Vaginitis

Bacterial vaginitis can be caused by STDs.

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 irritation of the vagina that can result in;

• burning,
• itching,
• pain,
• vaginal discharge,
• pain during sexual intercourse or urination, and
• vaginal odor.

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

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:
  • Douches, soaps, or fragrances
  • Spermicides
  • Reduced estrogen levels around the time of menopause

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.

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.

The symptoms and signs of vaginitis strongly suggest the diagnosis. At the time of diagnosis, a pelvic examination is typically performed that may include the 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.

The treatment for vaginitis depends upon its cause. Infectious vaginitis is treated with antibiotic medications. Bacterial vaginitis is treated with either 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.

What medications treat vaginitis?

Antibiotics that may be used in the management of bacterial vaginosis include ceftriaxone, erythromycin, metronidazole, and clindamycin, cefixime, doxycycline, and azithromycin.

Antifungal medications are used to treat yeast infections, and antifungal preparations are available over-the-counter for yeast vaginitis. Examples of antifungal medications include fluconazole, terconazole, clotrimazole, miconazole, butoconazole, and Nystatin.

Metronidazole 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 in 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 topical (applied directly to the vagina) or oral form. Non-hormonal vaginal lubricant products are also available.

Can vaginitis be cured? What if it is not treated? 

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 a 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.

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 the spread of fecal material to the vagina may help prevent vaginitis in young girls.