Vaginitis is an inflammation of the vagina that can result in discharge, itching and pain. The cause is usually a change in the normal balance of vaginal bacteria or an infection. Vaginitis can also result from reduced estrogen levels after menopause.
The most common types of vaginitis are:
- Bacterial vaginosis, which results from overgrowth of one of several organisms normally present in your vagina
- Yeast infections, which are usually caused by a naturally occurring fungus called Candida albicans
- Trichomoniasis, which is caused by a parasite and is commonly transmitted by sexual intercourse
- Vaginal atrophy (atrophic vaginitis), which results from reduced estrogen levels after menopause
Treatment depends on the type of vaginitis you have.
SYMPTOMS OF VAGINITIS
Vaginitis signs and symptoms may include:
* Change in color, odor or amount of discharge from your vagina
* Vaginal itching or irritation
* Pain during intercourse
* Painful urination
* Light vaginal bleeding or spotting
The characteristics of vaginal 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 fish-like, may be more obvious after sexual intercourse.
- Yeast infection – The main symptom is itching, but you may have a white, thick discharge that resembles cottage cheese.
- Trichomoniasis – An infection called trichomoniasis (trik-o-moe-NIE-uh-sis) can cause a greenish yellow, sometimes frothy discharge.
The right time to see a doctor
See your doctor if you develop any unusual vaginal discomfort, especially if:
You’ve never had a vaginal infection. Seeing your doctor can establish the cause and help you learn to identify the signs and symptoms.
You’ve had vaginal infections before, but in this case, it seems different.
You’ve had multiple sex partners or a recent new partner. You could have a sexually transmitted infection. The signs and symptoms of some sexually transmitted infections are similar to those of a yeast infection or bacterial vaginosis.
You’ve completed a course of over-the-counter anti-yeast medication and your 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.
CAUSES OF VAGINITIS
The cause depends on the type of vaginitis you have.
Bacterial vaginosis results from an overgrowth of one of several organisms normally present in your vagina. Usually, “good” bacteria (lactobacilli) outnumber “bad” bacteria (anaerobes) in your vagina. But if anaerobic bacteria become too numerous, they upset the balance, causing bacterial vaginosis. This type of vaginitis seems to be linked to sexual intercourse especially if you have multiple sex partners or a new sex partner but it also occurs in women who aren’t sexually active.
A yeast infection occurs when there’s an overgrowth of a fungal organism — usually C. albicans — in your vagina. Besides causing most vaginal yeast infections, C. albicans also causes infections in other moist areas of your body, such as in your mouth (thrush), skin folds and nail beds. The fungus can also cause diaper rash.
Trichomoniasis is a common sexually transmitted infection caused by a microscopic, one-celled parasite called Trichomonas vaginalis. This organism spreads during sexual intercourse with someone who already has the infection. In men, the organism usually infects the urinary tract, but often it causes no symptoms. In women, trichomoniasis typically infects the vagina, and usually it causes symptoms.
Vaginal sprays, douches, perfumed soaps, scented detergents and spermicidal products may cause an allergic reaction or irritate vulvar and vaginal tissues. Thinning of the vaginal lining , a result of decreased hormone levels following menopause or surgical removal of the ovaries ,can also cause vaginal itching and burning.
RISK FACTORS OF VAGINITIS
Factors that increase your risk of developing vaginitis include:
* Hormonal changes, such as those associated with pregnancy, birth control pills or menopause
* Sexual activity
* Having a sexually transmitted infection
* Medications, such as antibiotics and steroids
* Uncontrolled diabetes
* Use of hygiene products such as bubble bath, vaginal spray or vaginal deodorant
* Wearing damp or tight-fitting clothing
* Using an intrauterine device (IUD) for birth control
COMPLICATIONS OF VAGINATIS
Generally, vaginal infections don’t cause serious complications. In pregnant women, however, symptomatic bacterial vaginosis and trichomoniasis have been associated with premature deliveries and low birth weight babies. Women with trichomoniasis or bacterial vaginosis are also at a greater risk of acquiring HIV and other sexually transmitted infections.
TESTS AND DIAGNOSIS
To diagnose vaginitis, your doctor may:
Review your medical history, including your history of vaginal or sexually transmitted infections.
Doctors can also perform a pelvic exam. During the pelvic exam, doctor may collect a sample of cervical or vaginal discharge for lab testing to confirm what kind of vaginitis you have.
TREATMENTS AND DRUGS
A variety of organisms and conditions can cause vaginitis, so treatment targets the specific cause:
Bacterial vaginosis. For this type of vaginitis, your doctor may prescribe :
* metronidazole tablets (Flagyl) that you take by mouth
* metronidazole gel (MetroGel) that you apply to your vagina or clindamycin cream (Cleocin) that you apply to your vagina
N.B – Medications are usually used once or twice a day for five to seven days.
Yeast infections. Yeast infections usually are treated with an antifungal cream or suppository, such as :
* miconazole (Monistat)
* clotrimazole (Gyne-Lotrimin)
* tioconazole (Vagistat)
Yeast infections may also be treated with a prescription oral antifungal medication, such as :
* fluconazole (Diflucan).
The catch is you may be treating something other than a yeast infection. It’s possible to mistake a yeast infection for other types of vaginitis or conditions that need different treatment. Using the wrong medicine may delay an accurate diagnosis and proper treatment.
Trichomoniasis – Your doctor may prescribe metronidazole (Flagyl) or tinidazole (Tindamax) tablets.
Thinning of vaginal lining (vaginal atrophy). Estrogen in the form of vaginal creams, tablets or rings can effectively treat atrophic vaginitis. This treatment is available by prescription from your doctor.
Noninfectious vaginitis – To treat this type of vaginitis, you need to pinpoint the source of the irritation and avoid it. Possible sources include new soap, laundry detergent, sanitary napkins or tampons. Your doctor may prescribe topical estrogen, such as a cream, to relieve your symptoms.