The vagina is a sensitive part of the woman’s body, which sometimes develops infections or inflammation that could affect the quality of your life, anxiety, and discomfort.
All Women’s Care is a team of OB-GYNs dedicated to the health of women from all social, political, and economic backgrounds.
We diagnose and treat conditions such as vaginitis by first determining the exact cause and providing the right treatment.
Overview of Vaginitis
We have all had those moments when something does not feel quite right down there. It could be the smelly discharge, pain during sex, itchiness, or soreness on your vagina, affecting your concentration on important projects. Most of these symptoms could be a sign that you have vaginitis.
Vaginitis is a broad term defining conditions that cause vaginal infections or inflammation. The common organisms responsible for vaginitis include yeast, bacteria, protozoa, and irritation from beauty products and clothing.
Yeast and bacteria are naturally occurring microbes present in the vagina. They are responsible for maintaining a healthy vagina, and an imbalance could lead to infections or susceptibility to contracting other infections such as HIV.
The balance of these microbes requires that beneficial microbes be higher than pathogenic ones to keep the vagina healthy.
Slight changes can lead to an unhealthy balance of the bacterial in the vagina leading to symptoms such as discharge of an unusual color, smell, irritation of the vulva and vagina, and a burning sensation during sex or urination. Vaginal discharge also cleans up the vagina, maintaining a healthy balance of the flora found there.
Conditions such as lack of estrogen and vaginal dryness could increase the risk of passing organisms responsible for vaginitis.
Vaginitis can be one of the following types:
- Bacterial vaginosis caused by a change in the normal bacteria found in the vagina
- Yeast infections
- Trichomoniasis usually transmitted through sexual intercourse with an infected person.
- Viral vaginitis
- Sexually transmitted infections such as gonorrhea and chlamydia
Most women will have a vaginal infection at least once in their lifetime, but even this experience can be frustrating.
Vaginitis is not a sexually transmitted infection, but it can develop due to sexually transmitted diseases like trichomoniasis. Having sex with different partners also increases the risk of developing bacterial or yeast infections as a reaction to that person’s vaginal discharge or semen.
Causes of Vaginitis
Vaginitis is a broad name referring to several infections or inflammatory conditions affecting the vagina. These conditions can have seven different causes, which form different types of vaginitis. Accurate diagnosis and treatment depend on determining the correct cause of the infection. The common causes of vaginitis include:
- Changes in the healthy bacteria found in the vagina lead to an overgrowth of one or more of these bacteria leading to bacterial vaginosis. Bacterial vaginosis is the common cause of vaginitis among women, including those who are not sexually active. Bacterial vaginosis could also occur due to STDs, such as gonorrhea and chlamydia. You will notice a smelly odor when you have bacterial vaginosis, especially after intercourse. Your risk for the condition increases if you have multiple or new sexual partners, douche, or smoke cigarettes.
- Yeast infections, such as candida, also cause vaginitis. Candida is a part of the normal flora found in the vagina and digestive tract. However, an overgrowth of this flora due to changes in the vaginal pH causes vaginitis. Yeast infections typically do not cause smelly odor, but the vagina could be red and itchy, and you could experience a burning sensation when urinating. Yeast infections are not necessarily a result of sexual contact, although your risk increases if you have multiple sexual partners. You could develop the infection due to causes unrelated to intercourse, including pregnancy, medication, and diabetes.
- Trichomoniasis is a sexually transmitted protozoan. This form of vaginitis causes a greenish-yellow discharge with a foul smell. It also causes vaginal and vulval itching and soreness. It could also present no symptoms among most women. Since it is sexually transmitted, sexual partners are advised to be treated and abstain from sex for at least seven days after treatment. Men might not show symptoms of trichomoniasis unless they are tested.
- Viruses are another common cause of vaginitis. Herpes simplex is a common virus associated with viral vaginitis. It is sexually transmitted, often accompanied by pain from the sores or lesions that develop on the vulva or vagina. The virus could also be transmitted to the mouth during oral sex. HPV could also cause vaginitis leading to the development of genital warts on the vulva, vagina, rectum, and groin. Most warts from HPV are detectable through an exam, but you could notice white, grey, pink, or purple warts on your genitalia.
- Allergic reactions to sprays, douches, detergents, and spermicides irritate the vaginal tissues. Products such as tampons and tissues could also cause a form of non-infectious vaginitis and resolve by removing the irritant.
- Vaginal atrophy is a condition common among menopausal women. Estrogen levels reduce during menopause, causing thinning of the vaginal lining. This thinning causes irritation, burning, dryness, urinary urgency, and frequency. The condition could also occur if you are under medication for breast cancer or endometriosis, which typically reduces the estrogen level.
- Young girls who are not sexually active could develop vaginitis due to poor hygiene, especially when they wipe from back to front, thus introducing fecal bacteria to the vagina.
Symptoms of Vaginitis
The symptoms of vaginitis vary depending on the cause of the infection or inflammation. Most women with vaginitis are asymptomatic. Some of the symptoms you could experience include:
- Abnormal vaginal discharge
- A burning feeling when urinating
- Vaginal itchiness
- Discomfort or pain during sex
- Genital irritation
- Inflammation causing swelling of the labia
- Foul-smelling vaginal discharge
- Spotting or bleeding
- Fever or chills
- Pelvic pain
An abnormal vaginal discharge could include:
- Thick, white and odorless vaginal discharge
- Graying and foamy vaginal discharge with a fishy smell
- Frothy, yellow-green and foul-smelling discharge
Some people also experience recurring vaginal infections, or the symptoms of vaginitis persist even after medication. In such cases, you need to visit a doctor for an exam.
You should visit a doctor if you are experiencing these symptoms since some STDs such as chlamydia and gonorrhea have symptoms similar to those of vaginitis.
Any woman can develop vaginitis in the course of her life. However, some women are more at risk of developing the infection. The risk factors for vaginitis include:
- Hormonal changes associated with pregnancy, menopause, or the use of birth control pills.
- Sexual activity
- You have a sexually transmitted infection
- Use of medications such as antibiotics or steroids (antibiotics could kill the healthy bacteria in the vagina causing an overgrowth of candida)
- Use of spermicides
- Diabetes, which increases the level of sugar in the urine triggering an overgrowth of bacteria
- Use of hygiene products such as vaginal sprays, bubble baths, and scented soaps
- Wearing damp clothing
- Tight-fitting clothing
- Use of IUD as a form of birth control
Vaginitis also increases the risk that you could acquire sexually transmitted infections. Pregnant women who have vaginitis are at an increased risk of premature birth and low birth weight.
Diagnosis and Treatment
The diagnosis of vaginitis depends upon the symptoms you display. Your doctor will discuss the symptoms you are experiencing and the likely causes.
However, he or she will still perform tests to identify the actual cause of vaginitis (it is possible to have one or more types of vaginitis co-occurring.)
Your doctor will collect a sample of your vaginal discharge during a pelvic for lab analysis and prescribe the right medication based on the causative organism. The doctor will also test your vaginal pH to check for either bacterial vaginosis or trichomoniasis.
In some cases, your doctor might have to biopsy the vulva, especially if you do not respond to treatment.
Your doctor will also collect your medical history and ask questions about the products you could be using.
The treatment approach your doctor takes will depend on the cause of the infection but could include:
- The wait-and-see approach in which your doctor could advise you to wait out the infection, especially if it is due to wearing tight clothing, douching, or other causes of allergic reactions to the vagina. Your doctor will advise on the lifestyle changes you can make and some home remedies to relieve these symptoms.
- Bacterial vaginosis will require Flagyl tablets, Metrogel, or Cleocin cream, which require your doctor’s prescription.
- The treatment for yeast infections involves antifungal creams, which you could buy over the counter. Oral antifungal medications require a prescription from your doctor.
- Vaginitis due to trichomoniasis could be treated using prescribed medications such as tinidazole and Flagyl tablets.
- Your doctor could prescribe estrogen creams, tablets, or rings for vaginal atrophy. The specific treatment your doctor prescribes will depend on your risk factors and possible complications that could develop due to estrogen use.
Effective treatment of vaginitis might require screening and treating your sexual partner(s) to reduce the risk of recurring.
For children, proper hygiene, antibacterial medication, and steroids could be used to treat the condition. However, infections among pre-pubescent girls resolve by themselves during puberty due to the changes in hormones and the regulation of the vaginal pH by vaginal discharge.
You could also apply lifestyle changes and home remedies to cure vaginitis. Some of these include:
- Over the counter medication for yeast infections
- Cold compress to relieve discomfort (while using OTC or prescribed medication)
- Limiting the number of sexual partners
- Correct use of condoms during intercourse (use that made from materials that do not irritate your vagina)
- Use plain warm water to clean the outside of the vagina.
- Avoid douching
- Wipe from front to back to avoid introducing fecal bacteria to the vagina
- Wear loose clothing
- Wear cotton underwear or use a cotton crotch when wearing pantyhose (cotton is breathable and prevents the accumulation of moisture in your vagina. The moisture creates an ideal environment for the growth of bacteria responsible for vaginitis).
Consult your gynecologist before you combine home remedies with prescribed medication.
Complications of Vaginitis
Vaginitis affects more than a million women in America every year and is one of the leading gynecological problems for American women aged 15-45.
You can treat vaginitis with over the counter or prescription medication or using home remedies and lifestyle changes without the risk of developing complications. However, left untreated, vaginitis can be the source of more serious problems. The common complications resulting from untreated vaginitis include:
- A higher chance of contracting HIV when you have sex with an infected person
- Premature labor
- Higher chances of developing STDs such as chlamydia, and gonorrhea
- You could develop the pelvic inflammatory disease
Pelvic inflammatory disease arises when sexually transmitted bacteria travel from the vagina into the upper reproductive tract. Chlamydia and gonorrhea are common sources of bacteria that cause PID.
Left untreated, PID can cause ectopic pregnancies, infertility, chronic pelvic pain, and an abscess in the fallopian tubes and ovaries.
Prevention of Vaginitis
Some cases of vaginitis are avoidable if you take several preventative measures. The common ways you can prevent vaginitis include:
- Avoid using vaginal sprays, scented toilet papers, and tampons as they could have chemicals that could irritate your vagina
- Avoid douching unless your doctor recommends it; douching affects the balance of bacteria, yeast in the vagina, and increases the chances of infections.
- Clean the vaginal area daily with plain warm water daily or with a mild, unscented soap
- Keep the vaginal area as dry as possible to avoid developing yeast infections.
- Wipe correctly from front to back to avoid transferring bacteria from the anus to the vagina
- Change your tampon regularly to avoid irritation when you have an overstayed tampon.
- Limit your sexual partners and use a condom every time you have sex. Having fewer sexual partners reduces the risk of developing vaginal infections. If you are allergic to latex, you can use condoms made from alternative materials such as nitrile, polyurethane, or polyisoprene.
- Reduce your weight (if you are overweight) to facilitate better blood circulation to the vagina
- Exercise regularly to keep your body healthy.
- Take the antibiotics under the direction of a doctor. Antibiotics are responsible for killing bad bacteria, but when taken incorrectly, they could kill the good bacteria in your digestive system and the vagina.
- Avoid wet or damp clothes as they create a warm and damp environment for the growth of yeast infections.
- Avoid tight clothing as they trap moisture and warmth in your genitals.
- Wear cotton underwear for air circulation and dryness around the vagina
- Stop using lubricants or spermicides that irritate you.
- Understand your genitals, the regular smells, and your vaginal discharge, including the changes during the menstrual cycle so that you can detect problematic changes and get prompt treatment.
Vaginitis during Pregnancy
Pregnancy is a sensitive time during a woman’s life, with changing body functions and hormonal levels that make you more vulnerable and at risk of developing vaginal infections. Bacterial vaginosis is the most common type of vaginitis in pregnant women. Approximately 10%-30% of pregnant women will develop bacterial vaginosis during their pregnancy.
The imbalance in normal bacteria due to hormonal changes causes this infection. Most infections might be asymptomatic, but most doctors usually check for them in pregnant women.
You could also discuss your concerns during the prenatal checkups, especially if you have had the infection in previous pregnancies or have had such infections in the past.
Bacterial vaginosis (BV) increases the risk of preterm labor and low birth weight. It could also contribute to miscarriages, especially in the early weeks of pregnancy. BV also increases the risk of developing the pelvic inflammatory disease, which could affect your fertility.
Yeast infections are more common during the second trimester. These infections during pregnancy occur due to the related hormonal imbalances that allow for the overgrowth of the healthy yeast cells found in the vagina. High blood sugar, douching, and vaginal intercourse could also contribute to these infections.
The treatment for yeast infections includes the use of vaginal creams and suppositories. The oral drugs used for the treatment of yeast infections in non-pregnant women could be unsafe during pregnancy or lactation.
You must have a doctor’s prescription or advice before you purchase creams or suppositories as some are unsafe for use during pregnancy. Untreated yeast infections can pass to the baby during birth and cause thrush.
You can prevent the recurrence of these infections by consuming probiotic yogurt, limit your sugar intake, and take more rest to give your body room to fight infections. You should also apply the preventative measures discussed above.
Vaginitis in Women with HIV
Women with HIV are treated as a special population during the treatment of bacterial infections. HIV increases the risk of recurrent bacterial infections and heightens the risks of transmitting HIV.
Bacterial vaginosis increases the concentration of HIV in the vaginal, thus increasing the risk of transmitting the virus to your partners during sex.
Treatment for vaginitis is similar to that of non-HIV women. However, if treatment includes the use of clindamycin ovules, the medication could weaken latex condoms for up to 72 hours. This is a concern, especially if you have a non-HIV partner and use condoms for protection.
When you have four or more cases of vaginitis within twelve months, you are experiencing recurrent vaginitis. Recurrent vaginitis can be bothersome and frustrating due to the discomfort associated with the condition.
Bacterial vaginosis and yeast infections are recurring types of vaginal infections. The common causes of recurrent vaginitis include having multiple sexual partners, diabetes, HIV, and failing to complete your vaginitis treatment.
The infection can be a new infection or a redevelopment of an existing condition that did not heal completely during the previous treatment. This could be the case if you used over the counter medications to treat the infection, without a lab analysis to identify the exact cause of vaginitis.
HIV and diabetes lower your immunity, making it hard to fight infections. Diabetes also alters the sugar level in the blood and urine, creating an ideal environment for the growth of pathogenic bacteria.
Full treatment is essential in restoring the normal balance of the vaginal ecosystem and preventing recurrence. Treatment is typically longer and could include:
- Suppressants to keep you asymptomatic
- Counseling on lifestyle changes that you can adopt to lower the risks of recurrence
- Probiotic therapy either orally or vaginally
- Use of boric acid and nitroimidazole
Candidiasis or yeast infections are common recurring infections, with up to 8% of women experiencing recurrent infections. The number could be higher due to the large number of women who self-treat.
Recurrence can occur due to reinfection, diabetes, recent use of antibiotics, immunosuppression, and an increase in estrogen. Pregnancy also increases the risk of recurrence.
Treatment for complicated yeast infections requires longer therapy using topical or oral medication.
Implementing vulval care practices and avoiding douching and contact irritants can increase the chances of preventing recurrence. Doctors often isolate the specific strain causing the infection for better treatment.
Self-diagnosis and treatment are major contributing causes of recurrent vaginitis as it is hard for them to determine the exact cause of the infection. Lab analysis with your gynecologist can pinpoint the exact cost of the infection and provide the right treatment.
Find a Gynecologist Near Me
Your sexual and reproductive health is an important part of your womanhood, and when something is wrong, it could affect the quality of your life.
Infections such as bacterial and yeast infections are common for most women. While some could clear out on their own, others require medical attention to prevent complications such as urinary tract infections.
All Women's Care consists of gynecologists and obstetricians who provide healthcare services to all women regardless of their background, age, sexual identity, or political affiliation.
We are dedicated to ensuring that you understand your body and keep it healthy at all times. We care for you during puberty, pregnancy, and menopause and through life changes that increase the risk of developing vaginal infections.
Contact our offices at 213-250-9461 to book an appointment if you have a concern about your health.