Vaginitis

Vaginitis is an inflammation or infection of the vagina that can cause itching, burning, pain, discharge, or bad odor. The vagina is the tubelike passage that connects the opening of the womb to the outside of a woman's body. It is sometimes called the "birth canal." There are a several types of vaginitis, each with its own causes, symptoms, and treatments.

Vaginitis is different from vulvodynia, which describes chronic pain or discomfort of the vulva, the area outside the vagina. Whereas vulvodynia affects only the vulva, vaginitis affects the vagina and can also cause itching, burning, and pain on the vulva.

What causes vaginitis?

Vaginitis is often caused by infections. Some vaginal infections are passed through sexual contact. Some infections occur if there is a change in the balance of organisms normally found in the vagina.

For a majority of affected women, vaginitis is caused by one of these types of infection:

  • Bacterial vaginosis (BV) is the most common vaginal infection in women of childbearing age. It occurs when there are too many harmful (bad) bacteria and too few protective (good) bacteria in the vagina.
  • Candida or "yeast" infection occurs when too much Candida grows in the vagina. Candida is yeast, which is a type of fungus frequently present in the vagina.
  • Trichomoniasis. Trichomoniasis is a sexually transmitted disease caused by a single-cell parasite.

Vaginitis has other causes, too. For instance, some women are sensitive or allergic to vaginal sprays, douches, spermicides, soaps, detergents, and fabric softeners. These products can cause burning, itching, and discharge, even if there is no infection. Women also can have vaginal irritation caused by the natural lessening in estrogen levels during breast-feeding and after menopause.

A woman may have more than one cause of vaginitis at the same time.

What are the symptoms of vaginitis?

Symptoms depend on the type of vaginitis a woman has:

Bacterial vaginosis often causes a thin, milky discharge from the vagina that may have a "fishy" odor. It may also cause itching. Most women have no symptoms and only find out they have it during a routine gynecologic exam.

Yeast infections produce a thick, white discharge from the vagina that can look like cottage cheese. The discharge can be watery and often has no smell. Yeast infections usually cause the vagina and vulva to become itchy and red.

Trichomoniasis can cause itching, burning, and soreness of the vagina and vulva, as well as burning during urination. Some women have a "frothy" gray-green discharge, which may smell bad. Many women have no symptoms.

How do healthcare providers diagnose vaginitis?

To find out the cause of a woman's symptoms, her healthcare provider will

  • Examine the vagina, the vulva, and the cervix (opening to the womb).
  • Look for vaginal discharge, noting its color, qualities, and any odor.
  • Study a sample of vaginal fluid under a microscope.

Other lab tests are also sometimes used to diagnose vaginitis.

How is vaginitis treated?

The treatment needed depends on the type of vaginitis a woman has. Some women try to treat symptoms on their own rather than see a doctor, but an exam and lab tests are needed to learn the specific type of vaginitis.

Bacterial Vaginosis

Bacterial vaginosis (BV) is treated with an antibiotic that gets rid of the harmful bacteria and leaves the good bacteria. Women need a prescription for this medicine. There is no over-the-counter treatment for BV. Treatment is recommended for women with symptoms. During treatment, women should either not have sex or use a condom during sex.

Yeast Infections

Yeast infections are usually treated with a topical cream or with medicine that is placed inside the vagina. A healthcare provider can write a prescription for most yeast infection treatments. Although yeast infection treatments can be purchased over the counter, women should see a healthcare provider to confirm the cause of vaginal symptoms. Medicines used to treat yeast infection will not cure other types of vaginitis.

Trichomoniasis

Trichomoniasis and other sexually transmitted infections (STIs) need to be treated right away. Trichomoniasis is usually treated with a single-dose antibiotic medicine. Both a woman and her partner(s) need to be treated to prevent spreading the infection to others and to keep from getting it again. Some other STIs that cause vaginal discomfort cannot be cured, but their symptoms can be controlled with treatment.

Vaginitis Caused by Allergy or Sensitivity

Vaginitis caused by allergy or sensitivity can be treated by not using the product that causes symptoms. A woman's healthcare provider may also give her a medicated cream to relieve symptoms until the reaction goes away.

Can vaginitis lead to other health problems?

Without treatment, symptoms of vaginitis can worsen. Some types of vaginitis can increase a woman's risk of other health problems.

Bacterial vaginosis (BV) increases a woman's risk of getting other sexually transmitted diseases, including HIV, if she is exposed to the pathogens that cause them. BV also is associated with pelvic inflammatory disease, a serious disease that can harm a woman's reproductive organs and cause infertility. Having BV increases a woman's risk of preterm labor and preterm birth. Women who have it also are more likely to get an infection after having surgery such as an abortion or hysterectomy.

Trichomoniasis increases a woman's risk of getting or spreading other sexually transmitted diseases such as HIV. Trichomoniasis also may cause preterm labor or preterm birth.

Does vaginitis affect a pregnant woman & her infant?

Some types of vaginitis can cause problems during pregnancy.

Pregnant women with bacterial vaginosis (BV) are more likely to go into labor and give birth too early (preterm). Preterm infants may face a number of health challenges, including low birth weight and breathing problems. However, treating BV in women who are pregnant has not been consistently found to reduce rates of preterm birth. For this reason, most pregnant women without symptoms are not screened for BV. Evidence does not support routine screening for BV in asymptomatic pregnant women at high risk for preterm delivery. NICHD scientists are trying to clarify the link between BV and pregnancy problems to help prevent them.

Sexually transmitted types of vaginitis can be very harmful to a pregnant woman and her unborn child. Trichomoniasis can cause preterm labor and preterm birth. Some sexually transmitted infections can be passed from a mother to her infant before, during, or after birth. A pregnant woman should tell her doctor about symptoms of vaginitis. She also should get routine prenatal care, including screening tests for sexually transmitted infections.

Can vaginitis be prevented?

These steps can help prevent vaginitis:

  • Women who often get yeast infections may want to avoid clothes that hold in heat and moisture, such as pantyhose without a cotton lining, nylon panties, or tight jeans.
  • Do not douche or use vaginal sprays because they can kill "good" bacteria or cause irritation.
  • Practicing safe sex can help protect against sexually transmitted forms of vaginitis. Limiting the number of sex partners and using condoms are examples of safe sex.

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Last updated: 6/3/2022