Vaginitis is, generically, inflammation of the vagina and affects women of all ages. It is one of the most common complaints in the office. There are a number of causes of vaginitis and the treatment depends on the specific type.
The vagina contains a small amount of microorganisms like bacteria and yeast that are important for its normal function. Clear or white discharge in the vagina is also normal to keep the tissues healthy and moist so they don’t stick together. The normal environment of the vagina is acidic and when factors occur to alter this balance, the result is vaginitis. This inflammation may cause itching, burning, odor or a large amount of discharge. Things that can alter the normal environment include: medication use like antibiotics, changes in hormones, sexual intercourse, other substances in the vagina like spermicides, condoms or douches, and infections.
Types of vaginitis include yeast infections, bacterial vaginosis, trichomoniasis, and atrophic vaginitis. Yeast infections are due to a fungus and while they are commonly present in the vagina in small numbers they can overgrow when the normal environment is disrupted by things like antibiotics that kill off the normal vaginal bacteria. Pregnancy or menopause can lead to yeast infections due to the change in hormone levels. Diabetes or high sugar intake can also increase your risk for a yeast infection. The typical symptoms include itching and burning outside of the vagina and may be worse with urination or sex. The tissues are usually red and may be swollen. Some women see an increased white, clumpy discharge while others do not notice a change in discharge. Treatment involves an antifungal medication either placed in the vagina or taken orally. Bacterial Vaginosis (BV) is caused by an overgrowth of the normal vaginal bacteria. This is usually due to a pH change in the vagina. The typical symptoms are increased thin, discolored discharge with a fishy odor. Treatment involves antibiotic use either inserted vaginally or taken orally. BV can return easily and it may be beneficial to try an over the counter vaginal pH gel or suppository after the antibiotic course to reset the normal environment. Trichomoniasis is caused by a microscopic parasite and is transmitted through sexual contact. The typical symptoms involve increased discolored discharge, odor, redness and burning. Treatment requires an antibiotic, and sexual partners should also be treated to prevent recurrence. Abstinence until both partners have been treated is recommended. Atrophic Vaginitis is due to hormonal changes from menopause or breastfeeding and can cause vaginal irritation, and discharge. Symptoms are dryness, burning, irritation and even itching. Many women have pain with sex. Treatment is to apply estrogen to the vagina and external tissues.
Diagnosis is made by your provider taking a sample of the vaginal secretions for examination. Some tests are performed in the office with results right away and others have to be sent out to a lab and are available in a few days. To be certain of the most accurate results, it is best to not use anything in the vagina for a couple of days prior to your visit including medication, douches, having sex or using spermicides.
You can reduce your risk of getting vaginitis by avoiding scented products in the vagina including soaps, feminine hygiene sprays, vaginal lubricants, etc. Wash with plain water and avoid douches. Condoms with intercourse are helpful and thoroughly washing diaphragms, menstrual cups, cervical caps and spermicide applicators after each use is recommended. Although vaginitis is unpleasant and uncomfortable, it can almost always be treated and often prevented.
