Vaginitis

Vaginitis is the broad term for inflammation or infection of the vagina. There are many types of vaginitis; each of which is characterized by different causes and symptoms.1  

Symptoms of vaginitis include vaginal itching and irritation, painful urination, pain during intercourse, light vaginal bleeding or spotting, and vaginal discharge that has a foul smell or strange color. These symptoms are characteristic of most vaginal infections and may vary or not occur at all depending on the type of infection present.1

Types of Vaginitis

Bacterial Vaginosis

Bacterial Vaginosis (BV) is the most common type of vaginal infection in females ages 15-44. This infection is caused by an imbalance of normal bacteria in the vagina in which harmful bacteria outnumber healthy bacteria. This imbalance can result from having multiple sexual partners, having a new sexual partner, or from douching. However, cases of BV do commonly occur in females who have never had sex. Thus, BV is not considered a sexually transmitted infection. However, having a vaginal infection puts a female at an increased risk of contracting STIs.2

The most common symptoms of bacterial vaginosis are white or gray vaginal discharge, fishy odor, itching, burning, or pain inside or around the vagina, especially when urinating or after engaging in sex. As with many genital infections, bacterial vaginosis may be aymptomatic.2  

Yeast Infections

Yeast infections are also known as genital/vulvovaginal candidiasis (VVC). The fungal yeast Candida is found in small quantities all over the body. When there is an overgrowth of Candida in the vulva, candidiasis occurs. This overgrowth can result from a hormonal imbalance or a change in the pH in the vagina. Symptoms are usually the burning, itching, or pain that typical of other vaginal infections accompanied by a thick, white, cottage cheese-like discharge.1 This type of infection is very common in women who are sexually active and in women who are not sexually active. The Center for Disease Control and Prevention reports that about 75% of women have had a yeast infection in their lifetime. A female is at a higher risk for contraction of she has a weak immune system. Candidiasis is common in pregnant women because of the hormonal changes that a woman’s body undergoes when carrying a child.3

Trichomoniasis

Trichomoniasis is a sexually transmitted infection caused by a microscopic parasite called Trichomonas vaginalis. The parasite can be transmitted through vaginal intercourse (coitus), often unknowingly, as only about 30% of infected people exhibit symptoms.4 Symptoms in women include vaginal itching and burning, and a frothy greenish-yellow discharge.1 When the infection does present symptoms in men, it tends to cause burning or itching inside the urethra, painful urination and ejaculation, or a discharge from the urethra. Trichomoniasis infects about 3.7 million people in the US yearly. There are less cases of trichomoniasis in males than in females.4 Females can contract the infection from sexual contact with both males and females. Males typically contract the infection from only females because the parasite is rarely transmitted from male to male. Therefore, the reason that trichomoniasis is more common in females is that males are less likely to come into contact with the infection.

Noninfectious Vaginitis

Inflammation of the vagina is not always a result of infection. Douching or using vaginal sprays, scented soaps, detergents, and spermicides can cause irritation of the vagina or vulva. Post menopausal women or women who have had their ovaries or uterus removed sometimes experience vaginal atrophy-the thinning of the vaginal walls that is caused by hormonal changes.1

Risk

Women are more susceptible to getting vaginitis if they have uncontrolled diabetes, use scented hygiene products, engage in sex with multiple partners, are under emotional stress, take medications such as antibiotics and steroids, or are pregnant. Women who take birth control pills and women who douche are also more susceptible to vaginal infections. All of these risk factors can contribute to hormonal or bacterial imbalances in the vagina and vulva, which leads to irritation and sometimes infection.1

Complications

Serious complications relating to vaginitis are uncommon. However, leaving any type of vaginal infection untreated is never a good idea. Inflammation or lesions in the vagina make a female significantly more likely to transmit or contract an STI, especially HIV.1 Pregnant women who have vaginal infections such as bacterial vaginosis and trichomoniasis are at risk for giving birth prematurely and having babies with low birth weight.4

Diagnosis and Treatment

If a woman suspects that she may have a vaginal infection, she should see a doctor for a professional diagnosis. The symptoms related to vaginal infections are also characteristics of many sexually transmitted infections, so it is necessary for a doctor to make sure that it is a vaginal infection before you start treatment. A doctor usually cannot diagnose a vaginal infection based on symptoms alone. A doctor will perform a pelvic exam to take samples of vaginal fluid and have them tested in a laboratory to determine the type of infection present.1

Treatments of vaginal infections vary depending on the type of vaginitis. Typically the cure for infections such as BV, candidiasis, and trichomoniasis involves applying creams to the vagina or vulva, inserting suppositories into the vagina, taking oral medications, or a combination of these treatments. Some treatments can be bought over the counter, while others require a prescription from a doctor. With the help of medication, most infections will clear up within a week.1 It is important to note that vaginal infections can be passed from partner to partner (even to males), so it might be necessary for both partners to be treated in order for the infection to be cured completely. It is also wise to discontinue sexual contact until the infection is gone.

Noninfectious vaginitis can be treated simply by identifying the cause and taking steps to fix it. The use of soaps, detergents, sprays, and other things that irritate the vagina should be discontinued if a noninfectious inflammation is present. Doctors can prescribe hormone-regulating medications for vaginal atrophy. There may be some creams or suppositories available over-the-counter to treat any discomfort, but remember that is it not a good idea to use over-the-counter treatments without consulting a doctor to make an accurate diagnosis.3

Prevention

To prevent the contraction of sexually transmitted vaginitis, use latex condoms consistently and correctly and communicate with potential sexual partners about their history of STIs before having sex. Limiting the number of sexual partners or abstaining from sex altogether can also significantly lower a person’s risk of contracting and transmitting STIs.1

To help prevent vaginitis that is contracted non-sexually, avoid using scented tampons, soaps, and detergents that could cause irritation. Make sure to wash away all soap after showering. Wipe front to back after using the toilet in order to prevent anal bacteria from entering the vagina.1 Wear cotton underwear instead of nylon underwear. Nylon traps heat and moisture, creating an environment conducive to bacterial growth. Don’t douche. The vagina has many “good” bacteria that are washed away by repetitive douching. Disrupting the vagina’s healthy environment will only increase the risk of contracting a vaginal infection.1

 

References

1. "Vaginitis." Mayo Clinic-Diseases and Conditions. Mayo Clinic, n.d. Web. 29 Oct. 2014. <http://www.mayoclinic.org/diseases-conditions/vaginitis/basics/definitio....

2. "Bacterial Vaginosis – CDC Fact Sheet." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 11 Mar. 2014. Web. 29 Oct. 2014. <http://www.cdc.gov/std/bv/stdfact-bacterial-vaginosis.htm>.

3. "Genital / Vulvovaginal Candidiasis." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 13 Feb. 2014. Web. 29 Oct. 2014. <http://www.cdc.gov/fungal/diseases/candidiasis/genital/definition.html>.

4. "Trichomoniasis - CDC Fact Sheet." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 03 Aug. 2012. Web. 29 Oct. 2014. <http://www.cdc.gov/std/trichomonas/stdfact-trichomoniasis.htm>.

 

Last Updated 29 October 2014.

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