Vaginitis

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,
• Yeast infections
• Trichomoniasis
• Vaginal atrophy (atrophic vaginitis)

Treatment depends on the type of vaginitis you have.

Symptoms

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

When 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.

Risk factors

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
• Douching
• Wearing damp or tight-fitting clothing
• Using an intrauterine device (IUD) for birth control

Complications

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.
• Perform a pelvic exam. During the pelvic exam, your 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 that you take by mouth, metronidazole gel that you apply to your vagina or clindamycin cream that you apply to your vagina. 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 , clotrimazole or tioconazole. Yeast infections may also be treated with a prescription oral antifungal medication, such as fluconazole .
• Your doctor may prescribe metronidazole or tinidazole 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.

Lifestyle and home remedies

You’ll need prescription medication to treat trichomoniasis, bacterial vaginosis and vaginal atrophy. If you know you have a yeast infection, you may go ahead with treatment on your own, taking these steps:

• Use an over-the-counter medication specifically for yeast infections.
• Apply a cold compression

Prevention

Good hygiene may prevent some types of vaginitis from recurring and may relieve some symptoms:

• Avoid baths, hot tubs and whirlpool spas. Rinse soap from your outer genital area after a shower, and dry the area well to prevent irritation. Don’t use scented or harsh soaps, such as those with deodorant or antibacterial action.
• Avoid irritants. These include scented tampons and pads.
• Wipe from front to back after using the toilet. Doing so avoids spreading fecal bacteria to your vagina.

Other things that may help prevent vaginitis include:

• Don’t douche. Your vagina doesn’t require cleansing other than normal bathing. Repetitive douching disrupts the normal organisms that reside in the vagina and can actually increase your risk of vaginal infection. Douching won’t clear up a vaginal infection.
• Use a latex condom. Both male and female latex condoms may help you avoid infections spread by sexual contact.
• Wear cotton underwear. Also wear pantyhose with a cotton crotch. If you feel comfortable without it, skip wearing underwear to bed. Yeast thrives in moist environments.