What is causing the itching?

Dear Doctor: I am 32-years-old and unmarried. I have been experiencing itching in my private parts and lower abdominal pains for the last three or so years every two weeks to or after my periods. I have been treating with antibiotics such as doxy, cipro, ketaconazole, nystatin pessaries and metro, but they keep recurring. I even changed my underwear and make sure that I wash and iron for relief but in vain. What can I do?
— Wakikatu

Dear Wakikatu: Although vaginal itching is usually blamed on yeast infections, other vaginal infections including sexually transmitted trichomoniasis, herpes simplex and bacterial vaginosis can cause it.
Vaginal itching can also arise due to chemical irritants including detergents used to wash knickers, body soap, vaginal creams, toilet paper, and vaginal contraceptive products.
Women about to go into menopause or those past menopause are susceptible due to fluctuations in estrogen levels.
However, all non-candida causes of itching have to be ruled out before treating for candida. The vagina naturally contains a balanced mix of candida and bacteria. Lactobacillus bacteria produce acid, which prevents yeast overgrowth. That balance can be disrupted and lead to yeast infection.
Too much candida in the vagina causes itching, burning and a yoghurt-like discharge. Although candida infection is not considered a sexually transmitted infection, oral sex can lead to it.

Possible causes
Overgrowth of yeast can result from:
•Antibiotic use, which decreases lactobacillus bacteria in your vagina and changes the pH of your vagina
•Pregnancy
•Uncontrolled diabetes
•Impaired immune system
•Taking oral contraceptives or hormone therapy, which increases estrogen levels
Some studies have shown a link between psychological stress and vaginal yeast infections. This is likely due to the fact that stress is known to have a negative effect on the immune system and could possibly increase the likelihood of getting a yeast infection in women and men.

Dear Doctor: My boyfriend and I were apart for six months. Ever since we rekindled, I have noticed that I always bleed after sex. What could be the cause?
— Annita

Dear Annita: When a woman who is not in her periods bleeds after sex, this is called Post-coital bleeding.
Bleeding once without any other symptoms might mean the bleeding is harmless but recurring bleeding or when it is associated with symptoms like painful sex can be a sign of a serious condition requiring immediate investigation and treatment.

Bleeding after sex without any symptoms can occur once in a while in any normal woman especially when she has sex around the time of ovulation, or nearing periods, or when she is using contraceptives especially injectaplan.

Bleeding associated with symptoms such as painful sex, or vaginal discharge may indicate sexually transmitted disease.
Sometimes a man may be producing bloody semen (Hematospermia) when he has no other symptoms hence confusing this with blood from a female partner. Hematospermia is common though it goes unnoticed.

Dear Doctor: I have pain on the right part of the chest. I do gyming and also jog. I am quite fit but I fear it could be my heart.

— Batanda

Dear Batanda: Chest pain can originate from the heart, lungs, chest skin or even the gullet when one has acid reflux. Sometimes, structures in the neck, pressure on the neck nerves, or abdomen like a peptic ulcer disease can lead to chest pain.

Pain from a heart problem usually is on the left side of the chest where the heart is located. In a few cases, the heart may be on the right (dextrocardia) with the heart pain also being on the right.

Your pain is likely to be from an injured muscle requiring that you visit the doctor to check it out. Many of our gyms do not have qualified instructors with many people getting injuries from gym workouts and continuing to gym when the injuries are not healed.

When it comes to fitness, it is necessary to use appropriate exercises. Eccentric isotonic exercise is when the force of the weight is greater than the force the muscle generates i.e. lifting an object that weighs much more than ones capacity to lift it. This can be a major cause for soreness and muscle injury especially if there has been no warm up. Also try out other exercises like aerobics which are definitely better than lifting.

Dear Doctor: I am married to two women. Ever since I got the second woman, whenever I sleep with the older woman I cannot perform. Have I been charmed?
— Davis

Dear Davis: Erectile dysfunction is the inability for a man to achieve or maintain an erection, sufficient for his sexual needs or those of his partner.