What is vaginitis?

Vaginitis is the medical name for swelling, burning, itching, or an infection of the vagina. When the vulva is also affected, it is called vulvovaginitis. (The vulva is the fold of skin around the opening of the vagina.) Vaginitis is a very common problem that can occur in females of any age.

How does it occur?

Vaginitis can be caused by organisms that infect the vagina, such as bacteria, viruses, protozoa, or yeast. It can also be caused by irritants such as soap or powders.

Sexually transmitted diseases (STDs) that cause vaginal infections are:

• trichomoniasis
• chlamydial infections
• gonorrhea
• syphilis
• genital herpes
• human papillomavirus.

Yeast infections of the vagina are caused by overgrowth of a fungus called Candida. Vaginitis can also be caused by an overgrowth of bacteria normally found in the vagina. This is a condition called bacterial vaginosis or nonspecific vaginitis.

Irritants that can cause vaginitis include:

• birth control products such as condoms, diaphragms, and spermicides
• feminine hygiene products such as perfumed sprays, powders, or douches
• perfumed soaps, detergents, or fabric softeners
• nonabsorbent, heat-retaining clothing such as nylon pantyhose and tights
• antibiotics
• tampons
• sexual devices
• injury.

Vaginitis can also be caused by psychological stress, poor hygiene, or a decrease in estrogen hormone.

Sometimes the cause of vaginitis is not known.

What are the symptoms?

The main symptom of vaginitis is a lot of whitish or yellowish discharge from the vagina. Some milky vaginal discharge is normal for females of all ages, but infections cause an abnormal amount of discharge. The discharge may have a bad odor.

You may also have:

• an unpleasant odor from the vagina
• itching
• a swollen, red vulva, which may be painful or itchy
• painful intercourse
• bleeding in the vaginal area.

If you have pain in your lower abdomen or irregular bleeding with these symptoms, see your health care provider right away. If you are at risk for a sexually transmitted disease and have the above symptoms, you should also see your provider right away.

How is it diagnosed?

Your health care provider will examine you and do lab tests. The lab tests may include tests of vaginal discharge, urine tests, and blood tests.

How is it treated?

The goal of treatment is to eliminate the organisms or irritants that are causing the symptoms.

Infections are treated with antibiotic pills or shots, antifungal or antibacterial creams or gels, vaginal tablets, or vaginal inserts. Your health care provider may ask you to stop sexual activity for a time. Your provider may also ask that your partner be treated to prevent reinfection or spread of the infection.

Vaginitis caused by irritants can usually be treated by stopping exposure to the irritant. Some irritations are treated with steroid or hormone creams.

For women in menopause, vaginal dryness (atrophic vaginitis) can be treated with hormone pills or cream.

Do not treat vaginitis with nonprescription medicine without the approval of your health care provider. It could be the wrong treatment.

How long will the effects last?

The symptoms usually start to decrease after a day of treatment. Infections clear up in about a week. It is very important that you take all of your prescribed medicine, even if your symptoms are gone. This will help to prevent recurrence. If you stop taking your medicine after the symptoms are relieved but before the scheduled end of treatment, the infection or irritation may come back.

How can I take care of myself?

To help relieve the symptoms you can:

• Bathe with nonirritating, unscented soap. Use water that is warm but not hot. Rinse the genital area thoroughly but gently. Pat dry without rubbing.
• Wear loose-fitting, all-cotton underwear or cotton-crotch underwear.
• Keep your genital area dry.

Call your health care provider if you notice a change in color, odor, consistency, or quantity of vaginal discharge.

How can I help prevent vaginitis?

Practice good personal hygiene:

• Bathe daily with mild soap and warm water.
• Wear all-cotton underwear or underwear with cotton crotches.
• Change underwear and pantyhose every day.
• Avoid wearing pantyhose or tights for too many hours, especially in hot, humid weather.
• Use deodorant-free white toilet paper to avoid perfume and dye that might irritate.
• Avoid using feminine hygiene products (such as sprays and powders) and bath additives (such as bubble baths and oils).
• Avoid douching more than once a month. Douching is not necessary.
• Use deodorant-free sanitary pads or tampons.
• Avoid spermicidal foams, gels, and creams.
• Have just 1 sexual partner who is not sexually active with anyone else, and practice safe sex.

From: MD Consult patient information