What Is Vaginitis? Vaginitis is an inflammation of the vagina. The vagina is the muscular canal which extends from the cervix to the outside of the body. Vaginitis can result in discharge, itching, a burning sensation, and pain.
Generally, the cause is a change in the normal balance of vaginal bacteria or an infection. Also, vaginitis can result from reduced estrogen levels after menopause. Vaginitis is often caused by a fungus. Certain factors may predispose a woman to develop vaginitis, such as diabetes.
According to Medilexicon’s medical dictionary:
Vaginitis is “Inflammation of the vagina.”
There are several types of vaginitis. The most common are:
Atrophic vaginitis (or senile vaginitis). It results from reduced estrogen levels after menopause. The vaginal tissues become thinner and drier, which may lead to itching, burning or pain.
Bacterial vaginosis. This type of vaginitis results from overgrowth of one of several organisms normally present in the vagina. This alters the natural balance of vaginal bacteria.
Trichomoniasis. This type of vaginitis is caused by a parasite. It is commonly transmitted by sexual intercourse.
Yeast infections. A naturally occurring fungus called Candida albicans usually causes this type of vaginitis. It is estimated that three out of four women will have a yeast infection in their lifetimes.
The treatment for the inflammation depends on the type of vaginitis.
What are the symptoms of vaginitis?
A symptom is something the patient feels and reports, while a sign is something other people, such as the doctor detect. For example, pain may be a symptom while a rash may be a sign.
Signs and symptoms may include:
Discharge from the vagina may change in color, odor or amount
Pain during intercourse
Light vaginal bleeding
In addition to these signs and symptoms, there may be others depending on the type of vaginitis:
Bacterial vaginosis. A grayish-white, foul-smelling discharge may develop. The odor is often described as fish-like. It may be more obvious after sexual intercourse.
Yeast infections. The main symptom is itching. But there may be a white, thick discharge that resembles cottage cheese.
Trichomoniasis. This infection can cause a greenish yellow, sometimes frothy discharge.
When to seek medical advice?
It is recommended to see a doctor if:
You have never had a vaginal infection. Seeing a doctor will establish the cause and help you learn to identify the signs and symptoms.
You have had vaginal infections before, but the signs and symptoms seem different.
You have had multiple sex partners or a recent new partner. You could have a sexually transmitted disease. The signs and symptoms of some sexually transmitted diseases are similar to those of a yeast infection or bacterial vaginosis.
You have completed a course of over-the-counter anti-yeast medication and symptoms persist. You have a fever, or you have a particularly unpleasant vaginal odor. These are signs the infection may be from something other than yeast or from a resistant strain of yeast.
It is probably not necessary to see a doctor if you have vaginal discharge or burning, irritation and:
You are familiar with the signs and symptoms of a yeast infection. You are confident that you have a yeast infection.
You have previously had a diagnosis of vaginal yeast infections and the signs and symptoms are the same as before.
What causes vaginitis?
The cause depends on the type of vaginitis.
Bacterial vaginosis results from an overgrowth of one of several organisms normally present in the vagina. When a type of bacteria become too numerous, they upset the balance and can result in bacterial vaginosis. It is often caused by the bacterium Gardnerella. This type of vaginitis can spread during sexual intercourse. It also occurs in people who are not sexually active.
Other less common infections are caused by gonorrhea, chlamydia, mycoplasma, herpes, campylobacter and some parasites.
Women with new or multiple sex partners, as well as women who douche or use an intrauterine device (IUD) for birth control, have a higher risk of bacterial vaginosis.
Yeast infections occur when certain internal or external factors change the normal environment of the vagina. This triggers an overgrowth of a microscopic fungus. The most common is Candida albicans (C. albicans).
A yeast infection is not considered a sexually transmitted disease. Besides causing most vaginal yeast infections, C. albicans also causes infections in other moist areas of the body, such as in the mouth, skin folds and fingernail beds. The fungi can also cause diaper rash.
Factors that increase the risk of yeast infections include:
Hormonal changes, such as those associated with pregnancy, birth control pills or menopause
Medications, such as antibiotics and steroids
The following do not cause yeast infections, but they may increase susceptibility to infection:
Damp or tight fitting clothing
Feminine hygiene products, such as sprays and deodorants
It is a common sexually transmitted disease caused by a microscopic, one-celled parasite called Trichomonas vaginalis. This organism spreads during sexual intercourse. The infection affects the urinary tract in men, but often causes no symptoms in men. Trichomoniasis typically infects the vagina in women. pH is elevated in trichomonas vaginitis.
Vaginal sprays, douches, perfumed soaps, scented detergents and spermicidal products may cause an allergic reaction or irritate the delicate skin of the vulva and vagina.
Vaginal itching and burning can also result from thinning of the vaginal lining caused by a drop in the hormone levels after natural menopause or surgical removal of the ovaries.
They may also have infectious vaginitis, although the causes are different than those for women. This can result in bacterial vaginosis: which is a type of vaginitis caused by Streptococcus spp. Also, improper hygiene may introduce bacteria or other irritants from the anal region to the vaginal area.
The pH balance in adolescent girls’ bodies does not lead to the growth of Candida albicans, so they are unlikely to contract a yeast infection.
What are the complications of vaginitis?
In general, vaginal infections do not cause serious complications. However, there can be persistent discomfort, superficial skin infection (from scratching) and complications of the causative condition.
In pregnant women, however, both bacterial vaginosis and trichomoniasis have been associated with premature deliveries and low birth weight babies.
Women infected with trichomoniasis or bacterial vaginosis are also at a greater risk of acquiring HIV and other sexually transmitted diseases.
How is vaginitis diagnosed?
In order to diagnose the condition, the patient´s history of vaginal infections or sexually transmitted diseases is reviewed and a pelvic examination is conducted. A sample of a cervical or vaginal discharge may be taken for laboratory analysis. This sample can confirm the type of vaginitis.
What is the treatment for vaginitis?
The type of medication used for treatment depends on the type of vaginitis.
Bacterial vaginosis. Metronidazole (Flagyl, MetroGel) or clindamycin (Cleocin) as tablets or vaginal gels or creams may be prescribed.
Yeast infections. Yeast infections are usually treated with an antifungal cream or suppository, such as miconazole (Monistat), clotrimazole (Gyne-Lotrimin) and tioconazole (Vagistat). Yeast infections may also be treated with an oral antifungal medication, such as fluconazole (Diflucan).
The advantages of over-the-counter treatment for a yeast infection are convenience, cost and not having to wait to see a doctor. However, the problem is that the patient might be trying to treat something other than a yeast infection. It is possible to mistake a yeast infection for other types of vaginitis or other conditions that need different treatment. Using the wrong medicine may delay a proper diagnosis and the most appropriate treatment, and can lead to complications.
Often, after an anti-infective treatment, the vaginal flora is disturbed. As a result, post anti-infective treatment also requires the strengthening of the natural vaginal flora. This is done with local administration of lactobacillus and potentially a low dose of hormone (e.g. estriol).
Trichomoniasis. Metronidazole (Flagyl) or tinidazole (Tindamax) tablets may be prescribed.
Atrophic vaginitis. Estrogen, in the form of vaginal creams, tablets or rings, can effectively treat atrophic vaginitis. This treatment is available by medical prescription.
Noninfectious vaginitis. In order to treat this type of vaginitis, the source of the irritation must be pinpointed and avoided. Possible sources include new soap, laundry detergent, sanitary napkins or tampons.
Prescription medication will be needed to treat trichomoniasis, bacterial vaginosis and atrophic vaginitis.
If you know you have a yeast infection, you may go ahead with treatment on your own, taking these steps:
Using an over-the-counter medication specifically for yeast infections. Options include one-day, three-day or seven-day courses of cream or vaginal suppositories. The active ingredient varies depending on the product: clotrimazole (Gyne-Lotrimin), miconazole (Monistat) or tioconazole (Vagistat). Some products also come with an external cream to apply to the labia and opening of the vagina.
It is important to follow package directions and complete the entire course of treatment, even if symptoms disappear right away.
Applying a cold compress to the labial area to ease discomfort until the antifungal medication takes full effect.
How can vaginitis be prevented?
Good hygiene and a few precautions may prevent some types of vaginitis from recurring and may relieve some symptoms:
Avoid baths, hot tubs and whirlpool spas. Rinse soap from the outer genital area after a shower. Dry the area well to prevent irritation. Do not use scented or harsh soaps (such as soaps with deodorant or antibacterial action).
Avoid irritants. Such as scented tampons and pads.
Wipe from front to back after using the toilet. Doing so avoids spreading fecal bacteria to the vagina.
Other things that may help prevent vaginitis include:
Do not douche. The vagina does not require cleansing other than normal bathing. Repetitive douching disrupts the normal organisms that reside in the vagina. This can actually increase the risk of vaginal infection. Douching will not clear up a vaginal infection.
Use a latex condom during intercourse. This helps avoid infections spread by sexual contact.
Wear cotton underwear and pantyhose with a cotton crotch. If you feel comfortable, sleep with no underwear. Yeast develops in moist environments.
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