeds with vaginal infections, but Dr. Brewer highlights the possible link. "Candida are activated by exposure to ultraviolet light, so sun beds can increase the risk."/LI>
• Upsetting the vagina's delicate balance. Using feminine hygiene products can upset the pH balance "down there" and kill off the 'good' bacteria. The vagina can cleanse itself, so you don't need to give it a helping hand.

Solutions

• Self treatment. "If you are fairly certain of the diagnosis, treatments are available over the counter (usually in the form of creams, pessaries and capsules)," advises Dr. Brewer.
• Make sure you're self-diagnosing correctly. "If symptoms keep recurring, it's worth seeing a doctor," suggests Dr. Brewer. "There is a common condition called Bacterial Vaginosis (a bacterial imbalance), which can cause similar symptoms and is easily confused with thrush, so don't keep treating blindly without confirming diagnosis."
• Lifestyle changes. Making a few simple changes to your lifestyle can reduce your chances of developing thrush in the future. Dr. Brewer suggests a number of prevention techniques including wearing cotton underwear to help air to circulate more freely; wearing panty liners and changing them regularly; ironing the gussets of your underwear to kill spores (which won't be killed by modern low temperature washing machine cycles); ensuring an adequate iron intake; taking probiotic supplements, and avoiding perfumed bath products, vaginal deodorants and douches.