Information for Patients
Genital herpes is a sexually transmitted disease (STD) caused by a herpes simplex virus (HSV). It can cause sores on your genital or rectal area, buttocks, and thighs. You can get it from having vaginal, anal, or oral sex with someone who has it. The virus can spread even when sores are not present. Mothers can also infect their babies during childbirth.
Symptoms of herpes are called outbreaks. You usually get sores near the area where the virus has entered the body. The sores are blisters which break and become painful, and then heal. Sometimes people do not know they have herpes because they have no symptoms or very mild symptoms. The virus can be more serious in newborn babies or in people with weak immune systems.
Repeat outbreaks are common, especially during the first year. Over time, you get them less often and the symptoms become milder. The virus stays in your body for life.
There are tests that can diagnose genital herpes. There is no cure. However, medicines can help lessen symptoms, decrease outbreaks, and lower the risk of passing the virus to others. Correct usage of latex condoms can reduce, but not eliminate, the risk of catching or spreading herpes. If your or your partner is allergic to latex, you can use polyurethane condoms. The most reliable way to avoid infection is to not have anal, vaginal, or oral sex.
What is vaginitis?
Vaginitis, also called vulvovaginitis, is an inflammation or infection of the vagina. It can also affect the vulva, which is the external part of a woman's genitals. Vaginitis can cause itching, pain, discharge, and odor.
Vaginitis is common, especially in women in their reproductive years. It usually happens when there is a change in the balance of bacteria or yeast that are normally found in your vagina. There are different types of vaginitis, and they have different causes, symptoms, and treatments.
What causes vaginitis?
Bacterial vaginosis (BV) is the most common vaginal infection in women ages 15-44. It happens when there is an imbalance between the "good" and "harmful" bacteria that are normally found in a woman's vagina. Many things can change the balance of bacteria, including:
- Taking antibiotics
- Using an intrauterine device (IUD)
- Having unprotected sex with a new partner
- Having many sexual partners
Yeast infections (candidiasis) happen when too much candida grows in the vagina. Candida is the scientific name for yeast. It is a fungus that lives almost everywhere, including in your body. You may have too much growing in the vagina because of:
- Diabetes, especially if it is not well-controlled
- Corticosteroid medicines
Trichomoniasis can also cause vaginitis. Trichomoniasis is a common sexually transmitted disease. It is caused by a parasite.
You can also have vaginitis if you are allergic or sensitive to certain products that you use. Examples include vaginal sprays, douches, spermicides, soaps, detergents, or fabric softeners. They can cause burning, itching, and discharge.
Hormonal changes can also cause vaginal irritation. Examples are when you are pregnant or breastfeeding, or when you have gone through menopause.
Sometimes you can have more than one cause of vaginitis at the same time.
What are the symptoms of vaginitis?
The symptoms of vaginitis depend on which type you have.
With BV, you may not have symptoms. You could have a thin white or gray vaginal discharge. There may be an odor, such as a strong fish-like odor, especially after sex.
Yeast infections produce a thick, white discharge from the vagina that can look like cottage cheese. The discharge can be watery and often has no smell. Yeast infections usually cause the vagina and vulva to become itchy and red.
You may not have symptoms when you have trichomoniasis. If you do have them, they include itching, burning, and soreness of the vagina and vulva. You may have burning during urination. You could also have gray-green discharge, which may smell bad.
How is the cause of vaginitis diagnosed?
To find out the cause of your symptoms, your health care provider may:
- Ask you about your medical history
- Do a pelvic exam
- Look for vaginal discharge, noting its color, qualities, and any odor
- Study a sample of your vaginal fluid under a microscope
In some cases, you may need more tests.
What are the treatments for vaginitis?
The treatment depends on which type of vaginitis you have.
BV is treatable with antibiotics. You may get pills to swallow, or cream or gel that you put in your vagina. During treatment, you should use a condom during sex or not have sex at all.
Yeast infections are usually treated with a cream or with medicine that you put inside your vagina. You can buy over-the-counter treatments for yeast infections, but you need to be sure that you do have a yeast infection and not another type of vaginitis. See your health care provider if this is the first time you have had symptoms. Even if you have had yeast infections before, it is a good idea to call your health care provider before using an over-the-counter treatment.
The treatment for trichomoniasis is usually a single-dose antibiotic. Both you and your partner(s) should be treated, to prevent spreading the infection to others and to keep from getting it again.
If your vaginitis is due to an allergy or sensitivity to a product, you need to figure out which product is causing the problem. It could be a product that you started using recently. Once you figure it out, you should stop using the product.
If the cause of your vaginitis is a hormonal change, your health care provider may give you estrogen cream to help with your symptoms.
Can vaginitis cause other health problems?
It is important to treat BV and trichomoniasis, because having either of them can increase your risk for getting HIV or another sexually transmitted disease. If you are pregnant, BV or trichomoniasis can increase your risk for preterm labor and preterm birth.
Can vaginitis be prevented?
To help prevent vaginitis:
- Do not douche or use vaginal sprays
- Use a latex condom when having sex. If your or your partner is allergic to latex, you can use polyurethane condoms.
- Avoid clothes that hold in heat and moisture
- Wear cotton underwear
General Equivalence Map Definitions
The ICD-9 and ICD-10 GEMs are used to facilitate linking between the diagnosis codes in ICD-9-CM and the new ICD-10-CM code set. The GEMs are the raw material from which providers, health information vendors and payers can derive specific applied mappings to meet their needs.
- Approximate Flag - The approximate flag is on, indicating that the relationship between the code in the source system and the code in the target system is an approximate equivalent.
- No Map Flag - The no map flag indicates that a code in the source system is not linked to any code in the target system.
- Combination Flag - The combination flag indicates that more than one code in the target system is required to satisfy the full equivalent meaning of a code in the source system.
Index of Diseases and Injuries Definitions
- And - The word "and" should be interpreted to mean either "and" or "or" when it appears in a title.
- Code also note - A "code also" note instructs that two codes may be required to fully describe a condition, but this note does not provide sequencing direction.
- Code first - Certain conditions have both an underlying etiology and multiple body system manifestations due to the underlying etiology. For such conditions, the ICD-10-CM has a coding convention that requires the underlying condition be sequenced first followed by the manifestation. Wherever such a combination exists, there is a "use additional code" note at the etiology code, and a "code first" note at the manifestation code. These instructional notes indicate the proper sequencing order of the codes, etiology followed by manifestation.
- Type 1 Excludes Notes - A type 1 Excludes note is a pure excludes note. It means "NOT CODED HERE!" An Excludes1 note indicates that the code excluded should never be used at the same time as the code above the Excludes1 note. An Excludes1 is used when two conditions cannot occur together, such as a congenital form versus an acquired form of the same condition.
- Type 2 Excludes Notes - A type 2 Excludes note represents "Not included here". An excludes2 note indicates that the condition excluded is not part of the condition represented by the code, but a patient may have both conditions at the same time. When an Excludes2 note appears under a code, it is acceptable to use both the code and the excluded code together, when appropriate.
- Includes Notes - This note appears immediately under a three character code title to further define, or give examples of, the content of the category.
- Inclusion terms - List of terms is included under some codes. These terms are the conditions for which that code is to be used. The terms may be synonyms of the code title, or, in the case of "other specified" codes, the terms are a list of the various conditions assigned to that code. The inclusion terms are not necessarily exhaustive. Additional terms found only in the Alphabetic Index may also be assigned to a code.
- NEC "Not elsewhere classifiable" - This abbreviation in the Alphabetic Index represents "other specified". When a specific code is not available for a condition, the Alphabetic Index directs the coder to the "other specified” code in the Tabular List.
- NOS "Not otherwise specified" - This abbreviation is the equivalent of unspecified.
- See - The "see" instruction following a main term in the Alphabetic Index indicates that another term should be referenced. It is necessary to go to the main term referenced with the "see" note to locate the correct code.
- See Also - A "see also" instruction following a main term in the Alphabetic Index instructs that there is another main term that may also be referenced that may provide additional Alphabetic Index entries that may be useful. It is not necessary to follow the "see also" note when the original main term provides the necessary code.
- 7th Characters - Certain ICD-10-CM categories have applicable 7th characters. The applicable 7th character is required for all codes within the category, or as the notes in the Tabular List instruct. The 7th character must always be the 7th character in the data field. If a code that requires a 7th character is not 6 characters, a placeholder X must be used to fill in the empty characters.
- With - The word "with" should be interpreted to mean "associated with" or "due to" when it appears in a code title, the Alphabetic Index, or an instructional note in the Tabular List. The word "with" in the Alphabetic Index is sequenced immediately following the main term, not in alphabetical order.