Vaginitis

Description

Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the balance of vaginal bacteria or an infection. Reduced estrogen levels after menopause and some skin disorders can also cause vaginitis.

The most common types of vaginitis are:

  • Bacterial vaginosis. This is the result of an overgrowth of the bacteria that is naturally found in the vagina, which upsets the natural balance.
  • For yeast infections. These are usually caused by a naturally occurring fungus called Candida albicans.
  • Trichomoniasis. This is caused by a parasite and is often sexually transmitted.

The treatment depends on the type of vaginitis you have.

Symptoms

Vaginitis signs and symptoms may include:

  • Change in the color, odor or amount of discharge from the vagina
  • Vaginal itching or irritation
  • Pain during sex
  • Pain when urinating
  • Light vaginal bleeding or spotting

If you have vaginal discharge, the characteristics of the discharge may indicate the type of vaginitis you have. Examples include:

  • Bacterial vaginosis. You may develop a grayish-white, foul-smelling discharge. The odor, often described as a fishy odor, it might be more obvious after sexual intercourse.
  • Yeast infection. The main symptom is itching, but may have a thick white discharge that resembles cottage cheese.
  • Trichomoniasis. An infection called trichomoniasis (trik-o-moe-NIE-uh-sis) may cause a greenish-yellow, sometimes frothy discharge.

When to see a doctor

Consult your health care provider if vaginal discomfort, especially if:

  • You have a particularly unpleasant vaginal odor, discharge, or itching.
  • You've never had a vaginal infection. See your health care provider can establish the cause and help you learn to identify the signs and symptoms.
  • You've had vaginal infections before.
  • Have you had multiple sex partners or a new partner. You could have a sexually transmitted infection, some of which have signs and symptoms similar to those of a yeast infection or bacterial vaginosis.
  • You have completed a course of over-the-counter anti-fungal medication and the symptoms persist.
  • You have a fever, chills, or pelvic pain.

Wait-and-see approach

You probably don't need to see your doctor every time you have vaginal irritation and discharge, especially if:

  • You previously had a diagnosis of vaginal yeast infection and its signs and symptoms are the same as before
  • Know the signs and symptoms of a yeast infection, and you are sure it is what you have

Causes

The cause depends on what type of vaginitis you have:

  • Bacterial vaginosis.This most common type of vaginitis results from a change of the bacteria found in the vagina, upsetting the balance. What causes the imbalance is unknown. It is possible to have bacterial vaginosis without symptoms. This type of vaginitis seems to be linked to, but not caused by sex — especially if you have multiple sex partners or a new sex partner— but also occurs in women who are not sexually active.
  • For yeast infections. These occur when there is an overgrowth of a fungal organism — usually Candida albicans in the vagina. C. albicans also causes infections in other moist areas of the body, such as in the mouth (thrush), the folds of the skin and nails. The fungus can also cause diaper rash.
  • Trichomoniasis.This common sexually transmitted infection is caused by a microscopic, single-celled parasite called Trichomonas vaginalis. This organism spreads during sexual intercourse with someone who has the infection. In men, the organism usually infects the urinary tract, but often does not cause symptoms. In women, trichomoniasis typically infects the vagina, and can cause symptoms. It also increases women's risk of contracting other sexually transmitted infections.
  • Non-infectious vaginitis. Vaginal sprays, douches, perfumed soaps, detergents, perfumed and spermicide products can cause an allergic reaction or irritate the vulva of the vagina and the tissues. Foreign objects, such as toilet paper or forgotten tampons, in the vagina can also irritate the vaginal tissues.
  • Genitourinary syndrome of menopause (vaginal atrophy). Reduced estrogen levels after menopause or surgical removal of the ovaries can cause the vaginal lining to thin, sometimes resulting in vaginal irritation, burning, and dryness.

Bacterial vaginosis. This most common type of vaginitis results from a change of the bacteria found in the vagina, upsetting the balance. What causes the imbalance is unknown. It is possible to have bacterial vaginosis without symptoms.

This type of vaginitis seems to be linked to, but not caused by sex — especially if you have multiple sex partners or a new sex partner— but also occurs in women who are not sexually active.

Trichomoniasis. This common sexually transmitted infection is caused by a microscopic, single-celled parasite called Trichomonas vaginalis. This organism spreads during sexual intercourse with someone who has the infection.

In men, the organism usually infects the urinary tract, but often does not cause symptoms. In women, trichomoniasis typically infects the vagina, and can cause symptoms. It also increases women's risk of contracting other sexually transmitted infections.

Risk factors

The factors that increase the risk of developing vaginitis include:

  • Hormonal changes, such as those associated with pregnancy, birth control pills, or menopause
  • The Sexual activity
  • Having a sexually transmitted infection
  • Medications, such as antibiotics and steroids
  • The use of spermicides
  • Diabetes is not controlled.
  • The use of hygiene products such as bubble bath, vaginal, or spray deodorant vaginal
  • Douching
  • Using wet or tight clothing
  • The use of an intrauterine device (IUD) for birth control

Complications

Women with trichomoniasis or bacterial vaginosis are at greater risk of contracting sexually transmitted infections due to the inflammation caused by these diseases.

Prevention

Good hygiene can prevent some types of recurrent vaginitis and relieve some of the symptoms:

  • Avoid baths, hot tubs and whirlpool spas.
  • Avoid irritants. These include scented tampons, tampons, douches, and scented soaps. Rinse the soap out of your external genital area after a shower and dry the area well to avoid irritation. Do not use strong soaps, such as those with deodorant or antibacterial action, or bubble bath.
  • Wipe from front to back after using the toilet. Doing so avoids the spread of fecal bacteria to your vagina.

Other things that can help prevent vaginitis include:

  • Avoid douching. Your vagina doesn't require cleansing other than regular shower. Repetitive douching disrupts the good organisms that live in the vagina and may increase your risk of vaginal infection. Douching is not a vaginal infection.
  • Practice safe sex. The use of a condom, and limit the number of sexual partners can help.
  • Wear cotton underwear. Also, wear pantyhose with a cotton crotch. Consider the possibility of not wearing underwear to bed. Yeast thrives in moist environments.

Vaginitis

Diagnosis

To diagnose vaginitis, your health care provider is likely to:

  • Review of the clinical history. This includes its history, vaginal or sexually transmitted infections.
  • Perform a pelvic exam. During the pelvic exam, the doctor may use an instrument (a speculum) to see the inside of your vagina for inflammation and download.
  • Collect a sample for lab testing. Your health care provider may collect a sample of cervical or vaginal for lab testing to confirm what type of vaginitis you have.
  • Perform pH tests. Your health care provider might test your vaginal pH through the application of a pH test stick or the pH of the paper to the wall of your vagina. A high pH may indicate either bacterial vaginosis or trichomoniasis. However, pH testing alone is not a reliable diagnostic test.

Treatment

A variety of organisms and conditions can cause vaginitis, so the goals of treatment of the specific cause:

  • Bacterial vaginosis.For this type of vaginitis, your health care provider may prescribe metronidazole tablets (Flagyl) that you take by mouth, or metronidazole gel (MetroGel) is applied to the affected area. Other treatments include clindamycin (Cleocin) cream that you apply to your vagina, clindamycin tablets that you take by mouth or capsules that you put in your vagina. Tinidazole (Tindamax) or secnidazole (Solosec) are taken by mouth. Bv can recur after treatment.
  • For yeast infections.Yeast infections are usually treated with an over-the-counter antifungal cream or suppository, such as miconazole (1), clotrimazole (Lotrimin AF, Mycelex, Trivagizole 3), butoconazole (Gynazole-1) or tioconazole (1). Yeast infections can also be treated with a prescription oral antifungal medicine such as fluconazole (Diflucan). The advantages of over-the-counter treatment are convenience, cost, and not waiting to see to your health care provider. However, you could have something other than a yeast infection. The use of the wrong medicine may delay an accurate diagnosis and an appropriate treatment.
  • Trichomoniasis. Your health care provider may prescribe metronidazole (Flagyl) or tinidazole (Tindamax) tablets.
  • Genitourinary syndrome of menopause (vaginal atrophy). The estrogen in the form of vaginal creams, tablets or rings can treat this condition. This treatment is available by prescription from your health care provider, after that other risk factors and potential complications are reviewed.
  • Non-infectious vaginitis. To treat this type of vaginitis, you need to identify the source of the irritation and avoid it. Possible sources include the new soap, detergent, sanitary towels or tampons.

Bacterial vaginosis. For this type of vaginitis, your health care provider may prescribe metronidazole tablets (Flagyl) that you take by mouth, or metronidazole gel (MetroGel) is applied to the affected area. Other treatments include clindamycin (Cleocin) cream that you apply to your vagina, clindamycin tablets that you take by mouth or capsules that you put in your vagina. Tinidazole (Tindamax) or secnidazole (Solosec) are taken by mouth.

Bv can recur after treatment.

For yeast infections. Yeast infections are usually treated with an over-the-counter antifungal cream or suppository, such as miconazole (1), clotrimazole (Lotrimin AF, Mycelex, Trivagizole 3), butoconazole (Gynazole-1) or tioconazole (1). Yeast infections can also be treated with a prescription oral antifungal medicine such as fluconazole (Diflucan).

The advantages of over-the-counter treatment are convenience, cost, and not waiting to see to your health care provider. However, you could have something other than a yeast infection. The use of the wrong medicine may delay an accurate diagnosis and an appropriate treatment.

Self-care

You will need prescription medications for the treatment of trichomoniasis, bacterial vaginosis, and vaginal atrophy. If you know that you have a yeast infection, you can take these steps:

  • The use of a medication specifically for yeast infections that you can get without a prescription.Options include one-day, three-day or seven-day courses of cream or vaginal suppositories. The active ingredient varies, depending on the product: clotrimazole, miconazole (1) or tioconazole (The). Some products also come with an external cream that is applied to the lips and the opening of the vagina. Follow the instructions on the package, and completing the full course of treatment even if you feel better immediately.
  • Apply a cold compress, such as a cloth, so that the lip of the area to relieve the discomfort until the antifungal medication to take effect.

The use of a medication specifically for yeast infections that you can get without a prescription. Options include one-day, three-day or seven-day courses of cream or vaginal suppositories. The active ingredient varies, depending on the product: clotrimazole, miconazole (1) or tioconazole (The).

Some products also come with an external cream that is applied to the lips and the opening of the vagina. Follow the instructions on the package, and completing the full course of treatment even if you feel better immediately.

Preparing for your appointment

Your family doctor, gynecologist or other health care professional can diagnose and prescribe treatment of vaginitis.

What you can do

To prepare for your appointment, make a list of:

  • Your symptoms and how long you have had
  • Key personal information, including the number of sexual partners you have and if you have a new sexual partner
  • All the drugs, vitamins, and other supplements that you take, including over-dose
  • Questions to ask your health care provider

Avoid the use of tampons, have sexual intercourse or douching before your appointment so that your health care provider can assess your vaginal discharge.

To vaginitis, some basic questions include:

  • What can I do to prevent vaginitis?
  • What are the signs and symptoms should I watch for?
  • I need medication?
  • There are over-the-counter products that is going to treat my condition?
  • What can I do if my symptoms return after treatment?
  • Does my partner need to be examined or treated?

Do not hesitate to ask other questions.

What to expect from your doctor

Your health care provider is likely to ask you questions, such as:

  • How to note a strong vaginal odor?
  • Do your symptoms seem to be tied to your menstrual cycle? For example, symptoms are more intense just before or just after your period?
  • Have you tried over-the-counter products for the treatment of your condition?
  • Are you pregnant?
  • Does the use of scented soaps or bubble bath?
  • How to use douches or feminine hygiene spray?

Don't be embarrassed to talk about symptoms that might suggest the vaginitis. Talk with your health care provider as soon as possible in order not to delay the treatment.

Symptoms and treatment of Vaginitis