Vaginitis

Vaginitis is an inflammation of a woman’s vagina. As many as one third of women will have symptoms of vaginitis sometime during their lives. Vaginitis affects women of all ages but is most common during the reproductive years. There are many possible causes, and the type of treatment depends on the cause. This pamphlet will explain:

• Symptoms of vaginitis
• Types of treatment
• How to reduce your risk

The Vagina

It is normal for a small amount of clear or cloudy white fluid to pass from a woman’s vagina. This keeps the tissue moist and healthy. The vagina holds organisms, such as bacteria and yeast, in balance so it can function normally. Some factors can upset this normal balance of the vagina:

• Antibiotics
• Changes in hormone levels
• Pregnancy
• Breastfeeding
• Menopause
• Douches
• Spermicides
• Sexual intercourse
• Infection

A change in the normal balance can allow either yeast or bacteria to increase and result in vaginitis. This causes the lining of the vagina to become inflamed. Vaginitis may cause itching, a bad odor, or a large amount of discharge.

Diagnosis

To diagnose vaginitis, your doctor will take a sample of the discharge from your vagina and look at it under a microscope. Your doctor also may suggest other tests. To ensure the results of the test are accurate, do not douche or use any vaginal medications or spermicide before you see your doctor.

Treatment

Treatment will depend on the cause of the vaginitis. Treatment may be either with a pill or a cream or gel that is applied to the vagina.

It is important to follow your doctor’s instructions exactly, even if the discharge or other 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 recur after the treatment is finished, see your doctor. A different treatment may be needed.

Types of Vaginitis

Yeast Infection

Yeast infection also is known as candidiasis. It is one of the most common types of vaginal infection.

Cause. Yeast infection is caused by a fungus called Candida. It is found in small numbers in the normal vagina. However, when the balance of bacteria and yeast in the vagina is altered, the yeast may overgrow and cause symptoms.

Some types of antibiotics increase your risk of a yeast infection. The antibiotics kill normal vaginal bacteria, which keep yeast in check. The yeast can then overgrow. A woman is more likely to get yeast infections if she is pregnant or has diabetes. Overgrowth of yeast also can occur if the body’s immune system, which protects the body from disease, is not working well. For example, in women infected with human immunodeficiency virus (HIV), yeast infections may be severe. They may not go away, even with treatment, or may recur often. In many cases, the cause of a yeast infection is not known.

Symptoms. The most common symptoms of a yeast infection are itching and burning of the area outside the vagina called the vulva. The burning may be worse with urination or sex. The vulva may be red and swollen. The vaginal discharge usually is white, lumpy, and has no odor. Some women with yeast infections notice an increase or change in discharge. Others do not notice a discharge at all.

Treatment. 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. You can buy over-the-counter yeast medication, but be sure to see your doctor if:

• This is the first time you have had a vaginal infection
• Your symptoms do not go away after treatment
• Your vaginal discharge is yellow or green or has a bad odor
• There is a chance that you have a sexually transmitted disease (STD)

Sometimes a woman thinks she has a yeast infection when she actually has another problem. There are several conditions that cause itching and burning, just like yeast. If there is another cause, it may be harder to find if a woman is taking medication for a yeast infection.

Bacterial Vaginosis

Cause. The bacteria that cause bacterial vaginosis occur naturally in the vagina. Bacterial vaginosis is caused by overgrowth of these bacteria.

Symptoms. 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 usually is thin and dark or dull gray, but may have a greenish color. Itching is not common, but may be present if there is a lot of discharge.

Treatment. Several different antibiotics can be used to treat bacterial vaginosis, but there are two that are most commonly used: metronidazole and clindamycin. They can be taken by mouth or inserted into the vagina as a cream or gel.

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

Usually there is no need to treat a woman’s sex partner. But, if the woman has repeated infections, treatment of the partner may be helpful.

Bacterial vaginosis often recurs. It may require long-term or repeated treatment. In most cases, treatment works in time. Sometimes when bacterial vaginosis keeps coming back it may mean that you have an STD. Your doctor may test you for other infections.

Trichomoniasis

Cause. Trichomoniasis is a condition caused by the microscopic parasite Trichomonas vaginalis. It is spread through sex. Women who have trichomoniasis are at an increased risk of infection with other STDs.

Symptoms. 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.

Treatment. Trichomoniasis usually is treated with a single dose of metronidazole by mouth. Do not drink alcohol for 24 hours after taking this drug because it causes nausea and vomiting. Sexual partners must be treated to prevent the infection from recurring.

Atrophic Vaginitis

This condition is not caused by an infection but can cause a discharge and vaginal irritation. It may occur any time when female hormone levels are low such as during breastfeeding and after menopause. Symptoms include dryness and burning. Atrophic vaginitis is treated with estrogen, which can be applied as a vaginal cream, ring, or tablet. A water-soluble lubricant also may be helpful during intercourse.

Finally…

At the first sign of any abnormal discharge or symptoms of vaginitis, such as burning or itching, contact your doctor. Although vaginitis can cause discomfort, it almost always can be treated once the cause has been found.

Glossary

Bacterial Vaginosis: A type of vaginal infection caused by the overgrowth of a number of organisms that are normally found in the vagina.

Candidiasis: Also called yeast infection or moniliasis, a type of vaginitis caused by the overgrowth of Candida (a fungus normally found in the vagina).

Clindamycin: An antibiotic used to treat, among other kinds of infections, certain types of vaginitis.

Estrogen: A female hormone produced by the ovaries that stimulates the growth of the lining of the uterus.

Human Immunodeficiency Virus (HIV): A virus that attacks certain cells of the body’s immune system and causes acquired immunodeficiency syndrome (AIDS).

Metronidazole: An antibiotic used to treat some vaginal and abdominal infections.

Sexually Transmitted Disease (STD): A disease that is spread by sexual contact, including chlamydial infection, gonorrhea, genital warts, herpes, syphilis, and infection with human immunodeficiency virus (HIV), the cause of acquired immunodeficiency syndrome (AIDS).

Spermicides: Chemicals that inactivate sperm. They come in creams, gels, foams, and suppositories. Some condoms are coated with spermicides.

Vulva: The lips of external female genital area.