Vaginitis

Vaginitis is an inflammation of the vagina. Vaginitis may cause itching, burning, a bad odor, or a large amount of discharge. It is one of the most common reasons for visiting an obstetrician–gynecologist (ob-gyn). Vaginitis can develop at any age. There are many possible causes of vaginitis, and the type of treatment depends on the cause.

Common types of vaginitis include

• yeast infections

• bacterial vaginosis (BV)

• trichomoniasis

• atrophic vaginitis

The vagina contains many organisms, such as bacteria and yeast, that are important to its normal function. A change in the normal balance of either yeast or bacteria can result in vaginitis. This causes the lining of the vagina to become inflamed. Factors that can change the normal balance of the vagina include

• antibiotics

• changes in hormone levels during pregnancy, breastfeeding, or menopause

• douching

• spermicides

• sexual intercourse (vaginal sex)

• infection

To diagnose vaginitis, your ob-gyn should take a sample of the discharge from your vagina. Several tests may be done. Some test results may be available right away. For others, the sample must be sent to a lab, and results are ready in a few days.

To ensure the results of the tests are accurate, do not use any vaginal medications for at least 3 days before you visit your ob-gyn. You also should not douche, have sex, or use spermicides before your visit.

Treatment depends on the cause of the vaginitis. Treatment may be a pill, cream, or gel that is inserted into the vagina.

It is important to follow treatment directions exactly, even if the symptoms go away before you finish the medication. Even though the symptoms disappear, the infection could still be present. Stopping the treatment early may cause symptoms to return.

If symptoms do not go away after the treatment is finished, or if they come back, talk with your ob-gyn. A different treatment may be needed.

There are a number of things you can do to reduce the risk of getting vaginitis:

• Do not use feminine hygiene sprays, "full body deodorants," or scented tampons.

• Do not douche. It is better to let the vagina cleanse itself.

• Use plain warm water to clean the vulva. Soaps and detergents can change the normal balance of organisms inside the vagina.

• Thoroughly clean diaphragms, cervical caps, spermicide applicators, and menstrual cups after each use.

• Use condoms during sex.

• Check with your ob-gyn about preventing yeast infections if you are prescribed antibiotics for another type of infection.

Yeast infection is also called candidiasis. It is one of the most common types of vaginitis.

Yeast infections are caused by a fungus called Candida. It normally is found in small numbers in the vagina. But when the balance of bacteria and yeast in the vagina is altered, the yeast may overgrow and cause symptoms.

• Antibiotics—Some types of antibiotics increase the risk of a yeast infection. The antibiotics kill normal vaginal bacteria, which keep yeast in check. The yeast can then overgrow.

• Pregnancy—Changes in the body's hormone levels during pregnancy can increase the risk.

• Diabetes—Having diabetes can also increase your risk of yeast infection.

• Conditions that affect the immune system—Yeast can overgrow if the immune system, which protects the body from disease, is not working well. For example, in people infected with human immunodeficiency virus (HIV), yeast infections may be severe. They may not go away, even with treatment, or may recur (come back) often.

In many cases, the cause of a yeast infection is not known.

The most common symptoms of a yeast infection are itching and burning of the vulva. The burning may be worse with urination or sex. The vulva may be red and swollen.

Sometimes yeast infections cause an increase or change in vaginal discharge. Discharge may be white, lumpy, and have no odor. Sometimes there is no change in discharge.

Yeast infections can be treated either by placing medication into the vagina or by taking a pill. In most cases, treatment of male sex partners is not necessary.

Over-the-counter treatments are safe and often effective. But you may think you have a yeast infection when you actually have another problem. In this case, a medication for a yeast infection will not work. It may also cause a delay in proper diagnosis and treatment of the actual problem.

Even if you have had a yeast infection before, it may be a good idea to call your ob-gyn before using an over-the-counter medication to treat your symptoms. If this is the first time you have had vaginal symptoms, you should visit your ob-gyn. If you have used an over-the-counter medication and your symptoms do not go away, visit your ob-gyn.

Bacterial vaginosis (BV) not a true infection. BV is caused by an imbalance in the types of normal bacteria that live in the vagina. Anyone can get it, no matter their age or whether they’ve had vaginal sex.

Researchers have learned that sexual partners are often carriers of the bacteria that causes this imbalance. If you are having sex, ask about getting your partner treated as well.

The main symptom is increased discharge with a strong fishy odor. The odor may be stronger during your menstrual period or after sex. The discharge is usually thin and dark or dull gray, but it may have a greenish color. Itching is not common, but there may be itching if there is a lot of discharge.

Several different antibiotics can be used to treat BV, including metronidazole and clindamycin. They can be taken by mouth or inserted into the vagina as a cream or gel.

If you’re having sex, your sex partners should consider getting treatment to reduce the risk that BV will recur. Female partners have the same treatment as you. Male partners are treated with antibiotic pills and an antibiotic cream on the penis.

When metronidazole is taken by mouth, it can cause side effects in some patients. These include nausea, vomiting, and darkening of the urine. Do not drink alcohol when taking metronidazole. The combination can cause severe nausea and vomiting.

BV often recurs. It may require repeated treatment. If you’re having sex, the risk of recurrence is lower when your partner gets treatment as well.

In some cases, longer treatment for 3 to 6 months may be needed.

Trichomoniasis is a condition caused by the microscopic parasite Trichomonas vaginalis. It is a sexually transmitted infection (STI). If you have trichomoniasis, you are at increased risk of infection with other STIs.

Signs of trichomoniasis may include a yellow-gray or green vaginal discharge. The discharge may have a fishy odor. There may be burning, irritation, redness, and swelling of the vulva. Sometimes there is pain during urination.

Trichomoniasis is treated by taking metronidazole pills. Sexual partners must be treated so that you do not get infected again. You should not have sex until you and your partner have finished treatment.

Atrophic vaginitis is not caused by an infection, but it can cause vaginal discharge and irritation. It may develop when hormone levels are low, such as during breastfeeding and after menopause. When it happens around the time of menopause, it is called genitourinary syndrome of menopause.

Symptoms include dryness, itching, and burning. Other symptoms include abnormal vaginal discharge and pain during sex.

Atrophic vaginitis is treated with estrogen that is applied inside the vagina. It is available as a cream, tablet, or ring. A water-soluble lubricant may also be helpful during sex.

Antibiotics: Medications that treat or decrease the risk of certain infections caused by bacteria.

Atrophic Vaginitis [ay-TROH-fik vaj-uh-NY-tuhs]: A condition caused by a lack of estrogen. Vaginal symptoms may include tissue changes, itching, burning, irritation, discharge, dryness, or inflammation. Also called vaginal atrophy.

Bacteria: One-celled organisms that can cause infections in the human body.

Bacterial Vaginosis [va-juh-NOH-suhs] (BV): A condition caused by an overgrowth of certain bacteria in the vagina. Symptoms may include vaginal discharge, fishy odor, pain, itching, and burning.

Candidiasis [kan-dih-DY-uh-sis]: A type of vaginal infection caused by the overgrowth of a fungus called Candida. Also called a yeast infection.

Carriers: People infected with a virus or bacteria without showing symptoms of disease. These people can pass the virus or bacteria to others.

Diabetes: A condition that causes high levels of sugar in the blood.

Estrogen: A sex hormone made in the ovaries.

Genitourinary Syndrome of Menopause [jen-uh-toh-YUR-uh-nair-ee] (GSM): A collection of signs and symptoms caused by a decrease in estrogen and other sex hormones. Signs and symptoms can include vaginal dryness, pain with sex, bladder symptoms, frequent urinary tract infections (UTIs), burning, itching, and irritation.

Hormone: A substance made in the body that controls the function of cells or organs.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system. If left untreated, HIV can cause acquired immunodeficiency syndrome (AIDS).

Immune System: The body’s natural defense system against viruses and bacteria that cause disease.

Inflammation: Pain, swelling, redness, and irritation of tissues in the body.

Menopause: The last menstrual period, often happening around age 51. Menopause can only be confirmed after 1 year of no periods.

Menstrual Period: The monthly shedding of blood and tissue from the uterus. Also called menstruation.

Obstetrician–Gynecologist (Ob-Gyn): A doctor with medical and surgical training and education in the female reproductive system.

Sexual Intercourse: The act of the penis entering the vagina. Also called vaginal sex.

Sexually Transmitted Infection (STI): An infection that is spread by sexual contact. Infections include chlamydia, gonorrhea, trichomoniasis, human papillomavirus (HPV), herpes, syphilis, and human immunodeficiency virus (HIV).

Spermicides: Chemicals (creams, gels, foams) that stop sperm from traveling to an egg.

Trichomoniasis [trik-uh-muh-NY-uh-suhs]: A type of vaginal infection caused by a parasite. This infection is passed through sex.

Vagina: A tube-like structure surrounded by muscles. The vagina leads from the uterus to the outside of the body.

Vulva: The external female genital area.

Yeast Infections: Infections caused by an overgrowth of a fungus. Symptoms may include itching, burning, and irritation of the vulva or vagina and a thick, white discharge