Vaginitis

What is vaginitis?

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Vaginitis refers to any inflammation or infection of the vagina. It's common in women of all ages. One-third of  women have at least one form of vaginitis at some time during their lives.

When the walls of the vagina become inflamed, because some irritant has disturbed the balance of the vaginal area, vaginitis can occur.

What causes vaginitis?

Bacteria, yeast, viruses, chemicals in creams or sprays, and even clothing can cause vaginitis. Sometimes, it occurs from organisms that are passed between sexual partners. Also, a number of different factors can affect the health of your vagina. These include your overall health, your personal hygiene, medicines, hormones (particularly estrogen), and the health of your sexual partner. Changes in any of these factors can trigger vaginitis. 

These are the most common types of vaginitis:

• Candida or "yeast" infection

• Bacterial vaginosis

• Trichomoniasis vaginitis

• Viral vaginitis

• Noninfectious vaginitis 

Your healthcare provider will consider other causes of vaginal discharge such as gonorrhea and chlamydia. These organisms don't infect the vagina directly. If left untreated, they can lead to serious conditions, such as pelvic inflammatory disease (PID). PID increases a woman's risk of infertility, pelvic scarring, chronic pelvic pain, and ectopic pregnancy. Chlamydia is one of the most common sexually transmitted diseases in the U.S., although it often goes undiagnosed.

What is candida or "yeast" infections?

Yeast infections, as they are commonly called, are caused by one of the many species of fungus known as candida. It normally lives in the vagina in small numbers. Candida can also be present in the mouth and digestive tract in both men and women.

Yeast is normally present and well-balanced in the vagina. Infection occurs when something upsets this normal balance. For example, taking an antibiotic to treat another infection may upset this balance. In this case, the antibiotic kills the bacteria that normally protects and balances the yeast in the vagina. In turn, the yeast overgrows, causing an infection. Other factors that can cause imbalance include a weak immune system, pregnancy, and diabetes.

What are the symptoms of a yeast infection?

The following are the most common symptoms of a candida infection:

• A thick, white, cottage cheese-like vaginal discharge that is watery and usually odorless

• Itching and redness of the vulva and vagina

• Pain with urination or sex

The symptoms of a vaginal candida infection may look like other conditions or medical problems. Always consult your healthcare provider for a diagnosis.

Who is at risk for yeast infections?

Any woman can get a yeast infection. A woman may be at an increased risk if she:

• Has had a recent course of antibiotics

• Is pregnant

• Has diabetes that is not well-controlled

• Has HIV

• Is taking an immunosuppressant medicine

• Is using high-estrogen contraceptives

• Is undergoing corticosteroid therapy, which weakens the immune system

How is a yeast infection diagnosed?

Your healthcare provider will review your medical history and do a physical and pelvic exam.  He or she may also examine the vaginal discharge with a microscope. 

Treatment for yeast infection

Treatment for candida may include:

• Antifungal vaginal creams and suppositories

• Vaginal tablets

• Oral antifungal medicines

What is bacterial vaginosis?

Bacterial vaginosis is the most common type of vaginitis in women of reproductive age. This infection is caused by bacteria, not yeast. With a bacterial vaginosis infection, certain species of normal vaginal bacteria grow out of control and trigger inflammation. 

What are the symptoms of bacterial vaginosis?

These are the most common symptoms for bacterial vaginosis:

• A milky, thin discharge at times, or a heavy, gray or green discharge

• "Fishy" odor (may become more noticeable during sex)

The symptoms of bacterial vaginosis may look like other conditions. Always see your healthcare provider for a diagnosis.

It is important to get prompt treatment for this condition if you are pregnant. Bacterial vaginosis can cause complications during pregnancy and, in some cases, has been linked to preterm delivery.

Treatment for bacterial vaginosis

Bacterial vaginosis is caused by bacteria; therefore, it is generally treated with antibiotics.

What is trichomoniasis?

Trichomoniasis, trichomonas, or "trich" as it is commonly called, is a sexually transmitted disease. It is caused by a one-celled parasite called Trichomonas vaginalis that passes between partners during sex. Since most men don't get symptoms with trichomoniasis, the infection is often not diagnosed until the woman develops symptoms of vaginitis.

What are the symptoms of trichomoniasis?

The following are the most common symptoms of trichomoniasis:

• A frothy, often musty-smelling, greenish-yellow discharge

• Itching or burning in and around the vagina and vulva

• Swelling or redness at the opening of the vagina

• Light bleeding, especially after sex

• Burning during urination

• Discomfort in the lower abdomen

• Pain during sex

Some women with trichomoniasis have no symptoms. The symptoms of trichomoniasis may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

Treatment for trichomoniasis

Both partners must be treated for trichomoniasis to avoid reinfection. Treatment generally involves taking oral antibiotics. If a woman has more than one sexual partner, each partner (and any of their other partners) should also be treated.

It is especially important for pregnant women to get prompt treatment for trichomoniasis. This type of vaginitis can cause complications during pregnancy and, in some cases, has been linked to preterm delivery.

What is viral vaginitis?

Viruses are a common cause of vaginitis, with most being spread through sexual contact. One type of virus that causes viral vaginitis is the herpes simplex virus (HSV, or simply herpes). The main symptom is pain in the genital area associated with lesions and sores. These sores are generally visible on the vulva, or vagina, but may be found inside the vagina during a pelvic exam. Often stress or emotional situations can be a factor in triggering an outbreak of herpes.

Another source of viral vaginitis is the human papillomavirus (HPV), a virus that is also transmitted through sexual contact. HPV is the main cause of cervical cancer in women. This virus also causes painful warts to grow on the vagina, rectum, vulva, or groin. However, visible warts are not always present, in which case, the virus is generally detected by a test for HPV done with a Pap test.

Two HPV vaccines are effective in preventing infection by the particular strains of HPV that cause most cervical cancers, but they do not treat existing HPV infection or genital warts. One of the vaccines also is effective against genital warts as well as some cancers of the vulva, vagina, and anus. Both vaccines are approved for use in females between the ages of 9 and 26. One of the two vaccines is available for boys and men, ages 9 through 26, and protects against most genital warts. The vaccines are given as a three-dose series. 

What is noninfectious vaginitis?

Noninfectious vaginitis usually refers to vaginal irritation without an infection being present. Most often, this is caused by an allergic reaction to, or irritation from, vaginal sprays, douches, or spermicidal products. It may be also be caused by sensitivity to perfumed soaps, detergents, or fabric softeners.

Another form of noninfectious vaginitis, called atrophic vaginitis, usually results from a decrease in hormones because of menopause, surgical removal of the ovaries, radiation therapy, or even after childbirth--particularly in breastfeeding women. Lack of estrogen dries and thins the vaginal tissue, and may also cause spotting.

What are the symptoms of noninfectious vaginitis?

The following are the most common symptoms of noninfectious vaginitis:

• Vaginal itching

• Vaginal burning

• Vaginal discharge

• Pelvic pain (particularly during sex)

The symptoms of noninfectious vaginitis may look like other conditions or medical problems. Always see your healthcare provider for a diagnosis.

Treatment for noninfectious vaginitis

Treatment for noninfectious vaginitis depends greatly on the cause. If the cause is a reaction to an irritant, the irritant should be avoided.