Vaginitis

What is vaginitis?

Vaginitis is a general term used to describe inflammation of the vagina. It is sometimes called vulvovaginitis when it affects the vulva. This is the external part of a woman’s genitals.

Vaginitis is common in women. There are different types. Each has a different cause, symptoms, and treatment.

Symptoms of vaginitis

Symptoms vary, depending on which kind you have. Common symptoms that occur in many cases include:

• Vaginal itching
• Burning
• Pain
• Discharge

Other symptoms could include bad-smelling discharge, colored discharge, redness, or burning during urination.

What causes vaginitis?

There are many causes of vaginitis. The most common include:

Bacterial vaginosis (BV)

This is usually a mild infection. It happens when there are not enough “good” bacteria and too many “bad” bacteria in the vagina. It is not completely understood why this occurs. But some activities put you at higher risk of for it. These include:

• Douching
• Having a new sexual partner
• Having multiple sexual partners
• Having unprotected sex
• Smoking cigarettes
• Using an intrauterine device (IUD) for birth control
• Taking antibiotics

Common symptoms of BV include a thin white or gray discharge, and a fish-like odor. Some women with BV don’t have any symptoms.

Yeast infections (candidiasis)

These happen when the natural acid in your vagina decreases. This allows yeast (candida) to grow and cause an infection. The acidic imbalance of the vagina can be changed by:

• Your period
• Pregnancy
• Diabetes
• Douching
• Antibiotics
• Birth control pills
• Steroids

A common symptom of yeast infections is a thick, white discharge. Sometimes it can look like cottage cheese. Sometimes it is watery. It often does not smell. In addition, the vulva and vagina are often red and itchy. 

Trichomoniasis

This is a common sexually transmitted disease. It is caused by a parasite that is spread between sexual partners.

Common symptoms of trichomoniasis include itching, burning, and soreness in the vagina and vulva. You could feel burning during urination. Some women have a gray-green discharge that could smell bad.

Allergies

You could have an allergic reaction to a product you use, such as douches, soaps, fabric softeners, or spermicides.

Hormonal changes

Your hormones change when you are pregnant, breastfeeding, or after menopause. This can cause vaginal irritation that could lead to infection.

You could have more than one cause of vaginitis causing symptoms at the same time.

How is vaginitis diagnosed?

Your doctor will ask you about your health history. They will do a pelvic exam. They will examine the vulva, the vagina, and the cervix. They will look for abnormal discharge from the vagina. They may look at a sample of your vaginal fluid under a microscope. They might do additional tests for specific causes, such as a sexually transmitted infection (STI).

Can vaginitis be prevented or avoided?

Vaginitis is common and can be hard to prevent. But there are actions you can take to reduce your risk of getting it:

• Avoid clothes that hold in heat and moisture. This includes tight pants and non-cotton underwear.
• Do not douche. This introduces a foreign substance into your vagina. It could disrupt the natural balance of bacteria or yeast and cause infection.
• Limit your number of sexual partners. This can reduce exposure to new sources of germs that can cause vaginitis.
• Use condoms. When you have sex, use condoms. They can reduce the amount of new bacteria or other germs that can enter your vagina.
• Keep sex toys clean. Clean any sex toys immediately after use. Never share sex toys with other people.
• See your doctor. If you are showing signs of vaginitis, see your doctor.

Vaginitis treatment

Your treatment will depend on what is causing the vaginitis.

• Bacterial vaginosis –This can be treated with antibiotics. These may be in pill form that you take by mouth. Or it could be a cream or gel you insert directly in your vagina.
• Yeast infection –This is usually treated with cream that you insert into your vagina. You can buy it over the counter but talk to your doctor first. They can make sure it is a yeast infection and not another kind of vaginitis. Sometimes yeast infections are treated with pills that you swallow.
• Trichomoniasis –This is typically treated with a single-dose antibiotic. Because this is an STI, your partner should be treated, too.
• Allergies –After you determine what product you are allergic to, stop using it.
• Hormones –Your doctor may give you estrogen cream to help ease symptoms.

Living with vaginitis

Most women will have vaginitis at some point in their lives. It is normally a mild problem that can be treated and cured easily. If left untreated, it could cause complications:

• Having BV or trichomoniasis can increase your risk of getting an STI.
• If you’re pregnant, BV or trichomoniasis can increase your risk of preterm labor or birth.
• Untreated BV could cause more serious infections to spread to the uterus or fallopian tubes.

Some women experience recurrent infections. Talk to your doctor if your problem becomes chronic. They may be able to suggest lifestyle changes that can help you.

Questions to ask your doctor

• What is the likely cause of my vaginitis?
• Do I need any tests, such as for sexually transmitted infections?
• What do my test results mean?
• What treatment option do you recommend?
• Will I need medicine? How do I take it?
• When can I expect relief from my symptoms?
• Is it safe for me to have sex?

Resources

U.S. National Library of Medicine: Vaginitis

National Institute of Child Health and Human Development: Vaginitis