an increased discharge -- sometimes with an odour. Usually it is a nuisance and not a serious threat, but any woman experiencing any of these symptoms should make an appointment to see her physician or attend a public health clinic for evaluation.

As a woman it is important to be aware of the normal functioning of your body.

At puberty, hormones, active ovulation and menstruation are responsible for the release of secretions from the walls of the vagina. These secretions are white and practically odourless. Since every woman has her own pattern, learn to recognise yours and you will more easily recognise any abnormal changes which may occur. These secretions provide food for acid producing bacteria creating an environment which makes it difficult for most organisms which can cause vaginitis to thrive. Changes which can alter the secretions making them less acidic can occur from the use of tampons; by frequent douching, use of vaginal deodorants, sprays, and by some soaps.

It is important to note that whilst men rarely have symptoms, they can be infected by the same organisms as women so that during intercourse the organism can be passed between both partners.

There are three main causes of vaginitis: 1. Candida or Monilia (Yeast) A yeast infection is caused by a fungus which is rarely transmitted sexually.

Pregnancy, birth control pills, diabetic conditions, douching and antibiotics may increase the risk of creating conditions in which yeast will grow. In addition, women who are HIV positive are more likely to have problems with frequent yeast infections. Symptoms may include burning, itching, and a scanty white discharge which looks like cottage cheese. The treatment is simple.

Antifungal creams or suppositories inserted into the vagina for 3-7 days depending on the type of medication prescribed. Women with more frequent occurrences may be prescribed tablets to be taken by mouth. Over the counter medications are available, but it is important for a woman to make sure it is a yeast infection and not some other problem before self-medicating. As with any treatment, over use can lead to resistance in efficacy of medication.

2. Bacterial Vaginosis As the name implies, this is caused by a bacteria: "gardnerella''. Since it is normally a mild infection, it may go unnoticed. Symptoms may include a greyish discharge usually with a "fishy' odour'', and sometimes irritation of the external genitalia. Men may be "carriers'' of the organism and have no symptoms. Treatment can be given in two ways; tablets taken twice daily for a week, or a cream inserted vaginally for a week. Men are not usually treated as there is no evidence that this lowers the risk of transmission.

3. Trichomonas, or "Trich'' Caused by a one-celled organisminclude a profuse discharge yellow in colour, with an offensive odour; intense irritation of the genital area, and burning when urinating. Intercourse may also be painful. If untreated, trich can spread to infect the fallopian tubes causing pelvic inflammatory disease.

Generally speaking, men do not have any signs or symptoms but can act as a "carrier''. Unlike bacterial vaginosis, both partners need to receive treatment which consists of tablets taken just one time.

Although these common causes of vaginitis do not usually involve serious complications, they may be accompanied by other infections such as gonorrhoea, chlamydia, syphillis or HIV. It is important to be tested so that a correct diagnosis can be made. Equally as important is the necessity to complete all medication even if symptoms cease, and, for bacterial vaginosis and trichomonas, to repeat testing to ensure the infection has been cured.

Jennifer Fox, STD Clinic HEALTH AND SOCIAL ISSUES HTH