Vaginitis

  • Medical Author:
    Melissa Conrad Stöppler, MD

    Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

  • Medical Editor: John P. Cunha, DO, FACOEP
    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, FACOEP

    John P. Cunha, DO, is a U.S. board-certified Emergency Medicine Physician. Dr. Cunha's educational background includes a BS in Biology from Rutgers, the State University of New Jersey, and a DO from the Kansas City University of Medicine and Biosciences in Kansas City, MO. He completed residency training in Emergency Medicine at Newark Beth Israel Medical Center in Newark, New Jersey.

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Vaginitis facts

  • Vaginitis is inflammation of the vagina.
  • Symptoms of vaginitis include vaginal pain or discomfort, itching, discharge, and odor. Pain with urination or during sexual intercourse is also common.
  • Vaginitis may be due to infections or non-infectious causes.
  • Infectious vaginitis may be due to bacteria, fungus, or the parasitic organism known as Trichomonas.
  • Infectious vaginitis should be treated with antibiotics.
  • Vaginitis can also be related to physical or chemical irritation of the vagina.
  • Some infectious causes of vaginitis are sexually-transmitted diseases (STDs), but not all vaginal infections are sexually-transmitted.

What is vaginitis?

Vaginitis refers to inflammation of the vagina that often occurs in combination with inflammation of the vulva, a condition known as vulvovaginitis. Vaginitis is often the result of an infection with yeast, bacteria, or Trichomonas, but it may also arise due to physical or chemical irritation of the area. Not all infections that cause vaginitis are considered sexually transmitted diseases (STDs), but some STDs cause vaginitis.

Vaginitis Causes

Yeast Infections (a Type of Vaginitis) and Douching

Viewer question: Does douching cause yeast infections (a form of vaginitis)? Also, is it necessary to douche after a yeast infection?

Doctor's response:

All healthy women have bacteria and other organisms in the vagina. The balance of organisms and the normal acidity of the vagina both act to prevent overgrowth of specific organisms, leading to symptoms of a vaginal infection. Douching disturbs the normal environment of the vagina, which can lead to inflammation and further imbalance of the organisms normally present in the vaginal canal. This can result in symptoms such as chronic vaginal dischargeand discomfort.

What causes vaginitis?

Infectious causes of vaginitis include bacteria, yeast, and Trichomonas.

  • Bacterial vaginosis is the most common bacterial infection that causes vaginitis. This condition results from an imbalance in the bacteria normally present in the vagina. It is not clear if sexual activity plays a role in the development of bacterial vaginosis, and some experts believe it can occur in women who have not had sexual contact. The STDs gonorrhea and Chlamydia are other bacterial causes of vaginitis.
  • Yeast infections, such as Candida infection, are a common cause of vaginitis. Yeast infections are not considered to be STDs.
  • Trichomonas ("Trich") is a parasitic infection that is transmitted through sexual contact.
  • Non-infectious causes of vaginitis include physical or chemical irritation, such as:

Vaginitis in young girls has also been described and is thought to arise from poor hygiene practices that allow the spread of fecal bacteria from the anal area into the vagina.

What are the risk factors for vaginitis?

The risk factors for vaginitis depend upon the type of vaginitis.

Risk factors for STDs include multiple sexual partners and unprotected intercourse.

Some of the known risk factors for bacterial vaginosis include cigarette smoking, multiple sex partners, douching, and using IUDs for contraception.

Risk factors for yeast infection are varied. They can include suppression of the immune system either due to cancer or other conditions, or by taking immune-suppressing medications. Antibiotic use is another known risk factor. Pregnancy, diabetes, taking oral contraceptives, and douching can all increase a woman's likelihood of developing yeast vaginitis.

What are the symptoms of vaginitis?

Vaginitis causes irritation of the vagina that can result in burning, itching, or pain. Vaginal discharge is another common symptom of vaginitis. Other common symptoms include pain during sexual intercourse or urination and a vaginal odor.

It is also possible to have vaginitis or an STD without experiencing any symptoms.

How is vaginitis diagnosed?

The symptoms and signs of vaginitis strongly suggest the diagnosis. At the time of diagnosis, a pelvic examination is typically performed that may include removal of a sample of vaginal discharge. The sample may be viewed under the microscope to look for Trichomonas organisms, or it may be sent to a laboratory for culture or other specialized tests to identify infectious organisms.

What is the treatment for vaginitis?

The treatment for vaginitis depends upon its cause. Infectious vaginitis is treated with antibiotic medications. Bacterial vaginitis is treated either with oral antibiotics, intra-vaginal antibiotic creams, or injections (shots) of antibiotics. Treatment guidelines are always updated to reflect the patterns of resistance to antibiotics of circulating bacterial strains.

Medications to treat vaginitis

Antibiotics that may be used in the management of bacterial vaginosis include ceftriaxone (Rocephin), erythromycin, metronidazole (Flagyl), clindamycin (Cleocin), cefixime (Suprax), doxycycline (Doryx), and azithromycin (Zithramax).

Antifungal medications are used to treat yeast infections, and antifungal preparations are also available over-the-counter for yeast vaginitis. Examples of antifungal medications include fluconazoleterconazole (Terazol), clotrimazole (Gyne-Lotrimin), miconazole (Monistat), butoconazole (Gynazole), and Nystatin.

Metronidazole (Flagyl) is the drug of choice for treating Trichomonas infections.

Vaginitis due to infections cannot be cured by home remedies. However, many women find that home care strategies can help control unpleasant symptoms. These include allowing air to circulate around the vagina when possible by wearing loose, cotton undergarments and clothing. Removing undergarments at night may also be helpful.

Vaginitis due to thinning and irritation of the vaginal wall as a result of lowered estrogen levels at menopause can be treated with hormonal therapy, either in topic (applied directly to the vagina) or oral form. Non-hormonal vaginal lubricant products are also available.

Can vaginitis be prevented?

Vaginitis due to STDs can be prevented by practicing safe sex or abstinence. It is not possible to prevent all cases of yeast infection or bacterial vaginosis. Attention to hygiene practices and avoiding spread of fecal material to the vagina may help prevent vaginitis in young girls.

What is the prognosis for vaginitis?

Most cases of vaginitis do not cause long-term problems when properly treated. If untreated, vaginal infections may spread to other pelvic organs, a condition known as pelvic inflammatory disease (PID). PID can be serious and result in impaired fertility. Sometimes, vaginitis recurs even after successful treatment, and another course of treatment is necessary.

STDs that occur in pregnant women should also be promptly treated to avoid complications for the mother or baby.

Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology

REFERENCES:

CDC.gov. Bacterial Vaginosis Fact Sheet.

CDC.gov. Sexually Transmitted Diseases (STDs).

MedscapeReference.com. Vaginitis Treatment & Management

Last Editorial Review: 10/10/2016

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Reviewed on 10/10/2016
References
Medically reviewed by Wayne Blocker, MD; Board Certified Obstetrics and Gynecology

REFERENCES:

CDC.gov. Bacterial Vaginosis Fact Sheet.

CDC.gov. Sexually Transmitted Diseases (STDs).

MedscapeReference.com. Vaginitis Treatment & Management

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